Consumption of erythrocyte CR1 (CD35) is associated with protection against systemic lupus erythematosus renal flare.

Erythrocyte complement receptor type one (E-CR1) is thought to protect against immune complex (IC) disease through interactions that lead to E-CR1 consumption, and low E-CR1 levels are characteristic of systemic lupus erythematosus (SLE). The purpose of this study was to test the hypothesis that E-CR1 consumption can predict or mark SLE flare. Recurrently active SLE patients [n = 43; 28 with past or present major renal manifestations (SLER) and 15 without (SLENR)], were evaluated every 2 months by detailed protocol testing (mean follow-up 22 months), including direct measurements of E-CR1 levels using a radioimmunoassay. In all patients, detectable E-CR1 levels fluctuated widely through acute periods of consumption and regeneration, preventing the use of any single value as a baseline. However, when individual chronic baseline values were used, determined as the mean of all E-CR1 values 4 months or more from a flare, a clear trend was observed. In 16 of 16 instances of non-renal flare in SLER patients, E-CR1 levels decreased at flare (mean decrease 34%, P < 0.0001). In contrast, no consistent difference was observed for flare in SLENR patients or for renal flare in SLER patients. Changes in E-CR1 levels did not correlate with plasma CR1 levels. In conclusion, single occurrences of E-CR1 consumption did not generally predict or mark SLE flare. However, compared to the average E-CR1 levels measured during no-flare intervals, E-CR1 consumption in SLER patients at flare was strongly associated with freedom from signs of renal involvement. We postulate that E-CR1 consumption reflects E-CR1 function that includes protecting against SLE nephritis.

Cross-sectional and longitudinal patterns of three Wechsler Memory Scale Subtests.

This study evaluated cross-sectional and longitudinal age relationships, after age 60, for three subtests of the Wechsler Memory Scale: logical memory, associate learning, and visual reproduction. Cross-sectional regression analyses indicated that age, sex, race, and education accounted for approximately 20 to 35% of the variance in test scores, with education the strongest predictor. Longitudinally, consistent linear declines were found only for hard associates and visual reproduction. Visual reproduction was related more consistently and strongly to age than the two verbal subtests. The effects of selective attrition from the study were discussed.

Psychological measurement of memory deficits in dialysis patients.

In light of recent research on "dialysis dementia," two questions were raised: (1) Is such dementia an all-or-none phenomenon or is it distributed in severity throughout the population of dialysis patients? (2) Is the dementia related to the uremia itself or to some aspect of dialysis? Memory decline was used as the operational definition of dementia. The Russell revision of the Wechsler Memory Scale was used to measure short- and long-term semantic and figural memory. Results suggested that both semantic and figural memory disturbances were distributed in varying degrees throughout the population of dialysis patients (n = 28). Further findings suggested that figural memory functioning was negatively correlated with the number of dialysis sessions and with the amount of time elapsed since the first dialysis session. Suggestions are made for further research and clinical considerations.