Paroxysmal nocturnal hemoglobinuria in systemic lupus erythematosus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Paroxysmal nocturnal hemoglobinuria is an acquired disorder of hemopoiesis and is characterized by recurrent episodes of intravascular hemolysis due to an increased sensitivity to complement-mediated hemolysis. Systemic lupus erythematosus with paroxysmal nocturnal hemoglobinuria is very rare. We report a case of paroxysmal nocturnal hemoglobinuria that developed in a patient with systemic lupus erythematosus and lupus nephritis.</p> <p>Case presentation</p> <p>A 29-year-old Mongolian woman had systemic lupus erythematosus, which manifested only as skin lesions when she was 12 years old. She had leg edema and proteinuria when she was 23 years old, and a renal biopsy revealed lupus nephritis (World Health Organization type IV). She had been treated with steroids and immunosuppressant therapy. At 29, she had headaches, nausea, general fatigue, and severe pancytopenia and was admitted to our hospital. A laboratory evaluation showed hemolytic anemia. Further examination showed a neutrophil alkaline phosphatase score of 46 points, a CD55 value of 18%, and a CD59 value of 78.6%. The results of Ham test and sugar water tests were positive. The constellation of symptoms throughout the clinical course and the laboratory findings suggested paroxysmal nocturnal hemoglobinuria.</p> <p>Conclusions</p> <p>To the best of our knowledge, systemic lupus erythematosus with paroxysmal nocturnal hemoglobinuria is very rare. Clinicians should be aware of the association between autoimmune and hematological diseases.</p

Septic shock in pregnancy due to pyogenic sacroiliitis: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Low Energy Solutions for the Semiclassical Limit of Schrodinger–Maxwell Systems

We show that the number of positive solutions of Schrodinger– Maxwell system on a smooth bounded domain depends on the topological properties of the domain. In particular we consider the Lusternik– Schnirelmann category and the Poincaré polynomial of the domain

Severe propylthiouracil-induced hepatotoxicity in pregnancy managed successfully by liver transplantation: A case report

<p>Abstract</p> <p>Introduction</p> <p>Propylthiouracil-induced severe hepatotoxicity is a relatively rare occurrence, with very few cases reported in the literature. The management of this complication in pregnancy can be a challenge because of the effects of the various treatment options on the fetus.</p> <p>Case presentation</p> <p>We report a rare case of fulminant hepatic failure in a 36-year-old gravida 2 black woman of African descent that occurred at 17 weeks gestation following propylthiouracil treatment for Graves' disease. Her liver failure was managed by liver transplantation and thyroidectomy. Her pregnancy was continued to term, though with not so favorable early childhood sequelae.</p> <p>Conclusion</p> <p>This case illustrates a very rare complication of treatment with a presumed safe drug during pregnancy followed by adverse neonatal outcomes due to the extensive treatment.</p

Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the Mini-Mental State Examination

<p>Abstract</p> <p>Background</p> <p>This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS) using the Mini Mental State Examination (MMSE).</p> <p>Methods</p> <p>We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP) or mixed pain (MP) selected from a larger prospective study.</p> <p>Results</p> <p>FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1) than either NeP (27.3; 95% CI 27.2-27.4) or MP (27.3; 27.2-27.5). The percentage of patients with congnitive impairment (adjusted MMSE ≤ 26) was numerically higher in FMS (15%; 95% CI 6.3-29) compared with NeP (5%; 95% CI 1.8-12.2) or MP (5%; 95% CI 1.8-12.2) and higher than in the same age stratum of the general population (0.05%).</p> <p>Conclusions</p> <p>Compared with the population reference value, patients with FMS showed high frequency of cognitive impairment.</p

Appointing Women to Boards: Is There a Cultural Bias?

Companies that are serious about corporate governance and business ethics are turning their attention to gender diversity at the most senior levels of business (Institute of Business Ethics, Business Ethics Briefing 21:1, 2011). Board gender diversity has been the subject of several studies carried out by international organizations such as Catalyst (Increasing gender diversity on boards: Current index of formal approaches, 2012), the World Economic Forum (Hausmann et al., The global gender gap report, 2010), and the European Board Diversity Analysis (Is it getting easier to find women on European boards? 2010). They all lead to reports confirming the overall relatively low proportion of women on boards and the slow pace at which more women are being appointed. Furthermore, the proportion of women on corporate boards varies much across countries. Based on institutional theory, this study hypothesizes and tests whether this variation can be attributed to differences in cultural settings across countries. Our analysis of the representation of women on boards for 32 countries during 2010 reveals that two cultural characteristics are indeed associated with the observed differences. We use the cultural dimensions proposed by Hofstede (Culture’s consequences: International differences in work-related values, 1980) to measure this construct. Results show that countries which have the greatest tolerance for inequalities in the distribution of power and those that tend to value the role of men generally exhibit lower representations of women on boards

A two-phase flow model to simulate mold filling and saturation in Resin Transfer Molding

The final publication is available at Springer via http://dx.doi.org/10.1007/s12289-015-1225-zThis paper addresses the numerical simulation of void formation and transport during mold filling in Resin Transfer Molding (RTM). The saturation equation, based on a two-phase flow model resin/air, is coupled with Darcy s law and mass conservation to simulate the unsaturated filling flow that takes place in a RTM mold when resin is injected through the fiber bed. These equations lead to a system composed of an advection diffusion equation for saturation including capillary effects and an elliptic equation for pressure taking into account the effect of air residual saturation. The model introduces the relative permeability as a function of resin saturation. When capillary effects are omitted, the hyperbolic nature of the saturation equation and its strong coupling with Darcy equation through relative permeability represent a challenging numerical issue. The combination of the constitutive physical laws relating permeability to saturation with the coupled system of the pressure and saturation equations allows predicting the saturation profiles. The model was validated by comparison with experimental data obtained for a fiberglass reinforcement injected in a RTM mold at constant flow rate. The saturation measured as a function of time during the resin impregnation of the fiber bed compared very well with numerical predictions.The authors acknowledge financial support of the Spanish Government (Projects DPI2010-20333 and DPI2013-44903-R-AR), of the National Science and Research Council of Canada (NSERC) and of the Canada Reseach Chair (CRC) program.Gascón Martínez, ML.; García Manrique, JA.; Lebel, F.; Ruiz, E.; Trochu, F. (2016). A two-phase flow model to simulate mold filling and saturation in Resin Transfer Molding. 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Estimation of optimal birth weights and gestational ages for twin births in Japan

BACKGROUND: As multiple pregnancies show a higher incidence of complications than singletons and carry a higher perinatal risk, the calculation of birth weight – and gestational age (GA)-specific perinatal mortality rates (PMR) for multiple births is necessary in order to estimate the lowest PMR for these groups. METHODS: Details of all reported twins (192,987 live births, 5,539 stillbirths and 1,830 early neonatal deaths) in Japan between 1990 and 1999 were analyzed and compared with singletons (10,021,275 live births, 63,972 fetal deaths and 16,862 early neonatal deaths) in the annual report of vital statistics of Japan. The fetal death rate (FDR) and PMR were calculated for each category of birth weight at 500-gram intervals and GA at four-week intervals. The FDR according to birth weight and GA category was calculated as fetal deaths/(fetal deaths + live births) × 1000. The perinatal mortality rate (PMR) according to birth weight and GA category, was calculated as (fetal deaths + early neonatal deaths)/(fetal deaths + live births) × 1000. Within each category, the lowest FDR and PMR were assigned with a relative risk (RR) of 1.0 as a reference and all other rates within each category were compared to this lowest rate. RESULTS: The overall PMR per 1,000 births for singletons was 6.9, and the lowest PMR was 1.1 for birth weight (3.5–4.0 kg) and GA (40- weeks). For twins, the overall PMR per 1,000 births was 36.8, and the lowest PMR was 3.9 for birth weight (2.5–3.0 kg) and GA (36–39 weeks). At optimal birth weight and GA, the PMR was reduced to 15.9 percent for singletons, and 10.6 percent for twins, compared to the overall PMR. The risk of perinatal mortality was greater in twins than in singletons at the same deviation from the ideal category of each plurality. CONCLUSION: PMRs are potentially reduced by attaining the ideal birth weight and GA. More than 90 percent of mortality could be reduced by attaining the optimal GA and birth weight in twins by taking particular care to ensure appropriate pregnancy weight gain, as well as adequate control for obstetric complications