Infusion of plasma-derived mannan-binding lectin (MBL) into MBL-deficient humans.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOur first experience of mannan-binding lectin (MBL)-replacement therapy was with a patient experiencing recurrent erythema multiforme associated with reactivation of herpes simplex virus; his erythematous eruptions could be controlled with infusions of fresh frozen plasma containing MBL, but not with plasma lacking MBL. Some years later, we treated a young girl with recurrent, debilitating infections with purified MBL; this was also followed by a dramatic clinical improvement. We have now carried out a phase I clinical trial on 20 MBL-deficient, but healthy, adult volunteers. The MBL was prepared by the State Serum Institute in Copenhagen, Denmark, from blood donor plasma. Each volunteer received a total of 18 mg of MBL in three 6-mg doses given intravenously once a week over 3 weeks. The volunteers were monitored closely after each infusion and no adverse clinical or laboratory effects were observed. Laboratory parameters included C-reactive protein, various complement components, and antibodies to MBL, HIV and hepatitis viruses. C3a (the anaphylotoxin derived from complement component C3) was monitored for signs of complement activation, but no significant infusion-associated fluctuations were observed. Serum levels of MBL after each 6-mg infusion ranged between 1200 and 2500 ng/ml. The half-life of the infused MBL was about 70 h, or 3 days. It was concluded that infusion of purified MBL manufactured by the Danish State Serum Institute is a safe procedure. However, adults may have to be given 6 mg or more at least twice weekly to maintain protective plasma MBL levels in MBL-deficient individuals

The role of the palatine tonsils in the pathogenesis and treatment of psoriasis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96289/1/bjd11215.pd

Spontaneous subarachnoid haemorrhage : review

Spontaneous subarachnoid hemorrhage is a bleeding in to the subarachnoid space without trauma. Aneurysms are the underlying cause in 80% of the cases. Among other causes are: arteriovenous malformations, anticoagulation, vasculitis or brain tumor. Spontaneous subarachnoid hemorrhage is a serious disease, where up to half of the patients die. Of those who survive, only half return to work and many have a reduced quality of life. To prevent rebleeding the aneurysm is closed either with endovascular coiling or neurosurgical clipping.Sjálfsprottin innanskúmsblæðing er blæðing inn í innanskúmshol án þess að um áverka sé að ræða. Æðagúlar eru orsökin í 80% tilfella. Aðrar ástæður eru æðamissmíð, blóðþynningarmeðferð, æðabólga og æxli í heilavef. Sjálfsprottin innanskúmsblæðing er algengasta ástæða heilablóðfalls hjá ungu fólki. Nálægt helmingur sjúklinga deyr af völdum sjúkdómsins. Af þeim sem lifa af kemst aðeins helmingur í fulla vinnu aftur og margir búa við skert lífsgæði. Í endurblæðingu felst mesta bráðahættan. Því beinast fyrstu viðbrögð að lokun æðagúlsins, annaðhvort með innanæðahnoðrun með platínuþráðum, eða klemma er sett á æðagúlinn með taugaskurðaðgerð

Spontaneus intracerebral haemhorrhage--review

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnSjálfsprottin heilavefsblæðing (spontaneous intracerebral hemorrhage) er blæðing inn í heilavefinn án þess að um ytri áverka sé að ræða. Milli 10 og 15% allra heilablóðfalla stafa af henni. Árlega veikjast um 30-50 einstaklingar af heilavefsblæðingu á Íslandi. Dánartíðnin er afar há (30 daga dánartíðni er 25-50%). Háþrýstingur er algengasta orsökin en ávallt ber að hafa í huga sértækari orsakir, sér í lagi hjá yngra fólki. Ekki hefur verið sýnt fram á árangur af skurðaðgerðum nema í sérstökum tilvikum eins og stórum blæðingum í litlaheila. Hins vegar er afar mikilvægt að sjúklingar með heilavefsblæðingu séu vistaðir á gjörgæsludeildum eða heilablóðfallseiningum þar sem viðhaft er nákvæmt eftirlit með vökustigi, taugaeinkennum, blóðþrýstingi og vökvabúskap. ---------------------------------- Spontaneous intracerebral hemorrhage occurs when a blood vessel within the brain parenchyma ruptures without a near related trauma. It is the second most common form of stroke, accounting for approximately 10% to 15% of new strokes. The 30 day mortality is very high (25-50%). Hypertension is the most common cause. Unfortunately, surgery has not proven to be helpful except in certain exceptions such as in large cerebellar hemorrhage. Nonetheless, it is very important that patients with ICH are admitted to an intensive care or a stroke unit with close surveillance of consciousness, focal neurologic symptoms, blood pressure and fluid balance

Vaccination of COPD patients with a pneumococcus type 6B tetanus toxoid conjugate vaccine

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldThis paper examines how pneumococcal type 6B polysaccharide conjugated to tetanus toxoid (Pn6B-TT) compares to a 23 valent pneumococcal vaccine (pneumococcal polysaccharide (PPS)-23) with respect to immunogenicity and serum opsonic activity in patients with chronic obstructive pulmonary disease (COPD). Patients with COPD aged 55-75 yrs were vaccinated with Pn6B-TT (n=10) or with PPS-23 (n=9). Healthy young adults (HA) were vaccinated with Pn6B-TT as controls. Total antibodies to serotype 6B polysaccharide were measured by radioimmunoassay and immunoglobulin (Ig)G antibodies by enzyme-linked immunosorbent assay. Opsonic activity was measured by a phagocytosis assay using human neutrophils as effector cells. The patient groups were comparable by age, smoking history, lung function and use of steroids. COPD patients vaccinated with Pn6B-TT or PPS-23 showed an increase in IgG antibodies and a nonsignificant increase in opsonic activity. This was similar to the increase in IgG and opsonic activity seen in HA. There was a significant correlation between antibody levels and opsonic activity in COPD patients vaccinated both with Pn6B-TT and PPS-23. Pneumococcal antibodies have been shown to confer protection from infection. The results of the present study indicate that protective immunity can be expected in elderly chronic obstructive pulmonary disease patients vaccinated with conjugate vaccines

Leucocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women.

Problem We investigated leukocyte and lymphocyte subsets in HIV-infected or HIV-uninfected, pregnant or non-pregnant Malawian women to explore whether HIV infection and pregnancy may act synergistically to impair cellular immunity. Method of study We recruited 54 pregnant and 48 non-pregnant HIV-uninfected women and 24 pregnant and 20 non-pregnant HIV-infected Malawian women. We compared peripheral blood leukocyte and lymphocyte subsets between women in the four groups. Results Parturient HIV-infected and HIV-uninfected women had more neutrophils (each P<.0001), but fewer lymphocytes (P<.0001; P=.0014) than non-pregnant women. Both groups had fewer total T cells (P<.0001; P=.002) and CD8+ T cells (P<.0001; P=.014) than non-pregnant women. HIV-uninfected parturient women had fewer CD4+ and γδ T cells, B and NK cells (each P<.0001) than non-pregnant women. Lymphocyte subset percentages were not affected by pregnancy. Conclusion Malawian women at parturition have an increased total white cell count due to neutrophilia and an HIV-unrelated pan-lymphopenia

Recent changes in the surface salinity of the North Atlantic subpolar gyre

Sea surface salinity (SSS) was measured since 1896 along 60°N between Greenland and the North Sea and since 1993 between Iceland and Newfoundland. Along 60°N away from the shelves, and north of 53°N, the amplitude of the seasonal cycle is comparable to or less than interannual variability. In these parts of the North Atlantic subpolar gyre, large-scale deviations from the seasonal cycle correlate from one season to the next. This suggests that in these regions, summer and autumn surface data are useful for monitoring changes in upper ocean salinity best diagnosed from less common winter surface data. Further south near the subarctic front, the Labrador Current or near shelves where seasonal variability is strong, this is not the case. Along 60°N, the multiannual low-frequency variability is well correlated across the basin and exhibits fresher surface water since the mid 1970s than in the late 1920s to 1960s. SSS in the Irminger Sea along 60°N lags by 1-year SSS farther east in the Iceland Basin. Variability between Iceland and Newfoundland within the Irminger Sea north of 54°N presents similar characteristics to what is observed along 60°N. Variability near the northwest corner of the North Atlantic Current (52°N/45°W) is larger and is not correlated to what is found further north. Maps of SSS were constructed for a few recent seasons between July 1996 and June 2000, which illustrate the fresh conditions found usually during that period across the whole North Atlantic subpolar gyre, although this includes an episode of higher salinity. The SSS anomaly maps have large uncertainties but suggest that the highest SSS occurred before the spring of 1998 in the Iceland Basin, and after that, in the Irminger Sea. This is followed by fresher conditions, first in the Labrador and Iceland Basin, reaching recently the Irminger Sea

HLA-Cw*0602 associates with a twofold higher prevalence of positive streptococcal throat swab at the onset of psoriasis: a case control study

<p>Abstract</p> <p>Background</p> <p>The influence of streptococcal infections in the pathogenesis of psoriasis is not yet understood. <it>In vitro </it>data suggest that streptococcal factors influence T-cell function in psoriasis in a HLA-dependent manner, but studies designed to measure the HLA-C/Streptococci interaction are lacking. In the present study, we hypothesized that there is a statistical interaction between the result of streptococcal throat cultures and the presence of the HLA-Cw*0602 allele in psoriasis patients.</p> <p>Methods</p> <p>We performed a case control study using the "Stockholm Psoriasis Cohort" consisting of patients consecutively recruited within 12 months of disease onset (Plaque psoriasis = 439, Guttate psoriasis = 143), matched to healthy controls (n = 454) randomly chosen from the Swedish Population Registry. All individuals underwent physical examination including throat swabs and DNA isolation for HLA-Cw*0602 genotyping.</p> <p>The prevalence of positive streptococcal throat swabs and HLA-Cw*0602 was compared between patients and controls and expressed as odds ratios with 95% confidence intervals. Associations were evaluated separately for guttate and plaque psoriasis by Fisher's exact test.</p> <p>Results</p> <p>Regardless of disease phenotype, the prevalence of positive streptococcal throat swabs in HLA-Cw*0602 positive patients was twice the prevalence among HLA-Cw*0602 negative patients (OR = 5.8 C.I. = 3.57–9.67, p < 0.001), while no difference was observed among Cw*0602 positive versus negative controls.</p> <p>The corresponding odds ratios for the guttate and plaque psoriasis phenotypes were 3.5 (CI = 1.5–8.7, p = 0.01) and 2.3 (CI = 1.0–5.1, p = 0.02) respectively.</p> <p>Conclusion</p> <p>These findings suggest that among HLA-Cw*0602 positive psoriasis patients, streptococci may contribute to the onset or exacerbation of the inflammatory process independent of the disease phenotype. However, studies on the functional interaction between HLA-C and streptococcal factors are needed.</p

Ocean circulation causes the largest freshening event for 120 years in eastern subpolar North Atlantic

The Atlantic Ocean overturning circulation is important to the climate system because it carries heat and carbon northward, and from the surface to the deep ocean. The high salinity of the subpolar North Atlantic is a prerequisite for overturning circulation, and strong freshening could herald a slowdown. We show that the eastern subpolar North Atlantic underwent extreme freshening during 2012 to 2016, with a magnitude never seen before in 120 years of measurements. The cause was unusual winter wind patterns driving major changes in ocean circulation, including slowing of the North Atlantic Current and diversion of Arctic freshwater from the western boundary into the eastern basins. We find that wind-driven routing of Arctic-origin freshwater intimately links conditions on the North West Atlantic shelf and slope region with the eastern subpolar basins. This reveals the importance of atmospheric forcing of intra-basin circulation in determining the salinity of the subpolar North Atlantic

The mode of school transportation in pre-pubertal children does not influence the accrual of bone mineral or the gain in bone size - two year prospective data from the paediatric osteoporosis preventive (POP) study

<p>Abstract</p> <p>Background</p> <p>Walking and cycling to school are one source of regular physical activity. The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content (BMC) and bone width than when going by car or bus.</p> <p>Methods</p> <p>133 boys and 99 girls aged 7-9 years were recruited to the Malmö Prospective Paediatric Osteoporosis Prevention (POP) study. BMC (g) was measured by dual X-ray absorptiometry (DXA) in total body, lumbar spine (L2-L4) and femoral neck (FN) at baseline and after 24 months. Bone width was measured in L2-L4 and FN. Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car. All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and questionnaires. Comparisons were made by independent student's t-tests between means and Fisher's exact tests. Analysis of covariance (ANCOVA) was used to adjust for group differences in age at baseline, duration of organized physical activity, annual changes in length and BMC or bone width if there were differences in these traits at baseline.</p> <p>Results</p> <p>After the adjustments, there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus. Furthermore, there were no differences in the levels of everyday physical activity objectively measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day.</p> <p>Conclusion</p> <p>A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation, possibly due to the fact that the everyday physical activity in these pre-pubertal children, independent of the mode of school transportation, was high.</p