Serum IL-18 levels in tuberculosis: comparison with pneumonia, lung cancer and healthy controls

OBJECTIVE: The aim of the present study was to document the serum IL-18 levels in patients with pulmonary tuberculosis (P-TB), extrapulmonary tuberculosis (EP-TB), pneumonia, lung cancer and in healthy controls, and to investigate whether it may assist in the differential diagnosis of P-TB. METHODOLOGY: A total of 116 patients were included in the study. The study population consisted of patients with P-TB, EP-TB, pneumonia and lung cancer and controls. P-TB patients were graded according to sputum positivity and extent of disease. Serum levels of IL-18 (ELISA) were compared between groups and with other clinical measures of disease. RESULTS: Compared with the controls, all groups of patients had increased serum levels of IL-18. The highest mean concentration of IL-18 was observed in P-TB. Serum levels of IL-18 in the patients with P-TB correlated well with the extent of disease. CONCLUSIONS: Although increased serum levels of IL-18 were not specific for TB, the increased levels may favour active TB in radiologically advanced disease where CXR findings are difficult to interpret, and sputum smears or cultures are not helpful.     

Effects of a home-based exercise program on quality of life, fatigue, and depression in patients with ankylosing spondylitis

The aim of this trial was to investigate the effects of a 12-week home-based exercise program (HEP) on quality of life (QOL) and fatigue in patients with Ankylosing Spondylitis (AS). Forty-three patients with AS were included in this study. Group 1 was given a HEP; Group 2 served as the control group. The functional capacity (Bath Ankylosing Spondylitis Functional Index), disease activity (Bath Ankylosing Spondylitis Disease Assessment Index), fatigue (Multidimensional Assessment of Fatigue Scale), depression (Beck Depression Inventory scores), and QOL (Short Form 36) of all participants were evaluated. There were significant improvements for all the parameters in two groups after the treatment. The improvements for all the parameters were better in the exercise group than in the control group. Home-based exercise programs are very effective in improving QOL and reducing fatigue. Because of these advantages, HEP should be advised for the management program in AS in addition to medical treatments. This study was presented at the 21st National Physical Medicine and Rehabilitation Congress, Antalya, Turkey, 24–29 September 2007.     

Efficacy of the Combination of Tetracycline, Amoxicillin, and Lansoprazole in the Eradication of Helicobacter pylori in Treatment-Naïve Patients and in Patients Who Are Not Responsive to Clarithromycin-Based Regimens: A Pilot Study

Background/Aims

The aim of this study was to evaluate the eradication rate of a triple therapy regimen that included a proton pump inhibitor, amoxicillin, and tetracycline instead of clarithromycin in treatment-Naïve patients and in patients who did not respond to standard triple therapy.

Methods

This study included 110 patients infected with Helicobacter pylori. Patients in groups A and B were treatment-Naïve, and those in group C were not responsive to previous standard triple therapy. Patients in group A (n=40) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d. for 14 days. Patients in groups B (n=40) and C (n=30) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and tetracycline 500 mg q.i.d. for 14 days.

Results

In group A, eradication was achieved in 18 (45%) of the 40 patients included in the intention-to-treat (ITT) analysis and in 18 (47.4%) of the 38 patients included in the per-protocol (PP) analysis. In group B, eradication was achieved in 15 (37.5%) of the 40 patients included in the ITT analysis and in 15 (39.3%) of the 38 patients included in the PP analysis. In group C, eradication was achieved in 14 (46.6%) of the 30 patients included in the ITT analysis and in 14 (43.8%) of the 29 patients included in the PP analysis. There was no statistically significant difference among the 3 groups with regard to eradication rates (p>0.05).

Conclusions

Despite the low rate of resistance to tetracycline, the combination of lansoprazole, amoxicillin, and tetracycline instead of clarithromycin is not a good option for the eradication of H. pylori.     

Somatostatin, gastrin, and cholinergic muscarinic binding sites in rat gastric, duodenal, and jejunal mucosa

Clinical and experimental data indicate that the concentration of gastrin-I and somatostatin binding sites in human and rat gastric and duodenal mucosa may be changed in several pathologic conditions, including human peptic ulcer and cancer diseases. There are no data, however, indicating the distribution of receptor binding sites in the normal upper gastrointestinal tract. We studied the regional distribution of somatostatin-14, gastrin-I, and cholinergic muscarinic binding sites in membrane preparations from rat gastric corporeal and antral mucosa and in mucosa obtained from the duodenum and jejunum. The corporeal mucosa contained the most high-affinity gastrin binding sites (Bmax = 39.1 +/- 6.5 fmol/mg protein; Kd = 1.1 +/- 0.4 nM). The antral mucosa contained the most somatostatin and cholinergic muscarinic binding sites (Bmax = 65.7 +/- 6.6 fmol/mg protein and 460.3 +/- 101.8 fmol/mg protein, respectively). The duodenal and jejunal mucosal membranes contained somatostatin, gastrin, and cholinergic muscarinic binding sites in decreasing concentrations. Concentrations of binding sites are characteristic for particular gut regions and may help in analyzing their abnormalities.     

Fluoroscopic Anatomy of Right-Sided Heart Structures for Transcatheter Interventions

Performing transcatheter tricuspid valve interventions requires a thorough knowledge of right-heart imaging. Integration of chamber views across the spectrum of imaging modalities (i.e., multislice computed tomography, fluoroscopy, and echocardiography) can facilitate transcatheter interventions on the right heart. Optimal fluoroscopic viewing angles for guiding interventional procedures can be obtained using pre-procedural multislice computed tomography scans. The present paper describes fluoroscopic viewing angles necessary to appreciate right-heart chamber anatomy and their relationship to echocardiography using multislice computed tomography.     

Stafne bone defect in the anterior mandible

Lingual mandibular bone defect, also known as Stafne bone cavity, is mostly seen in the posterior portion of the mandible. Cavities in the anterior region are very unusual, with around 50 cases reported in the English literature. They are often asymptomatic and found during routine radiographic examinations. This article describes a case of anterior Stafne bone cavity in a 56-year-old male patient.