OBJECTIVE: To identify possible differences between ALS patients with symptom onset 70 years and older compared to those younger.
BACKGROUND: It is well recognized that older ALS patients have worse prognosis; some have found bulbar onset patients to be older. Whether patients differ regarding other clinical features or treatment choices based upon age has not been extensively studied.
DESIGN/METHODS: Retrospective chart review of ALS patients seen between January 2001 and March 2014.
RESULTS: In our 440 patients, 80 were 70 years or older at time of symptom onset (oALS) and 360 were younger than 70 (yALS). Median survival for oALS was 31 months and for yALS 36 months (p=.0022). There was no difference between the 2 groups regarding gender, onset site, diagnostic delay, or El Escorial classification. At first visit, there was no difference in BMI classification, ALS-FRS-R score, or vital capacity. A history of heart disease was more likely in oALS (22/80 oALS and 41/360 yALS, p=0.000198) as was hypertension (47/80 oALS and 154/360 yALS, p=0.00948); there was no difference in the frequency of cancer, diabetes mellitus, or pulmonary disease. Riluzole use was less common in oALS (25/80) compared to yALS (168/360), p=0.0120. There was not a significant difference in NIV use between the 2 groups. In those in whom a feeding tube was suggested, it was obtained in 40/48 of oALS patients and in 167/239 yALS, p=0.0577.
CONCLUSIONS: As expected, patients 70 years and older had shorter survival compared to those under 70. With the exception of less riluzole use, clinical features frequently associated with worse prognosis were not overrepresented in older patients, although they were more likely to have heart disease and hypertension compared to their younger counterparts.
Study Supported by: Kathryn and J Thomas May ALS Fund Disclosure: Dr. Rudnicki has nothing to disclose. Dr. Al-Lahham has nothing to disclose. Dr. Gundogdu has nothing to disclose. Dr. Limaye has nothing to disclose. Dr. Mahuwala has nothing to disclose. Dr. Williams has nothing to disclose.
Reactive oxygen species (ROS), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) have been shown in the pathogenesis of acrylamide neurotoxicity. Hippophae rhamnoides L. extract (HRE) has a cytoprotective effect by stabilizing the production of ROS, IL-1β and TNF-α. The objective of the article was to investigate the effect of HRE on acrylamide-induced brain damage in rats biochemically and histopathologically.To the HRE+acrylamide only (ACR) group (n=6) of the animals, HRE was administered orally at a dose of 50 mg / kg into the stomach by gavage. The same volume of solvent (olive oil) was administered orally to the ACR (n=6) and healthy (HG) (n=6) groups. One hour after HRE administration, acrylamide was given orally at a dose of 20 mg/kg to HRE+ACR and ACR groups in the same way. This procedure was repeated once a day for 30 days. At the end of this period, brain tissues extracted from animals killed with 50 mg/kg thiopental anesthesia were examined biochemically and histopathologically.It has been shown that HRE prevents the increase of malondialdehyde (MDA), myeloperoxidase (MPO), IL-1β and TNF-α with acrylamide and the decrease of total glutathione (tGSH) and glutathione reductase (GSHRd) levels in brain tissue.HRE may be useful in the treatment of acrylamide-induced neurotoxicity.
Background.Cyclophosphamide is a drug used in various types of cancer.It can cause oxidative and inflammatory ovarian damage and infertility.Thiamine pyrophosphate (TPP) to be investigated for its effect on cyclophosphamide-induced ovarian damage and reproductive dysfunction in the present study is the active metabolite of thiamine.It has been shown that TPP protects organs and tissues from oxidative stress and proinflammatory cytokine damage. Objectives.To investigate the effect of TPP against the ovarian damage and reproductive dysfunction caused by cyclophosphamide in rats. Materials and methods.Albino Wistar type female rats were divided into healthy control (HG), cyclophosphamide (CYC) and TPP + cyclophosphamide (TPPC) groups (for each group, n = 12).Thiamine pyrophosphate at a dose of 25 mg/kg was injected intraperitoneally (ip.) in the TPPC group, and 0.9% NaCI solution was injected ip. in the CYC and HG groups.One hour after the injection, 75 mg/kg of cyclophosphamide was administered ip. in the TPPC and CYC groups.This procedure was repeated once a day for 30 days.At the end of this period, 6 rats from each group were euthanized with a high dose of anesthetic (50 mg/kg of sodium thiopental).Biochemical and histopathological examinations were performed on the extracted ovarian tissue.The remaining animals were kept in the laboratory with mature male rats for 2 months for reproduction.Results.Thiamine pyrophosphate significantly decreased the cyclophosphamide-induced increase in the levels of the oxidant parameter malondialdehyde (MDA), proinflammatory nuclear factor kappa B (NF-κB), tumor necrosis factor alpha (TNF-α), and interleukin 1 beta (IL-1β).In addition, TPP decreased the severe histopathological damage associated with cyclophosphamide in the ovarian tissue and prevented infertility. Conclusions.Our experimental results have suggested that TPP could be beneficial in the treatment of cyclophosphamide-induced ovarian injury and infertility.
Hemangiopericytomas are rare hypervascular tumors arising from Zimmerman's pericytes. They usually occur in the soft tissue, and intraosseous lesions are very rare. Surgical excision is the first choice for treatment. Many studies show that patients should be monitored for some time following treatment because of a high rate of recurrence and metastasis after radical resection. This report introduces a 56-year-old patient with a hemangiopericytoma in his parietal bone.Parietal bone, Hemangiopericytoma.Hemanjioperisitomalar, Zimmermann perisitlerden köken alan nadir hipervasküler tümörlerdir. Sıklıkla uyluktaki yumuşak dokularda ve retroperitoneumda rastlanır. İntraosseöz lokalizasyon oldukça nadir-dir. İlk tedavi seçeneği cerrahi eksizyondur. Birçok çalışma geç rekürrens ve metastaz açısından hastaların radikal rezeksiyondan sonra uzun dönem takiplerinin gerkliliğini ortaya çıkarmıştır. Biz burada 56 yaşında erkek hastada parietal kemikte lokalize hemanjioperistom olgusunu sunuyoruz.
Pseudoankylosis of temporomandibular joint (TMJ) is characterized by limited mouth opening and impaired mandibular mobility induced by pathologic factors outside the joint itself, usually leading to compromised speech, swallowing, and breath functions. Multiple surgical approaches or reconstructive procedures have been proposed to resolve the joint pseudoankylosis and restore the mandibular movement for these affected patients. Free forearm flap has been widely used in reconstruction for various congenital or acquired defects or deformities; however, this flap has been rarely employed for TMJ pseudoankylosis in the literature. Here, the authors reported that noma-induced TMJ pseudoankylosis was diagnosed and successfully treated by extended free forearm flap with length over 10 cm in a Chinese female patient.
Background and Design: Bullous pemphigoid is a rare autoimmune blistering disease.The aim of this study was to investigate the epidemiological characteristics and clinical, laboratory, and radiological features of patients with bullous pemphigoid in Erzurum and to evaluate the association of bullous pemphigoid with comorbid diseases.Methods and Methods: Medical records of 38 patients, who were diagnosed with bullous pemphigoid after biopsy and hospitalized in our clinic between 2003 and 2013, were retrospectively studied.Results: Fifteen (39.5%) of the 38 patients were male, and 23 (60.5%) were female.The mean age at the time of diagnosis was 62.4±21 years.Analyses of the results of direct immunofluorescence showed that the most common finding was the presence of IgG and C3 (42.1%).The average time since the first presentation until diagnosis was 72.7±104.3days.The mean initial dose of corticosteroid was 54.7±26.01mg/ day.The mean length of hospitalization for bullous pemphigoid was 22.6±23.5 days.We did not detect any malignancy or comorbid diseases associated with bullous pemphigoid.However, eosinophilia was detected.Conclusions: Routine laboratory and radiological investigations are not necessary to detect malignancy in patients with bullous pemphigoid.(Turkderm 2015; 49: 66-9)
