Depressive symptoms are independently associated with pain perception in Colombians with rheumatoid arthritis.

AIMS: To examine the relationships between psychosocial factors and reported pain in Colombians with Rheumatoid Arthritis (RA). METHODS: One hundred and three RA patients [85% from the lowest socio-economic strata (SES) in the country] recruited from outpatient centers in Neiva, Colombia were administered the Disease Activity Scale (DAS) , which included a Visual Analog Scale (VAS) arthritis pain/activity rating, Zung Depression Scale, State-Trait Anxiety Inventory (STAI), Interpersonal Support Evaluation List-12 (ISEL-12), and Symptom Checklist-90 Revised (SCL-90R). MAJOR RESULTS: VAS pain was not associated with socio-demographic or medical factors, but was negatively associated with ISEL tangible subscale (r=-0.22, p< 0.01; r=0.28, p<0.01). VAS pain was positively associated with Zung Depression Scale score (r=0.38, p<0.001), STAI-State and STAI-Trait Anxiety (r=0.23 and r=0.25 respectively, p's<0.01), SCL-90R Global Severity Index (GSI) and Positive Symptom Total (PST) (r=0.23, p<0.05 and r=0.29, p<0.01 respectively), and SCL-90R Somatization, Depression, and Anxiety subscales (r=0.30, p< 0.01; r=0.28, p<0.01; and r=0.20, p<0.05 respectively). A linear regression model showed that socio-demographic characteristics theoretically associated with pain perception (gender, age, and SES) explained only 2.4% of the variance of VAS scores (R(2)=0.02, p=0.49). The full model, including psychosocial factors significantly associated with VAS scores explained 18.9% of the variance in VAS pain perception scores (R(2)=0.19, p=0.02). The Zung Depression Scale score was the only factor independently associated with VAS pain, such that higher depression scores were associated with higher VAS ratings (ß =0.13, p<0.01), controlling for gender, age, SES, STAI-State, STAI-Trait, ISEL tangible, SCL-90R GSI, and SCL-90R PST. CONCLUSIONS: Depressive symptoms, anxiety, social support, and psychopathological symptom distress were associated with pain ratings, but only depressive symptoms were found to be uniquely associated with higher pain perception, taking into account socio-demographic characteristics and other psychosocial factors. Findings provide evidence for the need to assess and treat pain in RA in Colombia from a bio-psycho-social perspective. Future research is needed to determine effective depression screening and evidence-based interventions for depressive symptoms in RA patients in this socio-cultural context, as intervening in depression may decrease pain perception.

Checkpoint kinase 1 modulates sensitivity to cisplatin after spindle checkpoint activation in SW620 cells.

Aneuploidy is a common feature of tumours that arise by errors in chromosome segregation during mitosis. The aim of this study was to evaluate possible signaling pathways involved in sensitization to chemotherapy in cells with chromosomal instability. We designed a screen using the fission yeast Squizossaccharomyces pombe, to isolate strains showing a phenotype of chromosome mis-segregation and higher sensitivity to the antitumoral drug Bleomycin. We examined differences in gene expression using a comparative analysis of genome-wide expression of the wild type strain and one of the mutants. The results revealed a set of genes involved in cell cycle control, including Mad3/BubR1 and Chk1. We then studied the levels of these two proteins in colorectal cancer human cell lines with different genomic content. Among these, SW620 cells showed higher BubR1 and Chk1 mRNA levels than control cells under normal conditions. Since Chk1 is required for both S and G2/M checkpoints, and the microtubule-destabilizing agent, nocodazole induces mitotic arrest, we attempted to investigate the potential anticancer effects of nocodazole in combination with cisplatin. These studies showed that SW620 cells undergo synergistic cell death after spindle checkpoint activation followed by cisplatin treatment, suggesting a role of Chk1 in this checkpoint, very likely dependent on BubR1 protein. Importantly, Chk1-depleted SW620 cells lost this synergistic effect. In summary, we propose that Chk1 could be a biomarker predictive of the efficacy of chemotherapy across different types of tumors with aneuploidy. These findings may be potentially very useful for the stratification of patients for treatment.

UV/H2O2 chemical oxidation for high loaded effluents: a degradation kinetic study of LAS surfactant wastewaters.

This paper describes a laboratory study conducted to elucidate the possibility of treating high loaded solutions of surfactants through an Advanced Oxidation Process. Synthetic solutions of linear alkylbenzene sulfonates are treated in this work as this is a model compound commonly used in the formulation of detergents, with a great presence in urban and industrial waste-waters. The application of UV combined with hydrogen peroxide to oxidise a surfactant effluent is shown to be suitable as a primary oxidation step since conversions of around 50% of the original compound are achieved in the most favourable cases. Initially, the influence of the operating variables on the degradation levels is analysed in this work. A kinetic model that takes into account both the contributions of direct photolysis and radical attack is also worked out. Direct photolysis is performed to determine the quantum yield in the single photodecomposition reaction. Additionally, the rate constant of the reaction between hydroxyl radicals and LAS in the oxidising system H2O2/UV is determined for different operational conditions. Finally, the contribution of each oxidation pathway is quantified; a higher contribution of the radical reaction than that of the direct photolysis was found in all cases.

[Atypical presentation and diagnosis of a case of Gitelman syndrome in the adult. How to distinguish between Bartter syndrome?]. / Presentación atípica y diagnóstico de un síndrome de Gitelman a la edad adulta. Cómo diferenciarlo de un síndrome de Bartter?

We described the case of a patient with 43 year-old, with Gitelman syndrome. The patient presented two epileptic crisis. The cranial computerized axial tomography (CT) was normal. In the seric and urinary analytic we found hypomagnesemia and hypermagnesuria with hypocalciuria. The patient was admitted in our Hospital, and with the administration of magnesium, the seric levels increased and the patient remained asymptomatic. In this article we describe the diagnosis of this infrequent disease, and the differential diagnosis with Bartter syndrome.

[Polymyositis as the first manifestation of acquired immunodeficiency syndrome]. / Polimiositis como primera manifestación del síndrome de inmunodeficiencia adquirida.

We present a case of polymyositis (PM) in a patient with no previous relevant medical history, who had received blood transfusion four years ago during surgery. It could be demonstrated that the patient was HIV infected inspite the fact that he did not belong to any other high risk groups. PM was the clinical presentation form of HIV infection, the patient dying five months later due to a Pneumocystis carinii. The main clinical and histologic characteristics of PM in HIV infected patients are described as well as the main myopathies that these patients present.

[Infections in 96 cases of systemic lupus erythematosus]. / Infecciones en 96 casos de lupus eritematoso sistémico.

The incidence, localization, etiology and predisposing factors of infections were evaluated in 96 cases of systemic lupus erythematosus (SLE) (15 males and 81 females) with a mean age of 40 years. Fifty-three patients (55%) had overall 102 infections (incidence 0.17 per year). 31% had urinary tract infections. In these, Escherichia coli was the most common causative organism (56%). 25% had respiratory infections (pneumonia in 14, pulmonary tuberculosis in 8, infections by opportunistic organisms in 4). 17% had skin infections, of which one half were due to Staphylococcus aureus. 16% had bacteremia, due to Staphylococcus spp in 5, to Salmonella spp in 4, and to Pseudomonas aeruginosa in 3. There was a higher incidence of infections in patients with active SLE, in those with nephropathy, and in those with previous immunosuppressant and/or corticosteroid therapy, Leukopenia was not associated to a higher number of infections. In 6 of the 12 patients who died, death was directly related with the infection; in one half of them, infections were due to an opportunistic organism (cytomegalovirus in 2 cases, disseminated candidiasis in one) and were not identified until necropsy. The need to rule out an opportunistic infection in any patient with SLE and fever is emphasized, particularly when there is pulmonary involvement and the patients have undergone aggressive diagnostic and/therapeutic interventions (immunosuppressants, plasmapheresis, renal dialysis).

[Polyneuropathy associated with human immunodeficiency virus infection]. / Polineuropatía asociada a la infección por el virus de la inmunodeficiencia humana.

We report five patients with human immunodeficiency virus (HIV) infection in stages IV-C1, IV-C2 and IV-D who developed peripheral polyneuropathy (PNP). Two patients had invalidating PNP with a demyelinating predominance, while in the remaining three axonal component predominated. However, both components were present in different degrees in all patients. We have observed two cases with transition from one type of PNP to the other during the course of the disease. Inflammatory polyradiculoneuropathy usually develops in the initial stages of the infection, while the distal axonal type is more commonly seen in patients with advanced infection. The possibility that PNP could have, in these patients, a common etiology and pathogenesis with variable clinical and electrophysiological expression is discussed.