Day-to-Day Variation in Iron Status Indexes is Similar for Most Measures in Elderly Women With and Without Rheumatoid Arthritis

Objective To determine the day-to-day variation in biochemical measures of iron status in a group of elderly women with rheumatoid arthritis compared with a group of healthy elderly women.Design Venous blood samples were collected from each subject on 3 nonconsecutive days during a 2-week study period; subjects had fasted overnight. Variability in hemoglobin level, hematocrit value, serum iron concentration, total iron-binding capacity, transferrin saturation, serum ferritin concentration, and plasma transferrin receptor level was determined.Subjects Two groups of women, one with rheumatoid arthritis (n=10) and another that was apparently healthy (n=10).Statistical analyses Variance component analysis was used to estimate the biological variation (σ²_day) and analytic variation (σ²_rep) for each iron index. The coefficient of variation (CV) for each variance component was calculated: coefficient of biological variation = CV_day, coefficient of analytic variation = CV_rep, and coefficient of a single future determination = CV_fd.Results The CV_rep for all iron indexes was smaller than the CV_day in both groups. The CV_day was considerably higher for serum iron concentration and for transferrin saturation than for the other indexes in both groups (16.6% arid 16.6% in healthy subjects and 33.6% and 28.2%, respectively, in subjects with rheumatoid arthritis). The higher CV_day for serum iron concentration and transferrin saturation translated into a higher CV_fd for these indexes. Because of the higher variance for these two indexes, more sampling days were required for reliable estimates. CV_da and CV_fd for plasma transferrin receptor level were relatively low.Conclusions These findings corroborate our previous finding that variation of serum ferritin concentration in the elderly is lower than that demonstrated in younger populations. This aging effect persists in the presence of rheumatoid arthritis. Fasting appeared to improve reliability in the determinations for serum iron concentration and transferrin saturation. Variability estimates for the indexes other than serum iron concentration and transferrin saturation were not altered by the inflammation of rheumatoid arthritis. Plasma transferrin receptor level is a reliable index for assessing iron status in populations with rheumatoid arthritis. J Am Diet Assoc. 1996; 96:247-251.     

Topical betamethasone-17-valerate inhibits heat-induced vasodilatation in man

Topical betamethasone-17-valerate inhibits the vasodilatation response to local non-pathological heating of rat skin.¹ We have shown that this effect can also be demonstrated in man. Topical betamethasone-17-valerate significantly inhibited the increase in human forearm cutaneous blood flow in response to heat of 44°C, as measured by laser-Doppler velocimetry. This suggests that the effects of topical steroids upon skin blood flow in the rat and in man are similar, and supports the use of the animal model as a paradigm for studying human skin blood flow, and changes in response to anti-inflammatory steroids.     

Evaluation of gastric antral motor performance in patients with dysmotility-like dyspepsia using real-time high-resolution ultrasound

Abstract Although manometric antral hypomotility and delayed gastric emptying have been reported separately in patients with dyspepsia, relationships between symptoms, antral contractility and emptying rate have not been sought. The present study therefore aimed to evaluate, simultaneously, gastric antral excursion characteristics and emptying in a sub-group of patients with severe functional dyspepsia using high-resolution real-time ultrasound. The circumference of the relaxed and contracted antrum was measured at 15-min intervals after ingestion of a 360 mL mixed nutrient meal in 36 chronic dyspepsia patients with symptoms of post-prandial bloating and epigastric distension, and in 25 healthy volunteers. Antral emptying (measured as the rate of decrease in circumference of the relaxed antrum) was slower in patients than normals (P = 0.02). In both groups, the average values for antral excursion were similar but the range of excursion in patients was significantly wider than in controls (F < 0.001), with 11 patients showing values above, and 8 showing values below the normal range. There was no relationship between antral emptying and antral excursion in either patients or volunteers. In conclusion, patients with severe functional dyspepsia show a wide range of antral performance characteristics, suggesting not only that the mechanisms responsible for the control of antral motor function are disturbed but also that the cause of the symptoms and the disturbed antral motor function are probably not directly related.