The effect of estrogen-containing birth control pills on the constituents of bradykinin expression in plasma.

Background: Hereditary angioedema with C1-inhibitor deficiency (HAE-C1INH) is a rare autosomal disorder presenting with recurrent angioedema. Estrogen-containing medications trigger angioedema in some patients, and conversely, progesterone may decrease attack frequency. The mechanism by which estrogen may exacerbate angioedema in HAE-C1INH is not well characterized.

Inflammatory markers in world trade center workers with asthma: Associations with post traumatic stress disorder.

Background: Post-traumatic stress disorders (PTSD) is associated with worse asthma outcomes in individuals exposed to the World Trade Center (WTC) site.

Research Question: Do WTC workers with coexisting PTSD and asthma have a specific inflammatory pattern that underlies the relationship with increased asthma morbidity?

Study Design And Methods: We collected data on a cohort of WTC workers with asthma recruited from the WTC Health Program. Diagnosis of PTSD was ascertained with a Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders) and the severity of PTSD symptoms was assessed with the PTSD Checklist 5.

A Feeding-Related Mechanoreceptor Identified in the Crab Shares Similarities and Differences with Homologs in Other Crustaceans.

AbstractSensory feedback plays an essential role in shaping rhythmic animal movements. In the crustacean stomatogastric nervous system, which is responsible for grinding and filtering food particles in the animal's foregut, a number of mechanoreceptors whose activity affects motor output have been characterized. The hepatopancreas duct receptor neurons, which are located in the pyloric region of the foregut that is responsible for filtering, are among the less well understood groups of stomatogastric mechanoreceptors.

Approaches In Carcinogenicity Hazard Assessment: Current Status and Future Needs.

Historically, identifying carcinogens has relied primarily on tumor studies in rodents, which require enormous resources in both money and time. models have been developed for predicting rodent carcinogens but have not yet found general regulatory acceptance, in part due to the lack of a generally accepted protocol for performing such an assessment as well as limitations in predictive performance and scope. There remains a need for additional, improved carcinogenicity models, especially ones that are more human-relevant, for use in research and regulatory decision-making.

The Effect of Age on T-Regulatory Cell Number and Function in Patients With Asthma.

T-regulatory cells (Tregs) play a key role in suppressing effector cells and maintaining self-tolerance. Studies of younger adults and children suggest that insufficient differentiation and functional defects of Tregs may contribute to the development of asthma; however, data from older patients with asthma are limited. To address the effects of aging on the relationship of Treg frequency and function with clinical outcomes, we collected induced sputum (differential cell count and Treg frequency) and peripheral blood (Treg function and frequency) from aged (> 60 years of age) and younger (20-40 years old) patients with asthma.

Dual modulatory effects on feedback from a proprioceptor in the crustacean stomatogastric nervous system.

Neuromodulatory actions that change the properties of proprioceptors or the muscle movements to which they respond necessarily affect the feedback provided to the central network. Here we further characterize the responses of the gastropyloric receptor 1 (GPR1) and gastropyloric receptor 2 (GPR2) neurons in the stomatogastric nervous system of the crab to movements and contractions of muscles, and we report how neuromodulation modifies those responses. We observed that the GPR1 response to contractions of the gastric mill 4 muscle (gm4) was absent, or nearly so, when the neuron was quiescent but robust when it was spontaneously active.

Emergent high fatality lung disease in systemic juvenile arthritis.

Objective: To investigate the characteristics and risk factors of a novel parenchymal lung disease (LD), increasingly detected in systemic juvenile idiopathic arthritis (sJIA).

Methods: In a multicentre retrospective study, 61 cases were investigated using physician-reported clinical information and centralised analyses of radiological, pathological and genetic data.

Results: LD was associated with distinctive features, including acute erythematous clubbing and a high frequency of anaphylactic reactions to the interleukin (IL)-6 inhibitor, tocilizumab.

Comparison of the Effects of a Pharmaceutical Industry Decision Guide and Decision Aids on Patient Choice to Intensify Therapy in Rheumatoid Arthritis.

Objective: To compare the effects a pharmaceutical industry decision guide and International Patient Decision Aids Standard (IPDAS) compliant patient decision aids (PtDA) on patient medication beliefs and choice to intensify therapy.

Methods: Rheumatoid arthritis (RA) patients, who had never taken etanercept (Enbrel), took part in a mail survey. They were presented with a hypothetical decision scenario where they were asked to consider adding etanercept to their current regimen.

Effect of aging on sputum inflammation and asthma control.

Background: Aged asthmatic patients experience increased morbidity and mortality. Knowledge of the aging effect on airway inflammation and asthma control is limited.

Objective: We sought to compare airway inflammation and its relationship to asthma control in aged versus younger patients and determine whether differences are asthma specific or caused by "inflamm-aging.

Incorporating spike-rate adaptation into a rate code in mathematical and biological neurons.

For a slowly varying stimulus, the simplest relationship between a neuron's input and output is a rate code, in which the spike rate is a unique function of the stimulus at that instant. In the case of spike-rate adaptation, there is no unique relationship between input and output, because the spike rate at any time depends both on the instantaneous stimulus and on prior spiking (the "history"). To improve the decoding of spike trains produced by neurons that show spike-rate adaptation, we developed a simple scheme that incorporates "history" into a rate code.

Case management directors: how to manage in a transition-focused world: part 2.

Purpose And Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role.

Case management directors: how to manage in a transition-focused world: part 1.

Purpose And Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role.

A framework of pediatric hospital discharge care informed by legislation, research, and practice.

To our knowledge, no widely used pediatric standards for hospital discharge care exist, despite nearly 10 000 pediatric discharges per day in the United States. This lack of standards undermines the quality of pediatric hospital discharge, hinders quality-improvement efforts, and adversely affects the health and well-being of children and their families after they leave the hospital. In this article, we first review guidance regarding the discharge process for adult patients, including federal law within the Social Security Act that outlines standards for hospital discharge; a variety of toolkits that aim to improve discharge care; and the research evidence that supports the discharge process.

High dose Anakinra for treatment of severe neonatal Kawasaki disease: a case report.

We report an 11-week-old female who presented with Kawasaki disease (KD) complicated by macrophage activation syndrome (MAS). The infant presented to the hospital with persistent fever, cough, diarrhea, and emesis, among other symptoms. Her condition quickly began to decompensate, and she developed classic features (conjunctivitis, rash, cracked lips, distal extremity edema) prompting a diagnosis of acute KD.

Influenza A infection enhances antigen-induced airway inflammation and hyperresponsiveness in young but not aged mice.

Background: Although morbidity and mortality rates from asthma are highest in patients > 65 years of age, the effect of older age on airway inflammation in asthma is not well established.

Objective: To investigate age-related differences in the promotion of allergic inflammation after influenza A viral respiratory infection on antigen-specific IgE production, antigen-induced airway inflammation and airway hyperresponsiveness in mice.

Methods: To accomplish this objective, the following model system was used.

Randomized, double-blind, placebo-controlled trial of the efficacy and safety of rilonacept in the treatment of systemic juvenile idiopathic arthritis.

Objective: To assess the efficacy and safety of rilonacept, an interleukin-1 inhibitor, in a randomized, double-blind, placebo-controlled trial.

Methods: An initial 4-week double-blind placebo phase was incorporated into a 24-week randomized multicenter design, followed by an open-label phase. Seventy-one children who had active arthritis in ≥2 joints were randomized (1:1) to the 2 arms of the study.

Therapeutic role of anakinra, an interleukin-1 receptor antagonist, in the management of secondary hemophagocytic lymphohistiocytosis/sepsis/multiple organ dysfunction/macrophage activating syndrome in critically ill children*.

Objectives: Secondary hemophagocytic lymphohistiocytosis, macrophage activating syndrome, and sepsis share the same inflammatory phenotype leading often to multiple organ dysfunction syndrome needing intensive care. The goal of this article is to describe our experience with anakinra (Kineret), a recombinant interleukin-1 receptor antagonist, in decreasing the systemic inflammation.

Design: Retrospective case series.

Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug.

Background: The causes of the underutilization of disease modifying anti-rheumatic drugs (DMARDS) for rheumatoid arthritis (RA) are not fully known, but may in part, relate to individual patient factors including risk perception. Our objective was to identify the determinants of risk perception (RP) in RA patients and predictors of their willingness to take a proposed DMARD (DMARD willingness).

Methods: A cross-sectional mail survey of RA patients in a community rheumatology practice.

Modifying spiking precision in conductance-based neuronal models.

The temporal precision of a neuron's spiking can be characterized by calculating its "jitter," defined as the standard deviation of the timing of individual spikes in response to repeated presentations of a stimulus. Sub-millisecond jitters have been measured for neurons in a variety of experimental systems and appear to be functionally important in some instances. We have investigated how modifying a neuron's maximal conductances affects jitter using the leaky integrate-and-fire (LIF) model and an eight-conductance Hodgkin-Huxley type (HH8) model.

Preventing readmissions through comprehensive discharge planning.

Unlabelled: Case managers, including nurses and social workers, provide essential services to hospitalized patients, including mandated discharge planning that has been shown to impact patient safety and patient outcomes. The heightened attention to readmission is evident in both reimbursement and accreditation initiatives. The Centers for Medicare & Medicaid Services, Office of Clinical Standards & Quality/Survey & Certification Group, is revising worksheets to be used by surveyors to review how hospitals are complying with the Medicare Conditions of Participation with a focus on discharge planning as it relates to patient safety.

Quantification and analysis of ecdysis in the hornworm, Manduca sexta, using machine vision-based tracking.

We have developed a machine vision-based method for automatically tracking deformations in the body wall to monitor ecdysis behaviors in the hornworm, Manduca sexta. The method utilizes naturally occurring features on the animal's body (spiracles) and is highly accurate (>95 % success in tracking). Moreover, it is robust to unanticipated changes in the animal's position and in lighting, and in the event tracking of specific features is lost, tracking can be reestablished within a few cycles without input from the user.

Effects of intraarticular IL1-Ra for acute anterior cruciate ligament knee injury: a randomized controlled pilot trial (NCT00332254).

Objective: To evaluate the clinical effectiveness of intraarticular IL-1 receptor antagonist (IL-1Ra) for anterior cruciate ligament (ACL) tear.

Methods: Eleven patients with acute ACL tear confirmed by magnetic resonance imaging (MRI) were randomized to receive a single intraarticular injection of IL-1Ra (anakinra 150 mg, n = 6) or equal volume of saline placebo (1 ml, n = 5). The double-blinded treatment was administered a mean 2 weeks after injury.

Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: report of forty-six patients from an international multicenter series.

Objective: To examine the safety and efficacy of the interleukin-1 (IL-1) receptor antagonist anakinra as first-line therapy for systemic juvenile idiopathic arthritis (JIA).

Methods: Patients with systemic JIA receiving anakinra as part of initial disease-modifying antirheumatic drug (DMARD) therapy were identified from 11 centers in 4 countries. Medical records were abstracted using a standardized instrument, and resulting data were analyzed to characterize concomitant therapies, clinical course, adverse events, and predictors of outcome.