Sex differences in clinical characteristics and their influence on clinical outcomes in an observational cohort of patients with rheumatoid arthritis

ObjectiveRheumatoid arthritis (RA) is more prevalent in women, but sex differences remain incompletely understood. This study aimed to elucidate sex differences in clinical characteristics and their potential impact on clinical outcomes in a large Korean cohort of patients with RA.MethodsIn total, 5376 RA patients from the KORean Observational study Network for Arthritis (KORONA) database were examined at baseline and for 3 consecutive years using the disease activity score 28 (DAS28), health assessment questionnaire (HAQ), and patient-reported outcomes (PROs). Within a subgroup with active disease (DAS28 ≥ 3.2) at baseline, sex impacts on clinical outcome during follow-up were analyzed using generalized estimating equation (GEE) models. The factors related to achieving clinical remission were analyzed using Cox-proportional hazard regression.ResultsAt baseline, women (n = 4574) were younger and had more erosive disease and longer disease duration than men (n = 802) with higher scores in DAS28, HAQ, and PROs. The prevalence of interstitial lung disease, cardiovascular disease, and diabetes in men was higher than that of women. In a RA subgroup with active disease at baseline, GEE analyses demonstrated that women RA significantly influenced the rate of change of DAS28 over time. In that group, men are associated with achieving DAS28 sustained remission and point remission.ConclusionsWomen with RA in Korea report higher levels of disease activity and PROs compared to men, whereas most comorbidities were more prevalent in men. The longitudinal change in disease activity and the rate of achieving clinical remission were found to be worse in women with RA.     

Vascularisation des glandes surrénales

Résumé La glande surrénale de l'homme réunit deux structures initialement sans rapport physiologique. Cette dualité phyllogénique et embryologique se retrouve dans sa structure vasculaire de façon paradoxale. Les artères métamériques de l'organe phéochrome irriguent en priorité le cortex. L'axe veineux de l'ébauche mésenchymateuse draine le réseau des capillaires sinusoïdaux vers la médulla. Le réseau lymphatique est quasi inexistant au niveau de la médulla. Bien développé dans le cortex, il se draine presque exclusivement de façon centrifuge le long des axes artériels. A côté de son intérêt anatomo-chirurgical évident, l'étude de la vascularisation des glandes surrénales se doit de répondre aux besoins des investigations morphologiques vasculaires. La connaissance des variations artérielles et de leur fréquence, des territoires glandulaires de distribution, des voies anastomotiques de suppléance et des regroupements typologiques a retenu notre attention. Elle facilitera la lecture des artériographies globales toujours difficile dans le plan rétro-péritonéal. Elle guidera l'angiographie artérielle sélective. La phlébographie cave occlusive permet d'obtenir des opacifications remarquables des veines centrales, en particulier à gauche. Cette méthode est utile dans l'étude des tumeurs rétro-péritonéales et dans l'exploration des masses ganglionnaires lombo-aortiques susceptibles d'imprimer leur empreinte sur les structures veineuses. Elle a d'autant plus d'intérêt que la lymphographie pédieuse qui opacifie bien les chaînes latéro-aortiques gauche et latérocave à droite, ne permet pas, sauf reflux à contrecourant, une étude de l'important carrefour inter-aortico-cave sous-rénal. Des cathétérismes et des prélèvements électifs au niveau des différentes voies excrétrices de cette glande endocrine (veines et lymphatiques) peuvent aider à une meilleure connaissance de la physiologie et de la pathologie de l'organe. Les voies de dérivations veineuses des glandes surrénales ont été étudiées dans cet esprit.     

Ginsenoside Rs3, a genuine dammarane-glycoside from Korean red ginseng

A genuine dammarane-glycoside, named as ginsenoside Rs₃, was isolated from the MeOH extracts of Korean red ginseng (Panax ginseng C.A. Meyer) through repeated silica gel column chromatographies and its chemical structure was determined as (20S)-protopanaxadiol 3-O-[6″-O-acetyl-β-D-glucopyranosyl (1→2)-β-D-glucopyranoside on the basis of several spectral and physical evidences including HMBC and FAB-MS.     

Mercury content in edible mushrooms in the Wyzyna Wieluńska region

Mercury concentration was determined in the caps and stalks of nine species of edible mushrooms collected at the area of Wieluńska Upland in district of Czestochowa in 1995-96. The mushroom species examined were such as: yellow-cracking bolete Xerocomus subtomentosus, brown birch scaber stalk Leccinum scabrum, slippery Jack Suillus luteus, larch bolete Suillus grevillei, gray knight-cap Tricholoma terreum, parasol mushroom Macrolepiota procera, horse mushroom Agaricus arvensis, fennel funnel cap Clitocybe odora, fairy-ring mushroom Marasmius oreades and tacky green brittle gills Russula aereuginea. The method of mercury measurement was cold-vapour atomic absorption spectroscopy (CV-AAS) after wet digestion of the samples with concentrated nitric acid in a whole glass system. The parasol mushroom and horse mushroom showed a highest mercury concentrations and contained, respectively, 4500 +/- 1700 and 4400 +/- 2400 ng/g dry wt in caps, and 2800 +/- 1300 and 2800 +/- 2100 ng/g dry wt in stalks. In the case of fennel funnel cap and fairy-ring mushroom the mean total mercury concentrations in caps was above 500 ng/g dry wt, and for other species were between 150 +/- 50 and 500 +/- 230 ng/g dry wt. The stalks of the mushroom species examined in all cases showed lower contamination with mercury than caps. The mean total mercury concentrations noted in caps and stalks of mushrooms examined were usually higher than was reported till now in the same species elsewhere in Poland, while a maximum values found in an individual fruiting bodies are within the range of the concentrations noted in specimens collected from an unpolluted areas.     

The combined effect of psychotherapy and fluoxetine on obesity]

Obesity as psychosomatic disease is a mass phenomenon. The number of obese males (BMI > 30) became doubled in the last ten years. In the etiology of obesity play an important role the reactive obesity. In the background of "yo-yo syndrome" often could be found depression, or other psychotic disorder. The low self-esteem, body dissatisfaction, tension, anxiety disorders is well-known in a slimming diet. Obese subjects (n = 29) who were admitted on their request with a view to losing weight were examined (Hamilton Depressive Scala, Hamilton Anxietas Scala, Eating Attitude Test) Physical Conditioning and internal Medicine Department of National Sports Medicine Institute, Budapest. Among obesities with mild and severe depression as treatment of somatic complications was used fluoxetine, in severe cases and depression with severe anxiety was associated with supportive or cognitive-behavioral treatment. The prevalence of binge eating disorders were at 57% and bulimia nervosa was at 3% in using population (n = 29). Decreasing of anxiety and grade of depression significantly correlated with body mass index (p < 0.023, F = 1.997, p < 0.034, F = 3.131). The treatment of fluoxetine significantly correlated with body mass index (T1: p < 0.023, T2: p < 0.03, T3: p < 0.004). The patients indicated their well being as fluoxetine reduced eating, satiety and lower binges.     

Effects of terbutaline on force and intracellular calcium in slow-twitch skeletal muscle fibres of the rat.

1. The effect of the alpha2-adrenoceptor agonist, terbutaline, was investigated on simultaneously measured force and intracellular free calcium ([Ca2+]i) in intact rat soleus muscle fibres, and on contractile protein function and Ca2+ content of the sarcoplasmic reticulum (SR) in skinned fibres. 2. Terbutaline (10 microM) had no significant effect on either resting force or [Ca2+]i. Exposure to terbutaline increased both the integral of the indo-1 ratio transient and peak twitch force by 37%. 3. At sub-maximal (10 Hz) stimulation frequencies, terbutaline accelerated force relaxation but had highly variable effects on tetanic force amplitude. The corresponding indo-1 ratio transients were significantly larger, and faster to decay than the controls. 4. Terbutaline increased tetanic force at near maximal stimulation frequencies (50 Hz) by increasing tetanic [Ca2+]i. Force relaxation was accelerated at this frequency with no significant change in the indo-1 ratio transient decay rate. 5. All of terbutaline's effects on force and indo-1 ratio transients in intact fibres were completely blocked and reversed by ICI 118551 (1 microM). 6. Mechanically skinned fibres isolated from intact muscles pre-treated with terbutaline showed no significant changes in SR Ca2+ content, myofilament [Ca2+]i-sensitivity or maximum force generating capacity. 7. The results suggest that terbutaline primarily modulates force by altering the amplitude and decay rate of the [Ca2+]i transient via phosphorylation of both the ryanodine receptor (RR) and the SR pump regulatory protein, phospholamban (PLB). The high variability of responses of slow-twitch muscles to beta2-agonists probably reflects individual differences in basal phosphorylation levels of PLB relative to that of RR.     

Verapamil in the prophylaxis of bronchial asthma

Summary A single oral dose of verapamil 80 mg was shown significantly to inhibit histamine-induced bronchoconstriction in 8 out of 16 asthmatic subjects (maximum increase in PD_20FEVHi 416%). There was still significant protection ( PD_20FEV1Hi>100%) in the responders 5 h after the oral dose. The relationship of the bronchoprotective effect to the plasma level of verapamil was also examined. Responders and non-responders did not differ significantly in the peak plasma level or the time course of the plasma verapamil concentration.The protective effect was not correlated with the peak plasma level of verapamil or with the baseline bronchial hyperreactivity.     

Antibiotic sensitivity of enteric pathogens in Vietnam

The in vitro antimicrobial susceptibilities of 675 common enteropathogenic isolates from faecal specimens of patients with diarrhea (E. coli, Shigella, Salmonella and V. cholerae), and 568 E. coli isolates from faecal flora of healthy persons, which were collected as part of a National antibiotic resistance surveillance in Vietnam, were determined. The agar dilution method was used for the following nine antibiotics: ampicillin, doxycycline, chloramphenicol, gentamicin, nalidixic acid, kanamycin, trimethoprim, trimethoprim in combination with sulfamethoxazole (1/20), and sulfisomidin. Gentamicin was the most active of the antibiotics tested against all bacterial species with MICs in the range 0.125-4 mg/l. All strains were susceptible to nalidixic acid (0.125-8 mg/l) and more than 90% were susceptible to kanamycin. Among E. coli and Shigella isolates from patients the frequencies of resistance to commonly used antibiotics were high: ampicillin 73% and 84%, doxycycline 83% and 94%, chloramphenicol 71% and 91%, sulfisomidin 82% and 92%, respectively. Resistance to trimethoprin, as well as to the combination with sulfamethoxazole was found in 21% and 23%, respectively. The frequencies of multiple resistance (resistance to three or more antibiotics) were also high (77% and 89%, respectively). Less than 10% of Salmonellae and V. cholerae isolates were resistant to ampicillin, sulfisomidin or trimethoprim. Among E. coli from healthy people the frequencies of resistance were lower than in isolates from patients: ampicillin 23%, doxycycline 40%, chloramphenicol 21% and sulfisomidin 34%. However, the same patterns of multiple resistance were found in both groups.     

兴山五味子的质量研究

兴山五味子;;襄五脂素;;主要药理作用