The effects of views of nature on autonomic control.

Previously studies have shown that nature improves mood and self-esteem and reduces blood pressure. Walking within a natural environment has been suggested to alter autonomic nervous system control, but the mechanisms are not fully understood. Heart rate variability (HRV) is a non-invasive method of assessing autonomic control and can give an insight into vagal modulation. Our hypothesis was that viewing nature alone within a controlled laboratory environment would induce higher levels of HRV as compared to built scenes. Heart rate (HR) and blood pressure (BP) were measured during viewing different scenes in a controlled environment. HRV was used to investigate alterations in autonomic activity, specifically parasympathetic activity. Each participant lay in the semi-supine position in a laboratory while we recorded 5 min (n = 29) of ECG, BP and respiration as they viewed two collections of slides (one containing nature views and the other built scenes). During viewing of nature, markers of parasympathetic activity were increased in both studies. Root mean squared of successive differences increased 4.2 ± 7.7 ms (t = 2.9, p = 0.008) and natural logarithm of high frequency increased 0.19 ± 0.36 ms(2) Hz(-1) (t = 2.9, p = 0.007) as compared to built scenes. Mean HR and BP were not significantly altered. This study provides evidence that autonomic control of the heart is altered by the simple act of just viewing natural scenes with an increase in vagal activity.

Racial and ethnic disparities in disease activity and function among persons with rheumatoid arthritis from university-affiliated clinics.

OBJECTIVE: Health outcomes in rheumatoid arthritis (RA) have improved significantly over the past 2 decades. However, research suggests that disparities exist by race/ethnicity and socioeconomic status, with certain vulnerable populations remaining understudied. Our objective was to assess disparities in disease activity and function by race/ethnicity and explore the impact of language and immigrant status at clinics serving diverse populations. METHODS: We examined a cross-sectional study of 498 adults with confirmed RA at 2 rheumatology clinics: a university hospital clinic and a public county hospital clinic. Outcomes included the Disease Activity Score in 28 joints (DAS28) and its components, and the Health Assessment Questionnaire (HAQ), a measure of function. We estimated multivariable linear regression models including interaction terms for race/ethnicity and clinic site. RESULTS: After adjusting for age, sex, education, disease duration, rheumatoid factor status, and medication use, clinically meaningful and statistically significant differences in DAS28 and HAQ scores were seen by race/ethnicity, language, and immigrant status. Lower disease activity and better function was observed among whites compared to nonwhites at the university hospital. This same pattern was observed for disease activity by language (English compared to non-English) and immigrant status (US-born compared to immigrant) at the university clinic. No significant differences in outcomes were found at the county clinic. CONCLUSION: The relationship between social determinants and RA disease activity varied significantly across clinic setting with pronounced variation at the university, but not at the county clinic. These disparities may be a result of events that preceded access to subspecialty care, poor adherence, or health care delivery system differences.

Contrasting physical activity patterns in children and adolescents living in differing environments in the U.K.

AIMS: There is evidence for lower physical activity (PA) in rural adults; it is important to evaluate how the environment influences the PA of children and adolescents. METHODS: We compared the PA of 6485 English 10-15.9 year olds according to two systems for classifying the immediate environment. System one compared urban and rural areas. System two compared urban, town and fringe, and rural areas. Analyses were carried out separately for children (<13 years) and adolescents (>13 years). RESULTS: Rural children were more active than those from urban areas (OR 1.38, 95% CI 1.15-1.66) as were adolescents (OR 1.30, 95% CI 1.11-1.51). Using trilateral division, children were more active if they lived in town and fringe (OR 1.32, 95% CI 1.03-1.67) or rural (OR 1.45, 95% CI 1.14-1.84) areas compared with urban areas. Adolescents from town and fringe areas were more active than urban dwellers (OR 1.50, 95% CI 1.24-1.81). Rural adolescents' PA did not differ from urban dwellers'. CONCLUSIONS: Rural environments support PA in children but not that of adolescents. Town and fringe areas with mixed elements of rural and urban land use appear to facilitate and sustain PA in both children and adolescents.

Association of Sweet's Syndrome and Systemic Lupus Erythematosus.

Sweet's syndrome is an acute febrile neutrophilic dermatosis which usually presents as an idiopathic disorder but can also be drug induced, associated with hematopoetic malignancies and myelodysplastic disorders, and more, infrequently, observed in autoimmune disorders. Sweet's syndrome has been reported in three cases of neonatal lupus, three cases of hydralazine-induced lupus in adults, and in nine pediatric and adult systemic lupus erythematosus (SLE) patients. We describe three additional adult cases of Sweet's associated with SLE and provide a focused review on nondrug-induced, nonneonatal SLE and Sweet's. In two of three new cases, as in the majority of prior cases, the skin rash of Sweet's paralleled underlying SLE disease activity. The pathogenesis of Sweet's remains elusive, but evidence suggests that cytokine dysregulation may be central to the clinical and pathological changes in this condition, as well as in SLE. Further research is needed to define the exact relationship between the two conditions.

Factor V Leiden and thrombosis in patients with systemic lupus erythematosus: a meta-analysis.

The aim of this study was to perform a meta-analysis of the association between the factor V Leiden polymorphism (FVL) and thrombosis among patients with systemic lupus erythematosus (SLE) and/or antiphospholipid antibody (aPL) positivity. Included studies recruited patients based on SLE or aPL-positive status, confirmed subjects' SLE diagnosis as defined by the American College of Rheumatology, and documented thrombotic events. Excluded studies were non-English or considered only arterial thrombosis. Individual patient data, available from 5 studies, together with unpublished data from 1210 European-American SLE patients from the UCSF Lupus Genetics Collection genotyped for FVL, were further analyzed. Seventeen studies (n=2090 subjects) were included in the initial meta-analysis. Unadjusted odds ratios (OR) were calculated to assess association of FVL with thrombosis. The OR for association of thrombosis with FVL was 2.88 (95% confidence interval (CI) 1.98-4.20). In the secondary analysis with our individual patient dataset (n=1447 European-derived individuals), SLE subjects with the FVL polymorphism still had more than two times the odds of thrombosis compared to subjects without this polymorphism, even when adjusting for covariates such as gender, age and aPL status. SLE and/or aPL-positive patients with the FVL variant have more than two times the odds of thrombosis compared to those without this polymorphism.

The pattern recognition receptor Nod1 activates CCAAT/enhancer binding protein beta signalling in lung epithelial cells.

The innate immune receptor nucleotide-binding oligomerisation domain protein 1 (Nod1) recognises peptidoglycan containing meso-diaminopimelic acid found in all Gram-negative and some Gram-positive bacteria. Nod1 has been shown to activate nuclear factor (NF)-kappaB. The aim of the present study was to examine the expression of Nod1 in the lung, particularly in lung epithelial cells, and to investigate the activation of CCAAT/enhancer binding protein (C/EBP) transcription factors downstream of the Nod1 receptor in these cells. The expression of Nod1 in mouse lung was examined using immunohistochemistry. A tissue array was used to determine the expression pattern in the human lung. Signalling downstream of Nod1 was examined in the human lung epithelial cell type, BEAS-2B, by electrophoretic mobility shift assay and reporter gene activation. Nod1 expression was seen in various cell types in the lung, including epithelial cells. Activation of Nod1 in these cells resulted in modest activation of NF-kappaB, together with strong activation of the C/EBP transcription factors, particularly C/EBPbeta. This activation appears to be independent of de novo protein synthesis. The present study showed that nucleotide-binding oligomerisation domain protein 1 is expressed in lung epithelial cells. The results demonstrate a novel pathway downstream of the nucleotide-binding oligomerisation domain protein 1 receptor in these cells and suggest that C/EBPbeta may play a role in immune responses to meso-diaminopimelic acid-containing bacteria in the lung.

A tissue specific IL-1 receptor antagonist homolog from the IL-1 cluster lacks IL-1, IL-1ra, IL-18 and IL-18 antagonist activities.

Interleukin (IL)-1-like protein 1 (IL-1L1) is a 155-amino acid protein that shares 27% identity with IL-1beta and 47% with IL-1 receptor antagonist (IL-1ra). A 2.7-kb IL-1L1 mRNA was cloned from human placenta and is detectable in the trophoblastic cell line JEG-3, in macrophages and in endotoxin-stimulated monocytes. Expression of IL-1L1 is much less abundant and less widespread than IL-1ra. We have determined the human and mouse IL-1L1 cDNA sequences and the complete sequence of the human gene, IL1L1. IL1L1 consists of four coding exons, has two alternative non-coding first exons, lies between IL1B and IL1RN, is orientated in the same direction as IL1RN and is separated from it by approximately 53 kb. The predicted IL-1L1 protein lacks both signal sequence and glycosylation signals. A 17-kDa protein was recovered by immunoprecipitation with IL-1L1-specific antibodies from JEG-3. IL-1L1 did not stimulate IL-6 production from primary human fibroblasts or human umbilical vein endothelial cells nor did it block the IL-1alpha or IL-1beta-dependent activation of IL-6 expression. We conclude, contrary to a recent suggestion made by others, that IL-1L1 is not a functional IL-1ra. IL-1L1 also had no detectable agonistic or antagonistic effect on IFN-gamma production in response to IL-18 in KG-1 cells.

Arterial inflammation in mice lacking the interleukin 1 receptor antagonist gene.

Branch points and flexures in the high pressure arterial system have long been recognized as sites of unusually high turbulence and consequent stress in humans are foci for atherosclerotic lesions. We show that mice that are homozygous for a null mutation in the gene encoding an endogenous antiinflammatory cytokine, interleukin 1 receptor antagonist (IL-1ra), develop lethal arterial inflammation involving branch points and flexures of the aorta and its primary and secondary branches. We observe massive transmural infiltration of neutrophils, macrophages, and CD4(+) T cells. Animals appear to die from vessel wall collapse, stenosis, and organ infarction or from hemorrhage from ruptured aneurysms. Heterozygotes do not die from arteritis within a year of birth but do develop small lesions, which suggests that a reduced level of IL-1ra is insufficient to fully control inflammation in arteries. Our results demonstrate a surprisingly specific role for IL-1ra in the control of spontaneous inflammation in constitutively stressed artery walls, suggesting that expression of IL-1 is likely to have a significant role in signaling artery wall damage.

A mammalian homolog of the bacterial monomeric sarcosine oxidases maps to mouse chromosome 11, close to Cryba1.

We have cloned a cDNA from a mouse gene, Pso (peroxisomal sarcosine oxidase). Pso appears to encode a homolog of the single-subunit (40 kDa) bacterial sarcosine oxidases. The mouse Pso gene product would contain a peroxisomal localization sequence, like that of the recently reported rabbit enzyme, Mouse Pso lies between 20 and 50 kb upstream of the promoter of the Sez6 gene, close to Crybal on chromosome 11. Pso is expressed very strongly and specifically in liver and kidney. The gene appears to be present widely in eutherian mammals.

Dermoid cysts of the ovary: their ultrasonographic appearances.

Ultrasonograms of 45 patients with 51 surgically proved benign cystic teratomas (dermoid cysts) of the ovary were reviewed to evaluate the ultrasonographic appearance of this entity. Contrary to several recent reports stressing a "typical" appearance for ovarian dermoid cysts, ie, an echogenic focus with acoustic shadowing situated within a predominantly cystic mass, the authors observed a much broader spectrum of appearances. Thirty-three percent of the cases demonstrated "typical" findings, 23.5% were predominantly solid, 20% were almost entirely cystic, and 23.5% were not visible. Ultrasound and conventional radiography in patients with dermoid cysts were compared: Ultrasonography contributed significantly to the correct diagnosis in the majority of cases. Because ultrasonography lacks ionizing radiation, and its use may reveal unrelated pelvic pathology, it should be the initial diagnostic modality in the examination of patients with suspected dermoid cysts of the ovary.

Delusional misidentification and platelet monoamine oxidase.

Recently, reduced platelet monoamine oxidase (MAO) activity was demonstrated in two cases of paranoid schizophrenia exhibiting Capgras' syndrome. The present authors report platelet MAO studies in an additional patient with the Delusion of Doubles. In this case, one of delusional hyperidentification (false recognition), decreased platelet MAO activity compared with normal controls was detected. The patient, while not schizophrenic, showed platelet MAO activity comparable with that of a chronic schizophrenic control group. The possible significance of the findings are discussed.