Increase in physiological inhibitory control results in better suppression of unwanted memories

Forgetting or suppressing a memory with unwanted content is just as important as remembering a desirable one. In addition to emphasizing the role of inhibitory control in memory suppression processes, neuropsychological studies have indicated that an intentional inhibition targeting a brain area may exert its inhibitory effects in seemingly unrelated areas through a common inhibitory network. In this study, we aimed to investigate whether the suppression of unwanted memories can be strengthened by recruiting an inhibitory task that can be simultaneously performed with a memory suppression task. Therefore, we manipulated the level of urinary urgency-induced inhibition of participants (N = 180) and test its effect on the suppression of unwanted memories using a Think/No-Think (T/NT) task. The results of our study indicated that individuals with high levels of urinary urgency demonstrated greater memory suppression compared to those with low urinary urgency. Findings and their implications are discussed within the context of cognitive and clinical perspectives, and recommendations are made for future research.

EXPRESS: High Bladder Pressure Reduces the Ability to Filter Out Interference From Distractors in Low Perceptual Load Condition

According to the load theory of attention, an active cognitive control mechanism is needed to ensure that behavior is controlled by target-relevant information when distractors are also perceived. Although the active cognitive control mechanism consists of working memory, cognitive flexibility, and inhibition components, predictions regarding the load effects of this mechanism were derived mostly from studies on working memory. We aimed to test whether these predictions are also valid for an inhibition component. The inhibitory load was manipulated physiologically by creating different bladder pressure and its effects on distractor interference were examined under low and high perceptual load conditions. Results indicated that the availability of inhibitory control resources was important for decreasing the interference of distractors in the low perceptual load condition and that the high perceptual load reduced the effects of distractors independently from the availability of inhibitory resources. Results were consistent with the predictions of load theory, and to the best of our knowledge, the study provided the first piece of evidence in terms of the load effect of inhibition component on distractor interference.

AB0480 AN OPEN-LABEL, EXPLORATORY STUDY TO ESTABLISH THE EFFICACY AND SAFETY OF 1-YEAR CANAKINUMAB TREATMENT IN BEHÇET’S DISEASE PATIENTS WITH NEUROLOGIC OR VASCULAR INVOLVEMENT

Background:

Previous observations in Behcet’ s disease (BD) patients receiving anti-IL 1 therapies suggested that dosage and route of administration may be critical in controlling disease manifestations. This was supported by favorable observations with infliximab infusions reaching higher serum trough levels in refractory BD patients compared to other anti-TNF agents.

Objectives:

The primary objective was to evaluate the safety and efficacy of intravenous (IV) canakinumab (CAN) on the clinical and inflammatory findings of BD patients with neurologic and vascular involvement.

Methods:

Biologic-naïve BD patients, who had a recent attack of large vessel vascular or parenchymal neurologic disease within the last month were enrolled and all received 300 mg CAN IV without a change in other medications. Response was assessed on day 30 as the primary objective; partial responders were able to take the 2nd 300 mg IV on day 30 and continued the treatment with monthly 150 mg IV 4 times. Others continued the treatment with 150 mg IV monthly. At month 6, patients were able to switch to SC injections or continue 150 mg IV for 6 months. Non-responder patients were dropped out. Prednisolone dosage was ≤20 mg at baseline and not increased during the trial. Complete response was defined as full clinical recovery to pre-attack state, disappearance of MRI lesions, normalization of CSF findings; partial response was defined as partial improvement in clinical findings, which were still worse than pre-attack state, with MRI lesions becoming smaller with no or less enhancement, and a decrease in CSF cell count. Complete response of vascular findings was defined as ≥50% improvement in patient’s and physician’s global assessments, ≥50% reduction in CRP; along with stable or ≥20% reduced aneurysm size or stable or ≥20% reduced calf swelling; and partial response was an improvement between 20-49% in global assessments, 20-49% reduction in CRP; stable or ≤20% reduced aneurysm size or ≤20% reduced calf swelling.

Results:

9 subjects were screened, and 8 male subjects (5 vascular, 3 neurologic) aged 27.3 ± 2.3 years entered the study. No new attack or worsening of manifestations was observed, and at least a partial response was obtained in all patients on day 30. Two vascular patients (2/5, 40%) and 1 neurologic patient (1/3, 33%) received another 300 mg infusion on day 30; one of them left the study on day 120 because of safety concerns after noticing the use of illicit drugs, and the other required 150 mg IV CAN after day 180 and discontinued the study because of the worsening of pulmonary artery aneurysm, despite favorable response in venous findings. The remaining 3 patients (3/5, 60%) with deep vein thrombosis completed the study with clinical and radiological improvement. 2 patients with parenchymal involvement had lesions in the brain stem and showed complete improvement of clinical findings between 1-3 months and radiologic findings between 3-6 months. Clinical findings of 1 patient with sinus thrombosis improved within 2 months, and the last cranial MRI showed that the vein thrombus was recanalized. Patients experienced other mild manifestations of BD following a switch to SC administration.

BD, %Healthy, %PArterial hypertension22,113,3nsSmoked29,524,4nsDiabetes mellitus00nsLipid abnormalities76,864,4nsTotal cholesterol5,0 ±1,405,3 ±0,96nsTGs0,91 ±0,650,90 ±0,68nsHDL1,18 ±0,391,26 ±0,29nsLDL3,40 ±1,463,47 ±0,90nsHs CRP2,42 ±21,00,3 ±0,63<0,00Mean IMT carotid artery0,68 ±0,090,64 ±0,09nsIMT <0,5 mm31,66,6<0,00IMT > 0,5-0,89 mm49,586,6nsIMT - 0,9 – 1,2 mm13,686,6nsIMT > 1,2 mm (plaques)5,70ns

The mean carotid IMT in BD pts was similar with controls. In pts thinning IMT and concentration of hsCRP was significantly higher compared with controls.

IMT correlated with age of pts, concentration of total cholesterol, LDL and hsCRP but did not correlated with clinical manifestation and disease duration. Carotid atherosclerotic plaques were found in 5 pts with BD – mean age 40,0±8,1, who had traditional cardiovascular risk factors (high body masse index, hypertension) and received long time therapy with glucocorticoids.

Conclusion:

Response to CAN without high-dose methylprednisolone treatment suggests that IL-1 antagonism plays a role in acute exacerbations of neurologic and vascular manifestations of BD, and no new safety signal was recorded with IV use. Favorable responses during the early months of the study and development of clinical and laboratory findings after switching to SC administration may suggest that achievement of higher serum trough levels may be critical, and up-titration of the dosages may provide better results in individual patients with higher inflammatory activity.

References:

NA

Acknowledgments :

This study was supported by Novartis.

Disclosure of Interests:

Ahmet Gül: None declared, Murat Kurtuncu Grant/research support from: Travel, symposia speaker and Honoraria grants (Novartis, Bayer, Teva, Ali Raif, Gen), Consultant of: (Novartis, Bayer, Teva, Ali Raif, Gen), Speakers bureau: (Novartis, Bayer, Teva, Ali Raif, Gen), Murat Erdugan: None declared, Emin Oguz: None declared, Tuncay Gunduz: None declared, Gulsen Akman Demir Grant/research support from: Novartis, Consultant of: Novartis, Serhan Sevgi Employee of: Novartis, Soner Turgay Employee of: Novartis, Ersen Acar Employee of: Novartis

Physiotherapy students as a partner for the prevention of healthcare associated infections

Background: Hand hygiene compliances of healthcare students have been examined extensively. However, there has been no study in this area for the students of the department of physiotherapy and rehabilitation. The aim was to evaluate hand hygiene compliance of the department of physiotherapy and rehabilitation students after a briefing on hand hygiene. Methods: Before the summer practice, the students were briefed on hand hygiene. Then their hand hygiene compliance were assessed. Their sociodemographic characteristics, clinical summer practice data, and hand hygiene compliance based on the recommendations commented in the Centers for Disease Control and Prevention Guideline for Hand Hygiene in Health Care Settings were assessed with a questionnaire prepared by the researchers. Results: Of 53 students, 52 met inclusion criteria. The average correct answer rate was 82.69%. Students had inadequacies in selecting suitable hand hygiene techniques and in complying with hand hygiene indications in some situations related to their profession. Moreover, the students suggested that there was a great need for education (n = 24; 39.34%) and improvements in physical conditions (n = 21; 34.43%). Conclusions: As a conclusion, department of physiotherapy and rehabilitation students were aware of the importance of hand hygiene in terms of prevention of healthcare-associated infections. However, for department of physiotherapy and rehabilitation students, educational programs about hand hygiene is needed in order to gain optimal competence and to be able to protect and improve health care workers and patients safety.

Identification of candidate biomarkers in converting and non-converting clinically isolated syndrome by proteomics analysis of cerebrospinal fluid

Multiple sclerosis (MS) often starts in the form of clinically isolated syndrome (CIS) and only some of the CIS patients progress to relapsing-remitting MS (RRMS). Biomarkers to predict conversion from CIS to MS are thus greatly needed for making correct treatment decisions. To identify a predictive cerebrospinal fluid (CSF) protein, we analyzed the first-attack CSF samples of CIS patients who converted (CIS-MS) (n = 23) and did not convert (CIS-CIS) (n = 19) to RRMS in a follow-up period of 5 years using proteomics analysis by liquid chromatography tandem-mass spectrometry (LC-MS/MS) and verified by ELISA. Label-free differential proteomics analysis of CSF ensured that 637 proteins were identified and 132 of these proteins were found to be statistically significant. Further investigation with the ingenuity pathway analysis (IPA) software led to identification of three pathway networks mostly comprised proteins involved in inflammatory response, cellular growth and tissue proliferation. CSF levels of four of the most differentially expressed proteins belonging to the cellular proliferation network function, chitinase-3-like protein 1 (CHI3L1), tumor necrosis factor receptor superfamily member 21 (TNFRSF21), homeobox protein Hox-B3 (HOXB3) and iduronate 2-sulfatase (IDS), were measured by ELISA. CSF levels of HOXB3 were significantly increased in CIS-MS patients. Our results indicate that cell and tissue proliferation functions are dysregulated in MS as early as the first clinical episode. HOXB3 has emerged as a potential novel biomarker which might be used for prediction of CIS-MS conversion.

Onychomycosis in primary school children: association with socioeconomic conditions

Onychomycosis in childhood is reported to be unusual. The aim of this study was to determine the prevalence of onychomycosis in primary school children and to make comparison between different socioeconomic status in the rural and urban areas of the city. Hand and foot nails of 23235 children aged 7-14 were examined. Onychomycosis was suspected and nail scrapings for mycological examination were taken in 116 of them. Hyphae or spores were seen in 41 (0.18%) by direct microscopic examination, and mycological cultures were positive in 24 (0.1%) of them. Toenails were affected in all of the fungal culture positive cases. Trichosporon spp, Trichophyton rubrum, Candida albicans and Candida glabrata grew in 11, 6, 5 and 2 of the cultures respectively. Onychomycosis prevalence was significantly higher in the children living in the rural areas (p = 0.016) [Odds ratio = 3.43 (%95 CI 1.11<OR<11.84)], and onychomycosis was more frequent in boys than girls (p = 0.001) [(Odds ratio = 5.85 (1.66<OR<24.61)].

Evaluation of hepatitis B surface antigen, anti-hepatitis C virus and anti-human immunodeficiency virus antibodies and syphilis seropositivity in blood donors: six years' seropositivity

This retrospective study was carried out to evaluate the seropositivity of hepatitis B surface antigen (HbsAg), anti-hepatitis C virus (HCV), anti-human immunodeficiency virus (HIV) and syphilis in blood donors in Manisa Government Hospital. Data were evaluated in 10,189 blood donors between April 1, 1997, which is the time from which regular records began to be collected, and April 1, 2003. The blood samples of the blood center from April 1, 1997, to January 1, 1998, were examined via the card method, those between January 1, 1998, and January 1, 2002, were examined via micro enzyme-linked immunosorbent assay (ELISA) method and the rest were evaluated with macro ELISA methods. In blood donors, the positivity of HbsAg, anti-HCV anti-HIV and the rapid plasmin reagin test were 2.95%, 0.68%, 0.00% and 0.16%, respectively.

The resistance of Pseudomonas aeruginosa strains to fluoroquinolone group of antibiotics

Fluoroquinolones are antibiotics that are very effective against many gram negative microorganisms, including P. aeruginosa. However, resistance to these antibiotics has been reported in recent years as well. In this study, the sensitivity of 136 P. aeruginosa strains, isolated from various clinical materials, to fluoroquinolones has been investigated. The lowest resistance rate was in ciprofloxacin with 12.5%. The resistance rates of the others were as follows: norfloxacin 14.7%, levofloxacin 16.9%, ofloxacin 19.9% and pefloxacin 28.7%. The 88.2% of the resistant strains to all fluoroquinolones were originated from intensive care unit.