Gender-matched Healthy Individuals Research Articles

Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study

BackgroundGout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China.MethodsA total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data.ResultsAfter adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year, presence of tender joints, depression, anxiety, colchicine and corticosteroids use contributed to low HRQoL.ConclusionsAfter adjusted demographic variables, gout subjects have poorer HRQoL compared to healthy controls. Chinese gout population experiencing poor HRQoL and functional disability were likely to suffer from gout-related features and psychological problems. The results underscore the need of effective interventions including psychological nursing and appropriate treatment approaches to reduce their functional disability and improve their HRQoL.

Left ventricular twist is impaired in acromegaly: Insights from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study.

Acromegaly is a rare, chronic, disfiguring, and debilitating disease caused, in 90% of cases, by a benign monoclonal growth hormone-secreting pituitary adenoma. The present study aimed to assess left ventricular (LV) rotational and twist mechanics in acromegalic patients and to compare their results to age- and gender-matched healthy controls. The present study comprised 24 acromegalic patients, from which 4 were excluded due to insufficient image quality (mean age: 57.8 ± 13.7 years, 7 men). The control group consisted of 18 age- and gender-matched healthy individuals (mean age: 54.8 ± 6.9 years, 8 men). In 4 out of 20 acromegalic patients, LV showed near absence of twist, as the so-called LV "rigid body rotation" (RBR). Between all acromegalic patients without LV-RBR and controls, both LV basal (-3.76 ± 1.73 vs. -6.17 ± 2.66°, P = .004) and apical rotation (6.12 ± 4.03 vs. 10.81 ± 3.65°, P = .001) and LV twist (9.88 ± 4.74 vs. 16.98 ± 3.88°, P < .001) differed significantly. Between active and nonactive acromegaly subgroups, only the time-to-peak LV twist (377 ± 78 vs. 229 ± 97 ms, P = .005) showed significant difference. Acromegaly is associated with impaired LV rotation and twist as assessed by 3-dimensional speckle tracking echocardiography. LV-RBR is a frequent phenomenon in acromegaly.

Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study

This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.

Evaluation of Heart Rate Variability in Drug Free Panic Disorder Patients.

It is well-known that autonomic function is impaired in panic disorder (PD). Heart rate variability (HRV) is a reliable and noninvasive method to evaluate autonomic functions. The aim of this study is to evaluate 24-hour heart rate variability (HRV) parameters in drug-free panic disorder patients. These results are compared with those obtained from healthy controls. Thirty-two (mean age 33.12±11.94 years, 20 female, 12 male) drug-free patients for at least 2 weeks, (for fluoksetin 3 weeks) diagnosed with panic disorder (PD) on the basis of DSM-IV criteria were included in the study. The control group comprised of 24 age and gender-matched healthy individuals (mean age 33.45±8.6 years, 17 female and 7 male) without any cardiac, endocrine (including diabetes), and neurological disease. Two groups were evaluated for any axis-I diagnosis with SCID-I. We used Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Index-3 (ASI-3) tests in both groups. After the psychiatric evaluation 24 hours Holter ECG monitoring was performed in all participants for the determination of HRV including frequency and time domain parameters. The time domain RMSSD and PNN50 values tended to be lower in panic patients but this difference did not reach significance (p=0.229, p=0.571). There was no significant difference in mean values for all time and frequency domain HRV measures over the total 24-hours recording between patients and controls. RMSSD, pNN50 and HF was increased to reflect the parasympathetic predominance in the sleeping period (p=0.0001) but there was no significant difference between groups. However LF value which showing sympathetic activity was increased significantly in healthy control and patients in the sleeping period (p=0.0001) but there was no significant difference between two groups (p=0.905). Correlation analysis in the panic disorder patients presented a negative correlation between disease age at onset HF value (p=0.004) and positive correlation between LF/HF value (p=0.007). When both smokers and non-smokers were compared in terms of HRV values, smoking significantly decreased HRV in both groups [SDNN (p=0,18)]. HRV parameters of panic disorder patients were not different from healthy controls. To better clarify the effects of panic disorder on HRV, factors effecting HRV should be minimized and more Holter ECG studies with longer records should be obtained to reflect the daily life activities.

Does Valsalva Maneuver Affect Corneal Morphology in Eyes With Keratoconus?

The aim of this study was to investigate the effect of the Valsalva maneuver on corneal morphology and anterior chamber parameters in patients with keratoconus. A total of 39 eyes from 39 patients with keratoconus and 41 eyes from 41 age-matched and gender-matched healthy individuals were included in this cross-sectional study. Measurements of corneal front keratometry values (K-flat, K-steep, and K-max), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume (ACV), anterior chamber depth (ACD), and iridocorneal angle (ICA) were performed with a Pentacam Scheimpflug camera (Oculus, Germany) before and during the Valsalva maneuver. Changes in the anterior segment parameters from baseline and during the Valsalva maneuver and the differences in parameters between the keratoconus group and the control group were analyzed. A P value less than 0.05 was accepted as statistically significant. In the patients with keratoconus, the Valsalva maneuver did not have any significant influence on the corneal parameters (P>0.05). However, ACV, ACD, and ICA decreased markedly during the Valsalva maneuver (P=0.006, P=0.048, and P=0.025, respectively). Changes caused by the Valsalva maneuver were similar for all parameters when compared with those in healthy individuals (P>0.05). During corneal topography imaging, the Valsalva maneuver observed in patients with keratoconus does not typically cause any significant change in corneal morphology.

Oral squamous cell carcinoma patients can be differentiated from healthy individuals with label-free serum proteomics

Background:No blood biomarkers to detect early oral cavity squamous cell carcinoma (OSCC) without clinical signs exist – diagnosis is solely based on histology of a visible tumour. Most OSCC patients are diagnosed at advanced stage, which leads to significant morbidity and poor survival. Our aim was to find the serum screening or detection biomarkers in OSCC.Methods:Serum samples from patients with OSCC treated at the Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital (Finland) were collected. Age- and gender-matched healthy individuals served as controls. Quantitative label-free proteomics in high definition MSE mode(HDMSE) was performed on 13 patients and 12 healthy samples. Various statistical analyses were performed on quantitative proteomics data to obtain the most influential proteins, which classify the patients vs healthy samples.Results:In quantitative proteomic analysis (HDMSE), 388 proteins were quantified in our pilot study. A complete separation between cases and controls was seen in supervised and unsupervised classification techniques such as orthogonal projections on latent structure-discriminant analysis (OPLS-DA) and self-organising maps. Using OPLS-DA S-plot, we identified a set of eight proteins that completely separated OSCC patients from healthy individuals.Conclusions:Although the tumour stages varied from I to IVa, these potential biomarkers were able to identify all OSCCs demonstrating their sensitivity to detect tumours of all stages. We are the first to suggest a set of serum biomarkers in our pilot study to be evaluated further as a diagnostic panel to detect preclinical OSCC in risk patients.

Sleep Quality and its Association with Disease Severity in Psoriasis.

The main purpose of this research was to crosscheck sleep quality in patients with psoriasis with that in healthy individuals and to evaluate a possible relationship between sleep quality and disease severity in these patients. Fifty-eight patients with plaque psoriasis and 58 age- and gender-matched healthy individuals were included. The Psoriasis Area and Severity Index (PASI) scoring method was used to assess the disease severity in patients with psoriasis. The sleep quality of the participants was evaluated by the Pittsburgh Sleep Quality Index (PSQI). The sleep quality scores of the patients with psoriasis were compared to those of healthy controls. Pearson's correlation test and independent samples t-test and were used to interpret the data. The mean disease duration was 11.1±7.4 years (mean±standard deviation), and the mean PASI was 14.1±5.3. In total, 60% of the patients with psoriasis (n=35) experienced poor sleep quality, and this frequency was considerably higher in the patients with psoriasis than in the healthy controls (p<0.000). Further, the mean PSQI in the patients with psoriasis (7.01±41.4) was higher than that in the healthy controls (4.18±2.76, p=0.000). The scores of daytime dysfunction, habitual sleep efficiency, and subjective sleep quality, which are the three components of sleep quality, were considerably higher in the patients with psoriasis than in the healthy controls (p=0.007, p=0.032, and p=0.034, respectively). Our results showing impaired sleep quality and its association with disease severity in patients with psoriasis may contribute to the management of psoriasis.

Serum levels of adipokines in patients with idiopathic inflammatory myopathies: a pilot study.

Adipokines are cytokines not only regulating metabolic and endocrine activities, but also modulating inflammatory and immune responses in several clinical settings, including autoimmunity. This study was aimed to evaluate whether serum adipokine levels may be useful as markers of disease activity in patients with idiopathic inflammatory myopathies (IIM). Adiponectin, leptin, chemokine C-C motif ligand-2 (CCL2), interleukin (IL)-6, and tumor necrosis factor (TNF) were measured in the serum of all participants. For each adipokine, we evaluate the area under the ROC curve (AUC) and its correlation with creatine kinase (CK) levels. Thirteen patients with IIM and 13 age- and gender-matched healthy individuals were studied. In patients, the levels of CK (273±321 versus 54±29 U/L; P<0.0001), leptin (1994±1355 versus 818±738pg/mL; P=0.024), and IL-6 (32.4±24.1 versus 13.9±3.5pg/mL; P=0.003) were significantly higher than in controls. As a result, CK (AUC=0.929, 0.833-1.00; P=0.0002), leptin (AUC=0.783, 0.588-0.977; P=0.025), and IL-6 (AUC=0.846, 0.680-1.00; P=0.005) significantly discriminated between patients and controls. Neither CCL2 (3256±4585 versus 1118±399pg/mL; P=0.319) nor TNF (85.1±83.3 versus 58.2±16.8pg/mL; P=0.809) levels were different. Additionally, only serum levels of CCL2 were significantly correlated with CK titers (Spearman´s rho coefficient 0.620, 0.087-0.877; P=0.023). The levels of CCL2 are in parallel with CK activity in the serum of patients with IIM, suggesting a potential utility as markers of disease activity. Elevated levels of leptin and IL-6 also support a role for adipokines in IIM.

The Role of p16 and MDM2 Gene Polymorphisms in Prolactinoma: MDM2 Gene Polymorphisms May Be Associated with Tumor Shrinkage

Prolactinomas are thought to arise from clonal expansion of a single mutated cell which is subjected to growth stimuli of several permissive factors, although the pathogenetic mechanisms underlying tumorigenesis remain unclear. The present study aimed to investigate the role of p16 (540C→G and 580C→T) and mouse double minute 2 (MDM2) (SNP309T→G) gene polymorphisms in tumorigenesis and characteristics of prolactinoma. A total of 74 patients with prolactinoma and 100 age- and gender-matched healthy individuals were enrolled in the study. Serum prolactin levels were measured by enzyme-linked immunosorbent assay (ELISA). p16 and MDM2 polymorphisms were determined by polymerase chain reaction-restriction fragment polymorphism and agarose gel electrophoresis. p16 540C→G genotype distribution was found to be: CC: 66.2%, CG: 28.4%, GG: 5.4%; p16 580C→T genotype distribution was found to be: CC: 82.4%, CT: 17.6%, TT: 0% and MDM2 genotype distribution was found to be: TT: 31.1%, TG: 47.3%, GG: 21.6% in patients with prolactinoma. Tumor diameter before treatment was correlated with prolactin levels before treatment and percentage of prolactin decrease with treatment (r=0.719, p<0.001, p=0.034 r=0.256, respectively). The number of patients with tumor size decrease of more than 50% in those with homozygous genotype (TT+GG) of MDM2 SNP309T→G was significantly higher than in heterozygous genotype (TG) carriers (odds ratio(OR)=0.18, 95% confidence interval(CI)=0.06-0.58; p=0.003). This study showed that p16 and MDM2 polymorphisms do not play a decisive role in tumorigenesis, but some genotypes of these polymorphisms might be associated with follow-up characteristics of prolactinoma.

Effect of fingolimod (FTY720) on choroidal thickness in patients with multiple sclerosis

ObjectiveUsing spectral domain optical coherence tomography (SD-OCT), to compare the choroidal thickness in a healthy population (group 1), with newly diagnosed multiple sclerosis (MS) patients (group 2), with MS patients who underwent β-interferon monotherapy (group 3) and MS patients who underwent fingolimod therapy for 1 year (group 4) MethodsTwenty-five control subjects (25 eyes), 24 newly diagnosed (24 eyes) MS patients, 22 MS patients who underwent fingolimod monotherapy for 1 year (22 eyes), and 24 MS patients who underwent β-interferon monotherapy for 1 year (24 eyes) were included in this study. The control group consisted of age- and gender-matched healthy individuals. The choroidal thickness measurements were performed using a high-speed and high-resolution SD-OCT device. The choroidal thickness measurements were compared using a One Way Anova and Post-Hoc Tukey test. ResultsNinety-five eyes of 95 participants were included in this study. The mean age of the control group was 27.83±4.60, and it was 26.83±6.79, 27.87±6. 46 and 27.58±6.65 in the newly diagnosed MS group, fingolimod group and β-interferon group, respectively. In fingolimod group N-1000, N-1500 and T-1500 was significantly lower than control group. (p=0.026, p=0.06 p=0.13) ConclusionChoroidal thickness values at N-1000, N-1500 and T-1500 levels in fingolimod group were found lower than in control but higher than in newly diagnosed MS group. This result can be explained with the therapeutic effect of the fingolimod on MS.

Reduced optimism and a heightened neural response to everyday worries are specific to generalized anxiety disorder, and not seen in social anxiety.

Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are co-morbid and associated with similar neural disruptions during emotion regulation. In contrast, the lack of optimism examined here may be specific to GAD and could prove an important biomarker for that disorder. Unmedicated individuals with GAD (n=18) and age-, intelligence quotient- and gender-matched SAD (n=18) and healthy (n=18) comparison individuals were scanned while contemplating likelihoods of high- and low-impact negative (e.g. heart attack; heartburn) or positive (e.g. winning lottery; hug) events occurring to themselves in the future. As expected, healthy subjects showed significant optimistic bias (OB); they considered themselves significantly less likely to experience future negative but significantly more likely to experience future positive events relative to others (p<0.001). This was also seen in SAD, albeit at trend level for positive events (p<0.001 and p<0.10, respectively). However, GAD patients showed no OB for positive events (t 17=0.82, n.s.) and showed significantly reduced neural modulation relative to the two other groups of regions including the medial prefrontal cortex (mPFC) and caudate to these events (p<0.001 for all). The GAD group further differed from the other groups by showing increased neural responses to low-impact events in regions including the rostral mPFC (p<0.05 for both). The neural dysfunction identified here may represent a unique feature associated with reduced optimism and increased worry about everyday events in GAD. Consistent with this possibility, patients with SAD did not show such dysfunction. Future studies should consider if this dysfunction represents a biomarker for GAD.

Left and right atrial feature tracking in acute myocarditis: A feasibility study

PurposeThe present study aims at evaluating the feasibility and reproducibility of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain and strain rate (SR) parameters of the left and right atrium (LA, RA) in patients with acute myocarditis as well as their potential to detect diastolic dysfunction. In addition, the diagnostic value of LA and RA strain parameters in the setting of acute myocarditis is investigated. MethodsCMR cine data of 30 patients with CMR-positive acute myocarditis were retrospectively analyzed. 25 age- and gender-matched healthy individuals served as a control. Analysis of longitudinal strain and SR of both atria was performed in two long-axis views using a dedicated FT-software. LA and RA deformation was analyzed including reservoir function (total strain [εs], peak positive SR [SRs]), conduit function (passive strain [εe], peak early negative SR [SRe]) and booster pump function (active strain [εa], peak late negative SR [SRa]). Intra- and inter-observer reproducibility was assessed for all strain and SR parameters using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation (CV). ResultsFT analyses of both atria were feasible in all patients and controls. Reproducibility was good for reservoir and conduit function parameters and moderate for booster pump function parameters. Myocarditis patients demonstrated an impaired LA reservoir and conduit function when compared to healthy controls (LA εs: 32±17 vs. 46±13, p=0.019; LA SRs: 1.5±0.5 vs. 1.8±0.5, p=0.117; LA SRe: −1.3±0.5 vs. −1.9±0.5, p<0.001), while LA booster pump function was preserved. In logistic regression and ROC-analyses, LA SRe proved to be the best independent predictor of acute myocarditis (AUC 0.80), and using LA SRe with a cut-off of −1.6s−1 resulted in a diagnostic sensitivity of 83% and a specificity of 80%. Changes in RA phasic function parameters showed a tendency to parallel those of the LA and showed no additional effect with respect to the diagnostic potential in acute myocarditis. ConclusionsMyocarditis patients exhibit an impaired atrial reservoir and conduit function, what might be indicative of ventricular diastolic dysfunction. LA SRe was the best predictor for the presence of acute myocarditis in our study, pointing towards the discriminative power of atrial strain analysis in the CMR-based diagnosis of acute myocarditis.

Enzymatic antioxidants status in patients with recurrent aphthous stomatitis.

Oxidative stress (OS) has been thought to play a main role in the etiopathogenesis of recurrent aphthous stomatitis (RAS), which is one of the most common oral mucosal diseases characterized by recurrent and painful oral ulcers. The aim of this investigation was to evaluate the enzymatic antioxidants status in patients with RAS in the active stage and remission stage. Ninety-seven patients with idiopathic minor RAS and 102 race-, age- and gender-matched healthy individuals were recruited. All these subjects were allocated to three groups: RAS patients with active lesion (group A); the same patients in group A in the remission stage of RAS (group B); and healthy individuals without RAS (group C). Following an overnight fast, blood samples were obtained. The serum levels of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSHPx) were measured by the spectrophotometric method. Independent-samples t-test and paired t-test were performed for statistical evaluation. The serum levels of SOD, GSHPx, and CAT (83.9 ± 17.1 U/ml, 6687.2 ± 2629.2 U/ml, 1789.7 ± 593.8 U/l) were found to be significantly lower in group A as compared to those of group B (99.8 ± 11.1 U/ml, 9364.1 ± 1607.9 U/ml, 2789.1 ± 1113.4 U/l; P < 0.05) or group C (97.3 ± 12.1 U/ml, 9246.2 ± 2376.1 U/ml, 2819.0 ± 914.8 U/l; P < 0.05). No significant differences were found between group B and group C with respect to any one of these enzymatic antioxidants (P > 0.05). Our results indicate that enzymatic antioxidant defense system is impaired in RAS patients with active lesion and seems to play a crucial role in its pathogenesis.

Natural regulatory T cells from patients with end-stage renal disease can be used for large-scale generation of highly suppressive alloantigen-specific Tregs

Natural occurring regulatory T cells (nTregs) have the potential to offer a targeted approach of immunosuppression and are the cell type of interest for inducing tolerance in kidney transplantation. End-stage renal disease (ESRD) profoundly affects the composition and function of circulating T cells but little is known with respect to how nTreg potential is affected. To address this, nTregs of patients with ESRD (on dialysis or not) and healthy individuals were isolated, expanded using allogeneic mature monocyte-derived dendritic cells followed by anti-CD3/anti-CD28-coated beads and the different nTregs were extensively characterized by the demethylation status of the Treg-specific demethylated region within FOXP3 and expression of typical nTreg markers. Additionally, the suppressive capacity as well as cytokine producing cells were analyzed for allogeneic mature monocyte-derived dendritic cell-expanded nTregs. Compared to age- and gender-matched healthy individuals, similar frequencies of nTregs were present within the circulation of patients with ESRD either on dialysis or not. The isolated nTregs could be equally well or even better expanded using allogeneic mature monocyte-derived dendritic cells and extensive characterization did not reveal significant differences. The demethylation status of the Treg-specific demethylated region was maintained or even further promoted as was the expression of markers characteristic for nTregs. Moreover, suppressive capacity and the cytokine profile of allogeneic mature monocyte-derived dendritic cell-expanded nTregs was similar to that of healthy individuals. Thus, circulating nTregs of patients with ESRD can effectively be expanded to stable allo antigen-specific nTregs with potential clinical applicability.

Brain-Derived Neurotrophic Factor Val66Met Polymorphism and Its Synergism with L/S Polymorphism in the Promoter Region of Serotonin Transporter in Bipolar I Disorder Patients in Western Iran

Background: Brain-derived neurotrophic factor (BDNF) might involve in the pathogenesis of mental disorders. There are inconsistent reports related to the role of BDNF Val66Met in susceptibility to bipolar disorder (BD). Objectives: The aim of the present study was to investigate the role of BDNF Val66Met and its synergism with 5-HTT gene-linked polymorphic region (5-HTTLPR) variants in susceptibility to bipolar I disorder (BP-I) in Western Iran. Materials and Methods: In this case-control study, 153 patients with BP-I and 146 age- and gender-matched healthy individuals were investigated for BDNF and 5-HTTLPR variants using PCR-RFLP method. Results: The frequency of BDNF A (Met) allele in patients (17.7%) was slightly lower than that in controls (19.9%, P = 0.5). The concomitant presence of BDNF G (Val) and 5-HTTLPR S alleles tended to increase the risk of BP-I by 1.41 times (P = 0.064) compared to the combined presence of BDNF G and 5-HTTLPR L alleles. Also, interaction between BDNF G (Val) and 5-HTTLPR S tended to increase the risk of BP-I by 1.28-fold (P = 0.062) compared to the concomitant presence of BDNF A and 5-HTTLPR S alleles. Conclusions: This study, conducted for the first time on Kurdish population in Western Iran, did not indicate any association between BDNF Val66Met with BP-I. However, the interaction between BDNF and 5-HTTLPR variants tended to increase the susceptibility to BP-I.

Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere's Disease from BPPV.

Utility of frequency tuning of ocular vestibular evoked myogenic potential (oVEMP) for evaluation of utricular function in individuals with Meniere's disease is a recent development. However, there is dearth of studies regarding its utility in differential diagnosis of Meniere's disease from other vestibular pathologies. The present study aimed at investigating the feasibility of frequency tuning of oVEMP in discriminating Meniere's disease from benign paroxysmal positional vertigo (BPPV). Static group comparison. oVEMPs were acquired from 36 individuals, each with unilateral Meniere's disease and unilateral BPPV. Thirty-six age- and gender-matched healthy individuals formed comparison group for each of the two clinical groups. Contralateral oVEMPs were recorded from both ears of all the participants. The responses pertaining to octave and mid-octave frequencies from 250 to 4000 Hz, one frequency presented at a time, were recorded from infra-orbital electrodes (noninverting placed 1 cm below the lower eyelid and inverting 2 cm below the inverting on the cheek) with forehead as ground. Starting intensity was 125 dB peSPL with subsequent reductions in 10-dB steps to arrive at threshold. The stimuli were delivered to the ear at a rate of 5.1 Hz. The frequency corresponding to the largest peak-to-peak amplitude, best threshold, and/or largest peak-to-peak amplitude at thresholds was considered as the tuning frequency. Proportions of ears with frequency tuning at a particular frequency were compared between the groups. The frequency tuning at 1000 Hz was found to exist in a significantly higher proportion of affected ears with Meniere's disease than the comparison group as well as ears with BPPV (p < 0.05). Using a criterion point of frequency tuning at 875 Hz, the sensitivity and specificity for identifying Meniere's disease was found to be 68% and 100%, respectively. The shift in frequency tuning is an efficient parameter for not only discriminating Meniere's disease from healthy individuals but also distinguishing it from BPPV. Therefore, frequency tuning is recommended as a test parameter of oVEMP for identification of Meniere's disease.

Left Ventricular Mechanics in Functional Ischemic Mitral Regurgitation in Acute Inferoposterior Myocardial Infarction.

Ischemic mitral regurgitation (MR) is an established adverse prognostic factor after myocardial infarction (MI). Functional ischemic mitral regurgitation in acute phase of MI remains under‐investigated due to its often transient and dynamic nature. We aimed to assess left ventricular (LV) mechanics by speckle‐tracking echocardiography in acute inferoposterior MI and ischemic mitral regurgitation (MR).MethodsSixty‐nine patients with no structural cardiac valve abnormalities and first acute inferoposterior MI were prospectively enrolled into the study. Two‐dimensional transthoracic echocardiography for regional myocardial function and valve assessment was performed within 48 hours of presentation after reperfusion therapy (percutaneous coronary intervention). Based on degree of MR, patients were divided into no significant MR (NMR) group (N = 34, with no or mild (grade 0–I) MR) and ischemic MR (IMR) group (N = 35, with grade ≥2 MR). Thirty‐five age‐ and gender‐matched healthy individuals served as a normal reference group. Offline 2D speckle tracking analysis was performed with GE EchoPAC software.ResultsLV ejection fraction and longitudinal myocardial deformation parameters were significantly better in healthy subjects, but did not differ between both study groups. All circumferential myocardial deformation parameters were significantly worse in IMR group compared to healthy subjects and NMR group. Global, basal, and mid‐ventricular radial strain was significantly lower in IMR group compared to both—healthy subjects and NMR group.ConclusionIschemic mitral regurgitation in acute inferoposterior MI is associated with worse radial and circumferential LV deformation parameters assessed by 2D speckle tracking echocardiography.

Increased Tear Film Osmolarity in Systemic Lupus Erythematosus

Purpose: To evaluate tear film osmolarity in patients with systemic lupus erythematosus (SLE). Methods: A total of 55 eyes from 55 patients with SLE and 47 eyes from 47 age- and gender-matched healthy individuals were included in this study. Tear film osmolarity was evaluated with a lab-on-a-chip technique (TearLab; TearLab Corporation, San Diego, CA) in SLE patients in comparison with healthy individuals, and results were correlated to clinically available diagnostic tests for dry eye, such as tear film break-up time (BUT), Schirmer’s test, and Ocular Surface Disease Index (OSDI). Results: The mean tear film osmolarity in the SLE patients and healthy individuals was 306.02 ± 13.27 mOsm/L and 300.74 ± 9.11 mOsm/L, respectively, which made for a statistically significant difference (p = 0.020). In the SLE group, tear film osmolarity was negatively correlated with the Schirmer’s test score and the BUT value (r = −0.295 p = 0.029 and r = 0.347 p = 0.009, respectively), whereas tear film osmolarity was not correlated with OSDI score (r = −0.182 p = 0.183). Conclusions: This study revealed that tear film hyperosmolarity and abnormal tear film function are associated with SLE.

Frequency-Amplitude Ratio of Ocular Vestibular-Evoked Myogenic Potentials for Detecting Meniere's Disease: A Preliminary Investigation.

Several parameters of ocular vestibular-evoked myogenic potential (oVEMP) have been used to identify Meniere's disease. Nonetheless frequency-amplitude ratio (FAR), which is the ratio of amplitude between two frequencies, is one among the parameters that has failed to attract researchers' attention despite proving its worth in diagnosis of Meniere's disease when used in conjunction with cervical VEMP. Thus, the present study aimed at investigating the utility of FAR of oVEMP in identifying Meniere's disease and finding out an optimum frequency pair for its diagnosis. Using a case-control design, oVEMPs were recorded for tone bursts of 500, 750, 1000, and 1500 Hz from 36 individuals with unilateral definite Meniere's disease in the age range of 15 to 50 years. For comparison purposes, oVEMP at the above frequencies were also obtained from an equal number of age- and gender-matched healthy individuals. The amplitudes of 750, 1000, 1500 Hz and tuned frequency, which was the frequency with the largest peak to peak amplitude among the above-mentioned frequencies, were divided by the amplitude of 500 Hz to obtain FARs for 750/500, 1000/500, 1500/500, and tuned frequency/500 frequency pairs. The results revealed significantly higher FAR in the Meniere's disease group than the healthy controls for all the frequency pairs (p < 0.05). The sensitivity of almost 90% and the specificity 100% was obtained for 1000/500 and 750/500, whereas the other frequency pairs produced a sensitivity of about 56% while still showing a specificity of 100%. High sensitivity and specificity, coupled with considerably lowered test duration when using only two frequencies, makes the use of FAR a more attractive prerogative, with 1000/500 as the frequency pair of choice.

Restless leg syndrome: a risk factor of higher prevalence of anxiety and depression in Parkinson’s disease patients

Background: Many studies have assessed the relationship of depression and anxiety with Parkinson’s disease (PD), as well as examining restless leg syndrome (RLS) with depression and anxiety. Nonetheless, there has not been an extensive effort to show how the prevalence of RLS affects both depression and anxiety in PD patients. The objective of this study was to examine how the prevalence of RLS in PD patients affects the prevalence and severity of depression and anxiety and how they compare with each other. This study is the first of its kind that examines the effects of the combination of the two neurological conditions with depression and anxiety as well as comparing their prevalence and severity to each other.Methods: The study included 27 PD patients who also suffered from RLS, 27 PD patients not suffering from RLS, and 27 gender-matched healthy individuals. All were evaluated for caseness and severity of both anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); HADS-A and HADS-D, respectively.Results: PD patients with RLS reported having the highest prevalence of both anxiety and depression. The least reported cases for both anxiety and depression were in the control group. In comparison, the results for severity of anxiety and depression within the three groups showed that PD patients with and without RLS had significantly higher severity scores for both anxiety and depression than the control group, but the scores did not significantly differ between the two PD patient groups.Conclusion: The presence of RLS in PD patients may increase the occurrence of both anxiety and depression, but the severity of the symptoms is not significant in the two groups of the PD patients.