The relationship between severity and extent of spinal involvement and spinal mobility and physical functioning in patients with ankylosing spondylitis

The present study was undertaken to determine the relationship between spinal radiological changes of ankylosing spondylitis (AS), spinal mobility, and physical functioning. Thirty-one patients diagnosed as AS according to the modified New York criteria for AS were included in this study. Three radiographic scoring methods were used to assess spinal damage. Severity of spinal involvement was assessed by using Stoke Ankylosing Spondylitis Spine Score (SASSS) and Bath Ankylosing Spondylitis Radiographic Index–Spine (BASRI–S). To assess the extent of spinal involvement, the total number of vertebrae showing radiological findings attributable to AS [number of vertebrae involved (NoVI)] was calculated according to the AS grading system defined by Braun et al. Statistical analysis, consisting of bivariate correlation, Spearman correlation, and multiple linear regression analysis, was performed using Windows Statistical Package for the Social Sciences 13.0. NoVI was negatively correlated with modified Schober and lateral spinal flexion and was positively correlated with occiput-to-wall distance and BASMI. SASSS was negatively correlated with the modified Schober. BASRI–S was negatively correlated with the modified Schober and positively correlated with BASMI. When BASMI and Bath Ankylosing Spondylitis Functional Index were taken as dependent variables, only the NoVI was found to be associated with BASMI. In our data, the extent of spinal involvement (NoVI) showed a more significant correlation with spinal measurements such as modified Schober and BASMI as compared with the other radiologic scores (SASSS and BASRI–S). Furthermore, because only the NoVI was found to be associated with BASMI, we can conclude that the extent of spinal involvement, which also includes thoracic vertebrae, affects spinal measurements.     

Small Cell Carcinoma of the Gall Bladder: Role of Adjuvant Chemotherapy

Introduction

Small cell cancer of the gallbladder is a rare malignancy with a poor prognosis. There is limited information in the literature on the best therapeutic approach towards this cancer with anecdotal therapy extrapolated from experience in small cell cancer of the lung.

Case Report

We are presenting a 70-year-old woman with this cancer who is undergoing multimodality treatment, along with a review of literature on previously reported cases.     

Brain targeted nanoparticulate drug delivery system of rasagiline via intranasal route

The aim of the present study was to prepare and evaluate a rasagiline-loaded chitosan glutamate nanoparticles (RAS-CG-NPs) by ionic gelation of CG with tripolyphosphate anions (TPP). RAS-loaded CG-NPs were characterized for particle size, size distribution, encapsulation efficiency and in vitro drug release. The mean particles size, polydispersity index (PDI) and encapsulation efficiency was found to be 151.1?±?10.31, 0.380?±?0.01 and 96.43?±?4.23, respectively. Biodistribution of RAS formulations in the brain and blood of mice following intranasal (i.n.) and intravenous (i.v.) administration was performed using HPLC analytical method. The drug concentrations in brain following the i.n. of CG-NPs were found to be significantly higher at all the time points compared to both drug (i.n.) and drug CG-NPs (i.v.). The Cmax (999.25?ng/ml) and AUC (2086.60?ng?h/ml) of formulation CG-NPs (i.n) were found to be significantly higher than CG-NPs (i.v.) and RAS solution (i.n.). The direct transport percentage (DTP%) values of RAS-loaded CG-NPs (i.n.) as compared to drug solution (i.n.) increased from 66.27?±?1.8 to 69.27?±?2.1%. The results showed significant enhancement of bioavailability in brain, after administration of the RAS-loaded CG-NPs which could be a substantial achievement of direct nose to brain targeting in Parkinson's disease therapy.     

The Family Check-up Intervention Moderates Polygenic Influences on Long-Term Alcohol Outcomes: Results from a Randomized Intervention Trial

Prevention Science - Alcohol problems are influenced by both genetic and environmental factors. Evidence from twin models and measured gene-environment interaction studies has demonstrated that the...     

Can midline brain shift be used as a prognostic factor to predict postoperative restoration of consciousness in patients with chronic subdural hematoma?

BACKGROUND AND PURPOSE: Our aim was to determine if midline brain shift could be used as a prognostic factor to predict postoperative restoration of consciousness in patients with CSDH. In these patients, we evaluated the relation (1) between midline brain shift as measured on CT and alteration of level of consciousness, and (2) between midline brain shift and restoration of consciousness after the operation. METHODS: Prospectively recorded data of 45 patients with CSDH were evaluated. We compared level of consciousness of patients measured by GCS score, brain displacement at PG and SP both in the preoperative and early postoperative period. RESULTS: Preoperatively, PG and SP shifts of the patients who were alert (GCS = 15) were significantly less than those of patients who had diminished consciousness. However, in patients with diminished consciousness (GCS < 15), the amount of lateral brain displacement and the degree of diminution of consciousness did not correlate. Those patients who had a preoperative SP shift of less than 10 mm had a significantly lesser chance to become alert after operation (2 of 5 patients) when compared with those patients who had a preoperative SP shift of 10 mm or more (21 of 23 patients). CONCLUSIONS: We conclude that preoperative SP shift may be used as a factor to predict restoration of consciousness in patients with CSDH; the likelihood of becoming alert after operation is increased if SP shift is 10 mm or greater, and is decreased if SP shift is less than 10 mm.     

Erythropoietin restores bowel damage and hypoperistalsis in gastroschisis

Background and Purpose

Despite the decreased mortality in gastroschisis (Gx), patients experience postoperative intestinal hypoperistalsis, malabsorption, and shortened bowel length. The trophic effects of recombinant human erythropoietin (rEpo) in the developing small bowel have been reported, increasing the length and height of the villi, and villous surface area. This study investigated the effects of rEpo on intestinal malfunction in the chick embryos with Gx.

Methods

Thirteen-day-old fertilized chicken eggs were used to create Gx model. Study groups included the following: group 1, control; group 2, Gx-only; group 3, Gx + 0.075% saline exchange; group 4, Gx + 10 IU rEpo exchange; group 5, Gx + 20 IU rEpo exchange. The bowels were evaluated by in vitro muscle strip technique, and the response was expressed as a percentage of the maximum carbachol-evoked contraction (E_max). In addition, parasympathetic ganglion cells per 10 plexuses and villi height were determined by light microscopy. Results were evaluated statistically by Mann-Whitney U, χ², and Fisher's Exact test tests.

Results

Saline exchange had no effect on ganglion cell number (P = .63) and villi height (P = .10). In group 4, ganglion cell number was not increased (P = .82), but villi height increase was significant (P = .03). In Gx + 20 IU rEpo group, both the number of ganglia (P = .0001) and villi height (P = .002) were significantly increased. The decrease in contractility in group 2 (P = .0121) was significantly reversed by rEpo 20 IU treatment (P = .0216), no significant difference was obtained in groups 3 (P = .0809) and 4 (P = .1516) compared with group 2.

Conclusion

These data suggest that rEpo has prokinetic effects on hypoperistalsis and restores bowel damage in Gx.     

Caloric test and simultaneous recording of sympathetic skin response

CONCLUSIONS: It was found that there was a close correlation between sympathetic skin response (SSR) parameters and nystagmus parameters obtained in caloric tests. Further studies are needed to investigate the clinical correlation of these findings. OBJECTIVES: To investigate whether the caloric response creates a measurable SSR and, if so, to compare the SSR parameters with the nystagmus parameters and the feelings of the patient. MATERIAL AND METHODS: Patients completed an autonomic symptom questionnaire (ASQ) regarding their past history of autonomic symptoms. They used a visual analog scale (VAS) to assess the severity of symptoms during simultaneous SSR and caloric tests. Symptoms were also noted separately by the investigator. RESULTS: Eighteen patients were included in the study (13 females, 5 males). Eight of the patients had central and 10 had peripheral vertigo. The mean VAS score was 6.6+/-1.9 and the mean ASQ score was 7.2+/-3.6. In terms of the recorded parameters, there were no significant differences between patients with central and peripheral vertigo, males and females or warm and cold irrigation. The number of SSR waves increased significantly when the slow-phase velocity was > 26 degrees/s (p<0.01) and the nystagmus latency was < or = 27 s (p<0.05). The VAS score was also correlated with the number of SSR waves (p<0.01).     

Hepatoprotective evaluation of Anogeissus latifolia： In vitro and in vivo studies

AIM： To evaluate the hepatoprotective activity of a hydroalcoholic extract of the bark of Anogeissus latifolia; in vitro in primary rat hepatocyte monolayer culture and in vivo in the liver of Wistar rats intoxicated by carbon tetrachloride （CCl4）. METHODS： In the in vitro study, a primary hepatocyte monolayer culture was treated with CCh and extract of Anogeissus latifolia. Hepatoprotective activity was demonstrated in the CCh damaged primary monolayer culture. In the in vivo study, the hepatoprotective activity of a hydroalcoholic extract ofAnogeissus latifolia was analyzed in liver injured CCh-treated rats. Biochemical parameters including serum transaminases [aspartate aminotransferase （AST） and alanine aminotransferase （ALT）] and alkaline phosphatase （ALP） in serum wereanalyzed. The biochemical findings were supplemented with histopathological examination of rat liver sections. RESULTS： In vitro： primary hepatocyte monolayer cultures were treated with CCh and extract of Anogeissus latifolia. A protective activity could be demonstrated in the CCh damaged primary monolayer cultUre. In vivo： Hydroalcoholic extract of Anogeissus latifolia （300 mg/kg） was found to have protective activity in rats with CCh-induced liver damage as judged from serum marker enzyme activity. CONCLUSION： The above findings lead to the conclusion that the hydroalcoholic extract of Anogeissus latifol/a is hepatoprotective. Hence, we suggest that the inclusion of this plant in the management of liver disorders is justified.