74 research outputs found
Aspects of Order and Chaos for the Cityscape
Rombos explores the qualities of experience, specifically within urban contexts, aiming to define those factors which affect through visual perception and human behavior. within his inquiry of the type of experience
The role of IL-15 in central nervous system disorders
IL-15 is a proinflammatory cytokine. It is produced by activated blood
monocytes, macrophages, dendritic cells, and activated glial cells. It
promotes T-cell proliferation, induction of cytolytic effector cells
including natural killer and cytotoxic cells and stimulates B-cell to
proliferate and secrete immunoglobulins. Little information is available
on the exact role of IL-15 in the neurological diseases. Microglial
cells are the main regulators of both innate and adaptive immune
responses in the central nervous system (CNS). IL-15 may be involved in
the inflammatory reactions and microglial activation of some common CNS
disorders such as multiple sclerosis, Alzheimer’s and Parkinson’s
disease, but its exact role in their pathogenesis is not clear
Hemothorax due to extramedullary erythropoietic masses
We describe a 27-year-old male patient suffering from beta-thalassemia
intermedia who presented with a nontraumatic spontaneous hemothorax due
to extramedullary hemopoietic foci. In reviewing the literature, four
similar reports were found. The details of this unusual entity are
discussed
Pseudoxanthoma elasticum lesions and cardiac complications as contributing factors for strokes in β-thalassemia patients
Background and Purpose: Pseudoxanthoma elasticum (PXE) lesions, which lead to intracranial hemorrhages and cardiac complications, predisposing to thrombotic strokes, are frequent findings in β-thalassemia. Nevertheless, the association of these lesions with strokes in thalassemic patients has not been previously discussed. Methods: Ten β-thalassemic patients who developed an intracranial hemorrhage or a thrombotic stroke were reviewed. Results: In the group of the four patients presenting with hemorrhage, one had PXE lesions, one had cardiac abnormalities, and one both PXE and cardiac disorders. In the group presenting with thrombotic stroke, all six patients had cardiac abnormalities and platelet count elevation due to splenectomy. Three also had PXE findings. No other predisposing factor for stroke was present. Conclusions: Cardiac complications and PXE may be risk factors for strokes in β-thalassemia. Their frequent coexistence leads to a therapeutic dilemma in patients requiring antithrombotic therapy
Opsoclonus-myoclonus-ataxia syndrome with autoantibodies to glutamic acid decarboxylase
Opsoclonus-myoclonus-ataxia syndrome (OMS) is a rare neurological disorder of probably autoimmune origin. Most cases are associated with a remote neoplasm or a viral infection; however in some instances no underlying aetiology can be demonstrated. We report the presence of anti-glutamic acid decarboxylase antibodies (anti-GAD Abs) in the serum and CSF of a patient with idiopathic OMS. Treatment with intravenous immunoglobulin led to a remarkable clinical improvement with parallel reduction of anti-GAD titers. Anti-GAD Abs have been associated with several neurological syndromes. They could also be responsible for the clinical triad of OMS, by impairing GABAergic transmission in specific brainstem and cerebellar circuits. We propose that testing for anti-GAD Abs should be performed in OMS, especially when no other aetiological association can be demonstrated. © 2008 Elsevier B.V. All rights reserved
Therapeutic plasma exchange combined with immunomodulating agents in secondary progressive multiple sclerosis patients
Multiple sclerosis (MS) is the most common cause of neurological disability. Therapeutic plasma exchange (TPE) has been used in the management of patients with MS with equivocal efficacy. With this work we would like to present our experience with 10 patients (seven male and three female, mean age 34 years [range 27-53 years]) with secondary progressive MS, who were treated with immunomodulating agents and who also underwent TPE. The patients' expanded disability status scale (EDSS) score of entry to the study varied from 5.0 to 6.5. One year before study entry all patients showed a marked deterioration (12 months before starting TPE they had been rated 4.5-5.5 on the EDSS). TPE was performed three times a week for two weeks and thereafter once a week, or once a month for the stable patients. The machine used was the Cobe Spectra and albumin 5% was the replacement fluid. Peripheral veins were used in nine patients and indwelling vascular access was required in one patient. Eighteen months later, patients stopped taking the immunomodulating agent therapy and continued only with TPE. No side-effects occurred during the TPE session. After 36 months of TPE therapy, five patients were stabilized in their disability, while two patients showed a minor progression of the disease (an additional 0.5 degree in disability as determined by the EDSS). No relapses occurred during TPE. Three patients stopped the therapy: one patient because of persistent nausea and two patients for reasons unrelated to TPE. Periodic TPE was associated with reduced accumulation of neurological deficits (as documented by EDSS) in patients with secondary progressive MS. © 2008 International Society for Apheresis
Serum levels of soluble intercellular adhesion molecule-1 (s-ICAM-1) and soluble endothelial leukocyte adhesion molecule-1(s-ELAM-1) in amyotrophic lateral sclerosis
Immunological disturbances have been implicated in the pathogenesis of
amyotrophic lateral sclerosis (ALS). Adhesion molecules are markers of
activated endothelial cells up-regulated by action of cytokines. To
investigate the activation or inactivation of the vascular cells in ALS,
serum soluble intercellular adhesion molecule-1 (s-ICAM-1) and soluble
E-selectin (s-ELAM-1) were evaluated ( ELISA) in 16 patients with ALS,
30 patients with non-inflammatory neurological diseases (NINDS) and 15
healthy control subjects. Patients with ALS had no higher s-ICAM-1
levels compared with the NINDS patients and the control subjects (p<0.31
and p<0.21, respectively). s-ELAM levels were not statistically
significant compared with the NINDS patients and healthy subjects (
p<0.21 and p<0.24, respectively). We conclude that the low values of
s-ICAM-1 and s-ELAM-1 in the serum of ALS patients do not exclude the
presence of immunological abnormality in this disorder. Soluble
E-selectin is a glycoprotein which is considered an exclusive marker of
endothelial activation. Its low level in our study may suggest a neural
rather than an endothelial s-ICAM origin in patients with ALS
RANDOMIZED CLINICAL-TRIAL COMPARING CEFTRIAXONE AMIKACIN VERSUS CEFTAZIDIME AMIKACIN AS INITIAL THERAPY OF FEBRILE EPISODES IN NEUTROPENIC PATIENTS
Neutropenic patients with underlying hematologic (usually malignant)
diseases were randomized to receive either 2 g ceftriaxone once daily +
0.5 g amikacin or 2 g ceftazidime twice daily + 0.5 g amikacin b.i.d.
when fever was higher than 38-degrees-C and granulocyte counts less than
0.5 x 10(9)/l. 25 patients were included in each treatment group.
Successful outcome of treatment was observed in 28 (13/15) and in an
additional 5 (2/3) patients after modification of the therapy.
Tolerability was excellent in both groups
RETICULOCYTE COUNTING IN THALASSEMIC AND OTHER CONDITIONS WITH THE R-1000 SYSMEX ANALYZER
Precise reticulocyte counts are difficult to obtain by the manual method
when their percentage in the blood is low or normal. In these instances,
rapid reticulocyte counting by flow cytometry appears to offer more
accuracy and precision. The purpose of this study was to establish
reticulocyte counts in heterozygous beta-thalassemia for reference
purposes and to evaluate the performance of the recently introduced
apparatus R-1000 (Sysmex) in the very heterogeneous thalassemic and
sickle-cell syndromes. We studied a total of 364 samples; 102
heterozygous beta-thalassemia carriers, 180 normal matched controls, 36
patients with thalassemia major or intermedia, and 46 patients with
various sickle-cell syndromes. Reticulocyte counts (both as percentage
and as total number) were higher in heterozygous beta-thalassemia than
in normal controls (p < 0.001) and showed an inverse correlation with
the respective hemoglobin values (p < 0.001). These results confirm the
proposed slightly increased erythropoietic activity in heterozygous
beta-thalassemia carriers. A drawback of the technique is that the
reticulocyte-platelet discrimination error is signaled frequently in all
conditions displaying a marked red cell heterogeneity, especially when
these are associated with high reticulocyte numbers. This calls probably
for readjustment of the corresponding algorithm. In addition, all these
conditions show a significantly increased auramine-O mature red-cell
nonspecific fluorescence
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