Early detection of neutralizing antibodies to interferon-beta in multiple sclerosis patients: binding antibodies predict neutralizing antibody development

BACKGROUND

Neutralizing antibodies (NAb) affect efficacy of interferon-beta (IFN-b) treatment in multiple sclerosis (MS) patients. NAbs evolve in up to 44% of treated patients, usually between 6-18 months on therapy.

OBJECTIVES

To investigate whether early binding antibody (BAb) titers or different IFN-b biomarkers predict NAb evolution.

METHODS

We included patients with MS or clinically isolated syndrome (CIS) receiving de novo IFN-b treatment in this prospective European multicenter study. Blood samples were collected at baseline, before and after the first IFN-b administration, and again after 3, 12 and 24 months on that therapy; for determination of NAbs, BAbs, gene expression of MxA and protein concentrations of MMP-9, TIMP-1, sTRAIL, CXCL-10 and CCL-2.

RESULTS

We found that 22 of 164 (13.4%) patients developed NAbs during a median time of 23.8 months on IFN-b treatment. Of these patients, 78.9% were BAb-positive after 3 months. BAb titers ≥ 1:2400 predicted NAb evolution with a sensitivity of 74.7% and a specificity of 98.5%. Cross-sectionally, MxA levels were significantly diminished in the BAb/NAb-positive samples; similarly, CXCL-10 and sTRAIL concentrations in BAb/NAb-positive and BAb-positive/NAb-negative samples, respectively, were also diminished compared to BAb/NAb-negative samples.

CONCLUSIONS

BAb titers reliably predict NAbs. CXCL-10 is a promising sensitive biomarker for IFN-b response and its abrogation by anti-IFN-b antibodies.

Lactic acid bacterial extracts as anti-Helicobacter pylori: a molecular approach

BACKGROUND

Helicobacter pylori (H. pylori) infection, the main cause of chronic gastritis, increases gastric cancer risk. Antibiotics-based H. pylori eradication treatment is 90% effective. However, it is expensive and causes side effects and antibiotic resistance. Lactic acid bacteria (LAB) could present a low-cost, large-scale alternative solution to prevent or decrease H. pylori colonization.

AIM

This work aimed to study the inhibitory effects of LAB strains on the growth and pathogenic activity of H. pylori stains. To this end, we have selected the most virulent H. pylori strains (out of 20 mucosal antral biopsies) regarding cellular vacuolization and induction of apoptosis/necrosis.

METHOD

The selection of H. pylori pathogenic strains (clinically pre-isolated) were based on their impact of VacA activities on Hep-2 cell line, induction of apoptosis and necrosis in Caco-2 cell line. The Inhibitory effect of LAB strains on the invasion was carried out using the Caco-2 and Hela cell lines, where, they were co-cultured with the pathogenic H. pylori in the presence or absence of LAB extracts. The effect of LAB extracts on TNF-α secretion which induced by H. pylori-LPS was carried out by RT-qPCR.

RESULTS

L. bulgaricus DSMZ 20080, L. acidophilus and L. plantarum (studied previously and reported as high antioxidant candidate strains) showed the highest anti-pylori activities with inhibition ranged from 51.46 to 88.19%, they preventing the adhesion, invasion and DNA fragmentation of cell lines. In addition, they could reduce the TNF-α expression by 62.13%.

CONCLUSION

LAB extracts could inhibit the bacterial adhesion and invasion, gastric inflammation and DNA fragmentation induced by Helicobacter pylori.

Morphometric study of thyroid angle in different age and sex in Bangladeshi cadaver

This cross sectional descriptive study was to measure the thyroid angle and to establish the difference between sexes of different age groups in Bangladeshi cadaver. A total 60 human larynges were collected by purposive sampling from October 2008 to March 2009. Among them 45(male 23 and female 22) were collected from Bangladeshi cadavers (9 to 60 years) at the autopsy laboratory of Department of Forensic Medicine and 15 (male 6 and female 9) from stillborn infants of viable age (28 to 40 weeks of gestation) from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The thyroid angle was measured and significant differences of the dimensions between different age and sex groups were observed. In the present study observed findings was compared with those of other researchers. The mean±SD thyroid angle was found as 65.00±11.65 degree in age Group A (28 to 40 weeks of gestation), 73.69±6.56 degree in age Group B (9 to 16 years) and 77.76±7.76 degree in age Group C (17 to 60 years). The mean thyroid angle was higher in female (83.1667±5.78220 degree) than that in male (73.9412±7.09460 degree) and statistically moderately significant in Group C, where t = 3.853 and p = 0.001. In statistical analysis, differences between age and sex groups were calculated by using Students (unpaired) 't' test. The present study revealed that the value was significantly greater in adult female than male and the value increased with age.

Consensus recommendation for meningococcal disease prevention for Hajj and Umra pilgrimage/travel medicine

The Islamic Hajj to Makkah (Mecca) has been associated with outbreaks of invasive meningococcal disease and the global spread of Neisseria meningitidis serogroup W-135. For Hajj pilgrims the quadrivalent vaccination against serogroups A, C, W-135 and Y is a mandatory requirement. Novel conjugate vaccines may provide benefits for the community by reduction of carriage. With the introduction of the new generation of quadrivalent meningococcal conjugate vaccines (Menveo, Menactra, and others pending license) and their recent implementation in Saudi Arabia, experts from 11 countries in the Middle East region met at a Meningococcal Leadership Forum (MLF), in Dubai in May 2010 to exchange opinions on meningococcal disease and prevention strategies. These experts discussed the importance of introducing conjugate vaccines for pilgrims and travellers, and elaborated a consensus recommendation to support healthcare professionals and decision-makers.

Detecting missing signals in multichannel recordings by using higher order statistics

In real world applications, a multichannel acquisition system is susceptible of having one or many of its sensors displaced or detached, leading therefore to the loss or corruption of the recorded signals. In this paper, we present a technique for detecting missing or corrupted signals in multichannel recordings. Our approach is based on Higher Order Statistics (HOS) analysis. Our approach is tested on real uterine electromyogram (EMG) signals recorded by 4×4 electrode grid. Results have shown that HOS descriptors can discriminate between the two classes of signals (missing vs. non-missing). These results are supported by statistical analysis using the t-test which indicated good statistical significance of 95% confidence level.

Cross-correlation analysis of multichannel uterine EMG signals

The prevention of preterm labor remains one of the primary goals of obstetric research. One way to achieve this goal effectively is to understand the mechanisms regulating the uterine contractility. Herein, we evaluate the correlation between uterine electrical activities recorded from spatially-distributed regions by calculating the nonlinear regression coefficient. Results have shown that, during pregnancy, the degree of interdependence between signals is very high whereas, at labor, the correlation between the signals decreases remarkably. We conclude that pregnancy is characterized by the presence of few local potential sources dominating the other sources while at the onset of labor, the number of these sources increases remarkably which affects therefore the correlation between the signals.

Coiling of ruptured tiny cerebral aneurysms, feasibility, safety, and durability at midterm follow-up, and individual experience

BACKGROUND AND PURPOSE

The tiny size of cerebral aneurysms represents one of the challenging facets for endovascular treatment, with a high risk for intraoperative rupture (IOR). We report on the treatment of tiny ruptured saccular cerebral aneurysms by coil embolization. All cases were that of £ 2-3 mm aneurysms with at least one of the dimensions < 2 mm.

MATERIALS AND METHODS

Between April 2008 and December 2010, we performed a retrospective analysis of nine consecutive cases of tiny aneurysms treated by coil embolization in our institution.

RESULTS

Coil embolization was successfully performed in nine cases, whereas in one case, intraoperative rupture (IOR) of the fundus was encountered before complete obliteration of the aneurysm expected to be achieved with two coils. Complete occlusion (in n = 7 aneurysms) or near-complete immediate occlusion (in n = 2 aneurysms) was achieved. A total of 18 coils was used for coiling of the nine aneurysms, wherein five aneurysms were coiled with two coils each, two aneurysms with three coils each, and two aneurysms with only one coil each to achieve accepted results. Balloon assistance was used in three cases. Although a minimal coil projection in the parent vessel was seen in three cases, no untoward clinical complications were seen. At mean follow-up (6.7 months, interquartile range (IQR) 3-12 months), digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) in nine patients demonstrated persistent complete occlusion in six of the aneurysms; one aneurysm showed marked filling of the fundus, and two showed neck remnant but did not need retreatment. All patients with available follow-up were independent in day-to-day activities with a modified Rankin score (mRS) of 0 or 1.

CONCLUSIONS

Coil embolization of tiny ruptured cerebral aneurysms is feasible. Careful consideration of the technical issues in treatment of such aneurysms is essential to achieve technical success while avoiding complications.

Chemical studies on polyaniline titanotungstate and its uses to reduction cesium from solutions and polluted milk

Polyaniline titanotungstate (PATiW) was synthesized by the sol-gel method. Adsorption isotherm studies of Cs(+) from aqueous solution are described. Elemental Composition, chemical solubility, ion-exchange capacity (IEC) and pH-titration curve are studied. Distribution coefficients (K(d)) for 10 metal ions were determined. It was found that the polyaniline titanotungstate is highly selective to Cs(+) and the selectivity order is Cs(+)>>>Zr(4+)>Mo(6+)>V(5+)>As(5+)>Cr(3+)>Co(2+)>Cu(2+)>Zn(2+)>Cd(2+). The adsorbent capacity was determined using the Freundlich and Langmuir adsorption isotherm models. The Cs(+) adsorption isotherm data fit best to the Freundlich isotherm model. The maximum Cs(+) uptake of polyaniline titanotungstate was found to be 217 mg g(-1). Column tests were performed to determine the breakthrough curves with varying bed depths and flow rates in different solutions. The results showed that the half breakthrough time increases proportionally with increasing bed depths. Kinetic studies for removal of cesium from milk were also investigated using a scintillation detector head (NaI).

Linear-Response and Real-Time Time-Dependent Density Functional Theory Studies of Core-Level Near-Edge X-Ray Absorption

We discuss our implementation and application of time-dependent density functional theory (TDDFT) to core-level near-edge absorption spectroscopy, using both linear-response (LR) and real-time (RT) approaches. We briefly describe our restricted excitation window TDDFT (REW-TDDFT) approach for core excitations, which has also been reported by other groups. This is followed by a detailed discussion of real-time TDDFT techniques tailored to core excitations, including obtaining spectral information through delta-function excitation, postprocessing time-dependent signals, and resonant excitation through quasi-monochromatic excitation. We present results for the oxygen K-edge of water and carbon monoxide; the carbon K-edge of carbon monoxide; the ruthenium L3-edge for the hexaamminerutheium(III) ion, including scalar relativistic corrections via the zeroth order regular approximation (ZORA); and the carbon and fluorine K-edges for a series of fluorobenzenes. In all cases, the calculated spectra are found to be in reasonable agreement with experimental results, requiring only a uniform shift ranging from -4 eV to +19 eV, i.e., on the order of a few percent of the excitation energy. Real-time TDDFT visualization of excited state charge densities is used to visually examine the nature of each excitation, which gives insight into the effects of atoms bound to the absorbing center.

CSF neurofilament and N-acetylaspartate related brain changes in clinically isolated syndrome

Background:

Axonal damage is considered a major cause of disability in multiple sclerosis (MS) and may start early in the disease. Specific biomarkers for this process are of great interest.

Objective:

To study if cerebrospinal fluid (CSF) biomarkers for axonal damage reflect and predict disease progression already in the earliest stages of the disease, that is, in clinically isolated syndrome (CIS).

Methods:

We assessed CSF levels of neurofilament heavy (NFH), neurofilament light (NFL) and N-acetylaspartate (NAA) in 67 patients with CIS and 18 controls with neuropsychiatric diseases of non-inflammatory aetiology (NC). Patients with CIS underwent baseline magnetic resonance imaging (MRI) at 3T, and a follow-up MRI after 1 year was obtained in 28 of them.

Results:

Compared with NC, patients with CIS had higher NFH (p=0.05) and NFL (p<0.001) levels. No significant group differences were found for NAA. Patients’ NFH levels correlated with physical disability (r=0.304, p<0.05) and with change in brain volume over 1 year of follow-up (r=-0.518, p<0.01) but not with change in T2 lesion load.

Conclusion:

Our results confirm increased neurofilament levels already in CIS being related to the level of physical disability. The association of NFH levels with brain volume but not lesion volume changes supports the association of these markers with axonal damage.

Classification performance of the frequency-related parameters derived from uterine EMG signals

Frequency-related parameters derived from the uterine electromyogram (EMG) signals are widely used in many pregnancy monitoring and preterm delivery prediction studies. Although they are classical parameters, they are well suited for quantifying uterine EMG signals and have many advantages over amplitude-related parameters. The present work aims to compare various frequency-related parameters according to their classification performances (pregnancy vs. labor) using the receiver operating characteristic (ROC) curve analysis. The comparison between the parameters indicates that median frequency is the best frequency-related parameter that can be used for distinguishing between pregnancy and labor contractions. We conclude that median frequency can be the representative frequency-related parameter for classification problems of uterine EMG.

Classification of multichannel uterine EMG signals

Classification of multichannel uterine electromyogram (EMG) signals is addressed. Signals were recorded by a matrix of 16 electrodes. First, signals corresponding to each channel were individually classified using an artificial neural network (ANN) based on radial basis functions (RBF). The results have shown that the classification performance varies from one channel to another. Then, a decision fusion method based on these classification performances was tested. After fusion, the network yielded better classification accuracy than any individual channel could provide. The high percentage of correctly classified labor/non-labor events proves the efficiency of multichannel recordings in detecting labor. These findings can be very useful for the aim of classifying antepartum versus labor patients.

Differences and similarities in the evolution of morphologic brain abnormalities between paediatric and adult-onset multiple sclerosis

BACKGROUND

Paediatric-onset multiple sclerosis (pMS) is multiple sclerosis (MS) occurring before the age of 18 years and may present and develop differently from adult-onset MS (aMS). Whether there are also differences regarding the accrual of brain changes is largely unknown.

METHODS

We compared the evolution of the T2- and T1-lesion load (LL), the black hole ratio (BHR), and annualised brain volume change (aBVC) between 21 pMS patients (age at onset: 14.4±2.3 years) and 21 aMS patients (age at onset: 29.4±6.5 years) matched for disease duration (pMS: 1.0±1.8 years; aMS: 1.6±1.7 years, p=0.27). Follow-up was for 4.2±3.7 years in pMS and 3.1±0.6 years in aMS. Clinical comparisons included the course of disability assessed with the Expanded Disability Status Scale (EDSS) score and annualised relapse rate (ARR).

RESULTS

At baseline, pMS and aMS had similar EDSS, T1-LL, BHR, whereas T2-LL was higher in aMS (aMS: 9.2±11.6 ccm; pMS: 4.1±6.2 ccm, p=0.02). The change of T2-LL and T1-LL during the observation period was similar in both groups. At follow-up, disability was lower in pMS (EDSS score in pMS: 0.9±0.9; aMS: 1.7±1.3, p=0.04), despite a significantly higher accrual of destructive brain lesions (BHR in pMS: 23.7±23.7%; aMS: 5.9±4.0%, p=0.02) and a similar rate of brain volume loss.

CONCLUSION

Our observation of a morphologically more aggressive disease evolution paralleled by less disability in pMS than in aMS (defined using EDSS) suggests a higher compensatory capacity in pMS. This fact may obscure the need for treatment of pMS patients with disease modifying treatments (DMTs) based solely on clinical observation.

Stress propagation in a concentrated colloidal suspension under shear

The stress propagation in a concentrated attractive colloidal suspension under shear is studied using numerical simulations. The spatial correlations of the intercolloidal stress field are studied and an inertia-like tensor is defined in order to characterize the anisotropic nature of the stress field. It is shown that the colloids remain in a liquid order, the intercolloidal stress is strongly anisotropic. A transition under flow is observed: during a transient regime at low deformation, the stress propagates along the compression direction of the shear, whereas at larger deformations, the stress is organized into layers parallel to the (flow, vorticity) plane.

Fractional modeling dynamics of HIV and CD4+ T-cells during primary infection

In this paper, we introduce fractional-order into a model of HIV-1 infection of CD4+ T cells. We study the effect of the changing the average number of viral particles N with different sets of initial conditions on the dynamics of the presented model. Generalized Euler method (GEM) will be used to find a numerical solution of the HIV-1 infection fractional order model.

Morphometry of seminiferous tubules of human testes in different age groups in Bangladeshi cadavers

This cross sectional descriptive study was done to observe the mean diameter of seminiferous tubules and to determine its differences between different age groups in Bangladeshi male. Thirty human testes of different age groups were collected by purposive sampling technique. Among them 22 specimens were collected from cadavers during routine postmortem examination and 8 specimens were from dead fetuses from Gynaecology & Obstetrics Department. The specimens were grouped into three categories Group A (28 to 42 weeks of gestational age), Group B (Up to 14 years) and Group C (15 to 70 years). The mean diameter of seminiferous tubules was measured and significant differences of the dimensions between different age groups were determined. The mean±SD diameter was 85.37±15.51 μm in Group A, 144.04±63.34 μm in Group B and 227.92±22.47 μm in Group C. Statistically, differences between age groups were calculated by using Unpaired Students 't' test. The present study revealed that the diameter increased with age and mean differences were statistically significant between Groups A&C, B&C and A&B.

Histomorphometric study of lumen of human vermiform appendix

This study was done to find out the histomorphometry of lumen of vermiform appendix in Bangladeshi people. Total 100 fresh appendixes were collected for morphometric study of different age and sex during postmortem examination in the autopsy laboratory of Forensic Medicine Department of Mymensingh Medical College. This cross sectional descriptive study was done by convenient sampling technique. For convenience of differentiating the luminal diameter of vermiform appendix in relation to age and sex, findings were classified in four groups. Group A was up to 20 years, Group B 21-35 years, Group C 36-55 years and Group D 56-70 years. In the study the maximum diameter was in group A of female (87.00 μm) and minimum was (4.70 μm) in group B of female. The mean luminal diameter of vermiform appendix was more in female (60.71 μm) than in male (60.11 μm).

Use of transesophageal Doppler as a sole cardiac output monitor for reperfusion hemodynamic changes during living donor liver transplantation: An observational study

Aims:

To report the use of transesophageal Doppler (TED), a minimally invasive cardiac output (COP) monitor, before, during and after reperfusion and study its effect on anesthetic management during living donor liver transplantation (LDLT).

Setting and Design:

A prospective observational study.

Methods:

A total of 25 consecutive recipients with a MELD score between 15 and 20 were enrolled. Data were recorded at baseline (TB); anhepatic phase (TA); and post-reperfusion — 1, 5, 10 and 30 minutes. Fluid therapy was guided by corrected flow time (FTc) of the TED. Packed red blood cells (RBCs) were only given when hematocrit was less than 25%. Rotational thromboelastometry (ROTEM) and standard laboratory tests were used to guide component blood products requirements.

Results:

Post-reperfusion, the COP, Cardiac Index (CI) and stroke volume (SV) increased significantly at all points of measurements; this was associated with a significant decrease in systemic vascular resistance (SVR) (P ;< .05). Immediately post-reperfusion, for 5 minutes, mean arterial blood pressure (ABP) dropped significantly (P < .05), and 14 out of the 25 patients required boluses of epinephrine (10 μg) to restore the mean ABP; 3 of the 14 patients required norepinephrine infusion till the end of surgery. Central venous pressure (CVP) and urine output (UOP) at all measures were maintained adequately with FTc-guided fluid replacement. Eight out of the 25 patients required no blood transfusion, and 4 of the 8 patients required no catecholamine support.

Conclusion:

TED as a sole monitor for COP was able to present significant and reliable changes in the cardiovascular status of the recipients during reperfusion, which could help to guide fluid- and drug-supportive therapy in this population of patients. This preliminary study needs to be applied on a larger scale.

[Cryoenergy for the ablation of arrhythmogenic paraseptal substrates in children and adolescents with heart rhythm disorders]

BACKGROUND AND OBJECTIVE

Cryoablation is safe for the ablation of substrates in proximity to the AV node, because the initial lesion is reversible. We report our results of cryoablation in a transregional center for ablation in children and adolescents.

PATIENTS AND METHODS

Data on 39 children and adolescents (4 - 18 years of age) who had been treated with cryo energy were analyzed retrospectively. The diagnosis was AV nodal reentry tachycardia (AVNRT; n = 30), para-Hisian accessory pathway (AP; n = 6) and congenital junctional ectopic tachycardia (JET; n = 4). In addition to non-inducibility, the targeted endpoint for AP-ablation was a missing or decremental concentric retrograde conduction, for ablation of AVNRT the endpoint was no slow pathway, no AH jumps and no echo-beats. The median follow-up was 3 years (270 - 1919 days).

RESULTS

The targeted endpoint was reached in 35/39 patients (90 %), in four patients (10 %) RF energy had to be applied. A recurrence occurred in 7/35 (20 %) successfully treated patients. Two patients had a pre-excitation again after AP ablation, but no symptoms. Thus, 28/35 patients (80 %) remained asymptomatic after cryoablation, and 26/35 (74 %) are definitively cured, regarding all follow-up data. The subgroup of AVNRT patients does not differ from the entire group. There was no AV block in the cryoablation group.

CONCLUSIONS

Cryoablation is very safe and effective for the definitive treatment of arrhythmias in children and adolescents. The price for the high safety is a reduced efficacy and a higher recurrence rate.

Morphometry of isthmus of thyroid gland in Bangladeshi cadaver

This cross sectional descriptive study was carried out to determine the length, breadth & thickness of isthmus of thyroid gland of Bangladeshi people. To fulfill this aim sixty postmortem tissue blocks containing thyroid gland and its neighbouring structures were collected by convenience sampling technique from 48 male and 12 female cadavers of different age groups, age ranging from 11 to 70 years and fixed and preserved in 10% formol-saline solution. Specimens were collected from dead bodies autopsied on different dates from October'2004 to February'2005 at the autopsy laboratory of Forensic Medicine Department of Mymensingh Medical College, Mymensingh, Bangladesh. Gross and fine dissection was carried out to study the length, breadth and thickness of isthmus of thyroid gland. In the present study, observed findings were compared with those of Western and Bangladeshi researchers. It was seen that the mean±SD lengths of isthmus were 10.42±7.49 mm, 10.17±5.70 mm and 9.33±6.64) mm in Group A(upto 18 years), B(19 to 45 years) and C(>45 years) respectively. Highest length (30mm) was observed in Group A and lowest length (2mm) was observed in Group C. Variance analysis showed that there was no significant difference in mean length between the age groups (F=0.086, p=0.918). The mean±SD values of breadth were 13.66±5.06 mm, 14±5.41 mm and 12.27±3.97 mm in Group A, B and C respectively. In the ranges, there was much overlapping among the groups. In Group B breadth of the isthmus was greater than other age groups. But these differences were statistically not significant, where F=0.430 & p=0.654. It was interesting to note that in this study the mean breadth of isthmus was significantly greater than the mean length (where, t=-2.727 and p=0.01). In the present study the mean±SD thickness of the isthmus of thyroid glands were 4.91±1.78 mm, 4.72±2.68 mm and 4.45±1.36 mm in three age groups respectively & the thickness of isthmus of thyroid gland was also greater in Group B than other two groups. But the variance analysis reveals that, there was insignificant difference in the thickness (F=0.133, p=0.876) of isthmus of thyroid gland among different age groups.

Observation of superior and inferior limit of lobes of the thyroid gland: a postmortem study

The size of thyroid gland varies considerably with age, sex, physiologic state, race and geographical location. Diseases of thyroid may need surgical intervention. This study is to carry out the macroscopic architecture of thyroid gland of different age and sex groups in Bangladeshi people to establish a normal standard. This is a descriptive cross-sectional study with an analytic component and was carried out on 54 autopsied human thyroid glands aged 5 to 65 years were collected from unclaimed dead bodies autopsied in morgue of Sylhet MAG Osmani Medical College, Sylhet. It was done in department of Anatomy, from 1st July 2006 to 30th June 2007. The collected specimens were divided into age Group A (10 years and below), Group B (11 to 20 years), Group C (21 to 30 years), Group D (31 to 40 years), Group E (41 to 50 years) and Group F (51 years and above). All specimens were examined morphologically by fine dissection method. It was observed that in most cases superior limit did not reach the midpoint of thyroid cartilage on either side. Inferior limit reached up to 6th tracheal ring on right side and 5th tracheal ring on left side in most cases.

Identification of biomarkers for diagnosis and progression of MS by MALDI-TOF mass spectrometry

INTRODUCTION

Body fluid biomarkers for clinical subtyping and monitoring of disease progression are of considerable interest in multiple sclerosis (MS). Proteomics tools are optimal for the unbiased simultaneous detection of large series of peptides and proteins.

OBJECTIVES

To identify novel candidate biomarkers discriminating patients with MS from patients with other neurological diseases (OND), and for subtyping of relapsing-remitting (RR), secondary progressive (SP) and primary progressive (PP) MS patients using a high-throughput MALDI-TOF-based mass spectrometry method.

METHODS

Paired cerebrospinal fluid (CSF) and serum samples of 41 RRMS, 30 SPMS, 13 PPMS patients and 25 patients with OND were analysed.

RESULTS

Out of a total of 100 detected peptides in CSF and 200 peptides in serum, 11 peptides were differentially regulated in serum and two in CSF between patients with MS and the OND control group. Eleven peptides were differentially regulated in both serum and CSF between relapse-onset MS and PPMS patients. Lastly, four peptides were differentially regulated in serum and two in CSF between RRMS and SPMS patients. Specific peaks regulated in MS were tentatively identified as fragments of secretogranin III and complement C3. The peak intensity of the CSF peptide ion with m/z value 8607.7 correlated to atrophy (r = -0.27, p < 0.005), black hole volumes (r = 0.31, p < 0.008) and total lesion load (r = 0.34, p < 0.003). A serum peptide with m/z value of 872.4 elevated in SPMS correlated to Expanded Disability Status Scale (r = 0.341, p < 0.005) and atrophy (r = -0.286, p < 0.028).

CONCLUSIONS

Using high-throughput body fluid profiling by MALDI-TOF mass spectrometry, small proteins and peptides were detected as promising candidate biomarkers for diagnosis and disease progression of MS.

Occupational exposure to staff during endoscopic retrograde cholangiopancreatography in Sudan

Endoscopic retrograde cholangiopancreatography (ERCP) procedure is an invasive technique that requires fluoroscopic and radiographic exposure. The purpose of this study was to determine the occupational dose of ionising radiation at three gastroenterology departments (Fedial, Soba and Ibn seena hospitals) in Khartoum, Sudan. The radiation dose was measured during 55 therapeutic ERCP procedures. Thermoluminescence dosemeters were used. The mean radiation dose for the first operator was 0.27 mGy for the eye lens, 0.21 for the thyroid, 0.32 for the chest, 0.17 for the hand and 0.22 for the leg. The mean radiation dose for the second operator was 0.21 mGy for the hand and 0.20 mGy for the chest, while the mean radiation dose for the nurse was 0.44 mGy for the hand and 0.19 for the chest. The radiation dose received by the staff in these hospitals was found to be higher than most of the values in the literature. The radiation absorbed dose received by the different organs is relatively low. Additional studies need to be conducted for radiation dose optimisation.