Maternal Serum Meteorin Levels and the Risk of Preeclampsia

BACKGROUND

Meteorin (METRN) is a recently described neutrophic factor with angiogenic properties. This is a nested case-control study in a longitudinal cohort study that describes the serum profile of METRN during different periods of gestation in healthy and preeclamptic pregnant women. Moreover, we explore the possible application of METRN as a biomarker.

METHODS AND FINDINGS

Serum METRN was measured by ELISA in a longitudinal prospective cohort study in 37 healthy pregnant women, 16 mild preeclamptic women, and 20 healthy non-pregnant women during the menstrual cycle with the aim of assessing serum METRN levels and its correlations with other metabolic parameters. Immunostaining for METRN protein was performed in placenta. A multivariate logistic regression model was proposed and a classifier model was formulated for predicting preeclampsia in early and middle pregnancy. The performance in classification was evaluated using measures such as sensitivity, specificity, and the receiver operating characteristic (ROC) curve. In healthy pregnant women, serum METRN levels were significantly elevated in early pregnancy compared to middle and late pregnancy. METRN levels are significantly lower only in early pregnancy in preeclamptic women when compared to healthy pregnant women. Decision trees that did not include METRN levels in the first trimester had a reduced sensitivity of 56% in the detection of preeclamptic women, compared to a sensitivity of 69% when METRN was included.

CONCLUSIONS

The joint measurements of circulating METRN levels in the first trimester and systolic blood pressure and weight in the second trimester significantly increase the probabilities of predicting preeclampsia.

Antibody desensitization therapy in highly sensitized lung transplant candidates

As HLAs antibody detection technology has evolved, there is now detailed HLA antibody information available on prospective transplant recipients. Determining single antigen antibody specificity allows for a calculated panel reactive antibodies (cPRA) value, providing an estimate of the effective donor pool. For broadly sensitized lung transplant candidates (cPRA ≥ 80%), our center adopted a pretransplant multi-modal desensitization protocol in an effort to decrease the cPRA and expand the donor pool. This desensitization protocol included plasmapheresis, solumedrol, bortezomib and rituximab given in combination over 19 days followed by intravenous immunoglobulin. Eight of 18 candidates completed therapy with the primary reasons for early discontinuation being transplant (by avoiding unacceptable antigens) or thrombocytopenia. In a mixed-model analysis, there were no significant changes in PRA or cPRA changes over time with the protocol. A sub-analysis of the median fluorescence intensity (MFI) change indicated a small decline that was significant in antibodies with MFI 5000-10,000. Nine of 18 candidates subsequently had a transplant. Posttransplant survival in these nine recipients was comparable to other pretransplant-sensitized recipients who did not receive therapy. In summary, an aggressive multi-modal desensitization protocol does not significantly reduce pretransplant HLA antibodies in a broadly sensitized lung transplant candidate cohort.

[Incidence of suicide in Catalan prisons: a descriptive and comparative study]

INTRODUCTION

The prevention of suicide in prison is one of the most important challenges facing prison health care services in developed countries. The aim of this study is to analyse the incidence of suicide in Catalan prisons and accumulate data about a number of variables that have also been studied in other prison populations.

MATERIALS AND METHODS

Retrospective study of suicide cases in prisons administrated by the Catalan Regional Government (Generalitat de Catalunya) between 1990 and 2005 (n=65). Comparative study of incidence with European countries using published data.

RESULTS

The average annual incidence for the period is of 59/100.000, multiplying by eight the level corresponding to the general population.

CONCLUSIONS

Entry into prison is the most important event trigger for suicide. Other data open the way to new research.

[Staphylococcus aureus in residents from a nursing-home in Cartagena]

OBJECTIVES

Determining Staphylococcus aureus nasal carriage, antibiotic susceptibility and association with potential risk factors in residents from the Hogar Asilo de Ancianos San Pedro Claver nursing-home in Cartagena during the second semester of 2007.

METHODS

Nasal swabs were taken from each person participating in the study after they had signed an informed consent form. Staphylococcus aureus strains were identified by classical methods; antibiotic susceptibility was determined by disk diffusion methods, according to CLSI standards. SPSS for Windows 13.0 statistical package was used for analysing data collected from medical records and from a questionnaire for analysing association with potential risk factors.

RESULTS

11 Staphylococcus aureus isolates were obtained from 69 participants, corresponding to 15.9% prevalence. No methicillin-resistant strains were detected. Staphylococcus aureus nasal carriage was significantly associated with limited mobility and skin lesions. There was no significant association with the other risk factors analysed.

CONCLUSIONS

Staphylococcus aureus nasal carriage found in this study was lower than that reported from other similar studies in other countries, taking into account that this is a population at risk for colonisation by this pathogen.

Radiation-induced lung injury in vivo: expression of transforming growth factor-beta precedes fibrosis

Cytokine release from irradiated cells has been postulated to start soon after irradiation preceding detectable clinical and pathological manifestation of lung injury. The expression of transforming growth factor beta (TGF beta), a fibrogenic and radiation-inducible cytokine, was studied from 1-16 weeks after the 15 and 30 Gray (Gy) of thoracic irradiation to rats. Thoracic irradiation caused an increase in TGF beta protein in bronchoalveolar lavage (BAL) fluid peaking at 3-6 weeks as compared to sham-irradiated control rats. Steady state TGF beta mRNA expression as shown by whole lung northern blot assay paralleled the TGF beta protein expression in BAL fluid. The peak of TGF beta protein increase in BAL fluid between 3 and 6 weeks coincided with the initial influx of inflammatory cells in BAL fluid, but preceded histologically discernable pulmonary fibrosis that was not apparent until 8-10 weeks after irradiation. In conclusion. TGF beta and mRNA and protein upregulation preceded the radiation-induced pulmonary fibrosis, suggesting a pathogenetic role in the development of radiation fibrosis.

The intratracheal administration of endotoxin: X. Dexamethasone downregulates neutrophil emigration and cytokine expression in vivo

Intratracheal instillation of endotoxin (LPS) causes acute pulmonary inflammation characterized by the accumulation of plasma proteins and leukocytes within the pulmonary airways. The synthetic glucocorticoid dexamethasone 1) inhibits the LPS-initiated vascular leak of plasma proteins into the airspace, 2) inhibits the LPS-initiated emigration of neutrophils and lymphocytes into the airspace in a dose-dependent fashion, and 3) inhibits LPS-initiated mRNA and/or bronchoalveolar lavage protein expression of cytokines (TNF, IL-1 and IL-6) and chemokines (MIP-1 alpha, MIP-2 and MCP-1). In conclusion, dexamethasone inhibits both the vascular and cellular aspects of acute inflammation by downregulation of a broad spectrum of inflammatory cytokines and chemokines.

Differential characteristics of AIDS patients with a history of imprisonment

BACKGROUND

AIDS is among the leading causes of death in prisons, but there is little information about AIDS patients with a history of imprisonment.

METHODS

AIDS patients diagnosed in Barcelona between 1988 and 1993 were studied. Those with prison histories were compared to those without, with respect to epidemiological variables, including survival analysis.

RESULTS

28.5% of 2336 AIDS patients, 49.4% of intravenous drug users (IVDU) and only 2.6% of homosexuals who were not IVDU had a prison history. Those with prison histories, compared to those without, were younger (median age of 30.6 versus 36.4, P < 0.0001), more often IVDU than homosexuals (87.8% versus 35.8%, OR = 36.9, 95% CI: 22.6-60.8, P < 0.0001), and diagnosed with AIDS because of extrapulmonary tuberculosis (32.0% versus 14.7%, P < 0.001). Among IVDU, those with prison histories were more frequently males (OR: 2.2; 95% CI: 1.6-2.9), lived in the poorest district of Barcelona more frequently than in the richest district (OR: 6.6; 95% CI: 3.4-12.9) and presented with extra-pulmonary tuberculosis more frequently than Pneumocystis carinii pneumonia (OR: 1.7; 95% CI: 1.2-2.4). Longer survival in the prison group did not persist when adjusted for age and AIDS-defining disease. Those with prison histories who presented with AIDS with only extrapulmonary tuberculosis had better probability of survival than those who presented only with P. carinii pneumonia (P < 0.001).

CONCLUSIONS

AIDS patients in Barcelona with prison histories tended to be younger, more likely to be IVDU, and to present with extrapulmonary tuberculosis as an AIDS-defining illness than other patient groups. Better survival appears to be related to age and AIDS-defining illnesses in the prison group. The fact that half the IVDU AIDS cases had prison histories has important implications for the care and prevention of HIV, tuberculosis, and drug abuse in comparable prison settings.

Keratinocyte growth factor induces pancreatic ductal epithelial proliferation

Keratinocyte growth factor (KGF) causes a proliferation of pancreatic ductal epithelial cells in adult rats after daily systemic administration for 1 to 2 weeks. Even before the proliferation of intralobular ducts is histologically evident, KGF also induces proliferating cell nuclear antigen expression within the ductal epithelium of intercalated, intralobular, and interlobular ducts. KGF also causes incorporation of 5-bromodeoxyuridine in ductal epithelial cells. Epithelial cell proliferation is histologically most prominent at the level of the intralobular ducts adjacent to and within the islets of Langerhans. Pancreatic ductal proliferation is not histologically apparent in rats sacrificed 7 to 10 days after the cessation of KGF administration. The pancreatic hormones insulin, glucagon, somatostatin, and pancreatic polypeptide are normally distributed within islets that demonstrate intrainsular ductal proliferation. The proliferating ductal epithelium does not show endocrine differentiation as evidenced by the lack of immunoreactivity for pancreatic hormones. KGF is a potent in vivo mitogen for pancreatic ductal epithelial cells.

Acute respiratory tract infections among a birth cohort of children from Cali, Colombia, who were studied through 17 months of age

For this study, 340 children less than 18 months old from a low-income, urban neighborhood in Cali, Colombia, were observed from birth by means of weekly home visits to detect cases of acute respiratory tract infection. All suspected cases were confirmed by trained doctors in a special clinic. Information on symptoms, signs, and potential risk factors was documented prospectively. Etiologic agents were identified in cases of lower respiratory tract infection (LRI). The overall incidence of acute respiratory tract infection was 6.6 cases per child-year at risk. The incidence of upper respiratory tract infection was 4.9 cases per child-year at risk and that of LRI was 1.7 cases per child-year at risk. Crowding in the home was found to be significantly associated with an increased incidence of LRI. Respiratory syncytial virus was the viral agent most frequently isolated from cultures of nasopharyngeal aspirates of children with LRI. Staphylococcus aureus was the bacterial agent most frequently isolated from the blood of patients with LRI.