Correlation of cumulative corticosteroid treatment with magnetic resonance imaging assessment of avascular femoral head necrosis in patients with multiple sclerosis

Increased risk of osteoporosis, fractures, and avascular necrosis (AVN) has been suggested in multiple sclerosis (MS). Patients with MS are often exposed to corticosteroid treatment (CST) during the disease course and conflicting reports exist regarding complications of CST. Our study aims to investigate the association between cumulative doses of CST and radiographic evaluation of AVN of the femoral head in MS. Twenty-six MS patients (mean age, 38.4±10 yr) were enrolled and prospectively evaluated for AVN by magnetic resonance imaging (MRI). The mean disease duration was 11.5±8.5 years and mean expanded disability status scale (EDSS) score was 3±2. The cumulative dosage of CST varied between 20 g and 60 g; patients were grouped into two categories: 1) CST between 20-40 g, 17 (65%) patients; 2) CST ≥40 g; 9 (35%) patients. The relationship between cumulative CST dosage and MRI diagnosis of AVN was stat­istically insignificant (P>0.9). Clarification of the cumulative effect of CST in the development of AVN is of great importance for future long-term steroid treatment strategies

Infection and genotype relationship in multiple sclerosis: Do Chlamydophila pneumoniae and human herpes virus-6 infections together with APO E alleles have a role in the etiopathogenesis of multiple sclerosis?

Despite numerous studies in many laboratories over several years, the etiology of Multiple Sclerosis (MS) is still unknown. It was suggested that some infectious agents play a role in the etiology of MS. This study included 39 patients with MS, 10 patients with other neurological disorders (OND) and a control group of 42 healthy people. There was no significant difference between MS, OND and HC groups for Chlamydophila pneumoniae based on having past infection positivity (p > 0.05). Chronic C. pneumonia infection was detected in 8 cases with MS and 3 cases in the healthy control group, and no chronic chlamydia infection was detected in patients with OND. No significant difference was found among the three groups. Antibody titres at 1/50 and higher IgG were detected in 34(87.2%), 8(80%) and 30(71.4%) of the patients with MS, OND and the healthy control group, respectively. There was no statistically significiant difference among these groups. No C. pneumoniae and HHV-6 DNA was detected in CSF samples from the patients with MS and OND. There was no significant difference for the distribution of all APO E alleles for MS and healthy control groups. Moreover, no significant difference was found in the distribution of all APO E alleles for patients who had antibody titres for past infection with C. pneumonia and HHV-6 between MS and control group. In conclusion, our data suggested that there was no contribution from the association of the C. pneumoniea and HHV-6 infections to the etiopathogenesis of the MS and our results are in concurrance with two important meta-analysis studies reported in 2006, but large scale, prospective new trials are needed to clarify this subject as proposed in meta-analysis considirations

Prevalence of Multiple Sclerosis in the Metropolitan Area of Edirne City, Turkey

Objective: The prevalence and incidence of multiple sclerosis may vary according to the influence of the altitude of a geographical area as well as the genetic and environmental factors. This study ained to determine the incidence and prevalence of multiple sclerosis in Edirne population