Mean Erythrocyte Sedimentation Rate Research Articles

Late Quaternary development of the Storfjorden and Kveithola Trough Mouth Fans, northwestern Barents Sea

The development of two Arctic Trough Mouth Fans (TMFs), the Storfjorden and Kveithola TMFs, is investigated by means of sub-bottom and seismic reflection profiles, multibeam bathymetry and sediment samples allowing their detailed stratigraphic architecture to be defined. We find that the TMFs mainly consist of an alternation of rapidly deposited glacigenic debris flows during glacial maxima and a sequence of well-layered plumites and hemipelagic sediments, which were mainly deposited during the deglaciation phase of the adjacent glacial trough. We have identified eight units above regional reflector R1, which indicate that the ice sheet reached the shelf edge within the Storfjorden Trough on at least three occasions during the last ∼200 ka. A shallow subsurface unit of glacigenic debris flows suggests that the ice sheet had a short re-advance over the northern and central part of Storfjorden after the Last Glacial Maximum. From stratigraphy, core and literature data, we estimate that ice sheets reached the shelf edge between 19.5 to 22.5 ka, 61 to 65 ka and 135 to 167 ka. Detailed seismic imaging allows us to refine the sedimentary model of Arctic TMFs. The main differences to previous models involve gully formation during not only the deglaciation phase, but also during interglacials by dense shelf water cascading, and a specific timing for the occurrence of slope failures (i.e., shortly after the deglaciation phase). High mean sedimentation rates during glacial maxima of up to 18 kg m−2 yr−1 likely allow excess pore pressure to develop in the water rich plumites and hemipelagic sediments deposited in the previous deglacial period, particularly where such plumites attain a significant thickness. The position of the submarine landslides in the stratigraphic record suggest that such excess pore pressure is not enough to trigger the slope failures and suggests that earthquakes related to isostatic rebound are likely involved in the final activation.

Dating recent sediments from the subaqueous Yangtze Delta and adjacent continental shelf, China

In this study we analyzed sediment lithology, fallout of 210Pb and 137Cs, and spheroidal carbonaceous particles (SCPs) for two short cores, YZE and CX38, obtained by gravity corer from the Yangtze River mouth offshore and adjacent continental shelf, to compare geochronological methods on the recent sediments of this area. Lithology and grain size changes in YZE suggested the re-discharging of the North Channel of the Yangtze River mouth by flood events during 1949–1954 and associated accretion in the offshore area. This event was validated by a remarkable zone of declination in both 137Cs and 210Pb activities and the absolute ages derived from the 137Cs and SCPs. In contrast, 210Pb results show obvious disturbance of grain size by sediment mixing and cannot be interpreted above 100cm. In CX38, absolute ages for the early- and mid-1950s were derived by the 137Cs and the SCP profile respectively, which occurred in a reasonable sequence. The excess 210Pb distribution shows exponentially decreasing activities with depth, and the mean sedimentation rate agrees roughly with the one inferred from the SCP profile. We suggest that the limitation of the 210Pb method needs consideration while the SCP profile has the potential to provide a useful and independent dating method for recent Yangtze offshore and adjacent shelf sediments.

Expression of CD69 molecule in Rheumatoid Arthritis Iraqi patients

Background: Rheumatoid arthritis (RA) is an autoimmune disease, where the normal joint tissues attacked by body’s immune system, causing their inflammation. Cluster of Differentiation 69 (CD69) is a human transmembrane C-Type lectin protein encoded by the CD69 gene. It’s expression was induced by activation (in vivo and in vitro) of T lymphocytes and Natural Killer (NK) Cells. As CD69 early activation has been implicated in the pathogenesis of some inflammatory diseases, its expression on peripheral blood T-lymphocytes must be evaluated.Objective: To evaluate the expression of CD69 on peripheral blood T-lymphocytes in RA Iraqi patients. Patients and methods: This study carried out between March 2014 and May 2014. The study involved 40 patients diagnosed with RA attending rheumatology outpatient’s clinic at Baghdad medical city teaching hospital diagnosed clinically and classified according to the 2010 American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) classification criteria for rheumatoid arthritis, compared to 40 apparently healthy individuals as a control group. Erythrocyte sedimentation rate (ESR) was measured by Westergren method. Flow cytometric immunophenotype analysis applied on T-lymphocytes for measuring the fluorescence intensity of CD3 and CD69 expression on those cells.Results: This study showed that the mean of ESR in RA patients was (66.8) while in healthy control it is only (20.4). And the mean of CD3 was higher in healthy individuals (41.88) than in RA patients (35.32), while the mean of CD69 was significantly higher among RA patients (11.09) than that of healthy controls (3.58). Also a moderately strong positive linear correlation was found between CD69 expression and RA severity.Conclusions: the expression of CD69 was up-regulated in freshly isolated peripheral blood lymphocytes from RA patients in comparison to healthy individuals.

Abdominal Pain in Ulcerative Colitis After Ileal Pouch-Anal Anastomosis

Introduction: Chronic abdominal pain is common in inflammatory bowel disease (IBD), including ulcerative colitis (UC). Few studies have investigated abdominal pain in UC patients who have had an ileal pouch-anal anastomosis (IPAA). The aims of this study were to determine the prevalence of chronic abdominal pain in UC patients with an IPAA and to examine the role of several potential risk factors in IPAA patients with abdominal pain. Methods: We used a prospective, consented IBD registry between the years 2008-2014 from a single tertiary care referral center. Age, gender, IPAA duration, presence of pouchitis and/or cuffitis (based on endoscopic and histologic evaluation), subjective pain rating (based on SIBDQ and UCAI pain scores), presence of psychiatric comorbidity, medication use, tobacco use, C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were abstracted. Results: 88 UC patients with an IPAA (43f:45m) were identified. 50 individuals (56.8%; 30f) described having abdominal pain. Using univariate analysis, female gender (P < 0.05), antidepressant use (P < 0.05) and lack of smoking history (P < 0.05) were more likely to be found in those with pain. There was no endoscopic or histologic evidence of pouch inflammation in 38 patients (43%; 19f). 20 of these patients (52.6%; 12f) had abdominal pain while 10 individuals (26.3%; 6f) complained of moderate to severe pain (operationally defined as a pain score of 4 or less). We also compared subgroups of patients without any pain to those with at least some pain. They demonstrated similar mean ages, CRP and ESR values, incidence of cuffitis and use of most medications (including antibiotics, probiotics, mesalamine, immunomodulators, biologics, NSAIDs and opiates). However, antidepressant use correlated with abdominal pain (P < 0.01). Conclusion: Abdominal pain is common in UC patients who have undergone an IPAA, even in those without overt evidence of inflammation in or around the pouch. While these findings do not establish a clear cause and effect relationship, the skewed gender distribution of those describing pain and correlation with use of therapies targeting affective spectrum disorders have strong similarities with functional bowel disorders and suggest an important role for central mechanisms. UC patients with an IPAA who demonstrate chronic abdominal pain should be screened for affective spectrum disorders and consideration should be made for therapeutic strategies similar to those tailored to functional disorders.

Anemia of Chronic Disease in Rhenumatoid Arthritis And Its Realationship With Disease Activities

Anemia is a frequent cause of morbidity in patients with Rheumatoid Arthritis (RA) that reduces quality of life. This observational cross sectional study was carried out in Rheumatology OPD and Medicine Indoor of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2009 to December 2010 to find out the frequency of Anemia of Chronic Disease (ACD) and relative frequency of pure ACD and ACD with coexistent Iron Deficiency Anemia (IDA) in RA and to describe the relationship between ACD and disease activity of RA patients. For this purpose a total of 130 RA patients were enrolled according to the inclusion and exclusion criteria of the study and divided into ACD group and non anemic group on the basis of hemoglobin level (11g/dl in females and &lt;12g/dl in males). ACD group of patients again divided into pure ACD and ACD with co-existent IDA subgroups on the basis of ratio of Soluble Transferrin Receptor (sTfR) to log ferritin (sTfR­F index).Patients with sTfR-F index value&lt;1 were classified as pure ACD and sTfR-F index value &gt;1 were classified as ACD with coexistent IDA. Disease activity were assessed by modified Disease Activity Score (DAS-28), Tender joint count, Swollen joint count, Morning stiffness in minutes, Health Assessment Questionnaire (HAQ) Erythrocyte Sedimentation Rate (ESR) in mm in 1st hour and Rheumatoid Factor (RF) positivity. Out of 130 patients, estimated frequency of ACD was 59%.Among the ACD patients, 16% were found to have pure ACD and 84% had both ACD and IDA. Disease activity parameters were compared between ACD group and non anemic group and then pure ACD and ACD with co­existent IDA subgroups of patients. We found significantly higher mean DAS-28 score ,tender joint count, swollen joint count, HAQ score and mean ESR in ACD group of patients as compared to non anemic RA patients. When differing levels of disease activity indices were compared, we also found significant difference between ACD and non anemic groups. Patients with pure ACD subgroups had significantly higher mean DAS-28, tender joint count, swollen joint count and HAQ score as compared to ACD with co-existent IDA subgroups of patients. When comparing differing levels of disease activity indices, no significant difference was observed between pure ACD and ACD with coexistent IDA patients with RA. This it can be said in conclusion that ACD is frequently encountered with high frequency of iron deficiency anemia among rheumatoid arthritis patents. RA patents with ACD tend to have severe disease than non anemic RA patents but pure ACD patints not necessarily had severe disease as compared to combined ACD and IDA. JCMCTA 2015 ; 26 (1) : 14-20

Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review.

Septic arthritis in infants is rare and can be difficult to diagnose. This study reviewed a series of patients younger than 3 months to identify factors that may assist in early diagnosis and treatment. A query of records at a large Midwestern pediatric hospital (1994-2010) was performed to identify all patients younger than 3 months at the time of diagnosis. Analysis included birth history, joint involvement, physical examination findings, laboratory results, imaging results, method of treatment, and outcome. In 14 cases (11 boys, 3 girls; mean age at diagnosis, 42.2 days), complete records were available for review. Involved joints included the knee, hip, and shoulder. The most common findings on physical examination were decreased range of motion (100%), tenderness (100%), and swelling (71.4%). Mean temperature was 38.5°C. Mean white blood cell count was 18.5 K/µL, mean erythrocyte sedimentation rate was 48.9 mm/h, and mean C-reactive protein level was 6.1 mg/dL. More than half (57.1%) of joint aspirates grew positive cultures, and 41.7% of blood cultures had positive results. Causative organisms were group B streptococcus, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Salmonella enterica, and Candida albicans. The most common physical examination findings in infants younger than 3 months with septic arthritis include tenderness, decreased range of motion, and swelling. White blood cell count, C-reactive protein level, and erythrocyte sedimentation rate are likely to be elevated, but these findings should be used in combination with findings on physical examination and radiographic studies to aid in diagnosis.

Stepwise Therapy for Treating Tuberculosis of the Upper Cervical Spine: A Retrospective Study of 11 Patients

Aims: Tuberculosis of the upper cervical spine is a rare occurrence with serious consequence, and its optimal treatment protocol remains inconclusive. This study aims at investigating the clinical characteristics and management outcomes of the stepwise therapy for different stages of tuberculosis of the upper cervical spine. Methods: We conducted a retrospective analysis of 11 patients with tuberculosis of the upper cervical spine who received anti-tuberculosis chemotherapy for 15 months. Two infants were treated by individualized chemotherapy, while 9 patients with retropharyngeal abscess were first treated with CT-guided percutaneous puncture, and the catheter was used to administer local chemotherapy. Two of these 9 patients continued to receive posterior instrumentation due to atlantoaxial subluxation. Patients were followed up clinically and radiologically for an average period of 60 months. Results: Two patients underwent catheter change due to catheter falling off and blockage, 2 patients had gastrointestinal side effects, and 2 patients had drug-induced hepatitis derived from the chemotherapy. Mean erythrocyte sedimentation rate was 10.27 mm/h (range 4-16 mm/h) and average visual analogue scale score was 2.55. A total of 11 cases underwent routine anti-tuberculosis chemotherapy for 15 months. 9 of 11 cases received supplementary surgical therapy, and all patients were cured at the final follow-up. Conclusion: Standard anti-tuberculosis chemotherapy is the cornerstone of stepwise therapy for tuberculosis of the upper cervical spine. Local chemotherapy is effective and minimally invasive for patients with severe local symptoms without spinal cord compression. Just as in patients with atlantoaxial instability, open fixation and bone grafting are necessary.

Adverse local tissue reactions in metal-on-polyethylene total hip arthroplasty due to trunnion corrosion: the risk of misdiagnosis.

Adverse reaction to wear and corrosion debris is a cause for concern in total hip arthroplasty (THA). Modular junctions are a potential source of such wear products and are associated with secondary pseudotumour formation. We present a consecutive series of 17 patients treated at our unit for this complication following metal-on-highly cross-linked polyethylene (MoP) THA. We emphasise the risk of misdiagnosis as infection, and present the aggregate laboratory results and pathological findings in this series. The clinical presentation was pain, swelling or instability. Solid, cystic and mixed soft-tissue lesions were noted on imaging and confirmed intra-operatively. Corrosion at the head-neck junction was noted in all cases. No bacteria were isolated on multiple pre- and intra-operative samples yet the mean erythrocyte sedimentation rate was 49 (9 to 100) and C-reactive protein 32 (0.6 to 106) and stromal polymorphonuclear cell counts were noted in nine cases. Adverse soft-tissue reactions can occur in MoP THA owing to corrosion products released from the head-neck junction. The diagnosis should be carefully considered when investigating pain after THA. This may avoid the misdiagnosis of periprosthetic infection with an unidentified organism and mitigate the unnecessary management of these cases with complete single- or two-stage exchange.

Deposition history and ecological risk assessment of heavy metals in sediments from Xuwen Coral Reef Reserve, China

The deposition history, enrichment influence factors, and ecological risk assessment of heavy metals are examined on two sediment cores retrieved from the Xuwen National Coral Reef Nature Reserve, China. 210Pbex and 137Cs dating reveals that the mean sedimentation rate is about 1.5 cm a−1 in the reserve. The concentrations of Pb, Cd, As, and Hg in sediments begin to show evident increasing trends in the 1980s. This is most likely to be caused by the anthropogenic excessive inputs originated from the large-scale development of agricultural chemical usage, coal combustion in cane sugar industry, and marine transportation after the implementation of China open policy in 1979. The annual load of heavy metals received by the reserve in recent years is estimated at about 594 tons, in which Cr and Zn are dominated and account for a proportion of 64 %. Although the ecological risk of heavy metals is assessed as low according to the sediment quality guidelines (China marine sediment quality and US NOAA screening quick reference), appropriate pollution control measures should be undertaken to prevent the occurrences of significant adverse biological effects induced by the continuous accumulations of Pb, Cd, As, and Hg in the sediments of study area.

Caloric Restriction and Formalin-Induced Inflammation: An Experimental Study in Rat Model

Background:Acute and chronic inflammations are difficult to control. Using chemical anti-inflammatory medications along with their complications considerably limit their use. According to Traditional Iranian Medicine (TIM), there is an important relation between inflammation and Imtila (food and blood accumulation in the body); food reduction or its more modern equivalent Caloric Restriction (CR) may act against both Imtila and inflammation.Objectives:This experimental study aimed to investigate the effect of 30% reduction in daily calorie intake on inflammation in rats.Materials and Methods:A total of 18 male rats (Rattus rattus) weighing 220 to 270 g were obtained. Then, the inflammation was induced by injecting formalin in their paws. Next, the rats were randomized by generating random numbers into two equal groups (9 + 9) putting on either normal diet (controls) or a similar diet with 30% reduction of calorie (cases). Paw volume changes were recorded twice per day by one observer in both groups using a standard plethysmometer for 8 consecutive days. Serum C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), complete blood count (erythrocyte, platelet, and white blood cell) and hemoglobin were compared between the groups.Results:Decline of both body weight and paw volume was significantly more prominent in the case than in the control rats within the study period (P < 0.001 and < 0.001, respectively). Paw volume decrease was more prominent after day 3. On day 8, serum CRP-positive (1 or 2 +) rats were more frequent in ad libitum fed group comparing with those received CR (33.3% vs. 11.1%). This difference, however, was insignificant (P = 0.58). At the same time, mean ESR was significantly higher in the control rats comparing with that in the case group (29.00 ± 2.89 h vs. 14.00 ± 1.55 h; P = 0.001). Other serum parameters were not significantly different between the two groups at endpoint.Conclusions:Rats fed with a 30% calorie-restricted diet in comparison with to ad libitum fed controls for 8 days had significantly more prominent regression of inflammation.

English

In humans, it has been suggested that low-level mean platelet volume (MPV) may be related to secondary thrombosis due to inflammation. For this reason, MPV can be used as a marker showing inflammation in the body. To evaluate the association of MPV with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Disease Activity Score-28 (DAS-28), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with rheumatic diseases. The study consisted of 261 patients with rheumatoid arthritis (203 females, 77.8%; 58 males, 22.2%), 85 patients with ankylosing spondylitis (57 males, 67.1%; 28 females, 32.9%), 56 patients with familial Mediterranean fever (32 females, 57.1%; 24 males, 42.9%) and 194 patients (139 females, 71.6%; 55 males, 28.4%) with other rheumatic diseases (Behçet's disease, psoriatic arthritis, spondyloarthropathy, systemic lupus erythematosus, systemic sclerosis, or undifferentiated connective tissue disease). There was an inversely significant correlation between MPV and ESR and CRP in patients with rheumatoid arthritis (r = -0.164, p = 0.008). Mean platelet volume was negatively correlated with DAS-28-ESR/CRP (r = -0.393, p < 0.001) in rheumatoid arthritis. Mean platelet volume was inversely correlated with BASDAI (r = -0.580, p < 0.001) in ankylosing spondylitis. In the group with familial Mediterranean fever (especially M694V homozygous), there was a negative correlation between MPV and ESR and CRP (p < 0.001). Mean platelet volume and CRP were negatively correlated in psoriatic arthritis (r = -0.599, p = 0.011). Mean platelet volume and ESR were inversely related in patients with systemic lupus erythematosus (r = -0.421, p = 0.045). There was a negative correlation between MPV and ESR (r = -0.219, p = 0.002), and between MPV and CRP (r = -0.208, p = 0.004) in other rheumatic diseases. The lower MPV level surrogates active and/or chronic inflammatory state in the body. Thus, MPV may be used as a negative acute-phase reactant in rheumatic diseases.

PP08.11 – 2891: Predictors of intensive care requirement in children with Guillain-Barré syndrome: A retrospective study

Objective Pre-emptive transfer to a tertiary centre with onsite paediatric intensive care unit (PICU) support is preferable to transfer of the decompensated child in Guillain-Barre syndrome (GBS). Our aim was to identify presenting clinical, laboratory and neurophysiological features associated with requirement for PICU in children with GBS. Methods Retrospective review of children attending our tertiary centre over an 11 year period. Inclusion criteria Documented nerve conduction study and examination by a paediatric neurologist during the acute illness with features meeting consensus case definitions for GBS or Fisher syndrome (FS). Data were collected on symptoms, examination findings, laboratory and neurophysiological investigations, PICU admission and illness course. Results 52 children met case definition for GBS; one child met case definition for FS. Median age was 4 years (range 0.6–16); 55% were female. 13 children (25%) required PICU admission and 9 (17%) required ventilation for respiratory failure for a median 7 days (range 3–22). Significant predictors of requirement for PICU were bulbar involvement (odds ratio [OR] 55.0, 95% confidence interval [CI] 3.0–996), respiratory involvement (OR 25.9, 95% CI 4.7–144), autonomic dysfunction (OR 4.8, 95% CI 1.3–18.1), hypertension (OR 11.9, 95% CI 1.9–72.4), bradycardia (OR 27.0, 95% CI 1.3–564) and loss of antigravity power in ≥1 muscle group (OR 10.6, 95% CI 2.5–44.7). Mean erythrocyte sedimentation rate was 97 mm/hr in the PICU group and 34 mm/hr in the non-PICU group (p=0.004). Other variables including CSF protein, neurophysiological parameters and rate of progression did not differ significantly between groups. Conclusion Bulbar involvement, respiratory involvement, dysautonomia, profound weakness and extreme elevation in ESR are significantly associated with requirement for PICU in GBS. Identification of these features at presentation should prompt early consideration for transfer to a tertiary centre with onsite PICU support. Slow progression of weakness is a false reassuring feature in predicting eventual requirement for PICU.

Preoperative antibiotics for septic arthritis in children: delay in diagnosis.

To review the records of 50 children who underwent open joint washout for septic arthritis with (n=25) or without (n=25) preoperative antibiotics. Records of 50 children who underwent open joint washout for presumed septic arthritis with (n=25) or without (n=25) preoperative antibiotics were reviewed. 17 boys and 8 girls aged 3 weeks to 16 years (median, 1.5 years) who were prescribed preoperative antibiotics before joint washout were compared with 12 boys and 13 girls aged one month to 14 years (median, 2 years) who were not. Following arthrotomy and washout, all patients were commenced on high-dose intravenous antibiotics. Patients were followed up for 6 to 18 months until asymptomatic. Patients who were referred from places other than our emergency department were twice as likely to have been prescribed preoperative antibiotics (p=0.0032). Patients prescribed preoperative antibiotics had a longer median (range) time from symptom onset to joint washout (8 [2-23] vs. 4 [1-29] days, p=0.05) and a higher mean erythrocyte sedimentation rate (93.1 vs. 54.3 mm/h, p=0.023) at presentation. Nonetheless, the 2 groups were comparable for weight bearing status, fever, and positive culture, as well as the mean (range) duration of antibiotic treatment (4.9 [4-7] vs. 4.7 [1-8] weeks, p=0.586). Preoperative antibiotics should be avoided in the management of septic arthritis in children. Their prescription delays diagnosis and definitive surgery, and leads to additional washouts and complications. A high index of suspicion and expedite referral to a specialist paediatric orthopaedic unit is needed if septic arthritis is suspected.

Marshall syndrome – a challenge in medical practice

Marshall syndrome (periodic fever, adenitis, pharyngitis, aphthae, PFAPA syndrome) is characterized by recurrent episodes of fever associated with aphthous stomatitis, cervical adenitis or pharyngitis. Although it is the most common cause of recurrent fever in children, the diagnosis is rarely established. The aim of this study was to describe a group of Romanian children with Marshall syndrome. In seven children with PFAPA, the following methods were used: patient history, clinical examination, and determination of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and tumor necrosis factor α (TNF-α). The treatment consisted in prednisone at a dose of 1 mg/kg. The age at onset was 2.2 years and at diagnosis 4.8 years. The mean interval between episodes was 3.1 weeks and the duration per febrile episode was 3.7 days. The patients presented with pharyngitis (100%), adenitis (100%) and aphthous lesions (57.1%). The mean ESR value was 31 mm/h, CRP 7.8 mg/dL and leukocytes 17700/mm3. TNF-α remained elevated between febrile episodes. Six patients treated with prednisone had favorable evolution. In conclusion, PFAPA should be suspected in children with periodic fever associated with pharyngitis, cervical adenitis and aphthous stomatitis.

Clinical Features, Treatment and Monitoring in Patients With Polymyalgia Rheumatica

Objectives: This study aims to evaluate the clinical symptoms and laboratory findings of Turkish patients with polymyalgia rheumatica. Patients and methods: Clinical data of 41 patients (9 males, 32 females; mean age 65.5±7.6 years; range 60 to 80 years) with polymyalgia rheumatica were retrospectively evaluated. Patients’ clinical symptoms, laboratory findings, therapies and therapeutic responses were analyzed. Results: The most common symptoms were bilateral shoulder pain (59.9%) and morning stiffness (48.78%). Mean erythrocyte sedimentation rate at diagnosis was 66.8±22.5 mm/h, while mean C-reactive protein value was 48.7±25.8 mg/dL. In the third week of corticosteroid treatment, good response to treatment was detected in 33 patients (80.5%). Mean age of patients who gave good response to treatment (67.2±6.7) was higher than mean age of patients who gave poor or no response to treatment (58.5±7.8) (p=0.009). Conclusion: Patients’ clinical features, laboratory findings, initial steroid doses, and responses to corticosteroid therapy were consistent with the literature. However, the rate of morning stiffness was high and peripheral arthritis was rare. Giant cell arteritis was not detected in patients with polymyalgia rheumatica. Good response to early steroid treatment was observed in older patients. Rate of relapse was low. Further studies are required to evaluate factors affecting response to treatment, remission, and relapse.

The Prevalence and Characteristics of Psoriatic Arthritis in Patients With Psoriasis in a Tertiary Hospital

Objectives: This study aims to investigate psoriatic arthritis (PsA) prevalence in patients with psoriasis (Ps), and compare clinical and laboratory characteristics of patients with or without PsA. Patients and methods: A total of 126 patients (59 males, 67 females; mean age 45.6±13.8 years; range 18 to 82 years) with Ps who applied to Dermatology Outpatient Clinic between October 2009 and September 2010 were included in this study. The patients were screened for PsA using Classification of Psoriatic Arthritis criteria. The patients classified as PsA were grouped according to Moll and Wright criteria. Enthesopathy was evaluated according to Maastricht Ankylosing Spondylitis Enthesis score. Psoriasis Area and Severity Index scores were calculated by the same dermatologist. Results: The prevalence of PsA was 25.4%. Ps duration was significantly longer in the group with PsA. The most common type was asymmetrical oligoarticular type (53.1%). Compared to previous studies, the rate of isolated spondyloarthropahty was higher in our study (21.9%). Nail involvement, Psoriasis Area and Severity Index score, mean erythrocyte sedimentation rate, and C-reactive protein values were significantly higher in the group with PsA. Conclusion: High rate of isolated spondyloarthropahty in patients with PsA indicates that PsA must be kept in mind in the differential diagnosis of seronegative spondyloarthropathies. The fact that nail involvement is seen more frequently in patients with arthritis may assist in screening of PsA in patients with Ps. In addition, our results showing a higher probability of PsA development in patients with more severe skin lesions and a higher probability of arthritis development in patients with long lasting Ps may guide clinicians in terms of the probability of arthritis development in patients with Ps.

Patients with Takayasu's arteritis having persistent acute-phase response usually have an increased major vessel uptake by 18F-FDG-PET/CT

Objectives. Although not uniformly accepted, an increased uptake by 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in large vessels is accepted to be a sign of active disease in Takayasu's arteritis (TAK). We aimed to investigate the value of 18F-FDG-PET/CT for clinical assessment in a subset of TAK patients having a persistent acute-phase response (APR) without any signs or symptoms of clinical disease activity.Method. We studied 14 patients (mean age: 38.6 ± 13.9 years, Female/Male: 11/3, and disease duration: 5.7 ± 5 years). Patients were clinically inactive (according to the definition of activity by Kerr et al.), while categorized as having “persistent” disease activity by physician's global assessment due only to APR. 18F-FDG uptake was graded using a four-point scale from grade 0 (no uptake present) to grade 3 (high grade: uptake higher than that of liver). Any uptake in major vessels with a grade ≥ 2 was accepted to be “active.”Results. Mean erythrocyte sedimentation rate was 50.8 ± 13.2 mm/hour and mean C-reactive protein level was 28.5 ± 22.1 mg/L. Active vasculitic lesions were observed by 18F-FDG-PET/CT in 9 of 14 (64.3%) patients. The median number of active vascular lesions was 2 (range: 1–5). A step-up treatment change was decided in 8 patients according to 18F-FDG-PET/CT results.Conclusion. We observed increased 18F-FDG uptake in the majority of TAK patients with an increased APR, but clinically silent disease. 18F-FDG-PET/CT showed the presence and localization of active inflammation in the aorta and its branches. Although specificity for observed lesions is not clear, 18F-FDG-PET/CT imaging may influence physician's assessment of clinical activity and treatment choices in TAK.

High frequency environmental changes and deposition processes in a 2 kyr-long sedimentological record from the Cap-Breton canyon (Bay of Biscay)

The core MD03-2693 (43°39.258′N; 01°39.805′W; 431 m water depth) was collected on an abandoned meander of the Capbreton Canyon (SE Bay of Biscay), filled over the last millennia by very high sedimentation rates (mean sedimentation rate of 1.2 cm/yr) linked to its specific environmental location and fine-grained clayed sediment decantation from the proximal canyon axis. This archive thus permits to undertake the study of late Holocene regional climatic patterns at a decadal temporal resolution. In the present work, we use data derived from planktonic foraminifera assemblages coupled to a multiproxy approach that associates grain-size measurements, x-ray fluorescence (XRF) elemental analysis and stable oxygen isotope on Globigerina bulloides shells to infer Sea Surface Temperature (SST) and Sea Surface Salinity (SSS) changes over the last two millennia. Signals reconstructed in the Bay of Biscay show significant oscillations that are consistent with well-known temperature anomalies such as the ‘Little Ice Age’ (LIA) and the ‘Medieval Warm Period’ (MWP). It additionally displays strong similarities with other areas in the western temperate and northern North Atlantic Ocean, suggesting a narrow coupling between its main gyre surface systems. Abrupt decrease of SSS together with significant change in terrigenous inputs suggests a change in precipitation regime at the onset of the LIA (around ad 1400). Moreover, superimposed to the relative long-term change in environmental parameter, the core MD03-2693 records rapid and discrete pulses of sand grain–sized material that are correlated with the local history of migration of the mouth of the Adour River.

Spectral domain-optical coherence tomographic findings in patients with ankylosing spondylitis under anti-tumor necrosis factor-alpha therapy

Objective: To evaluate the effect of tumor necrosis factor-alpha (TNF-α) blockade on the thickness of the peripapillary retinal nerve fiber layer (RNFL), the ganglion cell-inner plexiform layers (GCIPL), and the macula in ankylosing spondylitis (AS) patients under anti-TNF-α therapy.Materials and methods: Twenty-one patients with AS received etanercept, or adalimumab, or infliximab for at least 6 months. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were measured before and 6 months after the beginning of the treatment. Peripapillary RNFL, four regional fields (superior, inferior, nasal, and temporal), GCIPL, and macular thicknesses of the patients were analyzed by optical coherence tomography before the treatment, at 3 months and 6 months after the beginning of the treatment.Results: The mean BASDAI, ESR, and CRP values were 5.2 ± 1.5, 31.6 ± 21.7, and 15.7 ± 13.9, respectively, at the beginning of the treatment and 2.3 ± 1.7, 21.3 ± 15.1, and 10.1 ± 10.3, respectively, 6 months after the beginning of treatment. There were significant differences among the mean BASDAI, ESR, and CRP values at the beginning of treatment and 6 months later (p < 0.001, p = 0.007, and p = 0.009, respectively). There were no significant differences among peripapillary RNFL (p = 0.24), four regional fields (p = 0.98, p = 0.23, p = 0.09, p = 0.47), GCIPL (p = 0.25), or macular (p = 0.33) thicknesses of the patients during anti-TNF-α treatment. In addition, the mean intraocular pressure levels throughout the follow-up did not show significant variation on repeated-measures ANOVA (p = 0.77).Conclusions: TNF-α blockade does not seem to influence RNFL, GCIPL, or macular thickness of patients with AS in the short term.

The Impact of Treatment on Serum Level of Procalcitonin in Patients with Active Pulmonary Tuberculosis

Introduction: About one third of the world's population is infected with tuberculosis (TB) and each year, about 1.5 to 2 million people die from TB. Procalcitonin (PCT) is an inflammatory marker that its level has variable Materials and Methods: This conducted on patients with pulmonary TB. Data were collected using a check list. The serum level of PCT was measured by ELISA test at the beginning and after six months of treatment. All data were analyzed using SPSS 16. Results: There are some discussions in the utilization of PCT as a diagnostic marker in active pulmonary TB. The aim of this study was to compare serum PCT before and after treatment in patients with pulmonary TB. Results: Forty-two patients with active pulmonary TB entered in this study. The mean age of the patients was 45.48 ± 12.54 years and 54.8% of them were male. Most of the patients (59.5 %) were rural inhabitants. There was a family history of TB in 26% of patients. The most common symptom (45.2%) was cough. Mean PCT prior to treatment was 1.25 ± 0.98 ng/ml. and 81% of the patients had PCT higher than 0.5 to 5. After treatment PCT level reduced significantly (P<0.001). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before treatment were 45.88 ± 21.87 and 7.16 ± 3.98 respectively that were reduced significantly after treatment (P<0.001). Neutrophil counts before treatment was 6221 ± 3161 Cells per ml. and decreased statistically significant after treatment (P=0.01). Conclusion: Our results showed that the PCT levels in pulmonary TB were high in active disease and reduced after treatment. PCT level may be used for follow-up as a discriminative marker between active and cured pulmonary TB and predict treatment response, although the PCT assay cannot be substituted for microbiological and pathological data.