Background. Fracture risk assessment tool (FRAX) index was developed for estimating of the 10-year risk of major or hip osteoporotic fracture. To date, there is insufficient information regarding the ...correlation between FRAX and serum bone turnover markers (BTMs), such as soluble ligand of receptor activator of nuclear factor-κB (sRANKL), osteoprotegerin (OPG), and other molecules related with secondary osteoporosis in rheumatoid arthritis (RA). Therefore, this study is aimed at assessing the correlation between the FRAX and serum levels of sRANKL, OPG, sRANKL/OPG ratio, Dickkopf-1 (DKK-1), and sclerostin (SOST) in RA. Methods. Cross-sectional study included 156 postmenopausal women with RA. Bone mineral density (BMD) was measured at lumbar spine (L1-L4) and total hip using dual-energy X-ray absorptiometry (DXA). RA patients were divided into (A) RA + osteoporosis and (B) RA without osteoporosis. FRAX scores were calculated including the total hip BMD. Serum sRANKL, OPG, DKK-1, and SOST levels were measured by ELISA. Pearson tests were used for assessing the correlation between serum levels of these molecules and FRAX scores in RA. Results. The RA + osteoporosis group had elevated sRANKL levels (p=0.005), higher sRANKL/OPG ratio (p=0.017), decreased DKK-1 (p=0.028), and lower SOST levels (p<0.001). Low total hip BMD correlated with high sRANKL (p=0.001) and sRANKL/OPG ratio (p=0.005). Total hip and lumbar spine BMD correlated with DKK-1 (p=0.009 and p=0.05, respectively) and SOST levels (p<0.001 and p<0.001, respectively). Higher sRANKL levels and sRANKL/OPG ratio correlated with estimated 10-year risk of a major osteoporotic fractures (p=0.003 and p=0.003, respectively) and hip fracture (p=0.002 and p=0.006, respectively). High serum SOST levels were associated with a low estimated 10-year risk of a major osteoporotic fracture (p=0.003) and hip fracture (p=0.009). Conclusion. High sRANKL levels and sRANKL/OPG ratio can be useful to detect a subgroup of RA patients who has an increased 10-year risk of major and hip osteoporotic fractures.
Tardive dyskinesia (TD) is a syndrome characterized by repetitive involuntary movements induced by the administration of typical neuroleptics such as haloperidol. TD generally persists after ...haloperidol withdrawal indicating that haloperidol produces long-lasting changes in brain function. In contrast to the typicals, atypical medications, such as clozapine, have very low rates of TD. The mechanisms underlying drug-induced TD are poorly understood. We have investigated the role of nigral expression of the bcl-2 family of proteins on haloperidol-induced neurotoxicity. Rats were treated for 21 days with the following drugs: haloperidol (1 mg/kg), clozapine (1 mg/kg) or saline. After a 3-day washout period, apomorphine-induced stereotyped behavior was scored. Western blotting was performed to evaluate the nigral expression of the dopamine transporter (DAT), bax, bcl-x
L and bcl-2 proteins. Haloperidol administration, but not clozapine, increased stereotyped behavior (
p
<
0.01) in association with a decrease in striatal DAT expression (
p
<
0.05). Haloperidol and clozapine treatment significantly decreased the nigral expression of bax (
p
<
0.05,
p
<
0.01, respectively). Neither treatment modified bcx
L expression. Haloperidol increased (
p
<
0.05), whereas clozapine did not significantly modify the nigral expression of bcl-2. Our results suggest that the increase in bcl-2 expression in the haloperidol-treated animals might be a compensatory mechanism that may reflect cellular damage induced by haloperidol in the dopaminergic neurons in the pars compacta of the substantia nigra.
Isolated kinematic properties of visible speech can provide information for lip reading. Kinematic facial information is isolated by darkening an actor's face and attaching dots to various ...articulators so that only moving dots can be seen with no facial features present. To test the salience of these images, the authors conducted experiments to determine whether the images could visually influence the perception of discrepant auditory syllables. Results showed that these images can influence auditory speech independently of the participant's knowledge of the stimuli. In other experiments, single frozen frames of visible syllables were presented with discrepant auditory syllables to test the salience of static facial features. Although the influence of the kinematic stimuli was perceptual, any influence of the static featural stimuli was likely based on participant's misunderstanding or postperceptual response bias.
Exposure to certain environmental toxicants may be associated with increased risk of developing diabetes. The authors' aim was to investigate the relation between lifetime exposure to specific ...agricultural pesticides and diabetes incidence among pesticide applicators. The study included 33,457 licensed applicators, predominantly non-Hispanic White males, enrolled in the Agricultural Health Study. Incident diabetes was self-reported in a 5-year follow-up interview (1999–2003), giving 1,176 diabetics and 30,611 nondiabetics for analysis. Lifetime exposure to pesticides and covariate information were reported by participants at enrollment (1993–1997). Using logistic regression, the authors considered two primary measures of pesticide exposure: ever use and cumulative lifetime days of use. They found seven specific pesticides (aldrin, chlordane, heptachlor, dichlorvos, trichlorfon, alachlor, and cyanazine) for which the odds of diabetes incidence increased with both ever use and cumulative days of use. Applicators who had used the organochlorine insecticides aldrin, chlordane, and heptachlor more than 100 lifetime days had 51%, 63%, and 94% increased odds of diabetes, respectively. The observed association of organochlorine and organophosphate insecticides with diabetes is consistent with results from previous human and animal studies. Long-term exposure from handling certain pesticides, in particular, organochlorine and organophosphate insecticides, may be associated with increased risk of diabetes.
•During their evolution, most NMOSD patients develop permanent disability•Diagnosis ≥ 12 months is the most important risk factor for permanent disability•EDSS ≥ 4.0 and age of onset ≥ 50 years old ...at first visit are also risk factors•Prompt recognition and treatment of NMOSD is paramount to prevent disability
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system. In NMOSD, a relapse results in increased disability.
To assess risk factors associated with permanent disability (PD) in patients with neuromyelitis optica spectrum disorders (NMOSD).
We evaluated 34 cases (who developed permanent disability) and 33 controls. The assessment included the following variables: sociodemographic data and characteristics of the disease. Logistic regression analysis was performed to adjust variables associated with PD.
fifty-one percent developed PD during follow-up; 15 (22%) developed permanent visual disability, 13 (19%) developed permanent motor disability and 6 (9%) were restricted to wheelchair. Factors associated with PD in the crude analysis were: age at onset ≥ 50 years (OR 3.95, 95% IC 1.12-13.94, p= 0.032), time from onset to diagnosis ≥ 12 months (OR 3.30, 95% IC 1.13-9.64, p= 0.029), time from onset to treatment ≥ 60 months (OR 4.16, 95% IC 1.03-16.85, p= 0.045), EDSS ≥ 4.0 at the first appointment (OR 3.21, 95% IC 1.18-8.76, p= 0.022) and severe relapses during disease evolution (OR 5.72, 95% IC 1.98-16.57, p= 0.001). Factors associated with PD in the adjusted analysis were: age at onset ≥ 50 years (OR 5.82, 95% IC 1.30-26.05, p= 0.021), time from onset to diagnosis ≥ 12 months (OR 5.43, 95% IC 1.47-20.08, p= 0.011) and severe relapses during disease evolution (OR 6.65, 95% IC 1.98-22.31, p= 0.002).
Half of patients with NMOSD may develop PD during disease evolution. Age of onset ≥ 50 years, delay to diagnosis ≥12 months and initial EDSS ≥ 4.0 constitute the strongest risk factors for PD.
Background. Neuropeptide Y (NPY) is a sympathetic neurotransmitter with effects on the regulation of inflammatory cells. The role of NPY on autoimmune inflammatory diseases such as rheumatoid ...arthritis (RA) is not completely understood. Therefore, we evaluate if NPY levels are markers of disease activity in RA and if there is a correlation between NPY levels and tumor necrosis factor-alpha (TNF-α), leptin, and interleukin 6 (IL-6) levels. Methods. Cross-sectional design, including 108 women with RA. We assessed disease activity by DAS28-ESR (considering active disease a score of ≥2.6). Serum NPY levels and anti-CCP2 antibody, TNF-α, IL-6, and leptin levels were quantified (ELISA). Results. Sixty-eight RA had an active disease (RA-active), and 40 were in remission (RA-remission). RA-active patients had higher NPY levels vs. RA-remission (22.8±13.6 vs. 17.8±10.3; p=0.04). NPY levels correlated with increased TNF-α levels (r=0.32, p=0.001). Leptin or IL-6 did not correlate with NPY levels. In the logistic regression analysis, NPY increased the risk of disease activity (OR: 1.04, 95% CI 1.006-1.09, and p=0.03). Conclusion. Higher NPY levels are an independent marker of disease activity in RA. This study encourages the quantification of NPY levels as a surrogate marker for RA-active. Future studies evaluating the role of NPY levels interacting with other proinflammatory cytokines are required.
Considerable effort is being made to remediate soils contaminated with petroleum hydrocarbons, polyaromatic hydrocarbons, polychlorinated biphenyls, dioxins, heavy metals and other organic and ...inorganic compounds that have resulted from industrial activities, accidental spills and improper waste disposal practices. Current remediation technologies may be limited when treating certain types of contaminated soils and therefore new, efficient and cost effective technologies are being investigated. Supercritical fluid extraction is a potential remediation technology for contaminated soils. It is a simple, fast and selective solvent extraction process that uses a supercritical fluid as the solvent. A commonly used fluid is carbon dioxide at pressures and temperatures greater than 7.4 MPa and 31°C, respectively. In supercritical fluid extraction, the extracted contaminants first dissolve into the supercritical solvent and then these contaminants are separated from the supercritical solvent via a simple change in pressure and temperature conditions or by using a separation process. This paper provides a review of supercritical fluid extraction and its application to the remediation of contaminated soils. This review focuses on the removal of organic contaminants (such as petroleum hydrocarbons, polyaromatic hydrocarbons, polychlorinated biphenyls and others) and inorganic contaminants (such as heavy metals and radioactive elements) from soils. Recent data (1994-2004) on the supercritical fluid extraction of spiked soils and field-contaminated soils were collected. The success of supercritical fluid extraction as a method for removing these contaminants from soils is highlighted and some of the future research needed to develop it as a commercial-scale economic remediation technology are discussed.
The Institute for Healthcare Improvement encourages use of the Global Trigger Tool to objectively determine and monitor adverse events (AEs).
Baylor Health Care System (BHCS) is an integrated ...healthcare delivery system in North Texas. The Global Trigger Tool was applied to BHCS's eight general acute care hospitals, two inpatient cardiovascular hospitals and two rehabilitation/long-term acute care hospitals.
Data were collected from a monthly random sample of charts for each facility for patients discharged between 1 July 2006 and 30 June 2007 by external professional nurse auditors using an MS Access Tool developed for this initiative. In addition to the data elements recommended by Institute for Healthcare Improvement, BHCS developed fields to permit further characterisation of AEs to identify learning opportunities. A structured narrative description of each identified AE facilitated text mining to further characterise AEs. INITIAL FINDINGS: Based on this sample, AE rates were found to be 68.1 per 1000 patient days, or 50.8 per 100 encounters, and 39.8% of admissions were found to have ≥1 AE. Of all AEs identified, 61.2% were hospital-acquired, 10.1% of which were associated with a National Coordinating Council - Medical Error Reporting and Prevention harm score of "H or I" (near death or death).
To enhance learning opportunities and guide quality improvement, BHCS collected data-such as preventability and AE source-to characterise the nature of AEs. Data are provided regularly to hospital teams to direct quality initiatives, moving from a general focus on reducing AEs to more specific programmes based on patterns of harm and preventability.
Summary
Cryptorchidism is a frequent genitourinary malformation considered as an important risk factor for infertility and testicular malignancy. The aetiology of cryptorchidism is multifactorial in ...which certain SNPs, capable of inhibiting the development of the gubernaculum, are implicated. We analysed 16 SNPs by allelic discrimination and automated sequencing in 85 patients and 99 healthy people, with the objective to identify the association between these variants and isolated cryptorchidism. In two different patients with unilateral cryptorchidism, we found the variants rs121912556 and p.R105R of INSL3 gene in a heterozygous form associated with cryptorchidism, so we could considered them as risk factors for cryptorchidism. On the other hand, SNPs rs10421916 of INSL3 gene, as well as the variants rs1555633 and rs7325513 in the RXFP2 gene, and rs3779456 variant of the HOXA10 gene were statistically significant, when the patients and controls were compared and could be considered as protective factors since are predominantly present in controls. The genotype–phenotype correlation did not show statistical significance. With these results, we could conclude that these polymorphisms can be considered as important variants in our population and would contribute in the future knowledge of the aetiology and physiopathology of cryptorchidism.
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