Polyarteritis nodosa and Henoch–Schönlein purpura nephritis in a child with familial Mediterranean fever: a case report

Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent self-limited attacks of fever accompanied by peritonitis, pleuritis, and arthritis. Approximately 5% of individuals with familial Mediterranean fever have been reported to have Henoch–Schonlein purpura and about 1% to have polyarteritis nodosa. A 7-year-old girl presenting with complaints of purpuric rash, abdominal pain, arthritis, hematuria, and proteinuria and having IgA depositions on renal biopsy was diagnosed as Henoch–Schönlein nephritis. She had a history of recurrent fever, abdominal and joint pain and M694 V compound homozygote mutation. Colchicine treatment was started for the diagnosis of FMF. When constitutional symptoms such as myalgia, weight loss, fatigue, fever, and hypertension were added to the clinical picture, the diagnosis of polyarteritis nodosa HSP was thought and confirmed by the demonstration of microaneurisms on renal arteries. There was no response to corticosteroid and cyclophosphamide treatments; however, the symptoms were rapidly and dramatically reduced after the administration of intravenous immunoglobulin. In conclusion, polyarteritis nodosa and Henoch–Schonlein purpura can be seen together with familial Mediterranean fever. It is also suggested that IVIG might be an important adjunct therapy in selected patients with polyarteritis nodosa, especially in the lack of response to steroids and immunsuppressive drugs.     

Multidimensional feature interactions in visual crowding: When configural cues eliminate the polarity advantage

Crowding occurs when surrounding objects (flankers) impair target perception. A key property of crowding is the weaker interference when target and flankers strongly differ on a given dimension. For instance, identification of a target letter is usually superior with flankers of opposite versus the same contrast polarity as the target (the “polarity advantage”). High performance when target-flanker similarity is low has been attributed to the ungrouping of target and flankers. Here, we show that configural cues can override the usual advantage of low target-flanker similarity, and strong target-flanker grouping can reduce – instead of exacerbate – crowding. In Experiment 1, observers were presented with line triplets in the periphery and reported the tilt (left or right) of the central line. Target and flankers had the same (uniform condition) or opposite contrast polarity (alternating condition). Flanker configurations were either upright (||), unidirectionally tilted (\\ or //), or bidirectionally tilted (\/ or /\). Upright flankers yielded stronger crowding than unidirectional flankers, and weaker crowding than bidirectional flankers. Importantly, our results revealed a clear interaction between contrast polarity and flanker configuration. Triplets with upright and bidirectional flankers, but not unidirectional flankers, showed the polarity advantage. In Experiments 2 and 3, we showed that emergent features and redundancy masking (i.e. the reduction of the number of perceived items in repeating configurations) made it easier to discriminate between uniform triplets when flanker tilts were unidirectional (but not when bidirectional). We propose that the spatial configurations of uniform triplets with unidirectional flankers provided sufficient task-relevant information to enable a similar performance as with alternating triplets: strong-target flanker grouping alleviated crowding. We suggest that features which modulate crowding strength can interact non-additively, limiting the validity of typical crowding rules to contexts where only single, independent dimensions determine the effects of target-flanker similarity.     

The effect of CAPE on lipid peroxidation and nitric oxide levels in the plasma of rats following thermal injury

Both experimental and clinical studies have shown that oxygen-derived free radicals rise in the plasma after thermal injury and participate in the pathogenesis of tissue damage. Hence, various antioxidant molecules have been used in treatment of burn injury both experimentally and clinically. Caffeic acid phenethyl ester (CAPE), an active component of propolis from honeybee hives, is known to have potent antioxidant property. The purpose of the present study was to investigate the effects of CAPE on oxidative stress in plasma of burned rats. Experiment was designed in three groups of rats with 20% full-thickness burn: (a) sham burn (n = 7); (b) burn only (n = 22); (c) burn + treatment with CAPE (n = 22). Plasma levels of malondialdehyde (MDA), nitric oxide (NO) and the activities of xanthine oxidase (XO), and superoxide dismutase (SOD) were used as both bio-indicators of oxidant status and determinant of antioxidant effect of CAPE. They were assessed by biochemical methods at 1st, 3rd, 7th, and 14th post-burn days. In conclusion, CAPE was shown to possess antioxidant activity by saving SOD activity, preventing XO activity and decreasing the levels of MDA, and NO. Our study showed that CAPE may be beneficial in burn injury.     

Comparison of early postoperative enteral nutrients versus chow on colonic anastomotic healing in normal animals

We aimed to clarify the effects of different enteral nutrients (normal chow, complete balanced nutrition, elemental nutrition enriched with glutamine, immune-enhancing diet and fiber) on colonic anastomotic healing in the stress-free metabolic state. The study was carried out with 50 male Balb-C mice in five groups of 10 animals each. After transverse colon anastomosis, animals were fed with early enteral nutrients using normal chow (group 1), Ensure((R)) (group 2), Alitraq((R)) (group 3), Impact((R)) (group 4), and Benefiber Resource((R)) orange juice drink (group 5) for 7 days. There were no significant differences among the groups in bursting pressure (p > 0.05). There was no statistical difference in terms of hydroxyproline level among groups 1-3. The hydroxyproline levels of groups 4 and 5 were statistically higher than that of the control group (p < 0.05 for both comparisons). Under normal conditions without stress, we could not demonstrate the superior effects of early enteral feeding with specialized enteral preparations over normal diets on colonic anastomoses when the bursting pressures were compared.     

Erdosteine prevents bleomycin-induced pulmonary fibrosis in rats

Oxidative stress plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. Therefore, erdosteine, an antioxidant, is expected to have an inhibitor potential against the disease. Rats were given one dose of bleomycin in pulmonary fibrosis groups and saline in controls. The first dose of oral erdosteine (10 mg/kg/day) was given 2 days before the bleomycin injection to achieve the plateau level in blood and continued until killing. At day 14, fibrotic changes were evaluated, using Aschoft's criteria and lung hydroxyproline content. Bleomycin produced a fivefold increase in fibrosis score that was decreased by 87% by erdosteine (P>0.001) and almost twofold increases in hydroxyproline content which were completely prevented by erdosteine. Myeloperoxidase activities and MDA levels, which were significantly higher in the bleomycin group, were then significantly attenuated by erdosteine. These results revealed that oral erdosteine may prevent the development of acute pulmonary inflammation caused by bleomycin injection via the repression of neutrophil accumulation and lipid peroxidation, resulting in the inhibition of subsequent lung fibrosis.