LC-MS/MS characterization, antidiabetic, antioxidative, and antibacterial effects of different solvent extracts of Anamur banana (Musa Cavendishii).

The main objective of this study was to examine the phenolic compounds and the antibacterial, antioxidant, anti-α-glucosidase and anti-α-amylase activities of the different extracts (methanol, ethanol and hexane) of Musa cavendishii collected from the Anamur district in Turkey. LC-MS/MS was used to identify phenolic compounds. Quinic acid, acotinic acid, hesperidin and amentoflavone were identified in methanol extract. These phenolic compounds, excluding hesperidin, were also identified in the ethanol extract. Methanolic extract appeared the most active in all enzyme inhibition, antibacterial and antioxidative activity assays which is mainly due to its rich phenolic content. The methanol extract of banana showed the highest anti-α-glucosidase and anti-α-amylase activities with IC50 values of 5.45 ± 0.39 mg/mL, 9.70 ± 0.29 mg/mL, respectively. This study showed that methanol and ethanol extract, especially the methanol extract, have potential for use in the development of functional foods for reducing the diabetes and bacterial risks.

Fatigue in Multiple Sclerosis: Is it related to cytokines and hypothalamic-pituitary-adrenal axis?

BACKGROUND: Fatigue is a common symptom of Multiple Sclerosis (MS) that diminishes the quality of life of patients, but its exact mechanism remains poorly understood. There is not a generally adopted scale to determine MS fatigue. Studies that investigated physiopathology of fatigue symptom have shown dysregulation of hypothalamic-pituitaryadrenal (HPA) axis. In the current study, we aimed to compare the results obtained with two separate scales, namely the Fatigue Severity Scale (FSS) and the Neurological Fatigue Index-Multiple Sclerosis (NFI-MS), and assess the relationship between fatigue and serum IL-1ß, TNF-α, IL-35, IL-2, IL-10, ACTH, cortisol, α-MSH, ß-MSH, γ-MSH and CLIP (Corticotropinlike intermediate lobe peptide) in MS patients categorized as fatigued and non-fatigued on the basis of FSS scores. METHODS: For the study, a total of 54 (29 females, 25 males) patients diagnosed with RRMS including 26 with fatigue symptom (48.1%), and 26 healthy controls (13 females, 13 males) were enrolled. A FSS score ≥36 was considered as cut-off score to separate fatigued patients from nonfatigued patients. RESULTS: A significant positive correlation was determined between FSS score and NFI-MS scale, NFI-MS 1, NFI-MS 2, NFI-MS 3 and NFI-MS 4 scores. IL-1ß, IL-10 and TNF-α levels did not differ between patient and control groups. IL-35 and IL-2 levels were significantly higher among MS patients (p<0.01). However, no difference was observed between fatigued and nonfatigued patients in the cytokines and HPA parameters studied. ACTH, cortisol and α-MSH were significantly higher in MS group (p=0.02, p<0.01 and p<0.01, respectively). CLIP level was significantly low in MS patient group (p<0.01). CONCLUSION: NFI-MS scale is equally sensitive as FSS scale for assessment of MS fatigue; thus, it may also be widely used to evaluate that symptom. Generally HPA axis is hyperactive in MS patients, but it is not correlated with fatigue in our study. For the first time, levels of CLIP (a type of melanocortin) are studied, and determined to be lower among MS patients. Elevated levels of IL-35 and IL-2 suggest that these cytokines may have a prominent role in MS pathophysiology and can be investigated as potential targets for development of novel therapies.

Direct current therapy with/without lidocaine iontophoresis in myofascial pain syndrome.

OBJECTIVES: This study aimed to assess the effectiveness of lidocaine iontophoresis for inactivation of trigger points (TrPs) in the treatment of myofascial pain syndrome (MPS). METHODS: Fifty-eight trigger points (cervical and/or periscapular regions) in 18 female and 2 male patients with MPS were randomly assigned to two groups. These groups were treated with: lidocaine iontophoresis using direct current (3 mA, 10 min) (n: 10, 28 TrPs) or only direct current (n: 10, 30 TrPs). Lidocaine iontophoresis or direct current, followed by stretching and strengthening exercises of each of the involved muscles and postural exercises were given in both groups once daily for ten days. Clinical assessment including cervical range of motion (ROM), TrP pain pressure threshold (PPT) measurement, and manual pain scores (PS), Visual analogue scale-pain (VAS-pain), fatigue and work disability scores were evaluated at baseline, at the end of a 10 session course of treatment and at the end of fourth week. Additionally, Hamilton depression and anxiety rating scales and Nottingham Health Profile (NHP) were used to evaluate and assess depression and anxiety and quality of life, respectively. The subjects were also asked to describe their side effects. RESULTS: PPT, pain scores, VAS-pain were significantly improved in both groups at the end of treatment and during evaluation at fourth week. The improvement of these parameters was not significantly different between groups at the end of treatment. Quality of life (NHP scores) (p<0.016) and depression and anxiety scores (p<0.05) significantly improved with treatment in both groups. CONCLUSION: Direct current therapy with/without lidocaine iontophoresis were determined to be effective treatment modalities in TrP management. These treatment modalities are non-invasive, cost effective and provide long term improvement. Thus, these modalities could be safely used in the management of MPS with minimal side effects, particularly if patients may not accept injection or other treatments (Tab. 3, Ref. 44). Full Text (Free, PDF) www.bmj.sk.

Acute-phase response, clinical measures and disease activity in ankylosing spondylitis.

OBJECTIVE: The evaluation of disease activity in ankylosing spondylitis (AS) is sometimes difficult. In this study we assessed acute-phase reactants (APR) and immune response status (humoral and cellular) in active and inactive untreated AS patients categorized according to different activation/remission criteria. METHODS: Patients with AS were categorized into three groups as active and inactive according to ASsessment in Ankylosing Spondylitis (ASAS) International Working Group remission/partial remission criteria, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) less than 4 or equal or more than 4 and peripheral joint involvement present or absent. Health Assessment Questionnaire-Spondyloarthropathies (HAQ-S), Daugados Articular Index and Bath Ankylosing Spondylitis Functional Index were performed. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), immunoglobulin A, G and M, and complements C3 and C4, interferon-gamma, interleukin-4 and alpha-1-antitrypsin (AAT), alpha-2-macroglobulin, ceruloplasmin, haptoglobin, and transferrin were measured. Immunophenotypic analysis by flow cytometry was performed (CD45, CD3, CD4, CD8, CD4+/CD8+ T cell ratio, CD19, CD16, CD56, CD23, CD25 and CD30 were assayed). RESULTS: Patients with peripheral involvement had higher ESR and CRP levels. According to ASAS criteria patients in remission had significantly lower values of disease activity and functional limitation measures, and AAT was the only APR significantly lower in remission/partial remission group. Lymphocyte subpopulations did not show significant correlation with clinical parameters or APR. CONCLUSIONS: Our results showed weak a relation between APR and disease activity in AS; however, APR should not be disregarded in the evaluation of disease and/or response to the treatment, which was supported by the new research on biologic agents infliximab and etanercept in AS. The ASAS remission/partial remission criteria may discriminate patients' clinical activity status and AAT may be a good indicator of disease activity in AS.

[Thoracic findings in neurofibromatosis]. / Nörofibromatoziste torasik bulgular.

Neurofibromatosis type 1 (von Recklinghausen' disease) is an autosomal dominant hereditary syndrome. It is characterized with multiple light brown (café-au-lait) spots, Lisch nodules and neurofibromas. Thorax and lungs are affected in various forms. Four cases with symptoms of thoracic involvement were investigated in our clinic. Mean age was 46. All cases had dyspnoea and cough; two of them had chest pain. Skin lesions of neurofibromatosis type 1 (NF 1) were pathologically confirmed in all cases. Moreover, case 3 had diffuse interstitial fibrosis and honeycomb pattern. Case 2 had thorax deformity, kyphoscoliosis and intrathoracic benign mass. Case 1 had two neurofibrosarcoma masses on the right hemithorax. Case 4 had multiple intrathoracic neurofibromas. Cases 1 and 3 died within two years after diagnosis due to malignancy and respiratory failure, respectively. Cases 2 and 4 are still under our control.

Rupture of Baker's cyst producing pseudothrombophlebitis in a patient with Reiter's syndrome.

This is an unusual case of pseudothrombophlebitis resulting from rupture of Baker's cyst in a patient with Reiter's syndrome. The patient presented with a swollen, painful left calf and persistent itching on the skin of the calf. Ultrasonography showed a ruptured popliteal cyst with minimal hemorrhage and fluid collection within the fascial compartments and gastrocnemius muscle. Color Doppler ultrasound showed a patent popliteal vein and artery and duplex Doppler scans revealed a normal flow pattern. In conclusion, the clinical picture of deep vein thrombosis and that of pseudothrombophlebitis are difficult to distinguish by clinical examination and necessitate detailed examination by imaging techniques. Persistent pruritus on calf skin resulting from irritation of inflammatory synovial fluid may be an important clinical feature.