Physical activity in the life of the patient with rheumatoid arthritis

BACKGROUND AND PURPOSE

Physical activity is an important tool used by patients with rheumatoid arthritis (RA) in order to reduce inflammation and pain as well as preserve and improve function. The aim of this study was to investigate how patients with RA perceive and relate to physical activity in everyday life.

METHODS

Ten patients diagnosed with RA were interviewed. The data collected were transcribed and analysed for categories of meaning and main themes. Inter-judge reliability was tested and showed an 81.5% agreement.

RESULTS

Three themes were identified. The first represented a 'driving force' and included two positively loaded categories 'satisfaction' and 'support', and two negatively loaded categories 'keep at bay' and 'intimidation'. The second theme was 'hindrance' and included the categories 'internal barrier' and 'external barrier' and, finally, the third theme 'physical activity' included the categories 'organized activity' and 'everyday activity'.

CONCLUSION

Physical exercise was an important strategy for patients with RA and was promoted primarily by patients' own experiences, positive as well as negative. A salutogenic (explaining health) approach to patient education, as well as an increased use of everyday activities as additional exercise, is advocated.

Positive atopy patch test reactions to Pityrosporum orbiculare in atopic dermatitis patients

BACKGROUND

Pityrosporum orbiculare, although a part of our normal cutaneous microflora, can cause skin infections and induce specific immunoglobulin (Ig) E antibodies in atopic dermatitis patients. P. orbiculare is therefore considered to be one of the trigger factors for atopic dermatitis.

OBJECTIVE

To investigate if P. orbiculare can induce an eczematous reaction in atopic dermatitis patients, seborrhoeic dermatitis patients and healthy controls.

METHODS

Fifteen atopic dermatitis patients, eight seborrhoeic dermatitis patients and eight healthy controls were patch tested with extract of P. orbiculare on non-lesional, tape-stripped skin of the back. NaCl was used as a negative control. The patch tests were evaluated after 24, 48 and 72 h. Skin biopsies were taken from P. orbiculare patch test sites at 24 h and 72 h, from NaCl patch test sites at 72 h, from non-lesional skin and, in the atopic dermatitis patients, also from lesional skin. The skin biopsies were investigated with immunohistochemical techniques. P. orbiculare-specific IgE in serum was analysed with RAST.

RESULTS

Specific IgE to P. orbiculare was found in serum from 13/15 atopic dermatitis patients and in eight of them a positive patch test reaction to P. orbiculare was observed, with a maximal reaction at 48 h. Significantly higher serum levels of P. orbiculare-specific IgE were detected in patch test-positive compared with patch test-negative atopic dermatitis patients (P < 0. 01). The seborrhoeic dermatitis patients and healthy controls were RAST and patch test-negative for P. orbiculare. In the patch test-positive atopic dermatitis patients an infiltration of CD4+ T cells and eosinophils was observed at the P. orbiculare patch test sites together with an upregulation of ICAM-1 and HLA-DR expression.

CONCLUSIONS

P. orbiculare can induce an eczematous reaction in sensitized atopic dermatitis patients and may be an important trigger factor in these patients. The P. orbiculare patch test can be of diagnostic value in this subgroup of atopic dermatitis patients.

Topology of an amiloride-binding protein

Amiloride and structurally related compounds inhibit many transport proteins, enzymes, and drug or hormone receptors, although the topology of amiloride binding sites on these proteins has not been defined. We have previously raised and characterized a monoclonal antiamiloride antibody (mAb BA7.1) which is similar to epithelial Na+ channels in its specificity of binding of amiloride and amiloride analogs, suggesting that their amiloride binding sites may be similar in topology, mAb BA7.1 was used as a model system to analyze the three-dimensional conformation of an amiloride binding site. The photoactive amiloride analog 2'-methoxy-5'-nitrobenzamil specifically labeled the heavy chain of mAb BA7.1, suggesting that the heavy chain participates in amiloride binding. The nucleotide sequences of the variable regions of the heavy and light chains of mAb BA7.1 were determined and amino acid sequences deduced to analyze the structure of the amiloride binding site. A comparative modeling approach was used to construct a model of the amiloride binding domain of mAb BA7.1, and a docking procedure was used to place amiloride within this domain. The model indicated that planar aromatic amino acid resides form a pocket into which amiloride, a planar molecule, inserts. Constraints on amiloride binding predicted by this model correlated with the measured specificity of binding of amiloride analogs with mAb BA7.1. These results provide a potential guide for the identification of motifs or amino acid contact residues present within other amiloride-sensitive proteins.

Habituation of the electrodermal orienting reaction is dependent on the cerebral hemisphere initially stimulated

The purpose of the present study was to investigate the relationship between habituation of the electrodermal orienting reaction (OR) and asymmetrical hemisphere functioning. Subjects were exposed to lateralized visual input with fear-relevant and neutral content. Skin conductance recordings were taken bilaterally. The experiment consisted of four groups in a randomized 2 X 2 factorial design (N = 40). Half of the subjects habituated to repeated presentations (25 trials) of a snake-slide, whereas the other half viewed a slide of a rectangular black geometric shape. Within each stimulus category, half of the subjects had the picture presented 6 degrees of visual angle lateral to the right of a central fixation point (i.e. initial right hemisphere input). The other half had the picture presented to the left (i.e. initial right hemisphere input). Results showed a significant overall decrease in response magnitude over trials, and a significant main effect of type of projection field. Responses in the left field groups were larger than responses in the right field groups on all trials. No other comparisons reached significance. The results are discussed in terms of hemisphere asymmetry and its role in the regulation of the habituation process.