Eosinophilic granulomatosis with polyangiitis (EGPA) and PRES: a case-based review of literature in ANCA-associated vasculitides

Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-sized vessel systemic necrotizing vasculitis and belongs to the family of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. The involvement of central nervous system in this condition is pretty rare. Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity described for the first time by Hinchey et al. (N Engl J Med 334(8):494-500, 1996) and characterized by MRI findings of reversible subcortical vasogenic edema predominantly in the white matter of posterior cerebral lobes. There are few case reports describing the concurrence of PRES with ANCA-associated vasculitides. We describe a case of PRES in a patient with a diagnosis of EGPA with a concise review of the literature. The exact cause of this syndrome is unknown. It has been related to eclampsia, drug-induced hypertension, renal insufficiency and also to rheumatologic diseases. Endothelial injury, hypertension and immunosuppressive medications can compromise the regulation of cerebral blood flow. In ANCA-associated vasculitides, patients presenting with symptoms of PRES represent a challenge to treatment with immunosuppressive medications. However, since an inflammatory process might be implicated, judicious use of these agents along with tight control of blood pressure and a supportive therapy may contribute to the resolution of the encephalopathic syndrome treating at the same time other manifestation related to the rheumatologic disease. Larger clinical studies are warranted to optimize the management of vasculitis-associated PRES

Mechanistic Insight into the Catechol Oxidase Activity by a Biomimetic Dinuclear Copper Complex

The biomimetic catalytic oxidation of 3,5-ditert- butylcatechol by the dicopper(II) complex of the ligand a,a¢-bis{bis[1-(1¢-methyl-2¢-benzimidazolyl) methyl]amino}-m-xylene in the presence of dioxygen has been investigated as a function of temperature and pH in a mixed aqueous/organic solvent. The catalytic cycle occurs in two steps, the first step being faster than the second step. In the first step, one molecule of catechol is oxidized by the dicopper(II) complex, and the copper(II) centers are reduced. From the pH dependence, it is deduced that the active species of the process is the monohydroxo form of the dinuclear complex. In the second step, the second molecule of catechol is oxidized by the dicopper(I)-dioxygen complex formed upon oxygenation of the reduced complex. In both cases, catechol oxidation is an inner-sphere electron transfer process involving binding of the catechol to the active species. The binary catechol-dicopper(II) complex formed in the first step could be characterized at very low temperature (90 C), where substrate oxidation is blocked. On the contrary, the ternary complex of dicopper( I)-O2-catechol relevant to the second step does not accumulate in solution and could not be characterized, even at low temperature. The investigation of the biphasic kinetics of the catalytic reaction over a range of temperatures allowed the thermodynamic (DH and DS) and activation parameters (DH „ and DS „ ) connected with the key steps of the catecholase process to be obtained

A simple and efficient statistical potential for scoring ensembles of protein structures

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A case of tension-type headache in fibromyalgia

Ref.: Ms. No. TJHP-D-10-00029R1 A 57 years-old-woman was admitted to our ward for a daily tension-type headache, non responsive to usual pharmacological treatment. Five years ago she underwent a hysterectomy. Since then, she referred muscular rigor of the neck and the shoulder girdle, intense constrictive pain localized in the occipital spine. She also reported weakness of the upper and lower limbs, tingling, tremors and difficulties in walking and climbing. She referred widespread pain, unusually severe, above all at joints and muscles, without any sign of inflammation at clinical examination. The diagnosis of a connective tissue was excluded, remaining the diagnosis of tension-type headache in Fibromyalgia the most probable one. The patient has been treated with antidepressants, anxiolytics, and antiepileptic drugs with improvement of the symptoms

THE STRAIT OF MESSINA: A KEY AREA FOR PELAGIA NOCTILUCA (CNIDARIA, SCYPHOZOA)

The Strait of Messina is certainly a focal area for the biological cycle of the jellyfish Pelagia noctiluca in the Western Mediterranean Sea. By means of both original and literature data, a conceptual model outlining the biological cycle of this species is proposed. P. noctiluca reproduces from late winter to late spring in the Aeolian Island Archipelago. From late spring to early summer, currents transport newly produced young individuals (20-30 mm bell diameter) eastwards, towards the Strait. The Strait of Messina ecosystem is not a suitable reproduction area for its intense hydrodynamism that would surely lead to a very low reproductive success due to gamete dispersion. This area, however, represents an optimal site for growth, due to its intensive primary and secondary production, but also for an optimal temperature range, lower in summer and higher in winter in respect to the surrounding basins. Pelagia remains all the summer inside the Strait, increasing in bell diameter (50-70 mm) and biomass. Subsequently, in late summer-early autumn, the mature specimens, taking advantage of a typical autumnal downwelling transport, move to deep Tyrrhenian waters where overwinter, to upwell in the Aeolian Archipelago by late winter to start a new cycle

Nocturnal cough and difficulty breathing during exertion in a young boy: Do not miss the forest for the trees

No abstract avaiable

Synthetic Crysotile Nano-Crystals as a Reference Standard to Investigate Surface-Induce Serum Albumin Structural Modifications

Geoinspired synthetic chrysotile, which represents an ideal asbestos reference standard, has been utilized to investigate homomolecular exchange of bovine serum albumin (BSA), the major plasma protein, between the adsorbed and dissolved state at the interface between asbestos fibers and biological medium. FTIR spectroscopy has been used to quantify BSA structural modifications due to surface adhesion on chrysotile fibers as a function of the surface coating extent. Circular dichroism spectroscopy has been used to investigate the adsorption/desorption equilibrium through analysis of the BSA structural perturbations after protein desorption from chrysotile surface. Data results show clearly that in the solid state BSA modifications are driven by surface interaction with the substrate, following a bimodal adsorption evidenced by two different binding constants. On the other hand, BSA desorbed in solution is able to rearrange, in the lack of substrate, although keeping irreversible modifications with respect to the native species. The lack of regaining its native structure certainly affects albumin interaction with biological environment. The present investigation on the stoichiometric synthetic geoinspired chrysotile nanocrystals is the first approach toward a deeper attempt to use standard synthetic chrysotile reference samples in mimicking the behavior of asbestos fibers and allows to better understand their interaction with a biological environment