Plant functional trait response to environmental drivers across European temperate forest understorey communities.

Functional traits respond to environmental drivers, hence evaluating trait-environment relationships across spatial environmental gradients can help to understand how multiple drivers influence plant communities. Global-change drivers such as changes in atmospheric nitrogen deposition occur worldwide, but affect community trait distributions at the local scale, where resources (e.g. light availability) and conditions (e.g. soil pH) also influence plant communities. We investigate how multiple environmental drivers affect community trait responses related to resource acquisition (plant height, specific leaf area (SLA), woodiness, and mycorrhizal status) and regeneration (seed mass, lateral spread) of European temperate deciduous forest understoreys. We sampled understorey communities and derived trait responses across spatial gradients of global-change drivers (temperature, precipitation, nitrogen deposition, and past land use), while integrating in-situ plot measurements on resources and conditions (soil type, Olsen phosphorus (P), Ellenberg soil moisture, light, litter mass, and litter quality). Among the global-change drivers, mean annual temperature strongly influenced traits related to resource acquisition. Higher temperatures were associated with taller understoreys producing leaves with lower SLA, and a higher proportional cover of woody and obligate mycorrhizal (OM) species. Communities in plots with higher Ellenberg soil moisture content had smaller seeds and lower proportional cover of woody and OM species. Finally, plots with thicker litter layers hosted taller understoreys with larger seeds and a higher proportional cover of OM species. Our findings suggest potential community shifts in temperate forest understoreys with global warming, and highlight the importance of local resources and conditions as well as global-change drivers for community trait variation.

Low levels of dehydroepiandrosterone sulphate in plasma, and reduced sympathoadrenal response to hypoglycaemia in premenopausal women with rheumatoid arthritis.

OBJECTIVES: To evaluate the function of the hypothalamic-pituitary-adrenal axis and sympathoadrenal system in premenopausal women with rheumatoid arthritis (RA). METHODS: Insulin-induced hypoglycaemia (0.1 IU/kg) was produced in 15 glucocorticoid-naive patients with long term RA with low disease activity and in 14 healthy women matched for age and body mass index. Concentrations of glucose, adrenocorticotropic hormone (ACTH), cortisol, Delta4-androstenedione (ASD), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), 17alpha-hydroxyprogesterone (17OHP), epinephrine (EPI), norepinephrine (NE), interleukin 6 (IL6), and tumour necrosis factor alpha (TNFalpha) were analysed in plasma. RESULTS: Patients had comparable responses of glucose, cortisol, ACTH, ASD, and 17OHP to hypoglycaemia, without any signs of hypothalamic insufficiency. Patients had lower basal DHEAS than controls (3.03 (0.37) micromol/l v 5.1 (0.9) micromol/l, respectively; p<0.05); borderline lower basal DHEA levels (p = 0.067); while the response of DHEA to hypoglycaemia was comparable to that of controls. Patients with RA had lower EPI (p = 0.005) and NE (p<0.001) responses to hypoglycaemia. TNFalpha and IL6 were higher (p<0.05) in patients with RA (TNFalpha 8 (2.8) pg/ml in RA v 1.1 (0.5) pg/ml in controls and IL6 15.1 (6.7) pg/ml v 1.4 (0.7) pg/ml). CONCLUSIONS: Lower basal DHEAS levels, without concomitant differences or changes in DHEA, ASD, 17OHP, and cortisol responses to hypoglycaemia in patients with RA, indicate an isolated decrease in adrenal androgen production. Significantly lower responses of EPI and NE to hypoglycaemia may suggest sympathoadrenal hyporeactivity in patients with RA.

[Secondary hypertrophic osteoarthropathy in a patient with pulmonary carcinoma]. / Sekundárna hypertrofická osteoartropatia u pacienta s pulmonálnym karcinómom.

BACKGROUND: Hypertrophic osteoarthropathy (HOA) is a syndrome that manifests itself by clubbing of fingers, periosteal and osteal neoformation in acral bones and oligo- or polysynovitis. It may occur as primary form (mostly hereditary) or secondary form, associated with various diseases, especially neoplastic or infectious diseases. PURPOSE: The purpose of the study was to point out that when the symptoms of HOA occur, it is necessary to search for the primary disease, which is usually represented by tumor. METHODS: The study reports a case of a patient with symptoms of HOA, pulmonary adenocarcinoma confirmed by histological examination, and with metastases spread into peripheral lymph nodes. The examination of symptomatology of HOA indicated that to pulmonary carcinoma. RESULTS: The medical history of the patient shows that if there is, at an early stage, little attention paid to the fact that HOA represents a paraneoplastic syndrome, cancer is then confirmed later at a more advanced stage. Neglection of this fact delays the primary diagnosis, deteriorates the prognosis and limits the treatment by the extent of the cancerous process. CONCLUSION: In practice, manifestations of HOA may point to the primary cancerous disease. When the symptomatology of HOA appears, radiograms usually pick up tumours at their early stages, which is important for the prognosis and the strategy of their treatment. The situation was different with the case reported in the study, because the disease was diagnosed at a more advanced stage, which unfavourably affected the prognosis and the treatment of the disease. (Tab. 1, Fig. 4, Ref. 15.)

Treatment with cyclosporin in patients with psoriatic arthritis: results of clinical assessment.

An open 18-week study with a preparation of cyclosporin administered to patients with psoriatic arthritis confirmed the therapeutic efficacy of the preparation. Given the low frequency of adverse effects (at the initial and maintenance daily dose), the preparation could also be considered relatively safe. A pronounced improvement in psoriatic symptoms was observed during the study. As early as 2 weeks after administration of an average daily dose of cyclosporin A of 4.8 mg/kg, skin symptoms improved by 65.5%. The most intense effect on the activity of arthritis was observed after 18 weeks. The lowest optimal effective maintenance dose was 3.26 mg/kg/day. Improvement was achieved after an average of 10 weeks' cyclosporin administration.

Contribution to the problem of occurrence of tuberculosis in patients with systemic lupus erythematosus.

The association of SLE with tuberculosis (TB) was studied in a group of 388 patients with SLE monitored between 1953-1994. TB was diagnosed in 14 patients (3.6%). The occurrence of septic fevers in SLE patients that did not respond to glucocorticoid therapy indicated the possibility of complication with TB. SLE-associated TB included miliary and far-advanced pulmonary and extrapulmonary forms. Three patients from our group died due to myco-bacterial infection and one patient died of active SLE and TB. The treatment was successful in nine patients. Early diagnosis and appropriate management are mandatory in SLE associated TB, which otherwise may have a potentially fatal outcome.

[General therapeutic approaches in systemic vasculitides]. / Vseobecné terapeutické prístupy pri systémových vaskulitídach.

The paper presents general therapeutic principles applied in systemic vasculitis. Several factors may help to contain the clinical activity, such as the location and extent of the inflammatory process affecting the vascular system, the ultimate narrowing of the vascular lumen with subsequent ischemia of the affected tissue and organ. Treatment of vasculitis involves besides glucocorticoids not only cytotoxic drugs (cyclophosphamide, chlorambucil, methotrexate), and immunomodulatory therapeutic agents with immunosuppressive action (cyclosporin A) but also other immunomodulatory drugs, as e.g. dialyzed homogenate of leukocytes (DHL), pentoxyphylline, hydrolytic enzymes, and monoclonal antibodies. The authors emphasize the importance of a complex approach in the management of systemic vasculitis. (Tab. 1, Ref. 36.).

[Cardiac impairment detected by echocardiography in patients with ankylosing spondylitis]. / Postihnutie srdca u pacientov s ankylozujúcou spondylitídou v echokardiografickom obraze.

The authors subjected to complete echocardiographic examination 40 patients with ankylosing spondylitis (AS) in order to assess pathological changes of the heart (changes of the structure and function of valves, myocardial function of the left ventricle and the pericardium) and compare their incidence with clinical characteristics of the patients (age, duration, stage, form and activity of the disease) as well as with the presence of ECG changes. Based on the results and their statistical analysis they revealed that structural changes of the aorta and its valves associated with dilatation of the root of the aorta, its mild insufficiency and the possible finding of a typical bump on its posterior wall is found in half the patients with AS, being more frequent when the disease develops early, when it persists for a long time or is in an advanced stage. A similar relationship is found also in the presence of mild diastolic dysfunction of the left ventricle. The authors did not observe a more frequent incidence of other pathological changes of the heart in patients with AS. None of the detected changes were clinically severe and did not call for aimed treatment or surgery. In the conclusion the authors compare the assessed facts with data in the literature and confront data in the literature.

[New findings on the immunologic diagnosis of systemic lupus erythematosus]. / Nové poznatky v imunologickej diagnostike systémového lupus erythematosus.

The authors review recent findings pertaining to the pathogenesis of systemic lupus erythematosus. It was revealed that knowledge of impaired humoral and cellular immunity is of great practical importance and substantially improves the prognosis of the disease.

Comparative study of the estimation of exocrine pancreatic function using p-(N-acetyl-L-tyrosyl)- and p-(N-benzoyl-L-tyrosyl)aminobenzoic acid.

A comparative study using the oral test with chymotrypsin substrates p-(N-acetyl-L-tyrosyl)- and p-(N-benzoyl-L-tyrosyl) aminobenzoic acid (Ac-Tyr-PAB and Bz-Tyr-PAB) was carried out in 43 adults divided into four groups comprising controls (n = 18), chronic pancreatitis (n = 13), after acute pancreatitis (n = 7), and celiac sprue (n = 4), after separate administration of both derivatives and determination of PABA urinary output in 6 and 8 hours. Both derivatives were diagnostically comparable. The specificity of both derivatives in the investigated group in 6 and 8 hours was 100%, and test sensitivity in patients with chronic pancreatitis, was in 6 hours 90.9% for Ac-Tyr-PAB and 72.7% for Bz-Tyr-PAB, and 8 hours 81.8% for both compounds. Differentiation between the controls and the chronic pancreatitis group was better in Ac-Tyr-PAB, as adjudged by the sensitivity and significance of the Student t-test criterion.

A new method of testing pancreatin therapy in vivo by the use of a peroral chymotrypsin substrate 4-(N-acetyl-L-tyrosyl)aminobenzoic acid.

The efficacy of pancreatin in vivo was determined in 14 patients with advanced pancreatic insufficiency using a peroral test with 2 g of chymotrypsin substrate, 4-(N-acetyl-L-tyrosyl)aminobenzoic acid, the Lundh test meal and 1000 ml tea. Chymotrypsin hydrolysis was quantified by 4-aminobenzoic acid excreted in 6-hr or 8-hr urine samples. After a control test without pancreatin, one or two tablets of Panpur (Nordmark-700 mg of pancreatin and 50 mg of bile per tablet) were applied simultaneously with the Lundh meal on repeated examinations. The urinary excretion of 4-aminobenzoic acid was restored to normal values in 5 subjects during both sampling periods. With this method, stimulated and substituted chymotrypsin is measured at the same time. The conditions of the tests, both with and without pancreatin replacement, are fully comparable and thus the significance of factors modifying the activity of enzymic components in the digestive tube is limited. The method appears appropriate for the institution of an effect pancreatin therapy and its control in vivo.