Life threatening pneumonia in a lupus patient: a case report

We report a case of systemic lupus erythematosus (SLE) in a 44-year old Caucasian woman complicated with pneumonia and severe respiratory failure requiring ICU treatment and mechanical ventilation. Symptoms developed in a generally well controlled SLE course after sudden stop in immunosupresant therapy (methotrexate, cyclosporin and methylprednisolone). A fulminant course of the disease, an interstitial pattern in a high resolution computed tomography (HRCT) and negative repeated sputum, blood and bronchoaspirate cultures enabled diagnosis of fulminant lupus pneumonitis. The response to pulses of cyclophosphamide and methylprednisolone was good but complicated with a significant leukopenia. HRCT confirmed significant remission of pulmonary changes. Fulminant lupus pneumonitis is a rare but potentially life threatening complication of SLE. Differential diagnosis requires exclusion of pneumonia induced by pathogens such as Pneumocystis jirovevecii (carinii) and Mycobacterium sp. Intensive immunosuppressive therapy and close cooperation between ICU, pulmonology and rheumatology departments is necessary in such a case to minimalize the risk of fatal outcome

R497K polymorphism in epidermal growth factor receptor gene is associated with the risk of acute coronary syndrome

<p>Abstract</p> <p>Background</p> <p>Previous studies suggested that genetic polymorphisms in the epidermal growth factor receptor (EGFR) gene had been implicated in the susceptibility to some tumors and inflammatory diseases. EGFR has been recently implicated in vascular pathophysiological processes associated with excessive remodeling and atherosclerosis. Acute coronary syndrome (ACS) is a clinical manifestation of preceding atherosclerosis. Our purpose was to investigate the association of the EGFR polymorphism with the risk of ACS. In this context, we analyzed the HER-1 R497K and EGFR intron 1 (CA)_nrepeat polymorphisms in 191 patients with ACS and 210 age- and sex-matched controls in a Chinese population, using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) strategy and direct sequencing.</p> <p>Results</p> <p>There were significant differences in the genotype and allele distribution of R497K polymorphism of the EGFR gene between cases and controls. The <it>Lys </it>allele had a significantly increased risk of ACS compared with the <it>Arg </it>allele (adjusted OR = 1.49, 95% CI: 1.12–1.98, adjusted <it>P </it>= 0.006). However, no significant relationship between the number of (CA)_nrepeats of EGFR intron 1 (both alleles < 20 or any allele ≥ 20) and the risk of ACS was observed (adjusted OR = 0.97, 95% CI: 0.58–1.64, adjusted <it>P </it>= 0.911). Considering these two polymorphisms together, there was no statistically significant difference between the two groups.</p> <p>Conclusion</p> <p>R497K polymorphism of the EGFR gene is significantly associated with the risk of ACS. Our data suggests that R497K polymorphism may be used as a genetic susceptibility marker of the ACS.</p

Cytomegalovirus infection in pediatric rheumatic diseases: a review

Human cytomegalovirus (HCMV) is familiar to pediatric rheumatologists mainly as a cause of opportunistic disease in pharmacologically immune suppressed patients. However, HCMV also has a variety of immuno-modulatory effects, through which it may influence the course of rheumatic conditions. In this article we discuss the interplay between HCMV and the immune system, and review the clinical manifestations, diagnosis, and treatment of HCMV infection in children with rheumatic disease

In-utero development of the fetal anal sphincter

Objective To investigate the in-utero development of the fetal anal sphincter using transabdominal ultrasound. Methods This was a cross-sectional study in which the diameter of the fetal anal sphincter was measured sonographically once in 631 well-dated, non-anomalous fetuses scanned between 19 and 38 weeks of gestation. Visualization rates were determined. Regression analysis was used to assess the relationship between the diameter of the fetal anal sphincter and gestational age (GA), and reference values including the mean and 95% reference interval were calculated for each GA. Results The sonographic visualization rate of the fetal anal sphincter increased with gestational age, plateauing at 90-100% between 23-34 weeks of gestation. There was a significant positive relationship between fetal anal sphincter diameter and GA, which was best described by the equation: anal sphincter diameter (mm) = 0.014 x GA(2) + 1.107 x GA - 11.664 (R(2) = 0.62). Conclusion We have provided reference values for the inutero development of the fetal anal sphincter throughout gestation. Copyright (C) 2010 ISUOG. Published by John Wiley & Sons, Ltd.Brantberg A, 2006, ULTRASOUND OBST GYN, V28, P904, DOI 10.1002/uog.3862Pohl-Schickinger A, 2006, ULTRASOUND OBST GYN, V28, P341, DOI 10.1002/uog.2852Cajal CLRY, 2003, AM J OBSTET GYNECOL, V188, P153, DOI 10.1067/mob.2003.107Bourdelat D, 2001, EUR J PEDIATR SURG, V11, P124Ciftci AO, 1999, EUR J PEDIATR SURG, V9, P376Bland JM, 1999, STAT METHODS MED RES, V8, P135COPIN H, 1999, MORPHOLOGIE, V83, P23Royston P, 1998, ULTRASOUND OBST GYN, V11, P30GUZMAN ER, 1995, J ULTRAS MED, V14, P547PENA A, 1989, ATLAS SURG MANAGEMEN, P1HARRIS RD, 1987, AM J ROENTGENOL, V149, P395MORGAN CL, 1978, PEDIATR RADIOL, V7, P19

Mechanical Properties of Direct and Indirect Composite Materials Used in Prosthodontics

This study was conducted to investigate composite materials using mechanical equipment corresponded to masticatory system composed of two antagonistic parts that simulates bimaxilar contact in occlusion and articulation. The aim of this study was to investigate restorative materials with different chemical properties and to find out which material showed the best mechanical properties. The experiment was conducted using 4 types × 20 specimens of direct resin composite materials and equal number of indirect resin composites (IRCs). The following composites were tested: Tetric (Ivoclar Vivadent), Kerr Herculite XRV (Kerr), Charisma (Heraeus Kulzer), Heliomolar (Ivoclar Vivadent), Artglass (Heraeus Kulzer), Targis/Vectris (Ivoclar Vivadent), Vita Zeta LC (Vita) and Kerr Herculite Lab (Kerr). The universal dimensions of all specimens were 5 mm × 5 mm with 2 mm thickness. This was achieved using silicone molds. A total of 160 specimens (80 direct composite specimens and 80 indirect composite specimens) were tested using tensile testing machine. Artglass showed minimal change in thickness (30.20 ± 23.0 μm) compared to others. The highest change in thickness was found in Heliomolar (86.2 ± 32.6 μm). In the group of direct composite materials, Tetric experienced the lowest thickness change (31.0 ± 8.8 μm), while Charisma showed thickness variation of 65.2 ± 27.3 μm. Among indirect composites, Vita Zeta LC showed the highest value of thickness variation (76.2 ± 31.3 μm). In this experimental study, indirect composite specimens showed superior mechanical performance compared to direct composite specimens highlighted Artglass as the material of choice viewed from mechanical aspect