The aim of this study was to determine whether the levels of serum cytokines IL-6 and TNFalpha and of the soluble receptors p55 srTNFalpha, p75 srTNFalpha and srIL-2ac are valuable markers of disease activity in patients with systemic lupus erythematosus (SLE) compared with the established parameters of anti-dsDNA, C3, C4 and CH50. Forty patients with SLE, 19 ambulatory and 21 hospitalised, were included in this study. On the day of blood sampling a clinical examination was performed and SLEDAI and ECLAM disease activity scores were used to assess disease activity. Nineteen patients had inactive disease and 21 patients had active disease. Thirteen patients from the second group developed nephritis. In these patients the blood sampling and disease activity assessment were performed twice (at presentation and 6 months after treatment). Serum levels of cytokines and soluble receptors were measured by ELISA. Serum levels of cytokines and soluble receptors of patients with active disease were significantly higher than in patients with inactive disease (IL-6 p = 0.0004, TNFalpha p = 0.0015, srIL-2c p<0.0001, p55 srTNFalpha p<0.0001, p75 srTNFalpha p<0.0001). Serum soluble receptor levels of patients with inactive disease were higher than those of healthy controls (p55 srTNFalpha p<0.0001, p75 srTNFalpha p = 0.0002, srIL-2alpha p = 0.0012). No significant difference was found for TNFalpha and IL-6 (TNFalpha p=0.015, IL-6 p=0.019). Serum TNFalpha levels and especially srIL-2alpha, p55 srTNFalpha( and p75 srTNFalpha levels correlated strongly with SLEDAI and ECLAM disease activity scores, anti-dsDNA, C3, C4 and CH50 (p<0.0001). Serum soluble receptor (srIL-2alphac, p55 srTNFa, p75 srTNFalpha) levels were higher in patients with nephritis before treatment and decreased significantly 6 months after treatment (p=0.005). The same trend was noticed with SLEDAI and ECLAM disease activity scores (p = 0.005) and anti-dsDNA (p = 0.008). In contrast, no significant differences were observed for C3 and C4 levels before and after treatment, which suggests that soluble receptors of cytokines are more sensitive markers of disease activity than C3 or C4 in predicting improvement. Serum levels of srIL-2alpha, p55 srTNFalpha and p75 srTNFalpha could provide useful information about disease activity in SLE patients, especially in cases where the other markers do not.

These findings suggest that rheumatic diseases constitute a major public health problem and should be considered in planning undergraduate and postgraduate medical education, research and health-care services.

Background: Accumulating evidence suggests that synthetic retinoids may be capable of affecting the differentiation and growth of nervous tissue in vivo and in vitro. On the other hand, adverse reactions concomitant with brainstem involvement definitely or probably related to oral retinoid therapy have been reported in a small number of patients. Objective: The purpose of the present study was to substantiate the possible effects of oral isotretinoin on the synaptic activity and propagation of action potentials along the nerve fibers. Methods: The auditory brainstem response of 33 patients with severe nodulocystic acne before and 3 weeks after the onset of oral isotretinoin administration was investigated using auditory evoked potentials. Results: The paired analysis of the response variables before and after treatment failed to reveal any statistically significant differences. However, a marked increase in latencies and interpeak latencies and a decrease in amplitudes for both ears were found in 3 patients after therapy. Conclusions: It seems reasonable to suggest that these subclinical changes may be due to an isotretinoin-induced synaptic malfunction or to a conduction defect in the auditory nerve fibers.

OBJEcTIVE: In this cross-sectional epidemiologic study we examined the association between type 2 diabetes mellitus and demographic, clinical, and socioeconomic parameters in large rural, urban and suburban populations of adult Greeks. DEsIGN: Of the total target adult population (≥19 years, n=14233) in nine selected geographical regions covering rural, suburban, and urban areas of Greece, 10,647 subjects were included in the study. Data were collected by physicians who interviewed subjects at their homes between 1996 and 1999. rEsULTs: A total of 8740 subjects participated (response rate 82.1%). Among participants there were 360 subjects with type 2 diabetes. Multivariate logistic regression analysis after adjustment for factors associated with type 2 DM in univariate analyses including occupation, education level, place of residence, and number of persons living together demonstrated that advancing age, obesity-but not overweight status-and smoking in the past were associated with higher odds of type 2 diabetes. Moreover, low socioeconomic status was associated with type 2 diabetes independently of the effects of age, obesity, and smoking. cONcLUsIONs: In large representative rural, urban, and suburban populations of adult Greeks, type 2 Diabetes was associated with advancing age, obesity, exposure to smoke, and low socioeconomic status.

This paper describes a wavelet-transform-based system for the V wave identification in brainstem auditory evoked potentials (BAEP). The system combines signal denoising and rule-based localization modules. The signal denoising module has the potential of effective noise reduction after signal averaging. It analyses adaptively the evolution of the wavelet transform maxima across scales. The singularities of the signal create wavelet maxima with different properties from those of the induced noise. A non-linear filtering process implemented with a neural network extracts out the noise-induced maxima. The filtered wavelet details are subsequently analysed by the rule-based localization module for the automatic identification of the V wave. In the first phase, it implements a set of statistical observations as well as heuristic criteria used by human experts in order to classify the IV–V complex. At the second phase, using a multiscale focusing algorithm, the IV and V waves are positioned on the BAEP signal. Our experiments revealed that the system provides accurate results even for signals exhibiting unclear IV–V complexes.