Preeclampsia: the role of tissue factor and tissue factor pathway inhibitor

Preeclampsia (PE) is a multi-system disorder of human pregnancy, whose etiology remains poorly understood. Preeclamptic women are known to have an increased hypercoagulable state that result in excess fibrin deposition in several organs, which compromises their function. Tissue factor (TF) is the main physiological initiator of blood coagulation and its activity is regulated by a specific inhibitor known as Tissue factor pathway inhibitor (TFPI). Based on the important role of TF and TFPI in hemostasis, we hypothesize that their levels may change in the severe PE contributing to exacerbate hypercoagulable state. Some studies have assessed the balance between TF and TFPI in preeclamptic women, but results are inconsistent. Therefore, the aim of this study was to examine these inconsistencies and to assess TF and TFPI plasma levels in three groups of age matched women; pregnant with severe PE (n = 60), normotensive pregnant (n = 50) and normotensive non-pregnant women (n = 50). There was not significantly different among the three groups for TF plasma levels; severe PE women: 338.4 pg/mL (248.1-457.6), normotensive pregnant women: 301.5 pg/mL (216.4-442.9) and normotensive non-pregnant women 393 pg/mL (310.3-522.9). TFPI plasma levels were higher in severe PE comparing to normotensive pregnant women and normotensive non-pregnant women, 115.8 ng/mL (75-149.8); 80.3 ng/mL (59.6-99.7) and 74.5 ng/mL (47.1-98.0), respectively No difference was found between normotensive pregnant women and normotensive non-pregnant women. As for gestational age, a significant difference in TFPI levels was found between severe PE and normotensive pregnant women up to the 33rd week of pregnancy (p = 0.001), and severe PE and non-pregnant women up to the 34th (p = 0.01). In summary, our results indicated that TF plasma levels did not vary in the studied groups, while TFPI plasma levels were significantly increased in severe PE compared to normotensive pregnant and normotensive non-pregnant women. So, our data do not explain the exacerbated hypercoagulability state observed in severe PE. Further studies evaluating genes expression, TF activity and antigen, total and free TFPI and TFPI-2, both in plasma and obstetric tissues, throughout the pregnancy in PE (mild and severe forms) are required.     

Computer accessibility for individuals suffering from mild to moderate Alzheimer's disease

New technology will allow the ageing population (including people with cognitive impairment) to keep in contact with their families, friends and professionals and to be stimulated by a range of different services and facilities. Since no data existed so far on the ability and feasibility of persons suffering from Alzheimer's disease (AD) in using a basic computer, this pilot study was carried out in order to compare the performances of these persons with older persons with no cognitive impairment (NI) when working with basic keyboard, mouse pad and a computer screen. We also asked participants of both groups their preferences and suggestions in order to draw a guideline that can be used to adapt a basic computer to their use. Although this pilot study only included a small amount of participants (18), the results showed that basic computers can be accessible to individuals suffering from mild to moderate Alzheimer's disease under certain conditions.     

Management of early endometrial carcinoma

Management of early endometrial carcinoma is controversial in regard to timing and indication of adjunctive radiation therapy. Two hundred eighty patients with stage I carcinoma of the endometrium are analyzed: 135 patients were treated with surgery only and 61 patients underwent preoperative and 83 patients postoperative radiation therapy. The overall survival was 94%. Recurrence rates in all three treatment arms were equal. Tumor grade was found to change from the diagnostic D&C specimen to the definite surgical specimen in 31% of all cases and in 50% of all grade 3 lesions. As only 39% of all patients required postoperative radiation therapy with equal survival, a primary surgical approach spares the majority of patient unnecessary treatment and preserves prognostically important histology.     

Toward a comparison of survival in American and European cancer patients

BACKGROUND: Only recently have extensive population-based cancer survival data become available in Europe, providing an opportunity to compare survival in Europe and the United States. METHODS: The authors considered 12 cancers: lung, breast, stomach, colon, rectum, melanoma, cervix uteri, corpus uteri, ovary, prostate, Hodgkin disease, and non-Hodgkin lymphoma. The authors analyzed 738,076 European and 282,398 U.S. patients, whose disease was diagnosed in 1985-1989, obtained from 41 EUROCARE cancer registries in 17 countries and 9 U.S. SEER registries. Relative survival was estimated to correct for competing causes of mortality. RESULTS: Europeans had significantly lower survival rates than U.S. patients for most cancers. Differences in 5-year relative survival rates were higher for prostate (56% vs. 81%), skin melanoma (76% vs. 86%), colon (47% vs. 60%), rectum (43% vs. 57%), breast (73% vs. 82%), and corpus uteri (73% vs. 83%). Survival declined with increasing age at diagnosis for most cancers in both the U.S. and Europe but was more marked in Europe. CONCLUSIONS: Survival for most major cancers was worse in Europe than the U.S. especially for older patients. Differences in data collection, analysis, and quality apparently had only marginal influences on survival rate differences. Further research is required to clarify the reasons for the survival rate differences.     

Fine structure of the developing trout erythrocytes and thrombocytes with special reference to the marginal band and the cytoplasmic organelles

The cytological changes accompanying the development of red blood cells of trout were studied. These changes appear to parallel closely those seen in the maturation of red blood cells of mammals. Immature erythrocytes of the trout contain mitochondria, Golgi complex, rough and smooth endoplasmic reticulum, centrioles, bundles of microtubules and numerous ribosomes in their cytoplasm. With progressive differentiation and maturation such cells appear to shrink in size, acquire a biconvex ellipsoid form, lose most of their cytoplasmic organelles and concomitantly increase their hemoglobin content. Mitochondrial degradation begins early in the process of maturation and usually consists of the following sequence of morphological changes within them: the appearance of small dense bodies, degeneration of the cristae and the formation of lamellar bodies. Degenerating mitochondria are often observed bulging from the surface of the cell, suggesting that they are in the process of being extruded from it. However, this observation does not preclude the possibility that mitochondria may also be disposed of in situ through the action of lysosomal enzymes. It is suggested that the disappearance of mitochondria and other cytoplasmic organelles contributes to the volumetric shrinkage which accompanies the maturation of trout red blood cells. The existence of an equatorially oriented “marginal band” of microtubules has been confirmed in this material in agreement with studies on other species. A band of microtubules was also observed in trout thrombocytes. It is concluded that the marginal band plays an important role in the maintenance of the flat ellipsoidal shape of these cells as has been suggested by other investigators studying other vertebrate forms.