The clinical and laboratory findings of infants with atopic dermatitis during diagnosis and follow-up

Summary

Background. Atopic dermatitis is a chronic disease that affects patient and parents life worsely. What time will the patient go into remission is not known. Therefore, clinical and laboratory indicators that can indicate remission are needed. Materials and Methods. The study was conducted in İzmir Health Sciences University, Tepecik Training and Research Hospital. The clinical and laboratory data of patients between January 2014 and December 2019 were scanned from the patient records and the hospital data system. Results. 102 patients with a median age of 8 (min 2- max 24) months were included in the study. The median age of onset of the symptoms was 3 (min 1-max 21) months. The patients most frequently (85.2%) presented with eczema and lesions were most common (60.7%) in the extremities. Most of the patients (56.9%) had mild dermatitis. In the 6th month, 26.5% who continued follow-up had clinical improvement. Food allergy was present in 33.3% of the patients. The most common food allergen was egg (52.9%). Food allergy was associated with the severity of atopic dermatitis (p = 0.033), and the symptoms started earlier (p = 0.002). There is no relationship between the severity of atopic dermatitis and gender, family history, presence of additional atopic disease, response to treatment, total IgE and eosinophil count (p > 0.05); however, it was determined that the symptoms started earlier in patients with moderate/severe atopic dermatitis (p = 0.002). Conclusions. Food allergy is more common in the early-onset and moderate/severe atopic dermatitis. Accurate diagnosis of food allergy is necessary to increase the success of treatment and to prevent unnecessary diets.

Complex Genomic Rearrangement Patterns in Malignant Pleural Mesothelioma due to Environmental Asbestos Exposure

Malignant pleural mesothelioma (MPM) is a rare type of cancer, and its main risk factor is exposure to asbestos. Accordingly, our knowledge of the genomic structure of an MPM tumor is limited when compared to other cancers. In this study, we aimed to characterize complex genomic rearrangement patterns and variations to better understand the genomics of MPM tumors. We comparatively scanned 3 MPM tumor genomes by Whole-Genome Sequencing and High-Resolution SNP array. We also used various computational algorithms to detect both CNAs and complex chromosomal rearrangements. Genomic data obtained from each bioinformatics tool are interpreted comparatively to better understand CNAs and cancer-related Nucleotide variations in MPM tumors. In patients 1 and 2, we found pathogenic nucleotide variants of BAP1, RB1, and TP53. These two MPM genomes exhibited a highly rearranged chromosomal rearrangement pattern resembling Chromomanagesis particularly in the form of Chromoanasynthesis. In patient 3, we found nucleotide variants of important cancer-related genes, including TGFBR1, KMT2C, and PALLD, to have lower chromosomal rearrangement complexity compared with patients 1 and 2. We also detected several actionable nucleotide variants including XRCC1, ERCC2. We also discovered the SKA3-DDX10 fusion in two MPM genomes, which is a novel finding for MPM. We found that MPM genomes are very complex, suggesting that this highly rearranged pattern is strongly related to driver mutational status like BAP1, TP53 and RB1.

Whole-Genome Comparative Copy Number Alteration Profiling between Malignant Pleural Mesothelioma and Asbestos-Induced Chronic Pleuritis

Malignant pleural mesothelioma (MPM) is rare and aggressive cancer. The most important risk factor for MPM is exposure to asbestos. In this study, we scanned the genomes of individuals MPM and asbestos-induced chronic pleuritis (AICP) to compare and determine copy number alterations (CNAs) between two asbestos-related diseases. We used high-resolution SNP arrays to compare CNA profiles between MPM (n = 55) and AICP (n = 18). DNAs extracted from pleural tissues in both groups. SNP array analysis revealed common losses at 1p, 3p, 6q, 9p, 13q, 14q, 15q, 16q, 22q and frequent gains at chromosomes 1, 3, 5, 7, 8, and 6p, 12q, 15q, 17p, 20q in MPMs (frequencies max 67%-min 30%; these alterations were not detected in AICPs. Besides detecting well-known MPM-associated CNAs, our high -resolution copy number profiling also detected comparatively rare CNAs for MPMs including losses like 9q33.3, 16q and gains of 1p, 1q, 3p, 3q, 6p, 7q, 15q, 12q, 17p, 20q at significant frequencies in the MPM cohort. We also observed Copy Number gains clustered on the NF2 locus in AICPs, whereas this region was commonly deleted in MPMs. According to this distinct genomic profiles between the two groups, AICPs genomes can be clearly distinguished from highly altered MPM genomes. Hence, we can suggest that SNP arrays can be used as a supporting diagnostic tool in terms of discriminating asbestos-related malignant disease such as MPM and benign pleural lesions, which can be challenging in most instances.

[Use of osteoanabolics in fracture nonunion]

BACKGROUND

The treatment of fracture nonunion (pseudarthrosis) is often lengthy and debilitating for the patient. There are operative and conservative therapies available.

RESEARCH QUESTION

Does the systemic use of osteoanabolic acting substances (osteoanabolics) lead to an acceleration of the delayed fracture healing and/or strengthening of the fracture? Which types of pseudarthrosis are suitable for this treatment option?

MATERIALS AND METHODS

A literature review was carried out focusing on the systemic anabolic therapy options for the treatment of delayed healing of fractures or pseudarthrosis. Additionally, our own case studies are presented.

RESULTS

Teriparatide and strontium ranelate have a positive effect on the healing of fractures in animal studies and in humans. There are also case studies on the use of both substances in delayed fracture healing or pseudarthrosis. The scientific knowledge regarding teriparatide is significantly more comprehensive. However, prospective randomized trials are lacking so far.

CONCLUSION

The systemic use of anabolics can be a therapeutic option, especially for biological reactive pseudarthrosis. However, these are off-label treatments and contraindications should be especially well heeded. Because of the numerous positive results, from the point of view of teriparatide treatment, a multicentric, prospective randomized study on the treatment of aseptic pseudarthrosis should be initiated.

[Score-controlled duration of follow-up treatment after alloplastic hip and knee replacement]

BACKGROUND

In the literature many studies can be found addressing the effectiveness of individual measures and therapies within the medical rehabilitation. The duration of the rehabilitation itself is rarely taken into account. Consequently the duration of postoperative inpatient medical rehabilitation after initial implantation of alloarthroplastic hip and knee replacements in osteoarthritis of the hip or knee was the object of our analysis.

PATIENTS AND METHODS

In the present prospective study 100 patients each with osteoarthritis of the hip or knee were presented at a follow-up treatment postoperatively after primary implantation of alloarthroplastic hip and knee replacements. Two different scores were used (Staffelstein score, Lequesne score), which were collected at a weekly follow-up (T1-T4) to determine the degree of mobility in the initial examination of the patient and after three weeks. By setting a target score at admission of the patient to the CSO, which stood for achieving the rehabilitation objective, the rehabilitation period could be changed individually.

RESULTS

Our study showed that the highest rehabilitation progress has been achieved in both the total hip replacement and total knee replacement in patients at the end of the second week of rehabilitation (T2-T3). Thus, in the Staffelstein score 74 % (n = 74) of hip replacement patients and 46 % (n = 46) of knee replacement patients had already reached their rehabilitation aim between T2 and T3. From the third week on there was a marked flattening of the rehabilitation progress. Also the Lequesne scores obtained confirmed these results.

CONCLUSION

Based on the score-driven detection of mobility degree of rehabilitation at the beginning of the follow-up treatment, the individual design of the rehabilitation process with the active participation of the patient is possible. In a large number of cases a reduction of the rehabilitation period can be achieved to less than 21 days. This finding is particularly important in times of limited financial resources, because the saved resources can be used for other rehabilitation groups. Therefore, in a greater number of patients, a shortening of the duration of the rehabilitation is possible.

Is there a genetic predisposition for Turkish patients with sarcoidosis in the 329-bp region containing the BTNL2 rs2076530 polymorphism?

BACKGROUND/AIM

Sarcoidosis is a complex, multifactorial immune disorder with unknown etiology. A single nucleotide polymorphism (G→A, rs2076530) in the butyrophilin-like 2 (BTNL2) gene results in a truncating protein formation. It has been previously reported that this variation may be a risk factor for sarcoidosis in certain ethnic groups. This study was conducted to determine whether there is any genetic predisposition for the BTNL2 rs2076530 polymorphism in the 329-bp region in Turkish patients with sarcoidosis.

MATERIALS AND METHODS

DNA samples were obtained from volunteers including 53 Turkish patients with sarcoidosis and 52 healthy controls. Analysis of the 329-bp region was carried out by polymerase chain reaction and sequencing of genomic DNA.

RESULTS

We did not find any genetic variation except the rs2076530 polymorphism in the 329-bp region. The AA genotype was associated with an increased risk of sarcoidosis in a recessive model [P = 0.027, OR 2.56 (95% CI 1.02-6.49)], but it did not include a risk for sarcoidosis in a dominant model (P = 0.885).

CONCLUSION

Our results emphasize the recessive characteristic of the rs2076530 polymorphism in Turkish patients with sarcoidosis. The lack of any genetic variation except rs2076530 in the 329-bp region is another significant finding for Turkish patients.

Beneficial effects of erythropoietin on airway histology in a murine model of chronic asthma

BACKGROUND

Erythropoietin (EPO) is originally defined as a haematopoietic growth factor, but also has anti-inflammatory effects through cytokine modulation. This anti-inflammatory and cytokine modulating effect has not been investigated for the treatment of asthma. We aimed to determine the beneficial effects of erythropoietin on lung histology of murine model of chronic asthma.

METHODS

Thirty-five BALB/c mice were divided into five groups: I; II; III; IV; and control group. All groups except control group were sensitised and challenged with ovalbumin. Mice with experimentally induced asthma in Group I received saline; Group II EPO 500IU/kg; Group III EPO 1000IU/kg; and Group IV dexamethasone 1mg/kg intraperitoneally once a day in the last five days of the challenge period. Animals were sacrificed 24h after the last administration of study drugs. Histological findings of airways were evaluated by light and electron microscopic examination.

RESULTS

All histological parameters of asthma in the group treated with a high dose of EPO (Group III) were significantly ameliorated when compared with the group treated with saline (Group I). In comparison to the group treated with low dose of EPO (Group II) and the group treated with saline (Group I), basement membrane thicknesses and number of mast cells were significantly lower in the group treated with low dose of EPO (Group II). All histological parameters were similar between the group treated with high dose of EPO (Group III) and the group treated with dexamethasone (Group IV) except higher number of mast cells in the group treated with high dose of EPO (Group III). Additionally, the results of all histological parameters in the group treated with high dose of EPO (Group III) were significantly better when compared with the group treated with low dose of EPO (Group II).

CONCLUSIONS

We found that EPO ameliorated histological changes of chronic murine model of asthma. Further studies are needed to evaluate the efficacy of EPO in the treatment of asthma.

In vitro and in vivo studies on microcapsules and tabletted microcapsules of cephradine

Cephradine was microencapsulated by coacervation. Ethyl cellulose was used as the polymer and a core/wall ratio of 1:1 was selected. The repose angle, apparent and tapped density, particle size distribution of cephradine microcapsules (CM) and of cephradine powder were examined. Then flat-surfaced tablets of CM were prepared using Avicel PH 101 and magnesium stearate. In vitro and in vivo properties of CM and tabletted CM (both equivalent to 150 mg cephradine) were compared with commercial capsules (equivalent to 250 mg cephradine). The dissolution studies were carried out by the rotating basket method and the agar diffusion method was applied for quantitative determinations. Among the investigated kinetic models for the release of cephradine from CM and tabletted CM the best fit was found with the Higuchi model. In vivo studies were made in rabbits. Bioavailabilities of CM and their tabletted form were higher than that of the commercial capsules. In vitro/in vivo correlations between mean residence time (MRT) and mean dissolution time (MDT) for CM and tabletted CM were calculated. A good correlation was found between the in vitro and in vivo results.