Erythrokinetic Studies in Thalassaemia

Erythrocyte survival studies were performed in a group of thalassaemic patients. The survival and sites of destruction of autologous and normal donor cells were determined. These studies were repeated in patients who had undergone splenectomy. The life span of the autologous red cells was found to be invariably shortened with some evidence of splenic sequestration. On the other hand, the life span of the donor cells was normal or decreased after repeated blood transfusions.
Following surgery, there was no noticeable improvement in the survival of the patient's abnormal cells, while transfused red cells now survived normally.     

Detection of Epstein-Barr virus DNA by polymerase chain reaction in lymph node biopsies from patients with angioimmunoblastic lymphadenopathy

Epstein-Barr virus DNA was detected by the polymerase chain reaction (PCR) in five lymph node biopsies from eight patients with diagnosis of angioimmunoblastic lymphadenopathy (AILD). Three pairs of specific primers detected EBV DNA sequences near the 5' end (Bam W region), the middle (BMRF 1 region) and the 3' end (Eco RI D region) of the viral genome with equal accuracy when 1 microgram of DNA and 30 amplification cycles were used. When only 100 ng of DNA were screened with the BMRF 1 set of primers, a specific amplification product was still identifiable. The 593 base pair amplification product obtained using the Eco RI D set of primers was shown to contain an expected Sma I site at position 215, confirming the viral origin of the amplified sequence [corrected]. Our findings indicate that lymph nodes of AILD patients frequently harbour the entire EBV genome at a high percentage of at least 1 viral copy per 15,000 human cells.     

Synoviales Plica-Impingement nach inverser Schulterarthroplastik

Background

Persisting pain following artificial joint replacement is a diagnostic and therapeutic challenge. Based on a case report, the feasibility of arthroscopy of a reverse shoulder prosthesis as a diagnostic and therapeutic tool is discussed.

Case report

The case of a 67-year-old woman with refractory pain in the anterior aspect of the shoulder when flexing and internally rotating the joint 14?months after an uneventful implantation and rehabilitation of a reverse shoulder arthroplasty is reported. Imaging and laboratory findings were all normal. Diagnostic arthroscopy confirmed the suspected plica-like synovial proliferation impinging between the glenosphere and humeral components.

Results

By means of arthroscopic resection of the plica, the patient recovered pain free and with full range of motion within weeks following the revision. Neither at the time of the index operation nor after the revision was instability of the implant evident.

Conclusion

Arthroscopy of reverse shoulder arthroplasty is technically feasible and safe. Its diagnostic potential is high and not only facilitates detection but also allows soft tissue impingement to be successfully treated. Nevertheless, introduction of the instruments has to be performed carefully in order to prevent iatrogenic damage to the prosthesis.     

Supervised classification approach of biometric measures for automatic fetal defect screening in head ultrasound images

Abstract

This paper presents an advanced approach for foetal brain abnormalities diagnostic by integrating significant biometric features in the identification process. In foetal anomaly diagnosis, manual evaluation of foetal behaviour in ultrasound images is a subjective, slow and error-prone task, especially in the preliminary treatment phases. The effectiveness of this appearance is strictly subject to the attention and the experience of gynaecologists. In this case, automatic methods of image analysis offer the possibility of obtaining a homogeneous, objective and above all fast diagnosis of the foetal head in order to identify pregnancy behaviour. Indeed, we propose a computerised diagnostic method based on morphological characteristics and a supervised classification method to categorise subjects into two groups: normal and affected cases. The presented method is validated on a real integrated microcephaly and dolichocephaly cases. The studied database contains the same gestational age of both normal and abnormal foetuses. The results show that the use of a support vector machine (SVM) classifier is an effective way to enhance recognition and detection for rapid and accurate foetal head diagnostic.     

Neuromuscular fatigue during high-intensity intermittent exercise in individuals with intellectual disability

This study examined neuromuscular fatigue after high-intensity intermittent exercise in 10 men with mild intellectual disability (ID) in comparison with 10 controls. Both groups performed three maximal voluntary contractions (MVC) of knee extension with 5 min in-between. The highest level achieved was selected as reference MVC. The fatiguing exercise consists of five sets with a maximal number of flexion-extension cycles at 80% of the one maximal repetition (1RM) for the right leg at 90° with 90 s rest interval between sets. The MVC was tested again after the last set. Peak force and electromyography (EMG) signals were measured during the MVC tests. Root Mean Square (RMS) and Median Frequency (MF) were calculated. Neuromuscular efficiency (NME) was calculated as the ratio of peak force to the RMS. Before exercise, individuals with ID had a lower MVC (p < 0.05) and a lower RMS (p < 0.05). No significant difference between groups in MF and NME. After exercise, MVC decreases significantly in both groups (p < 0.001). Individuals with ID have greater force decline (p < 0.001 vs. p < 0.01). RMS decreased significantly (p < 0.001) whereas the NME increased significantly (p < 0.05) in individuals with ID, but both remained unchanged in controls. The MF decreased significantly in both groups (p < 0.001). In conclusion, individuals with ID presented a lower peak force than individuals without ID. After a high-intensity intermittent exercise, individuals with ID demonstrated a greater force decline caused by neural activation failure. When rehabilitation and sport train ID individuals, they should consider this nervous system weakness.     

Association of Plasma 25‐Hydroxyvitamin D Concentrations and Pathogenic Oral Bacteria in Postmenopausal Females

Background: Previous findings of an association between 25‐hydroxyvitamin D [25(OH)D] concentrations and periodontal disease may be partially explained by the antimicrobial properties of vitamin D. To the best of the authors’ knowledge, no study has investigated the association between 25(OH)D and pathogenic oral bacteria, a putative cause of periodontal disease. Methods: The association between plasma 25(OH)D concentrations and pathogenic oral bacteria was examined among postmenopausal females in the Buffalo Osteoporosis and Periodontal Disease Study (1997 to 2000), an ancillary study of the Women's Health Initiative Observational Study. Subgingival plaque samples were assessed using immunofluorescence for the presence of Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, and Campylobacter rectus. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent bacteria by quintile (Q) of 25(OH)D concentrations, adjusting for age and body mass index. Results: Of the 855 participants, 288 (34%) had deficient/inadequate (<50 nmol/L) 25(OH)D concentrations, and 496 (58%) had at least one species of pathogenic bacteria. No significant association was found between 25(OH)D and presence of any of these bacteria (adjusted OR for high [Q5] compared to low [Q1] 25(OH)D = 0.96; 95% CI: 0.61 to 1.50; P for trend = 0.50). Inverse, although not statistically significant, associations were found between 25(OH)D and more than one species of pathogenic bacteria (adjusted OR for adequate compared to deficient/inadequate 25(OH)D = 0.85; 95% CI: 0.60 to 1.19). Conclusions: No association was observed between pathogenic oral bacteria and 25(OH)D concentrations in postmenopausal females. This may be attributable to the species of bacteria assessed, small effect size, or a true absence of an association.     

The effects of backpack load and carrying method on the balance of adolescent idiopathic scoliosis subjects

Background contextConcerns have been raised about the effect of backpack carrying on adolescent balance. For adolescent idiopathic scoliosis (AIS) subjects, the effect of backpack carrying method on their balance has not been determined. Our aim is to examine the effects of backpack load and carrying method on AIS subjects' balance.Study design/settingPaired sample matched for age and sex.Patient sampleTwelve healthy adolescents matched for age and sex with 14 adolescents with mild AIS participated in this study.Outcome measuresA test battery including clinical examination, radiological assessment, and stabilometric measurements of the postural sways in the upright standing posture were conducted.MethodsCenter of pressure excursions of our subjects were recorded with a stabilometric platform during the upright standing posture without a backpack and while carrying a backpack symmetrically and asymmetrically on each shoulder. For each carrying method, the backpack is loaded at 10% and 15% of body weight (BW).ResultsOur results indicated that postural sways increased with increasing backpack load. These postural sways were observed when normal adolescents carried a backpack loaded with 15% BW load, whereas, for age- and sex-matched AIS subjects, these postural responses were observed for the 10% BW load. The symmetrical backpack carrying induced better balance compared with the asymmetrical one. Asymmetrical carrying on the convex side of the scoliotic curve affects AIS subjects' balance more than carrying it on the concave side.ConclusionsLoad carriage of 10% BW seems to alter AIS subjects' balance. Asymmetrical carrying should be avoided especially on the convex side of the scoliotic curve because it causes balance impairments that may increase spinal pain.     

Dietary Intake of Lutein and Diabetic Retinopathy in the Atherosclerosis Risk in Communities Study (ARIC)

Purpose: We tested the hypothesis that dietary intake of lutein is inversely associated with prevalence of diabetic retinopathy (DR) due to its antioxidant and anti-inflammatory properties and location within the retina.

Methods: We used logistic regression to examine the association between prevalent DR and energy-adjusted lutein intake by quartile (Q) using data collected from 1430 Atherosclerosis Risk in Communities Study (ARIC) participants with diabetes (n = 994 white, n = 508 black). DR was assessed from 45° non-mydriatic retinal photographs of one randomly chosen eye taken at visit 3 (1993–1995). Dietary lutein intake was estimated using a 66-item food frequency questionnaire at visit 1 (1987–1989).

Results: Median estimated daily lutein intake was 1370 µg/1000 kcals and prevalence of DR was ~21%. We found a crude association between lutein and DR (odds ratio, OR, 2.11, 95% confidence interval, CI, 1.45–3.09 for Q4, high intake, vs. Q1, low intake; p for trend <0.0001), which was attenuated after adjustment for ethnicity, duration of diabetes, glycosylated hemoglobin levels, field center and energy intake (OR 1.41, 95% CI 0.87–2.28; p for trend = 0.01). In analyses limited to persons with short diabetes duration (<6 years), the association no longer persisted (OR 0.94, 95% CI 0.31–2.16; p for trend =0.72) compared to the association in those with longer diabetes duration (≥6 years; OR 1.58, 95% CI 0.91–2.75; p for trend = 0.01).

Conclusion: Contrary to our hypothesis, we found that the odds of higher lutein intake were greater among those with DR than those without DR. However, after adjusting for confounders, intake of lutein was not associated with DR.     

What is the ability of anti-cyclic citrullinated peptide antibodies determination in synovial fluid in discriminating rheumatoid arthritis from non-rheumatoid arthritis patients? A Tunisian cross-sectional study

Anti-cyclic citrullinated peptide antibodies (ACPA) seem to be produced locally at the site of joints inflammation in the first stage of rheumatoid arthritis (RA). A strong correlation between serum ACPA and ACPA in the synovial fluid (SF-ACPA) is now suggested. A case-control study was conducted to evaluate the usefulness of ACPA determination in SF of patients with RA. A total of 53 patients with a knee-joint effusion (26 RA, 18 peripheral spondyloarthropathies (SPA), and 9 osteoarthritis (OA)) were included in our study. SF samples were obtained by performing therapeutic arthrosynthesis. IgG serum ACPA and SF-ACPA levels were determined by the enzyme-linked immunosorbent assay (ELISA). We have also determined IgG levels in serum and SF by nephelometry. Higher levels of IgG ACPA antibodies in SF (p = 0.045) and serum (p = 0.045) were found in patients with RA with respect to SPA and OA patients. The Spearman correlation analysis showed a significant and positive correlation between ACPA in serum and SF (rho = 0.516; p = 0.007) not only in the RA group but also in patients with SPA. Serum ACPA discriminated RA from non-RA at a cut-off value of 2.7 U/ml (sensitivity, 69%; specificity, 78%; and area under the curve (AUC), 0.72), whereas SF-ACPA discriminated RA from non-RA at a higher cut-off value of 4.95 U/ml (sensitivity, 73%; specificity, 61%; and AUC, 0.71). Our study suggests that the determination of SF-ACPA give complement information to serum ACPA in patients with RA.