Secretion,blood levels and cutaneous expression of TL1A in psoriasis patients

TL1A is a TNF‐like cytokine which has been shown to co‐stimulate TH1 and TH17 responses during chronic inflammation. The expression of this novel cytokine has been investigated in inflammatory disorders like rheumatoid arthritis and inflammatory bowel disease, but little is known about expression and induction in psoriasis. Indeed, the pathogenesis in psoriasis is still not fully understood and it is speculated that cytokines other than TNF‐α are important in subsets of patients. Also, for patients with severe disease that are treated with systemic anti‐TNF‐α blockade, novel candidates to be used as disease and response biomarkers are of high interest. Here, we demonstrate TL1A expression in biopsies from psoriatic lesions. Also, we investigated spontaneous and induced TL1A secretion from PBMCs and blood levels from a cohort of psoriasis patients. Here, increased spontaneous secretion from PBMCs was observed as compared to healthy controls and a small subset of patients had highly elevated TL1A in the blood. Interestingly, activation of PBMCs with various cytokines showed a decreased sensitivity for TL1A activation in psoriasis patients compared to healthy controls.TL1A levels in blood and biopsies could not be correlated with disease activity with this patient cohort. Thus, additional large‐scale studies are warranted to investigate TL1A as a biomarker.     

Reversal of startle gating deficits in transgenic mice overexpressing corticotropin-releasing factor by antipsychotic drugs.

Chronically elevated levels of corticotropin-releasing factor (CRF) in transgenic mice overexpressing CRF in the brain (CRF-OE) appear to be associated with alterations commonly associated with major depressive disorder, as well as with sensorimotor gating deficits commonly associated with schizophrenia. In the present study, we tested the hypothesis that antipsychotics may be effective in normalizing prepulse inhibition (PPI) of acoustic startle in CRF-OE mice, which display impaired sensorimotor gating compared to wild-type (WT) mice. The typical antipsychotic haloperidol and atypical antipsychotic risperidone improved PPI in the CRF-OE mice, but were ineffective in WT mice. The atypical antipsychotic clozapine did not influence PPI in CRF-OE mice, but reduced gating in WT mice. This effect of clozapine in the CRF-OE mice may thus be regarded as a relative improvement, consistent with the observed effect of haloperidol and risperidone. As expected, the anxiolytic, nonantipsychotic chlordiazepoxide was devoid of any effect. All four compounds dose-dependently reduced the acoustic startle response irrespective of genotype. These results indicate that antipsychotic drugs are effective in improving startle gating deficits in the CRF-OE mice. Hence, the CRF-OE mouse model may represent an animal model for certain aspects of psychotic depression, and could be a valuable tool for research addressing the impact of chronically elevated levels of CRF on information processing.     

Leitbild für die Leitstelle — Gefahren im Einsatz — Notfallmedizin im DRG-Zeitalter

Zusammenfassung Die 20. notfallmedizinische Jahrestagung der Arbeitsgemeinschaft Südwestdeutscher Notärzte (agswn) behandelte auch in diesem Jahr aktuelle berufspolitische Themen. Aktuelle Entwicklungen zur Verbesserung der Arbeitsabläufe in den Leitstellen wurden dargestellt, EDV-gestützte Systeme zur Notrufabfrage, die Vernetzung der Leitstellen und technische Verbesserungen der Leitstellensysteme genannt. Die Gefahren im Rettungsdienst waren ein weiterer Schwerpunkt der Tagung. Eine Ansteckungsgefahr bei Infektionstransporten bei MRSA-Patienten ist bei sachgemäßem Verhalten nicht zu befürchten. Weiterhin wurden die Möglichkeiten des terroristischen Einsatzes von biologischen Waffen realistisch deutlich relativiert. Amoklagen stellen dagegen eine nur schwer kalkulierbare Gefahrensituation dar. Als 3. Themenschwerpunkt wurden die besonderen Herausforderungen der Notfallmedizin im DRG-Zeitalter umrissen. Die Änderung des Einsatzspektrums und die Reduktion von Notarztstandorten erfordert die Bildung von Kompetenzzentren und eine hohe Qualifikation der Notärzte.     

Cisplatinum Dose Dependent Response in Germ Cell Cancer Evaluated by Tumour Marker Modelling

This study presents an analysis on longitudinal tumour marker series in twenty-two patients with non-seminomatous germ cell cancers treated with cisplatinum (DDP) based combination chemotherapy. Series of alphafoetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) were analyzed applying a dynamic mathematical marker model. The model analysis provided quantitated values for growth rate and treatment response in the marker producing cells. The analysis showed that LDH had to be above 2 000 U/l to be a trustworthy tumour marker. HCG producing cells tended to grow faster than AFP producing cells, and were 3-5-fold more sensitive to the chemotherapy given than AFP producing cells. Treatment response versus DDP dose appeared to be bi-phasic, but with no significant change in treatment efficiency within the given range of DDP doses.     

Safety and efficacy of topical norfloxacin versus tobramycin in the treatment of external ocular infections.

Bacterial conjunctivitis appears to resolve more rapidly when treated with appropriate topical antimicrobial agents. In this multicenter, randomized, double-blind study of efficacy and safety, patients with presumed bacterial external eye infections were assigned to topical therapy with 0.3% norfloxacin or 0.3% tobramycin. A total of 120 patients were enrolled. Of the total, 65 had documented bacterial infections and were evaluable; 59 of these patients had bacterial conjunctivitis. All of the patients with documented infections were cured or improved regardless of the drug treatment regimen or in vitro susceptibility testing results. The most common bacteria isolated were Haemophilus influenzae, Streptococcus pneumoniae, alpha-hemolytic streptococci, Staphylococcus aureus, and Staphylococcus sp. No patients had serious adverse reactions attributed to their therapy. Norfloxacin ophthalmic solution seems to be a safe, effective, and appropriate agent for the treatment of bacterial external eye infections.     

Neurologische Notfälle nach Leitsymptomen

This review focuses on acute non-traumatic disorders of the central nervous system. Rare diseases and intoxications are not included in this summary. The emergency examination aims at rapid identification of cardinal symptoms. For the most part, meningitis, headache, an epileptic seizure, dizziness, and acute hemiplegia together with the patient’s history can already suggest a suspected diagnosis. Since a vascular origin often underlies the acute neurological disease, it is very important to recognize a so called vascular syndrome. Thus neurological deficits are assessed diagnostically and medical communication is facilitated. Appropriate treatment can be initiated more promptly, which considerably improves the prognosis and neurological outcome. Knowledge of anatomic landmarks of the nervous system is essential, because “you cannot trust on your eyes if your imagination is out of focus” (Mark Twain)