1,721,122 research outputs found
Systematic review: macrophage activation syndrome in inflammatory bowel disease
Full text linkBACKGROUND:
Recently, there have been increasingly frequent reports on the occurrence of macrophage activation syndrome (MAS) in patients with inflammatory bowel disease (IBD). Clinically, MAS is characterized mainly by fever, hepatosplenomegaly, cytopenia, and elevated circulating ferritin and CD25. Mortality, even if diagnosed rapidly, is high.
AIM:
To identify all reports on MAS in IBD and to establish data on triggering agents, immunosuppression leading to MAS, and mortality.
METHODS:
A language unrestricted search on Pubmed and Scopus relating to the past 30 years was carried out by matching the following search-terms: h(a)emophagocytic lymphohistiocytosis OR h(a)emophagocytic lymphohistiocytic syndrome OR macrophage activation syndrome OR opportunistic infections OR cytomegalovirus OR Epstein-Barr virus AND Crohn's disease OR ulcerative colitis OR inflammatory bowel disease(s).
RESULTS:
Fifty cases were identified with an overall mortality of 30%. Virus-related MAS associated with cytomegalovirus or Epstein-Barr virus infections represents the main type of MAS, but in isolated cases bacterial infections precipitated the syndrome. In four cases (8%), a lymphoma was present at the time of MAS diagnosis or developed shortly thereafter. Thiopurine monotherapy was given before MAS onset in 56% of the patients, whereas multiple immunosuppression, including biologics, was administered to 24%.
CONCLUSIONS:
In IBD patients, the syndrome appears to be triggered by infections, but genetic susceptibility may contribute to its development. Since immunosuppressive therapy represents the backbone of therapeutic interventions in IBD, with the risk of new, or the reactivation of latent infections, even more frequent cases of macrophage activation syndrome may be expected
Effect of stress on the paracellular barrier in the rat ileum
No full textBackground: Restraint stress induces permeability changes in the rat small intestine but little is known of the ultrastructural events leading to defects of the paracellular sealing or of the short term evolution of these alterations.
Methods: In the present study, we performed transmission electron microscopy in the terminal ileum perfused with lanthanum after two hours of immobilisation stress and in non-stressed control rats. Moreover, immunohistochemistry of the tight junction (TJ) associated proteins, occludin and zonula occludens 1 (ZO-1), was carried out together with western blot analysis of the transmembrane protein occludin. TJ morphology was also assessed after a 22 hour recovery period.
Results: Immobilisation stress induced a significant increase in epithelial permeability to the lanthanum tracer (p<0.005) which recovered completely after 22 hours. Compared with unstressed controls, in stressed rats no differences were found on freeze fracture analysis. The TJ related immunofluorescence signals of occludin and of ZO-1 were irregularly distributed in stressed rats after two hours but returned to a normal pattern at 24 hours although with minor intensity. No quantitative alterations in occludin were detectable in stressed rats by immunoblot whereas a perinuclear concentration of occludin was observed by immunolocalisation.
Conclusions: Immobilisation stress induced an increase in TJ permeability in the rat terminal ileum. These changes were mainly due to modifications and redistribution of the TJ transmembrane protein occludin and of the plaque protein ZO-1 whereas protein synthesis, at least that of occludin, was not affected by stress
A 3-year pilot study with 1,25-dihydroxyvitamin D, calcium, and calcitonin for severe osteodystrophy in primary biliary cirrhosis.
No full textAbstract: We carried out a 3-year pilot study of 59 consecutive women with osteoporosis of primary biliary cirrhosis (PBC), allocating them to two groups according to the severity of bone demineralization assessed by means of dual-photon absorptiometry (DPA) of the lumbar spine. Group A (36 patients; bone mineral density [BMD] > 0.800 g/cm(2)) received no treatment; group B (23 patients; BMD < 0.800 g/cm(2)) was treated as follows: oral 1,25-dihydroxyvitamin D (0.5 mu g twice a day for 5 days) followed by a 1-month course with oral calcium carbonate (1,500 mg/day) + carbocalcitonin (40 UMRC intramuscularly three times weekly). This treatment was repeated every 3 months. The following parameters were assessed at baseline and every 12 months: DPA, serum and urinary minerals, serum parathyroid hormone (PTH), osteocalcin (BGP), 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. During follow-up, 11 initially untreated patients whose BMD dropped below 0.800 g/cm(2) were switched to the treatment group (8 after 12 months and 3 after 24 months). No significant changes were observed in either group for PTH, BGP, or vitamin D metabolites. Comparing patients who were always treated, those who were never treated, and those who switched to the treatment group (ever treated) in this 36-month period, the percentage of annual bone loss in the never-treated patients was significantly less (p < 0.002) than in the ever-treated patients, suggesting the presence of two subgroups in PBC patients; one with rapid bone loss and the other with slow bone loss. Moreover, in the ever-treated patients, ADFR (activate, depress, free, repeat) therapy resulted in an improvement in BMD (p < 0.05 compared with the Value before therapy). We conclude that ADFR therapy is effective in the treatment of patients with PBC with severe osteodystrophy, despite no change in osteoblastic activity, although controlled, randomized studies are in order to confirm our data
MICRORADIOGRAPHIC ANATOMY OF THE EXPLANTED RAT COLON
Full text linkThe colon of 32 healthy Sprague-Dawley rats was studied microradiographicallp. The colonic arterial distribution of 18 rats was examined after injecting barium sulfate into the isolated aorta. The mucosal surface in 9 rats was studied using double-contrast technique after colon explantation. In 5 animals arterial and mucosal studies were carried out simultaneously. The radiographic thickness of the colonic wall was measured using a comparative microscope. The specimens were observed, photographed and examined histologically. Unlike the cecum and distal colon which, when insufflated, do not have mucosal folds, the proximal colon exhibits folds in an oblique direction corresponding to that of the arteries, and the colonic wall in this region is thicker. Comparison between arterial and mucosal microradiographic anatomy and wall thickness enables the proposition of a simple nontopographic division of the rat colon into cecum, proximal colon and distal colon
Effects of brain-lesion size and location on temporal-order judgment
No full textWe assessed the effect of size and localization of a brain lesion on patients' abilities to perceive the temporal order of two acoustic stimuli. In those patients who had performed with impaired order thresholds, local overlaps of lesions as analyzed with CT were found in specific left-hemispheric regions of the temporal and parietal lobe. However, a moderate association of lesion size and temporal-order threshold was found among all brain-injured patients (n=30), a correlation that was most pronounced in patients with right-hemispheric lesions. This non-specific effect of lesion size has to be discussed critically with respect to behavioral findings of an association between temporal-processing abilities and language competence
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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