Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients

The authors performed a cross-sectional study to examine the relationship between specific cognitive domains and behavioral and psychological symptoms in dementia (BPSD) in 125 patients with probable AD. Cognitive deficits were evaluated with the mini mental state examination (MMSE), trail-making test (TMT), Rey auditory verbal learning test (RAVLT), and semantic fluency test (SFT) and phonemic fluency test (PhFT), whereas the neuropsychiatric inventory (NPI) was used to rate BPSD. Patients’ performance in cognitive tests significantly correlated with total NPI scores (p < 0.0001). After controlling for demographic and clinical characteristics, cognitive impairments in memory, executive function, and language (RAVLT, TMT, PhFT, SFT) importantly estimated total NPI scores (p < 0.001, multivariate regression models). These findings suggest that the evaluation of cognitive domains may have a predictive value for the occurrence of BPSD.     

Lack of association between IL6 single nucleotide polymorphisms and cardiovascular disease in Spanish patients with rheumatoid arthritis

Introduction

Rheumatoid arthritis (RA) is a complex polygenic inflammatory disease associated with accelerated atherosclerosis. IL-6 is a key mediator of inflammation in RA. A recent study showed an association between IL6-174 G/C gene polymorphism and cardiovascular (CV) disease in UK individuals with RA. To confirm this association we assessed the influence of three IL6 gene polymorphisms in the risk of CV disease in a large series of patients with RA.

Material and methods

We studied 1250 Spanish patients with RA. Besides genotyping the traditional single nucleotide polymorphism (SNP) promoter -174G/C (rs1800795), we assessed another two SNPs (rs2069827 and rs2069840) located in the IL6 gene that were selected by SNP-tagging.

Results

Two-hundred and twenty (17.6%) of the 1250 patients experienced CV events. No significant differences in the genotype, allele and haplotype frequencies between RA patients with and without CV events were observed.

Conclusion

Our results do not confirm in a Spanish population the association of IL6 gene with CV disease in RA previously reported in the UK.     

Hb Extremadura [β64(E8)Gly→Ser;β133(H11)Val→Leu]: a new molecular analysis

Unstable hemoglobin (Hb) variants account for 9.5% of structural hemoglobinopathies. The majority of these unstable variants are the result of gene point mutations resulting in the substitution of a single amino acid by another. The presence of two mutations in the same allele is infrequent: of the 781 variants of the β-globin cluster described, only 32 are due to two point mutations (4.1%). Hb Extremadura is a structural variant that is included within the so-called unstable Hb anomalies. It was first described in 1989, employing the most up-to-date techniques available at that time, reversed phase high performance liquid chromatography (HPLC) to separate the abnormal chain (β(X)) digesting it with trypsin and analysis of the fragments with an automatic analyzer.     

Plasma β-amyloid peptides in canine aging and cognitive dysfunction as a model of Alzheimer's disease

Aging dogs naturally demonstrate cognitive impairment and neuropathology that model early Alzheimer's disease (AD). In particular, there is evidence that canine cognitive dysfunction syndrome (CDS) in aged dogs is accompanied by cortical deposition of Aβ peptides and neurodegeneration. Plasma Aβ levels have been examined in humans as putative biomarkers for AD, but to date, no similar studies have been conducted for canine dementia. The aim of the present study was to assess plasma Aβ1-42 and Aβ1-40 levels in a blind study using pet dogs that were either successfully aging or exhibiting CDS. The severity of cognitive impairment was assessed using an owner-based questionnaire. On average, young dogs presented significantly higher plasma levels of Aβ1-42 and Aβ1-40 than aged, cognitively unimpaired dogs. Notably, among aged dogs, the levels of Aβ1-42 and the Aβ42/40 ratio were significantly higher in those showing mild cognitive impairment than in either cognitively unimpaired or severely affected dogs. These results suggest that increased plasma Aβ1-42 levels and Aβ42/40 ratio could be a biomarker for canine cognitive dysfunction, which is considered an excellent natural model of early AD.     

Avances en patología gastrointestinal relacionada con el tratamiento con antiinflamatorios no esteroideos y antiagregantes plaquetarios

The most important and recent advance reported in the field of the non-steroidal antiinflammatory drug (NSAID)-associated gastrointestinal (GI) lesions is the CONDOR study. This study shows that treatment with celecoxib 200 mg/12 hours is associated with a lower frequency of clinically significant adverse effects throughout the GI tract when compared with treatment with diclofenac 75 mg/12 hours + omeprazole 20 mg/day in at-risk patients with osteoarthritis or rheumatoid arthritis. Other studies of interest report that most arthritis patients requiring NSAIDs are at increased GI and cardiovascular risk and that more than 50% do not receive appropriate therapy based on current recommendations. Recent epidemiological studies confirm that aspirin use, alone or associated with other antiplatelet agents, is associated with increased risk of GI bleeding from either the upper or the lower GI tract, and that proton pump inhibitors (PPIs) reduce the risk of upper GI bleeding. The most recent data also question the negative interaction between PPI and clopidogrel, but the data are still generally of low quality. A notable new compound is cobiprostone, a local chloride channel activator. When combined with NSAIDs, this agent reduces the occurrence of gastric lesions. Another new agent that combines aspirin with phosphatidylcholine is associated with a lower degree of gastroduodenal mucosal damage than aspirin and has identical antiplatelet effect to aspirin alone.