Psychiatric manifestations in systemic lupus erythematosus

Psychiatric abnormalities are common in systemic lupus erythematosus (SLE) with a prevalence of 17% to 75%, reflecting different methods of patient selection and assessment, the different professional orientation of clinicians, and lack of an accepted consensus for diagnosing active neuropsychiatric lupus (NPSLE). The psychiatric syndromes included in the ACR Neuropsychiatric Lupus Nomenclature Committee criteria are cognitive dysfunction, acute confusional state (delirium), anxiety disorder, mood disorder, and psychosis. In SLE patients, identification of psychiatric phenomena and the generation of a differential diagnosis are crucial. Possible mechanisms include vascular injury and pathogenic antibodies. Treatment strategies are based on small case studies. The purpose of this review is to discuss clinical manifestations, pathogenesis and the present therapeutic options in psychiatric lupus.     

Ocular manifestations in antiphospholipid syndrome

Antiphospholipid syndrome (APS) is characterized by increased hypercoagulability and divergent symptoms including ocular manifestations. In APS patients arterial and/or venous thromboses and repeated fetal loss are diagnosed in presence of antiphospholipid (aPL) antibodies. Antiphospholipid antibodies are heterogeneous group of immunoglobulins with different antigenic structure. Primary APS is defined in the absence of underlying disease, while secondary APS is seen within another pathological condition. In both primary and secondary APS ocular and neuroophthalmic manifestations, such as retinal arteritis, retinal venous occlusion, ischemic optic neuropathy, transient loss of vision - amaurosis fugax, diplopia and others can be diagnosed. In secondary APS occlusion of central retinal artery and vein (OACR, OVCR) is the most common finding, thus when found in younger patients it should be considered indicative of APS. Bilateral ocular changes are considered more significant since they affect both ocular function and life prognosis.     

Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group

Uncontrolled proliferation is a hallmark of cancer. In breast cancer, immunohistochemical assessment of the proportion of cells staining for the nuclear antigen Ki67 has become the most widely used method for comparing proliferation between tumor samples. Potential uses include prognosis, prediction of relative responsiveness or resistance to chemotherapy or endocrine therapy, estimation of residual risk in patients on standard therapy and as a dynamic biomarker of treatment efficacy in samples taken before, during, and after neoadjuvant therapy, particularly neoadjuvant endocrine therapy. Increasingly, Ki67 is measured in these scenarios for clinical research, including as a primary efficacy endpoint for clinical trials, and sometimes for clinical management. At present, the enormous variation in analytical practice markedly limits the value of Ki67 in each of these contexts. On March 12, 2010, an international panel of investigators with substantial expertise in the assessment of Ki67 and in the development of biomarker guidelines was convened in London by the co-chairs of the Breast International Group and North American Breast Cancer Group Biomarker Working Party to consider evidence for potential applications. Comprehensive recommendations on preanalytical and analytical assessment, and interpretation and scoring of Ki67 were formulated based on current evidence. These recommendations are geared toward achieving a harmonized methodology, create greater between-laboratory and between-study comparability, and allow earlier valid applications of this marker in clinical practice.     

Determination of 210Pb and 210Po in sediment and soil leachates and in biological materials using a Sr-resin column and evaluation of column reuse.

In this work we present a suitable way to release lead and polonium from sediments and other samples. Results obtained by hot-acid dissolution and cold leaching showed that while good recoveries of 210Pb were obtained in both the cases, 210Po recovery in hot dissolution was poor due to volatility of polonium, and might lead to erroneous results due to non-equilibration of added 208Po tracer and 210Po in the matrix. A Sr-resin column was used for separation of Pb and Po. We also studied the possibility of reusing columns used earlier. The most significant problem in reuse is the reduction in column capacity, resulting in a reduction to half of its initial capacity. Other natural radionuclides do not interfere in the determination of 210Pb and 210Po and we found no measurable contamination of the column on repeated usage.     

Haemolytic-uraemic syndrome associated withAeromonas hydrophila enterocolitis

Haemolytic-uraemic syndrome (HUS) associated withAeromonas hydrophila enterocolitis is reported in a 23-month-old female infant. TheA. hydrophila strain isolated from the patient's stool sample produced cytotoxin against verocells; increasing levels of cytotoxinneutralizing antibody in the patient's sera were demonstrated, suggesting a recent infection. This report indicates thatA. hydrophila should be suspected as a possible cause of HUS, and that this pathogen should be looked for in cases of post-diarrhoeal HUS.     

The influence of heparin and indol on the catalytic properties of α- and β/δ -thrombins

Heparin was shown to form an equimolar complex with α- and β/δ -forms of thrombin. The formation of the complex resulted in inhibition of the TAME esterase activity of thrombin ( by 40% form α- and 17% for β/δ-form ) and in stimulation of its BAME esterase activity ( by 50% for α- and 64% for β/δ-form ). Heparin caused the 70% inhibition of the activity of both forms of the enzyme towards the synthetic amid substrate Bz-Phe-Val-Arg-pNA; at the same time it had little if any effect on the enzyme activity towards Tos-Gly-Pro-Arg-pNA and stimulated the α- and β/δ-thrombins activities towards H-D-Phe-Pip-Arg-pNA by 16% and 57% respectively. In the case of both ester and amid substrates heparin exerted its effect on kcat, but had no effect on Km(app).Indol was shown to activate the TAME hydrolysis catalyzed by α- and β/δ-thrombins. The identity of the binding site for indol and for the additional TAME molecule in the effect of substrate activation was demonstrated. Heparin did not prevent the effects of indol and substrate activation of the thrombin-catalyzed hydrolysis of ester substrates. Moreover the kinetic parameters of indol activation are similar for the free enzyme and its complex with heparin indicating the different localization of the binding sites for indol and heparin in the molecule of thrombin.     

Ethylene Polymerization over Homogeneous and Supported Catalysts Based on Bis(imino)pyridine Co(II) Complex: Data on the Number of Active Centers and Propagation Rate Constant

The number of active centers (C_P) and propagation rate constant (k_P) for ethylene polymerization with homogeneous catalyst LCoCl₂ + MAO and supported catalyst LCoCl₂/SiO₂ + Al(i‐Bu)₃, where L is 2,6‐(2,6‐(Me)₂C₆H₃N = CMe)₂C₅H₃N, have been determined using the method of polymerization quenching by radioactive carbon monoxide (¹⁴CO). The unstable rate profile of the reaction was attributed to a decrease in the number of active centers from 0.23 to 0.14 mol · mol^?1(Co) corresponding to an increase in the reaction time from 5 to 15 min, whereas the k_P value remained constant, amounting to 3.5 × 10³ L · mol^?1 · s at 35 °C. A narrow molecular weight distribution of the obtained polyethylene (PE) samples ( = 1.9) testifies that the homogeneous catalyst LCoCl₂ + MAO can be regarded as a single‐site system. The activity of the supported catalyst was stable and noticeably lower than that of the homogeneous catalyst due to the low concentration of the active centers (0.02–0.03 mol · mol^?1(Co)). PE with a broad molecular weight distribution ( = 36) and noticeably higher molecular weight is formed in the presence of the supported catalysts. The activity of the supported catalyst increases sharply at polymerization in the presence of hydrogen. The data obtained on the C_P and k_P values allow suggesting the formation of the “dormant” centers at polymerization without hydrogen and regeneration of the active centers in the presence of hydrogen. The average k_P values for the supported catalyst containing multiple active centers were determined to be 5.9 × 10³ and 10.5 × 10³ L · mol^?1 · s, respectively, at 35 and 50 °C.

     

Electrocardiographic exercise testing and ambulatory monitoring to identify patients with ischemic heart disease at high risk of sudden death

Prognostic significance of ambulatory electrocardiographic monitoring and exercise testing was studied in 144 patients with established ischemic heart disease. A follow-up study showed that 10 sudden deaths occurred within 2 years. The univariates most strongly associated with the subsequent occurrence of sudden death included reduced maximal exercise heart rate, exercise-induced frequent ventricular arrhythmias, complex ventricular arrhythmias revealed by 24 hour ambulatory electrocardiographic monitoring and onset of S-T segment depression during exercise testing. Groups of patients at very high and very low risk of sudden death were identified using conjunction and inclusive disjunction of the foregoing variables. The presence of bivariate and trivariate combinations was associated with an increase up to 20-fold in the incidence of sudden death. Patients with the poorest prognosis were those who stopped exercise before achieving a high heart rate and who exhibited either pronounced electrocardiographic abnormalities during stress testing or complex ventricular arrhythmias during ambulatory monitoring. Combinations of exercise variables identified patients at a very high risk of sudden death, whereas combinations of monitoring variables appeared to be preferable for defining groups of patients at very low risk. The results obtained suggest that the two methods carry different prognostic information and, therefore, may complement each other in identifying potential victims of sudden cardiac death.