FROM PEDAGOGY TO ACTIVISM: The AWARE Saga

Australian Feminist Studies2774421-43

Melioidosis in systemic lupus erythematosus: the importance of early diagnosis and treatment in patients from endemic areas

Serious infection is a common problem in immunosuppressed patients with systemic lupus erythematosus (SLE). Melioidosis is caused by the Gram-negative bacterium Burkholderia pseudomallei and may present as an acute fulminant pneumonia or septicaemia that is often fatal. The organism is endemic in much of South-east Asia but is being increasingly reported from other parts of the world, including India, Northern Australia and North and South America. In addition to occurring in people who come into contact with contaminated soil or water in endemic areas, the infection is more common in immunosuppressed patients and must be recognised early and treated with appropriate antibiotics. Importantly, it can activate many years after the initial exposure, causing diagnostic confusion. We present the cases of three patients with SLE who were admitted with fever and in whom Burkholderia pseudomallei was isolated from blood cultures. Following treatment with intravenous ceftazidime all patients made a good recovery. These cases demonstrate the importance of considering this infectious organism in patients from endemic areas with unexplained fever. They also illustrate how successful outcomes can be achieved in a frequently fatal disease if an early diagnosis is made and appropriate antibiotics are started promptly.<br/

Orthogonal least-squares learning algorithm with local adaptation process for the radial basis function networks

10.1109/97.511811IEEE Signal Processing Letters38253-255ISPL

SLE mortality in an oriental population

Lupus6127-31LUPU

Diagnostic tests for food allergy

Singapore Medical Journal5114-

Hospitalization of individuals with systemic lupus erythematosus: characteristics and predictors of outcome

We performed a retrospective study of patients with systemic lupus erythematosus (SLE) admitted to hospital during a one-year period to describe characteristics associated with a poor outcome. There were 348 episodes of hospitalization of 223 individuals. The cause of admission was clinical flare of SLE (58%), infection (37%) and thromboembolic disease (8%). Readmission occurred in 35.8% and was associated with: active nephritis (HR 2.53, P &lt; 0.01), flare of lupus (HR 2.0, P &lt; 0.01) and more ACR criteria (HR 1.34 per extra criteria, P &lt; 0.01). Individuals with multiple reasons for admission had a longer duration of stay [one = four days (2,6), two = five days (3,7) and three = 9.5 days (6.5,14.5), P &lt; 0.01]. There were 11 deaths (3.2% of admissions). The deaths were due to infection in nine cases (four with concurrent active SLE). In multivariate modelling, the main predictors of death were: previous multiple admissions (OR 12.4, P &lt; 0.01), the presence of infection (OR 7.3, P &lt; 0.01) and youngerage (OR 0.93 perincrease of one year, P = 0.03). The presence of active lupus nephritis and multisystem disease makes readmission more likely and individuals with multiple problems at the time of admission have longer hospital stays. Young patients with frequent readmissions and coexistent infections are most likely to die

Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications

We sought to test our clinical impression that using a low dose methylprednisolone pulse (MEP; 1500mg over 3 days) in treating flares of systemic lupus erythematosus (SLE) was effective and associated with fewer serious infections. We retrospectively studied SLE patients who received MEP between 1989 and 2000. A 'low dose' group of 26 patients who had received 1-1.5g and a 'high dose' group of 29 patients who received 3-5g of MEP were identified. SLEDAI scores and prednisolone doses were recorded at the time of MEP pulses and 6 months later. All serious infections (requiring admission and i.v. antibiotics) occurring during this 6 month period and their outcomes were recorded. Both groups had similar demographic data, initial SLEDAI scores, i.v. cyclophosphamide use, and SLE organ involvement. Despite high- and low-dose MEP being efficacious in controlling disease activity (lowering of SLEDAI scores and subsequent prednisolone dose) there were only nine episodes of serious infection in seven patients in the low-dose group compared with 20 episodes in 17 patients from the high-dose group (P=0.04). In both groups a majority of infections (75 and 77% in the high- and low-dose groups) occurred in the first month after MEP. Those with a low serum albumin (&lt;20g/l) had an increased risk of mortality (OR 44, 90% CI 6.19-312.98) and a trend towards greater numbers of infections. Low-dose MEP was effective in controlling SLE flares and associated with fewer serious infections than traditional high-dose MEP

Mite Amylase from Blomia tropicalis (Blo t 4): Differential allergenicity linked to geographical regions

10.1159/000176303International Archives of Allergy and Immunology149125-3