The study of factors associated with pregnancy outcomes in patients with systemic lupus erythematosus

Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease that can lead to unfavorable pregnancy complications in women. This study aimed to evaluate the factors associated with pregnancy outcomes in patients with SLE. Results: Fifty-nine pregnant women with SLE (121 pregnancies) participated in this retrospective cohort study. The mean age of the patients was 33.74 ± 3.80 years (range 21 to 48 years). Fetal loss occurred in 43.8 of pregnancies. The most common laboratory findings in SLE patients were antinuclear antibody (81.4) and anti-ds DNA positivity (54.2). High levels of C-reactive protein (CRP) during pregnancy, renal involvement, anti-double-stranded DNA positivity, anti-phospholipid antibody (APA) positivity and younger age at disease onset were significantly correlated with unfavourable pregnancy outcomes. A significant difference was observed between duration of SLE and low birth weight (P = 0.003), pre-eclampsia (P = 0.012) and still birth (P = 0.036). High CRP, APA positivity, anti-dsDNA positivity and kidney involvement were predictors of adverse pregnancy outcomes in SLE patients. Renal involvement increased risk of pregnancy with complication 8.5 times (OR = 8.5, 95 CI 1.396-63.373, P = 0.017). Antiphospholipid syndrome (APS) also was associated with an odds ratio of 5.18 (95 CI 1.681-13.647, P = 0.001). © 2020 The Author(s)

Effect of internal and external EGR on cyclic variability and emissions of a spark ignition two-stroke cycle gasoline engine

Conventional two-stroke cycle engine suffers from typical drawbacks including lower combustion efficiency and excessive emissions of uHC and CO which are largely due to low in-cylinder average charge temperature at low load and speed regions of engine operating conditions. Utilising the hot burned Exhaust Gas Recirculation (EGR) technique can boost the in-cylinder average charge temperature of the engine. The influence of hot burned gases applied by means of both Internal EGR and External EGR strategies on the combustion stability and exhaust gas emission of a single-cylinder two-stroke cycle engine running at low-load and mid-load of operating conditions was investigated experimentally along with simulation works using 1-D engine simulation code. The results indicated that both In-EGR and Ex-EGR improved the combustion stability (lower misfire cycle) and decreased the concentrations of uHC and CO emissions, specifically at low speed region; however, NOx concentration was increased. At Internal EGR setting of 30%, the Coefficient of Variation for maximum in-cylinder pressure (COVPmax) reached the minimum by 5.64 while when External EGR percentage was 25%, COVPmax approached about 6.67 at the mid-speed (2000 rpm) of engine operating condition

A tool for predicting the thermal performance of a diesel engine

This paper presents a thermal network model for the simulation of the transient response of diesel engines. The model was adjusted by using experimental data from a completely instrumented engine run under steady-state and transient conditions. Comparisons between measured and predicted material temperatures over a wide range of engine running conditions show a mean error of 7◦C. The model was then used to predict the thermal behavior of a different engine. Model results were checked against oil and coolant temperatures measured during engine warm-up at constant speed and load, and on a New European Driving Cycle. Results show that the model predicts these temperatures with a maximum error of 3◦C.Torregrosa, AJ.; Olmeda González, PC.; Martín Díaz, J.; Romero Piedrahita, CA. (2011). A tool for predicting the thermal performance of a diesel engine. Heat Transfer Engineering. 32(10):891-904. doi:10.1080/01457632.2011.548639S891904321

Differential profiling of lacrimal cytokines in patients suffering from thyroid-associated orbitopathy.

The aim was to investigate the levels of cytokines and soluble IL-6R in the tears of patients with thyroid-associated orbitopathy (TAO) disease. Schirmer's test was adopted to collect tears from TAO patients (N = 20, 17 women, mean age (±SD): 46.0 years (±13.4)) and healthy subjects (N = 18, 10 women, 45.4 years (±18.7)). Lacrimal cytokines and soluble IL-6R (sIL-6R) were measured using a 10-plex panel (Meso Scale Discovery Company) and Invitrogen Human sIL-6R Elisa kit, respectively. Tear levels of IL-10, IL-12p70, IL-13, IL-6 and TNF-α appeared significantly higher in TAO patients than in healthy subjects. Interestingly, IL-10, IL-12p70 and IL-8 levels increased in tears whatever the form of TAO whereas IL-13, IL-6 and TNF-α levels were significantly elevated in inflammatory TAO patients, meaning with a clinical score activity (CAS) ≥ 3, compared to controls. Furthermore, only 3 cytokines were strongly positively correlated with CAS (IL-13 Spearman coeff. r: 0.703, p = 0.0005; IL-6 r: 0.553, p = 0.011; IL-8 r: 0.618, p = 0.004, respectively). Finally, tobacco use disturbed the levels of several cytokines, especially in patient suffering of TAO. The differential profile of lacrimal cytokines could be useful for the diagnosis of TAO patients. Nevertheless, the tobacco use of these patients should be taken into account in the interpretation of the cytokine levels

DYSLIPIDEMIA IN TYPE 2 DIABETES MELLITUS: MORE ATHEROGENIC LIPID PROFILE IN WOMEN

Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular disease in women to a greater extent than in men. It seems that DM may alter lipid profiles more adversely in women compared to men. In this study we evaluated serum lipoprotein differences in type 2 diabetic men and women. The study included 350 type 2 diabetic patients (100 men and 250 women), aged 19-82 years. Demographic data were and biochemistry tests including serum lipoproteins were measured. There was no difference between men and women with respect to duration of DM and type of treatment. Body mass index (BMI), systolic and diastolic blood pressures were significantly higher in women than age matched men. Women also had significantly higher plasma levels of total cholesterol (233.7 vs. 190.3 mg/dl, P < 0.001), triglycerides (219.7 vs. 180.6 mg/dl, P < 0.05), lowdensity lipoprotein cholesterol (LDL-C) (141.2 vs. 116.1 mg/dl, P < 0.001), high-density lipoprotein cholesterol (HDL-C) (47.1 vs. 39.4 mg/dl, P < 0.001), non-HDL cholesterol (186.1 vs. 150.8 mg/dl, P <0.05), Lp(a) (50.7 vs. 38.2 mg/dl, P < 0.05) and apo-B (117.6 vs. 101.2 mg/dl, P < 0.001). All types of dyslipidemia were significantly more prevalent in females. Women had higher plasma levels of HDL-C compared to men. Higher prevalence of hypertriglyceridemia in females was due to their higher BMI, and sex was not an independent risk factor for hypertriglyceridemia. Type 2 diabetic women are exposed more profoundly to risk factors including atherogenic dyslipidemia and higher BMI, systolic and diastolic blood pressures compared to men

Outbreak of exogenous Cushing's syndrome due to unlicensed medications

Objective: Despite the widespread medical use of glucocorticoids, reports of factitious administration of these hormones have been uncommon. We herein report an outbreak of Cushing's syndrome in Tehran among the addicts using Tamgesic (a brand of Buprenorphine) to help them through the narcotic withdrawal stage, without knowledge of the glucocorticoid content of the black-market drug. Design and measurements: Case histories of 19 patients with a final diagnosis of iatrogenic Cushing's syndrome were reviewed. Liquid chromatography/mass spectrometry (LC-Mass) method was used to evaluate glucocorticoid existence in the brand. High performance liquid chromatography was used to determine plasma dexamethasone level. Results: No buprenorphine was present in the vials. Each Tamgesic vial contained 0.4 mg of Dexamethasone disodium phosphate; Heroin was also found in them. The duration of injection abuse and the total dexamethasone intake was 4.5 (1-18) months and 2.6 (0.8-8) mg/day, respectively. Median plasma dexamethasone concentration was 5.8 nmol/l, with a range of 5-8.7. Physical findings of the cases were not different from those of the classic endogenous Cushing's syndrome but their serum cortisol and urinary free cortisol were suppressed. Severe life-threatening complications were demonstrated in five cases. Conclusion: Surreptitious use of steroids resulting in Cushing's syndrome may be more common in opium addicts; a high degree of suspicion is needed to uncover this disorder. Whenever facing a cushingoid appearance in addicts, the possibility of using black market drugs with corticosteroid contents should be kept in mind. © 2008 The Authors