Search

Background: Bridging programs are offered to support migrated nurses, but in some countries, nurses can also choose to validate their nursing competence. Thus far, little is known about how migrated nurses estimate their competence when they are about to enter working life in a new country and how this differs from regular nursing students. Objective: To compare two groups of internationally educated nurses' - those from bridging programs and those who chose validation - and one group of regular nursing students' self-rated professional competence when they are about to start working as registered nurses. The hypotheses were: 1) internationally educated nurses rate their competence higher than regular nursing students and 2) those from bridging programs rate their competence higher than those who chose validation. In addition, the aim was to compare the groups' self-efficacy and thriving. Design: A cross-sectional, comparative design. Settings: Five universities in Sweden. Participants: Nurses educated in non-European countries from a bridging program (n = 128, response rate 79.0 %) or validation process (n = 61, response rate 59.2 %) and students graduating from the regular nursing program (n = 213, response rate 68.3 %). Methods: Data were collected with coded questionnaires (paper or online) between 2019 and 2021 and analyzed using non-parametric tests, e.g., Kruskal-Wallis. Results: Both groups of internationally educated nurses had higher median scores on total nursing competence (both groups p < 0.001), general self-efficacy (bridging programs p < 0.001, validation p = 0.020), and total thriving (bridging programs p < 0.001, validation p = 0.012) than regular nursing students did. However, comparing the groups of internationally educated nurses showed no significant differences. Conclusion: Internationally educated nurses rated their competence high but with differences within the groups for different competence areas. More research is needed to investigate whether the different paths are important for nurses' competence later in working life, and some of the competence areas might need extra attention when nurses start working.

Background:Malondialdehyde (MDA) is a highly reactive compound generated during lipid-peroxidation in conditions associated with oxidative stress. MDA can irreversibly modify proteins (e.g. lysine, arginine and histidine residues). In addition, acetaldehyde can further react with MDA adducts to form malondialdehyde-acetaldehyde (MAA) modification. Such protein modifications can lead to immunogenic neo-epitopes that are recognized by autoantibodies. In fact, anti-MDA/MAA IgG antibodies are significantly increased in the serum of patients with autoimmune diseases, such as rheumatoid arthritis (RA) (1). Interestingly, anti-MDA/MAA antibodies have been shown to promote osteoclast (OC) differentiation in vitro suggesting a potential role for these autoantibodies in bone damage associated with RA (1).Objectives:Little is known about the molecular mechanisms activated by autoantibodies in RA. Here, we elucidate the pathways specifically triggered by anti-MDA/MAA autoantibodies in developing osteoclasts.Methods:Recombinant human monoclonal anti-MDA/MAA antibodies, which were previously cloned from single synovial B cells of RA patients, were added to different OC assays. OCs were generated from monocyte-derived macrophages in the presence of the cytokines RANK-L and M-CSF. OC development was monitored by light microscopy following tartrate-resistant acid phosphatase staining and by erosion assays using calcium phosphate-coated plates. Bone morphometrics were studied in anti-MDA/MAA-injected mice using X-ray microscopy. Cellular metabolism was analyzed by mass spectrometry, Seahorse XF Analyzer and a colorimetric L-Lactate assay.Results:Anti-MDA/MAA antibodies induced a robust OC differentiation in vitro and bone loss in vivo. The anti-MDA/MAA antibodies acted on developing OCs by increasing glycolysis via an Fcγ receptor I-mediated pathway and the upregulation of the transcription factors HIF-1α, Myc and CHREBP. Such regulation of cellular metabolism was exclusively observed in the presence of the osteoclastogenic anti-MDA/MAA clones, whereas other RA-associated autoantibodies (anti-MDA/MAA or anti-citrullinated protein antibodies) had no effect on metabolism. The anti-MDA/MAA treatment induced a shift in the tricarboxylic acid (TCA) cycle activity in developing OCs, leading to the accumulation of citrate and aconitate.Conclusion:We described a novel type of autoantibody-induced pathway in RA, which might contribute to increased OC activation and a consequent bone loss. Anti-MDA/MAA antibodies promoted osteoclast development by increasing glycolysis and by modulating the TCA cycle through a signaling pathway that included Fcγ receptor I and a network of transcription factors acting on glycolysis. A TCA cycle bias towards citrate production suggests that the anti-MDA/MAA antibodies might stimulate OCs via increasing lipid biosynthesis in the cells.References:[1]Grönwall C. et al. J. Autoimmunity 84 (2017): 29-45.Acknowledgements:This Project has received funding from FOREUM, Foundation for Research in Rheumatology, from the European Research Council (ERC) grant agreement CoG 2017 - 7722209_PREVENT RA, the EU/EFPIA Innovative Medicine Initiative grant agreement 777357_RTCure, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse and Knut and Alice Wallenberg Foundation.Disclosure of Interests:Koji Sakuraba: None declared, Akilan Krishnamurthy: None declared, Alexandra Circiumaru: None declared, Vijay Joshua: None declared, Heidi Wähämaa: None declared, Marianne Engström: None declared, Meng Sun: None declared, Xiaowei Zheng: None declared, Cheng Xu: None declared, Khaled Amara: None declared, Vivianne Malmström Grant/research support from: collaboration with Pfizer, unrelated to the abstract, Sergiu-Bogdan Catrina: None declared, Caroline Grönwall: None declared, Bence Réthi: None declared, Anca Catrina Grant/research support from: collaboration with BMS and Pfizer, unrelated to the present abstract

The exploration of the unique properties of stored and cooled beams of highly-charged ions as provided by heavy-ion storage rings has opened novel and fascinating research opportunities in the realm of atomic and nuclear physics research. Since the late 1980s, pioneering work has been performed at the CRYRING at Stockholm (Abrahamsson et al. 1993) and at the Test Storage Ring (TSR) at Heidelberg (Baumann et al. 1988). For the heaviest ions in the highest charge-states, a real quantum jump was achieved in the early 1990s by the commissioning of the Experimental Storage Ring (ESR) at GSI Helmholtzzentrum fur Schwerionenforschung (GSI) in Darmstadt (Franzke 1987) where challenging experiments on the electron dynamics in the strong field regime as well as nuclear physics studies on exotic nuclei and at the borderline to atomic physics were performed. Meanwhile also at Lanzhou a heavy-ion storage ring has been taken in operation, exploiting the unique research opportunities in particular for medium-heavy ions and exotic nuclei (Xia et al. 2002).

Early dumping syndrome after gastric bypass surgery due to rapid delivery of hyperosmolar nutrients into the bowel causing intense symptoms is often described as a complication. Twelve patients, mean age 47 years, were interviewed approximately 9 years post-operation. The interviews were audiotaped and transcribed verbatim, followed by an inductive content analysis to reveal patients' experience of the dumping syndrome. The core category 'Dumping syndrome is a positive consequence of Roux-en-Y gastric bypass surgery and a tool to control food intake' was identified based on the following four sub-categories: (i) 'The multidimensional emergence and effects of dumping syndrome', (ii) 'Dumping syndrome as something positive although unpleasant', (iii) 'Developing coping mechanisms and ingenious strategies' and (iv) 'My own fault if I expose myself to dumping syndrome'. From the patients' perspective, dumping syndrome gives control over food intake; although the symptoms were unpleasant, patients considered dumping syndrome as a positive protection against over-consumption. Hence, healthcare professionals should not present dumping syndrome as a complication but rather as an aid to control eating behaviour and excessive food intake.

Objective: Anaemia in low-risk myelodysplastic syndromes (MDS) is associated with reduced quality of life (QoL). Response to treatment with erythropoietin +/- granulocyte colony-stimulating factor ...

Background and purpose: Substance P (SP) and calcitonin gene-related peptide (CGRP) released from capsaicin-sensitive sensory nerves induce local neurogenic inflammation; somatostatin exerts systemic anti-inflammatory actions presumably via sst4/sst1 receptors. This study investigates the effects of a high affinity, sst4-selective, synthetic agonist, J-2156, on sensory neuropeptide release in vitro and inflammatory processes in vivo. Experimental approach: Electrically-induced SP, CGRP and somatostatin release from isolated rat tracheae was measured with radioimmunoassay. Mustard oil-induced neurogenic inflammation in rat hindpaw skin was determined by Evans blue leakage and in the mouse ear with micrometry. Dextran-, carrageenan- or bradykinin-induced non-neurogenic inflammation was examined with plethysmometry or Evans blue, respectively. Adjuvant-induced chronic arthritis was assessed by plethysmometry and histological scoring. Granulocyte accumulation was determined with myeloperoxidase assay and IL-1β with ELISA. Key results: J-2156 (10–2000 nM) diminished electrically-evoked neuropeptide release in a concentration-dependent manner. EC50 for the inhibition of substance P, CGRP and somatostatin release were 11.6 nM, 14.3 nM and 110.7 nM, respectively. J-2156 (1–100 μg kg−1 i.p.) significantly, but not dose-dependently, inhibited neurogenic and non-neurogenic acute inflammatory processes and adjuvant-induced chronic oedema and arthritic changes. Endotoxin-evoked myeloperoxidase activity and IL-1β production in the lung, but not IL-1β- or zymosan-induced leukocyte accumulation in the skin were significantly diminished by J-2156. Conclusions and implications: J-2156 acting on sst4 receptors inhibits neuropeptide release, vascular components of acute inflammatory processes, endotoxin-induced granulocyte accumulation and IL-1β synthesis in the lung and synovial and inflammatory cells in chronic arthritis. Therefore it might be a promising lead for the development of novel anti-inflammatory drugs. British Journal of Pharmacology (2006) 149, 405–415. doi:10.1038/sj.bjp.0706876

Due to its practical relevance to conservation, considerable efforts have been devoted to understanding the effects of logging on orangutan (Pongo spp.) population densities. Despite these efforts, consistent patterns have yet to emerge. We conducted orangutan nest surveys and measured forest quality and disturbance level at 108 independent locations in 22 distinct sites in the forests of the Berau and East Kutai regencies of East Kalimantan, Indonesia. Survey locations varied substantially in orangutan density, forest structure, distance to villages, and logging intensity. We incorporated site-specific nest tree composition into our estimates of nest decay rates to reduce errors associated with inter-site differences in nest tree selection. Orangutan nest densities were uncorrelated with altitude, fig density, or any other ecological measure. Multivariate analyses demonstrated that densities were not significantly affected by logging intensity (at the relatively light levels we report here) or the distance to the nearest village, but were positively correlated with the distance from the nearest village known to hunt orangutans. These results indicate that provided hunting is absent, lightly to moderately degraded forests retain high conservation value for orangutans. Widespread incorporation of degraded areas into management plans for orangutan populations would substantially increase the size of populations that could be protected, and thereby improve their changes for long-term survival.

Background: There is no reliable technique for monitoring drug concentrations in totali.v. anaesthesia (TIVA) with muscle relaxation. An increased risk of awareness with TIVAhas been stated as a possible drawback (1, 2). The present study was conducted in order toassess the incidence of conscious awareness in TTVA based on propofol, alfentanil and neuromuscular blockade. Methods: One thousand patients anaesthetized with TIVA based on propofol, alfentanil, and neuromuscular blockade were subjected postoperatively to a structured interview for conscious awareness on two separate occasions: on discharge from the post-anaesthesia care unit, and the day after anaesthesia. Five hundred of these patientswere also interviewed a third time, approximately 1 week later. Results: Two cases of awareness were detected (0.2%). One of these was identified immediately after extubation. The second patient had no memory of intraoperative events or dreams at the first interview, recalled a bad dream on the day after, and had explicit recall of intraoperative events at the interview 8 days later. In both cases, haemodynamic signs of inadequate anaesthesia were present. The incidence of conscious awareness in this study is similar to the lowest previously reported incidence of awareness following general anaesthesia in patientswho had been paralyzed and thereafter subjected to a structured postanesthesia interview. Conclusions: If the true incidence of conscious awareness is to be determined, interviewsmust be extended beyond the first postoperative day. Our study indicates that if appropriate dosing of propofol and alfentanil are adhered to, and proper action is taken in case of haemodynamic alterations suggestive of inadequate anaesthesia, the incidence of conscious awareness in non-cardiac TIVA with neuromuscular blockade is low.

Vulnerable atherosclerotic plaques are structurally weak and prone to rupture, presumably due to local oxidative stress. Redox active iron is linked to oxidative stress and the aim of this study was to investigate the distribution of Fe(III) in carotid plaques and its relation to vulnerability for rupture.Atherosclerotic plaques from 10 patients (three asymptomatic and seven symptomatic) were investigated. Plaque vulnerability was classified using ultrasound and immunohistochemistry and correlated to Fe(III) measured by electron paramagnetic resonance spectroscopy.Large intra-plaque Fe(III) variations were found. Plaques from symptomatic patients had a higher Fe(III) concentration as compared with asymptomatic plaques (0.36 ± 0.21 vs. 0.06 ± 0.04 nmol Fe(III)/mg tissue, P 0.05, in sections adjoining narrowest part of the plaques). All but one plaque from symptomatic patients showed signs of cap rupture. No plaque from asymptomatic patients showed signs of cap rupture. There was a significant increase in cap macrophages in plaques from symptomatic patients compared with asymptomatic patients (31 ± 11% vs. 2.3 ± 2.3%, P 0.01).Fe(III) distribution varies substantially within atherosclerotic plaques. Plaques from symptomatic patients had significantly higher concentrations of Fe(III), signs of cap rupture and increased cap macrophage activity.

Leukotriene D4 (LTD4) has been found to induce calcium signalling in the intestinal epithelial cell line Int 407, and this action involves the activation of both different GTP-binding proteins (G-proteins) and phospholipase C of the gamma-subtype (PLC-gamma). With this knowledge as the incentive, we investigated the possible regulatory role of protein tyrosine kinase activities in the calcium signalling system of the LTD4 receptor. The tyrosine kinase inhibitors genistein and herbimycin. A both reduced the LTD4-induced calcium signal by 70% when Int 407 cells were stimulated in the presence of extracellular calcium, but had no effect on the signal when the cells were stimulated in a calcium-free medium. In accordance with these findings, pretreatment with a tyrosine kinase inhibitor also blocked thapsigargin-induced cellular influx of calcium. These inhibitors had no effect on the intracellular mobilisation of calcium, which was supported by the findings that LTD4 was able to induce an increase in the tyrosine phosphorylation of PLC-gamma even when one of the tyrosine kinase inhibitors was present. Of possible interest regarding the effect of genistein on LTD4-induced calcium influx is that two major tyrosine phosphorylated protein bands were detected in immunoprecipitates obtained with PLC-gamma antibodies from LTD4-stimulated cells. These proteins, which associate with PLC-gamma, have estimated molecular weights of 84 and 97 kD. Preincubation with genistein completely abolished the LTD4-induced increase in tyrosine phosphorylation of the major 97 kD band, whereas the 84 kD protein band, like the PLC-gamma band, still exhibited an increased phosphorylation of tyrosine residues in response to LTD4. Neither this effect nor any of the other effects of genistein were induced when cells were preincubated with daidzein, an inactive analogue of genistein. The present results suggest that LTD4-induced calcium signalling in epithelial cells involves not only tyrosine phosphorylation of PLC-gamma, but also a tyrosine kinase-dependent step which occurs downstream of PLC-gamma activation and is directly implicated in the regulation of agonist-mediated calcium influx.

To evaluate the treatment effect of prednisolone and/or valaciclovir in Bell's palsy patients with different baseline severity of palsy.Patient data were collected from the Scandinavian Bell's Palsy Study, a prospective, randomised, double-blind, placebo-controlled, multi-centre trial.Sixteen otorhinolaryngological centres in Sweden and one in Finland.Altogether, 829 patients aged 18-75 years were treated within 72 h of palsy onset. Patients were randomly assigned to treatment with prednisolone plus placebo (n = 210), valaciclovir plus placebo (n = 207), prednisolone plus valaciclovir (n = 206), placebo plus placebo (n = 206). Follow-up was 12 months.Facial function was assessed using the Sunnybrook grading scale at baseline and at 12 months. Complete recovery was defined as Sunnybrook score = 100.All patients, regardless of baseline severity, showed significantly higher complete recovery rates if treated with prednisolone compared with no prednisolone. In patients with severe palsy, recovery at 12 months was 51% with prednisolone treatment versus 31% without prednisolone (P = 0.02). Corresponding results were 68%versus 51% (P = 0.004) for moderate, and 83%versus 73% (P = 0.02) for mild palsy. In patient groups with moderate and mild palsy at baseline, significantly fewer prednisolone-treated patients had synkinesis at 12 months (P = 0.04 and P0.0001, respectively). For patients with severe palsy at baseline, prednisolone versus no prednisolone made no significant difference regarding synkinesis at 12 months. Valaciclovir did not add any significant effect to prednisolone regarding recovery rate or synkinesis at 12 months.Prednisolone treatment resulted in higher complete recovery rates, regardless of severity at baseline. Prednisolone treatment should be considered in all patients irrespective of degree of palsy.

Anaemia in low-risk myelodysplastic syndromes (MDS) is associated with reduced quality of life (QoL). Response to treatment with erythropoietin ± granulocyte colony-stimulating factor (G-CSF) is associated with improved QoL, but whether transfusion therapy with higher haemoglobin (Hb) target levels has similar effects is unknown. The objective for this prospective phase II Nordic multicentre trial was to assess QoL, response rate and physical function in elderly anaemic MDS patients treated to a target Hb level of120 g/L.Thirty-six elderly patients with low- and intermediate-1 risk MDS received darbepoetin (DA) 300 μg/wk, with the addition of G-CSF if no response. If the Hb target was reached at 16 wk, treatment was maintained until week 26. Remaining patients were transfused to reach the target level for at least 8 wk. Twenty-seven patients completed the study. Response rate to DA ± G-CSF was 67% in evaluable patients and 56% according to intention to treat. Eighteen patients reached the target Hb level according to protocol. QoL scores for fatigue, dyspnoea, constipation, and physical, role and social functioning improved significantly during study, with similar results for transfused and untransfused patients. Maintaining Hb120 g/L did not confer a higher transfusion rate, once the target was reached. In two of fourteen patients, magnetic resonance imaging T2* indicated cardiac iron overload, however, without association with ferritin levels.In elderly anaemic MDS patients, an increment in haemoglobin is associated with improved QoL, whether induced by growth factor treatment or transfusion therapy.

CRYRING is a small synchrotron and storage ring equipped with electron cooling. Highly charged ions from the electron beam ion source CRYSIS or singly charged ions from the plasmatron source MINIS are injected via an RFQ into the ring. The facility is in the commissioning phase. Full design energy has been achieved and electron cooling demonstrated both for atomic and molecular ions. The experimental program started in August with two projects, dissociative recombination of H+3 ions and radiative recombination to deuterons. The status as of September 20, 1992, is reported.

The aim of the present study was to describe dental hygienists' experiences of their physical and psychosocial work environment. The study was descriptive in design and used a qualitative approach. Eleven dental hygienists participated in the study and data were collected during spring 2008 using semi-structured interviews. The material was analysed using qualitative content analysis. The results showed that the dental hygienists experienced their work environment as motivating and facilitating, but at the same time as trying. The three categories revealed a theme: Being controlled in a modern environment characterized by good relationships. Motivating factors were the good relationship with co-workers, managers and patients, seeing the results of your work, having your own responsibility and making your own decisions. The new, pleasant and modern clinics, good cooperation between co-workers and varying duties were described as facilitating factors. The trying factors, as described by the dental hygienists, were above all being controlled by time limits or by some elements of the work, such as teamwork. The dental hygienists also felt stress because appointments were too-short. To conclude, the participants described their work environment as trying in several ways, despite the modern clinics and good relationships.

To examine the relationship between cardiovascular fitness (VO(2)max) and abdominal obesity (waist circumference) and individual cardiovascular disease (CVD) risk factors, as well as a clustered risk factor profile, and to study the impact of gender, age and smoking on these relationships.Cross-sectional.Astrand Laboratory of Work Physiology, Swedish School of Sport and Health Sciences, Stockholm, Sweden.Men (n = 781) and women (n = 890) from two random population-based samples of Swedish women and men aged 20 to 65 years.Odds ratios.Each unit of higher fitness was associated with a decrease in all individual risk factors ranging from 2% to 4% independent of waist circumference, each unit of higher waist circumference was associated with an increased risk ranging from 2% to 5% independent of fitness. For clustering of three or more of the risk factors, each unit of fitness was associated with a 5% decrease in risk and each unit of waist circumference with a 5% increase in risk. The clustered risk was higher in unfit participants who were older or smoked daily, regardless of waist circumference. Obese participants were at higher risk if they were men or older, regardless of fitness level. However, neither a higher fitness level nor lean status reduced the risk associated with smoking.Higher fitness and lower waist circumference are each independently associated to a similar extent with a lower CVD risk. Simultaneous evaluation of both fitness and abdominal obesity status in clinical practice is important.

Recombinant human activated protein C (rhAPC) is an anticoagulant that can be used for treatment of patients with severe sepsis. The use of rhAPC is accompanied by an increased risk of severe bleeding. Rotational thromboelastometry is a method for measuring the status of the coagulation. The aim of the study was to investigate whether rotational thromboelastometry could be used for monitoring the effects of rhAPC on the coagulation.Whole blood was mixed in vitro with concentrations of rhAPC ranging from 0 to 75 ng/ml and analysed with rotational thromboelastometry.The parameter Coagulation Time was significantly prolonged by increasing the concentrations of rhAPC (P=0.002). Other parameters were not significantly affected.rhAPC dose dependently affects the early humoral parts of the coagulation, while platelet function and fibrinogen to fibrin conversion seem virtually unaffected.

The Indonesian province of East Kalimantan is home to some of the largest remaining contiguous tracts of lowland Dipterocarp forest on the island of Borneo. Nest surveys recently conducted in these forests indicated the presence of a substantial population of Eastern Bornean orangutans (Pongo pygmaeus morio) in the Berau and East Kutai regencies in the northern half of the province. The Sangkulirang Peninsula contains extensive limestone karst forests in close proximity to the lowland Dipterocarp forests inhabited by orangutans in these regencies. Orangutans have been sighted in these limestone karst forests, but the importance of this forest type for orangutans has been unclear. Therefore, we conducted 49 km of nest surveys in limestone karst forest to obtain the first quantitative estimates of orangutan densities in this habitat, and walked 28 km of surveys in nearby lowland Dipterocarp forests for comparison. We also gathered basic ecological data along our transects in an attempt to identify correlates of orangutan abundance across these habitat types. Undisturbed limestone karst forests showed the lowest orangutan densities (147 nests/km2, 0.82 indiv/km2), disturbed limestone forests had intermediate densities (301 nests/km2, 1.40 indiv/km2), and undisturbed lowland Dipterocarp forests contained the highest density (987 nests/km2, 5.25 indiv/km2), significantly more than the undisturbed limestone karst forests. This difference was not correlated with variation in liana abundance, fig stem density, or stump density (an index of forest disturbance). Therefore, other factors, such as the relatively low tree species diversity of limestone karst forests, may explain why orangutans appear to avoid these areas. We conclude that limestone karst forests are of low relevance for safeguarding the future of orangutans in East Kalimantan. Am. J. Primatol. 69:1–8, 2007. © 2006 Wiley-Liss, Inc.

The experimental program at CRYRING storage ring began shortly after the installation of the electron cooler in May 1992. The performance of the ion sources and the ring is reported. Results of electron cooling are reviewed and a method to improve the efficiency of electron cooling is presented. >

To investigate the hypothesis that tumor necrosis factor alpha (TNFalpha) blockade in rheumatoid arthritis (RA) diminishes synovial synthesis of TNFalpha, interleukin-1alpha (IL-1alpha), and IL-1beta.Patients with active RA received a single 10 mg/kg infusion of infliximab. Multiple synovial biopsy specimens were obtained from a knee the day before infusion and 14 days later. A modified immunohistochemical method detecting cytokine-producing rather than cytokine-binding cells was applied to determine synthesis of TNFalpha, IL-1alpha, and IL-1beta in fixed, cryopreserved sections. Computerized image analysis using two different methodologies was performed by independent observers blinded to the identity of samples.All 8 patients met the American College of Rheumatology 20% improvement response criteria (ACR 20) at 2 weeks, and half of these patients met the ACR 50. With a few exceptions, there was concordance between both image analysis methodologies regarding the direction of change in immunopositive area fraction for all cytokines analyzed. TNFalpha synthesis was significantly reduced after treatment (P = 0.05 at the Karolinska Institute, Stockholm, Sweden; P = 0.008 at the Kennedy Institute, London, UK). Patients meeting the ACR 50 were those with the highest baseline levels of TNFalpha synthesis. There was a significant correlation between baseline levels of TNFalpha expression and change in TNFalpha levels in response to therapy. Both IL-1alpha and IL-1beta synthesis were reduced in 3 patients; IL-1alpha synthesis alone was reduced in 2 patients and IL-1beta synthesis alone was reduced in 2 patients. In 1 patient, neither IL-1alpha nor IL-1beta synthesis was reduced.Analysis of synovial tissue by means of immunomorphology and image analysis in a clinical trial setting may allow the drawing of biologically meaningful conclusions. Synovial TNFalpha synthesis was reduced 2 weeks after infliximab treatment. Reductions in IL-1alpha and IL-1beta synthesis were demonstrated in a subgroup of patients. High levels of synovial TNFalpha production prior to treatment may predict responsiveness to therapy.

Fifty percent of patients with clinically complete Bell’s palsy run the risk of suffering from sequelae, including persisting muscle weakness and dyskinesia (abnormal facial muscle movements). The pathophysiological event that causes facial dyskinesia and the location of the primary nerve injury in Bell’s palsy is unknown. It has been speculated that central (facial nucleus) hyperexcitability, ephaptic transmission along the facial nerve, or defect reinnervation (to false muscle) of the nerve fibers may be responsible for facial dyskinesias [2]. In the present study, gadolinium-enhanced MRI (GadMRI) and refined neurophysiological methods were used in an attempt to locate the primary nerve injury and get more information on the pathogenesis of facial dyskinesias in Bell’s palsy.

An inflammatory edema with secondary ischemia of the facial nerve may be the cause of Bell’s palsy [1, 5]. This may accord with the transient facial nerve enhancement on gadolinium-enhanced magnetic resonance imaging (GadMRI) that we recently have reported [4]. In this previous study [4] we used carbohydrate and gadolinium in an attempt to improve the GadMRI technique. The aim of the present preliminary study was to see if readministration of gadolinium may give additional information when examining patients with Bell’s palsy on high-Tesla MR equipment. Furthermore, we report our limited experience from three investigations using positron emission tomography (PET), a unique imaging technique which allows in vivo measurements of the anatomical distribution and rates of specific biochemical reactions [9].

The paranasal sinuses of 20 consecutive young adult patients with a complete Bell's palsy were investigated by magnetic resonance imaging (MRI) to obtain more information on the etiology of the disease. A high signal intensity on T2-weighted MRI was demonstrated in the paranasal sinuses, mainly the maxillary sinuses, in 12 of 20 (60%) patients in the early stage of Bell's palsy. Eleven of the 12 patients with positive MRI were followed up after 2 to 8 months (median 3 months), and in six of these, the bright signal intensity had disappeared, in two patients there was a regress, and in three patients the signal changes were persistent. The MRI findings indicate that transient inflammatory paranasal sinus disease, which may be caused by a viral and/or bacterial infection, infrequently may be associated with Bell's palsy. However, the relationship to the pathophysiologic process in Bell's palsy is still uncertain.

There has been no previous epidemiological study on anorexia nervosa (AN) and bulimia (BU) where non-medical care givers have also been included in the case-finding procedure. In this study, psychiatric, somatic, child psychiatric, social and primary care personnel were systematically asked for information on patients. Fifty-one cases of eating disorder (17 AN, 34 BU) according to slightly modified DSM-III criteria were traced in a suburban catchment area of 78,000 inhabitants during a two-year period. This means a two-year prevalence of 66/100,000 (22 AN and 44 BU). For females between 16-24 years the prevalence of AN was 258/100,000; BU: 473/100,000; total 730/100,000 (1/137). There were also 10 "possible cases" where the diagnosis could not be established with certainty, mainly because of insufficient information. If these patients were added, the number of cases would be 61 (or a prevalence of 79/100,000 inhabitants). The one-year incidence for AN was 2.6/100,000 and for BU 3.9. The incidence for AN was 43/100,000 for females 16-24 years old (1/2326). For BU it was 65/100,000 (1/1538). There seems to be no clear social class grouping. Twenty (56%) of the adult patients had been hospitalized for eating disorder during the last six-year period.

We evaluated the effect of sampling of capillary blood on filter paper on the later analysis for glucose. We found the method simple and reliable. Determination at the central laboratory of glucose in blood collected onto filter paper and comparison of the results with those obtained with test strips read in reflectometers at outpatient units is easy. Collecting duplicate samples on filter paper facilitates quality control by avoiding the complications that arise from using quality-control solutions that are not directly comparable with fresh blood, and it avoids the disturbances of test strip chemistry attributable to the glycolysis inhibitors added to blood samples intended for quality control.

We evaluated the effect of sampling of capillary blood on filter paper on the later analysis for glucose. We found the method simple and reliable. Determination at the central laboratory of glucose in blood collected onto filter paper and comparison of the results with those obtained with test strips read in reflectometers at outpatient units is easy. Collecting duplicate samples on filter paper facilitates quality control by avoiding the complications that arise from using quality-control solutions that are not directly comparable with fresh blood, and it avoids the disturbances of test strip chemistry attributable to the glycolysis inhibitors added to blood samples intended for quality control.

Male Wistar rats were exposed to ethylbenzene (0, 300, or 600 ppm for 6 h), and the metabolic fate of the compound was elucidated on the basis of the biotransformation products found in the urine. Fourteen different compounds thought to originate from ethylbenzene were identified. The main metabolites were 1-phenylethanol, mandelic acid, and benzoic acid. The metabolic conversion proceeded mainly through oxidation of the side chain, whereas ring oxidation seemed to be of minor importance. At the exposure level of 600 ppm, only 6% of the amount absorbed was eliminated in the urine during exposure. During the period of 48 h from the onset of exposure, the total urinary elimination was 59%. The corresponding values at 300 ppm were 13 and 83%.

Gas chromatographic methods have been developed for the urinalysis of metabolic products of ethylbenzene. "Minor" metabolites were emphasized in this process. The methods were worked out so that simultaneous determination of several compounds could be achieved with one method. On the whole, four assays are described, which together allow 12 different compounds to be measured. Since one of the methods presented can be applied to determine "minor" metabolites of xylene as well, methodological data for these are also reported. The methods described have successfully been used in metabolic studies of ethylbenzene in rat and man.

Comment inThe yin and yang of magnesium and calcium: New genetic insights for stroke? [Neurology. 2019]; International audience; Objective To determine whether serum magnesium and calcium concentrations are causally associated with ischemic stroke or any of its subtypes using the mendelian randomization approach. Methods Analyses were conducted using summary statistics data for 13 single-nucleotide polymorphisms robustly associated with serum magnesium (n = 6) or serum calcium (n = 7) concentrations. The corresponding data for ischemic stroke were obtained from the MEGASTROKE consortium (34,217 cases and 404,630 noncases). Results In standard mendelian randomization analysis, the odds ratios for each 0.1 mmol/L (about 1 SD) increase in genetically predicted serum magnesium concentrations were 0.78 (95% confidence interval [CI] 0.69-0.89; p = 1.3 × 10 −4) for all ischemic stroke, 0.63 (95% CI 0.50-0.80; p = 1.6 × 10 −4) for cardioembolic stroke, and 0.60 (95% CI 0.44-0.82; p = 0.001) for large artery stroke; there was no association with small vessel stroke (odds ratio 0.90, 95% CI 0.67-1.20; p = 0.46). Only the association with cardioembolic stroke was robust in sensitivity analyses. There was no association of genetically predicted serum calcium concentrations with all ischemic stroke (per 0.5 mg/dL [about 1 SD] increase in serum calcium: odds ratio 1.03, 95% CI 0.88-1.21) or with any subtype. Conclusions This study found that genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke but found no significant association of genetically higher serum calcium concentrations with any ischemic stroke subtype.