Relationship between arterial dysfunction and extra-articular features in patients with rheumatoid arthritis

Systemic inflammation may be a common process that underpins both atherosclerosis and extra-articular features (ExRA) of rheumatoid arthritis (RA). We evaluated the relationship between ExRA and arterial dysfunction in 114 consecutive patients with RA (82% women) without overt arterial disease aged 40–65?years. A trained research nurse undertook ‘SphygmoCor’ pulse wave analysis (PWA) using radial applanation tonometry to measure the extent (augmentation index, AIX%) and timing (reflected wave transit time, RWT, msec) of aortic wave reflection. Assessment included fasting blood sample, patient questionnaire and medical record review. Mean differences were adjusted for age, sex, mean blood pressure, smoking pack-years, fasting cholesterol, Stanford HAQ score and erythrocyte sedimentation rate. Mean age was 54 (SD 7) and median RA duration 10 (IQR 4–17) years. There was a trend for arterial dysfunction (higher AIX%; lower RWT) to increase as the number of ExRA features rose, but no difference in AIX% (?0.5, 95%CI ?2.8 to 1.8, P?=?0.65) or RWT (0.3?ms, 95%CI ?3.6 to 4.2, P?=?0.86) between ‘any ExRA’ and ‘no ExRA’. Arterial dysfunction was not associated with the presence of rheumatoid nodules, Sjogren’s syndrome or carpal tunnel syndrome. Our study was too small to determine whether severe (‘Malmo’) ExRA (vasculitis, pericarditis, episcleritis) was truly associated with a higher AIX% (3.8, 95%CI ?2.3 to 9.9, P?=?0.22) and lower RWT (?5.5?ms 95%CI ?13.1 to 2.1, P?=?0.16). While arterial dysfunction may be associated with the number of ExRA features and severe ExRA, it does not appear to be associated with other ExRA features.     

About Your Child’s Eating (AYCE) scale psychometrics when applied to children in hospital-based feeding clinics

This study examined the About Your Child’s Eating scale (AYCE) when applied to a sample of children referred to hospital-based feeding clinics. The AYCE measures three dimensions of the family mealtime environment (Child Resistance to Eating, Positive Mealtime Environment, Parent/Caregiver Mealtime Aversion). Confirmatory factor analysis for AYCE subscales revealed close to acceptable goodness-of-fit values, strong internal reliability, and strong test-retest reliability. ANCOVAs examining AYCE subscales and child demographics found caregivers of younger and thinner children reported more Child Resistance to Eating and Caregiver Aversion to Mealtime, with other demographics not statistically significant.     

Examination of the latent factor structure and construct validity of the stigma of suicide scale-short form

A major limitation of research on attitudes toward suicide is that most measures lack evidence of a stable factor structure. To investigate the structure of recently developed stigma of suicide scale-short form (SOSS-SF), we conducted an exploratory factor analysis in a sample of 499 undergraduates. Results revealed a three-factor structure: Stigma, Isolation/Depression, and Glorification/Normalization. We also identified good convergent and discriminant validity between the SOSS-SF and related constructs. In a separate sample of 570 undergraduates, a confirmatory factor analysis (CFA) demonstrated adequate fit for the three-factor model. In addition, a multiple-group CFA demonstrated invariance across gender.     

The heavy price of conversion from laparoscopic to open procedures for emergent cholecystectomies

Background

Laparoscopic cholecystectomy (LC) is the standard operative intervention for gallbladder disease. Complications may necessitate conversion to an open cholecystectomy (OC). This study aims to determine the cost-consequences of laparoscopic-to-open conversion using a nationally-representative sample.

Leave the levofloxacin? A case report of levofloxacin-induced psychosis

Fluoroquinolones, including levofloxacin, exhibit desirable antimicrobial characteristics, including broad spectrum of activity and excellent bioavailability. This widely prescribed class of antibiotics has come under scrutiny due to a new black box warning of adverse reactions. Central nervous system effects have been sparsely described in previous literature. We present a case of levofloxacin-induced psychosis in a patient without underlying psychological history.     

The Potential of Selected Brominated Flame Retardants to Affect Neurological Development

Various brominated flame retardants (BFR), including polybrominated diphenyl ether (PBDE) congeners, hexabromocyclododecane (HBCD), and tetrabromobisphenol A (TBBPA), are commonly used in household items and electronics and have been detected in the environment and/or the bodily fluids of people, including children. Some studies in animals suggest that exposure to PBDE congeners, HBCD, or TBBPA during the perinatal period may affect locomotor activity and/or memory and learning. Epidemiological studies showing similar effects in humans, however, are lacking. To assess whether an association exists between perinatal exposure and development of consistent neurobehavioral alterations, published animal studies investigating perinatal exposure to PBDE congeners, HBCD, or TBBPA with specific neurobehavioral evaluations—particularly, assessments of motor activity—were reviewed for consistency of results. Our analysis shows that although the majority of studies suggest that perinatal exposure affects motor activity, the effects observed were not consistent. This lack of consistency includes the type of motor activity (locomotion, rearing, or total activity) affected, the direction (increase or decrease) and pattern of change associated with exposure, the existence of a dose response, the permanency of findings, and the possibility of gender differences in response. Interestingly, Good Laboratory Practices (GLP)-compliant studies that followed U.S. Environmental Protection Agency (EPA)/Organization for Economic Cooperation and Development (OECD) guidelines for developmental neurotoxicity testing found no adverse effects associated with exposure to PBDE209, HBCD, or TBBPA at doses that were orders of magnitude higher and administered over longer durations than those used in the other studies examined herein. The lack of consistency across studies precludes establishment of a causal relationship between perinatal exposure to these substances and alterations in motor activity.