Induced liver injury after high-dose methylprednisolone in a patient with multiple sclerosis

A 33-year-old woman with multiple sclerosis, medicated with high doses of methylprednisolone, cyclophosphamide and glatiramer acetate, was referred to our department due to acute liver injury. The laboratory investigation was normal except for weakly positive antinuclear antibodies. Cyclophosphamide and glatiramer acetate were suspended, and intravenous immunoglobulin with maintenance of high doses of methylprednisolone was initiated. The patient developed another episode of acute hepatitis so the immunoglobulin was stopped. After that, she had three more episodes of elevation of liver enzymes with no hepatic insufficiency while medicated only with high doses of methylprednisolone. At this time, liver biopsy showed focal centrilobubar hepatocyte necrosis with minimal interface hepatitis. After the high doses of methylprednisolone were suspended, the patient remained asymptomatic, with normal hepatic enzymes. This case emphasises that, although rare, induced liver injury after high doses of methylprednisolone can occur.info:eu-repo/semantics/publishedVersio

Relationship between online role-playing games, personality and interpersonal relationships

Online gaming is a relatively new concept, yet due to the millions of followers these games have attracted over the past decade; it is not difficult to deduce that they are not going away any time soon. Individuals use the Internet for many things, including news, email, shopping, instant messaging and entertainment (gaming) (Griffiths, et al., 2003; Yee, 2006a; 2006b). Millions of these same individuals play Massively Multiplayer Online Role-Playing Games (MMORPGs) as their source of entertainment. These players interact socially within the game with one another, many on a daily basis, and spend huge amounts of time doing so. During these long hours, research has shown that many of these players form relationships and some of these relationships lead to real life relationships (Cole & Griffiths, 2007; Yee, 2006b). Many of these individuals consider these online relationships equal to their offline relationships (Ng & Wiemer-Hastings, 2005). It is suggested that these players are introverted and lack social interaction; however, some believe that using the Internet in this manner is equivalent to offline face to face social interaction. Many lose track of the time while playing MMORPGs and when engaging in other online activities, and some of these individuals experience symptoms related to loneliness (Ng & Wiemer-Hastings, 2005). Therefore, previous research suggests there is a relationship between Online Gaming, Personality, and Interpersonal Relationships. This study was designed to examine relationships between personality characteristics and amount of time playing a popular game called World of Warcraft (WoW). Additionally, this study examined how motivations to play the game are related to personality characteristics, preference for online interpersonal interaction, and social anxiety. A Demographics Questionnaire including age, country of residence, sex, occupation, employment status and other information about their online game playing was used. Additionally, the M5-50 Personality Inventory (McCord, 2002) was used as a short measure of the participant’s personality traits, collected through a fifty item scale which resulted in scores for the five domains of: Neuroticism, Extraversion, Openness to Experience, Conscientiousness, and Agreeableness. The participants also completed the Preference for Online Social Interaction Questionnaire (Caplan, 2003) which is a 4 item measure of the individual’s preference for online vs. offline face to face social interaction. The items were summed for a total score with higher scores representing preference for online social interaction. Motivations for Play Questionnaire (Yee, 2006a), which measures activities the participant engages in while online, which MMORPGs they play, the amount of time spent playing the specified MMORPG per week, and activities they are involved in while playing the MMORPG. The scale consisted of 40 questions which participants answered using a five point response scale then the individual items were summed into each of the primary components. Finally, the Interaction Anxiousness Scale (IAS), a measure of social anxiety was completed by the participants. The scale consisted of 15 items which participants answered based on a five point Likert-type scale. Scores were summed and overall higher scores on the scale reflect higher levels of social anxiety. The study included 381 participants who were recruited from the Internet sites where WoW players frequently post and read messages. The participants were 88% male and 12% female and the range of participants’ ages was 18 to 69 years, with a mean of 24.29 years. Participants were actually engaged in playing the MMORPG “World of Warcraft”. The median amount of time spent playing WoW per week was 16 to 20 hours. A small, positive correlation was found between the amount of time spent playing WoW and Neuroticism and a small, negative correlation between of time spent playing WoW and Extraversion. Examination of the relationships between achievement motivation to play and Openness to Experience and Conscientiousness found small, negative correlations between achievement motivation to play and Openness to Experience and Conscientiousness with higher levels of motivation to play associated with lower levels of Openness to Experience and Conscientiousness. An examination of the relationship between social motivation to play, Extraversion, Agreeableness and Openness to Experience found small, positive relationships between social motivation to play and Extraversion, Agreeableness, and Openness to Experience. The relationship between immersion motivation to play and Extraversion, Conscientiousness, and Openness to Experience was investigated which found small, negative relationships between immersion motivation to play and Extraversion and Conscientiousness; and a small, positive relationship between immersion motivation to play and Openness to Experience. Finally, the relationship between the preference for online social interaction and the interactive anxiousness scale was investigated resulting in a moderate to strong, positive relationship, with higher levels of preference for online social interaction associated with higher levels of interactive anxiousness

Role of glucose as a modulator of anabolic and catabolic gene expression in normal and osteoarthritic human chondrocytes

Cartilage matrix homeostasis involves a dynamic balance between numerous signals that modulate chondrocyte functions. This study aimed at elucidating the role of the extracellular glucose concentration in modulating anabolic and catabolic gene expression in normal and osteoarthritic (OA) human chondrocytes and its ability to modify the gene expression responses induced by pro-anabolic stimuli, namely Transforming Growth Factor-β (TGF). For this, we analyzed by real time RT-PCR the expression of articular cartilage matrix-specific and non-specific genes, namely collagen types II and I, respectively. The expression of the matrix metalloproteinases (MMPs)-1 and -13, which plays a major role in cartilage degradation in arthritic conditions, and of their tissue inhibitors (TIMP) was also measured. The results showed that exposure to high glucose (30 mM) increased the mRNA levels of both MMPs in OA chondrocytes, whereas in normal ones only MMP-1 increased. Collagen II mRNA was similarly increased in normal and OA chondrocytes, but the increase lasted longer in the later. Exposure to high glucose for 24 h prevented TGF-induced downregulation of MMP-13 gene expression in normal and OA chondrocytes, while the inhibitory effect of TGF on MMP-1 expression was only partially reduced. Other responses were not significantly modified. In conclusion, exposure of human chondrocytes to high glucose, as occurs in vivo in diabetes mellitus patients and in vitro for the production of engineered cartilage, favors the chondrocyte catabolic program. This may promote articular cartilage degradation, facilitating OA development and/or progression, as well as compromise the quality and consequent in vivo efficacy of tissue engineered cartilage

Is It Possible to Simplify Risk Stratification Scores for Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty?

INTRODUCTION: There are several risk scores for stratification of patients with ST-segment elevation myocardial infarction (STEMI), the most widely used of which are the TIMI and GRACE scores. However, these are complex and require several variables. The aim of this study was to obtain a reduced model with fewer variables and similar predictive and discriminative ability. METHODS: We studied 607 patients (age 62 years, SD=13; 76% male) who were admitted with STEMI and underwent successful primary angioplasty. Our endpoints were all-cause in-hospital and 30-day mortality. Considering all variables from the TIMI and GRACE risk scores, multivariate logistic regression models were fitted to the data to identify the variables that best predicted death. RESULTS: Compared to the TIMI score, the GRACE score had better predictive and discriminative performance for in-hospital mortality, with similar results for 30-day mortality. After data modeling, the variables with highest predictive ability were age, serum creatinine, heart failure and the occurrence of cardiac arrest. The new predictive model was compared with the GRACE risk score, after internal validation using 10-fold cross validation. A similar discriminative performance was obtained and some improvement was achieved in estimates of probabilities of death (increased for patients who died and decreased for those who did not). CONCLUSION: It is possible to simplify risk stratification scores for STEMI and primary angioplasty using only four variables (age, serum creatinine, heart failure and cardiac arrest). This simplified model maintained a good predictive and discriminative performance for short-term mortality

Differential effects of the essential oils of Lavandula luisieri and Eryngium duriaei subsp. juresianum in cell models of two chronic inflammatory diseases

CONTEXT: Effective drugs to treat osteoarthritis (OA) and inflammatory bowel disease (IBD) are needed. OBJECTIVE: To identify essential oils (EOs) with anti-inflammatory activity in cell models of OA and IBD. MATERIALS AND METHODS: EOs from Eryngium duriaei subsp. juresianum (M. Laínz) M. Laínz (Apiaceae), Laserpitium eliasii subsp. thalictrifolium Sennen & Pau (Apiaceae), Lavandula luisieri (Rozeira) Rivas-Martínez (Lamiaceae), Othantus maritimus (L.) Hoff. & Link (Asteraceae), and Thapsia villosa L. (Apiaceae) were analyzed by GC and GC/MS. The anti-inflammatory activity of EOs (5-200 μg/mL) was evaluated by measuring inducible nitric oxide synthase (iNOS) and nuclear factor-κB (NF-κB) activation (total and phosphorylated IκB-α), in primary human chondrocytes and the intestinal cell line, C2BBe1, stimulated with interleukin-1β (IL-1β) or interferon-γ (IFN-γ), IL-1β and tumor necrosis factor-α (TNF-α), respectively. RESULTS: The EO of L. luisieri significantly reduced iNOS (by 54.9 and 81.0%, respectively) and phosphorylated IκB-α (by 87.4% and 62.3%, respectively) in both cell models. The EO of E. duriaei subsp. juresianum caused similar effects in human chondrocytes, but was inactive in intestinal cells, even at higher concentrations. The EOs of L. eliasii subsp. thalictrifolium and O. maritimus decreased iNOS expression by 45.2 ± 8.7% and 45.2 ± 6.2%, respectively, in C2BBe1 cells and were inactive in chondrocytes. The EO of T. villosa was inactive in both cell types. DISCUSSION AND CONCLUSION: This is the first study showing anti-inflammatory effects of the EOs of L. luisieri and E. duriaei subsp. juresianum. These effects are specific of the cell type and may be valuable to develop new therapies or as sources of active compounds with improved efficacy and selectivity towards OA and IBD

The Analyticity of a Generalized Ruelle's Operator

In this work we propose a generalization of the concept of Ruelle operator for one dimensional lattices used in thermodynamic formalism and ergodic optimization, which we call generalized Ruelle operator, that generalizes both the Ruelle operator proposed in [BCLMS] and the Perron Frobenius operator defined in [Bowen]. We suppose the alphabet is given by a compact metric space, and consider a general a-priori measure to define the operator. We also consider the case where the set of symbols that can follow a given symbol of the alphabet depends on such symbol, which is an extension of the original concept of transition matrices from the theory of subshifts of finite type. We prove the analyticity of the Ruelle operator and present some examples

New supersymmetric higher-derivative couplings: Full N=2 superspace does not count!

An extended class of N=2 locally supersymmetric invariants with higher-derivative couplings based on full superspace integrals, is constructed. These invariants may depend on unrestricted chiral supermultiplets, on vector supermultiplets and on the Weyl supermultiplet. Supersymmetry is realized off-shell. A non-renormalization theorem is proven according to which none of these invariants can contribute to the entropy and electric charges of BPS black holes. Some of these invariants may be relevant for topological string deformations.Comment: 24 pages, v2: version published in JHEP, one reference added and typos corrected, v3: reference adde

Multimodal database of emotional speech, video and gestures

People express emotions through different modalities. Integration of verbal and non-verbal communication channels creates a system in which the message is easier to understand. Expanding the focus to several expression forms can facilitate research on emotion recognition as well as human-machine interaction. In this article, the authors present a Polish emotional database composed of three modalities: facial expressions, body movement and gestures, and speech. The corpora contains recordings registered in studio conditions, acted out by 16 professional actors (8 male and 8 female). The data is labeled with six basic emotions categories, according to Ekman’s emotion categories. To check the quality of performance, all recordings are evaluated by experts and volunteers. The database is available to academic community and might be useful in the study on audio-visual emotion recognition