Measurement and analysis of patient-reported outcomes.

The study of patient-reported outcomes, now common in clinical research, had its origins in social and scientific developments during the latter 20th century. Patient-reported outcomes comprise functional and health status, health-related quality of life, and quality of life. The terms overlap and are used inconsistently, and these reports of experience should be distinguished from expressions of preference regarding health states.

Baker cyst as seen on a PET/CT scan.

We present the case of a 48-year-old woman who had been diagnosed with multiple myeloma a year ago. She had persistent pain in her right knee that she tended to ignore. As part of her follow-up she underwent a PET/CT scan that did not show any metastatic lesions.

Rheumatoid lung disease as seen on PET/CT scan.

We present the case of a 63-year-old woman chronic smoker with a history of severe rheumatoid arthritis, who presented with dyspnea and cough. Her chest x-ray film and CT scan (as part of a PET/CT scan) showed multiple lung nodules and a left pleural effusion. A PET scan (as part of a PET/CT scan) revealed no uptake in the larger lung nodules and intense left pleural uptake.

Homocysteine lowering and cardiovascular disease risk: lost in translation.

Studies of the general population have suggested that high homocysteine levels are associated with cardiovascular morbidity and mortality. In chronic kidney disease, homocysteine levels rise, and cardiovascular risk increases with declining kidney function. While some studies in this population have found an association between elevated homocysteine and cardiovascular risk, others have noted that this association is largely attenuated by adjustment for kidney function, and several studies of patients with kidney failure have found that lower homocysteine levels predict mortality.

Calcium, phosphate, and parathyroid hormone levels in combination and as a function of dialysis duration predict mortality: evidence for the complexity of the association between mineral metabolism and outcomes.

Current literature suggests associations between abnormal mineral metabolism (MM) to cardiovascular disease in dialysis populations, with conflicting results. MM physiology is complex; therefore, it was hypothesized that constellations of MM parameters, reflecting this complexity, would be predictive of mortality and that this effect would be modified by dialysis duration (DD). Prevalent dialysis patients in British Columbia, Canada, who had measurements of calcium (Ca), phosphate (Pi), and parathyroid hormone (iPTH) between January and March 2000 were followed prospectively until December 2002.

Enhanced G protein-dependent modulation of excitatory synaptic transmission in the cerebellum of the Ca2+ channel-mutant mouse, tottering.

Tottering, a mouse model for absence epilepsy and cerebellar ataxia, carries a mutation in the gene encoding class A (P/Q-type) Ca2+ channels, the dominant exocytotic Ca2+ channel at most synapses in the mammalian central nervous system. Comparing tottering to wild-type mice, we have studied glutamatergic transmission between parallel fibres and Purkinje cells in cerebellar slices. Results from biochemical assays and electrical field recordings demonstrate that glutamate release from parallel fibre terminals of the tottering mouse is controlled largely by class B Ca2+ channels (N-type), in contrast to the P/Q-channels that dominate release from wild-type terminals.

Centenary of Gaule and Lewin, pioneers in cell counting methodology.

We commemorate the one hundredth anniversary of the publication of a pioneering paper on cell counting, by Gaule and Lewin. Their paper describes a new method for counting cells in tissue sections. First they found the mean number of cell profiles per cell by examining 50 selected cells in serial sections.

Race and self assessed health status: the role of socioeconomic factors in the USA.

Study Objective: To estimate relative odds ratios and to ascertain the relative contribution of each socioeconomic covariate in explaining racial disparities in self assessed health status (for example, global health perceptions and functional limitations of daily activities).

Design: National representative data from the 1987-88 national survey of families and households, a multistage, stratified probability sample of non-institutionalised American adults age 19 and older, were used. Logistic regression models enabled a multistage building strategy to be used in the analyses.

Function of dislocated hips in children with lower level spina bifida.

We reviewed 52 children, born between 1974 and 1985 with spina bifida affecting L3 and L4, who had dislocated hips. Their motor function was stable and they were able to walk at the time of dislocation. They were interviewed and examined physically and radiologically.

Summary of the WONCA/COOP International Health Assessment Field Trial. The Dartmouth COOP Primary Care Network.

This paper describes an international clinical feasibility trial conducted by WONCA in seven countries with the basic objective of increasing understanding of patient health. It was found that the Charts were understood by most patients and doctors found them useful. They produced good discrimination and different profiles for different conditions.

Production of interleukin-1-receptor antagonist during experimental endotoxaemia.

Interleukin-1 (IL-1) has been implicated in the pathogenesis of sepsis. IL-1-receptor antagonist (IL-1ra) is a naturally occurring inhibitor of IL-1 activity that competes with IL-1 for occupancy of cell-surface receptors but possesses no agonist activity. We induced endotoxaemia in 9 healthy human volunteers by injection of Escherichia coli endotoxin, and measured plasma concentrations of IL-1 and IL-1ra by radioimmunoassay during the next 24 h.

On the interaction of Trypanosoma cruzi neuraminidase and human lipoproteins.

Binding and penetration of Trypanosoma cruzi to host cells is a process that preludes infection and is mediated by specific recognition molecules. Neuraminidase is one of the parasite molecules involved in infection and, in this review, we describe some of its biochemical characteristics, its interaction with human lipoproteins and its effect on infection of mammalian cells.

Increased plasma noncortisol glucocorticoid activity in open-angle glaucoma.

Total biologic plasma glucocorticoid activity of normal, ocular hypertensive, and open-angle glaucoma patients was compared using a glucocorticoid receptor-based competitive binding assay. Multiple linear-regression analysis was used to adjust for the effects of significant ocular and nonocular variables, including therapy for glaucoma. The glaucoma patients had significantly greater plasma glucocorticoid activities than did normal subjects.

The visual field in chronic open angle glaucoma: the rate of change in different regions of the field.

Using automated perimetry the distribution of visual field loss in 40 chronic open angle glaucoma eyes (40 patients) was found to be predominantly in the nasal, supranasal, and superotemporal regions. The rate of change of visual field threshold values in seven regions of the field was measured by trend analysis over 44.9 +/- 17.