Investigation of effects of different treatment modalities on structural and functional vessel wall properties in patients with ankylosing spondylitis

Aim

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that is associated with increased cardiovascular burden. The aim of this study was to investigate vascular structural and functional changes in patients with AS, with special emphasis on the effects of different treatment modalities, through evaluation of level of vascular stiffness (pulse wave velocity [PVW]) and carotid intima media thickness (IMT-C).

Methods

A total of 67 AS patients, and age, sex, body mass index (BMI) smoking status, lipid profiles and blood pressure-matched healthy control subjects (n = 34) were studied. Of these, 34 patients were on anti-TNF alpha and 33 on non steroid anti inflammatory drugs (NSAIDs). The IMT-C and PWV values of the right common carotid artery were measured by high-resolution ultrasound.

Results

The AS patients (n = 67) had significantly higher PWV values than the controls [9.0 ± 1.49 m/sec vs. 8.27 ± 0.90 m/sec, P = 0.004; 95% confidence interval (CI), −1.22 to −0.24]. Multiple stepwise linear regression analysis revealed that PWV could only be explained by systolic blood pressure (P < 0.05) and IMT (P < 0.05) in AS. Even though IMT-C in anti-TNF alpha treated group was higher compared to the NSAID treated group, it was not statistically significant (P = 0.5).

Conclusion

PWV was found to be higher in AS patients than in the control group, and there was no significant difference between the average PWV values of AS patients treated with anti -TNF alpha or NSAIDs.     

Comparison of focally induced epileptiform activities in C57BL/6 and BALB/c mice by using in vivo EEG recording

Epilepsy characterized by repeated seizures is influenced by genetic factors. Seizure response of inbred mouse strains changes depending on the variety of stimuli including chemical (e.g., pentylenetetrazole, nicotine, cocaine, NMDA, kainate), physical (e.g., auditory) or electrical. In this study, we compared the susceptibilities of C57BL/6 and BALB/c mice strains to penicillin induced epileptiform activity (a focally induced, experimental epilepsy model), by analyzing the spike onset latency, spike amplitude and spike frequency. The power spectrums of baseline EEGs were also investigated. We found no alterations of spike onset latencies between the C57 and BALB mice. However, spike amplitudes and spike frequencies were found to be higher in BALB mice than C57 mice. With regard to EEG power spectrum, absolute power of investigated bands was not different between the two strains. Interestingly, the relative power of all investigated bands differed significantly between two strains. The relative power of delta and theta was lower whereas relative power of alpha, beta and gamma was higher in C57 mice compared to BALB mice. In conclusion, our findings showed that BALB mice are more sensitive to penicillin induced epileptiform activity when compared to C57 strain.     

A case with a ring chromosome 22

Ring chromosome 22, a rare cytogenetic finding, was first described in 1968, and since then about 60 patients have been reported. We describe a new patient with ring chromosome 22 syndrome and discuss the common features of the previously reported cases. Our patient had the major features of this syndrome including mental retardation, hypotonia, motor delay, microcephaly, dysplastic large ears, lack of speech, and hyperactivity disorder. Magnetic resonance imaging findings also revealed an arachnoid cyst, found in the posterior cerebellum. In patients with ring chromosome 22, variable clinical manifestations may be seen due to the size of lost sequences near the telomere. By fluorescent in situ hybridization (FISH) technique, LSI DiGeorge/VCFS/ ARSA locus-specific probes are used to detect deleted sequences. We found that 22q11.2 regions were intact on both chromosomes 22, but 22q13.3 (Arylsulfatase A; ARSA region) was absent in the ring chromosome. As far as we know this is the first reported Turkish patient in the literature.     

A study of perceptions, attitudes, and level of knowledge among pediatricians towards attention-deficit/hyperactivity disorder

The study aimed to evaluate the level of perception, attitude, and knowledge of pediatric residents to attention-deficit/hyperactivity disorder (ADHD) by a questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed) diagnostic criteria. One hundred and fifty-six pediatric residents from university and state hospitals answered a four-step Likert type questionnaire form consisting of 43 questions regarding sociodemographic features, age, duration of residency, marital status, and general knowledge of ADHD, differential diagnosis, coexisting conditions, and management of ADHD. Of the residents, 127 (81.4%) stated that their knowledge on ADHD was deficient, and 123 (85.2%) reported that they did not know the protocol used in establishing the diagnosis. There was no statistically significant difference with respect to differential diagnosis and co-morbid conditions of ADHD between the two groups (university and state hospital) (p>0.05). 60.9% of the residents were aware of the adverse effects. We believe that pediatric resident education programs must include more intensive focus on the topics of behavioral and developmental neurology as well as common neuropsychiatric disorders, and that child psychiatry and child neurology rotations, within our current rotation systems in pediatric residency training, should be extended.     

Intraocular pressure elevation after intravitreal triamcinolone acetonide injection: a Meta-analysis

AIM: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. METHODS: Systematic literature review of studies that investigated the effects of an injection of triamcinolone intravitreal triamcinolone acetonide on IOP was conducted according to the Cochrane Collaboration methodology and the reported effects have been analyzed with Meta-analysis. RESULTS: We found that the IOP follows an inverted-U shape pattern over time starting with an average value of 14.81±1.22 mm Hg before the injection, rising to a maximum of 19.48±2.15 mm Hg after one month of injection and falling down to 16.16±1.92 mm Hg after 6mo. Moreover, country of study, age, previous history of glaucoma and gender compositions matter for cross-study were different in reported IOP changes. CONCLUSION: Our findings may be helpful in determining pressure elevation risk of intravitreal triamcinolone acetonide therapy as well as comparing it with those of more recent therapies such as the anti-vascular endothelial growth factor agents.     

5q21 deletion is often heterogeneous in prostate cancer

Cancer heterogeneity represents a challenge for the analysis of prognostic molecular markers but can be used to study the evolution of molecular events in tumors. To assess the degree of heterogeneity of 5q21 deletions and their relationship with TMPRSS2:ERG status and 6q15 deletions in prostate cancer, a heterogeneity tissue microarray including 10 tissue spots from 10 different areas of 317 cancers was analyzed by fluorescence in situ hybridization for 5q21 deletion. Data on 6q and ERG were available from earlier studies. Deletions of 5q21 were found in 23% of 265 interpretable cancers and showed marked intratumoral heterogeneity. In the subset of 246 cancers with at least 3 interpretable spots, 23% had a 5q21 deletion. Heterogeneous 5q21 deletions were found in 71% and homogeneous in 29% of these cancers. The likelihood of 5q21 deletion was twice as high in ERG‐negative (28%) than in ERG‐positive cancers (16%, P = .024). In all 21 cases harboring both alterations, the tumor area containing a 5q21 deletion was smaller or equally large than the ERG‐positive area but never larger. Deletions of 5q and 6q were significantly linked. However, the analysis of 32 tumors harboring both deletions did not suggest a specific order of appearance of these deletions. The 5q21 deletion preceded 6q15 in 10 tumors and 6q15 preceded 5q21 in 14 tumors. In summary, our study identifies 5q21 deletion as a highly heterogeneous aberration in prostate cancer that usually occurs late during cancer progression. This is a severe limitation for using 5q21 testing as a prognostic tool.