Comparison of clinicodemographic characteristics and pattern of vascular involvement in 126 patients with Takayasu arteritis: a report from Iran and Turkey.

Takayasu arteritis (TA) is an extremely uncommon vasculitis that primarily affects the aorta and its branches. Due to the genetic and ethnicity effect, a diverse array of TA clinical manifestations has been reported worldwide. The purpose of the present study was to compare the clinicodemographic characteristics and pattern of vascular involvement of Iranian and Turkish TA patients. This study was a retrospective, cross-sectional investigation of 126 TA patients in Iran and Turkey. All of the variables analyzed were extracted from historical medical records. In 126 TA patients, the ratio of females to males was 8.6:1, and the average age at onset of disease was 30.5±11.1 years. Fatigue (49.2%) and a weak or absent pulse (79.4%) were the most prevalent symptoms and signs, respectively. The most prevalent angiographic classifications were types V and I in Iranian patients (41.09%) and type I in the Turkish population (47.7%) The left subclavian artery was the vessel most frequently affected by TA (66.6%). Our findings indicated that there were no significant differences between the two countries in terms of clinicodemographic characteristics or vascular involvement. Some clinical manifestations, such as claudication, were more prevalent in the Turkish population due to a higher incidence of occlusive lesions in the right subclavian artery.

Stainless steel surface biofunctionalization with PMMA-bioglass coatings: compositional, electrochemical corrosion studies and microbiological assay.

A solution is proposed to surpass the inconvenience caused by the corrosion of stainless steel implants in human body fluids by protection with thin films of bioactive glasses or with composite polymer-bioactive glass nanostructures. Our option was to apply thin film deposition by matrix-assisted pulsed laser evaporation (MAPLE) which, to the difference to other laser or plasma techniques insures the protection of a more delicate material (a polymer in our case) against degradation or irreversible damage. The coatings composition, modification and corrosion resistance were investigated by FTIR and electrochemical techniques, under conditions which simulate their biological interaction with the human body. Mechanical testing demonstrates the adhesion, durability and resistance to fracture of the coatings. The coatings biocompatibility was assessed by in vitro studies and by flow cytometry. Our results support the unrestricted usage of coated stainless steel as a cheap alternative for human implants manufacture. They will be more accessible for lower prices in comparison with the majority present day fabrication of implants using Ti or Ti alloys.

Cardiorespiratory response to exercise on a large therapeutic roll.

PURPOSE: Large therapeutic rolls (LTR) and balls are popular rehabilitation tools and have also been advertised as cardiovascular training devices. The aim of this study was to determine if individuals of varying fitness levels would reach aerobic training levels by evidence-based standards as described in American College of Sports Medicine (ACSM) publications. METHODS: Fourteen volunteers performed a maximal exercise test and on subsequent days, two submaximal exercise tests on the LTR (LTR-A and -B). LTR-A consisted of four 5-minute stages of exercise at progressive intensity levels. LTR-B included 20 minutes of continuous exercise. Oxygen consumption (VO2) and heart rate (HR) during exercise on the LTR were compared with ACSM recommended standards. RESULTS: The average (range) peak intensity achieved during LTR-A was 66.8% (51.7-82.7%) of maximal VO2 reserve (VO2R) and 82.9% (70.7%-91.2%) of maximal heart rate (HRmax). During LTR-B, HR and VO2 of all participants was maintained at moderate exercise intensity and averaged 56% of VO2R and 78% of HRmax during the 20 minute exercise period. CONCLUSIONS: These findings suggest that individuals with a wide range of aerobic fitness are able to reach and maintain aerobic training levels with appropriate exercise on a large therapeutic roll or ball.

Does three-dimensional power Doppler ultrasound predict histopathological findings of uterine fibroids? A preliminary study.

OBJECTIVES: To compare three-dimensional (3D) power Doppler sonographic characteristics of fibroids with histopathological parameters. METHODS: We evaluated sonographically 73 fibroids before myomectomy or hysterectomy. For each, the total fibroid volume, a shell of 3 mm and a 1-cm(3) spherical sample from the most vascularized area on subjective assessment were captured. 3D power Doppler vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were generated in the acquired volumes. The degree of cellularity, ischemic necrosis and fibrosclerosis, as well as CD31 and Ki-67 staining for vascular density and proliferation index, respectively, were estimated using the surgical sample. Pathological data were considered as dependent variables and ultrasound data as independent variables in multivariable logistic regression models including patients' characteristics. RESULTS: A high histological 'cellular activity score', combining hypercellularity, a fibrosclerosis rate < 25% and positive Ki-67 staining, was statistically related in multivariate analyses to high 3D power Doppler VI in spherical samples (odds ratio (OR), 1.1 (95% CI, 1.0-1.3), P < 0.05) and VFI (OR, 1.3 (95% CI, 1.0-1.8), P < 0.05). Positive CD31 staining was statistically related to high 3D power Doppler VI in spherical samples (OR, 1.1 (95% CI, 1.0-1.3), P < 0.05). In contrast, ischemic necrosis was statistically related to low 3D power Doppler VI in the total volume (OR, 0.6 (95% CI, 0.4-1.0), P < 0.05) and VFI (OR, 0.4 (95% CI, 0.1-1.1), P < 0.05). CONCLUSION: Vascular density, ischemic necrosis and histological cellular activity score are statistically significantly associated with some 3D power Doppler indices.

Fibronectin layers by matrix-assisted pulsed laser evaporation from saline buffer-based cryogenic targets.

The deposition of fibronectin (FN) from saline buffer-based cryogenic targets by matrix-assisted pulsed laser evaporation (MAPLE) onto silicon substrates is reported. A uniform distribution of FN was revealed by Ponceau staining after control experiments on nitrocellulose paper. Well-organized particulates with heights from hundreds of nanometers up to more than 1 µm packed in homogeneous layers were evidenced by optical microscopy and profilometry on Si substrates. Atomic force microscopy images showed regions composed of buffer and FN aggregates forming a compact film. Comparison of infrared spectra of drop-cast and MAPLE-deposited FN confirmed the preservation of composition and showed no degradation of the protein. The protein deposition on Si was confirmed by antibody staining. Small aggregates and fluorescent fibrils were visualized by fluorescence microscopy. Superior attachment of human osteoprogenitor cells cultivated for 3 h proved the presence of stable and intact FN molecules after transfer.

Immobilization of urease by laser techniques: synthesis and application to urea biosensors.

Urease thin films have been immobilized using matrix-assisted pulsed laser evaporation for biosensor applications in clinical diagnostics. The targets exposed to laser radiation were made of frozen composites that had been manufactured by dissolving urease in distilled water. An UV KrF* (lambda = 248 nm, tauFWHM congruent with 30 ns, nu = 10 Hz) excimer source was used for the multipulse laser irradiation of the targets that were cooled down to solidification using Peltier elements. The incident laser fluence was set at 0.4 J/cm2. The surface morphology and chemical bonding states of the laser immobilized urease thin films were investigated by atomic force microscopy and Fourier transform infrared spectroscopy. The enzymatic activity and kinetics of the immobilized urease were assayed by the Worthington method, which monitors urea hydrolysis by coupling ammonia production to a glutamate dehydrogenase reaction. Decreased absorbance was found at 340 nm and correlated with the enzymatic activity of urease.

Strontium-substituted hydroxyapatite coatings synthesized by pulsed-laser deposition: in vitro osteoblast and osteoclast response.

The increasing interest in strontium incorporation into biomaterials for hard tissue repair is justified by the growing evidence of its beneficial effect on bone. We successfully synthesized hydroxyapatite (HA) thin films with different extents of strontium substitution for calcium (0, 1, 3 or 7 at.%) by pulsed-laser deposition. The coatings displayed a granular surface and a good degree of crystallinity, which slightly diminished as strontium content increased. Osteoblast-like MG63 cells and human osteoclasts were cultured on the thin films up to 21 days. MG63 cells grown on the strontium-doped HA coatings displayed normal morphology, good proliferation and increased values of the differentiation parameters, whereas the number of osteoclasts was negatively influenced by the presence of strontium. The positive effect of the ion on bone cells was particularly evident in the case of coatings deposited from HA at relatively high strontium contents (3-7%), where significantly increased values of alkaline phosphatase activity, osteocalcin, type I collagen and osteoprotegerin/TNF-related activation-induced cytokine receptor ratio, and considerably reduced values of osteoclast proliferation, were observed.

Study of the relationship of psychosocial disorders to bruxism in adolescents.

BACKGROUND AND AIM: Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls). They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent's age and education, mother's marital status, child support status, mother's employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr) was then filled out by both groups for the evaluation of 12 psychosocial symptoms. RESULTS: Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P < 0.005), Conduct Disorders (P < 0.05), Antisocial Disorders (P < 0.06) as identified by YSR was significantly higher in bruxers. Significant differences between the two groups also emerged in total YSR scores (P < 0.005). The results of Odds Ratio revealed that a bruxer adolescent has 16 times greater probability for psychosocial disorders than a non-bruxer one. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. CONCLUSION: Support to the existence of an association between bruxism and psychosocial disorders has been provided.

The effect of hypovolemia due to hemorrhage on the minimum alveolar concentration of isoflurane in the dog.

OBJECTIVE: To determine the effect of hypovolemia on the minimum alveolar concentration (MAC) of isoflurane in the dog. STUDY DESIGN: Randomized, cross-over trial. ANIMAL POPULATION: Six healthy intact mixed breed female dogs weighing 18.2-29.0 kg. METHODS: Dogs were randomly assigned to determine the MAC of isoflurane in a normovolemic or hypovolemic state with a minimum of 18 days between trials. On both occasions, anesthesia was initially induced and maintained for 40 minutes with isoflurane delivered in oxygen while vascular catheters were placed in the cephalic vein and dorsal metatarsal artery. In dogs assigned to the hypovolemic group, 30 mL kg(-1) of blood was removed at 1 mL kg(-1) minute(-1) from the arterial catheter. All dogs were allowed to recover from anesthesia. Thirty minutes after the discontinuation of isoflurane, anesthesia was re-induced with isoflurane in oxygen delivered by face mask. The tracheas were intubated, and connected to an anesthetic machine with a Bain anesthetic circuit. Mechanical ventilation was instituted at a rate of 10 breaths minute(-1) with the tidal volume set to deliver 10-15 mL kg(-1). Airway gases were monitored continuously and tidal volume was adjusted to maintain an end-tidal carbon dioxide level of 35-40 mmHg (4.67-5.33 kPa). Body temperature was maintained at 37-38 degrees C (98.6-100.4 degrees F). The MAC determination was performed using an electrical stimulus applied to the toe web and MAC was defined as the mean value of end-tidal isoflurane between the concentrations at which a purposeful movement did and did not occur in response to the electrical stimulus. The MAC values were compared between groups using a Student's t-test. RESULTS: The MAC of isoflurane was significantly less in hypovolemic dogs (0.97 +/- 0.03%) compared with normovolemic dogs (1.15 +/- 0.02%) (p < 0.0079). CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of isoflurane is reduced in dogs with hypovolemia resulting from hemorrhage. Veterinarians should be prepared to deliver a lower percentage of isoflurane to maintain anesthesia in hypovolemic dogs during diagnostic and therapeutic procedures.

Anesthetic equipment fault leading to hypercapnia in a cat.

Spontaneous ventilation during positive pressure ventilation was observed in a 4-year-old DSH cat maintained under general anesthesia with isoflurane delivered with a nonrebreathing system. This was accompanied by an increase in heart rate and blood pressure. On investigation, neither an inadequate plane of anesthesia, nor hypoxemia, nor hyperthermia was present. The nonrebreathing system was replaced and the hypercapnia resolved. A defect in the inner fresh gas delivery tube of the Bain system was identified. A simple and quick test is described which can be performed to verify the integrity of the inner tube of the Bain breathing circuit.

Quantitative determination of circulating anodic and cathodic antigens in serum and urine of individuals infected with Schistosoma intercalatum.

Circulating anodic and cathodic Schistosoma antigens (CAA and CCA) have been determined by enzyme immunoassays in serum and urine of 60 individuals infected with S. intercalatum in Equatorial Guinea. The median egg output was 29 eggs/g of faeces (range 3-840). The egg output strongly correlated with concentrations of serum CAA (p = 0.47) and urine CAA (p = 0.42) (P < 0.001 for both); the later 2 quantities were also correlated with each other (p = 0.44, P < 0.001). All except 3 infected individuals had detectable amounts of serum CAA and/or urine CCA, a sensitivity of 95% for these 2 tests combined. Urine CAA was detected in 43% of patients. Serum CCA was detected in all infected individuals; however, no significant correlation was obtained between serum CCA levels and egg output in the stools of individual patients. This is the first study to demonstrate CCA in specimens of patients infected with S. intercalatum. The detection of CCA in urine is a new, non-invasive diagnostic method for S. intercalatum infection.

Integration of disease control programmes.

In Equatorial Guinea the structures of the Trypanosomiasis Control Programme and the primary health care network are being used by the country's campaign against schistosomiasis. The benefits--and considerable difficulties--of this endeavour are discussed in the present article.

Effect of repeated targeted mass treatment with praziquantel on the prevalence, intensity of infection and morbidity due to Schistosoma intercalatum in an urban community in equatorial Guinea.

A longitudinal community-based study was carried out in order to evaluate the impact of repeated selective population chemotherapy with praziquantel on the epidemiology of an urban focus of Schistosoma intercalatum in the city of Bata, capital of the Continental Region of Equatorial Guinea. Three surveys were undertaken in January of 1988, 1989 and 1990, determining parasitological prevalence, intensity of infection and morbidity and applying repeated targeted mass treatment. One dose of praziquantel (40 mg/kg body weight) was given one week after treatment with mebendazole (100 mg every 12 hours for 3 days). A reduction of the overall prevalence by S. intercalatum of 69.9% and 79.3% in the first and second year respectively was found. Persons showing high parasite burden suffered a reduction of 95.7%. The cure rate (no more eggs in stool) was between 90% and 98.9%. A significant decrease of signs and symptoms was observed. No important side effects were detected. This study shows the positive action of praziquantel in reducing prevalence, intensity of infection and morbidity due to S. intercalatum, above all in the case of a high human population participation response. Cure rates obtained being similar to the ones observed using the same drug in Schistosoma mansoni and Schistosoma haematobium.

Endemic human paragonimiasis in Equatorial Guinea. Detection of the existence of endemic human paragonimiasis in Equatorial Guinea as a result of an integrated sanitary programme.

Between February and April 1990 the first five cases of human paragonimiasis, tentatively due to Paragonimus africanus, have been detected in Equatorial Guinea, thanks to the normal activities of the National Schistosomiasis Project and its coordination with the National Tuberculosis Project.