Relationship Between Serum Adenosine Deaminase Levels and Liver Histology in Autoimmune Hepatitis

AIM To evaluate the relationship between serum adenosine deaminase (ADA) levels and histological features in patients with autoimmune hepatitis (AIH). METHODS A total of 80 subjects (52 AIH cases and 28 healthy controls) were included in the study. Patients were diagnosed according to the simplified criteria suggested by the International Autoimmune Hepatitis Group. All of the cases had been diagnosed with AIH between 2010-2015 at Hacettepe University, Department of Gastroenterology. Serum blood samples were collected and stored at -80 °C until the biochemical estimation of ADA activity. The diagnosis of patients was confirmed by liver biopsy. Serum ADA > 20 U/L was considered to be high level. RESULTS Mean serum ADA levels were significantly higher in AIH patients than those in healthy controls (25.4 ± 9.6 U/L vs 12.8 ± 2.2 U/L, P 20 U/L were found in 63.5% AIH patients and in 0% healthy controls (P < 0.001). Mean serum ADA levels were significantly increased in each stage of histological activity: 15.2 ± 3.5 U/L for patients with mild interface hepatitis, 23.1 ± 10.0 U/L for patients with moderate interface hepatitis and 30.9 ± 7.0 U/L for patients with severe interface hepatitis (P < 0.001). Correlation analysis showed that there was a positive association between serum ADA levels and histological activity (r = 0.71, P < 0.001). Receiver operating characteristic analysis suggested that 24.5 U/L was the optimum cut-off point of ADA level for severe interface hepatitis (sensitivity 88%, specificity 85.2%, area under the curve: 0.88). CONCLUSION Because of the positive correlation with inflammatory activity, serum ADA level may be a potential biomarker for predicting or monitoring histological activity in patients with AIH.PubMedWoSScopu

Abnormal Retinal Microvasculature Found In Active Rheumatoid Arthritis: A Different Perspective Of Microvascular Health

Background/aim: We aimed to assess the association between retinal vascular caliber (RVC) scores and disease activity in rheumatoid arthritis (RA) patients. Materials and methods: Forty-seven RA patients, 32 systemic lupus erythematosus (SLE) patients, and 45 healthy people were enrolled. RA and SLE patients were subdivided into groups according to C- reactive protein (CRP) levels. RA patients were also grouped according to Disease Activity Score-28 (DAS-28). Fundus photography was performed for all patients. RVC was summarized as the central retinal artery and vein equivalents (CRAE and CRVE). Results: Mean CRVE for RA patients was 213.3 +/- 17.8 mu m compared with 209.2 +/- 14.1 mu m for SLE and 217.5 +/- 26.2 mu m for the control group (P = 0.17). RVC scores did not differ between the CRP-high and CRP-low groups. As the RA disease activity increased, the widening of CRVE became more prominent and statistically significant. When the DAS-28 > 5.1 (CRVE, 220.4 (211.8-246.5) mu m) group and DAS-28 15 3.2 and DAS-28 <= 3.2 groups (P= 0.05). Conclusion: CRVE, which reflects systemic inflammation and possibly increased cardiovascular risk, was significantly increased in active RA patients. The association between retinal venular widening and disease activity, regardless of CRP, may be a sign that RA-related inflammation may have systemic vascular effects even with normal levels of CRP.WoSScopu

Occupational Stress and Risk Factors in Veterinary Surgeons

WOS: 000328083200007The aim of this study was to investigate occupational stress and risk factors among veterinary surgeons. The present cross-sectional study was performed in 2012 via a web-based survey. Data of 223 individuals who responded to the survey are presented. In order to evaluate the occupational stress Turkish Version of "Swedish Demand-Control-Support Questionnaire" was used. Mean age of participants was 37.45 +/- 9.11 and 28.3% of subjects were female. Work load, work control, skill, decision latitude, and social support mean points with standard deviations were found to be 9.42 +/- 1.86, 10.27 +/- 2.72, 7.06 +/- 1.78, 3.21 +/- 1.64 and 11.26 +/- 3.94, respectively. It was reported that 92 subjects were working for public institutions and 131 were working for private sector. Decision latitude and social support levels in surgeons working for public institutions were statistically significantly lower than their counterparts in the private sector. There was no statistically significant difference in work load, work control and skill use between two groups. Of participants 54.3% reported that they had car accidents, 19.3% reported that they had the accident in the last one year, and 9.9% reported that they had the accident during a patient visit. Majority of Turkish veterinary surgeons in our study group reported that they experienced occupational stress. Occupational stress and related factors in work environment can influence work health negatively by causing physical, mental and social problems

Certolizumab Pegol Treatment in Three Patients With Takayasu Arteritis

Although glucocorticoids are the mainstay of treatment in Takayasu arteritis (TA), anti-tumor necrosis factor agents are other treatment options in refractory disease. The onset of TA is generally observed in females of reproductive age. Certolizumab pegol (CZP) lacks a fragment crystallizable region and this gives advantage of minimal transfer through the placenta, which makes CZP a safer option in pregnancy. Although there are case reports and trials about use of infliximab, etanercept, and adalimumab in TA, there are scarce data about use of CZP. In this article, we present three TA cases treated with CZP. While two patients benefited from CZP, one patient was refractory to CZP