Blood perfusion of patellar bone measured by dynamic contrast-enhanced MRI in patients with patellofemoral pain: A case-control study

Background: Altered perfusion might play an important role in the pathophysiology of patellofemoral pain (PFP), a common knee complaint with unclear pathophysiology. Purpose: To investigate differences in dynamic contrast-enhanced (DCE)-MRI perfusion parameters between patients with PFP and healthy control subjects. Population/Subjects/Phantom/Specimen

Phenotypic variability in two patients with tumor necrosis factor receptor associated periodic fever syndrome emphasizes a rare manifestation: Immunoglobulin A nephropathy

PubMedID: 31586650Tumor necrosis factor receptor associated periodic fever syndrome (TRAPS) is caused by heterozygote mutations in TNFRSF1A, characterized by recurrent inflammatory attacks. In this report, we described two patients with different heterozygote mutations in TNFRSF1A. Patient 1, a 15-year-old male, had suffered from recurrent fever attacks accompanied by abdominal pain, eye manifestations, and myalgia with increased acute phase reactants since the age of 6-month. He had been unsuccessfully treated with colchicine for having familial Mediterranean fever without an identifiable MEFV mutation since the age of 4-year. At the age of 15 years, he was diagnosed with immunoglobulin (Ig) A nephropathy due to massive proteinuria and renal biopsy findings. Next generation sequencing revealed NM_001065.3: c.236C>T; p. (Thr79Met); T50M heterozygote mutation in TNFRFS1A. He was treated with methylprednisolone and cyclosporine for IgA nephropathy, thereafter with canakinumab for TRAPS. Patient 2, a 17-year-old female, had recurrent arthritis attacks accompanied by increased acute phase reactants for the last two months. She had neither fever attacks nor rashes or myalgia. Her physical examination was normal between attacks. Magnetic resonance imaging of both knees and ankles showed no signs of chronic arthritis. MEFV analyzes showed no mutation. Next generation sequencing revealed NM_001065.3: c.362G>A; p.(Arg121Gln); R92Q heterozygote mutation in TNFRFS1A. Arthritis attacks were treated successfully with ibuprofen thereafter. In conclusion, we wish to emphasize the diversity of the clinical manifestations between these two patients with distinct sequence variants in TNFRSF1A. Moreover, we presented a rare manifestation of TRAPS, IgA nephropathy. © 201

Juvenile systemic lupus erythematosus: a single-center experience from southern Turkey

PubMedID: 30648229Objectives: This study was conducted to analyze clinical characteristics, laboratory data, disease activity, and outcome of juvenile systemic lupus erythematosus (jSLE) patients from southern Turkey. Methods: Fifty-three patients with jSLE diagnosed according to the revised American College of Rheumatology 1997 criteria between January 2005 and June 2018 were included in the present study. Results: The median age at the diagnosis was 12.8 (range, 5.1–17.7) years. The female to male ratio was 9.6:1. The most prevalent clinical features were mucocutaneous involvement (96.2%) and constitutional manifestations (94.3%). Renal manifestations, hematological manifestations, and neuropsychiatric involvement were detected in 40 (75%), in 38 (71.7%), and in 13 (24.5%) patients, respectively. Renal biopsy was performed to 49 patients (92.5%). Class IV lupus nephritis (LN) (34%) and class II LN (20.4%) were the most common findings. Mycophenolate mofetil, cyclophosphamide with corticosteroid were the main treatment options. Eighteen patients received rituximab and one tocilizumab. The mean SLE Disease Activity Index (SLEDAI) score at the time of diagnosis was 22.47 ± 8.8 (range = 3–49), and 1.34 ± 1.85 (range = 0–7) at last visit. Twenty-one patients (39.6%) had damage in agreement with Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (PedSDI; mean = 0.60 ± 0.94; range = 0–5) criteria. Growth failure was the most prevalent cause of damage (n = 13, 26%). One patient deceased due to severe pulmonary hemorrhage and multiple cerebral thromboses. Conclusion: jSLE patients in this cohort have severe disease in view of the higher frequency of renal and neurologic involvement. Nevertheless, multicenter studies are needed to make a conclusion for all Turkish children with jSLE. © 2019, International League of Associations for Rheumatology (ILAR)

Clinical manifestations and outcomes of 420 children with Henoch Schönlein Purpura from a single referral center from Turkey: A three-year experience

PubMedID: 31662011Objectives: Henoch Schönlein Purpura (HSP) is the most common systemic vasculitis in childhood. We aimed to evaluate the clinical features, seasonal variation, treatment outcomes and the possible predicting factors related to outcome among a large cohort of pediatric HSP patients. Methods: We conducted a medical record review study between July 2016 and January 2019 and evaluated the clinical manifestations and potential risk factors for severe gastrointestinal (GI) involvement, biopsy-proven nephritis and relapses. Results: The study included 420 HSP patients, of which the mean age at diagnosis was 7.68 ± 3.15 years. Clinical manifestations were arthralgia and/or arthritis (n = 244, 58.1%), abdominal pain (n = 235, 56%), subcutaneous edema (n = 163, 38.8%), and renal involvement (n = 125, 29.8%). Disease recurred for at least once, in 69 (16.4%) patients and colchicine treatment yielded a favorable response in 11 of 12 relapsing patients, who did not respond to ibuprofen or steroids. Frequencies of renal involvement and biopsy-proven nephritis were higher in patients with severe GI involvement. Besides, patients with biopsy-proven nephritis had higher rates of abdominal pain, intussusception, severe GI involvement, and systemic steroid administration. Conclusion: We speculate that renal involvement, biopsy-proven nephritis and severe GI involvement can be related to each other. Colchicine may be effective in patients with relapsing disease. © 2019, © 2019 Japan College of Rheumatology

Yield and Chemical Composition of Brussels Sprout (Brassica oleracea L. gemmifera) as Affected by Boron Management

Boron (B) deficiency is widespread in the Anatolia region of Turkey. This could impact production and quality of Brussels sprout (Brassica oleracea L gemmifera). A 2-year field experiment was conducted to study yield and quality response of four cultivars (Star, Brilliant, Oliver, and Maximus) to B addition (0, 1, 3, and 9 kg.ha(-1) B). The optimum economic B rate (OEBR) ranged from 5.5 to 6.3 kg.ha(-1) B resulting in soil B levels of 0.94 to 1.13 mg.kg(-1). Independent of cultivar, B application decreased tissue nitrogen, calcium, and magnesium but increased tissue phosphorus, potassium, iron, manganese, zinc, and copper content. We conclude a B addition of 6 kg.ha(-1) is sufficient to elevate soil B levels to nondeficient levels. Similar studies with different soils and initial soil test B levels are needed to conclude if these critical soil test values anti OEBR can be applied across the region

Foliar Applications of Humic Substances Together with Fe/Nano Fe to Increase the Iron Content and Growth Parameters of Spinach (<i>Spinacia oleracea</i> L.)

Iron deficiency, which severely decreases the plant yield and quality, is one of the major problems of calcareous soils. Foliar applications of humic substances and/or Fe fertilizers are environmentally friendly methods to cope with Fe deficiency. The aim of this study was to investigate the combined effect of Fe/nano Fe and humic/fulvic acid-based biostimulant foliar applications on the Fe content and plant growth parameters of spinach. Treatment solutions were prepared either by mixing a common Fe fertilizer, FeSO4·7H2O, with different commercial biostimulants (Fulvic-based: Fulvagra®, Fulvagra®WSG; Humic-based: HS300®, Humin Fe® and Liqhumus®, Grevenbroich, Germany) or by mixing nano ferrihydrite with different ratios of fulvic substance (FA-50, FA-75, and FA-100) and humic acid (Nano Iron). Growth parameters (plant fresh and dry weights, plant dry matter, root fresh and dry weights, root dry matter, leaf number per plant, and leaf area); chlorophyll reading value (SPAD); chlorophyll (a,b, and total) and carotenoid contents; and leaf and root mineral contents (N, P, K, Ca, Mg, S, Cu, Mn, Zn, B, active Fe, and total Fe) of samples were determined. Our results showed that foliar application of biostimulants together with Fe sources improved the nutrient uptake, chlorophyll contents, growth characteristics, and yield; however, not all humic substances had the same effect. When all parameters were considered, Fulvagra treatment—which contained 17% fulvic acid and microorganisms in its content together with 20 mM FeSO4·7H2O—was the most effective application, followed by FA100 treatment containing fulvic acid and 20 mM nano ferrihydrite. This finding indicates that fulvic acid containing biostimulants is more effective in foliar applications than humic-based biostimulants against Fe deficiency due to their low molecular weight which enables better penetration into the leaves. In conclusion, foliar applications of fulvic substances together with Fe fertilizers can be used to increase the Fe uptake of crops and the yields under Fe-deficient conditions