Efficacy and quality of life assessment in the use of subcutaneous immunoglobulin treatment for children with primary immunodeficiency disorder.

Summary: Introduction. Most patients with primary and secondary immunodeficiencies need regular Intravenous Immunoglobulin (IVIG) or Subcutaneous Immunoglobulin (SCIG) treatment. This study aimed to evaluate the serum IgG trough levels, frequency of mild and severe infections, frequency and duration of hospitalization, duration of absence of school, and quality of life in patients switching their IVIG therapy to SCIG administration. Materials. Twenty-nine patients with immunodeficiency on regular IVIG treatment and who agreed to receive SCIG treatment were included. Seven patients discontinued treatment after the first SCIG administration. We collected data regarding serum IgG levels, annual numbers of infections, hospital admissions, and adverse events prior to and following SCIG initiation. PedsQL tests such as Scale Total Score (STS), Physical Health Total Score (PHTS), Psychosocial Health Total Score (PsyHTS), emotional functionality, social functionality, school/work problems score were calculated separately for all patients and their parents. Results. In twenty-two cases who were diagnosed as primary immunodeficiency, the most common indication for initiation of SCIG treatment was the long transfusion period of IVIG treatments and the difficulty of access to the hospital. No systemic side effects were noted except local redness, pain, and swelling on the injection site. The median IgG value was 588.9 mg/dl during IVIG treatment and 872 mg/dl one year after SCIG treatment. Annual frequency of infections and absence to school/work decreased significantly in the SCIG group while the annual number of hospitalizations and hospital stay time did not change significantly. There was a significant increase in the "quality of life" scores of the patients and their families. Conclusions. SCIG treatment provides ideal and protective immunoglobulin levels and offers the comfort of treatment in their home environment, thus increasing the patient's satisfaction and quality of life.

Evaluation of self-administered versus interviewer-administered completion of Edinburgh Claudication Questionnaire.

BACKGROUND: The aim of this study was to determine the impacts of different administration modes on sensitivity and specificity of Edinburgh Claudication Questionnaire (ECQ) in estimation of Ankle Brachial Index (ABI) detecting lower extremity arterial disease (LEAD). METHODS: Eligible respondents aged fifty years or older underwent first a self-administered (SA-) ECQ, and then an interviewer-administered (IA-) ECQ. Interviewing included additional guidance on symptoms relevant to claudication. ABI was measured by hand-held Doppler. RESULTS: A total of 177 respondents (age: 64.67±9.19, male/female: 80/97) were enrolled. Questions 1, 2, 3, and 5 (collectively defines claudication) were responded significantly different on SA-ECQ and IA-ECQ modes. Markings of pain on the figure of ECQ also changed significantly when the procedure was guided. Of the respondents, none on SA-ECQ and 13.6% on IA-ECQ with positive claudication had a low ABI. Subjects with higher formal education level did similar to the whole group in both modes. Sensitivity and specificity of IA-ECQ was calculated as 25% and 88.5%, respectively, for ABI detected LEAD. CONCLUSIONS: Respondents' perceptions of pain, discomfort, exertion or body regions described on ECQ may subject to errors without guidance. ECQ seems reliable in evaluating claudication only when specifically interviewed by an observer.

Synthesis, characterization and radiolabeling of folic acid modified nanostructured lipid carriers as a contrast agent and drug delivery system.

Nanostructured lipid carriers (NLCs) are the new generation of solid lipid drug delivery systems. Their suitability as contrast agents for gamma scintigraphy is an attracting major attention. The aim of current study was to prepare surface modified nanostructured lipid carrier system for paclitaxel (PTX) with active targeting and imaging functions. In accordance with the purpose of study, PTX loaded nanostructured lipid carriers (NLCs) prepared, modified with a folate derivative and radiolabeled with technetium-99m tricarbonyl complex (99mTc(CO)3+). Cellular incorporation ratios of radiolabeled nanoparticles (99mTc(CO)3-PTX-NLC) were investigated in vitro on three cancer cell lines. Additionally in vivo animal studies conducted to evaluate biological behavior of 99mTc(CO)3-PTX-NLC on female Wistar Albino rats. Biodistribution results showed that the folate derivative modified 99mTc(CO)3-PTX-NLC had considerably higher uptake in folate receptor positive organs. The data obtained from present study could be useful in the design of biodegradable drug carriers of PTX and folate receptor based tumor imaging agents.

Does tamoxifen citrate prevent pulmonary fibrosis due to silica inhalation?

BACKGROUND: As shown in several studies, besides being used in breast cancer, tamoxifen is also known for its antifibrotic effects via reducing the serum TGF-beta levels. We investigated the possible preventive effect of tamoxifen in rats exposed to silica particles depending on the antifibrotic effect. MATERIALS AND METHODS: A total of 102 adult female Wistar Albino rats were divided into five groups. First two groups (control and tmx) were free of silica and the last three groups (slc, tmx1 and tmx 10) were exposed to crystalline silica. The rats in tmx, tmx1 and tmx10 groups received 10 mg/kg, 1 mg/kg and 10 mg/kg of body weight tamoxifen, respectively. On day 84, all rats were sacrified and tissue samples were obtained together with blood samples. The differences in serum TGF-ß levels, histological grades of fibrosis and inflammation in the lung and liver tissues together with addional biochemical markers were calculated between the groups. RESULTS: Silicosis occurred in slc, tmx1 and tmx10 groups in 100%, 91.7% and 52.1%, respectively. Liver fibrosis did not occur. The highest mean lung fibrosis scores were obtained in slc group while the scores were lower in tmx1 group and the lowest in tmx10 within silica-exposed rats. Nevertheless, the inflammation scores were higher in tamoxifen-administered rats in a dose-dependent pattern. CONCLUSION: Silica inhalation did not result in liver fibrosis. Tamoxifen is found to prevent lung fibrosis and reduce serum TGFß-1 levels while increasing lung inflammation (Tab. 3, Fig. 3, Ref. 27).

Diode laser transscleral retinopexy in rhegmatogenous retinal detachment surgery.

PURPOSE: To evaluate the safety and efficacy of transscleral diode laser for retinopexy in rhegmatogenous retinal detachment surgery. METHODS: Conventional retinal detachment surgery with transscleral diode laser retinopexy was performed on 52 eyes of 52 patients (22 female, 30 male), aged from 12 to 74 years (mean 51 + 4.1). RESULTS: Of the 52 eyes 36 (69%) were reattached in a single operation and adequate chorioretinal scars were achieved in 34 of them. Additional transpupillary laser photocoagulation was performed in two cases in the postoperative period. Retinal re-attachment was achieved with exoplant revision and transscleral laser retinopexy in six cases (12%). Ten cases (19%) with severe PVR were reattached with vitreoretinal surgery. CONCLUSIONS: Transscleral diode laser retinopexy was an effective and safe method, with accurate lesion location, concurrent permanent laser marks on the retina, and easy transmission through the extraocular muscles and solid buckling elements. Minor complications were minimized by gaining experience with the technique.

The NF kappa B heterodimer/homodimer balance and IL-1-stimulated IL-2 production in murine T lymphocytes.

Activation of NF kappa B is considered one way IL-1 exerts its costimulatory effect on T cell activation and IL-2 production. However, T helper 2 cells do not synthesize IL-2 upon IL-1 stimulation, although they depend on IL-1 for proliferation. The involvement of NF kappa B in IL-2 production was therefore addressed in two different murine cell lines: D10N, a T helper 2 cell line that does not synthesize IL-2, and EL4 6.1., a thymoma cell line producing IL-2 when stimulated with IL-1. In both cell types IL-1 activated the DNA binding activity of the NF kappa B heterodimers p50/65 and p50/c-rel via the IL-1 type I receptor. In D10N cells, however, the p50/p50 homodimer is present in large amounts in unstimulated cells, whereas the heterodimers were only activated by IL-1-treatment. In contrast, only marginal amounts of the p50/p50 homodimer were found in EL4 6.1. cells, but a strong activation of heterodimers was induced by IL-1. The findings are compatible with the concept of p50 homodimer being inhibitory by replacing the p50/p65 or p50/c-rel heterodimer from nuclear kappa B binding sites. The inability of D10N cells to respond to IL-1 exposure with IL-2 formation might therefore be due to their high constitutive levels of p50 homodimers.