Anti-tumor necrosis factor-alpha monoclonal antibody treatment in a case with persistent juvenile ankylosing spondylitis and inflammatory bowel disease [Jüvenil ankilozan spondilit ve enflamatuvar bagirsak hastaligi olan bir hastada anti-tümör nekrozis faktör-alfa monoklonal antikor tedavisi]

Juvenile ankylosing spondylitis and inflammatory bowel disease rarely develop simultaneously, and the treatment of the disease with disease-modifying antirheumatic drugs might be difficult. In this report we present an eight-year old boy with juvenile ankylosing spondylitis and inflammatory bowel disease resistant to combined therapy of antirheumatismal drugs because of its rarity in childhood. Anti-tumor necrosis factor-? monoclonal antibody administration, a new biological treatment, is discussed in view of the literature

Anomalous origin of the left coronary artery from the pulmonary artery presenting as dilated cardiomyopathy

PubMed ID: 23917013Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly and one of the causes of myocardial ischemia. It often presents with atypical signs and symptoms, especially in childhood. In this case report, an 11-year-old girl presented with dilated cardiomyopathy in our clinic and was followed for five years. Echocardiography showed multiple left-to-right shunts on the interventricular septum, the confirmation of which was done by multi-slice computed tomography and coronary angiography. Therefore, we suggest that ALCAPA should be suspected in young patients diagnosed with dilated cardiomyopathy. © 2013 Turkish Society of Cardiology

Heat shock protein 70 expression in neonatal rats after hypoxic stress

Objectives: The tissue damage due to hypoxia in newborns is to some-extent age-dependent; organs of premature babies are more vulnerable to hypoxic insult than full-term neonates. The aim of this immunohistochemical study was to investigate the role of heat shock protein 70 (HSP70), a stress-inducible protein, in developing the response to hypoxia in premature newborns. Methods: Postnatal day-7 rats (corresponding to a human fetus of 32-34 weeks' gestation) and day-12 rats (corresponding to a full-term newborn infant) (n = 7) were subjected to mild hypoxia at 33°C. Control rats (n = 7) for each group breathed room air for 4 h. After 4 h of recovery, the animals were killed, and brains, hearts and kidneys were removed for immunohistochemical staining. Results: Immunohistochemically, HSP70 expression was found to be induced in the hippocampus and myocardium after exposure to hypoxia. The level of HSP70 expression in the hippocampus after hypoxic stress was significantly higher in the 12-day rats than in the 7-day rats (p = 0.03). However, HSP70 expression in the myocardium did not show any significant difference between the two groups. In addition, no significant induction of HSP70 expression was apparent in the kidney of rats exposed to hypoxia or in any organ of the control animals. Conclusions: We conclude that diminished HSP70 expression in the hippocampus of premature newborns may play a critical role in developing the response to hypoxic stress. However, HSP70 expression in the heart and the kidney after exposure to hypoxia did not appear to be related to fetal maturity

Left ventricular diastolic abnormalities in children with ß-thalassemia major: A doopler echocardiographic study

PubMed ID: 9677725Left ventricular filling patterns were assessed by Doppler echocardiography in 63 ß-thalassemia major patients, aged for to 21 years, with no clinical evidence of congestive heart failure and 63 age- and sex-matched normal controls. The patients with ß-thalassemla major were divided into three age groups, namely four to nine years (6.8 ± 1.5 years), 10-15 years (12.1 ± 1.6 years) and older than 15 years (17.3 ± 1.7 years). They were compared with age- and sex-matched normal controls in respects of Doopler diastolic indices. The ratio between the early and late (atrial) peaks of flow velocity was higher and peak flow velocity in late diastole was significantly lower in patients with ß-thalassemia major as compared to controls in all three age groups (p .05). From the data presented here, we therefore conclude that left ventricular diastolic abnormalities develop in patients with ß-thalassemia major in the early phase of the disease and before the apearance of systolic abnormalities, when clinical symptoms of congestive heart failure are absent

Lymphocyte subsets and plasma IL-1 ?, IL-2, and TNF-? concentrations in acute rheumatic fever and chronic rheumatic heart disease

The distribution of CD3+, CD4+, CD8+, CD19+, CD16+, and CD25+ lymphocyte populations in peripheral blood as well as the plasma concentrations of interleukin-1 ? (IL-1 ?), and IL-2 and tumor necrosis factor ? (TNF-?) were investigated in 25 children with acute rheumatic fever (ARF) at the time of admission and after 3 months and in 15 children with chronic rheumatic heart disease (CRHD) and in 15 children with streptococcal pharyngitis (SP) in order to determine changes in lymphocyte subsets and cytokine concentrations occurring during different stages of the disease. The percentages and absolute counts of CD4+, CD16+, CD25+ cells, the ratio of CD4/CD8 and plasma concentrations of IL-1 a and IL-2 in patients with ARF were significantly higher at admission than 3 months later. These levels were also significantly higher than in patients with CRHD, SP, or normal controls. Production of IL-2 in ARF and CRHD patients directly correlated with the percentages of CD4+ and CD25+ cells. According to our results, the evidences of increased cellular immune response in ARF are increased percentages CD4+ and CD25+ cells, CD4/CD8 ratio, and increased plasma concentrations of IL-1 ? and IL-2. Furthermore, activation of cellular immune response was not present throughout all stages of rheumatic heart disease and also in SP. © 1995 Academic Press, Inc

The decline of BCG immunity after neonatal vaccination: what about revaccination at one year?

PubMed ID: 8378173Summary. Two hundred and nineteen healthy newborns were vaccinated with the BCG vaccine, and their immunity was checked thereafter at 3,6 and 12 months of age. We determined that 87% of tuberculin reactivity at 3 months declined to 61% at 12 months. Revaccination of nonreactive infants provided a 100% rate of reactivity. In the light of this information we propose a revision in the BCG vaccination programme in developing countries. We also found a close relationship between the tuberculin reactivity and scar formation after BCG vaccination, suggesting that a simple check of the left deltoid region for a BCG scar may give enough information about the child's immunity to tuberculosis. Copyright © 1993, Wiley Blackwell. All rights reserve