Adverse effects of two kinds of food additive mixtures [flavor enhancer, food preservative or food coloring agent] on physiological parameters in young male albino rats

Background: food additives are substances used in food industry in order to improve the food's taste, appearance by preserving its flavor and preventing it from souring. Food additives are added to the most junk and fast foods, especially food for kids

Aim of the work: this work was aimed to investigate the adverse effects of some food additives on the biochemical parameters in addition to study the side effects of these food additives in male albino rats

Materials and Methods: this study was performed on twenty four young male albino rats with an average 120-145 g body weight. Animals were divided into four groups [6 /cage]; Group I [Control untreated group], Group II [administered orally with sodium nitrite [0.1 mg/kg b.wt./day] and annatto [0.065 mg/kg b.wt./day]], Group III [administered orally with sodium nitrite [0.1 mg/kg b.wt./day] and monosodium glutamate [MSG] [15 mg/kg b.wt./day]] and Group IV [administered orally with annatto [0.065 mg/kg b.wt./day] and monosodium glutamate [15 mg/kg b.wt./day]]. Blood samples were collected on the last day of experiment, for biochemical estimations which included levels of serum glucose, total protein [TP], albumin, creatinine, urea, testosterone , thyroid hormones [T3 and T4], activities of AST and ALT in addition to lipid profile

Results: showed marked elevation in levels of fasting glucose, activities of AST, ALT, urea, creatinine, total cholesterol [TC], triglycerides [TG] and high density lipoprotein cholesterol [HDL-C], VLDL and ratios of TC/HDL-C and LDL-C/HDL-C [risk factors] as well as albumin / globulin ratio and serum thyroid hormones [T3 and T4] accompanied with marked decline in levels of serum total proteins, albumin, globulin, albumin/ creatinine ratio, testosterone and HDL-C in all treated groups in comparison to the control group. There was a significant reduction in the body weight in groups that received [NaNO2 with annatto] and [MSG with NaNO2] while treated rats with [MSG and annatto] showed a significant increase in body weight as compared to control rats

Conclusion: Due to the harmful effects of food additives, the use of these compounds must be limited as it resulted in a vehement disturbance in the biochemical and physiological parameters that was grievously pronounced on many hormones

Effect of Bisphenol A on the first generation of female rats from both parents treated with the same Xenoestrogen

Background: Bisphenol A [BPA] is a worldwide used endocrine disruptor that is incorporated in many plastic industries. The exposure of human to such substances starts early during the fetal life, postnatal life and extends throughout the life of the individual. Many agencies raised warnings against the excessive use of such substances. The aim of the present work was to evaluate the extent to which BPA can affect the first generation [of parents treated with the same compound, during pregnancy and lactation], which treated with the same compound during their life time

Materials and Methods: Group 1: 15 control female rats. Group 2: 15 female rats of the first generation treated with BPA [20mg/kg b.wt] for one month. Sexual hormones, liver and kidney functions were measured

Results: BPA induced increase in breast and ovarian tumor markers. It also showed significant increase in estrogen, FSH, prolactin, and progesterone. It is also increased liver function, kidney function, lipid profile. In the same time it leads to decrease in LH, HDL, and protein levels

Conclusion: BPA induced toxicity, which is mediated by oxidative stress. This study ringing the bells of danger for using such compounds

[Pharmacokinetic and bioequivalence studies on two brands of cephalexin monohydrate suspension]

To assess pharmacokinetics and bioequivalence of a locally produced cephalexin monohydrate suspension. Ten ml of test and reference products were given to 12 healthy male volunteers in a two-way open randomized cross-over study with a one week washout period. Blood samples were drawn at specified time intervals and plasma concentration of cephalexin was measured using HPLC with UV detection. Pharmacokinetic parameters were determined by non-compartmental analysis and tested statistically using two one-sided t-test and ANOVA. Pharmacokinetic parameters [Mean +/- SD] of test and reference suspensions are: T[max] 0.9 +/- 0.2 and 0.9 +/- 0.3 h, C[max] 19.4 +/- 3.9 micro g/ml and 18.7 +/- 2.2 micro g/ml, AUC infinity 29.5 +/- 7.5 and 28.2 +/- 5.2 micro g/ml, MRT 1.56 +/- 0.19 and 1.59 +/- 0.18 h, t[1/2] 0.82 +/- 0.06 and 0.86 +/- 0.13 h, CL/F 17.9 +/- 4.1 and 18.4 +/- 3.8 L/h, Vd/F 21.0 +/- 4.6 and 22.7 +/- 4.6 L. No statistically significant differences were observed between the two formulations [P>0.05]. 90% confidence intervals [CI] of the ratio of means were 83-117%, 87.8-112.2% and 85.2-114.8% for AUC infinity, C[max], and T[max], respectively. Since the 90% CIs were within the acceptable range of bioequivalence [80-120%], the test product is deemed bioequivalent to the reference product

Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia

To determine the prevalence of smoking among medical students at the medical college at King Fahad Medical City in Riyadh, and assess the association between smoking and socio-demographical factors, smoking contacts, reasons for smoking and attempts to quit. Cross-sectional survey in which anonymous, self-administered questionnaire was used to survey the cigarette smoking habits of the first-and second-year medical students in the Faculty of Medicine, King Fahad Medical City in June 2009. Overall 39.8% of the investigated students [153] had smoked before, and 17.6% were current smokers. The mean age of initiating smoking was 15.8 +/- 3.3]. There were significantly more males than females. The most important reasons for smoking were leisure, imitation of other people and a means of relieving psychological pressure. Reasons for not smoking were mostly health and religion-based. Smokers tended to have friends who smoked. Cigarettes smoking is highly prevalent among medical students in the Faculty of Medicine, King Fahad Medical City. Contact with smokers particularly friends are the major risk factors for the initiation of the habit. Health and religious considerations are important motives for not smoking, quitting or attempting to quit. These findings can be of help in designing future intervention strategies

Development of multiplex real-time PCR for the rapid detection of five bacterial causes of community acquired pneumonia

Establishing a microbial diagnosis for patients with community-acquired pneumonia (CAP) is still challenging and is often achieved in only 30-50% of cases. Polymerase chain reaction (PCR) has been shown to be more sensitive than conventional microbiological methods and it could help to increase the microbial yield for CAP patients. This study was designed to develop, optimize and evaluate multiplex real-time PCR as a method for rapid differential detection of five bacterial causes of CAP namely Streptococcus pneumoniae, Burkholderia pseudomallei and atypical bacterial pathogens, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila. Duplex and triplex real-time PCR assays were developed using five sets of primers and probes that were designed based on an appropriate specific gene for each of the above CAP pathogens. The performance of primers for each organism was tested using SYBR Green melt curve analysis following monoplex realtime PCR amplification. Monoplex real-time PCR assays were also used to optimize each primers-probe set before combining them in multiplex assays. Two multiplex real-time PCR assays were then optimized; duplex assay for the differential detection of S. pneumoniae and B. pseudomallei, and triplex assay for the atypical bacterial pathogens. Both duplex and triplex real-time PCR assays were tested for specificity by using DNA extracted from 26 related microorganisms and sensitivity by running serial dilutions of positive control DNAs. The developed multiplex real-time PCR assays shall be used later for directly identifying CAP causative agents in clinical samples.

Myringoplasty [Risk factors and the effect of post operative follow up on the outcome of success rate in Erbil / Kurdistan of Iraq]

The presence of a perforated tympanic membrane with intermittent discharge and hearing loss of conductive type are the indication for myringoplasty. The purpose of this study was to determine risk factors in candidates for myringoplasty and to evaluate the post operative myringoplasty success rate results in our local region in Erbil/Kurdistan, Iraq. The second objective is to appraise and assess the effect of close observation and post operative treatment and follow up on this result, to increase the success rate. A prospective study, randomly taken 68 patients with unilateral perforated tympanic membrane, who are candidates for myringoplasty; patients of different age groups ranging [16 -55] years old, of different gender 30 males and 38 females having dry unilateral perforated tympanic membrane of more than 3 months, underwent myringoplasty [underlay] between may 2006 and April 2009 at Rizgary teaching hospital. Measurement of the post operative results and outcome were depend on the take rate and the hearing level at the last follow up visit in different time postoperatively and with dry clean non infected operated ear. Small, dry posterior perforation, with postauricular approach in well pneumatized mastoid and in well educated non-smoker patient with close observation post-operatively using BIPP has better success rate. The success rate increased from 72% in the 1st postoperative visit to 88% in the last postoperative visit. To increase the success rate, its necessary to determine the factors that affect the success rate preoperatively, also close observation with meticulous toilet of the operated ear post-operatively using BIPP is necessary to increase the success rate

HER2 over expression in malignant palpable breast lumps of pre and postmenopausal women attending RICK

Human Epidermal growth factor Receptor 2 [HER-2/neu] over expression in breast cancer is associated with poor outcome and decrease disease free survival [DFS]. The aim of this study was to evaluate the over expression of HER2/neu among premenopausal and postmenopausal females presented with malignant palpable breast lumps to Radio Isotope Center Khartoum [RICK]. The study was a case-control conducted among patients attending Radiation Isotopes Centre Khartoum [RICK]. A total of 328 women were randomly selected. Data were collected by a pre coded, pre tested questionnaire. Tissue biopsies of breast lumps had been analyzed using immunohistochemical techniques for HERR-2/neu over expression and its relation to other prognostic factors was evaluated. HER-2/neu + vein first pregnancy at 23 years, were 32 [41%] in the cases, 6 [35%] in the controls of premenopausal women, and 21[44%] in the cases, 5 [38%] in the controls of postmenopausal women. HER-2/neu + veexpression in relation to age at menarche 12 years was 39 [51%] in the cases, 7[39%] in the controls of premenopausal women, and 36 [56%] in the cases, 7 [45%] in the controls of postmenopausal women. HER-2/neu+ vein relation to Body Mass Index > 29 kg/m2 showed 7 [37%] in the cases, 2 [33%] in the controls of premenopausal women [x2=0.024], and 8[38%] in the cases, 2[40%] in the controls of postmenopausal women [x2= 0.006]. HER-2/neu+ veexpression in relation to history of abortion or miscarriage [ever] was found to be 21 [39%] in the cases, 4 [33%] in the controls of premenopausal women, and 18 [44%] in the cases, 3 [33%] in the controls among postmenopausal women. HER-2/neu+ veexpression in relation to the history of breast cancer in a first degree relatives was 3 [25%] in the cases, 1[50%] in the controls of premenopausal women, and 4 [22%] in the cases, 2 [28%] in the controls of postmenopausal women. HER-2/neu+ veexpression in relation to the use of oral contraceptives was 3 [37%] in the cases, 1[50%] in the controls among premenopausal women, and 3 [27%] in the cases, 1 [50%] in the controls of postmenopausal women. The study confirmed an etiological association between HER2/neu+ve and HER2/neu - ve and age at first pregnancy >/= 23 years, age of menarche at

Pegylated interferon with ribavirin in the treatment of chronic active hepatitis C in Egyptian patients: efficacy of response in a retrospective study

Chronic hepatitis C is one of the major causes of cirrhosis, hepatocellular carcinoma and considered the main indication for liver transplantation. In Egypt, high HCV rates were reported among several population groups reaching up to 20%. Interferon Alfa is the current therapy forchronic hepatitis C .Yet, combination therapy of Alfa interferon and ribavirin is more effective than interferon alone in increasing the response rates. Aim of work is to study efficacy of response in Egyptian patients with chronic active hepatitis C who had received pegylated interferon plus ribavirin as regarding the biochemical and virologic response. The results of this study showed that patients received Pegylated interferon alfa-2a plus ribavirin had significant improvement in serum ALT levels in around 71% of them. Also 58.94%of these patients achieved sustained clearance of the virus six months after stopping treatment. The combination therapy of Pegylated interferon alfa and ribavirin is effective in achieving biochemical and virological responses and is highly recommended as an initial therapy for patients with chronic hepatitis C

adiponectin have a role in the pathogenesis of rheumatoid arthritis?

To elucidate the involvement of adipocytokines "Adiponectin" in the pathogenesis of rheumatoid arthritis [RA] by measuring serum and synovial fluid levels of adiponectin in RA patients and also by evaluating its expression in RA synovial tissue to find out its possible role in disease activity and severity in order to throw light on possible new strategy in the management of RA. Twenty RA patients and ten subjects with acute post traumatic knee effusion - who served as a control group-were recruited for this study. Serum adiponectin levels were measured using enzyme linked immunosorbent [ELISA]. Synovial fluid [SF] levels of adiponectin, IL-6 and pro MMP-1 were measured by ELISA. Modified disease activity score [DAS] and Larsen score were assessed in RA patients. Synovial tissue [ST] specimens were obtained from control subjects and RA patients. These specimens were assessed immunohistochemically for adiponectin and graded in a semiquantitative scale. Serum adiponectin was significantly raised in RA patients compared to controls [p<0.05]. There was a highly statistically significant increase in SF adiponectin, SF Pro MMP-1, ST adiponectin expression in RA patients compared to controls [p<0.01], while there was a significant increase in SF IL-6 in RA patients compared to controls [p<0.05]. SF adiponectin correlated positively with each of ST adiponectin expression, SF IL-6, SF pro MMP-1 [p<0.01]. A highly significant positive correlation was found between SF levels of adiponectin and each of DAS and Larsen score [p<0.01]. Adiponectin is expressed in the RA synovium and it stimulates the production of key mediators of destructive arthritis, IL-6 and pro MMP-1, so targeting the proinflammatory cascade of adiponectin may represent an exciting new therapeutic tool in RA

[Psychiatric morbidity and consultations among medical and surgical inpatients in a general hospital in Kuwait]

A number of studies have shown high prevalence of psychiatric morbidity among medical and surgical inpatients. However, few inpatients with psychiatric morbidity receive psychiatric consultation. The objectives of this study were to measure the prevalence of psychiatric problems requiring psychiatric consultation among general medical and surgical inpatients and the ratio between number of patients having such problems and those referred for psychiatric consultation. The study included all patients admitted to general medicine and general surgery departments of Farwaniya General Hospital in Kuwait over one month. These patients were screened for presence/absence of clinically significant depressive and anxiety symptoms, hallucinations, excitement, disorientation, suicidal behavior, and occurrence of psychiatric consultation during their hospital stay. Patients were assessed using Brief Psychiatric Rating Scale, Beck Depression Inventory, Self Rating Anxiety Scale, and patients' medical records. Results showed that of the studied 295 inpatients [193 medical and 102 surgical], 122 [41.4%] were found to have one or more of the manifestations of psychiatric morbidity. Clinically significant depressive symptoms were found in 99 patients [35.2%], anxiety symptoms in 24 patients [8.5%], disorientation in 14 patients [4.7%], excitement in 10 patients [3.4%], hallucinations in 6 patients [2%], and suicidal behavior in 8 patients [2.7%]. Only 13 patients [10.7% of patients having psychiatric morbidity] were referred for psychiatric consultation. The study concluded that the prevalence of psychiatric morbidity, especially depression, among general medical and surgical inpatients is high, and a small percentage of inpatients with psychiatric morbidity are referred for psychiatric consultation

Ophthalmomyiasis externa in Jordan

To describe the epidemiology of external ophthalmomyiasis at the Royal Medical Services military hospitals in Jordan. A retrospective chart review of patients with ophthalmomyiasis externa was done at Royal Medical Services military hospitals in Jordan. A total of 49 cases of ophthalmomyiasis externa were studied over a period of 3 years from 2001 to 2004; of those 65.2% were males and 34.8% were females. The median age was 31.6 +/- 13.45 standard deviation [SD]. The right eye was involved in 57% of the cases. About two thirds of cases occurred during April to June and one third during September to November. Number of extirpated worms ranged from one to 23 with an average of 8.37 +/- 5.52 SD. The clinical presentations ranged from mild to severe conjunctivitis, lacrimation and mild foreign body sensation to severe preseptal cellulitis. Ophthalmomyiasis externa condition affects the eyelids and conjunctiva in Jordan. Most of the cases are documented as case reports and are localized to certain parts of Jordan. This report includes cases from different parts of Jordan

Inpatient psychiatric referrals from general and specialist hospitals in Kuwait- a descriptive study

Psychiatrists are increasingly called on to evaluate and treat persons with comorbid physical disorders. The objectives of this study were to examine different elements of the psychiatric consultation process in Kuwait and to compare our findings to those of similar studies carried out in other parts of the world. The study included 263 psychiatric consultation requests received by Kuwait Psychological Medicine Hospital from all Kuwait hospitals in year 1999. The requests were studied retrospectively regarding referring medical/surgical specialty, sex and age of referred patients, types of requests as regards urgency [according to the referring physician's judgment], reason for psychiatric consultation, psychiatric diagnosis, and recommended psychiatric interventions. Results showed that males and females were almost equally represented in the study [49.8% and 52.2% respectively], 70% of the request were received from medical specialties and 30% from surgical specialties. Patients with ages between 21 and 40 years were more commonly referred for psychiatric consultation than those of other age groups [p=0.015], suicidal attempt [or threat] was the most common reason for consultation [24.6%], adjustment disorder, mood disorders, and organic mental disorders were the most common psychiatric diagnoses [22.3%, 22.3%, an d21.3% respectively], and pharmacotherapy was the most frequently recommended psychiatric intervention [45.9%]. The study concluded that suicidal behavior is the most common reason for psychiatric consultation in Kuwait, consultation psychiatrists do not tend to record the diagnosis of "personality disorder" and they are less likely to recommend psychotherapy for their patients

Clinical significance of anti-cyclic citrullinated peptide [anti-CCp] antibodies in juvenile idiopathic arthritis

Antibodies against cyclic citrullinated peptide [Anti-CCP] are considered to be specific for rheumatoid arthritis [RA]. To assess the clinical significance of anti-CCP antibodies in JIA, i.e. to determine if it can be detected in JIA patients and if they can be used to identify patients with a more destructive course of the disease. Fifty five JIA patients were included in this study. They represented the majority of subtypes of JIA patients. They were 14 boys and 41 girls with mean age 12.5 +/- 2.1 [Range 8-15.5 years] and mean disease duration 4.5 years [range 1-7.5 years]. One or more sera was taken from the patients at different time points of the disease course, 75 sera samples were analyzed using a commercial Kit using an Enzyme Linked Immunosorbent [ELISA] Assay. Our results showed that anti-CCP was positive in 7 patients [12.7%], 5 with polyarticular IgM-RF positive i.e. 5/12 [41.6%] and another 2 with oligoarthritis. This means that there was a significant difference between the prevalence of anti-CCP positivity in polyarticular IgM-RF positive subtypes and the other subtypes [p<0.05]. Disease duration, medications, and antinuclear antibody positivity effect did not show any significant difference between anti-CCP positive and negative patients. Follow up samples at different times also showed no significant difference of the anti-CCP results. Radiological joints damage was seen in 23 patients out of all the patients evaluated [41.8%]. All the patients with positive IgM-RF had radiological changes denoting joint damage, while 5/7 of anti-CCP positive JIA patients [71.4%] had those radiological changes with significant difference between anti-CCP positive and anti-CCP negative patients. Our study showed that anti-CCP autoantibodies can be detected in the sera of juvenile idiopathic arthritis patients, most exclusively in polyarticular IgM-RF positive patients. Longer prospective study with more patients sample will be necessary to verify whether these JIA patients with positive IgM-RF and anti-CCP constitute a differential subgroup with progressive destructive course similar to those of adult RA patients

Prevalence of primary dysmenorrhea in high school girls in Mukalla city, Yemen

To describe the prevalence, determinants and effects of dysmenorrhea in high school girls, the most common reported menstrual complaint at this age [Dysmenorrhea has not previously been described among high school girls in Mukalla]. Cross-sectional survey. Catchments area from two secondary schools for girls in Mukalla [Al-Mina

Secondary school and Fowah secondary school]. Five hundred and forty unmarried post menarcheal girls were involved in this study. Eligible participants were asked standardized questions regarding pain during menstruation, complaints, severity and its impact on their school activities. Data entry and analysis was done by using SPSS software computer program. Out of 540 girls, 332 girls [61.5 %] had dysmenorrhea. Out of the 540 girls it was severe enough to prevent the girls from going to schools in 151 girls [28%], while the other 181 girls [33.5%] they can still go to school [moderate dysmenorrhea]. The prevalence of painful menstruation was highest among girls with early onset of menarche [9-11 years], while the severity of pain was highest among girls with late onset of menarche [15-17 years]. One 42.2% of them used drugs for their pains. The most frequent associated symptom was fatigue. Dysmenorrhea is an important common gynecological complaint among high school girls and has a remarkable impact on their daily activity and study. Health education about dysmenorrhea is important and the different types of treatment and its efficacy in alleviating the symptom and improving the life style of the high schools girls, is also recommended

preliminary characterization of digestive proteease in the mid-gut of the third larval instar of gasterophilus intestinalis

Protinases contained in the mid-gut of the early third instar of Gasterophilus intestinals have been tentatively identified by midgut hydrolysis of synthetic substrates. Trypsin was identified by maximal hydrolysis of benzoyl-DL-arginine-p-nitroanilide [BApNA] at pH 8 and chymotrypsin by maximal hydrolysis of benzoyl-L-tyrosine ethyl ester [BTEE] at pH 9. Carboxypeptidase A and B were identified by their maximal hydrolysis of hippuryl-DL-phenyllactic acid and hippuryl-L-arginine at pH 9 and 8 respectively. Aminopeptidase was identified by maximal hydrolysis of leucine-p-nitroanilide at pH 9. The mid-gut also showed activity of aspartic proteinase and identified it as cathepsin D.A drug [Banmith 12.5% pyrantel tartarate] used for the routine control of helminthes parasites of horses and donkies in Egypt was used in vitro to investigate its effect on the optimal activity of studied enzymes. It was found that the drug has no effect on trypsin and carboxypeptidase A while it decreases the activity of chymotrypsin, aminopeptidase and acidic proteinase and was also found to increase the activity of carboxypeptidase B greatly

Characterization of glycosidase in the mid-gut of the early third larval instars in gasterophilus intestinalis

Mid-gut homogenates from the early third larval instars of Gasterophilus intestinalis contain at least four glycosidases. Enzyme activity was found alpha-galactosidase and beta-galactosidase. Also-alpha-amylase showed activity in midcythomogenates. All enzymes had acidic pH optima of 3.6-6.A drug [Banminth 12.5% pyrantel tartarate] used for the routine control of helminthes parasites of horses and donkies in Egypt was used in vitro to investigate its effect on the optimal activity of studied enzymes

Monocyte chemotactic protein-1 production and its correlation with disease activity and T-cell subsets in synovial fluid in psoriatic arthritis patients

Psoriatic arthritis [PsA] is a chronic inflammatory arthritis characterized by infiltration of the skin and joints with activated T lymphocytes. The latter have been implicated in both the initiation and maintenance of inflammatory lesions at these sites and it is mediated by the local production and secretion of chemotactic cytokines. To evaluate the role of monocyte chemotactic protein-1 [MCP-1] in the immunopathogenesis of PsA. Also, to find out whether evidence exists for a causal relationship between MCP-1 levels in synovial fluids and T cells recruitment to lesional sites during acute and chronic synovitis and its relation to disease activity in psoriatic arthritis patients. Thirty PsA patients were recruited for this study. They were subdivided into two groups: Group I: 15 patients with synovitis less than 6 months' duration [acute PsA]. Group II: 15 patients with synovitis more than 6 months' duration [chronic PsA]. The clinical activity of the disease was assessed by using modified disease activity score 28 [DAS28]. Their results were compared to 15 healthy age and sex matched volunteers [group III]. Peripheral blood [PB] and synovial fluid [SF] were obtained from PsA arthritis patients; also PB was obtained from normal controls. Immune cell populations in PB and SF samples were assessed with immunofluorescent labeling and flow cytometry, levels of soluble MCP-1 were determined in PB and SF samples with quantitative ELISA. DAS28 was significantly higher in group I [acute PsA] patients than group II [chronic PsA patients] [p<0.01]. CD4+, CD8+ T cells were significantly elevated in SF as compared to PB of acute but not chronic PsA patients and the majority of these cells expressed CD45RO [p<0.01]. Plasma MCP-1 levels were elevated in PsA [whether acute or chronic] relative to normal controls [p<0.01]. SF MCP-1 levels were significantly higher than paired plasma samples in acute PsA patients only [p<0.01]. A highly significant positive correlation was observed between MCP-1 levels in SF and DAS28 and also with T cell numbers in SF of acute PsA patients [p<0.01]. The elevated concentration of MCP-1 is concomitant with T cell infiltration in SF of acute PsA patients. This suggests that MCP-1 mediated chemotaxis is involved in the recruitment of T lymphocytes particularly memory cells into the synovial fluid in PsA during acute synovitis which is associated clinically with severely active disease and thus could be considered as an early inflammatory marker in acute PsA