Objective: To evaluate the effect of infliximab dose escalation in incomplete responders in a randomised controlled trial. Methods: 141 rheumatoid arthritis (RA) patients treated with infliximab for 12 months (3 mg/kg; intervals 0, 2, 6 and then 8 weeks) who responded to the drug (disease activity score in 28 joints (DAS28) decrease .1.2) but who were not in remission (DAS28 .2.6) were enrolled into the study. Patients were randomly assigned into arm A, 3 mg/kg, and arm B, 5 mg/kg infliximab every 8 weeks. Outcome measures included the DAS28, its components and C-reactive protein (CRP). Results: There were no significant differences in changes in the DAS28, its components, or CRP in patients in arms A and B during the 12 months of treatment. All patients showed a DAS28 decrease greater than 0.6 after 28 weeks. Eleven patients interrupted therapy in arm A and 14 in arm B. Infusion reactions and non-serious adverse events were observed in 4.2% and 28.2% of arm A patients and in 7.2% and 47.8% of arm B patients. The frequency of serious adverse events was comparable between arms A and B (16.9% and 15.9%, respectively), and the frequency of serious infections was not significantly greater in the higher dose group (5.8%) than in the lower dose group (5.6%). Conclusions: In this setting, increasing the infliximab dose from 3 mg/kg to 5 mg/kg in RA patients with residual disease activity did not improve efficacy but moderately increased toxicity. These data indicate that a switch to another biological treatment would be a more appropriate strategy in incomplete responders.

ABSTRACT:The parasite load of brown hares (Lepus europaeus) is of great interest to hunting ground managers and veterinarians. We compared the prevalence and intensity of parasitic infections in 362 hares from Austria and the Czech Republic with respect to age and body weight. Samples of the entire gastrointestinal tract, liver and lungs were collected during autumn hunting events in 2007. The parasite spectrum of hares included Protostrongylus pulmonalis, Graphidium strigosum, Trichostrongylus retortaeformis, Trichuris leporis, Eimeria spp. and tapeworms. The most prevalent gastrointestinal nematode was Trichostrongylus retortaeformis, while only individual specimens of tapeworms such as Andrya rhopalocephala, Mosgovoyia pectinata, Cittotaenia denticulata and Ctenotaenia ctenoides were found in subadult hares. A single hare was infected with Cysticercus pisiformis in Austria. Lungworms Protostrongylus pulmonalis and findings of pneumonia were significantly less prevalent in subadult than adult hares (P < 0.01) from both countries and were much less prevalent overall in the Czech Republic (P < 0.01). Graphidium strigosum, Trichostrongylus retortaeformis, Eimeria spp. and enteritis were more prevalent in subadult hares. The nematode Trichuris leporis, on the other hand, prevailed in adults. The body weight of adult hares was negatively correlated with the intensity of infection by Protostrongylus pulmonalis (r = -0.67) and Trichostrongylus retortaeformis (r = -0.73) and the parasite loads served as significant weight predictors in multiple regression equations. This study revealed that parasitic infections of the lungs and intestines influences the health and decreases the body weight of hares in Austrian and Czech hunting grounds.

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In a 7-year-old boy with normal hearing suffering from repeated syncope an extremely prolonged QTc interval (up to 700 ms) was found. The mother was completely asymptomatic and the father had an intermittently borderline QTc interval (maximum 470 ms) but no symptoms. In the proband a mutation analysis of KCNQ1 gene revealed a homozygous 1893insC mutation. The parents were heterozygous for this mutation. There was no consanguineous marriage in the family. The clinical relevance of these findings is that apparently normal individuals may have a latent reduction of repolarizing currents, a "reduced repolarization reserve," because they are carriers of latent ion channel genes mutations.