Clinical Sings Research Articles

Is it all MIS-C? Unusual findings in a series of nine German patients with multi-system inflammatory syndrome in children after SARS-CoV-2 infection

ObjectivesMulti-system inflammatory syndrome in children (MIS-C) is a post-viral inflammatory vasculopathy of children and adolescents following Covid-19 infection. Since the incidence of SARS-CoV-infections has been increasing in Germany since October 2020, we observe an increasing number of children presenting with MIS-C. DesignWe present detailed clinical characteristics of a cohort of nine children with MIS-C admitted to a tertiary PICU at the University Hospital of Cologne between March 2020 and February 2021. ResultsThe clinical sings and symptoms are largely in line with recent reports. All but one patient had positive SARS-CoV-2 antibodies. Latency form infection to MIS-C was 4–6 weeks. Two children presented with unusual findings: A girl had encephalomyelitis and a boy developed MIS-C side to side with acute leukemia. ConclusionMIS-C has been increasing in Germany paralell to SARS-CoV-2 infections. Rarely, unuasual findings may be associated with MIS-C.

POS-170 LEISHMANIASIS COMPLICATE SYSTEMIC LUPUS ERYTHEMATOSUS: ABOUT 7 CASES

The association between leishmania (Lsc) and systemic lupus erthematosus (SLE) is rare. It is particularly serious in cases of visceral leishmania (VL). It is a parasitic infection whose hallmarks may mimic SLE symptoms especially when the two pathologies appear concomitantly. The prognosis of SLE depends on the one hand on the rapidity of diagnosis and on the other hand on the quality of treatment. The aim of this study was to analyze the characteristics of infection in leishmania in patients affected by SLE. It was a retrospective study including 07 patients hospitalized for leishmania and systemic lupus erthematosus (SLE) in the Internal Medicine Department of the Charles Nicolle hospital during the period between January 1976 and November 2020. All patients fulfilled four or more criteria defined by the American College of Rheumatology1982, revised in 1997. The diagnosis of cutaneous leishmaniasis (CL) was confirmed by a biopsy specimen. The diagnosis of VL was confirmed by the association of clinical and biology sings associated with positive bone marrow smear and/or positive serologic tests for Leishmania antibodies. Seven patients were enrolled in the study. Their mean age was 27, 85 years [14-41].There were six women and one man. The diagnosis of and SLE was concomitant in three patients, while in four cases the diagnosis of leishmania was after the diagnosis of LES. The time interval between the date of discovery of leishmaniasis and the date of confirmation of the diagnosis of SLE was 36 months[2-24]. For the diagnosis of LES, malar rash, photosensitivity, nephritis, arthralgia and positive antinuclear antibody were observed in six cases. Anti-double stranded DNA antibody was positive in two cases. For the diagnosis of CL, it was based on clinical manifestation in one case and was based in cutaneous biopsy in two cases. Five patients had nephrotic syndrom and one patient had proteinuria. Patients who had renal biopsy had active lupus nephritis class III in one case and lupus nephritis class IV in three cases. Two patients had not renal biopsy because one of them had severe hypertension and the other had severe sepsis. The diagnosis of CL was clinical in one case and histological in two cases. Clinical manifestations of VL were dominated by fever, pale mucous membranes and splenomegaly. There was pancytopenia in all patients with VL. The diagnosis of VL was confirmed by serology(n=3) andbone marrow smear (n=4). Meglumine antimonite was prescribed in the three cases of CL, in the other cases pentosan polysulfate was prescribed in a single patient while in the other two cases, they required the addition of liposomal amphotericin B. One patient was died by tamponade before treatment. Two patients were died by septic shock and only one was cured. Patients with CL had scar in two cases. The last patient died of it. The distinction between the diagnosis of SLE or its exacerbation and VL may be a clinical dilemmaresponsible for diagnostic delay. All the cases diagnosed so far have been by conventional techniques, which may underestimate the incidence of this association. The results of this study highlight a high mortality rate in cases of VL with SLE accordingly with several studies in literature.

Multiple Cartilaginous Exostoses Causing Severe Cervical Myelopathy in a Puppy Dog

AbstractThis study aimed to report a case of multiple cartilaginous exostoses (MCE) causing severe cervical myelopathy in a puppy dog. An 80-day-old Dachshund cross weighing 2.2 kg presented with progressive development of non-ambulatory tetraparesis, proprioceptive ataxia in all four limbs, and cervical hyperesthesia. Multiple calcified masses in the cervical spine at the levels of C1–C2 and C4–C7, with several points of spinal cord compression, were identified. Ventral atlantoaxial fusion was performed. Four days later, four masses were surgically removed by dorsal laminectomy of C1–C2 and C4–C7, and a right facetectomy between C4 and C5 was performed. Multiple cartilaginous exostoses were confirmed by histopathological examination. Thirty-six months after surgery, the patient showed no recurrence of neurological signs. Ventral atlantoaxial fusion, and surgical removal of MCE masses followed by decompression was effective on alleviating clinical sings in the short and medium term.

Diagnosis of Acanthamoeba keratitis in Mashhad, Northeastern Iran: A Gene-Based PCR Assay.

Background:The genus Acanthamoeba is a free-living opportunistic protozoan parasite, which widely distributed in soil and fresh water. Acanthamoeba keratitis, which causes a sight-threating infection of the cornea, is going to rise in Iran and worldwide. The aim of this study was to compare direct microscopy, culture and PCR for detection of Acanthamoeba spp. in clinical samples and to determine the genotypes of Acanthamoeba spp. by sequencing 18SrRNA gene.Methods:Among patients clinically suspected to AK referred to a tertiary ophthalmology center at Mashhad, northeastern Iran. During 2017-18, twenty corneal scrapes specimens obtained. The samples were divided into three parts, subjected to direct microscopic examination, culture onto non-nutrient agar and PCR technique. Sensitivity, specificity, accuracy and likelihood ratio were evaluated.Results:Among 20 persons clinically suspected to amoebic keratitis, 13(69.2%) patients definitely diagnosed as Acanthamoeba keratitis. Wearing contact lens, eye trauma due to foreign particle and swimming in fresh water were the main predisposing factors. Most of patients suffered from pain and photophobia. Corneal ring infiltration and epithelial defect were common clinical sings. Direct examination had the lowest sensitivity and sensitivity of both Nelson-PCR and JDP-PCR methods were equal and highest. In addition, the results of sequencing identified that all strains belonged to T4 genotype.Conclusion:Amoebic keratitis is a sporadic parasitic keratitis, which is mainly seen in contact lens user in Mashhad. PCR based on 18S ribosomal DNA with JDP primers is a reliable and highly sensitive method for diagnosis of Acanthamoeba keratitis in clinically suspected cases.

Potencijalna uloga polifenolnog standardizovanog ekstrakta aronije (Aronia melanocarpa) na COVID-19 infekciju izazvanu SARS-CoV-2 virusom i njegove kardiometaboličke komplikacije

The COVID-19 pandemic marks the time in which we live. More than 167 million people have been infected so far, and over 3 million people have died. The increase in cardiometabolic risk factors during COVID-19 was due, among other things, to isolation and a sedentary lifestyle, as well as higher food intake. Serbia belongs to the group of countries with a high cardiovascular risk. The meta-analysis confirmed the relationship between the severity of cardiometabolic diseases and the development of a more severe clinical sings of COVID-19, while the metabolic syndrome is a significant inducer of disease complications. Endothelial dysfunction in patients with metabolic syndrome plays an important role in the development of COVID-19 complications. Any activity that leads to a reduction in inflammatory processes in the endothelium and improvement of microcirculatory function is beneficial. Polyphenolic compounds have potential to show a beneficial effect during prevention and treatment of COVID-19. Aronia melanocarpa polyphenol extract is a product that promises. Strong anti-inflammatory action, as well as a high degree of bacteriostatic and antiviral activity, including activity against the SARS-CoV-2 virus has been proven by clinical trials. Aronia extract in in vitro experiments leads to direct inactivation of various viral cultures: influenza A (99.99%), SARS-CoV-2 virus (96.98%) and adenoviruses (93.23%). With its systemic action, aronia extract manages to significantly affect the symptoms and parameters of the metabolic syndrome, so as such it is a logical and efficacy food supplement choice in the prevention and treatment of COVID-19 including and post-COVID-19 symptoms.

Prevalence and Antimicrobial Susceptibility Profiles of Microorganisms Associated with Lower Reproductive Tract Infections in Women from Southern Poland-Retrospective Laboratory-Based Study.

Objective: Female infections affecting the genital tract include sexually transmitted diseases, endogenous infections such as vulvovaginal candidiasis, bacterial vaginosis (BV) or aerobic vaginitis (AV) and healthcare-associated infections. The aim of the study was to analyze the etiological factors of the vaginal dysbacteriosis, and the antimicrobial susceptibility of the dominant bacterial and fungal infections in different age groups of outpatient women from the Silesian Region. Materials and methods: A retrospective laboratory-based multi-center study encompassed 4994 women of different ages in Silesian Voivodeship, in the south of Poland; patients who had vaginal swabs collected as per physicians’ orders during the period from 1 January 2017 until 30 June 2018 were included in the study. The inclusion criteria were: non-hospitalized female, aged ≤80, with suspected vulvovaginal candidiasis or bacterial vaginosis and clinical sings of infections. Results: Gram-positive cocci were the ones most often isolated: Enterococcus faecalis (29.2%) and Streptoccoccus agalactiae (13.1%), followed by bacilli from the Enterobacteriaceae group, including Escherichia coli (26.3%). The presence of Streptococcus agalactiae was confirmed in 13.1%, slightly more often in the 45–80 age group, and Gardnerella vaginalis in 6.4%, most often in women aged 15–24. The prevalence of yeast-like infections was 24.3%, Candida albicans accounted for 78.3%, whereas among C. non-albicans spp.—C. glabrata dominated (14.9%) followed by C. parapsilosis (3.8%). The highest resistance was observed only in Streptococcus agalactiae as the MLSB mechanism (Macrolide-lincosamide-streptogramin B) was identified in 38.6% of strains. The prevalence of vulvovaginal candidiasis was 24.3%, the highest in women aged 15–44. Conclusions: Drug resistance in studied vulvovaginitis was associated only with Streptococcus agalactiae. A high proportion of yeast-like aetiology was found, probably associated with recurrent infections. In the analyzed cases only the Amsel criteria and culture methods were used for diagnosis without preparations and microbiological Nugent criteria.

Spontaneous intranasal tumours in rabbits: 7 cases (2007-2019).

Neoplasms that arise in the nasal cavity are reported infrequently in rabbits. This case series aims to review and determine the clinical behaviour of neoplasms in the nasal cavity in rabbits. A retrospective study was conducted on seven pet rabbits diagnosed with intranasal tumours to describe the clinical and histopathological findings and prognoses after surgery and/or radiotherapy. The most common clinical signs were nasal snoring when breathing, nasal discharge, and subsequent dyspnoea and anorexia. Six different histopathological types of tumours were diagnosed: intranasal adenocarcinoma, squamous cell carcinoma, osteosarcoma, carcinoid tumour, osteoma, and lymphoma. Skull radiography only revealed the abnormalities in three of seven cases but on CT, the intranasal masses were more clearly identified in all cases. All cases received tumour resection through rhinostomy and four cases received radiotherapy after surgery. In the six cases with a known outcome, the survival time after surgery was more than 13 months. This case series provides an insight of the behavior of intranasal neoplasms in rabbits. Surgical treatment and radiotherapy could improve their clinical sings.

The effect of environmental changes on distribution of Pasteurella multocida in marsh buffaloes in south of Iraq.

The study was conducted to investigate the distribution of Pasteurella multocida in marsh buffaloes in south of Iraq and effect of environmental changes on distribution of Pasteurella multocida. A total 393 buffaloes of different ages and sexes, from May/2017 to April/2018, were clinically examined. Enrich and Selective medias ,biochemical test and Gram stain were used. All positive cases confirmed by polymerase chain reaction with specific primer to P. multocida. Statistically the distribution of P. multocida in infected buffalos (28%) were significantly higher than non-infected (14%).some buffalos with the clinical sings of hemorrhagic septicemia (HS). While other buffaloes showed clinical finding of Bovine respiratory disease (BRD) and other appeared normally. The isolation recorded in male 26% and in female 25%The number of infected buffaloes under one year of age(32.8%) showed significantly higher than 1-2 year (19.6%) and adult animal(18.9%). The distribution rate were 25.3% , 24.4 %,26.4% in Basrah. Dhi Qar, Misan respectively but there were no significantly variation between Provinces .Also The lower percentage of isolation in October /2017 (9%). and highest in February /2018 (37%), Significant correlations between distribution rates and mean of temperature at (P≤0.01) level but its non-significantly correlations between distribution rates and mean of humidity. We describe the P.multocida endemic in marsh buffaloes in south of Iraq, under 1 year old are more prone to P. multocida. There were a significant negative correlations between distribution rates and mean of temperatures

Detection of microfilaria infection in horses in Mosul city

The study was performed on 78 horses in Mosul city were examined from April 2007 to September 2009 for the detection of microfilaria in the blood Twenty five clinically normal animals served as control. The percentage of the infection with microfilaria of Setaria spp was 30.76% they were sheathed, measuring 204-228 µm within a mean of 218.4 µm in length and 4.5-4.8 mµ within a mean of 4.62 µm in width. A high percentage of infection was reported in females 54.28%) with significant differences from that of males. No significant differences were noticed between the healthy and these showing some clinical sings or between these treated with ivermectin or non treated. Haematological changes indicated decrease in level of hemoglobin concentration packed cell volume whereas there was significant increase (P�0.05) in total leukocytes count, anemia was macrocytic hypochromic type.

Molecular detection of Babesia vogeli, Ehrlichia canis and Anaplasma platys in a hospital population of dogs clinically diagnosed with hemoparasitosis

There is an increase in tick-borne diseases in dogs in urban and rural areas in Brazil and some of these are of public health importance. Rhipicephalus sanguineus-transmitted hemoparasitoses are the main causes of mortality in dogs. The present study investigated the molecular occurrence of Ehrlichia canis, Babesia vogeli and Anaplasma platys in dogs with clinical sings and hematological abnormalities suggestive of tick-borne diseases. These dogs were seen at a Veterinary Hospital of a Public University between January 2014 and December 2016, and were evaluated through anamnesis, clinical examination and complementary exams. The polymerase chain reaction technique was used to detect the presence of hemoparasites DNA. From the 461 dogs that were tested for B. vogeli, 10.6% (49/461) were positive, the associated variable was age. Regarding the 730 animals screened for E. canis, 15.1% (110/730) were positive, and the infection was associated with hematocrit and number of platelets. Relative to the 86 samples evaluated for A. platys, 15.1% (13/86) were positive, and no variable presented statistical significance. From the animals positive for B. vogeli, no of these showed positivity by qPCR for Rangelia vitalii. It is concluded that the occurrence of hemoparasitosis in dogs from the Londrina region is common. Therefore, it is emphasized that molecular techniques should be used as an auxiliary tool for the differential diagnosis of the different etiological agents causing hemoparasitosis. Additionally, these molecular tools are essential for better investigation and preventive assertiveness because it allows to detect parasite DNA.

Laboratory diagnosis of immuno-mediated reactions of hypersensitivity to drugs in patients with pulmonary tuberculosis

To date, there are no unified and standardized laboratory methods for diagnosis allergic reactions to anti-TB drugs.Objective — to optimize the methods of laboratory diagnostics of hypersensitivity reactions to anti-tuberculosis (TB) drugs in patients with pulmonary tuberculosis and to find out their immunological mechanisms.Materials and methods. Clinical and immunological examination was carried out in 39 patients with pulmonary tuberculosis, which were divided into two groups: 1st — with the presence of clinical manifestations of hypersensitivity to anti-TB drugs; 2rd — without visible clinical sings of hypersensitivity. The tests were performed to detect intolerance to first-line anti-TB drugs in vitro: activation of basophiles, determination of serum tryptase, total (IgE) and specific (IgEsp ) immunoglobulin E levels, and erythrocyte sedimentation rate (ESR).Results and discussion. Patients of the 1st group showed increase levels of tryptase, total IgE, specific IgEsp for rifampicin and ethambutol in the blood. Frequency of positive values of ESR for isoniazid was significantly higher in group 1. Correlation between ESR and number of activated basophils and its activated receptors, levels of tryptase and total IgE was observed.Conclusions. The most informative tests in vitro to determine the causative drug in TB patients with clinical manifestations of allergy are: the level of specific IgEsp for rifampicin and ethambutol; erythrocyte sedimentation reaction for isoniazid. The use of basophil activation test is limited in the diagnosis of immuno-mediated allergic reactions to first-line anti-TB drugs

Early markers of athrosclerotic cardiovascular diseases and osteoporotic fractures in a postmenopausal woman (сlinical case)

The aim to demonstrate that subclinical atherosclerosis and vascular rigidity in a postmenopausal patient without clinical sings of cardiovascular disease and osteoporosis are connected with a decreased bone mass.Materials and methods. Patient O., 64 years old, was examined at the National Medical Research Center for Preventive Medicine within the program “Comprehensive assessment of total risks and early preclinical markers of osteoporosis and atherosclerosis complications”. No complaints during the examination were revealed. Laboratory tests were performed to evaluate blood lipids level, calcium-phosphorus metabolism, determine marker of bone resorption – CTX (β-crosslaps), measure levels of vitamin D and parathyroid hormone. Instrumental examinations included dual-energy x-ray absorptiometry of the spine and femoral neck, carotid ultrasound, applanation tonometry, multispiral computed tomography of coronary arteries with calcium score determination.Results. During outpatient examination, densitometry revealed decreased bone mineral density in the lumbar spine and in the femoral neck, corresponding to osteoporosis, carotid ultrasound identified atherosclerotic plaques, multispiral computed tomography of coronary arteries – coronary calcification, applanation tonometry – increased aortic stiffness.Conclusion. The clinical case is an example of early-detected preclinical signs of atherosclerosis and osteoporosis, as well as an increased risk of cardiovascular complications. Due to the high frequency of subclinical atherosclerosis, vessel wall state should be examined in women at the beginning of postmenopause. Signs of vascular stiffness and subclinical atherosclerosis give occasion to assess risk of fractures using the FRAX ® calculator and, if necessary, to diagnose bone mass loss using X-ray densitometry. Proposed algorithm can contribute to the early detection of cardiovascular diseases and at the same time improve fracture risk assessment.

Acute Traumatic Intracranial Hematoma Index and its Significance for Objectifying Indications for Their Surgical Treatment

THE AIM OF THE STUDY. was an index creation for both single and multiple acute traumatic intracranial hematomas (ATIH) for objectification of the surgical treatment indications and using multispiral computed tomography (MSCT) and based on up-to-date clinical recommendations.MATERIAL AND METHODS. We performed a retrospective study of 3 groups of patients with ATIH. Group 1 included 19 patients who were treated conservatively and discharged from the hospital without complications (group of conservative treatment). Group 2 included 9 patients who were observed after hospitalization and were treated in a delayed manner surgically due to growth of the intracranial hematoma volume or the patient condition deterioration (group of observation). Group 3 included 18 patients who were operated due urgent indications (group of surgical treatment). For each patient, the acute traumatic hematoma index (ATHI) was calculated by our original formula. It took the ATIH location, volume in milliliters according to the first MSCT, and risk factors significant for poor outcomes into account. After a preliminary assessment of the significance of differences between the studied characters of groups, a discriminant analysis was carried out with determination of the ATHI values in each group.RESULTS AND CONCLUSIONS. The suggested ATHI index has been shown to be effective in assessing single and multiple ATIHs of any location in accordance with current recommendations. The index is an objective (digital) and easy-to-use for determining ATIH surgical treatment indications and statistical treatment. If ATHI is less than 3 points, there are no indications for surgery and the repeated MSCT of the brain is indicated at least 12 hours after the first checkup or if the suspicious clinical sings appear; if ATHI is 3–4, the indications for surgery are relative and the repeated MSCT of the brain is required 6 hours later even if the patient condition is unaltered; the surgery is indicated if ATHI is more than 4 points.Authors declare lack of the conflicts of interests.

Clinical sings and pathomorphologic changes of pigs by the spontaneous ochratoxicosis

The most dangerous natural contaminants of food are mycotoxins – low molecular weight secondary toxic metabolite prodacted by organisms of the fungus kingdom that suppress or toxicly affect other living organisms. Mycotoxins are a significant danger of ochratoxins, the main producers of which are Aspergillus ochraceus and Pennicilium viridicatum. The pigs are very sensitive to the effects of ochratoxins, under the influence of which the most pronounced changes develop in the organs of the urinary system, as well as in the gastrointestinal tract, liver, immune and nervous systems. The pigs are very sensitive to the effects of ochratoxin A, under the influence of which the most pronounced changes develop in the organs of the urinary system, as well as in the gastrointestinal tract, liver, immune and nervous systems. In the course of the research, complex diagnostics of spontaneous ochratoxicosis was performed, based on the anamnesis data of the results of clinical (including biochemical), pathoanatomical, mycological and chemical-toxicological studies. As a result of mycological and mycotoxicological research in feeds fed to sows revealed the producer of ochratoxins Aspergillus ochraceus. The content of ochratoxin A in feed fed to sows varied from 8.32 mg/kg to 85.72 mg/kg, and in the kidneys its concentration was 4.34–48.33 mg/kg. With ochratoxicosis, the most striking clinical symptoms (polyuria and polydipsia, accompanied by a significant increase of serum creatinine) indicate significant renal involvement, and a increase of serum activity of alanine aminotransferase levels indicates the development of necrocytic changes of the hepatocits. In a pathologoanatomical study in the gastrointestinal tract was detected acute catarrhal or catarrhal-hemorrhagic inflammation and and in 28.57% of sows the ulcers of the fundus zone of the mucous membrane of the stomach, the development of which was accompanied by massive hemorrhage in the gastrointestinal tract. It developed in the kidneys hyalinosis and sclerosis of the vascular plexus of the renal glomeruli developed, as well as hyaline-drip dystrophy, necrotic changes of nephrocytes, polymorphocellular infiltration of interstitium, which in 21.4% of sows was accompanied by the appearance of cystic in the kidneys. In the peripheral organs of the immune system, necrotic changes in the lymphoid elements were recorded. This indicates the immunosuppressive effect of ochratoxins, which also needs detailed study.

Thioctic Acid and Vitamin B Complex Improves Clinical Sings in Diabetic Peripheral Neuropathy

Diabetic neuropathy is the most common cause of neuropathy worldwide and it is estimated to affect about half of people with diabetes. The goal of our study is to compare the effectiveness of thioctic acid treatment alone versus the efficacy of thioctic acid plus vitamin B complex in patients with diabetic peripheral polyneuropathy (DPN). We conducted a prospective, observational study staring from October 2017 to December 2018, in which we included 56 DPN patients. Depending on the Michigan neuropathic screening instrument (MNSI) we divided the patients into two subgroups: patients with MNSI [7 and patients whose MNSI did not decrease sufficiently during the therapeutic protocol. 36 patients (64.2%) of the total patients enrolled in the study had an MNSI [7 at one of the follow-up meetings. These patients were also divided according to the therapeutic protocol applied in a group of patients who were treated with only thioctic acid (TA group) and in a group of patients who were treated with thioctic acid plus vitamin B complex (TA + B group). We noticed a greater proportion of patients who had a MNSI [7 in the TA + B group. This study revealed that the treatment of peripheral diabetic neuropathy with thioctic acid plus Vitamin B complex compared to thioctic acid alone was superior in terms of improving clinical features.

Thioctic Acid and Vitamin B Complex Improves Clinical Sings in Diabetic Peripheral Neuropathy

Diabetic neuropathy is the most common cause of neuropathy worldwide and it is estimated to affect about half of people with diabetes. The goal of our study is to compare the effectiveness of thioctic acid treatment alone versus the efficacy of thioctic acid plus vitamin B complex in patients with diabetic peripheral polyneuropathy (DPN). We conducted a prospective, observational study staring from October 2017 to December 2018, in which we included 56 DPN patients. Depending on the Michigan neuropathic screening instrument (MNSI) we divided the patients into two subgroups: patients with MNSI <7 and patients whose MNSI did not decrease sufficiently during the therapeutic protocol. 36 patients (64.2%) of the total patients enrolled in the study had an MNSI <7 at one of the follow-up meetings. These patients were also divided according to the therapeutic protocol applied in a group of patients who were treated with only thioctic acid (TA group) and in a group of patients who were treated with thioctic acid plus vitamin B complex (TA + B group). We noticed a greater proportion of patients who had a MNSI <7 in the TA + B group. This study revealed that the treatment of peripheral diabetic neuropathy with thioctic acid plus Vitamin B complex compared to thioctic acid alone was superior in terms of improving clinical features. Keywords: diabetes mellitus, thioctic acid, Vitamin B complex, diabetic peripheral neuropathy

Real-life data – a characteristic of RA in patients with cardiovascular diseases on the background of treatment with biological agents

The purpose of this study is to analyze real-life data in order to characterize patients with RA and cardiovascular diseases that are treated with biological agents. Material and Methods: In a retrospective study, data from real clinical practice were analyzed in 195 patients with seropositive RA, which are being treated with biological agents. Results: In patients with existing CVD, significantly higher mean ESR values ​​(23.95 vs. 19.31, p = 0.031) and CRP (6.41 vs. 3.36, p = 0.004) were detected over the period of the study period of treatment. In contrast to the laboratory parameters, mean values of clinical parameters of RA - TJC, SJC and VAS clinical sings did not show a significant difference in patients with and without CVD. The time average value of DAS28 (ESR) during the study period was significantly higher in patients with CVD (3.7 vs. 3.39, p = 0.002) compared to those without CVD. DAS28 (CRP) shows the same trend. In patients with CVD, the time average value of the follow-up indicator was 3.21, and in patients without CVD, 2.88 (p <0.001). Conclusion: The results of this study, in PA patients conducting treatment with biological agents in the real life, outside of the clinical study conditions, demonstrate that independently of treatment, patients with CVD continue to maintain higher background inflammation. An optimization of therapeutic behavior in real life is necessary to improve the long-term prognosis of these patients.

Approbation of the iimiquimod-induced psoriasislike skin inflammation in BALB/с mice

Background.Antipsoriatic medicines that have been successfully tested by imiquimod-induced psoriasislike skin inflammation in BALB/c mice may be used for therapy of psoriasis induced by the immune response as inflammatory cascade into skin layers.Objective.Imiquimod-induced psoriasis-like skin inflammation approbation in BALB/c mice and search of more informative method of pathologic progress assessment for further extrapolating data to clinical cases.Design and methods. Psoriasis-like skin inflammation in mice was induced by topical applying of the Aldara® cream (5 % imiquimod) to back skin for 7 days. Psoriasis Area and Severity Index (PASI), histological study, calculation of relative spleen and thymus mass to the body weight, hematological analysis and skin disease area determination were used for registration of pathologic building.Results.During the study, was detected the increase of PASI score of animals with pathology to 18 with the formation of psoriasis-like plaques, significantly decrease body weight and relative thymus mass, significantly increase relative spleen mass, leukocytosis and leukocytic blood profile change, significant increase epidermal thickness, hyperkeratosis and inflammatory infiltration different degree.Conclusion.Results of approbation studied pathologic model with using of hematological analysis and skin disease area determination consistent with similar studies’ data and partly clinical sings in patient with psoriasis.

Effect of curcumin on clinical sings and cytotoxicity molecules in htlv-1 associated mylopathy/tropical spastic pararesis

People develop HAM/TSP that causes symptoms such as weakness or paralysis of the lower limbs,lower back pain and urinary tract symptoms.Immunological and inflammatory responses influence the proviral load and play on important role in the development of HAM/TSP. Curcumin is yellow pigment extracted from turmeric and aside from it’s well-documented anti-inflammatory properties, curcumin possessess strong anti-oxidative, anti-bacterial,anti- fungal,anti- viral,lipid-modifying and pro-apoptotic activies. In this pilot clinical trial study was performed in the HTLV-1 clinic of the Ghaem Hospital,Mashhad.we enrolled 21 adults HAM/TSP patients in this study(19 women, 2 men), all participants were between 21 and 65 yaers. Nanomicellar curcumin soft gels containing 80 mg curcuminoids were administered once a day for a period of 3 months and their clinical sings were assessed using Osame motor disability scale,Ashworth spasticity scale,check list of urinary sings. HTLV-1 Seropositivity was determined using an ELISA test and confirmed Western blot, granzyme A and viral load were assessed in months 0 and 3 Between months 0 and 3, there was a significant improvement of motor disability (P=0.001), spasticity (P<0.001) and pain (P=0.001) but urinary symptoms did not show a significant difference.Curcumin reduces mRNA levels of Fasl and induces mRNA expression of granzyme A. (P=0.008) and Serum grahulysin levels were significantly elevated with curcumin(P=0.035). In summary, Finding of present clinical study,showed that curcumin supplementation an effective treatment for motor disability,spasticity and pain of patients with HAM/TSP and there are significant improvement. Curcumin enhance viral clearance in patients with HAM/TSP Via up-regulation of grazyme A and granulysin.

Equine Back Disorders: A comparative study between palpation and radiographic findings

The reason for performing this study was to investigate relationship between presence or absence of clinical signs of back problems with radiological findings and also to determine the prevalence of concurrent osseous pathology. Forty-four horses underwent clinical and radiological investigation of thoracolumbar spine. Results were recorded. Statistical analysis was performed to determine relationships between age, gender, work discipline, clinical and radiological features. The most common pathological finding was kissing spines syndrome. There was significant association between age, gender and work discipline and prevalence of pathological and radiological findings. X-rays revealed that horses with clinical signs of back problems were more likely to have osseous changes. Radiological examination should be always critically interpreted in a connection to the clinical sings in order to establish a diagnosis of a patient.