Diagnostic profile of young and middle-aged memory clinic patients

With the objective of characterizing the underlying conditions in younger patients with cognitive symptoms, 314 consecutive patients were studied, aged <60 years, referred to a multidisciplinary memory clinic over a period of 54 months. Fifteen percent of the patients fulfilled Diagnostic and Statistical Manual IV criteria for dementia, 17% had selective cognitive deficits, and 55% had no cognitive deficits. Cognitive symptoms in younger patients rarely reflect dementia but more often other medical and psychiatric conditions.     

Thrombin markers in pregnant women: measurements of prothrombin fragments F 1+2 and thrombin-antithrombin III complexes (TAT) in the cord blood, the mother's blood and in amniotic fluid

OBJECTIVES: Hypercoagulability is a well known feature of pregnancy, while hypocoagulability is attributed to newborns. The level of thrombin markers in the blood reflects the relations in coagulation system. We have measured two markers of thrombin generation, e.i prothrombin fragments F 1+2 and thrombin-antithrombin III complexes (TAT), in the cord blood and the mother's blood, as well as in amniotic fluid. MATERIAL AND METHODS: The study group consisted of 33 parturient women, 24.2 +/- 3.6 years old, 20 primiparas and 13 multiparas with normal course of pregnancy. The level of F 1+2 and the level of TAT were estimated by ELISA method. RESULTS: The highest level of F 1+2 and TAT was in amniotic fluid, e.i. 29.99 (9.15 - 50.75) nmol/l vs. 519.62 +/- 270.51 microg/l. In the blood cord the level of F 1+2 was 7.15 (5.05 - 22.05) nmol/l, and the level of TAT was 151.57 +/- 134.17 microg/l. In the mother's blood plasma the levels of F 1+2 and TAT were significantly lower than in cord blood (5.15, range 3.50 - 6.05 nmol/l vs. 36.30 +/- 18.65 microg/l respectively, p < 0.001). CONCLUSION: Increased generation of thrombin in foetal blood which is reflected in increased levels of F 1+2 and TAT, is one of the features of "foetal phenomenon" concerning foetal coagulation system. High concentration of F 1+2 and TAT in amniotic fluid can be consider to be a result of increased thrombin generation or the lowered metabolism of F 1+2 and TAT.     

Bronchopulmonary dysplasia: new insights

The pathology of BPD has changed over time, with the old BPD characterized by airway injury, inflammation, and parenchymal fibrosis giving way to the new BPD manifesting less fibrosis but with decreased alveolar and vascular development. The pathogenesis of BPD involves factors affecting the severity and management of RDS, alterations in lung development and maturation, alveolar-vascular interactions, and extracellular matrix remodeling. These factors in pathogenesis are mediated and modulated by hyperoxic lung injury, antioxidants, NO, the pulmonary neuroendocrine system and peptide growth factors, the immune system, and various genetic polymorphisms and predispositions. Future therapeutic interventions are likely to target one or more of these abnormalities in lung development, maturation, and response to injury.