This trial illustrates that photosensitization of riboflavin using UVA at 365 nm has the potential to induce healing in patients with microbial keratitis. The results from the treatment of these 16 patients with corneal ulcers indicate that UVA-riboflavin photochemical therapy merits a controlled study in order to assess its efficacy and safety compared to antibiotics.

During a period of three years in Goteborg, Sweden, 126 cases of giant cell arteritis (GCA) were diagnosed. Histologic evidence of arteritis was found on temporal artery biopsy in 74 (59%). The total annual incidence of GCA was calculated to be 9.3 per 100,OOO inhabitants. In the age group over 50, incidence was 28.6 per 100, OOO. For histologically proven GCA, the incidence was 5.5 per 100,OOO of the total population. The corresponding figure in the age group over 50 was 16.8 per 100,OOO. Twenty-six patients (21%) had a clinical presentation of temporal arteritis, and 23 (18%) had a combined picture of temporal arteritis and polymyalgia rheumatica (PMR). Sixty-seven (53%) had the PMR syndrome without any temporal symptoms, and 10 patients (8%) had a "silent" presentation with only general symptoms. The PMR syndrome was more common among women with GCA (79%) than among men (56%).The group of patients without muscular symptoms contained an equal number of men and women. Eye complications were seen in 15 patients (12%). In 6, the ocular symptoms were transient, while 9 suffered from permanent loss of vision. In 3 of these patients, temporal artery biopsy revealed no evidence of arteritis, and 5 had no clinical signs of localized temporal arteritis.There is growing recognition that giant cell arteritis (GCA) is not a rare disease among elderly people.

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BackgroundPrevious studies indicate that successful resolution of Lyme neuroborreliosis (NB) is associated with a strong T helper (Th) 1-type cytokine response in the cerebrospinal fluid (CSF) followed by a down-regulating Th2 response, whereas the role of the recently discovered Th17 cytokine response is unknown.MethodsTo investigate the relative contribution of different Th associated cytokine/chemokine responses, we used a multiple bead array to measure the levels of CXCL10 (Th1 marker), CCL22 (Th2 marker), IL-17 (Th17 marker) and CXCL8 (general inflammation marker), in serum and in CSF from untreated patients with confirmed NB (n = 133), and non-NB patients (n = 96), and related the findings to clinical data. Samples from patients with possible early NB (n = 15) and possible late NB (n = 19) were also analysed, as well as samples from an additional control group with orthopaedic patients (n = 17), where CSF was obtained at spinal anaesthesia.ResultsThe most prominent differences across groups were found in the CSF. IL-17 was elevated in CSF in 49% of the patients with confirmed NB, but was not detectable in the other groups. Patients with confirmed NB and possible early NB had significantly higher CSF levels of CXCL10, CCL22 and CXCL8 compared to both the non-NB group and the control group (p < 0.0001 for all comparisons). Patients in the early NB group, showing a short duration of symptoms, had lower CCL22 levels in CSF than did the confirmed NB group (p < 0.0001). Furthermore, patients within the confirmed NB group showing a duration of symptoms <2 weeks, tended to have lower CCL22 levels in CSF than did those with longer symptom duration (p = 0.023). Cytokine/chemokine levels were not correlated with clinical parameters or to levels of anti-Borrelia-antibodies.ConclusionOur results support the notion that early NB is dominated by a Th1-type response, eventually accompanied by a Th2 response. Interestingly, IL-17 was increased exclusively in CSF from patients with confirmed NB, suggesting a hitherto unknown role for Th17 in NB. However, for conclusive evidence, future prospective studies are needed.