Circulating Levels of Interleukin-10 and -17 in Patients with Cerebral Sinovenous Thrombosis (CSVT) in Acute and Subacute Stages: A Prospective Case-Control Study.

BACKGROUND: Cerebral sinovenous thrombosis (CSVT) is a neurovascular disorder that occurs when a blood clot develops in a vein near the brain. Evaluating the subsequent changes in inflammatory cytokines can better reveal the underlying pathogeneses. OBJECTIVE: To assess the serum levels of interleukin-10 (an anti-inflammatory cytokine) and IL-17 (a pro-inflammatory cytokine) in patients with aseptic non-vasculitic CSVT. METHODS: In this prospective case-control study, 31 patients with aseptic non-vasculitic CSVT (admitted in Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran) were enrolled. IL-10 and IL-17 serum levels were measured at diagnosis, before initiation of treatment (acute stage), 3 months later (subacute stage). These cytokines were also measured in samples obtained from 30 gender- and age-matched healthy subjects, which were considered as control values. RESULTS: Patients' IL-10 and IL-17 levels were higher in both acute and subacute stages as compared to controls. However, no significant differences existed between the acute stage and control groups for both cytokines. Moreover, subacute levels were significantly higher than their acute and control levels. CONCLUSION: This study demonstrated the alteration of IL-10 and IL-17 levels in aseptic non-vasculitic CSVT. The rise in subacute IL-10 can be explained by the assumption that IL-10 is released as an anti-inflammatory response to subside the effects of IL-17 mediated reactions. More importantly, the immediate sampling in the acute stage did not allow enough time for triggering the immune system to produce such mediators. However, a balance was established between IL-10 and IL-17 in the subacute stage to prevent further tissue damage.

Correlation of clinical grading, physical tests and nerve conduction study in carpal tunnel syndrome.

Background and aims Carpal tunnel syndrome (CTS) is a common debilitating condition. As the reliability of CTS-specific physical tests and its clinical grading remain a matter of debate, we determined the correlations between these assessments with nerve conduction study (NCS). Methods In this cross-sectional study, patients with uni or bilateral CTS, which was confirmed in electrodiagnosis, were enrolled. Clinical grading was based on the modified criteria of the Italian CTS Study Group. Numeric Pain Rating Scale (NPRS) and Boston Questionnaire (BQ) were used. Physical tests [Phalen's, reverse Phalen's, Tinel's and manual carpal compression test (mCCT)] were performed by a single blinded neurologist. A p-value<0.05 was considered statistically significant. Results A total of 100 patients (age=47.48±11.44 years; 85% female) with 181 involved hands were studied. The majority of hands (59.7%) were classified as grade 2 of clinical grading. On NCS, hands with mild (64%), moderate (27%) and severe (9%) CTS were identified. Sensory (velocity, latency and amplitude) and motor parameters (latency and amplitude) were significantly correlated with clinical grades (p-value<0.001). The correlation of NPRS (p-value=0.009) and BQ (p-value<0.001) scores with NCS was significant. None of the physical tests were significantly correlated with NCS in terms of result or duration (p-value>0.05). Conclusions We found that physical tests are not a reliable screening method for evaluation of CTS severity. However, the BQ and clinical grading can be more valuable due to their significant correlation with NCS. Implications Physicians might benefit from employing clinical grading and BQ in practice for better assessment of CTS severity.

Network scale-up correction factors for population size estimation of people who inject drugs and female sex workers in Iran.

INTRODUCTION: The results of the network scale-up (NSU) method in estimating the size of key populations for HIV might be biased if the recruited subjects are not fully informed of the risky behaviors of people in their networks (low visibility), or key populations have a smaller social network (low popularity). We aimed to measure such biases in the size estimation of people who inject drugs (PWIDs), and female sex workers (FSWs) in Iran. METHODS: We interviewed 163 male PWIDs, 76 FSWs (known as egos) and 600 subjects from the general population. We selected twenty first-names (ten males and ten females) and asked the study subjects separately how many people they knew with one of these names (known as alters). Visibility Factor (VF) was defined as the percentage of FSW or PWID alters that were aware of their behavior. In addition, the popularity factor (PF) was calculated by dividing the number of alters reported by FSWs and PWIDs into that of the general population. The 95% uncertainty intervals (UI) were calculated using bootstrap technique. RESULTS: The VF was estimated at 54% (95% UI: 52%-56%) for PWID and 45% (95% UI: 42%- 48%) for FSW. The VF among the peer alters was significantly higher than non-peer ones. The PF for PWID and FSW was 69% (95% UI: 66%-73%) and 77% (95% UI: 72%-83%), respectively. The cross-validation and name splitting analysis showed that our estimates were not influenced by any single name. CONCLUSIONS: Both correction factors, particularly VF were far from one, and NSU results without correction, could lead to up to 4 times underestimation of the sizes. Therefore, applying these coefficients is necessary in NSU projects.