Blueberry muffin rash in a patient with hemolytic disease of the newborn due to anti-Cw

Blueberry muffin rash is a characteristic multiple bluish skin nodules associated with perinatal infection, severe and chronic anemia, and neoplastic infiltrative diseases. We present an unusually severe case of hemolytic disease of the newborn. He required exchange transfusions for several times. The complete work up led to the diagnosis of anti-Cw. The skin lesion regressed spontaneously within one month

Tocilizumab for treatment patients with COVID-19: Recommended medication for novel disease

The coronavirus disease 2019 (COVID-19) virus has spread all over the world. Scientists are trying to discover drugs as effective treatment for patients with COVID-19. So far about 30 drugs have been introduced that one of them is Tocilizumab. Recently Tocilizumab has been introduced to treat patients with COVID-19 and researchers are investigating further the efficacy of this drug for different are patients. In Iran and China, some reports showed a positive effect of Tocilizumab on Saturation of Peripheral Oxygen (SPO2) but results of CT scan in patients in different. In some patients, CT scan showed reduced infiltration, however in other no change was observed. Unfortunately, until now there has been no definitive and effective treatment for patients with COVID-19. Although Tocilizumab has been accepted by China Health Commission to treat infected patients, its positive effects still cannot be predicted in all patients. Based on evidence of the Tocilizumab's effect on the SARS COV 2, researchers hope this drug will make effective and promising treatment to improve lung tissue inflammation in patients with the fatal COVID-19 virus. The present study provides an overview of respiratory inflammation with COVID-19 and probable effect of Tocilizumab on SARS-COV 2. © 2020 Elsevier B.V

Administration of intravenous immunoglobulin in the treatment of COVID-19: A review of available evidence

Since December 31, 2019, unknown causes of pneumonia have been reported in Wuhan, China. This special pneumonia associated with a novel coronavirus was named 2019-nCoV by the World Health Organization (WHO) in January 2020. From the beginning of this infectious disease, clinicians and researchers have been endeavoring to discover an effective and suitable treatment for affected patients. To date, there is no definitive and specific treatments for coronavirus disease-19 (COVID-19) infection while drugs introduced are still in the clinical trial phase. Intravenous immune globulin (IVIG) is a biological product prepared from the serum and an optional treatment for patients with antibody deficiencies. In many countries, much attention has been paid to the use of IVIG in the treatment of patients with COVID-19. Due to the therapeutic importance of IVIG in virus infections, in the current study, we reviewed the possible effect of IVIG in viral infections and potential evidence of IVIG therapy in patients with COVID-19 virus. © 2020 Wiley Periodicals LL

Neonatal diabetes mellitus due to pancreatic agenesis

Neonatal diabetes mellitus, which is defined as hyperglycemia presenting within the first six weeks of life, is a rare disorder. It may result in transient or permanent disease. Pancreatic agenesis is a tare cause of neonatal diabetes. We report a neonate who was small for gestational age and presented with diabetes mellitus and signs of malabsorption because of pancreatic agenesis

A comprehensive investigation of the strengthening effects of dislocations, texture and low and high angle grain boundaries in ultrafine grained AA6063 aluminum alloy

The effect of equal channel angular pressing (ECAP) on the microstructure and mechanical properties of AA6063 aluminum alloy was investigated. For this purpose, samples of AA6063 aluminum alloy were deformed up to 10 passes using ECAP and the evolution of microstructure, texture and dislocation density was investigated. It was found that the dislocation density increased and cells mostly surrounded by low angle boundaries (LABs) formed after 2 passes ECAP. Increasing the dislocation density continued with further processing and reached a maximum at the 4th ECAP pass. With further deformation to 6 passes, the dislocation density reduced, the fraction of high angle boundaries (HABs) increased and the averages of cell size and grain size reduced, significantly, which indicated the occurrence of grain refinement. However, a slight increase in dislocation density, average cell size (ACS) and average grain size (AGS), indicating coarsening, occurred when 10 passes of ECAP are imposed. Hardness, yield (YS) and ultimate tensile strength (UTS) increased continuously although the most significant enhancement occurred after 2 passes of ECAP. Investigating the correlation between the microstructure and mechanical properties indicated that Hall-Petch relationship was valid for ultrafine grained AA6063 before the coarsening started provided that the property of interest was correlated to average cell size but not the average grain size.Accepted Author ManuscriptBiomaterials & Tissue Biomechanic

Simultaneous improvements of the strength and ductility of fine-grained AA6063 alloy with increasing number of ECAP passes

In this research, grain refinement through severe plastic deformation (SPD) in combination with a thermal treatment to create a fine initial grain structure with a high degree of supersaturation was taken as a viable approach to achieving simultaneous increases in the hardness, strength and ductility of the aluminum alloy AA6063 during further SPD. A recrystallized structure with grain sizes around 20 µm was obtained after two passes of equal channel angular pressing (ECAP), followed by a thermal treatment at 500 °C for 10 s and water quenching. The alloy with the supersaturated α-Al matrix was subjected to further ECAP processing up to six passes to create a cellular structure on a nano scale. Hardness and tensile tests revealed the changes of hardness, strength and ductility along with increasing number of ECAP passes. It was found that after two ECAP passes, the ductility of the alloy decreased from the value after the prior two-pass ECAP and thermal treatment. However, by further ECAP processing up to six passes, the ductility increased along with the increases in hardness and strength. The remarkable improvement in ductility was attributed to a nanosized cellular structure with a large area of high-angle grain boundaries developed from the fine initial grain structure formed during the two-pass ECAP and thermal treatment applied earlier.Accepted Author ManuscriptBiomaterials & Tissue Biomechanic

Comparison of performance of self-expanding and balloon-expandable transcatheter aortic valves

Objective: To evaluate the flow dynamics of self-expanding and balloon-expandable transcatheter aortic valves pertaining to turbulence and pressure recovery. Transcatheter aortic valves are characterized by different designs that have different valve performance and outcomes. Methods: Assessment of transcatheter aortic valves was performed using self-expanding devices (26-mm Evolut [Medtronic], 23-mm Allegra [New Valve Technologies], and small Acurate neo [Boston Scientific]) and a balloon-expandable device (23-mm Sapien 3 [Edwards Lifesciences]). Particle image velocimetry assessed the flow downstream. A Millar catheter was used for pressure recovery calculation. Velocity, Reynolds shear stresses, viscous shear stress, and pressure gradients were calculated. Results: The maximal velocity at peak systole obtained with the Evolut R, Sapien 3, Acurate neo, and Allegra was 2.12 ± 0.19 m/sec, 2.41 ± 0.06 m/sec, 2.99 ± 0.10 m/sec, and 2.45 ± 0.08 m/sec, respectively (P \u3c .001). Leaflet oscillations with the flow were clear with the Evolut R and Acurate neo. The Allegra shows the minimal range of Reynolds shear stress magnitudes (up to 320 Pa), and Sapien 3 the maximal (up to 650 Pa). The Evolut had the smallest viscous shear stress magnitude range (up to 3.5 Pa), and the Sapien 3 the largest (up to 6.2 Pa). The largest pressure drop at the vena contracta occurred with the Acurate neo transcatheter aortic valve with a pressure gradient of 13.96 ± 1.35 mm Hg. In the recovery zone, the smallest pressure gradient was obtained with the Allegra (3.32 ± 0.94 mm Hg). Conclusions: Flow dynamics downstream of different transcatheter aortic valves vary significantly depending on the valve type, despite not having a general trend depending on whether or not valves are self-expanding or balloon-expandable. Deployment design did not have an influence on flow dynamics