Fulminant systemic capillary leak syndrome due to C1 inhibitor deficiency complicating acute dermatomyositis: a case report

INTRODUCTION: Dermatomyositis is a chronic inflammatory disorder characterized by muscular and dermatologic symptoms with variable internal organ involvement. This is the first report on a patient with acute dermatomyositis and fulminant systemic capillary leak syndrome. CASE PRESENTATION: A 69-year-old Caucasian woman with chronic dermatomyositis presented with clinical signs of severe hypovolemic shock and pronounced hemoconcentration (hematocrit, 69%). Her colloid osmotic pressure was 4.6mmHg. Following a bolus dose of prednisolone (500mg), fluid resuscitation was initiated. During volume loading, anasarca and acute respiratory distress rapidly developed. Echocardiography revealed an underfilled, hypokinetic, diastolic dysfunctional left ventricle with pericardial effusion but no signs of tamponade. Despite continued fluid resuscitation and high-dosed catecholamine therapy, the patient died from refractory shock 12 hours after intensive care unit admission. A laboratory analysis of her complement system suggested the presence of C1 inhibitor deficiency as the cause for systemic capillary leakage. The post-mortem examination revealed bilateral pleural, pericardial and peritoneal effusions as well as left ventricular hypertrophy with patchy myocardial fibrosis. Different patterns of endomysial/perimysial lymphocytic infiltrations adjacent to degenerated cardiomyocytes in her myocardium and necrotic muscle fibers in her right psoas major muscle were found in the histological examination. CONCLUSIONS: This case report indicates that acute exacerbation of chronic dermatomyositis can result in a fulminant systemic capillary leak syndrome with intense hemoconcentration, hypovolemic shock and acute heart failure. In the presented patient, the cause for diffuse capillary leakage was most probably acquired angioedema, a condition that has been associated with both lymphoproliferative and autoimmunologic disorders

Predictors of performance in engineering mathematics

International audienceMathematics in university courses was identified as a main obstacle for engineering students in the beginning of their study. Since difficulties with mathematics could lead to a dropout, our research aims to analyse students' profiles referring to individual characteristics that allow identifying possible risks for students' achievement or success in the first year of study. As a first step to identify possibly risky profiles, we started to find possible predictors of students' performance. For this, we give a short overview of the research state and our derived research interest. We discuss theoretical constructs that are possibly crucial characteristics of students with respect to encountering mathematics as an obstacle. Further, we describe the method for measuring different variables of 182 engineering students. Finally, we present results referring to predictors of performance in engineering mathematics and discuss further steps of our research

Investigating Motivational and Cognitive Factors which Impact the Success of Engineering Students

Gefördert im Rahmen des Projekts DEALThis study was funded by the Hessen State Ministry for Higher Education, Research and the Arts

Predictors of performance in engineering mathematics

International audienceMathematics in university courses was identified as a main obstacle for engineering students in the beginning of their study. Since difficulties with mathematics could lead to a dropout, our research aims to analyse students' profiles referring to individual characteristics that allow identifying possible risks for students' achievement or success in the first year of study. As a first step to identify possibly risky profiles, we started to find possible predictors of students' performance. For this, we give a short overview of the research state and our derived research interest. We discuss theoretical constructs that are possibly crucial characteristics of students with respect to encountering mathematics as an obstacle. Further, we describe the method for measuring different variables of 182 engineering students. Finally, we present results referring to predictors of performance in engineering mathematics and discuss further steps of our research

The Arsenic–Antimony Creek at Sauerbrunn/Burgenland, Austria: A Toxic Habitat for Amphibians

(1) Background: All Austrian amphibians are affected by the degradation of habitats. Mining contributes to habitat destruction by the formation of spoil heaps and mine drainage waters. In Stadtschlaining/Burgenland, antimony mining led to increased arsenic (As) and antimony (Sb) concentrations in soil and water. This study investigates a contaminated creek, still inhabited by amphibians. (2) Methods: Water and soil were analyzed along the creek and correlated with the occurrence of amphibians. (3) Results: As and Sb were increased, with up to 49,000 mg/kg As and 2446 mg/kg Sb in the soil. Up to 317 mg/kg As and 156 mg/kg Sb became bioavailable under gastric, and up to 298 mg/kg As and 30 mg/kg Sb under intestinal conditions, and were absorbed upon ingestion of soil. Larvae of Salamandra salamandra were found throughout the creek; survival rates were low. Rana temporaria occurs in the most contaminated sections but does not propagate here. Bombina variegata appears occasionally. Amphibians seem not to be able to detect and avoid metal or metalloid contamination. (4) Conclusion: Survival of larvae is dubious, but adult amphibians survive without apparent damage under severe metalloid contamination

Toxic Elements in Sediment and Water of the Crocodile River (West) System, South Africa, Following Acid Mine Drainage

The upper reaches of the Crocodile River (West) system are located in the western basin of the Witwatersrand mountain chain, an area heavily influenced by gold mining. After the spill of highly acidic and contaminated mining-influenced water into the river system in 2002, chemical water treatment was implemented to compensate for the consequences of acid mine drainage. Some studies thereafter have shown metal concentrations of concern in the system, but never considered longer periods of time. For this study, we investigated water and sediments over a period of 13 months from 7 sampling sites in the system. In addition to physico-chemical parameters such as temperature, pH, and electrical conductivity, a multi-element analysis was conducted. We used various versions of atomic-absorption-spectroscopy, total reflection x-ray fluorescence spectroscopy, and inductively coupled plasma mass spectrometry in filtered and acidified water samples as well as sediment leachates. Concentrations of Ni, Zn, As, Pb, and U in the sediment were clearly elevated at the site closest to the mine as well as further downstream, some of them far exceeding quality guidelines. Moreover, dissolved Mn, Fe, Ni, Zn and U occurred irregularly in concentrations of concern at the site of mining-influenced water inflow. Our findings clearly indicate a risk of further and chronic mobilization of toxic elements from this site and a possible threat to the connected river system