Evaluation of the fluorescent treponemal antibody absorption test for detection of antibodies (immunoglobulins G and M) to Treponema pallidum in serologic diagnosis of syphilis

We compared the fluorescent treponemal antibody-absorption (FTA-ABS) (immunoglobulin (Ig)G + IgM) assay with the (micro-) Treponema pallidum haemagglutination assay (TPHA), the T. pallidum particle agglutination assay (TPPA), the Murex syphilis ICE (ICE) enzyme-linked immunosorbent assay (ELISA), the Diesse Enzywell TP (TP) (ELISA) using 122 serum samples and the Western blot (WB) assay using 42 serum samples whose results were inharmonious with other tests. Additionally, the Captia syphilis-M (IgM) (ELISA) were performed. All sera had already been examined by the rapid plasma reagin (RPR) card test, a non-treponemal test and the TPHA, a treponemal test using routine screening tests. Agreements of the FTA-ABS with the TPHA test, the TPPA test, the ICE test and the TP test were 97.5%, 95.9%, 98.3% and 98.3%, respectively. The results suggest that the FTA-ABS test is a useful confirmatory test, but can be inadequate as a confirmatory test for serologic diagnosis of syphilis by giving equivocal and false-negative results even rarely.     

Forty-years (1961-2001) of all-cause and coronary heart disease mortality and its determinants: the Corfu cohort from the Seven Countries Study

AIMS: This study examined risk factors in relation to 40-year all-cause and coronary heart disease mortality in the Corfu cohort of the Seven Countries Study. METHODS: The population studied in this analysis consisted of 529 rural middle-aged men enrolled in 1961. Multivariate analysis was performed using the proportional hazards Cox model with all-cause as well as coronary heart disease death as end points and age, blood pressure, serum total cholesterol, smoking, physical activity, body mass index, skinfold thickness, vital capacity and forced expiratory volume as predictors. RESULTS: The 40-year all-cause mortality rate was 87.1% (461 deaths/529 individuals at entry), while the CHD mortality rate was 22.7% (120 deaths/529 individuals at entry). The proportion of CHD deaths varied from 16 to 28.5% of all deaths during the period investigated. Age (hazard ratio (HR)=1.08, P<0.001), smoking (HR=1.40, P<0.01), diastolic blood pressure (HR=1.01, P<0.05), and forced expiratory volume (HR=0.97, P<0.05) were independently associated with 40-year all-cause mortality. Moreover, age (HR=1.093, P<0.001), smoking (HR=1.596, P<0.05), and body mass index (HR=1.05, P<0.05) were independently associated with 40-year CHD mortality. CONCLUSION: Among the investigated cardiovascular risk factors, age, smoking, physical activity, skinfold thickness, diastolic blood pressure, and forced expiratory volume seem to be associated with all-cause mortality, while age, smoking, and body mass index were consistently associated with 40-year CHD mortality.     

Involvement of sympathetic reflex activity in patients with acute and chronic stroke: A comparison with functional motor capacity

OBJECTIVE: To investigate sympathetic nervous system functions in patients with acute and chronic phase of stroke by measuring sympathetic skin reflex (SSR) and the relationship between sympathetic dysfunction and motor function capacity. DESIGN: Cross-sectional, case-control study. SETTING: A physical medicine and rehabilitation department in a research hospital of a university referral center in Turkey. PARTICIPANTS: Fifty-six patients with stroke-13 in the acute phase and 43 in the chronic phase-and 42 age- and sex-matched healthy volunteers were included. INTERVENTION: SSR was recorded with electric stimulation of the bilateral median nerves. MAIN OUTCOME MEASURES: SSR was recorded to assess sympathetic reflex activity in patients in the acute and chronic phase of stroke and in controls. Motor functions was classified using the Brunnstrom stages. RESULTS: The mean SSR latency in the acute phase was significantly prolonged and the amplitudes were decreased compared with controls. In the chronic phase, the mean amplitudes were significantly attenuated compared with controls, whereas the mean latency did not change. The mean latency of SSR in patients in Brunnstrom groups 1 and 2 was longer, and the mean amplitude was smaller than in controls (P<.05). The mean amplitude was significantly reduced in patients classified as Brunnstrom groups 3 and 4 compared with controls (P<.05), but the mean latency was not affected. CONCLUSIONS: Depression of sympathetic reflex activity was more prominent in the acute phase of stroke and was associated with moderate or highly limited motor function capacity. Improvement of motor dysfunction may parallel recovery of sympathetic reflex activity.     

Lipid, protein, DNA oxidation and antioxidant status in rheumatoid arthritis

ObjectivesTo investigate lipid, protein, DNA oxidation and antioxidant status in blood and synovial fluid of rheumatoid arthritis (RA) patients and to determine the importance of oxidative stress parameters in reflecting disease activity.Design and methods20 RA patients and 15 healthy controls were included. Lipid peroxidation (thiobarbituric acid reactive substances (TBARS), lipid hydroperoxide, and conjugated diene), protein oxidation (carbonyl and thiol), DNA oxidation (8-OHdG) and antioxidant status markers (glutathione (GSH), glutathione peroxidase (GSH Px), superoxide dismutase (CuZn SOD), and catalase) were determined in blood and synovial fluid.ResultsTBARS (p < 0.001), lipid hydroperoxide (p < 0.001), conjugated diene (p < 0.001), carbonyl (p < 0.001) and 8-OHdG (p < 0.01) levels were significantly higher; thiol (p < 0.01) and GSH levels (p < 0.01) and GSH Px (p < 0.001) and CuZn SOD (p < 0.01) activities were significantly lower in blood of RA patients. TBARS (p < 0.001), lipid hydroperoxide (p < 0.001), conjugated diene (p < 0.01), carbonyl (p < 0.001) and 8-OHdG (p < 0.05) levels were significantly higher, catalase activity (p < 0.001) significantly lower in synovial fluid of RA patients.ConclusionsIncreased lipid, protein and DNA oxidation markers and impaired antioxidant status confirm the role of oxidative stress in the pathogenesis of RA. Lipid peroxidation markers can serve as surrogate markers for disease activity.     

Secondary aortoenteric fistula in Beh?et's disease.

Vascular manifestations of Beh?et's disease include venous and arterial occlusions, arterial aneurysm and pseudo-aneurysm formation. The main problem of the surgical treatment of vascular lesions in Beh?et's disease is the high incidence of complications such as recurrent aneurysms, thrombosis and fistulization to the adjacent organs. Here we present a case of Beh?et's disease with multiple complications after aortic reconstructive surgery, including perigraft infection, abscess distal to the graft, occlusion of arteries of the lower extremities, aortoenteric fistula and distal anastomotic site aneurysm rupture.     

Serum and synovial fluid leptin levels and markers of inflammation in rheumatoid arthritis

This study was designed to investigate the serum and synovial fluid leptin levels, and inflammatory markers in rheumatoid arthritis (RA) patients. Serum and synovial fluid leptin levels were significantly higher (P > 0.05) in RA patients than control group; RA patients with moderate disease activity (DAS < 2.7) having significantly higher leptin levels (P > 0.05) than those with low disease activity (DAS < 2.7). Leukocytes and erythrocyte sedimentation rate (ESR) were found to be significantly higher in moderate disease activity RA group compared to low activity group (P > 0.05, P < 0.001, respectively). Serum leptin level is found to be independent of age and inflammatory markers. ESR is positively correlated with DAS activity and CRP values. Our finding of no correlation between leptin and BMI shows that regulation of leptinemia is complex, and leptin levels cannot be used to assess RA activity.     

Femoral Vein Wall Thickness Measurement May Be a Distinctive Diagnostic Tool to Differentiate Behçet’s Disease with Intestinal Involvement and Crohn’s Disease

Digestive Diseases and Sciences - Behçet’s disease (BD) and Crohn’s disease (CD) cannot be easily differentiated in young adults presenting with nonspecific gastrointestinal (GI)...     

Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers' pneumoconiosis

OBJECTIVE: The aim of this study was to investigate the effect of the radiological evidence of emphysema, and the extent of interstitial involvement, on lung function and pulmonary arterial pressure (PAP) in patients with coal workers' pneumoconiosis (CWP). METHODS: The records of 48 patients with suspected CWP were evaluated retrospectively. Pulmonary function tests, arterial blood gas analyses and right heart catheterization were evaluated in all patients. Radiological scoring was according to International Labour Organization criteria, and emphysema was scored by CT scanning. Patients were grouped according to the mean PAP (> or =20 mm Hg or < or =19 mm Hg). RESULTS: All patients showed a mild decrease in FEV(1)/FVC and a mild increase in FRC. Forty-four per cent of patients developed mild to moderate pulmonary hypertension. Emphysema scores correlated significantly with airflow rates, including FEV(1)%, FEV(1)/FVC and FEF(25-75%), and with carbon monoxide diffusing capacity (DLCO)% predicted as well as FRC% predicted and the ratio RV/TLC, which are indices of air trapping. Additionally, profusion and global profusion scores showed significant correlation with FEV(1)/FVC, DLCO% predicted, specific airway conductance and smoking. Mean PAP showed a significant negative correlation with FEF(50%) predicted, DLCO% predicted and profusion score. CONCLUSIONS: The impairment of pulmonary function (mainly disturbance in airflow rates and air trapping) and pulmonary hypertension may be present, even in a simple form of CWP. The pulmonary function impairment in patients with CWP is likely to be attributable to the occurrence of emphysema. However, pulmonary hypertension was directly related to the profusion of pneumoconiotic nodules, which may result in obliteration of the vascular bed.