Comparing different methods for homocysteine determination.

Slightly elevated values of homocysteine are commonly associated with thromboembolic diseases, while high values can be found in patients with congenital metabolic defects or nutritional problems. The clinical use of homocysteine as an independent marker of cardiovascular disease was limited in the past by technical problems with its measurement, the instrumentation (HPLC, radioenzymatic assays, gas chromatography-mass spectrometry, etc.) and the necessary skills required. Commercially available immunoassays now permit a simpler and more rapid measurement of homocysteine, that is more suitable for routine clinical laboratories; in this paper we analyze the results obtained by using three fully automated methods for homocysteine determination (Abbott IMx immunoassay, Abbott AxSYM immunoassay and Immulite 2000 homocysteine immunoassay) and their correlation with the widely used HPLC method. The results clearly indicate that all three automated immunochemical methods correlate well with the HPLC method (slope 0.97-1.03; intercept 0.95-1.91 with a recovery above 95% for all three methods).     

Neuronal activity in the globus pallidus of multiple system atrophy patients.

The pathophysiological changes in neural activity that characterize multiple system atrophy (MSA) are largely unknown. We recorded the activity of pallidal neurons in 3 patients with clinical and radiological features of MSA who underwent unilateral microelectrode-guided pallidotomy for disabling parkinsonism. Findings in these patients were compared with 4 control patients with a clinical diagnosis of Parkinson's disease (PD). The position, firing rates, and firing patterns of single neurons in the pallidal complex were analyzed in both MSA and PD patients. The mean spontaneous firing rate of neurons in the internal segment of the globus pallidus internus (GPii) was significantly lower in MSA than in PD patients. There were no significant differences between MSA and PD patients, however, in firing rates of neurons in the external globus pallidus (GPe) or in the external segment of GPi (GPie). In addition, no significant differences in firing pattern were found between MSA and PD patients. In conclusion, this study has shown that firing rates of neurons in GPii but not in GPie and GPe are different in MSA patients compared with that in PD patients, a finding that may reflect the poor clinical results of pallidotomy reported in patients with MSA.     

Sirolimus and mycophenolate mofetil as calcineurin inhibitor-free immunosuppression in a cardiac transplant patient with chronic renal failure.

Chronic renal failure triggered by calcineurin inhibitor (CNI)-based immunosuppression is a common complication after cardiac transplantation. Sirolimus and mycophenolate mofetil (MMF) are 2 newer immunosuppressive agents with no documented nephrotoxic side effects. This case report describes a patient with ongoing chronic renal failure 10 months after cardiac transplantation on cyclosporine-based immunosuppressive therapy. Conversion of the immunosuppressive regimen from cyclosporine to sirolimus and MMF resulted in freedom from acute rejection, excellent cardiac graft function and consistently improved renal function. This case illustrates the beneficial potential of sirolimus and MMF as CNI-free and safe long-term immunosuppression in a patient with chronic renal failure after heart transplantation.     

Life events exposure before a treated major depressive episode depends on the number of past episodes.

A cross-sectional survey investigated the relationship between the number of previous depressive episodes and life events, testing the kindling hypothesis, in a sample of 13,377 treated patients with unipolar depression. A linear decline of average life events exposure is observed for more frequent past episodes, even when age, gender and severity are taken into account.     

Effect of short-term training cessation on performance measures in distance runners.

This study examined if measures associated with distance running performance were affected by short-term (14 d) training cessation in 12 distance runners. VO2max decreased by approximately 3 ml.kg-1.min-1 (mean +/- SE, 61.6 +/- 2.0 vs 58.7 +/- 1.8 ml.kg-1.min-1, p < 0.05) with training cessation. Time to exhaustion (TTE) during the incremental VO2max test decreased by 1.2 min (13.0 +/- 0.5 vs 11.8 +/- 0.5 min, p < 0.001) and maximal heart rate increased (p < 0.001) by 9 beats per minute (BPM). No changes in running economy (75 and 90% VO2max) were evident, although submaximal heart rate increased by 11 BPM (p < 0.001) at both running speeds. Other evidence for detraining were decreases in estimated resting plasma volume (-5.1 +/- 1.9%) and muscle citrate synthase activity (-25.3 +/- 2.6%, p < 0.05). Muscular atrophy (muscle fiber cross-sectional area) was not evident. TTE and submaximal heart rate exhibited relatively large percent changes (-9 and +6%, respectively) compared to VO2max (-4%). These findings indicate that the reduction in VO2max with short-term training cessation is relatively small. TTE and submaximal heart rate may be easily measured, yet more sensitive indicators of decrements in distance running performance.     

Rare anatomic coronary variant. Description of a case]

A case of a patient with post-infarction angina and peculiar abnormalities of the coronary arteries is reported. We describe the anatomic findings as well as the possible therapeutical options.