Prediction of efficacy of octreotide therapy in patients with acromegaly

Octreotide (OCT) administration provides a biochemical cure in most acromegalic patients. This drug, however, causes several side effects and is very expensive. Acute testing has been reported to predict chronic responsiveness to OCT administration. The aim of this retrospective study was to evaluate which test, if any, among acute testing, short-term (1 month) administration, and 111In-pentetreotide (111In-DTPA-Phe-D-OCT) scintigraphy, is best in predicting response to long-term OCT treatment. Sixty-eight patients with active acromegaly were studied. An acute test (100 micrograms sc OCT) was performed as usual: a GH decrease greater than or equal to 50% of baseline was considered a positive response. GH and insulin-like growth factor I (IGF-I) were then assayed after 1 month (300 micrograms daily) and 3 months (150-600 micrograms daily) of OCT administration. GH was considered normalized when decreased less than or equal to 5 micrograms/L. Twenty-six of 68 patients were subjected to 111In-pentetreotide scintigraphy. Linear correlation analysis of the results was performed. Sensitivity, specificity, and positive and negative predictive values of the three tests were also calculated. Thirty-eight of 68 patients (56%) responded to the acute test. Among these 38 patients, 20 experienced normalization of GH and IGF-I levels during long-term therapy, as did 8 patients who did not respond to the acute test. No significant correlation was found between GH percent decrease during acute testing and long-term therapy (r = 0.11). Seven patients who responded to the acute test and 2 who did not respond had adenoma shrinkage during therapy. Conversely, GH and IGF-I decrease after short-term treatment significantly correlated with long-term treatment (r = 0.76 and 0.64, P < 0.01). Of the 26 patients subjected to 111In-pentetreotide scintigraphy, 13 had significant tracer uptake: normalization of GH and IGF-I was obtained in 8 patients. A significant correlation was found between tracer uptake and GH/IGF-I inhibition after 3 months of therapy (r = 0.6; P < 0.05). In the whole population, the positive predictive value of acute testing, short-term OCT administration, and 111In-penetreotide scintigraphy was 53%, 70%, and 73%, respectively, when the GH normalization (< 5 micrograms/L) after 3 months of therapy was considered. Moreover, 111-In-pentetreotide scintigraphy had the highest specificity (100% in patients with baseline GH values below 50 micrograms/L) compared with that of acute testing and short-term OCT administration. The acute test cannot be considered as a valuable index to identify patients' responsiveness to long-term OCT therapy, but it can be useful to test tolerability. By contrast, 1 month of OCT administration or the in vivo imaging of somatostatin receptors by 111-In-pentetreotide might better indicate the patients who might effectively benefit from this treatment.     

Use of compatible blends to fabricate carbon black composite vapor detectors

The aim of this work was the development of materials to be used in the field of gas sensing for the detection of organic vapors. Conductive sensors were prepared with carbon black filled blends of poly(vinyl chloride) and diol‐terminated poly(?‐caprolactone), an oligomeric plasticizer. For comparison, blends with di(2‐ethylhexyl)phthalate, a traditional low‐molecular‐weight plasticizer, were also prepared. All sensors were tested upon exposure to different organic vapors. In general, the plasticizer content affected the response rates of the sensors, and a linear variation of the relative resistance with the analyte concentration was observed. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 91: 1816–1821, 2004     

Data vs. Capta or Sumpta.

In a recent book called Becoming, Gordon Allport points out that there are two approaches to psychology which historically have been called empiricism and rationalism and which he prefers to designate as Lockean and Leibnitzian. The former put the emphasis on the external world and described the human mind as essentially passive; the latter stressed the activity of the individual rather than the environment. With considerable philosophical insight, Allport showed that American psychology followed the leadership of British empiricism-behaviorism and operationalism are good examples of it. The rational position has been more current in Europe. In the psychology of personality, the Leibnitzian position has slowly gained some prominence. But despite the emphasis we are putting on the self and its creative nature, the terminology we use unfortunately is the old language of empiricism. When the word data is used, whether the writer is trying to emphasize what is empirically given or what is phenomenally taken is uncertain. This article recommends a different terminology for the phenomenologist. One might use the word capta for that which is taken from experience or sumpta for that which one takes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monitoring the oxidative modification of lipoprotein(a) by capillary zone electrophoresis

Lipoprotein(a) [Lp(a)] is a recognized risk factor for atherosclerotic cardiovascular disease. It is made of a lipoprotein particle containing apoB100 linked by a single disulfide bridge to apolipoprotein(a), a glycosylated protein with a variable mass. Some authors suggest that oxidative modification could explain the contribution of Lp(a) in the development of atheromatous lesions in a comparable way to low‐density lipoproteins (LDL). Recently, the use of capillary electrophoresis to measure the variations in the relative electrophoretic mobility (REM) of LDL subjected to copper oxidation has been proposed. The aim of this work is to employ this method also to monitor the copper‐induced oxidative modification of Lp(a). Migration of Lp(a) was monitored by absorption at 200 nm in a 50 mmol/L tricine, 100 mmol/L methylglucamine, pH 9.7 run buffer. Contrary to the conventional slab gel methods, our procedure provides a rapid and reproducible means to measure the electrophoretic mobility of Lp(a) (migration time <10 min with a CV% <0.5).     

Mood regulation expectancies, anxiety sensitivity, and emotional distress.

Mood regulation expectancy is a behavior–outcome response expectancy; anxiety sensitivity can be conceptualized as a stimulus–outcome response expectancy. Current expectancy models of emotion and distress focus on stimulus–outcome expectancies, potentially neglecting behavior–outcome expectancies. In a sample of 502 college students, measures of each expectancy were independently related to distress, measured by the Beck Depression Inventory and Trait Anxiety Inventory: Those with weak beliefs about their ability to regulate negative moods and strong beliefs that the experience of anxiety causes further negative consequences reported the highest levels of distress. Implications for integrating behavior–outcome and stimulus–outcome response expectancies in models of emotion are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The guanosine monophosphate reductase gene is conserved in rats and its expression increases rapidly in brown adipose tissue during cold exposure

Non-shivering thermogenesis is required for survival of rodents during cold stress. Uncoupling protein-1 acts in brown adipose tissue (BAT) to transport protons, thus dissipating the proton gradient across the inner mitochondrial membrane. This permits respiration uncoupled from ATP synthesis. UCP-1 function is inhibited by the binding of purine nucleotides, with GTP/GDP being more potent than ATP/ADP. We used a cDNA subtraction analysis to identify cDNAs rapidly induced by cold exposure. One of these encodes rat guanosine monophosphate reductase (GMP-r). This was surprising in that previous data had suggested that this enzyme was absent in rodents. Rat GMP-r is 96% identical to human GMP-r, and its mRNA is increased 30-fold in BAT within 6 h of cold exposure. The gene is also expressed (but not cold-responsive) in muscle and kidney, but not in white fat. We speculate that the physiological function of the marked increase in BAT GMP-r during cold stress may be to deplete the brown adipocyte of guanine nucleotides, converting them to IMP, thus permitting enhanced UCP-1 function. This is a previously unrecognized regulatory aspect of thermogenesis, an essential physiological response of rodents to cold.     

Prognostic value of myocardial hypoperfusion indexes in patients with suspected or known coronary artery disease

BACKGROUND: We evaluated the prognostic value of exercise 201Tl indexes of myocardial hypoperfusion in patients with suspected or known coronary artery disease. METHODS AND RESULTS: Patients were divided into two groups: group I consisted of 332 patients with diagnostic electrocardiographic stress test results and group II consisted of 144 patients with nondiagnostic (inadequate or uninterpretable) stress electrocardiograms. At the 2-year follow-up, 20 hard events (16 cardiac deaths and 4 nonfatal myocardial infarctions) and 80 soft events (coronary revascularization procedures) occurred in group I. Considering total events, thallium imaging provided significant prognostic information in addition to clinical and exercise stress test data in the total study population (p < 0.001) and in patients with previous myocardial infarction (p < 0.001); in patients without previous infarction, thallium imaging added incremental prognostic value only in those with positive electrocardiographic stress test results (p < 0.01). When only hard events were considered, thallium variables added further information only in patients with previous myocardial infarction (p < 0.05). In group II at the end of follow-up, 15 hard and 39 soft events had occurred. In these patients occurrence of total (p < 0.001), hard (p < 0.05), and soft (p < 0.001) events was higher in those with abnormal thallium scintigraphic results than in those without. Moreover, no clinical and exercise variable, except history of myocardial infarction, was significantly related to outcome, whereas both indexes of extent and severity of hypoperfusion were significant. CONCLUSIONS: The results of this study demonstrate that scintigraphic indexes of myocardial hypoperfusion obtained by qualitative planar thallium imaging give unique prognostic information in patients with nondiagnostic electrocardiographic stress test results. Thallium imaging provides incremental prognostic information even in patients with diagnostic electrocardiographic stress test results but not in the low-risk subset of patients without previous infarction who have negative electrocardiographic stress test results.