Connecting the Dots: A Rare Cause of Pulmonary Nodules in a 13-Year-Old Boy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140177/1/ped.2014.0392.pd

2016 ACR-EULAR adult dermatomyositis and polymyositis and juvenile dermatomyositis response criteria-methodological aspects

Objective. The objective was to describe the methodology used to develop new response criteria for adult DM/PM and JDM. Methods. Patient profiles from prospective natural history data and clinical trials were rated by myositis specialists to develop consensus gold-standard ratings of minimal, moderate and major improvement. Experts completed a survey regarding clinically meaningful improvement in the core set measures (CSM) and a conjoint-analysis survey (using 1000Minds software) to derive relative weights of CSM and candidate definitions. Six types of candidate definitions for response criteria were derived using survey results, logistic regression, conjoint analysis, application of conjoint-analysis weights to CSM and published definitions. Sensitivity, specificity and area under the curve were defined for candidate criteria using consensus patient profile data, and selected definitions were validated using clinical trial data. Results. Myositis specialists defined the degree of clinically meaningful improvement in CSM for minimal, moderate and major improvement. The conjoint-analysis survey established the relative weights of CSM, with muscle strength and Physician Global Activity as most important. Many candidate definitions showed excellent sensitivity, specificity and area under the curve in the consensus profiles. Trial validation showed that a number of candidate criteria differentiated between treatment groups. Top candidate criteria definitions were presented at the consensus conference. Conclusion. Consensus methodology, with definitions tested on patient profiles and validated using clinical trials, led to 18 definitions for adult PM/DM and 14 for JDM as excellent candidates for consideration in the final consensus on new response criteria for myositis

Combined effect of chronic bombesin and secretin or cholecystokinin on the rat pancreas

International audienceThis work investigates the pancreatico-trophic action of bombesin, a peptide stimulating pancreatic secretion in vivo and in vitro and examines whether this effect is altered by CCK or secretin. Rats were injected three times daily for 5 days either with saline, bombesin (1 or 10 μg/kg), CCK (20 I.D.U. kg), secretin (20 C.U./kg) or a combination of bombesin and CCK or secretin. Bombesin alone induced growth of the pancreas beginning with the dose of 10 μg/kg. This growth was characterized by an increase of pancreatic weight, its protein, RNA and enzyme content, but not of its DNA content. The ratios of the three former parameters to DNA increased, suggesting cellular hypertrophy. Cholecystokinin alone exhibited a similar trophic action on the pancreas as bombesin. Secretin alone had no effect on pancreatic size and composition. Cholecystokinin and secretin did not modify the pancreatico-trophic response of bombesin. These findings suggest that bombesin, administered for 5 days in the rat, induces pancreatic growth due to cellular hypertrophy. Cholecystokinin has the same effect. However the mode of action, at the cellular level, of bombesin appears to be different from that of cholecystokinin

Trophic effect of bombesin on the rat pancreas: is it mediated by the release of gastrin or cholecystokinin?

International audienceWe investigated the role of low-doses of bombesin in the regulation of exocrine secretion in the pancreas of the conscious pig. In ten growing castrated male Large White pigs, bombesin was infused intravenously for 1 h at doses of 0 to 500 pmol/kg/h under a stimulation of secretin (36 pmol/kg/h). In six pigs, bombesin (50 pmol/kg/h) was administered alone for 2 h and its effect on pancreatic secretion was compared to that of an infusion of secretin. The pancreatic juice and the blood were collected at 15-min intervals for use in assays of protein in the juice and gastrin in the plasma. When bombesin was infused alone or in combination with secretin, the volume secreted was not altered. The protein output was not altered by secretin, but was increased by the infusion of bombesin, in a dose-dependent manner, reaching a plateau at 250 pmol/kg/h. The plasma gastrin levels were increased by bombesin, starting with the 50 pmol/kg/h dose. This effect was maximal at a dose of 100 pmol/kg/h. The levels remained below those measured after a standard meal, demonstrating that the effect of bombesin on the studied parameters is of physiological significance