Post-infection immunocomplex glomerulonephritis and Legionnaires' disease in a patient with adult Still's disease during treatment with interleukin 1 receptor antagonist anakinra: a case report

<p>Abstract</p> <p>Introduction</p> <p>Legionellosis is a systemic disease that primarily affects the lungs. However, dysfunction in many organ systems, including the kidneys, has also been described. There are only a few reported cases of renal dysfunction in patients with legionellosis.</p> <p>Case presentation</p> <p>A 27-year-old Caucasian woman with known adult Still's disease was admitted to our hospital for community-acquired pneumonia, due to <it>Legionella </it>infection, with acute renal failure. Although her respiratory symptoms responded well to antibiotic treatment, her renal function worsened, with severe proteinuria and edema. A renal biopsy showed extracapillary and endocapillary proliferative glomerulonephritis with accompanying chronic and acute interstitial nephritis. This was consistent with a post-infection immunocomplex glomerulonephritis. After initiation of steroid therapy, her renal function improved. Additionally, therapy with diuretics and an angiotensin-converting enzyme inhibitor was initiated because of persistent proteinuria. Under this treatment regimen, her severe edema and proteinuria disappeared.</p> <p>Conclusion</p> <p>To the best of our knowledge, there is only a handful of reported cases of post-infection glomerulonephritis with a nephrotic syndrome in a patient with legionellosis. Our findings suggest that, in patients with Legionnaires' disease with renal failure, post-infection immunocomplex glomerulonephritis should be considered and steroid therapy may be an effective modality to treat the renal complication.</p

Acute tubulointerstitial nephritis complicating Legionnaires' disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Legionnaires' disease is recognized as a multi-systemic illness. Afflicted patients may have pulmonary, renal, gastrointestinal tract and central nervous system complications. However, renal insufficiency is uncommon. The spectrum of renal involvement may range from a mild and transient elevation of serum creatinine levels to anuric renal failure requiring dialysis and may be linked to several causes. In our present case report, we would like to draw attention to the importance of the pathological documentation of acute renal failure by reporting a case of a patient with acute tubulointerstitial nephritis complicating Legionnaires' disease.</p> <p>Case presentation</p> <p>A 55-year-old Caucasian man was admitted to our hospital for community-acquired pneumonia complicated by acute renal failure. <it>Legionella pneumophila </it>serogroup type 1 was diagnosed. Although the patient's respiratory illness responded to intravenous erythromycin and ofloxacin therapy, his renal failure worsened, he became anuric, and hemodialysis was started. A renal biopsy was performed, which revealed severe tubulointerstitial nephritis. After initiation of steroid therapy, his renal function improved dramatically.</p> <p>Conclusions</p> <p>This case highlights the importance of kidney biopsies in cases where acute renal failure is a complicating factor in Legionnaires' disease. If the presence of acute tubulointerstitial nephritis can be confirmed, it will likely respond favorably to steroidal treatment and thus irreversible renal damage and chronic renal failure will be avoided.</p

Dynamic response of Dam-Reservoir systems : review and a semi-analytical proposal

This paper presents a review of current techniques employed for dynamic analysis of concrete gravity dams under seismic action. Traditional procedures applied in design bureaus, such as the Pseudo-Static method, often neglect structural dynamic properties, as well as ground amplification effects. A practical alternative arises with the Pseudo-Dynamic method, which considers a simplified spectrum response in the fundamental mode. The authors propose a self-contained development and detailed examples of this latter method, including a comparison with finite element models using transient response of fluid-structure systems. It is verified that application of the traditional procedure should be done carefully and limited to extremely rigid dams. On the other hand, the proposed development is straightforward and in agreement with finite element results for general cases where dam flexibility plays an important role

Prediction of Protein Modification Sites of Pyrrolidone Carboxylic Acid Using mRMR Feature Selection and Analysis

Pyrrolidone carboxylic acid (PCA) is formed during a common post-translational modification (PTM) of extracellular and multi-pass membrane proteins. In this study, we developed a new predictor to predict the modification sites of PCA based on maximum relevance minimum redundancy (mRMR) and incremental feature selection (IFS). We incorporated 727 features that belonged to 7 kinds of protein properties to predict the modification sites, including sequence conservation, residual disorder, amino acid factor, secondary structure and solvent accessibility, gain/loss of amino acid during evolution, propensity of amino acid to be conserved at protein-protein interface and protein surface, and deviation of side chain carbon atom number. Among these 727 features, 244 features were selected by mRMR and IFS as the optimized features for the prediction, with which the prediction model achieved a maximum of MCC of 0.7812. Feature analysis showed that all feature types contributed to the modification process. Further site-specific feature analysis showed that the features derived from PCA's surrounding sites contributed more to the determination of PCA sites than other sites. The detailed feature analysis in this paper might provide important clues for understanding the mechanism of the PCA formation and guide relevant experimental validations

Optical Environmental Sensing in Wireless Smart Meter Network

In recent years, the traditional power grid is undergoing a profound revolution due to the advent and development of smart grid. Many hard and challenging issues of the traditional grid such as high maintenance costs, poor scalability, low efficiency, and stability can be effectively handled and solve in the wireless smart grid (WSG) by utilizing the modern wireless sensor technology. In a WSG, data are collected by sensors at first and then transmitted to the base station through the wireless network. The control centre is responsible for taking actions based on this received data. Traditional sensors are failing to provide accurate and reliable data in WSG, and optical fiber based sensor are emerging as an obvious choice due to the advancement of optical fiber sensing technology, accuracy, and reliability. This paper presents a WSG platform integrated with optic fiber-based sensors for real-time monitoring. To demonstrate the validity of the concept, fresh water sensing of refractive index (RI) was first experimented with an optical fiber sensor. The sensing mechanism functions with the reflectance at the fiber’s interface where reflected spectra’s intensity is registered corresponding to the change of RI in the ambient environment. The achieved sensitivity of the fabricated fiber sensor is 29.3 dB/RIU within the 1.33–1.46 RI range. An interface between the measured optical spectra and the WSG is proposed and demonstrated, and the data acquired is transmitted through a network of wireless smart meters

Role of Artificial Intelligence and Knowledge-Base Expert System Methods in Civil Engineering

Present use of computers in civil engineering is largely devoted to numeric, algorithmic calculations. This mode is not appropriate for the empirical, heuristic, ill-structured problems of civil engineering practice. The paper reviews recent work in artificial intelligence and expert systems addressing these latter issues, identifies the distinctive features of engineering knowledge based systems, the roles of such systems, and attempts to predict their evolutio

Concurrent computer-integrated building design

This monograph assesses the means by which building design can be achieved in a more rapid and integrated fashion through the use of advanced computer aids.