Asymptomatic stage I sarcoidosis complicated by pulmonary tuberculosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, <it>Mycobacterium tuberculosis </it>and <it>Nocardia </it>species. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications for the patient.</p> <p>Case presentation</p> <p>We present a case of a 67-year-old woman with undiagnosed asymptomatic stage I sarcoidosis for at least 8 years before her admission and a 1-month history of fever, exertional dyspnea and dry cough, in whom pulmonary tuberculosis was documented.</p> <p>Conclusion</p> <p>This case highlights the need for great vigilance among physicians in order to rule out any possible infection before establishing the diagnosis of sarcoidosis.</p

Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study

Objective: The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied. Methods: This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid-femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40-49, 50-59, 60-74, 75-90 years. In this report, we present the baseline data of this study. Results: Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P < 0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r 2 = 0.06, P < 0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57 ± 0.06 vs. 8.65 ± 0.10, P < 0.001; CAVI: 8.34 ± 0.03 vs. 8.29 ± 0.04, P = 0.40; mean ± SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV. Conclusion: This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF-PWV and suggests that age may have a more pronounced effect on CAVI, whereas MetS increases CF-PWV but not CAVI. This important finding may be due to heterogeneous effects of MetS components on CAVI. The clinical significance of these original results will be assessed during the longitudinal phase of the study

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Remarques sur l’édition critique des Formes Élémentaires

La parution en mai 2015, chez Classiques Garnier, de l’édition critique des Formes Élémentaires de la vie religieuse constitue pour nous une occasion de mettre en relief quelques réflexions sur la publication des oeuvres classiques. Aux parties qui composent traditionnellement une édition critique (restitution du texte, des citations et des références, bibliographie, index des noms, notices biographiques, index des concepts), nous avons ajouté certaines innovations éditoriales qui contribuaient à la meilleure compréhension du texte durkheimien. Nous avons complété la bibliographie avec les sources premières que Durkheim a exploitées. Dans le même sens venait notre décision de mettre en annexe les comptes rendus que Durkheim avait consacrés aux oeuvres sur lesquelles il s’était appuyé pour rédiger son magnum opus.Our critical edition of E. Durkheim’s Elementary Forms of the Religious Life, released in May 2015 by Classiques Garnier, was an occasion for expressing certain thoughts regarding the way classic texts should be published. In addition to using the elements constituting the traditional parts of a critical edition (restitution of text, citations and references, bibliography, index of names, biographical notes, index of concepts and terms), we proceeded to certain innovations considered necessary for the complete understanding of the Durkheimian text. We completed the bibliography by citing primary sources, which Durkheim had used, and we annexed reviews authored by Durkheim, pertaining to certain works cited in his magnum opus.La aparición en mayo del 2015, en los Clásicos Garnier, de la edición crítica de Las Formas Elementales de la Vida Religiosa, constituye para nosotros una ocasión para poner de relieve algunas reflexiones sobre la publicación de obras clásicas. A las partes que componen tradicionalmente una edición crítica (restitución del texto, de citas y referencias, bibliografía, índice de nombres, notas biográficas, índice de conceptos), nosotros hemos agregado ciertas innovaciones editoriales que contribuyen a una mejor comprensión del texto durkhemiano. Hemos completado la bibliografía con las primeras fuentes que Durkheim explotó. En este sentido, hemos decidido incluir en el Anexo los informes que Durkheim había utilizado para redactar su magnum opus

Electrophoretic mobility of serum post-heparin tributyrinesterase

MUCH work has been devoted to the mechanism of the clearing action of heparin, and it is now generally accepted that its action is exerted by a lipolytic enzyme called clearing factor. On the other hand, it has been found that the injection of heparin is followed by the appearance in the serum of an eserine-resistant tributyrinesterase, which is considered to be one and the same with clearing factor1. Various techniques were used to locate the clearing factor in the serum protein fractions, including fractional precipitation2 and ultracentrifugal fractionation methods3. The findings of the different investigators are not in agreement. Thus, it has been claimed that clearing factor remains in the albumin fraction of serum after half saturation with ammonium sulphate2. However, Graham et al., using ultracentrifugal and ethyl alcohol fractionation, found the enzyme in the globulin fraction3. Because of this discrepancy, investigations were made in order to study the electrophoretic mobility of the clearing factor (post-heparin tributyrinesterase1) in comparison with the fractions of the proteinogramme. © 1962 Nature Publishing Group

Heparin and blood lipids in fasted individuals

IT is well known that intravenous administration of heparin induces in hyperlipæmic individuals a clearing of the plasma turbidity1. This effect has been explained by changes in physicochemical properties of the circulating lipids, consisting mainly of hydrolysis and dissolution of the fat in the plasma, due to the activation of a lipæmia-clearing mechanism 2. There is also a suggestion that heparin could accelerate the removal of hydrolysed lipids from the blood stream since it was found that it induces a decrease in total fatty acids of plasma in hyperlipæmic rats3. © 1962 Nature Publishing Group