Seropositivity is associated with insulin resistance in patients with early inflammatory polyarthritis: results from the Norfolk Arthritis Register (NOAR): an observational study

Introduction  

Cardiovascular disease (CVD) is the leading cause of death in patients with inflammatory polyarthritis (IP), especially in seropositive disease. In established rheumatoid arthritis (RA), insulin resistance (IR) is increased and associated with CVD. We investigated factors associated with IR in an inception cohort of patients with early IP.     

The morphology and post-hatching development of the skull of Bolitoglossa nicefori (Caudata: Plethodontidae): developmental implications of recapitulation and repatterning

The cranial morphology of the direct-developing salamander Bolitoglossa nicefori and its post-hatching development are described and compared with that of other urodeles. Four stages of cranial development are defined on the basis of conspicuous events that occur during post-hatching ontogeny. The adult skull morphology of B. nicefori is similar to that of other plethodontids; however, some regions show interspecific variation. The post-hatching ontogeny of the skull and the stage of ossification observed in the hatchlings of B. nicefori show two important ontogenetic features: (1) a mosaic of early larval, metamorphic and post-metamorphic skull features in hatchlings, and (2) absence of characteristic larval elements in skull and hyoid apparatus. The distinctive stage of ossification in the hatchlings of B. nicefori could be caused by heterochronic changes in the ossification sequence, compared to the ontogeny of metamorphic salamanders. The possible heterochronic changes and the absence of larval traits are perhaps due to ontogenetic repatterning, yet without an obvious impact on the adult skull morphology (absence of morphological novelties). This might indicate a compartmentalized development. Further studies should be performed in order to establish the possible occurrence of recapitulatory patterns or ontogenetic repatterning in the skull morphogenesis of B. nicefori during its embryonic development.     

Biomechanical factors and physical examination findings in osteoarthritis of the knee: associations with tissue abnormalities assessed by conventional radiography and high-resolution 3.0 Tesla magnetic resonance imaging

Introduction

We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA.

Methods

This was an explorative cross-sectional study of 105 patients with knee OA. Index knees were imaged using CR and MRI. Multiple features from CR and MRI (cartilage, osteophytes, bone marrow lesions, effusion and synovitis) were related to biomechanical factors (quadriceps and hamstrings muscle strength, proprioceptive accuracy and varus-valgus laxity) and physical examination findings (bony tenderness, crepitus, bony enlargement and palpable warmth), using multivariable regression analyses.

Results

Quadriceps weakness was associated with cartilage integrity, effusion, synovitis (all detected by MRI) and CR-detected joint space narrowing. Knee joint laxity was associated with MRI-detected cartilage integrity, CR-detected joint space narrowing and osteophyte formation. Multiple tissue abnormalities including cartilage integrity, osteophytes and effusion, but only those detected by MRI, were found to be associated with physical examination findings such as crepitus.

Conclusion

We observed clinically relevant findings, including a significant association between quadriceps weakness and both effusion and synovitis, detected by MRI. Inflammation was detected in over one-third of the participants, emphasizing the inflammatory component of OA and a possible important role for anti-inflammatory therapies in knee OA. In general, OA-related tissue abnormalities of the knee, even those detected by MRI, were found to be discordant with biomechanical and physical examination features.     

Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologics Register

Introduction  

Anti-TNF therapies represent a breakthrough in the treatment of severe psoriatic arthritis. However, little is known about long-term drug persistence with these treatments in patients with psoriatic arthritis in routine clinical practice. The aim of this study was to assess persistence with first-course and second-course treatment with anti-TNF agents in a prospective cohort of psoriatic arthritis patients and to identify factors associated with and reasons for drug discontinuation.     

Acute effects of 17beta-estradiol on myocardial pH, Na+, and Ca2+ and ischemia-reperfusion injury

Evidence suggests that 1) ischemia-reperfusion injury is due largely to cytosolic Ca²⁺ accumulation resulting from functional coupling of Na⁺/Ca²⁺ exchange (NCE) with stimulated Na⁺/H⁺ exchange (NHE1) and 2) 17-estradiol (E2) stimulates release of NO, which inhibits NHE1. Thus we tested the hypothesis that acute E2 limits myocardial Na⁺ and therefore Ca²⁺ accumulation, thereby limiting ischemia-reperfusion injury. NMR was used to measure cytosolic pH (pH_i), Na⁺ (Na), and calcium concentration ([Ca²⁺]_i) in Krebs-Henseleit (KH)-perfused hearts from ovariectomized rats (OVX). Left ventricular developed pressure (LVDP) and lactate dehydrogenase (LDH) release were also measured. Control ischemia-reperfusion was 20 min of baseline perfusion, 40 min of global ischemia, and 40 min of reperfusion. The E2 protocol was identical, except that 1 nM E2 was included in the perfusate before ischemia and during reperfusion. E2 significantly limited the changes in pH_i, Na and [Ca²⁺]_i during ischemia (P < 0.05). In control OVX vs. OVX+E2, pH_i fell from 6.93 ± 0.03 to 5.98 ± 0.04 vs. 6.96 ± 0.04 to 6.68 ± 0.07; Na rose from 25 ± 6 to 109 ± 14 meq/kg dry wt vs. 25 ± 1 to 76 ± 3; [Ca²⁺]_i changed from 365 ± 69 to 1,248 ± 180 nM vs. 293 ± 66 to 202 ± 64 nM. E2 also improved recovery of LVDP and diminished release of LDH during reperfusion. Effects of E2 were diminished by 1 µM N-nitro-L-arginine methyl ester. Thus the data are consistent with the hypothesis. However, E2 limitation of increases in [Ca²⁺]_i is greater than can be accounted for by the thermodynamic effect of reduced Na accumulation on NCE. myocardial ischemia; Na⁺/H⁺ exchange; Na⁺/Ca²⁺ exchange; nuclear magnetic resonance; ischemic biology; ion channels/membrane transport; transplantation     

Hypertonic perfusion inhibits intracellular Na and Ca accumulation in hypoxic myocardium

Muchevidence supports the view that hypoxic/ischemic injury is largely dueto increased intracellular Ca concentration([Ca]_i) resulting from 1) decreasedintracellular pH (pH_i), 2) stimulated Na/H exchangethat increases Na uptake and thus intracellular Na (Na_i),and 3) decreased Na gradient that decreases or reverses net Catransport via Na/Ca exchange. The Na/H exchanger (NHE) is alsostimulated by hypertonic solutions; however, hypertonic media mayinhibit NHE's response to changes in pH_i (Cala PM and Maldonado HM. J Gen Physiol 103: 1035-1054, 1994). Thus wetested the hypothesis that hypertonic perfusion attenuates acid-induced increases in Na_i in myocardium and, thereby, decreasesCa_i accumulation during hypoxia. Rabbit hearts wereLangendorff perfused with HEPES-buffered Krebs-Henseleit solutionequilibrated with 100% O₂ or 100% N₂. Hypertonic perfusion began 5 min before hypoxia or normoxicacidification (NH₄Cl washout). Na_i,[Ca]_i, pH_i, and high-energyphosphates were measured by NMR. Control solutions were 295 mosM, andhypertonic solutions were adjusted to 305, 325, or 345 mosM by additionof NaCl or sucrose. During 60 min of hypoxia (295 mosM),Na_i rose from 22 ± 1 to 100 ± 10 meq/kg dry wt while[Ca]_i rose from 347 ± 11 to 1,306 ± 89 nM.During hypertonic hypoxic perfusion (325 mosM), increases inNa_i and [Ca]_i were reduced by 65 and 60%, respectively (P < 0.05). Hypertonicperfusion also diminished Na uptake after normoxic acidification by87% (P < 0.05). The data are consistent with the hypothesisthat mild hypertonic perfusion diminishes acid-induced Na accumulationand, thereby, decreases Na/Ca exchange-mediated Ca_iaccumulation during hypoxia.

     

Microbial diversity and complexity in hypersaline environments: A preliminary assessment

The microbial communities in solar salterns and a soda lake have been characterized using two techniques: BIOLOG, to estimate the metabolic potential, and amplicon length heterogeneity analysis, to estimate the molecular diversity of these communities. Both techniques demonstrated that the halophilic Bacteria and halophilic Archaea populations in the Eilat, Israel saltern are dynamic communities with extensive metabolic potentials and changing community structures. Halophilic Bacteria were detected in Mono Lake and the lower salinity ponds at the Shark Bay saltern in Western Australia, except when the crystallizer samples were stressed by exposure to Acid Green Dye #9899. At Shark Bay, halophilic Archaea were found only in the crystallizer samples. These data confirm both the metabolic diversity and the phylogenetic complexity of the microbial communities and assert the need to develop more versatile media for the cultivation of the diversity of bacteria in hypersaline environments. Journal of Industrial Microbiology & Biotechnology (2002) 28, 48–55 DOI: 10.1038/sj/jim/7000175 Received 20 May 2001/ Accepted in revised form 15 June 2001     

Chest wall and lung volume estimation by optical reflectance motion analysis

Cala, S. J., C. M. Kenyon, G. Ferrigno, P. Carnevali, A. Aliverti, A. Pedotti, P. T. Macklem, and D. F. Rochester. Chest wall and lung volume estimation by optical reflectance motion analysis.J. Appl. Physiol. 81(6):2680-2689, 1996.Estimation of chest wall motion by surfacemeasurements only allows one-dimensional measurements of the chestwall. We have assessed an optical reflectance system (OR), which tracksreflective markers in three dimensions (3-D) for respiratory use. Weused 86 (6-mm-diameter) hemispherical reflective markers arrangedcircumferentially on the chest wall in seven rows between the sternalnotch and the anterior superior iliac crest in two normal standingsubjects. We calculated the volume of the entire chest wall andcompared inspired and expired volumes with volumesobtained by spirometry. Marker positions were recorded by four TVcameras; two were 4 m in front of and two were 4 m behind the subject.The TV signals were sampled at 100 Hz and combined with gridcalibration parameters on a personal computer to obtain the 3-Dcoordinates of the markers. Chest wall surfaces were reconstructed bytriangulation through the point data, and chest wall volume wascalculated. During tidal breathing and vital capacity maneuvers andduring CO₂-stimulated hyperpnea, there was a very close correlation of the lung volumes(VL) estimated by spirometry[VL(SP)] and OR[VL(OR)]. Regressionequations of VL(OR)(y) vs.VL(SP)(x,BTPS in liters) for the two subjects were given by y = 1.01x  0.01 (r = 0.996) andy = 0.96x + 0.03 (r = 0.997), and byy = 1.04x + 0.25 (r = 0.97) andy = 0.98x + 0.14 (r = 0.95) for the two maneuvers,respectively. We conclude spirometric volumes can be estimated veryaccurately and directly from chest wall surface markers, and wespeculate that OR may be usefully applied to calculations of chest wallshape, regional volumes, and motion analysis.