Schwangerschaft bei rheumatoider Arthritis oder Spondyloarthritiden

The activity of a rheumatic disease can be influenced by pregnancy and puerperium. Prospective studies have shown an improvement in joint involvement in rheumatoid arthritis in two thirds to three quarters of pregnancies. After birth, an exacerbation is common. In spondylarthropathies there is no relevant change in disease activity. The fetal outcome is not impaired in patients with rheumatoid arthritis and inflammatory spondylarthropathies. Every pregnancy in women with a rheumatic disease should be considered as high-risk, and such pregnancies require close collaboration between rheumatologists and obstetricians.     

On verification of hyperthermia treatment planning for cervical carcinoma patients.

PURPOSE: The aim of this study was to verify hyperthermia treatment planning calculations by means of measurements performed during hyperthermia treatments. The calculated specific absorption rate (SAR(calc)) was compared with clinically measured SAR values, during 11 treatments in seven cervical carcinoma patients. METHODS: Hyperthermia treatments were performed using the 70 MHz AMC-4 waveguide system. Temperatures were measured using multisensor thermocouple probes. One invasive thermometry catheter in the cervical tumour and two non-invasive catheters in the vagina were used. For optimal tissue contact and fixation of the catheters, a gynaecological tampon was inserted, moisturized with distilled water (4 treatments), or saline (6 treatments) for better thermal contact. During one treatment no tampon was used. At the start of treatment the temperature rise (DeltaT(meas)) after a short power pulse was measured, which is proportional to SAR(meas). The SAR(calc) along the catheter tracks was extracted from the calculated SAR distribution and compared with the DeltaT(meas)-profiles. RESULTS: The correlation between DeltaT(meas) and SAR(calc) was on average R = 0.56 +/- 0.28, but appeared highly dependent on the wetness of the tampon (preferably with saline) and the tissue contact of the catheters. Correlations were strong (R approximately 0.85-0.93) when thermal contact was good, but much weaker (R approximately 0.14-0.48) for cases with poor thermal contact. CONCLUSION: Good correlations between measurements and calculations were found when tissue contact of the catheters was good. The main difficulties for accurate verification were of clinical nature, arising from improper use of the gynaecological tampon. Poor thermal contact between thermocouples and tissue caused measurement artefacts that were difficult to correlate with calculations.     

Age, fiber type composition and in vitro contracture responses in human malignant hyperthermia

Muscle fiber typing and in vitro contracture tests were performed in 59 patients investigated for susceptibility to malignant hyperthermia (MH). Eighteen patients were found to be susceptible to MH. There was no difference in age or fiber type distribution between MH susceptible and non-susceptible patients. No correlation was found between age and fiber type distribution. Separate analyses for each diagnostic group revealed no relationship between age or fiber type distribution and response to halothane or caffeine. When all caffeine results were pooled, however, there was a significant effect of age on the caffeine specific concentration (the concentration eliciting a contracture of 1 g), but not on the caffeine threshold concentration (the minimal concentration eliciting an increase in tension). It is concluded that age and fiber type distribution have no influence on MH diagnosis, if the protocol of the European MH Group for evaluation of susceptibility to MH is followed.     

Muscle cell leakage due to long distance training

Summary Abnormal myoglobinemia (above 77 g/1) and free hemoglobin in plasma were found in 16 runners and in nine non runners immediately following distance running. The same abnormalities were found in six elite rowers following rowing. In parallel with the rise in myoglobin and free hemoglobin a rise was found in serum concentrations of cellular enzymes (LDH, CK, ASAT, alkaline phosphatase) and of various metabolites. We found no proteinuria nor casts in the urine. Non runners had a higher rise in serum myoglobin than runners. Competitive running caused a rise in the serum concentration of the heart specific fraction of creatine kinase in seven of the nine (healthy) elite runners. The abnormal findings are only explainable on the basis of leakage of proteins from muscle cells to the circulation in otherwise healthy, well trained persons. Myoglobinemia and a transient rhabdomyolysis is a common phenomenon in long distance running, but evidently also occurs in distance rowing. Three months of running training prevented most of the muscle damage from relaxed jogging in the nine previous non runners. Neither the observed myoglobinemia nor the hemoglobinemia resulted in any significant loss of iron in the urine.Supported by IdrÆttens Forskningsråd, Dansk IdrÆtsforbund     

The effect of a high calory diet on hormonal changes in young men during prolonged physical strain and sleep deprivation

Summary Major changes occur in the serum level of several hormones during 5 days of heavy and continuous physical activities, with less than a total of 2 h of sleep. The present investigation was designed to evaluate the importance of caloric deficiency, energy requirement being about 8,000–10,000 kcal/24 h. A comparison between well fed subjects and those with food deprivation revealed significantly higher levels of (T₃) triiodothyronin, insulin and thyroid stimulating hormone (TSH) in the well-fed subjects, who also had lower levels of growth hormone (hGH) and cortisol, whereas no difference was found between the two groups for thyroxin (T₄). Increased levels were found for T₃ and T₄ in both groups during the first day of activity, with a concomitant decrease in TSH and a subsequent decrease of T₄ during the next 2 days. T₃ decreased only in the low-calory group whereas increased levels were found in the iso-calory group throughout the course. The resting levels of insulin decreased during the course in the low-calory group whereas it increased in the iso-calory group. High levels were maintained throughout the course for hGH. Cortisol showed high levels just before the start of the course and then decreased from day 2 to day 4. No difference was found between the morning and evening levels for cortisol, indicating disappearance of the circadian rhythm. The present investigation has shown that energy deficiency during prolonged physical strain is responsible for the decreased serum levels of T₃ and insulin and may contribute to the decrease in TSH and the increase in hGH and cortisol.     

Novel mouse model of chronic Pseudomonas aeruginosa lung infection mimicking cystic fibrosis

Pseudomonas aeruginosa causes a chronic infection in the lungs of cystic fibrosis (CF) patients by establishing an alginate-containing biofilm. The infection has been studied in several animal models; however, most of the models required artificial embedding of the bacteria. We present here a new pulmonary mouse model without artificial embedding. The model is based on a stable mucoid CF sputum isolate (NH57388A) with hyperproduction of alginate due to a deletion in mucA and functional N-acylhomoserine lactone (AHL)-based quorum-sensing systems. Chronic lung infection could be established in both CF mice (Cftr(tmlUnc-/-)) and BALB/c mice, as reflected by the detection of a high number of P. aeruginosa organisms in the lung homogenates at 7 days postinfection and alginate biofilms, surrounded by polymorphonuclear leukocytes in the alveoli. In comparison, both an AHL-producing nonmucoid revertant (NH57388C) from the mucoid isolate (NH57388A) and a nonmucoid isolate (NH57388B) deficient in AHL were almost cleared from the lungs of the mice. This model, in which P. aeruginosa is protected against the defense system of the lung by alginate, is similar to the clinical situation. Therefore, the mouse model provides an improved method for evaluating the interaction between mucoid P. aeruginosa, the host, and antibacterial therapy.     

Increase in the ratio of serum levels of apolipoproteins A-I and A-II during prolonged physical strain and calorie deficiency

Summary Effects of four days of intense physical activity on serum concentrations of total triglycerides, total cholesterol and apolipoproteins A-I, A-II, and B were studied in 35 well-trained young men. Serum total triglyceride levels decreased to 70% of baseline levels after 24 h, and fell further to 50% of baseline levels after 4 days. Serum levels of total cholesterol fell steadily to about 80% of baseline levels on the 4th day. Apo-B levels fell to 85% of baseline levels after 24 h, and remained at that level. Apo A-I fell to about 90%, and apo A-II to about 80% of baseline levels, causing a significant increase in the ratio of apo A-I to apo A-II. The intraindividual changes in apo B were positively correlated to changes in cholesterol during the first day (r=0.60). The changes in apo A-I and apo A-II had no significant correlation with changes in total cholesterol or triglycerides, or with one another, suggesting that apo A-I and apo A-II are metabolized independently during conditions of hard physical exercise.