Prevalence and socioeconomic aspects of epilepsy in the Croatian county of Sibenik-Knin: community-based survey

The aim of the survey was to estimate the prevalence rate of epilepsy, as well as seizure types, frequency, etiology, and comorbidity, by gender, age, and socioeconomic status among people with epilepsy in the Croatian county of Sibenik-Knin. The survey revealed that of 112,871 inhabitants, 1228 were identified as having active epilepsy. The crude prevalence rate for Sibenik-Knin County was 10.9 per 1000 inhabitants. Prevalence rates (per 1000) by age and gender were: 6.9 (ages 0-19); 10.6 (ages 20-59); 15.1 (ages 60+), 10.1 (females), and 11.7 (males). A significant number of subjects had different comorbid disorders. Although the literature suggests that Dalmatia is a region with a low prevalence of epilepsy, our results showed that Sibenik-Knin County has a higher prevalence of epilepsy than expected for European populations. The most common comorbid disorders, such as mental retardation, psychotic episodes, and substance addiction, highly influence socioeconomic status and quality of life.     

Traumatic aortic dissection in a boy with Loeys-Dietz syndrome

A 9-year-old boy was admitted to the emergency department for interscapular chest discomfort. Bidimensional echocardiography revealed a severe aortic root and sino-tubular junction dilatation with a suspicion of intimal flap at the aortic isthmus and a pseudo-aneurysm which was confirmed by a computerized tomography scan. The patient was immediately transferred to the operating room for an emergent replacement of the aortic isthmus. His recovery after surgery was uneventful, and he was discharged home 12 days later on beta blockers and angiotensin II receptor antagonist. A genetic recognition confirmed the diagnosis of Loeys-Dietz syndrome type I.     

Right posterior-lateral minithoracotomy access for treating congenital heart disease

A modified right posterior-lateral minithoracotomy with the aid of peripheral cardiopulmonary bypass is a surgical option that has been adopted in our institution in selected patients with simple congenital heart disease. We present our selection criteria, describe our technique, and analyze our results with this modified technique.     

Interleukin-10 anti-inflammatory response to Borrelia burgdorferi, the agent of Lyme disease: a possible role for suppressors of cytokine signaling 1 and 3

It has been established that interleukin-10 (IL-10) inhibits inflammatory cytokines produced by macrophages in response to Borrelia burgdorferi or its lipoproteins. The mechanism by which IL-10 exerts this anti-inflammatory effect is still unknown. Recent findings indicate that suppressors of cytokine signaling (SOCS) proteins are induced by cytokines and Toll-like receptor (TLR)-mediated stimuli, and in turn they can down-regulate cytokine and TLR signaling in macrophages. Because it is known that SOCS are induced by IL-10 and that B. burgdorferi and its lipoproteins most likely interact via TLR2 or the heterodimers TLR2/1 and/or TLR2/6, we hypothesized that SOCS are induced by IL-10 and B. burgdorferi and its lipoproteins in macrophages and that SOCS may mediate the inhibition by IL-10 of concomitantly elicited cytokines. We report here that mouse J774 macrophages incubated with IL-10 and added B. burgdorferi spirochetes (freeze-thawed, live, or sonicated) or lipidated outer surface protein A (L-OspA) augmented their SOCS1/SOCS3 mRNA and protein expression, with SOCS3 being more abundant. Pam(3)Cys, a synthetic lipopeptide, also induced SOCS1/SOCS3 expression under these conditions, but unlipidated OspA was ineffective. Neither endogenous IL-10 nor the translation inhibitor cycloheximide blocked SOCS1/SOCS3 induction by B. burgdorferi and its lipoproteins, indicating that the expression of other genes is not required. This temporally correlated with the IL-10-mediated inhibition of the inflammatory cytokines IL-1beta, IL-6, IL-12p40, IL-18, and tumor necrosis factor alpha. Our data are evidence to suggest that expression of SOCS is part of the mechanism of IL-10-mediated inhibition of inflammatory cytokines elicited by B. burgdorferi and its lipoproteins.     

Which Thrombophilic Gene Mutations are Risk Factors for Recurrent Pregnancy Loss?

PROBLEM: Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and recurrent pregnancy loss, 10 thrombophilic genes were investigated. METHOD OF STUDY: A total of 550 women with a history of recurrent pregnancy loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, beta-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. RESULTS: When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P < 0.0001), and homozygous MTHFR C667T (P < 0.0001) correlated significantly with recurrent pregnancy loss compared with controls. The frequency of the factor V Y1702C mutation was extremely low in patients and controls; thus, this gene was removed from further calculations. The remaining six mutated genes, when analyzed cumulatively, also corresponded with recurrent pregnancy loss (P < 0.0001). CONCLUSION: A panel of thrombogenic gene mutations consisting of factor V G1691A, factor V H1299R (R2), factor II prothrombin G20210A, factor XIII V34L, beta-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), MTHFR C677T, and MTHFR A1298C can identify individuals at risk for recurrent pregnancy loss.     

Going beyond the rhetoric: the movement of critical health psychology towards social action

Health is a fundamental human right. Unfortunately the pursuit of good health remains a struggle for marginalized individuals/groups because of the rise of new centres of power. Hepworth argues that critical health psychologists can contribute to the promotion of public health by moving towards 'greater practice and action orientation'. Until we learn to become more actively involved in translating our research into practice, our efforts will only end up being done in vain. To pursue our humanitarian aims, CHP needs to move beyond the confines of its academic circle and begin to share its vision with a greater audience-society itself.     

A disalicylic acid-furanyl derivative inhibits ephrin binding to a subset of Eph receptors

Eph receptor tyrosine kinases and ephrin ligands control many physiological and pathological processes, and molecules interfering with their interaction are useful probes to elucidate their complex biological functions. Moreover, targeting Eph receptors might enable new strategies to inhibit cancer progression and pathological angiogenesis as well as promote nerve regeneration. Because our previous work suggested the importance of the salicylic acid group in antagonistic small molecules targeting Eph receptors, we screened a series of salicylic acid derivatives to identify novel Eph receptor antagonists. This identified a disalicylic acid-furanyl derivative that inhibits ephrin-A5 binding to EphA4 with an IC(50) of 3 μm in ELISAs. This compound, which appears to bind to the ephrin-binding pocket of EphA4, also targets several other Eph receptors. Furthermore, it inhibits EphA2 and EphA4 tyrosine phosphorylation in cells stimulated with ephrin while not affecting phosphorylation of EphB2, which is not a target receptor. In endothelial cells, the disalicylic acid-furanyl derivative inhibits EphA2 phosphorylation in response to TNFα and capillary-like tube formation on Matrigel, two effects that depend on EphA2 interaction with endogenous ephrin-A1. These findings suggest that salicylic acid derivatives could be used as starting points to design new small molecule antagonists of Eph receptors.