The Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire: predicting clinical arthritis development.

OBJECTIVE: There is a need to better define symptom characteristics associated with arthritis development in individuals at risk of rheumatoid arthritis (RA). We investigated whether reported symptoms in at-risk individuals could predict arthritis development and whether predictive symptoms differed between seropositive and seronegative at-risk individuals. METHOD: At-risk individuals from four cohorts (Netherlands, UK, Sweden, and Switzerland) completed the Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire. Participants had either (i) anti-citrullinated protein antibodies and/or rheumatoid factor, or (ii) relevant symptoms with or without RA antibodies. Follow up was ≥ 24 months or until clinical arthritis development. Stepwise forward selection created SPARRA prediction models for the combined group and for a seropositive subgroup. RESULTS: Of 214 participants, the mean age was 50 years, 67% were female, and 27% (n = 58) developed clinical arthritis after a median time of 7 months. Four symptoms predicted arthritis development: self-reported joint swelling, joint pain moving from side to side (combined group only), feeling pins and needles in the joints, and often feeling fatigued (predicting non-arthritis). CONCLUSION: Specific symptoms can provide useful information to estimate a person's RA risk. Differences in predictive symptoms between seropositive and seronegative at-risk individuals need to be further investigated. Future research is needed to determine whether changes in symptoms over time improve prediction and to determine the value of SPARRA in optimizing the selection of individuals who need to consult a rheumatologist.

Effects of thymoquinone on spinal cord injury in rats.

PURPOSE: Spinal cord injury (SCI) is a condition that causes disturbances in normal sensory, motor, and autonomic functions. During SCI, damages occur such as, contusion, compression, distraction. The aim of this study was to investigate effects of the antioxidative thymoquinone on neuron and glia cells in SCI biochemically, immunohistochemically and ultrastructurally. METHODS: Male Sprague-Dawley rats were divided into Control, SCI and SCI + Thymoquinone groups. After T10- T11 laminectomy was performed, a metal weight of 15 grams was left down the spinal tube for spinal damage. Immediately after the trauma, the muscles and skin incision were sutured. Thymoquinone was given to the rats by gavage as 30mg/kg/21days. Tissues fixed in 10% formaldehyde, embedded in paraffin wax and immunstained with Caspase-9 and phosphorylated signal transducer and activator of transcription 3 (pSTAT-3) antibodies. Remaining were stored at -80oC for biochemistry. Frozen spinal cord tissues were placed in a phosphate buffer solution and homogenized, centrifuged then used to measure malondialdehyde (MDA) levels, glutathione peroxidase (GSH) and Myeloperoxidase (MPO). RESULTS: In the SCI group, MDA, MPO, neuronal degeneration, vascular dilatation, inflammation, apoptotic appearance in the nucleus, loss of membrane and cristae in mitochondria, and dilatation in the endoplasmic reticulum were observed due to degeneration in the neuron structure. In the electron microscopic examination of the trauma + thymoquinone group, the membranes of the nuclei of the glial cells were thick and euchromatin, and mitochondria were shortened in length. In the SCI group, pyknosis and apoptotic changes were observed in neuronal structures and nuclei of glia cells in the substantia grisea and substantia alba region, along with positive Caspase-9 activity. An increase in Caspase-9 activity was observed in endothelial cells in blood vessels. In the SCI + thymoquinone group, Caspase-9 expression was positive in some of the cells in the ependymal canal while the cuboidal cells showed a negative Caspase-9 reaction in the majority. A few degenerated neurons in the substantia grisea region showed a positive reaction with Caspase-9. In SCI group, pSTAT-3 expression was positive in degenerated ependymal cells, neuronal structures, and glia cells. pSTAT-3 expression was positive in the endothelium and surrounding aggregated cells of the enlarged blood vessels. In the SCI+ thymoquinone group, pSTAT-3 expression was negative in most of the bipolar and multipolar neuron structures and glial cells in ependymal cells, enlarged blood vessel endothelial cells. CONCLUSIONS: It has been thought that thymoquinone application in spinal cord injuries may be an antioxidant that can be recommended as an alternative treatment in suppressing the apoptosis of neural cells by significantly reducing the inflammation process.

Characteristics and outcome of varicella-zoster virus central nervous system infections in adults.

We conducted an observational retrospective study of all adults hospitalized for documented varicella-zoster virus (VZV) meningitis or encephalitis during years 2000-2015 in one referral centre. Thirty-six patients (21 males, 15 females) were included, with meningitis (n = 21), or meningoencephalitis (n = 15). Median age was 51 years [interquartile range, 35-76], and 6 patients (17%) were immunocompromised. Aciclovir was started in 32 patients (89%), with a median dose of 11 mg/kg/8 h [10-15]. No patient died, but 12 (33%) had neurological sequelae at discharge. Age was the only variable associated with adverse outcome (OR 1.98 [1.17-3.35] per 10-year increment, P = 0.011).

A critical analysis of low molecular weight heparin use during pregnancy in a tertiary referral centre.

The aim of this study was to analyse low molecular weight heparin (LMWH) use during pregnancy in terms of patient evaluation, treatment indication and social and financial costs. This was a retrospective analysis of patients using LMWH in their pregnancies. A total of 147 women were included in the study. The most common indications were thrombophilia (55/147, 37.4%); recurrent pregnancy loss (RPL); (47/147, 32.0%) and previous single pregnancy loss (18/147, 12.2%). In the RPL group, 53.1% of patients were not evaluated with standard tests; 31.9% of women were incompletely evaluated and 15% were properly evaluated. Out of 104 women screened for thrombophilia, 32 (32/104, 30.8%) were tested during pregnancy. Despite published guidelines and increasing scientific evidence against their use in some indications, LMWHs are prescribed widely during pregnancy for a variety of indications. Public and healthcare providers' education to change this attitude should be implemented.

Evaluation of treatment processes in childhood fifth metacarpal bone (Boxer) fractures with QuickDASH scoring system.

OBJECTIVE: Metacarpal fractures are one of the most common orthopedic injuries seen in emergency departments. Despite this, only a few data have been published about the epidemiology of metacarpal fractures. Simple radiographs are the standard imaging modality used to diagnose boxer fractures and determine the degree of angulation. Fractures and angulations should be identified by anteroposterior and lateral radiographs. The aim of this study was to follow the healing after closed reduction of fifth metacarpal neck fractures in a pediatric population using the QuickDASH score to determine whether it results in clinically significant improvement. SUBJECTS AND METHODS: Between 2020 and 2022, our clinical record database for all metacarpal fractures treated at our institution was searched retrospectively every month. Children aged 18 years and younger with fifth metacarpal neck fractures treated with closed reduction and immobilization in our tertiary care emergency clinic were retrospectively reviewed. RESULTS: 52 pediatric patients were included in the study. The mean age at the time of injury was 14.04 years (SD=2.10, range=10-18 years). 92.30% (n=48) of the patients were male, and 7.70% (n=4) were female. CONCLUSIONS: Accurate diagnosis and appropriate treatment are crucial in the management of childhood fifth metacarpal fractures to ensure proper healing, prevent long-term complications, and facilitate optimal functional recovery.

Accurate diagnosis of COVID-19 from lung CT images using transfer learning.

OBJECTIVE: In this study, it is aimed to classify data by feature extraction from tomographic images for the diagnosis of COVID-19 using image processing and transfer learning. MATERIALS AND METHODS: In the proposed study, CT images are made better detectable by artificial intelligence through preliminary processes such as masking and segmentation. Then, the number of data was increased by applying data augmentation. The size of the dataset contains a large number of images in numerical terms. Therefore, the results of the models are more reliable. The dataset is split into 70% training and 30% testing. In this way, different features of the applied models were found, and positive effects were achieved on the result. Transfer Learning was used to reduce training times and further increase the success rate. To find the best method, many different pre-trained Transfer Learning models have been tried and compared with many different studies. RESULTS: A total of 8,354 images were used in the research. Of these, 2,695 consist of COVID-19 patients and the remaining healthy chest tomography images. All of these images were given to the models through masking and segmentation processes. As a result of the experimental evaluation, the best model was determined to be ResNet-50 and the highest results were found (accuracy 95.7%, precision 94.7%, recall 99.2%, specificity 88.3%, F1 score 96.9%, ROC-AUC score 97%). CONCLUSIONS: The presence of a COVID-19 lesion in the images was identified with high accuracy and recall rate using the transfer learning model we developed using thorax CT images. This outcome demonstrates that the strategy will speed up the diagnosis of COVID-19.

Publisher Correction: Accurate diagnosis of COVID-19 from lung CT images using transfer learning.

Eur Rev Med Pharmacol Sci 2024; 28 (3): 1213-1226-DOI: 10.26355/eurrev_202402_35360-PMID: 38375726, published online on February 16, 2024. This erratum corrects the references 1, 2, and 3, which have been mistakenly inserted in the text during the authors' drafting with the following: - Reference 1 has been substituted with the following: 1) Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H, Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J 2020; 96: 753-758. - Reference 2 has been substituted with the following: 2) Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, Tie Y, Fullerton KE. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 759-765. - Reference 3 has been substituted with the following: 3) Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/35360.

Speckle tracking echocardiographic analysis of left ventricular systolic and diastolic functions of young elite athletes with eccentric and concentric type of cardiac remodeling.

AIMS: In individuals who exercise regularly and for extended periods of time, some structural alterations in the heart, called the athlete's heart, develop in time. These alterations vary in type, can be eccentric or concentric, depending on the nature of exercise. Speckle tracking echocardiography (STE) is a novel, angle-independent method that accurately and reliably measures systolic and diastolic functions of the left ventricle (LV) with considerably lower inter-operator variability. METHODS AND RESULTS: Twenty-two marathon runners, 24 wrestlers, and 20 healthy sedentary individuals were included in the study. The average age of subjects is 17.5 ± 2.2 in marathon runners, 16.8 ± 1.9 in wrestlers, and 16.4 ± 1.8 in control group. The parameters of LV longitudinal strain (S), LV longitudinal strain rate systolic (SRS), LV longitudinal strain rate diastolic early filling (SRE), and longitudinal strain rate diastolic late filling (SRA) were evaluated by apical two-, three-, and four-chamber grayscale imaging using the global longitudinal strain (GLS) and GLS rate (GLSR). Conventional echocardiographic parameters demonstrated increased LV diameters and wall thickness in the marathon runners and increased wall thickness without increased LV diameters in the wrestlers. Systolic and diastolic functions were comparable between the marathon runners and wrestlers with conventional echocardiography. Analysis with STE, however, yielded higher systolic strain and strain rates in the athletes. Normalized GLS parameters and end-diastolic volume (EDV) were shown to be correlated. CONCLUSION: Overall, conventional echocardiography can detect some differences between young athletes with eccentric and concentric type of athlete's heart but it is incapable of revealing differences in intrinsic myocardial functions. However, analysis using STE demonstrated increased systolic functions in athletes commensurate with increased load, with unaltered diastolic functions.

Giant right coronary artery (RCA) aneurysm.

Coronary artery aneurysm (CAA) is a rare type of coronary artery disease. The angiographic incidence of the coronary artery aneurysm is reportedly between 1.5% to 4.9%, and it is more frequent in men. We have successfully carried out a simultaneous "coronary bypass together with aneurysm ligation" operation on a patient with coronary heart disease and an aneurysm within the right coronary artery.

Comparison of Shetty ankle test and Ottawa ankle rules in ankle injuries.

OBJECTIVE: Foot and ankle injuries are the most common extremity trauma and have an important place among the admissions to the emergency service. Ankle injuries are the most frequent form of orthopedic emergencies. Currently, Ottawa ankle rules (ORL) is the most popular test used worldwide for the ankle injuries. Shetty test is an important test used to evaluate the clinical status of patients admitted for the ankle trauma. PATIENTS AND METHODS: This study was initiated in the emergency service between May 1, 2018, and May 1, 2019, after the approval of the Ethics Committee. The patients were classified according to gender, age, and admission, Ottawa test results, Shetty test results, and radiography status. RESULTS: Shetty test can be used to differentiate between the foot sprains and fractures as a simple and inexpensive method. Despite its effectiveness, Ottawa ankle rules is not widely used due to the detailed implementation of the Ottawa ankle rules and the components of the test. The ease of applicability of the Shetty test in primary care makes the test stand out. In our study, although the sensitivity of Shetty and Ottawa tests resulted in close percentages (82.86% - 85.71%), the specificity of Ottawa test was found to be higher. CONCLUSIONS: Detecting a fracture in emergency services is more valuable than excluding a fracture. Even though Shetty test is simple to use, we recommend Ottawa test for the foot and ankle sprains due to the legal problem that could be caused by Shetty test.

Effect of melatonin and n-acetylcysteine on hepatic injury in rat induced by methanol intoxication: a comparative study.

BACKGROUND: Methanol intoxication leads liver injury; in contrast melatonin and n-acetyl cysteine (NAC) are known to have protective effects on liver. AIM: We aimed to investigate the ultrastructural effects of melatonin and NAC on livers of methanol intoxicated rats and compare potential protective effects of melatonin and NAC on their liver ultrastructure. MATERIALS AND METHODS: Fifty-six adult male Wistar rats were carried out and were randomized to eight groups that have seven rats each: Control groups (C 6h, C 24h), treated with intragastric (i.g.) 1.0 ml saline; Methanol groups (M 6h, M 24h), treated with a dose of 3 g/kg i.g. methanol; Melatonin plus methanol groups (MEL+M 6h, MEL+M 24h), treated with dose of 10 mg/kg i.p melatonin immediately, following with a dose of 3 g/kg i.g. methanol; NAC plus methanol groups (NAC+M 6h, NAC+M 24h), treated with dose of 150 mg/kg, following with a dose of 3 g/kg i.g. methanol. 24 h group rats were given the same dose of melatonin and NAC 12 h after intoxication. Electron microscopy was used to evaluate histological changes in liver tissue at both 6th and 24th hour. RESULTS: Histopathological damage was found to be higher in methanol-induced intoxicated rats compared with the controls. Extensive tubules of smooth endoplasmic reticulum, increased mitochondria, increased primary lysosomes and some marked openings of bile canaliculus were distinguished. Melatonin administration prevents liver injury especially in early hours and although not as effective as melatonin, NAC also prevents liver injury. CONCLUSIONS: Melatonin is much more efficient than NAC, as well as significantly greater hepatoprotective effect against the liver injury secondary to the methanol intoxication.

Magnetic resonance imaging (MRI) findings after knee, foot, and ankle traumas.

OBJECTIVE: The aim of this study is to investigate the demographic and clinical characteristics of knee and ankle traumas that could not be detected in the first post-traumatic evaluation and diagnosed within 15 days after the follow-up examination and to discuss the results we obtained with current data. PATIENTS AND METHODS: Patients admitted to the emergency department trauma department between January 1, 2017, and December 31, 2018, were retrospectively analyzed. Applications due to traffic accidents and all traumas except knee and ankle trauma were excluded from the study. Medical records were used to reveal the demographic characteristics of the cases, clinical findings, mechanisms of injury, additional injuries, and interventions in the emergency room. RESULTS: The mean age of 2,039 patients included in the study due to knee, foot, and ankle trauma was 35.69±12.01, and the median value was 36 (age range 11-71). The patients were divided into 2 groups knee trauma and ankle trauma and statistical evaluations were made. Of the patients evaluated for knee trauma (n=1,157), 463 (40%) were female and 694 (60%) were male. Of the patients evaluated for ankle trauma (n=882), 397 (45%) were female and 485 (55%) were male. CONCLUSIONS: It is evident that knee, foot, and ankle traumas after simple falls and sports injuries are frequently encountered by emergency physicians. It is known that post-traumatic ligament injury, bone contusion, intraarticular fluid/hematoma formation, and fractures that cannot be detected by radiographs can be overlooked in emergency departments where patient density is high.

Idiopathic pulmonary fibrosis: Significance of the usual interstitial pneumonia (UIP) CT-scan patterns defined in new international guidelines.

INTRODUCTION: The new 2018 international guidelines for diagnosing usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) by CT scan split the old pattern possible UIP (2011 IPF guidelines) into two new patterns: probable UIP and indeterminate for UIP. However, the proportions and prognoses of these new CT-scan patterns are not clear. METHODS: We used a monocentric retrospective cohort of 322 patients suspected of having IPF (University Hospital of Rennes; Competence Center for Rare Lung Diseases; 1 January 2012-31 December 2017). All patients initially diagnosed by CT scan as possible UIP were included. The chest CT-scans were then reclassified according to the new 2018 international guidelines by 3 observers. These data were then subjected to survival analysis with multivariate Cox regression using a composite endpoint of death, lung transplantation, a decline of≥10% in forced vital capacity (FVC), or hospitalization. RESULTS: Of the 89 possible UIP patients included, 74 (83%) were reclassified as probable UIP and 15 (17%) as indeterminate for UIP. Probable UIP patients were more likely to meet the composite endpoint (56/74 [75.7%] vs. 5/15 [33%] patients; HR [IC 95%] =3.12 [1.24; 7.83], P=0.015). Multivariate analysis indicated that the probable UIP pattern was associated with significantly increased risk of reaching the composite endpoint (HR [95% CI]=2.85[1.00; 8.10], P=0.049). CONCLUSION: The majority of possible UIP diagnoses corresponded to probable UIP, which was associated with a significantly worse prognosis than indeterminate for UIP. This distinction between these two CT patterns emphasizes the relevance of the new international guidelines for the diagnosis of IPF.

Neuroblastoma between 1990 and 2014 in the Netherlands: Increased incidence and improved survival of high-risk neuroblastoma.

PURPOSE: Long-term trends in neuroblastoma incidence and survival in unscreened populations are unknown. We explored trends in incidence, stage at diagnosis, treatment and survival of neuroblastoma in the Netherlands from 1990 to 2014. METHODS: The Netherlands Cancer Registry provided data on all patients aged <18 years diagnosed with a neuroblastoma. Trends in incidence and stage were evaluated by calculating the average annual percentage change (AAPC). Univariate and multivariable survival analyses were performed for stage 4 disease to test whether changes in treatment are associated with survival. RESULTS: Of the 593 newly diagnosed neuroblastoma cases, 45% was <18 months of age at diagnosis and 52% had stage 4 disease. The age-standardized incidence rate for stage 4 disease increased at all ages from 3.2 to 5.3 per million children per year (AAPC + 2.9%, p < .01). This increase was solely for patients ≥18 months old (3.0-5.4; AAPC +3.3%, p = .01). Five-year OS of all patients increased from 44 ± 5% to 61 ± 4% from 1990 to 2014 (p < .01) and from 19 ± 6% to 44 ± 6% (p < .01) for patients with stage 4 disease. Multivariable analysis revealed that high-dose chemotherapy followed by autologous stem cell rescue and anti-GD2-based immunotherapy were associated with this survival increase (HR 0.46, p < .01 and HR 0.37, p < .01, respectively). CONCLUSION: Incidence of stage 4 neuroblastoma increased exclusively in patients aged ≥18 months since 1990, whereas the incidence of other stages remained stable. The 5-year OS of stage 4 patients improved, mostly due to the introduction of high-dose chemotherapy followed by stem cell rescue and immunotherapy.

Medial olivocochlear suppression in musicians versus non-musicians.

The medial olivocochlear efferent (MOCE) branch synapses with outer hair cells (OHCs), and the efferent pathway can be activated via a contralateral acoustic stimulus (CAS). The activation of MOCE can change OHC motile responses and convert signals that are capable of controlling the sensitivity of the peripheral hearing system in a frequency-specific manner. The aim of this study was to examine the MOCE system activity in professional musicians using transient evoked otoacoustic emission test and CAS. Musician group showed stronger suppression in all frequency bands in the presence of CAS.

Estimation of the potential fertility based upon non-return rates of bulls: using polyacrylamide gel instead of cervical mucus in the sperm penetration test.

In the present study, we aimed to develop a polyacrylamide gel that could be used instead of bovine cervical mucus in the cervical mucus penetration test (CMPT) to obtain coherent and replicable results in bulls. The frozen semen samples of six Holstein bulls, which were divided into two fertility groups as low and high according to their non-return rate (NRR), were used. In this study, the modified CMPT (mCMPT) was carried out within 0.25 mL transparent plastic straws with an inner diameter 1.7 mm. The penetration ability of spermatozoa to bovine cervical mucus and to polyacrylamide gels swollen with two different solutions [NaCl (G1) and PBS (G2)] was compared. For the penetration test, the straws filled with cervical mucus and both gels were dipped into thawed semen samples and incubated at 37 degrees C for 15 min. After the incubation, straws were frozen in liquid nitrogen vapour and stored at -20 degrees C. On the evaluation day, the frozen straws were cut at 1.5-1.75 cm (penetration distance range=PDR1), 3.25-3.5 cm (PDR2) and 5.0-5.25 cm (PDR3), beginning from open-end of the straws. The separated frozen parts were then immediately transferred onto special counting slides by pushing with a mandrel and left to thaw. Thawed samples were covered with cover glass and penetrated spermatozoa in these parts were counted. The relation between the results and fertility of bulls was determined. In the tests performed using mucus, the number of spermatozoa determined in the high fertility group was found to be higher at PDR3 (p<0.0001) compared to the low fertility group, while in G1 spermatozoa number was significantly higher at PDR1 and PDR3 (p<0.0001). However, in G2 medium, no significant difference was observed between either of the fertility groups with respect to spermatozoa number determined at all distance ranges. In the study, we have determined that the gel swollen with NaCl produces better results and this gel can be used instead of bovine cervical mucus for the CMPT. Therefore, we have concluded that the penetration test performed by polyacrylamide gel swollen with NaCl can be a suitable technique for estimation of the potential fertility of bull spermatozoa.

Prostate adenocarcinoma cells release the novel proinflammatory polypeptide EMAP-II in response to stress.

The proinflammatory protein endothelial monocyte-activating polypeptide II (EMAP-II) was first detected in supernatants of murine tumor cells by virtue of its ability to stimulate endothelial-dependent coagulation in vitro. The purified protein has pleiotropic effects on endothelial cells, monocytes, and neutrophils; however, its function in vivo is unknown, and the mechanism whereby it is released from cells is poorly understood. We investigated the expression of EMAP-II in human prostate adenocarcinoma specimens by immunohistochemistry and in LNCaP and DU-145 human prostate adenocarcinoma cells by reverse transcription-PCR, flow cytometry, and Western blotting. We then examined the effects of chemical and physiological stress on release and processing of EMAP-II by LNCaP and DU-145 cells. These cells constitutively express a Mr 34,000 form of EMAP-II that is retained intracellularly. Exposure to agents that induce apoptosis or, in some cases, necrosis induces the release of the Mr 34,000 form and further processing to the Mr 27,000 and Mr 22,000 forms. Hypoxia, but not heat shock, is a potent inducer of release and processing of biologically active EMAP-II by LNCaP and DU-145 cells. We suggest that release of EMAP-II by prostate adenocarcinoma cells as a consequence of treatment with anticancer agents or as a result of constitutive hypoxia may potentiate the effects of those agents through the localized activation of host effector mechanisms.

Endothelial-monocyte-activating polypeptide II.

Endothelial-monocyte-activating polypeptide II (EMAP II) was initially identified as a product of murine methylcholanthrene A-induced fibrosarcoma cells. The deduced mRNA sequence indicates that EMAP II is synthesised as a 34 kDa precursor molecule (proEMAP) and enzymatically cleaved to produce a biologically active 22 kDa mature polypeptide, which has been isolated and characterised. It modulates a range of properties of endothelial cells, monocytes, and neutrophils in vitro, and induces an acute inflammatory reaction and tumour regression in vivo. Recent evidence suggests that EMAP II can induce apoptosis in endothelial cells, and as such may act in an anti-angiogenic role. The question arises whether EMAP II is primarily a pro-inflammatory cytokine or a novel mediator of programmed cell death.

Magnetic resonance evaluation of disease activity during pregnancy in multiple sclerosis.

We followed two women with MS during pregnancy by means of serial unenhanced MR imaging. On each follow-up image, we assessed the number of new or enlarging lesions. Both women showed a decrease in MR disease activity during the second half of pregnancy and a return of MR disease activity to prepregnancy levels in the first months postpartum. These findings support the view that pregnancy reduces disease activity in MS.