Antibodies against gonadotropin-releasing hormone (GnRH) and destruction of enteric neurons in 3 patients suffering from gastrointestinal dysfunction

Background: Antibodies against gonadotropin-releasing hormone (GnRH) and gastrointestinal dysmotility have been found after treatment with GnRH analogues. The aim of this study was to examine the presence of such antibodies in patients with dysmotility not subjected to GnRH treatment and study the anti-GnRH antibody effect on enteric neurons viability in vitro. Methods: Plasma and sera from 3 patients suffering from either enteric dysmotility, irritable bowel syndrome (IBS) or gastroparesis were analysed for C-reactive protein (CRP), and for GnRH antibodies and soluble CD40 by ELISA methods. Primary cultures of small intestinal myenteric neurons were prepared from rats. Neuronal survival was determined after the addition of sera either from the patients with dysmotility, from healthy blood donors, antiserum raised against GnRH or the GnRH analogue buserelin. Only for case 1 a full-thickness bowel wall biopsy was available for immunohistochemical analysis. Results: All 3 patients expressed antibodies against GnRH. The antibody titer correlated to the levels of CD40 (r(s) = 1.000, p < 0.01), but not to CRP. Serum from case 3 with highest anti-GnRH antibody titer, and serum concentrations of sCD40 and CRP, when added to cultured rat myenteric neurons caused remarkable cell death. In contrast, serum from cases 1 and 2 having lower anti-GnRH antibody titer and lower sCD40 levels had no significant effect. Importantly, commercial antibodies against GnRH showed no effect on neuron viability whereas buserelin exerted a protective effect. The full-thickness biopsy from the bowel wall of case 1 showed ganglioneuritis and decrease of GnRH and GnRH receptor. Conclusion: Autoantibodies against GnRH can be detected independently on treatment of GnRH analogue. Whether the generation of the antibody is directly linked to neuron degeneration and chronic gastrointestinal symptoms in patients with intestinal dysmotility, remains to be answered

Risk factors and in-hospital outcomes in stroke and myocardial infarction patients

BACKGROUND: Acute stroke (AS) and acute myocardial infarction (AMI) share major risk factors such as age, gender, and high blood pressure. The main objective of this study was to compare vascular risk factor profiles with in-hospital outcomes in AS and AMI patients. METHODS: We evaluated 486 consecutive patients who were admitted to Bjelovar General Hospital with diagnoses of AS (ischaemic stroke or intracerebral haemorrhage; N = 380) or AMI (N = 106) during a one year period. The frequency of risk factors and in-patient mortality rates were assessed in both groups. For statistical analysis we used t-tests and χ(2 )tests. RESULTS: AS patients were significantly older than AMI patients: the mean age for AS patients was 68.9 ± 9.1 years, and for AMI patients was 62.8 ± 11.7 years (p < 0.001). AMI was significantly more common than AS in patients younger than 65 years; 51% of this group had AMI and 26% had AS (p < 0.001). Hypertension was a more common risk factor in AS patients (69% AS patients vs. 58% AMI patients; p = 0.042). Patients who died did not differ significantly in age between the groups. In-patient mortality rates were significantly higher in AS than AMI cases (31% vs. 12%, p < 0.001 for all patients; 37% vs.5%, p < 0.001 for men). Women hospitalized for AMI were more likely to die in hospital than men (28% vs. 5%; p = 0.002). CONCLUSIONS: We found that age at the time of presentation was a significant differentiating factor between patients with AS and AMI. The only exceptions were women, whose ages at the onset of AS and AMI were similar. In contrast, patients who died did not differ significantly in age. We observed significantly higher inpatient mortality for men (when adjusted for age) than for women with AS. The five-fold higher in-patient mortality rate in women than in men with AMI is most likely to have resulted from other factors related to treatment

Cognitive impairment among an Egyptian sample of patients with schizophrenia and bipolar disorders: a comparative study

Abstract Background The cognitive profile among patients with schizophrenia (SZ) and bipolar disorder (BD) has varied widely across different studies. The aim of the current study was to compare different cognitive domains using psychometric and neurophysiological tests in patients with SZ to those with BD. A case–control study was conducted on 30 BD, 30 SZ and 30 age and sex matched control group. Each subject was submitted to the following: Wechsler Adult Intelligence Scale-3rd edition (WAIS-III), Montreal cognitive assessment scale (MoCA), Brief Visuospatial Memory Test-Revised (BVMT-R), Memory Assessment Scales (MAS), and the P300 event related potential (ERP). Results SZ and BD patients had significantly lower total and subscales of WAIS-III scores than the control group. SZ patients had significantly higher deterioration index (DI) than controls, while absence of such significant between BD and controls. SZ patients reported significantly lower MoCA scores and subitems, especially in visuospatial, naming, attention, delayed recall, and orientation subtests than controls. Only visuospatial and delayed recall scores were significantly decreased in BD than controls. SZ patients performed poorer on BVMT-R subscales than the control group. Both SZ and BD groups had lower mean values of all subscales except verbal assessment in the four memory tests. P300 latencies and amplitude had no significant difference among the three groups, although the BD group had a shorter P300 latency. Conclusion Patients with SZ and BD had significantly lower scores on various cognitive function domains in comparison to controls with more affection in SZ. The frequency of mood episodes, disease duration, and education level must be considered

An immunocytochemical study of calpain II in the hippocampus of rats injected with kainate

10.1007/BF02454147Experimental Brain Research1131117-129EXBR