Treating patients with fibromyalgia in primary care settings under routine medical practice: a claim database cost and burden of illness study

Introduction  

The objective of this study was to analyze health care and non-health care resource utilization under routine medical practice in a primary care setting claims database and to estimate the incremental average cost per patient per year of fibromyalgia syndrome (FMS) compared with a reference population.     

Glycogenolysis - and not gluconeogenesis - is the source of UDP-glucuronic acid for glucuronidation

Differences in cofactor (NADPH and UDP-glucuronic acid) supply for various processes of biotransformation were studied by investigating the interrelations between glucose production (gluconeogenesis and glycogenolysis) and drug (p-nitrophenol, aminopyrine, phenolphthalein) biotransformation (hydroxylation and conjugation) in isolated murine hepatocytes. In glycogen-depleted hepatocytes prepared from animals fasted for 48 h (i) p-nitrophenol conjugation was decreased by 80% compared to the fed control, while aminopyrine oxidation was unaltered, (ii) addition of glucose or gluconeogenic substrates failed to increase the rate of p-nitrophenol conjugation, while the rate of p-nitrophenol and also aminopyrine oxidation was increased and (iii) gluconeogenesis was inhibited by 80% by aminopyrine oxidation: it was moderately decreased by p-nitrophenol oxidation and conjugation and remained unchanged by phenolphthalein conjugation. In hepatocytes prepared from fed mice (i) p-nitrophenol conjugation was independent of the extracellular glucose concentration, (ii) it was linked to the consumption of glycogen - addition of fructose inhibited p-nitrophenol glucuronidation only, while sulfation was unaltered and (iii) p-nitrophenol oxidation was not detectable: aminopyrine oxidation was not affected by fructose addition. It is suggested that UDP-glucuronic acid for glucuronidation derives predominantly from glycogen, while the NADPH generation for mixed function oxidation is linked to glucose uptake and / or gluconeogenesis in the liver.     

Analysis of 5'-ends of short DNA fragments excreted by phytohemagglutinin stimulated lymphocytes

Human peripheral blood lymphocytes were stimulated with phytohemagglutinin and the excreted DNA was isolated from the medium after four days of incubation of cells. The excreted DNA was labeled at the 5'-end with [gamma-32P]ATP and polynucleotide kinase. Analysis of the end-labeled material revealed a size distribution with a chain length of 6 - 60 nucleotides. These short DNA fragments did not contain ribo-nucleotides at their 5'-termini. P1 nuclease digestion did not release specific deoxyribonucleoside monophosphates from the 5'-end of the excreted DNA fragments. These results point to the non-specific degradation of DNA excreted by stimulated lymphocytes.     

Effects of ozone and elevated atmospheric carbon dioxide on carbohydrate metabolism of spruce needles. Catabolic and detoxification pathways

We have studied the effects of ozone, carbon dioxide and ozone combined with carbon dioxide fumigations on catabolic and detoxification pathways in spruce ( Picea abies [L.] Karst.) needles. The results obtained showed an increase in the activities of three enzymes involved in the detoxification pathway, superoxide dismutase (SOD, EC 1.15.1.1), ascorbate peroxidase (AscPOD, EC 1.11.1.11) and glutathione reductase (GR, EC 1.6.4.2) when trees were exposed to ozone and to ozone‐carbon dioxide treatments. In these two treatments, the fraction of SOD activity due to the chloroplastic isoform was increased (1.5‐fold). In the needles of trees exposed to ozone and to ozone‐carbon dioxide fumigation, an increase in the activities of glucose‐6‐phosphate dehydrogenase (G‐6‐PDH, EC 1.1.1.49) showed that the cell had the capacity to produce more NADPH necessary for the detoxification. Stimulation of other enzymes of catabolic pathways (fumarase [EC 4.2.1.2], phosphofructokinase [PFK, EC 2.7.1.1] and phosphoenolpyruvate carboxylase [PEPC, EC 4.1.1.31]), was also observed making it possible for the cell to provide the reducing power necessary for detoxification as well as energy and carbon skeletons involved in the repair processes.
When carbon dioxide alone was applied, no effects could be detected on these enzyme activities. However, when carbon dioxide was combined with ozone, the effect of ozone on trees was less than that induced by ozone alone, suggesting that elevated atmospheric carbon dioxide concentrations may to some extent protect plants from ozone injury.     

Cytometric analysis of DNA replication inhibited by emetine and cyclosporin A

DNA staining methods based on aspecific interactions with dye molecules have been replaced by an immunofluorescent approach to measure DNA replication. Biotin-11-dUTP was incorporated into permeable thymocytes isolated after emetine or cyclosporin A treatment of mice. Active sites of DNA replication were amplified based on biotin-avidin interaction and verified under fluorescent microscope. Cytometry of fluorescent images allow the direct measurement of replicating DNA without aspecific detection of total cellular DNA. Cytometric analysis of replication revealed that emetine acts at the early S phase, while cyclosporin A blocks in vivo DNA synthesis at mid S phase.