Intravitreal Bevacizumab Followed by Ranibizumab for Neovascular Age Related Macular Degeneratıon

Purpose: To compare the outcomes after switching from intravitreal bevacizumab (IVB) to intravitreal ranibizumab (IVR) in patients with neovascular age related macular degeneration (ARMD). Material and Methods: A retrospective review of patients with neovascular ARMD, who were switched from treatment with Pro Re Nata (PRN) IVB to PRN IVR, was conducted in a university clinic. IVB (1.25 mg/0.05 ml) and IVR (0.5 mg/0.05 ml) were used. Retreatment criteria were defined based on an activity scoring (AS) system developed in our clinic. An AS was calculated for each lesion at each visit. AS results and the number of injections before and after switching treatment to IVR were compared. Results: 32 eyes of 31 patients with neovascular ARMD were included in the study. The mean follow-up period was 12.3±4.7 months. The mean duration of IVB treatment was 8.1±3.1 months followed by 4.2±1.6 months with IVR. At the beginning of the study the mean AS was 8.9, (Visual Acuity) VA : 0.99 logMAR, and Central Foveal Thickness (CFT): 312.7±81.1μ. A month after the last IVB injection, AS became 5.1, VA: 0.69 logMAR, and CFT: 210.4±80.4μ (p<0.05). Likewise, a month after the last IVR injection, AS, VA and CFT were 5.8, 0.78 logMAR, and 199.9±60.9μ, respectively. Comparison of post-injection results of IVB and IVR treatments did not reveal a statistically significant difference. Mean injection rates per patient while receiving IVB and IVR treatments were 0.46/month and 0.44/ month, respectively (p>0.05). Conclusions: This study shows that the improvement in AS, CFT, and VA, achieved with the PRN IVB treatment, seems to be maintained after switching to IVR

Early postpartum lactation effects of cesarean and vaginal birth

Objectives: Breastfeeding has positive effects for both, the mother and the infant. The purpose of the study was to ex­amine how cesarean delivery and vaginal delivery influenced subsequent breastfeeding. The study was conducted at the Kırıkkale University Medical School. Material and methods: Breastfeeding outcomes after an elective cesarean delivery and after a planned vaginal delivery were compared. The study included 169 consenting mothers who gave birth to healthy infants (86 cesarean deliveries and 83 vaginal deliveries) between March and September 2001. All cesarean deliveries were performed under regional anesthesia. Results: Elective cesarean delivery was performed at a significantly earlier gestational age as compared to vaginal delivery (p = 0.001). Maternal age in the planned vaginal delivery group was significantly lower (p = 0.003). As for the change in prolactin levels, the results were similar but not statistically significant (p = 0.21). The frequency of breastfeeding per day did not differ significantly between the groups (p = 0.20). However, women after cesarean delivery tended to breastfeed more often than after vaginal delivery (p = 0.003). Mean number of points recorded at the first breastfeeding session, according to the LATCH charting system, was lower in the group after cesarean delivery as compared to vaginal labor. The difference between the average point scores of vaginal delivery and cesarean delivery mothers was found to be meaningful in favor of the women after vaginal delivery (p = 0.05). Conclusions: Elective cesarean section has negative effects on breastfeeding. Our results indicate that cesarean section constitutes a risk factor for delayed lactogenesis

Mean platelet volume in brucellosis: correlation between brucella standard serum agglutination test results, platelet count, and C-reactive protein.

Background: Brucellosis, a zoonotic infection, was most widely diagnosed by the Brucella standard serum agglutination test (SAT). No previous publication has demonstrated a correlation between the degree of Brucella SAT agglutination positivity and the severity of brucellosis infection.Objective: To contribute to the clarification of the relationship between patelets and brucellosis. It is also aimed at evaluating the usefulness of the SAT titer as a measure of brucellosis severity.Material and Methods: We compared the control (n=60) and patients (n=96) groups in terms of mean platelet volume (MPV), C-reactive protein (CRP) and platelet values. Patients were grouped according to their degree of agglutination positivity titers and compared by means of CRP, MPV and platelet values. We also investigated the relationship among logarithmic values of MPV, platelet and CRP parameters for each group.Results: Although statistically meaningful difference was observed between control and patients group in terms of MPV and platelet value, there were no statistically significant differences observed among patients groups. The physiological negative correlation between MPV and platelet count was not encountered in group 2 and 3. Logarithmic values of CRP were not correlated with logarithmic values of MPV and platelet counts.Conclusion: The MPV could be a new parameter to evaluate hematologic abnormalities in patients with brucellosis. The SAT titer was not a useful measure for evaluation of the severity of brucellosis.Keywords: Brucella, CRP, platelet count, mean platelet volume, agglutinatio

Early postzygotic mutations contribute to de novo variation in a healthy monozygotic twin pair

Cataloged from PDF version of article.Background: Human de novo single-nucleotide variation (SNV) rate is estimated to range between 0.82-1.70×10-8 mutations per base per generation. However, contribution of early postzygotic mutations to the overall human de novo SNV rate is unknown. Methods: We performed deep whole-genome sequencing (more than 30-fold coverage per individual) of the whole-blood-derived DNA samples of a healthy monozygotic twin pair and their parents. We examined the genotypes of each individual simultaneously for each of the SNVs and discovered de novo SNVs regarding the timing of mutagenesis. Putative de novo SNVs were validated using Sanger-based capillary sequencing. Results: We conservatively characterised 23 de novo SNVs shared by the twin pair, 8 de novo SNVs specific to twin I and 1 de novo SNV specific to twin II. Based on the number of de novo SNVs validated by Sanger sequencing and the number of callable bases of each twin, we calculated the overall de novo SNV rate of 1.31×10-8 and 1.01×10-8 for twin I and twin II, respectively. Of these, rates of the early postzygotic de novo SNVs were estimated to be 0.34×10-8 for twin I and 0.04×10-8 for twin II. Conclusions: Early postzygotic mutations constitute a substantial proportion of de novo mutations in humans. Therefore, genome mosaicism resulting from early mitotic events during embryogenesis is common and could substantially contribute to the development of diseases

Selective expression of a VHIV subfamily of immunoglobulin genes in human CD5+ B lymphocytes from cord blood.

Human B lymphocytes expressing the CD5 surface antigen (CD5+ B cells) constitute a subset capable of producing polyspecific antibodies recognizing a variety of self antigens. The repertoire of antibodies produced by CD5+ and CD5- B cells is different. However, it is not yet established whether this distribution is reflected in different immunoglobulin variable region gene (IgV) use. Rearrangement of heavy chain IgV (IgVH) genes represents one of the first identifiable stages in the maturation of B cells, and occurs in a developmentally ordered fashion. The repertoire of IgVH gene expression is highly restricted during fetal life but diversifies progressively after birth. A high frequency of VH gene use from the relatively small VHIV gene family has previously been demonstrated in human fetal liver B cells. In the present study, 102 B cell lines established by Epstein-Barr Virus-transformation of separated CD5+ and CD5- cord blood B cells, were examined for the frequency of IgV expression using monoclonal antibodies to cross-reactive idiotypes (CRI). The results demonstrate a relatively high frequency of VHIV gene use (30%) in B cells from cord blood. Furthermore, two mutually exclusive CRI associated with distinct subgroups of the VHIV family are segregated in their association with either subset of B cells. One CRI is exclusively expressed in lines established from CD5+ B cells while the other is associated with lines established from CD5- B cells