SPECT imaging of the brain: regional cerebral blood flow before and after treatment of patients with primary fibromyalgia

Whether regional cerebral blood flow [rCBF] is affected by Duloxitine Hcl in Egyptian women with primary fibromyalgia [FM] and if it correlates with clinical findings. Thirty untreated women with FM [group I] and ten apparently healthy controls [group II] were studied with single photon emission computed tomography of the brain [brain SPECT] after IVI of Tc-99[m] HMPAO as a cerebral perfusion agent. The resting state [rCBF] was measured for the deep structures [thalamus and caudate] and cerebral cortices [anterior, lateral, posterior] of both sides. Fifteen patients[group Ia] received the conventional therapy of fibromyalgia and the other fifteen [group Ib] received a Duloxitine Hcl 60 mg daily for 3 months followed by measuring rCBF. There was a statistically highly significant lower [rCBF] in the thalamus and caudate nucleus in patients as compared to controls [p<0.01] but no such difference in the anterior, lateral and posterior cerebral cortices [p>0.05]. No significant difference clinically or radiologically was found comparing group Ia results before and after 12 weeks. There was a highly significant difference with fatigue and a significant difference as regard neck pain, headache, generalized body ache and morning stiffness when comparing group lb results before and after 12 weeks. The rCBF to thalamus and caudate nucleus showed a highly significant increase in group lb after 3 months. There was a significant difference in number of tender points, the duration of morning stiffness as well as thalamic and caudate blood flow comparing the change in Ia and lb. The decrease of regional cerebral blood flow to the thalamus and caudate nucleus in patients with primary FM may be the cause of their symptoms. Improvement of the symptoms by administration of duloxitine Hcl may be due to improvement of the cerebral blood flow

Correlation of myeloid related proteins [MRP8/MRP14] and disease activity in juvenile rheumatoid arthritis

To evaluate the expression of myeloid related proteins MRP8/MRP14 in the serum and synovial fluid of JRA and their correlation with local and systemic parameters of disease activity. Thirty JRA patients [Group I], and ten controls [Group II] were included in the study. The patients were subjected to thorough history taking and clinical examination. Synovial fluid aspiration was done from ten JRA patients. Laporatory investigations included CBC, ESR, RE, ASO, ANA, CRP, ALT, urine analysis and synovial fluid analysis for white blood cell count [SF-WBCs], lymphocytes%, and acute phase serum amyloid. MRP8/MRP14 was assessed with ELISA technique in serum and synovial fluid samples. Serum level of MRP8/MRP14 was elevated in Group I in comparison to up II. The serum and synovial levels of MRP8/MRP14 in Group I showed no significant inter-correlation. The MRP8/MRP14 in group I showed significant positive correlation with ESR, CRP, DAS, and A-SAA. The SF MRP8/MRP14 in group I showed positive significant correlation with SF-WBCs and A-SAA. The elevated MRP8/MRP14 in the serum and synovial fluids of patients with JRA showed a significant correlation with local and systemic disease activity parameters. So, it can be used to monitor disease activity and patient's response to treatment