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Sample records for pregnant sle patients

  1. Estudo-piloto: células NK nas gestantes com LES NK cells in pregnant patients with SLE: a preliminary study

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    Alessandra Cardoso Pereira

    2009-08-01

    SLE. OBJECTIVE: To measure the amount of circulating NK cells and their viability in pregnant SLE patients. MATERIALS AND METHODS: Blood samples from four groups of ten patients each were evaluated: 1. GLES: Pregnant SLE patients; 2. PLES: Non-pregnant SLE patients; 3. Gcontrols: Pregnant controls; 4. Controls: Healthy non-pregnant women. In all patients the amount and viability of NK cells was measured by flow cytometry, as well as the total apoptosis by annexin V and propidium iodite staining. RESULTS: Due to the great variability, median of each group was used for evaluation: CD56+ count [GLES (0.10, PLES (0.12, Gcontrols (0.15, Controls (0.08]; total apoptosis (addition of initial and late apoptosis to total number of dead cells [GLES (0.06, PLES (0.04, Gcontrols (0.11, Controls (0.11]. The results for live cells count had low variability, so the averages and standard deviations were used for comparisons: [GLES (0.91±0.06, PLES (0.95±0.03, Gcontrols (0.86±0.11, Controls (0.88+0.08]. CONCLUSION: Although not statistically significant, the total apoptosis in the SLE groups was lower than in the control groups, and the live cell count was higher. This suggests that in SLE patients, pregnant or not, the NK cells have a prolonged life cycle (or have a lower/different turnover, and that there may be a higher immune stimulus making the NK cells take longer to activate the apoptosis process.

  2. Characterization of the Phosphoproteome in SLE Patients.

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    Xinzhou Zhang

    Full Text Available Protein phosphorylation is a complex regulatory event that is involved in the signaling networks that affect virtually every cellular process. The protein phosphorylation may be a novel source for discovering biomarkers and drug targets. However, a systematic analysis of the phosphoproteome in patients with SLE has not been performed. To clarify the pathogenesis of systemic lupus erythematosus (SLE, we compared phosphoprotein expression in PBMCs from SLE patients and normal subjects using proteomics analyses. Phosphopeptides were enriched using TiO₂ from PBMCs isolated from 15 SLE patients and 15 healthy subjects and then analyzed by automated LC-MS/MS analysis. Phosphorylation sites were identified and quantitated by MASCOT and MaxQuant. A total of 1035 phosphorylation sites corresponding to 618 NCBI-annotated genes were identified in SLE patients compared with normal subjects. Differentially expressed proteins, peptides and phosphorylation sites were then subjected to bioinformatics analyses. Gene ontology(GO and pathway analyses showed that nucleic acid metabolism, cellular component organization, transport and multicellular organismal development pathways made up the largest proportions of the differentially expressed genes. Pathway analyses showed that the mitogen-activated protein kinase (MAPK signaling pathway and actin cytoskeleton regulators made up the largest proportions of the metabolic pathways. Network analysis showed that rous sarcoma oncogene (SRC, v-rel reticuloendotheliosis viral oncogene homolog A (RELA, histone deacetylase (HDA1C and protein kinase C, delta (PRKCD play important roles in the stability of the network. These data suggest that aberrant protein phosphorylation may contribute to SLE pathogenesis.

  3. Disease characterization of systemic lupus erythematosus (SLE) patients in Quebec.

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    Ng, R; Bernatsky, S; Rahme, E

    2017-01-01

    Objective Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by an array of organ manifestations that can appear during flares and disappear during remissions. The objectives of this study were: (i) to examine SLE manifestation groups longitudinally in an SLE cohort; and (ii) to assess the association between early antimalarial treatment and renal manifestations. Methods Seven SLE manifestation groups-cutaneous, hematologic, lung, musculoskeletal, neuropsychiatric, serositis, renal-were tracked using Kaplan-Meier survival curves in an incident SLE cohort from Quebec health administrative data ( n = 2010). A subgroup with provincial drug insurance coverage was followed over time to examine the association between early antimalarial treatment (within three months after SLE diagnosis) and renal manifestations using a Cox proportional hazards survival model. Results Cutaneous manifestations was the most common manifestation at SLE diagnosis (30.0%, 95% CI: 27.7-32.2%). About two-thirds (66.2%, 95% CI: 63.4-68.9%) of patients had evidence of at least one SLE manifestation at diagnosis, which increased to 87.2% (95% CI: 84.2-90.3%) by the end of follow-up. After adjusting for age, sex, early concomitant systemic steroid therapy, Charlson comorbidity index, primary care visits in the year prior and other SLE manifestations at baseline, no statistically significant association was established between antimalarial therapy and renal manifestations. Conclusion This study provides insight regarding organ manifestations within a population-based sample. Most patients identified with SLE had other diagnostic evidence that supports an underlying diagnosis of SLE. No protective effects for antimalarial agents against renal manifestations could be established in this population-based cohort.

  4. Spectrum of Histomorphologic Findings in Liver in Patients with SLE: A Review

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    Shrruti Grover

    2014-01-01

    Full Text Available Collagen vascular diseases (CVDs like systemic lupus erythematosus (SLE, rheumatoid arthritis, Sjogren syndrome (SS, and scleroderma are immunologically mediated disorders that typically have multisystem involvement. Although clinically significant liver involvement is rare, liver enzyme abnormalities are common in these patients. The reported prevalence of hepatic involvement in SLE, histopathologic findings, and its significance is very variable in the existing literature. It is important to be familiar with the causes of hepatic involvement in SLE along with histomorphological features which aid in distinguishing hepatitis of SLE from other hepatic causes as they would alter the patient management and disease course. Histopathology of liver in SLE shows a wide morphological spectrum commonly due to a coexisting pathology. Drug induced hepatitis, viral etiology, and autoimmune overlap should be excluded before attributing the changes to SLE itself. Common histopathologic findings in SLE include fatty liver, portal inflammation, and vascular changes like hemangioma, congestion, nodular regenerative hyperplasia, arteritis, and abnormal vessels in portal tracts.

  5. Complement-mediated solubilization of immune complexes. Solubilization inhibition and complement factor levels in SLE patients

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    Baatrup, Gunnar; Petersen, Ivan; Kappelgaard, E;

    1984-01-01

    Thirty-two of 36 serum samples from 19 SLE patients showed reduced capacity to mediate complement-dependent solubilization of immune complexes (IC). SLE patients with nephritis exerted the lowest complement-mediated solubilization capacity (CMSC) whereas sera from patients with inactive disease g...

  6. Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE: A Retrospective Study of 109 Pregnancies.

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    Ming Ku

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome, disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement. We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

  7. Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE): A Retrospective Study of 109 Pregnancies.

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    Ku, Ming; Guo, Shuiming; Shang, Weifeng; Li, Qing; Zeng, Rui; Han, Min; Ge, Shuwang; Xu, Gang

    2016-01-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome), disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement). We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

  8. High Affinity Antibodies against Influenza Characterize the Plasmablast Response in SLE Patients After Vaccination.

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    Kaval Kaur

    Full Text Available Breakdown of B cell tolerance is a cardinal feature of systemic lupus erythematosus (SLE. Increased numbers of autoreactive mature naïve B cells have been described in SLE patients and autoantibodies have been shown to arise from autoreactive and non-autoreactive precursors. How these defects, in the regulation of B cell tolerance and selection, influence germinal center (GC reactions that are directed towards foreign antigens has yet to be investigated. Here, we examined the characteristics of post-GC foreign antigen-specific B cells from SLE patients and healthy controls by analyzing monoclonal antibodies generated from plasmablasts induced specifically by influenza vaccination. We report that many of the SLE patients had anti-influenza antibodies with higher binding affinity and neutralization capacity than those from controls. Although overall frequencies of autoreactivity in the influenza-specific plasmablasts were similar for SLE patients and controls, the variable gene repertoire of influenza-specific plasmablasts from SLE patients was altered, with increased usage of JH6 and long heavy chain CDR3 segments. We found that high affinity anti-influenza antibodies generally characterize the plasmablast responses of SLE patients with low levels of autoreactivity; however, certain exceptions were noted. The high-avidity antibody responses in SLE patients may also be correlated with cytokines that are abnormally expressed in lupus. These findings provide insights into the effects of dysregulated immunity on the quality of antibody responses following influenza vaccination and further our understanding of the underlying abnormalities of lupus.

  9. High Affinity Antibodies against Influenza Characterize the Plasmablast Response in SLE Patients After Vaccination

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    Kaur, Kaval; Zheng, Nai-Ying; Smith, Kenneth; Huang, Min; Li, Lie; Pauli, Noel T.; Henry Dunand, Carole J.; Lee, Jane-Hwei; Morrissey, Michael; Wu, Yixuan; Joachims, Michelle L.; Munroe, Melissa E.; Lau, Denise; Qu, Xinyan; Krammer, Florian; Wrammert, Jens; Palese, Peter; Ahmed, Rafi; James, Judith A.; Wilson, Patrick C.

    2015-01-01

    Breakdown of B cell tolerance is a cardinal feature of systemic lupus erythematosus (SLE). Increased numbers of autoreactive mature naïve B cells have been described in SLE patients and autoantibodies have been shown to arise from autoreactive and non-autoreactive precursors. How these defects, in the regulation of B cell tolerance and selection, influence germinal center (GC) reactions that are directed towards foreign antigens has yet to be investigated. Here, we examined the characteristics of post-GC foreign antigen-specific B cells from SLE patients and healthy controls by analyzing monoclonal antibodies generated from plasmablasts induced specifically by influenza vaccination. We report that many of the SLE patients had anti-influenza antibodies with higher binding affinity and neutralization capacity than those from controls. Although overall frequencies of autoreactivity in the influenza-specific plasmablasts were similar for SLE patients and controls, the variable gene repertoire of influenza-specific plasmablasts from SLE patients was altered, with increased usage of JH6 and long heavy chain CDR3 segments. We found that high affinity anti-influenza antibodies generally characterize the plasmablast responses of SLE patients with low levels of autoreactivity; however, certain exceptions were noted. The high-avidity antibody responses in SLE patients may also be correlated with cytokines that are abnormally expressed in lupus. These findings provide insights into the effects of dysregulated immunity on the quality of antibody responses following influenza vaccination and further our understanding of the underlying abnormalities of lupus. PMID:25951191

  10. Microparticles in the blood of patients with systemic lupus erythematosus (SLE): phenotypic characterization and clinical associations

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    Mobarrez, Fariborz; Vikerfors, Anna; Gustafsson, Johanna T.; Gunnarsson, Iva; Zickert, Agneta; Larsson, Anders; Pisetsky, David S.; Wallén, Håkan; Svenungsson, Elisabet

    2016-01-01

    Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by circulating autoantibodies and the formation of immune complexes. In these responses, the selecting self-antigens likely derive from the remains of dead and dying cells, as well as from disturbances in clearance. During cell death/activation, microparticles (MPs) can be released to the circulation. Previous MP studies in SLE have been limited in size and differ regarding numbers and phenotypes. Therefore, to characterize MPs more completely, we investigated 280 SLE patients and 280 individually matched controls. MPs were measured with flow cytometry and phenotyped according to phosphatidylserine expression (PS+/PS−), cellular origin and inflammatory markers. MPs, regardless of phenotype, are 2–10 times more abundant in SLE blood compared to controls. PS− MPs predominated in SLE, but not in controls (66% vs. 42%). Selectively in SLE, PS− MPs were more numerous in females and smokers. MP numbers decreased with declining renal function, but no clear association with disease activity was observed. The striking abundance of MPs, especially PS− MPs, suggests a generalized disturbance in SLE. MPs may be regarded as “liquid biopsies” to assess the production and clearance of dead, dying and activated cells, i.e. pivotal events for SLE pathogenesis. PMID:27777414

  11. Autoantibodies against Modified Histone Peptides in SLE Patients Are Associated with Disease Activity and Lupus Nephritis

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    Dieker, Jürgen; Berden, Jo H.; Bakker, Marinka; Briand, Jean-Paul; Muller, Sylviane; Voll, Reinhard; Sjöwall, Christopher; Herrmann, Martin; Hilbrands, Luuk B.; van der Vlag, Johan

    2016-01-01

    Persistent exposure of the immune system to death cell debris leads to autoantibodies against chromatin in patients with systemic lupus erythematosus (SLE). Deposition of anti-chromatin/chromatin complexes can instigate inflammation in multiple organs including the kidney. Previously we identified specific cell death-associated histone modifications as targets of autoantibodies in SLE. In this study we addressed, in a large cohort of SLE patients and controls, the question whether plasma reactivities with specific histone peptides associated with serology and clinical features. Plasma from SLE patients with and without lupus nephritis, disease controls, and healthy controls, were tested in ELISA with histone H4 peptide acetylated at lysines 8, 12 and 16 (H4pac), H2B peptide acetylated at lysine 12 (H2Bpac), H3 peptide trimethylated at lysine 27 (H3pme), and their unmodified equivalents. SLE patients displayed a higher reactivity with the modified equivalent of each peptide. Reactivity with H4pac showed both a high sensitivity (89%) and specificity (91%) for SLE, while H2Bpac exhibited a high specificity (96%) but lower sensitivity (69%). Reactivity with H3pme appeared not specific for SLE. Anti-H4pac and anti-H2Bpac reactivity demonstrated a high correlation with disease activity. Moreover, patients reacting with multiple modified histone peptides exhibited higher SLEDAI and lower C3 levels. SLE patients with renal involvement showed higher reactivity with H2B/H2Bpac and a more pronounced reactivity with the modified equivalent of H3pme and H2Bpac. In conclusion, reactivity with H4pac and H2Bpac is specific for SLE patients and correlates with disease activity, whereas reactivity with H2Bpac is in particular associated with lupus nephritis. PMID:27780265

  12. Mesenchymal stem cells upregulate Treg cells via sHLA-G in SLE patients.

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    Chen, Chen; Liang, Jun; Yao, Genhong; Chen, Haifeng; Shi, Bingyu; Zhang, Zhuoya; Zhao, Cheng; Zhang, Huayong; Sun, Lingyun

    2017-03-01

    Soluble human leukocyte antigen-G (sHLA-G) is a non-classical HLA class I molecule, exhibiting strong immunosuppressive properties by inducing the differentiation of T regulatory cells (Treg). Mesenchymal stem cells (MSCs) transplantation alleviates disease progression in systemic lupus erythematosus (SLE) patients. However, the underlying mechanisms are largely unknown. To explore whether sHLA-G is involved in upregulating effects of MSCs on Treg, which contributes to therapeutic effects of MSCs transplantation in SLE. The serum sHLA-G levels of SLE patients and healthy controls were detected by ELISA. The percentages of peripheral blood CD4+ILT2+, CD8+ILT2+, CD19+ILT2+ cells and Treg cells were examined by flow cytometry. Ten patients with active SLE, refractory to conventional therapies, were infused with umbilical cord derived MSCs (UC-MSCs) and serum sHLA-G was measured 24h and 1month after infusion. The mice were divided into three groups: C57BL/6 mice, B6.MRL-Fas(lpr) mice infused with phosphate buffer saline (PBS), and B6.MRL-Fas(lpr) mice infused with bone marrow MSCs (BM-MSCs). Then, the concentrations of serum Qa-2 were detected. Peripheral blood mononuclear cells (PBMCs) were isolated from SLE patients and co-cultured with UC-MSCs for 3days at different ratios (50:1, 10:1, and 2:1) with or without HLA-G antibody, and the frequencies of CD4+CD25+Foxp3+ T cells were then determined by flow cytometry. The concentrations of serum sHLA-G were comparable between SLE patients and healthy controls. However, there was a negative correlation between sHLA-G levels and SLE disease activity index (SLEDAI) scores in active SLE patients (SLEDAI>4). We found that serum sHLA-G levels were negatively correlated with blood urea nitrogen, serum creatinine and 24-hour urine protein in SLE patients. The sHLA-G levels were significantly lower in SLE patients with renal involvement than those without renal involvement. The expression of ILT2 on CD4+ T cells from SLE patients

  13. Hormones, immune response, and pregnancy in healthy women and SLE patients.

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    Zen, Margherita; Ghirardello, Anna; Iaccarino, Luca; Tonon, Michele; Campana, Carla; Arienti, Silvia; Rampudda, Mariaelisa; Canova, Mariagrazia; Doria, Andrea

    2010-04-03

    During pregnancy the maternal immune system is modified in order to achieve immune tolerance toward paternal antigen expressed on foetal cells. These modifications, which occur both at the foeto-maternal interface and in the systemic circulation, are driven by oestrogens and progesterone whose blood concentrations increase during pregnancy. The cytokine profile is also modified. Th2 cytokines are enhanced while the Th1 response is inhibited. This could explain why Th1-mediated autoimmune diseases tend to improve and Th2-mediated diseases, such as systemic lupus erythematosus (SLE), tend to worsen during pregnancy. However, whether or not SLE relapses more frequently during pregnancy is still a matter of debate. Steroid hormone and cytokine profiles differ in SLE patients compared with healthy subjects during pregnancy leading to a dysregulation of the balance between cell-mediated and humoral immune response, which, in turn, could explain the variability of the SLE course during gestation. This review focuses on hormonal-related cytokine changes observed during pregnancy in healthy subjects and SLE patients.

  14. Clinical and immunological aspects and outcome of a Brazilian cohort of 414 patients with systemic lupus erythematosus (SLE): comparison between childhood-onset, adult-onset, and late-onset SLE.

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    das Chagas Medeiros, M M; Bezerra, M Campos; Braga, F N Holanda Ferreira; da Justa Feijão, M R Melo; Gois, A C Rodrigues; Rebouças, V C do Rosário; de Carvalho, T M Amorim Zaranza; Carvalho, L N Solon; Ribeiro, Át Mendes

    2016-04-01

    The clinical expression of systemic lupus erythematosus (SLE) is influenced by genetic and environmental factors and therefore varies between ethnicities. Information on the epidemiology of SLE in Brazil is scarce and practically limited to studies conducted in socioeconomically developed regions (South and Southeast). The objective of this study was to describe the clinical and immunological aspects and outcome of a cohort of patients with SLE treated at a university hospital in northeastern Brazil and compare patterns related to age at onset: childhood (cSLE), adult (aSLE), and late (lSLE). A random sample of 414 records (women: 93.5%) were reviewed. The mean age at SLE onset and the mean disease duration were 28.9 ± 10.9 years and 10.2 ± 6.6 years, respectively. Most patients had aSLE (n = 338; 81.6%), followed by cSLE (n = 60; 14.5%) and lSLE (n = 16; 3.9%). The female/male ratio was 6.5:1 in cSLE and 16.8:1 in aSLE; in lSLE, all patients were female (p = 0.05). During follow-up, the cSLE group presented higher rates of nephritis (70% vs. 52.9% vs. 12.5%; p = 0.0001) and leuko/lymphopenia (61.7% vs. 43.8% vs. 56.2%; p = 0.02). No significant differences were found for anti-dsDNA, anti-Sm, and antiphospholipid antibodies. Treatment with immunosuppressants was significantly more common, and higher doses of prednisone were used, in cSLE. The prevalence of cardiovascular diseases were more frequent in lSLE (p = 0.03). No significant differences were found between the three groups with regard to mean damage accrual (SDI), remission, and mortality. Although cSLE presented higher rates of nephritis and leuko/lymphopenia, more frequent use of immunosuppressants and higher prednisone doses than aSLE and lSLE, the three groups did not differ significantly with regard to damage accrual, remission, and mortality. © The Author(s) 2015.

  15. Multiple Autoantibodies Display Association with Lymphopenia, Proteinuria, and Cellular Casts in a Large, Ethnically Diverse SLE Patient Cohort

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    Rufei Lu

    2012-01-01

    Full Text Available Purpose. This study evaluates high-throughput autoantibody screening and determines associated systemic lupus erythematosus (SLE clinical features in a large lupus cohort. Methods. Clinical and demographic information, along with serum samples, were obtained from each SLE study participant after appropriate informed consent. Serum samples were screened for 10 distinct SLE autoantibody specificities and examined for association with SLE ACR criteria and subcriteria using conditional logistic regression analysis. Results. In European-American SLE patients, autoantibodies against 52 kD Ro and RNP 68 are independently enriched in patients with lymphopenia, anti-La, and anti-ribosomal P are increased in patients with malar rash, and anti-dsDNA and anti-Sm are enriched in patients with proteinuria. In African-American SLE patients, cellular casts associate with autoantibodies against dsDNA, Sm, and Sm/nRNP. Conclusion. Using a high-throughput, bead-based method of autoantibody detection, anti-dsDNA is significantly enriched in patienets with SLE ACR renal criteria as has been previously described. However, lymphopenia is associated with several distinct autoantibody specificities. These findings offer meaningful information to allow clinicians and clinical investigators to understand which autoantibodies correlate with select SLE clinical manifestations across common racial groups using this novel methodology which is expanding in clinical use.

  16. Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE

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    Hyun Sun Ko, Hyun Young Ahn, Dong Gyu Jang, Sae-Kyung Choi, Yong-Gyu Park, In Yang Park, Guisera Lee, Sung-Hwan Park, Jong Chul Shin

    2011-01-01

    Full Text Available This study was undertaken to investigate the pregnancy outcomes in patients with systemic lupus erythematosus (SLE and the appropriate timing of pregnancy. We performed a retrospective evaluation of 183 pregnancies with SLE at Catholic University Medical Center during the 13-year period from 1998 to 2010. Pregnancy outcomes were compared according to SLE characteristics. The predictive value of the different cut-off points of the stable period before conception on adverse pregnancy outcomes was calculated by ROC (Receiver operating characteristics curve analysis. In multivariate analysis, the presence of antiphospholipid antibodies (aPLs increased the risk of pregnancy loss (p<0.0001 and premature birth (p=0.0040. Active disease at conception increased the risk of premature birth (p< 0.0001 and complications (IUGR, PIH, or both (p= 0.0078. The other predictor of complications was found to be lupus flare (p=0.0252. At a cut-off level of stable period of 4 months before conception, sensitivity and specificity were 70.8% and 53.2%, 71.4% and 61.5%, and 63.6 % and 59.8 %, respectively on reducing pregnancy loss, premature birth, and complications. Pregnancies with aPLs, active disease at conception and SLE flares are at a higher risk of adverse outcomes. It is essential that disease activity remains stable at least 4 months before conception, for favorable pregnancy outcomes.

  17. Imaging Pregnant and Lactating Patients.

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    Tirada, Nikki; Dreizin, David; Khati, Nadia J; Akin, Esma A; Zeman, Robert K

    2015-10-01

    As use of imaging in the evaluation of pregnant and lactating patients continues to increase, misperceptions of radiation and safety risks have proliferated, which has led to often unwarranted concerns among patients and clinicians. When radiologic examinations are appropriately used, the benefits derived from the information gained usually outweigh the risks. This review describes appropriateness and safety issues, estimated doses for imaging examinations that use iodizing radiation (ie, radiography, computed tomography, nuclear scintigraphy, and fluoroscopically guided interventional radiology), radiation risks to the mother and conceptus during various stages of pregnancy, and use of iodinated or gadolinium-based contrast agents and radiotracers in pregnant and lactating women. Maternal radiation risk must be weighed with the potential consequences of missing a life-threatening diagnosis such as pulmonary embolus. Fetal risks (ie, spontaneous abortion, teratogenesis, or carcinogenesis) vary with gestational age and imaging modality and should be considered in the context of the potential benefit of medically necessary diagnostic imaging. When feasible and medically indicated, modalities that do not use ionizing radiation (eg, magnetic resonance imaging) are preferred in pregnant and lactating patients. Radiologists should strive to minimize risks of radiation to the mother and fetus, counsel patients effectively, and promote a realistic understanding of risks related to imaging during pregnancy and lactation.

  18. Negative Correlation Between miR-326 and Ets-1 in Regulatory T Cells from new-Onset SLE Patients.

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    Sun, Xiao-Ge; Tao, Jin-Hui; Xiang, Nan; Li, Xiao-Mei; Wang, Guo-Sheng; Fang, Xuan; Dai, Chao; Zhang, Min; Chen, Zhu; Li, Xiang-Pei

    2016-04-01

    To analyze the relationship between miR-326 and Ets-1 mRNA levels in Treg cells and clinical manifestations in patients with SLE and explore the role of miR-326 and Ets-1 in the pathogenesis and activity of SLE. Twenty-five new-onset SLE patients without treatment, twenty-eight inactive SLE patients (SLEDA ≤ 4) and twenty-two healthy controls were included in the present study. Clinical data of SLE patients were recorded. Treg cells were purified by MACS from 20 ml peripheral blood, in which the quantity of miR-326 and Ets-1 mRNA were assessed by real-time PCR. Data were analyzed using SPSS Version 17.0. The nonparametric Mann-Whitney U test was used to compare the groups, The Spearman test was used for correlation analyses. Two-tailed p values correlation was found between the expression of miR-326 mRNA in Treg cells with CRP and anti-C1q antibody from new-onset SLE patients. 2. The level of Ets-1 mRNA was decreased in SLE patients [0.382(0.232, 0.572)] compared to healthy controls(p = 0.013). The difference was also found in new-onset SLE patients [0.222(0.125, 0.296)] while compared to healthy controls. Also, the level in new-onset SLE patients was lower than that in inactive SLE patients [0.482(0.398, 0.512)] (p = 0.001). 3. Negative correlation was found between miR-326 and Ets-1 mRNA expression in Treg cells from new-onset SLE patients (r = -0.583 p = 0.01). 4. There was no correlation of miR-326 or Ets-1 mRNA expression with SLEDAI. The increase of miR-326 expression in Treg cells from SLE patients may inhibit the expression of Ets-1 to participate in the pathological process of SLE.

  19. Widely divergent transcriptional patterns between SLE patients of different ancestral backgrounds in sorted immune cell populations.

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    Sharma, Shruti; Jin, Zhongbo; Rosenzweig, Elizabeth; Rao, Swapna; Ko, Kichul; Niewold, Timothy B

    2015-06-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease of uncertain etiology. Patients from different ancestral backgrounds demonstrate differences in clinical manifestations and autoantibody profiles. We examined genome-wide transcriptional patterns in major immune cell subsets across different ancestral backgrounds. Peripheral blood was collected from African-American (AA) and European-American (EA) SLE patients and controls. CD4 T-cells, CD8 T-cells, monocytes, and B cells were purified by flow sorting, and each cell subset from each subject was run on a genome-wide expression array. Cases were compared to controls of the same ancestral background. The overlap in differentially expressed gene (DEG) lists between different cell types from the same ancestral background was modest (type between different ancestral backgrounds. IFN-stimulated gene (ISG) expression was not up-regulated synchronously in all cell types from a given patient, for example a given subject could have high ISG expression in T and B cells, but not in monocytes. AA subjects demonstrated more concordance in ISG expression between cell types from the same individual, and AA patients demonstrated significant down-regulation of metabolic gene expression which was not observed in EA patients. ISG expression was significantly decreased in B cells in patients taking immunosuppressants, while ISGs in other cell types did not differ with medication use. In conclusion, gene expression was strikingly different between immune cell subsets and between ancestral backgrounds in SLE patients. These findings emphasize the critical importance of studying multiple ancestral backgrounds and multiple cell types in gene expression studies. Ancestral backgrounds which are not studied will not benefit from personalized medicine strategies in SLE.

  20. An SLE patient with prolactinoma and recurrent granulomatous mastitis successfully treated with hydroxychloroquine and bromocriptine.

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    Zhang, L-N; Shi, T-Y; Yang, Y-J; Zhang, F-C

    2014-04-01

    Granulomatous mastitis (GM) is a rare benign mammary lesion in which autoimmunity and hyperprolactinemia are considered possible etiological factors. GM has a high frequency of relapse and may lead to chronic ulceration and fistula if not treated properly. Here we report a case of a 22-year-old systemic lupus erythematosus (SLE) patient with three years' disease duration, stable on prednisone and hydroxychloroquine, who was found to have prolactinoma and recurrent GM after she discontinued medication on her own accord. The patient subsequently recovered and remained free of GM relapse under treatment of prednisone, hydroxychloroquine and bromocriptine. Though autoimmune disorders and prolactinoma were reported in GM, a coexisting condition of SLE, prolactinoma, and granulomatous mastitis has rarely been observed in one patient. We suggest our case as an illustrative example of the complex interaction between autoimmunity, neuroendocrine dysfunction, and manifestations in the breast: Immunological disturbances in the background of SLE, coupled with elevated prolactin levels secondary to a prolactinoma, may have predisposed the patient to the development of GM. The mammary lesion recovered and maintained free of relapse under immunosuppressive and antiprolactinemic therapy.

  1. [Biologics in SLE].

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    Karonitsch, Thomas; Aringer, Martin

    2015-01-01

    Biologics have become indispensable in the last decade in the treatment of the more common rheumatic diseases. For treating systemic lupus erythematodes (SLE), B-cell depletion, albeit off-label, has been a well-accepted strategy in severe and refractory disease. Unexpectedly, however, the results of the first randomized controlled rituximab trials in SLE were negative. New trials with improved study protocols are ongoing, which should resolve this issue. In 2012, with the approval of belimumab, SLE finally entered the era of approved biological therapies. The anti-Blys/BAFF antibody belimumab showed prevention of SLE flares, glucocorticoid sparing, and significant improvement in the quality of life of SLE patients, in part by drastically reducing immune complex mediated fatigue. Positive reports on further targeting approaches give hope that additional biological agents will be available for SLE therapy soon.

  2. BRONCHOALVEOLAR LAVAGE CELL ANALYSIS AND LUNG-FUNCTION IMPAIRMENT IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS (SLE)

    NARCIS (Netherlands)

    GROEN, H; ASLANDER, M; BOOTSMA, H; VANDERMARK, TW; KALLENBERG, CGM; POSTMA, DS

    1993-01-01

    We examined the relationship between peripheral blood and bronchoalveolar lavage (BAL) lymphocyte phenotypes and lung function in 19 patients with SLE, and evaluated their association with disease activity. Lung function assessment showed a mildly restrictive pattern with frequent impairment of

  3. Dental considerations in pregnant patient

    Directory of Open Access Journals (Sweden)

    khedmat S.

    1999-07-01

    Full Text Available During the human gestation period, various systemic alterations occur in the mother"nsecondary to endocrine changes. These changes, combined with the presence of the gravid uterus, result"nin conditions affecting the various systems of the mother which must be considered by the dentist."nFetal development is divided into three stages:"n1 The fertilization and implantation period"n2 The embryonic period and"n3 The fetal period."nThe second period characterized by organogenesis which taratogens may result in functional and"nmorphogenic malformations."nThe ideal dental treatment schedule for the pregnant patient is twice during first trimester, at least once"nduring second trimester and once during third trimester."nThe second trimester is an ideal time for performing dental treatment."nEmergency problem should be alleviated immediately during pregnancy."nIndicated medications should not be with held because of pregnancy but patients must be informed of"nbenefits and risks."nWith careful attention to the special needs of the pregnant patient, the dentist can provide high quality"ndental care while minimizing potential risks to mother and fetus."nEmphasis should be on preventive strategies and meticulous oral hygiene to manage common oral"nproblems associated with pregnancy.

  4. Clinical and immunological manifestations in 151 SLE patients living in Dubai.

    Science.gov (United States)

    AlSaleh, J; Jassim, V; ElSayed, M; Saleh, N; Harb, D

    2008-01-01

    To gain better understanding of systemic lupus erythematosus (SLE) in Dubai we studied the clinical and immunological manifestations in a cohort of 151 patients attended Rheumatology Clinic in Dubai Hospital between January 2002 and January 2007. We found that the female to male ratio was 20.5:1, with a mean age of 35.5 years (0.9). The mean age at disease onset was 28.9 years (0.8) and mean disease duration 6.7 years (0.4). Five-year survival rate in our cohort was 94%. The commonest clinical manifestations in this cohort were arthritis (88%), haematological abnormalities (61.6%), and malar rash (60.3%). Leucopenia, fever, hair loss and proteinuria were observed in approximately half of the patients. Anaemia was found in 44.3% but only 9.9% had haemolytic anaemia. Photosensitive rash was seen in 43% of patients. Approximately one-third of the patients had serositis and mouth ulcers, 30.5 and 27.2% respectively. Vasculitis was observed in 19.2% of patients. Neuropsychiatric manifestations (15.9%), discoid lupus lesions (12.6%), and brain infarcts (13.2%) were infrequent. Subacute cutaneous lupus (6%) was also uncommon. Anti-nuclear antibodies were detected in 98%, anti-double stranded DNA antibodies in 88.7%, anti-Sm antibodies in 19.7%, anti-RNP in 40.4%, anti-Ro antibodies in 52.3% and anti-La antibodies in 19.8%. Anti-cardiolipin IgM and IgG were detected in 25.3 and 22.4%, respectively. This study suggests that Arabs with SLE residing in Dubai have comparable clinical features to their counterparts in other Arab countries and Western countries. The high prevalence of positive anti-Ro antibodies among our Arab patients probably reflects a character, that is, commonly seen in SLE patients of Middle East origin.

  5. IL22 in Egyptian SLE patients, could it reflect disease activity, skin or renal involvement or is it only an expensive ESR?

    Directory of Open Access Journals (Sweden)

    Iman Ibrahim El-Gazzar

    2017-01-01

    Conclusion: Our data suggest that increased serum IL-22 may contribute to the pathogenesis of SLE. Its elevated serum level allows discrimination between patients with different clinical and laboratory measures and indicates the potential of IL-22 as an additional tool for assessment of activity in SLE. IL22 in serum seems to be a significant index reflecting skin and renal involvement in SLE.

  6. Decreased SAP expression in T cells from patients with SLE contributes to early signaling abnormalities and reduced IL-2 production

    Science.gov (United States)

    Karampetsou, Maria P.; Comte, Denis; Kis-Toth, Katalin; Terhorst, Cox; Kyttaris, Vasileios C.; Tsokos, George C.

    2016-01-01

    T cells from patients with systemic lupus erythematosus (SLE) display a number of functions including increased early signaling events following engagement of the T cell receptor (TCR). Signaling lymphocytic activation molecule family (SLAMF) cell surface receptors and the X-chromosome-defined signaling lymphocytic activation molecule-associated protein (SAP) adaptor are important in the development of several immunocyte lineages and modulating immune response. Here we present evidence that SAP protein levels are decreased in T cells and in their main subsets isolated from 32 women and 3 men with SLE independently of disease activity. In SLE T cells the SAP protein is also subject to increased degradation by a caspase-3. Forced expression of SAP in SLE T cells simultaneously heightened IL-2 production, calcium (Ca2+) responses and tyrosine phosphorylation of a number of proteins. Exposure of normal T cells to SLE serum IgG, known to contain anti-CD3/TCR antibodies, resulted in SAP downregulation. We conclude that SLE T cells display reduced levels of the adaptor protein SAP probably as a result of continuous T cell activation and degradation by caspase-3. Restoration of SAP levels in SLE T cells corrects the overexcitable lupus T cell phenotype. PMID:27183584

  7. Chinese SLE Treatment and Research group (CSTAR) registry: V. gender impact on Chinese patients with systemic lupus erythematosus.

    Science.gov (United States)

    Zhang, S; Su, J; Li, X; Zhang, X; Liu, S; Wu, L; Ma, L; Bi, L; Zuo, X; Sun, L; Huang, C; Zhao, J; Li, M; Zeng, X

    2015-10-01

    Many studies have shown that differences were observed between male and female lupus patients. Although systemic lupus erythematosus (SLE) affects mostly females (female:male ratio 9:1), male SLE patients show higher mortality due to kidney and neurological disease. Currently there are limited epidemiological data concerning lupus in the Chinese population. As such, the Chinese SLE Treatment and Research group (CSTAR) developed the first online registry of Chinese lupus patients in 2009, and represents a multicenter observational study that attempts to describe and compile the major clinical characteristics of lupus in Chinese patients. To investigate the effect of gender on the phenotypes of Chinese SLE patients. Data for 2104 SLE patients were prospectively collected and included in the CSTAR registry. Patients fulfilled the 1997 American College of Rheumatology (ACR) SLE classification criteria. We conducted a cross-sectional case-control study to analyze patient clinical and laboratory data at onset and at enrollment. SLE disease activity scores (SLEDAI) were also measured at enrollment. This study included 1914 women and 190 men. Males and females showed no differences in mean ages at onset, delay of diagnosis and disease duration. Males presented more frequently with fever (p = 0.003), while musculoskeletal involvement (p = 0.001) and cytopenia (p = 0.017) was more common in females as the initial manifestation at onset of SLE. For manifestations at enrollment, males presented more frequently with fever (p = 0.005), renal disease (p = 0.019), vasculitis (p = 0.032) and neuropsychiatric lupus (p = 0.007). For cumulative manifestations at enrollment, males presented more frequently with discoid rash (p lupus (p = 0.036), while less frequently with arthritis (p = 0.011). However, the laboratory data showed no significant differences between the two groups at enrollment. Males also had higher SLEDAI scores at enrollment (p

  8. Complement Receptor Type 1 Suppresses Human B Cell Functions in SLE Patients

    Directory of Open Access Journals (Sweden)

    Mariann Kremlitzka

    2016-01-01

    Full Text Available Complement receptors (CRs play an integral role in innate immunity and also function to initiate and shape the adaptive immune response. Our earlier results showed that complement receptor type 1 (CR1, CD35 is a potent inhibitor of the B cell receptor- (BCR- induced functions of human B lymphocytes. Here we show that this inhibition occurs already at the initial steps of B cell activation since ligation of CR1 reduces the BCR-induced phosphorylation of key signaling molecules such as Syk and mitogen activated protein kinases (MAPKs. Furthermore, our data give evidence that although B lymphocytes of active systemic lupus erythematosus (SLE patients express lower level of CR1, the inhibitory capacity of this complement receptor is still maintained and its ligand-induced clustering results in significant inhibition of the main B cell functions, similar to that found in the case of healthy individuals. Since we have found that reduced CR1 expression of SLE patients does not affect the inhibitory capacity of the receptor, our results further support the therapeutical potential of CD35 targeting the decrease of B cell activation and autoantibody production in autoimmune patients.

  9. Early vascular alterations in SLE and RA patients--a step towards understanding the associated cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Maria José Santos

    Full Text Available Accelerated atherosclerosis represents a major problem in both systemic lupus erythematosus (SLE and rheumatoid arthritis (RA patients, and endothelial damage is a key feature of atherogenesis. We aimed to assess early endothelial changes in SLE and RA female patients (127 SLE and 107 RA without previous CV events. Biomarkers of endothelial cell activation (intercellular adhesion molecule-1 (sICAM-1, vascular cell adhesion molecule-1 (sVCAM-1, thrombomodulin (TM, and tissue factor (TF were measured and endothelial function was assessed using peripheral artery tonometry. Reactive hyperemia index (RHI, an indicator of microvascular reactivity, and augmentation index (AIx, a measure of arterial stiffness, were obtained. In addition, traditional CV risk factors, disease activity and medication were determined. Women with SLE displayed higher sICAM-1 and TM and lower TF levels than women with RA (p = 0.001, p<0.001 and p<0.001, respectively. These differences remained significant after controlling for CV risk factors and medication. Serum levels of vascular biomarkers were increased in active disease and a moderate correlation was observed between sVCAM-1 levels and lupus disease activity (rho = 0.246 and between TF levels and RA disease activity (rho = 0.301. Although RHI was similar across the groups, AIx was higher in lupus as compared to RA (p = 0.04. Also in active SLE, a trend towards poorer vasodilation was observed (p = 0.06. In conclusion, women with SLE and RA present with distinct patterns of endothelial cell activation biomarkers not explained by differences in traditional CV risk factors. Early vascular alterations are more pronounced in SLE which is in line with the higher CV risk of these patients.

  10. Anesthetic Management of Pregnant Patients with Appendectomy

    OpenAIRE

    Celik, Feyzi; Oguz, Abdullah; Yildirim, Zeynep Baysal; Guzel, Abdulmenap; Dogan, Erdal; Ciftci, Taner; Aycan, Ilker Onguc

    2014-01-01

    Our goal was to present our anesthesia procedure of pre-diagnosis and laparotomy on pregnant patients with acute appendicitis. After approval Ethics Committee, 77 pregnant patients with a diagnosis of acute appendicitis were evaluated. Patients were separated into two groups: group G (general anesthesia) and Group S (spinal anesthesia), according to the method of anesthesia applied. The patients' age, gestational age, method of anesthesia applied, duration of hospital stay, duration of a...

  11. Disease activity patterns over time in patients with SLE: analysis of the Hopkins Lupus Cohort

    Science.gov (United States)

    Györi, Noémi; Giannakou, Ioanna; Chatzidionysiou, Katerina; Magder, Laurence; van Vollenhoven, Ronald F; Petri, Michelle

    2017-01-01

    Objective To describe SLE disease activity patterns in the Hopkins Lupus Cohort. Methods Disease activity was studied in 1886 patients followed-up for 1–28 years. Disease activity patterns were defined using (1) Physician Global Assessment (PGA) and (2) modified SLE Disease Activity Index (M-SLEDAI) as follows: long quiescent (LQ), M-SLEDAI=0/PGA=0 at all visits; relapsing-remitting (RR), periods of activity (M-SLEDAI>0/PGA>0) interspersed with inactivity (M-SLEDAI=0/PGA=0); chronic active (CA), M-SLEDAI>0/PGA>0 at all visits. The pattern of first 3 consecutive follow-up years was determined in 916 patients as: persistent LQ (pLQ), persistent RR (pRR) and persistent CA (pCA), LQ, RR and CA pattern in each of the 3 years, respectively; mixed, at least two different pattern types were identified. Results The RR pattern accounted for the greatest proportion of follow-up time both by M-SLEDAI and PGA, representing 53.8% and 49.9% of total patient-years, respectively. The second most frequent pattern was LQ based on M-SLEDAI (30.7%) and CA based on PGA (40.4%). For the first 3-year intervals, the mixed pattern type was the most common (56.6%). The pRR was the second most frequent (M-SLEDAI 33.3%, PGA 26.5%), while pLQ (M-SLEDAI 6.4%, PGA 0.7%) and pCA were less frequent (M-SLEDAI 3.7%, PGA 16.3%). Conclusions The RR pattern was the most prevalent pattern. LQ was achieved in a subset of patients, using the M-SLEDAI. However, the PGA captured mild activity missed on the M-SLEDAI in these patients. Over a 3-year perspective, less than half of patients maintained their original pattern. PMID:28243457

  12. Management of Pregnant Patient in Dentistry

    OpenAIRE

    Kurien, Sophia; Kattimani, Vivekanand S.; Sriram, Roopa Rani; Sriram, Sanjay Krishna; Rao V K, Prabhakara; Bhupathi, Anitha; Bodduru, Rupa Rani; N Patil, Namrata

    2013-01-01

    The purpose of this article is to update general dentists and maxillofacial surgeons in the perioperative management of the pregnant patient. Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by hormones; which influences the treatment schedule. Understanding these normal changes is essential for providing quality care for pregnant women.

  13. The effect of polyamines on the binding of anti-DNA antibodies from patients with SLE and normal human subjects.

    Science.gov (United States)

    Wang, Xiao; Stearns, Nancy A; Li, Xingfu; Pisetsky, David S

    2014-07-01

    Antibodies to DNA (anti-DNA) are the serological hallmark of systemic lupus erythematosus (SLE). To elucidate specificity further, the effect of polyamines on the binding of anti-DNA antibodies from patients with lupus was tested by ELISA to calf thymus (CT) DNA; we also assessed the binding of plasmas of patients and normal human subjects (NHS) to Micrococcus luteus (MC) DNA. As these studies showed, spermine can dose-dependently inhibit SLE anti-DNA binding to CT DNA and can promote dissociation of preformed immune complexes. With MC DNA as antigen, spermine failed to inhibit the NHS anti-DNA binding. Studies using plasmas adsorbed to a CT DNA cellulose affinity indicated that SLE plasmas are mixtures of anti-DNA that differ in inhibition by spermine and binding to conserved and non-conserved determinants. Together, these studies demonstrate that spermine can influence the binding of anti-DNA autoantibodies and may contribute to the antigenicity of DNA.

  14. The resistance of activated T-cells from SLE patients to apoptosis induced by human thymic stromal cells.

    Science.gov (United States)

    Budagyan, V M; Bulanova, E G; Sharova, N I; Nikonova, M F; Stanislav, M L; Yarylin, A A

    1998-01-01

    In this paper we show the differential sensitivity of phytohemagglutinine (PHA) activated T-cells from healthy donors or patients with systemic lupus erythematosus (SLE) to apoptosis induced by human thymic stromal cell line of epithelial origin. T-cells from SLE patients were mainly resistant to the apoptotic action of the stromal cells, while normal T-lymphocytes readily died via apoptosis. Gel electrophoresis revealed a DNA fragmentation pattern characteristic of apoptosis after 18 h of coculture. The simultaneous measurement of [3H]-thymidine uptake showed that the proliferative response of T-cells from SLE patients was significantly decreased compared to their normal counterparts. Such difference may account for the distinct result of interactions between the stromal and lymphoid cells, leading to the subsequent survival of T-lymphocytes from SLE patients. Nevertheless pretreatment of normal activated T-lymphocytes with anti-Fas mAbs, which have the capacity to substantially inhibit signaling through this receptor resulted in abolition of this form of programmed cell death. Thus, the precise role of Fas receptor and its ligand in this in vitro test system needs further investigation.

  15. Complement receptor expression and activation of the complement cascade on B lymphocytes from patients with systemic lupus erythematosus (SLE)

    DEFF Research Database (Denmark)

    Marquart, H V; Svendsen, Anders Jørgen; Rasmussen, J M

    1995-01-01

    It has previously been reported that the expression of the complement receptors, CR1 on erythrocytes and blood leucocytes and CR2 on B cells, is reduced in patients with SLE, and that the reduced expression of CR1 on erythrocytes is related to disease activity. We have earlier demonstrated that n...

  16. Complement receptor expression and activation of the complement cascade on B lymphocytes from patients with systemic lupus erythematosus (SLE)

    DEFF Research Database (Denmark)

    Marquart, H V; Svendsen, A; Rasmussen, J M

    1995-01-01

    It has previously been reported that the expression of the complement receptors, CR1 on erythrocytes and blood leucocytes and CR2 on B cells, is reduced in patients with SLE, and that the reduced expression of CR1 on erythrocytes is related to disease activity. We have earlier demonstrated that n...

  17. Chinese SLE Treatment and Research group (CSTAR) registry: I. Major clinical characteristics of Chinese patients with systemic lupus erythematosus.

    Science.gov (United States)

    Li, M; Zhang, W; Leng, X; Li, Z; Ye, Z; Li, C; Li, X; Zhu, P; Wang, Z; Zheng, Y; Li, X; Zhang, M; Zhang, F; Zhao, Y; Zeng, X

    2013-10-01

    The Chinese systemic lupus erythematosus (SLE) treatment and research group (CSTAR) provides major clinical characteristics of SLE in China and establishes a platform to provide resources for future basic and clinical studies. CSTAR originated as a multicentre, consecutive, and prospective design. The data were collected online from 104 rheumatology centers, which covered 30 provinces in China. The registered patients were required to meet four or more of the American College of Rheumatology (ACR) criteria for the classification of SLE. All CSTAR centers use the same protocol-directed methods to provide uniform evaluations, which included demographic data, clinical features, laboratory examinations, and disease activity evaluations. The patient samples, including DNA samples and sera, were also collected for further quality controls and additional studies. Preliminary analysis from 2104 baseline evaluations was available for this analysis. Of 1914 female and 190 male patients (F:M=10.1), the mean age at onset was 29.2 y with confirmed diagnosis one year later at the age of 30.3 y. Eighty four (4.2%) of 2002 patients had a family history of rheumatic diseases, including 34 (1.7%) cases with SLE. In addition, one hundred and seven (5.2%) abnormal pregnancies were recorded among 2026 experiences. The characteristics of the CSTAR cohort were compared to similarly sized cohorts from other studies. We found that 56.1% of patients presented with concurrent hematological disorders compared to only 18.2% of European patients. Moreover, 47.4% of patients presented with nephropathy compared to 27.9% of European patients. Conversely, neurological manifestations were only seen in 4.8% of Chinese SLE patients compared to 19.4% of European patients, 12.1% of U.S. patients, 22.8% of Malaysian patients and 26.4% of Latin Americans. Pulmonary arterial hypertension and interstitial lung diseases were complications identified in 3.8% and 4.2% of Chinese lupus patients, respectively

  18. Validation of a Chinese version of the Medical Outcomes Study Family and Marital Functioning Measures in patients with SLE.

    Science.gov (United States)

    Thumboo, J; Feng, P H; Soh, C H; Boey, M L; Thio, S; Fong, K Y

    2000-01-01

    The objective was to validate a Chinese translation of the Medical Outcomes Study Family and Marital Functioning Measures (FFM and MFM) in patients with systemic lupus erythematosus (SLE). Chinese-speaking SLE patients (n = 69) completed a self-administered questionnaire containing the FFM and MFM and assessing demographic and socio-economic status twice within a 2 week period. SLE activity, disease-related damage and quality of life were assessed using the BILAG, SLICC/ACR Damage Index and SF-36 Health Survey, respectively. Scale psychometric properties were assessed through factor analysis, Cronbach's alpha, quantifying test-retest differences and known-groups construct validity. Factor analysis identified 1 factor corresponding to the FFM and 2 factors corresponding to the MFM. Internal consistency for the FFM was excellent (alpha = 0.92) while that for the MFM was acceptable (alpha = 0.62). Mean (s.d.) test-retest differences were 0.06 (1.54) points for the FFM and 0.03 (2.08) points for the MFM. 11 and 10 of 13 a priori hypotheses relating the FFM and MFM, respectively, to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales. The Chinese FFM and MFM are valid and reliable measures of family and marital functioning in Chinese-speaking SLE patients, with psychometric properties very similar to the source English version.

  19. Fibromyalgia, systemic lupus erythematosus (SLE), and evaluation of SLE activity.

    Science.gov (United States)

    Wolfe, Frederick; Petri, Michelle; Alarcón, Graciela S; Goldman, John; Chakravarty, Eliza F; Katz, Robert S; Karlson, Elizabeth W

    2009-01-01

    To determine if fibromyalgia (FM) or fibromyalgia-ness (the tendency to respond to illness and psychosocial stress with fatigue, widespread pain, general increase in symptoms, and similar factors) is increased in patients with compared to those without systemic lupus erythematosus (SLE); to determine whether FM or fibromyalgia-ness biases the SLE Activity Questionnaire (SLAQ); and to determine if the SLAQ is overly sensitive to FM symptoms. We developed a 16-item SLE Symptom Scale (SLESS) modeled on the SLAQ and used that scale to investigate the relation between SLE symptoms and fibromyalgia-ness in 23,321 patients with rheumatic disease. FM was diagnosed by survey FM criteria, and fibromyalgia-ness was measured using the Symptom Intensity (SI) Scale. As comparison groups, we combined patients with rheumatoid arthritis and noninflammatory rheumatic disorders into an "arthritis" group and also utilized a physician-diagnosed group of patients with FM. FM was identified in 22.1% of SLE and 17.0% of those with arthritis. The SI scale was minimally increased in SLE. The correlation between SLAQ and SLESS was 0.738. SLESS/SLAQ scale items (Raynaud's phenomenon, rash, fever, easy bruising, hair loss) were significantly more associated with SLE than FM, while the reverse was true for headache, abdominal pain, paresthesias/stroke, fatigue, cognitive problems, and muscle pain or weakness. There was no evidence of disproportionate symptom-reporting associated with fibromyalgia-ness. Self-reported SLE was associated with an increased prevalence of FM that was unconfirmed by physicians, compared to SLE confirmed by physicians. The prevalence of FM in SLE is minimally increased compared with its prevalence in patients with arthritis. Fibromyalgia-ness does not bias the SLESS and should not bias SLE assessments, including the SLAQ.

  20. Management of pregnant patient in dentistry.

    Science.gov (United States)

    Kurien, Sophia; Kattimani, Vivekanand S; Sriram, Roopa Rani; Sriram, Sanjay Krishna; Rao V K, Prabhakara; Bhupathi, Anitha; Bodduru, Rupa Rani; N Patil, Namrata

    2013-02-01

    The purpose of this article is to update general dentists and maxillofacial surgeons in the perioperative management of the pregnant patient. Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by hormones; which influences the treatment schedule. Understanding these normal changes is essential for providing quality care for pregnant women. The general principles that apply in this situation are discussed, followed by the relevant physiologic changes and their treatment implications, the risks of various medications to the mother and fetus, the management of concomitant medical problems in the pregnant patient, appropriate timing of oral and maxillofacial surgery during pregnancy, and management of emergencies during pregnancy. Information about the compatibility, complications, and excretion of the common drugs during pregnancy is provided. Guidelines for the management of a pregnant patient in the dental office are summarized. How to cite this article: Kurien S, Kattimani V S, Sriram R, Sriram S K, Prabhakar Rao V K, Bhupathi A, Bodduru R, Patil N N. Management of Pregnant Patient in Dentistry. J Int Oral Health 2013; 5(1):88-97.

  1. Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus.

    Science.gov (United States)

    Zhao, J; Bai, W; Zhu, P; Zhang, X; Liu, S; Wu, L; Ma, L; Bi, L; Zuo, X; Sun, L; Huang, C; Tian, X; Li, M; Zhao, Y; Zeng, X

    2016-05-01

    To investigate both the prevalence and clinical characteristics of serositis in Chinese patients with systemic lupus erythematosus (SLE) in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database. A prospective cross-sectional study of patients with SLE was conducted based on the data from the CSTAR registry. Serositis was defined according to the 1999 revised American College of Rheumatology (ACR) criteria for SLE - that is, pleuritis/pleural effusion and/or pericarditis/pericardial effusion detected by echocardiography, chest X-ray or chest computerized tomography (CT) scan. Peritonitis/peritoneal effusion were confirmed by abdominal ultrasonography. We analysed the prevalence and clinical associations of serositis with demographic data, organ involvements, laboratory findings and SLE disease activity. Of 2104 patients with SLE, 345 were diagnosed with serositis. The prevalence of lupus nephritis (LN), interstitial lung disease and pulmonary arterial hypertension, as well as the presence of leukocytopenia, thrombocytopenia, hypocomplementemia and anti-dsDNA antibodies was significantly higher in patients with serositis (P Lupus-related peritonitis had similar clinical manifestations and laboratory profiles as serositis caused by SLE. There is a significant association of nephropathy, interstitial lung disease, pulmonary arterial hypertension, hypocomplementemia, leukocytopenia, thrombocytopenia and elevated anti-dsDNA antibodies with serositis. The results suggest that higher SLE disease activity contributes to serositis development, and should be treated aggressively. © The Author(s) 2016.

  2. Effect of Proinflammatory Cytokines (IL-6, TNF-α, and IL-1β) on Clinical Manifestations in Indian SLE Patients

    Science.gov (United States)

    Pradhan, Vandana; Nadkar, Milind; Rajadhyaksha, Anjali; Patwardhan, Manisha; Ghosh, Kanjaksha K.; Nadkarni, Anita H.

    2014-01-01

    Systemic lupus erythematosus (SLE) is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. In this study we have investigated the effect of proinflammatory cytokines (IL-6, TNF-α, and IL-1β) on clinical manifestations in 145 Indian SLE patients. One hundred and forty-five healthy controls of the same ethnicity served as a control group. Clinical disease activity was scored according to SLEDAI score. Accordingly, 110 patients had active disease and 35 patients had inactive disease. Mean levels of IL-6, TNF-α, and IL-1β were found to be significantly higher in SLE patients than healthy controls (P < 0.001). Mean level of IL-6 for patients with active disease (70.45±68.32 pg/mL) was significantly higher (P = 0.0430) than those of inactive disease patients (43.85±63.36 pg/mL). Mean level of TNF-α was 44.76±68.32 pg/mL for patients with active disease while it was 25.97±22.03 pg/mL for those with inactive disease and this difference was statistically significant (P = 0.0161). Similar results were obtained for IL-1β (P = 0.0002). Correlation between IL-6, TNF-α, and IL-1β serum levels and SLEDAI score was observed (r = 0.20, r = 0.27, and r = 0.38, resp.). This study supports the role of these proinflammatory cytokines as inflammatory mediators in active stage of disease. PMID:25548434

  3. Effect of Proinflammatory Cytokines (IL-6, TNF-α, and IL-1β on Clinical Manifestations in Indian SLE Patients

    Directory of Open Access Journals (Sweden)

    Vinod Umare

    2014-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. In this study we have investigated the effect of proinflammatory cytokines (IL-6, TNF-α, and IL-1β on clinical manifestations in 145 Indian SLE patients. One hundred and forty-five healthy controls of the same ethnicity served as a control group. Clinical disease activity was scored according to SLEDAI score. Accordingly, 110 patients had active disease and 35 patients had inactive disease. Mean levels of IL-6, TNF-α, and IL-1β were found to be significantly higher in SLE patients than healthy controls (P<0.001. Mean level of IL-6 for patients with active disease (70.45±68.32 pg/mL was significantly higher (P=0.0430 than those of inactive disease patients (43.85±63.36 pg/mL. Mean level of TNF-α was 44.76±68.32 pg/mL for patients with active disease while it was 25.97±22.03 pg/mL for those with inactive disease and this difference was statistically significant (P=0.0161. Similar results were obtained for IL-1β (P=0.0002. Correlation between IL-6, TNF-α, and IL-1β serum levels and SLEDAI score was observed (r=0.20, r=0.27, and r=0.38, resp.. This study supports the role of these proinflammatory cytokines as inflammatory mediators in active stage of disease.

  4. Increased arterial stiffness in systemic lupus erythematosus (SLE patients at low risk for cardiovascular disease: a cross-sectional controlled study.

    Directory of Open Access Journals (Sweden)

    Karim Sacre

    Full Text Available Cardiovascular disease (CVD is a major cause of death in systemic lupus erythematosus (SLE patients. Although the risk for cardiovascular events in patients with SLE is significant, the absolute number of events per year in any given cohort remains small. Thus, CVD risks stratification in patients with SLE focuses on surrogate markers for atherosclerosis at an early stage, such as reduced elasticity of arteries. Our study was designed to determine whether arterial stiffness is increased in SLE patients at low risk for CVD and analyze the role for traditional and non-traditional CVD risk factors on arterial stiffness in SLE. Carotid-femoral pulse wave velocity (PWV was prospectively assessed as a measure of arterial stiffness in 41 SLE patients and 35 controls (CTL. Adjustment on age or Framingham score was performed using a logistic regression model. Factors associated with PWV were identified separately in SLE patients and in controls using Pearson's correlation coefficient for univariate analysis and multiple linear regression for multivariate analysis. SLE patients and controls displayed a low 10-year risk for CVD according to Framingham score (1.8±3.6% in SLE vs 1.6±2.8% in CTL, p = 0.46. Pulse wave velocity was, however, higher in SLE patients (7.1±1.6 m/s as compared to controls (6.3±0.8 m/s; p = 0.01, after Framingham score adjustment and correlated with internal carotid wall thickness (p = 0.0017. In multivariable analysis, only systolic blood pressure (p = 0.0005 and cumulative dose of glucocorticoids (p = 0.01 were associated with PWV in SLE patients. Interestingly, the link between systolic blood pressure (SBP and arterial stiffness was also confirmed in SLE patients with normal systolic blood pressure. In conclusion, arterial stiffness is increased in SLE patients despite a low risk for CVD according to Framingham score and is associated with systolic blood pressure and glucocorticoid therapy.

  5. Low frequency of CD4+CD25+ Treg in SLE patients: a heritable trait associated with CTLA4 and TGFβ gene variants

    Directory of Open Access Journals (Sweden)

    Viana João F

    2009-01-01

    Full Text Available Abstract Background CD4+CD25+ regulatory T cells play an essential role in maintaining immune homeostasis and preventing autoimmunity. Therefore, defects in Treg development, maintenance or function have been associated with several human autoimmune diseases including Systemic Lupus Erythematosus (SLE, a systemic autoimmune disease characterized by loss of tolerance to nuclear components and significantly more frequent in females. Results To investigate the involvement of Treg in SLE pathogenesis, we determined the frequency of CD4+CD25+CD45RO+ T cells, which encompass the majority of Treg activity, in the PBMC of 148 SLE patients (76 patients were part of 54 families, 166 relatives and 117 controls. SLE patients and their relatives were recruited in several Portuguese hospitals and through the Portuguese Lupus Association. Control individuals were blood donors recruited from several regional blood donor centers. Treg frequency was significantly lower in SLE patients than healthy controls (z = -6.161, P P bona fide FOXP3+CD4+CD25+ Treg. Treg frequency was negatively correlated with SLE activity index (SLEDAI and titers of serum anti-dsDNA antibodies. Both Treg frequency and disease activity were modulated by IVIg treatment in a documented SLE case. The segregation of Treg frequency within the SLE families was indicative of a genetic trait. Candidate gene analysis revealed that specific variants of CTLA4 and TGFβ were associated with the decreased frequency of Treg in PBMC, while FOXP3 gene variants were associated with affection status, but not with Treg frequency. Conclusion SLE patients have impaired Treg production or maintenance, a trait strongly associated with SLE disease activity and autoantibody titers, and possibly resulting from the inability to convert FOXP3+CD25- into FOXP3+CD25+ T cells. Treg frequency is highly heritable within SLE families, with specific variants of the CTLA4 and TGFβ genes contributing to this trait, while FOXP

  6. Glycated-H2A histone is better bound by serum anti-DNA autoantibodies in SLE patients: glycated-histones as likely trigger for SLE?

    Science.gov (United States)

    Alam, Sana; Arif, Zarina; Alam, Khursheed

    2015-02-01

    Histones are the most abundant proteins associated with genomic DNA. Recent observations show that histones are quite susceptible to non-enzymatic glycation which results in the generation of free radicals causing structural perturbations. In this study, our aim is to define the role of deoxyribose-modified H2A histone in SLE initiation/progression. Glycation reaction was carried out by incubating H2A histone with 10 mM deoxyribose for 21 days at 37 °C. Structural changes in glycated-H2A were studied by various physico-chemical techniques. The antigen-antibody interaction was studied by direct binding, inhibition ELISA and mobility shift assay. Deoxyribose-modified-H2A histone showed increased hyperchromicity and increased fluorescence intensity. CD results demonstrated almost 50% loss in alpha helix conformation as a consequence of glycation. This was supported by an increase in Tm value vis-à-vis thermal stability. Glycated-H2A showed cross linking in SDS-PAGE. SLE sera positive for anti-nDNA autoantibodies showed preference for deoxyribose-modified-H2A histone compared to native H2A histone or native DNA. Inhibition ELISA supported the above findings. Band shift assay further reiterated the preferential recognition of glycated-H2A over native H2A by SLE IgG autoantibodies. Deoxyribose-modified-H2A histone exhibited damage as revealed by various physico-chemical studies. Glycation of H2A has resulted in the generation of neo-epitopes on H2A histone, which are preferably bound by SLE anti-nDNA autoantibodies. It implies that deoxyribose-modified-H2A may trigger immune response resulting in the generation of anti-glycated H2A antibodies with DNA cross reacting properties.

  7. Drug therapy for the pregnant dental patient.

    Science.gov (United States)

    Mendia, Jonathan; Cuddy, Michael A; Moore, Paul A

    2012-09-01

    Providing needed dental treatment, managing oral infection, and controlling pain are essential functions of dentists for helping patients maintain overall health during pregnancy. Medications commonly required for dental care consist of local anesthetics and associated vasoconstrictors, centrally and peripherally acting analgesics, sedative and anxiolytic agents, and antibiotics. Therapeutic drugs routinely used in dental practice are selected because of their known safety and effectiveness. However, for a pregnant patient requiring dental care, the agents routinely prescribed should be reevaluated for potential risks to the mother and/or fetus. The decision to administer a specific drug requires that the benefits outweigh the potential risks of the drug therapy. This article reviews and updates the recommendations for using dental therapeutic agents, thereby enabling general practitioners to select the safest drugs when treating pregnant dental patients.

  8. SLE ASSOCIATED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS WITH DISSEMINATED HISTOPLASMOSIS IN A HIV SEROPOSITIVE PATIENT

    Directory of Open Access Journals (Sweden)

    Pranati Mohanty

    2016-10-01

    Full Text Available BACKGROUND Hemophagocytic Lymphohistiocytosis (HLH is an uncommon, life-threatening and likely underdiagnosed disease of diverse aetiologies caused by a defective NK/T - cell cytotoxic pathway resulting in uncontrolled hypercytokinaemia leading to end organ damage carrying a high mortality rate. Here, we report HLH complicating SLE in a 42 years old female associated with disseminated histoplasmosis and accidentally detected as seropositive for HIV. This is extremely rare in the world literature.

  9. Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports.

    Science.gov (United States)

    Bexelius, C; Wachtmeister, K; Skare, P; Jönsson, L; Vollenhoven, R van

    2013-07-01

    The objective of this paper is to investigate drivers of cost and health-related quality of life (HRQoL) related to disease activity and fatigue among patients with systemic lupus erythematous (SLE). A questionnaire was sent to members of a patient organization with a self-reported diagnosis of SLE, requesting information on demographics and disease characteristics, medications, resource utilization, informal care, loss of productivity, fatigue and HRQoL in relation to SLE. Mean annual costs per patient were estimated from a societal perspective. HRQoL was measured through EQ-5D and fatigue was measured through a 10 cm VAS scale. Patient-reported disease activity was measured through the Systemic Lupus Activity Questionnaire (SLAQ) and corticosteroid dose. Drivers of costs and HRQoL were analyzed through regression analysis. A total of 339 patients out of 737 returned the questionnaire. Mean age was 55; 94% were female. The mean HRQoL measured through the five-item EQ-5D instrument was 0.64 and total costs were estimated at €22,594 (direct costs €7818; indirect costs €14,776). Disease activity, fatigue and corticosteroid doses had a statistically significant impact on costs and HRQoL. This study demonstrates that Swedish patients with SLE have low HRQoL and incur high societal costs and that are both associated with and most likely driven by disease activity, fatigue and corticosteroid use.

  10. Moderate Sle With Lupus Nefritis

    OpenAIRE

    Marpaung, Blondina; Sinurat, Faisal

    2016-01-01

    Lupus nephritis is one of the most serious manifestations of systemic lupus erythematosus (LES) and usually appear within 5 years after diagnosis. Lupus nephritis is histologically evident in most patients with SLE, even those who do not show clinical manifestations of kidney disease. Symptoms of lupus nephritis is generally associated with hypertension, proteinuria and renal failure. Reported a case of systemic lupus erythematosus (SLE) with severe lupus nephritis in a man 23-years old bo...

  11. Treatment of pregnant and non-pregnant rheumatic patients : a survey among Dutch rheumatologists

    NARCIS (Netherlands)

    Vroom, F.; van de Laar, M. A. J. F.; van Roon, E. N.; Brouwers, J. R. B. J.; den Berg, L. T. W. de Jong-van

    2008-01-01

    Background: The aim of this study was to explore, among Dutch rheumatologists, aspects such as attitude towards guidelines, pharmacotherapy and information needs in the treatment of pregnant as well as non-pregnant rheumatoid arthritis (RA) patients. Methods: Fifteen rheumatologists from nine differ

  12. Treatment of pregnant and non-pregnant rheumatic patients: a survey among Dutch rheumatologists

    NARCIS (Netherlands)

    Vroom, F.; Laar, van de M.A.F.J.; Roon, van E.N.; Brouwers, J.R.B.J.; Jong-van den Berg, de L.T.W.

    2008-01-01

    Background: The aim of this study was to explore, among Dutch rheumatologists, aspects such as attitude towards guidelines, pharmacotherapy and information needs in the treatment of pregnant as well as non-pregnant rheumatoid arthritis (RA) patients. - Methods: Fifteen rheumatologists from nine dif

  13. Chinese SLE Treatment and Research Group Registry: III. Association of Autoantibodies with Clinical Manifestations in Chinese Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Jing Li

    2014-01-01

    Full Text Available We investigated the characteristics of Chinese SLE patients by analyzing the association between specific autoantibodies and clinical manifestations of 2104 SLE patients from registry data of CSTAR cohort. Significant (P<0.05 associations were found between anti-Sm antibody, anti-rRNP antibody, and malar rash; between anti-RNP antibody, anti-SSA antibody, and pulmonary arterial hypertension (PAH; between anti-SSB antibody and hematologic involvement; and between anti-dsDNA antibody and nephropathy. APL antibody was associated with hematologic involvement, interstitial lung disease, and a lower prevalence of oral ulcerations (P<0.05. Associations were also found between anti-dsDNA antibody and a lower prevalence of photosensitivity, and between anti-SSA antibody and a lower prevalence of nephropathy (P<0.05. Most of these findings were consistent with other studies in the literature but this study is the first report on the association between anti-SSA and a lower prevalence of nephropathy. The correlations of specific autoantibodies and clinical manifestations could provide clues for physicians to predict organ damages in SLE patients. We suggest that a thorough screening of autoantibodies should be carried out when the diagnosis of SLE is established, and repeated echocardiography annually in SLE patients with anti-RNP or anti-SSA antibody should be performed.

  14. Down-regulated NOD2 by immunosuppressants in peripheral blood cells in patients with SLE reduces the muramyl dipeptide-induced IL-10 production.

    Directory of Open Access Journals (Sweden)

    Shui-Lian Yu

    Full Text Available BACKGROUND: Pattern recognition receptors (PRRs such as Toll-like receptors are aberrantly expressed of peripheral blood mononuclear cells (PBMCs in systemic lupus erythematosus (SLE patients, for playing immunopathological roles. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the expression and function of the PRR nucleotide-binding oligomerization domain (NOD2 in SLE. NOD2 expression in T, B lymphocytes, monocytes, myeloid dendritic cells (mDCs and plasmacytoid dendritic cells (pDCs was assessed in SLE patients and healthy controls (HCs using flow cytometric analysis. Ex vivo production of cytokines from PBMCs upon NOD2 agonist muramyl dipeptide (MDP stimulation was assessed using Cytometric Bead Array. Over-expression of NOD2 in monocytes was observed in immunosuppressant naïve SLE patients, and was positively associated with longer disease duration. Immunosuppressive therapy was an independent explanatory variable for downregulating NOD2 expression in CD8+ T, monocytes, mDCs and pDCs. Ex vivo basal productions of cytokines (IL-6, IL-8 and IL-10 were significantly increased in immunosuppressant naïve patients and patients with active disease despite immunosuppressants compared with HCs. Upon MDP stimulaiton, relative induction (% of cytokines (IL-1β from PBMC was significantly increased in immunosuppressant naïve patients with inactive disease, and patients with active disease despite immunosuppressant treatment compared with HCs. Immunosuppressant usage was associated with a decreased basal production and MDP induced relative induction (% of IL-10 in patients with inactive disease compared with immunosuppressant naïve patients and HCs. CONCLUSIONS/SIGNIFICANCE: Bacterial exposure may increase the NOD2 expression in monocytes in immunosuppressant naïve SLE patients which can subsequently lead to aberrant activation of PBMCs to produce proinflammatory cytokines, implicating the innate immune response for extracellular pathogens in the

  15. Acute kidney injury in the pregnant patient.

    Science.gov (United States)

    Nwoko, Rosemary; Plecas, Darko; Garovic, Vesna D

    2012-12-01

    Acute kidney injury (AKI) is costly and is associated with increased mortality and morbidity. An understanding of the renal physiologic changes that occur during pregnancy is essential for proper evaluation, diagnosis, and management of AKI. As in the general population, AKI can occur from prerenal, intrinsic, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. For each of these disorders, delivery of the fetus is the recommended therapeutic option, with additional therapies indicated for each specific disease entity. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management, prevention of adverse maternal outcomes, and safe delivery of the fetus. In pregnant women with pre-existing kidney disease, the degree of renal dysfunction is the major determining factor of pregnancy outcomes, which may further be complicated by a prior history of hypertension.

  16. 系统性红斑狼疮患者妊娠时机选择与妊娠结局%Selection of pregnant time in patients with systemic lupus erythematosus and their pregnant outcome

    Institute of Scientific and Technical Information of China (English)

    周红辉; 卢彦平; 高志英; 付晓宇

    2012-01-01

    Objective To study the correlation between selection of pregnant time in patients with systemic lupus erythematosus (SLE) and their pregnant outcome. Methods Clinical data about 33 pregnant SLE patients admitted to our hospital from January 2005 to July 2011 were retrospectively analyzed. The patients were randomly divided into persistent SLE remission group (Group A, n=20) and active SLE group(Group B, n=13) according to their pregnant time. Complications and pregnant outcomes were compared between the two groups. Results Severe complications occurred in 6 (30%) out of the 20 patients in group A, with full-term delivery, premature delivery, therapeutic abortion, and fetal death in 10, 7, 2, and 1 patients respectively, no death of pregnant and parturient, women, and no deformity of neonates. Severe complications occurred in 11 (84.6%) out of the 13 patients in group B, with premature delivery, therapeutic abortion, and fetal death in 8,3 and 2 patients respectively. The incidence of complications, the fetal loss and the premature delivery rate were significantly higher while the body weight of neonates was significantly lower in group B than in group A(P<0.05). Conclusion SLE patients should have pregnancy when their SLE is stable. Careful monitoring, rational use of drugs, and termination of pregnancy are the keys to decreasing the incidence of complications during pregnancy and improving the outcomes of both mothers and infants.%目的 探讨系统性红斑狼疮(SLE)患者妊娠时机的选择与妊娠结局的相关性.方法 回顾性分析2005年1月-2011年7月我院收治的33例SLE合并妊娠患者临床资料,根据妊娠时机分为孕前持续缓解期(A组)和活动期(B组),比较两组孕期并发症及母婴结局.结果 A组20例中,孕期发生严重并发症者6例(30.0%),足月终止妊娠10例,早产7例,治疗性引产2例,胎死宫内1例,无孕产妇死亡,无新生儿畸形;B组13例中,孕期发生严重并发症11例(84.6

  17. Standard medical care of patients with systemic lupus erythematosus (SLE) in large specialised centres: data from the Russian Federation, Ukraine and Republic of Kazakhstan (ESSENCE)

    OpenAIRE

    Nasonov, E.; Soloviev, S; Davidson, J E; A Lila; Togizbayev, G; Ivanova, R.; Baimukhamedov, Ch; Omarbekova, Zh; Iaremenko, O; Gnylorybov, A; Shevchuk, S; Vasylyev, A; Pereira, M H S

    2015-01-01

    Objectives To describe disease characteristics and treatment regimens for adult patients with systemic lupus erythematosus (SLE) with autoantibody positive disease in three countries (the Russian Federation, Ukraine and Republic of Kazakhstan). Methods The ESSENCE study was a 1-year, retrospective, multicentre, observational study. Data included patients’ characteristics, disease activity and severity, and healthcare resource use in 2010. Results Twelve centres enrolled 436 eligible patients:...

  18. Nocardia brain abscesses in a male patient with SLE: successful outcome despite delay in diagnosis.

    Science.gov (United States)

    Justiniano, Maria; Glorioso, Sarah; Dold, Sylvia; Espinoza, Luis R

    2007-06-01

    We report a 37-year-old African-American man with systemic lupus erythematosus (SLE) diagnosed in May 2001 when he presented with biopsy-proven nephritis. He had been treated intermittently from May 2001 to November 2004 with intravenously (i.v.) administered cyclophosphamide and high doses of prednisone due to unrelenting proteinuria. In November 2004, he was admitted to the hospital because of deterioration of renal function and massive proteinuria (21 g dl(-1) 24 h(-1)) and treated with pulses of methylprednisolone and two courses of i.v. administered cyclophosphamide. His hospital course was complicated by cellulitis and bacteremia with Pseudomonas spp. and Streptococcus bovis. He was discharged on prednisone 60 mg daily, ciprofloxacin, augmentin, and hemodialysis. He was readmitted a week later with new onset of seizure activity, slurred speech, and left-sided hemiparesis. Magnetic resonance imaging of the brain revealed multiple ringlike enhancing foci in the frontal and occipital lobes. Brain biopsy was performed, and Gram stain and initial cultures were negative. Empiric tobramycin, cefepime, and metronidazole were administered. Diagnosis was delayed for several months, but culture eventually grew Nocardia asteroides. Trimethoprim-sulfomethoxazole and linezolid therapy was begun. This was followed by slow, but steady, clinical improvement. Risk factors, diagnostic clues, and treatment are reviewed.

  19. Stationarity of SLE

    CERN Document Server

    Kemppainen, Antti

    2009-01-01

    A new method to study a stopped hull of SLE(kappa,rho) is presented. In this approach, the law of the conformal map associated to the hull is invariant under a SLE induced flow. The full trace of a chordal SLE(kappa) can be studied using this approach. Some example calculations are presented.

  20. Treatment of acne vulgaris in pregnant patients.

    Science.gov (United States)

    Pugashetti, Rupa; Shinkai, Kanade

    2013-01-01

    The management of acne vulgaris in the setting of pregnancy raises important clinical considerations regarding the efficacy and safety of acne treatments in this special patient population. Particular challenges include the absence of safety data, discrepancy in safety data between different safety rating systems, and lack of evidence-based recommendations for the treatment of acne during pregnancy. Nonetheless, many therapeutic options exist, and the treatment of acne in pregnant women can be safely and often effectively accomplished. For mild or moderate disease, patients can be treated with topical antimicrobial agents, anti-inflammatory agents, as well as glycolic and salicylic acid. Several topical agents, notably benzoyl peroxide, previously viewed as potentially dangerous are cited by many sources as being considered safe. When necessary, systemic therapies that can be safely added include penicillins, amoxicillin, cephalosporins, erythromycin, clindamycin, and tetracyclines or sulfonamides, depending on the stage of fetal development. Adjunct therapy may include phototherapy or laser treatments. Physicians should work with this often highly motivated, safety-conscious patient population to tailor an individualized treatment regimen. This treatment regimen will likely shift throughout the different stages of fetal development, as distinct safety considerations are raised prior to conception as well as during each of the trimesters of pregnancy. Important considerations regarding acne management in breast-feeding mothers is also discussed.

  1. A Chinese version of the Rheumatology Attitudes Index is a valid and reliable measure of learned helplessness in patients with SLE.

    Science.gov (United States)

    Thumboo, J; Feng, P H; Chan, S P; Boey, M L; Thio, S T; Fong, K Y

    2002-01-01

    Despite the prognostic importance of learned helplessness (LH) in rheumatic diseases, there are no validated measures of LH in Chinese or other Asian languages. We therefore assessed the validity of a Chinese translation of the Rheumatology Attitudes Index (CRAI; a widely used measure of LH) and its Helplessness (CHS) and Internality (CIS) subscales in patients with SLE. Chinese-speaking SLE patients (n = 69) completed identical, self-administered questionnaires containing the CRAI and assessing demographic/socio-economic variables twice within 2 weeks. SLE activity, damage and quality of life were assessed using the BILAG, SLICC/ACR Damage Index and SF-36 respectively. Scale psychometric properties were assessed through Cronbach's alpha, intra-class correlations, quantifying test-retest differences, factor analysis and known-groups construct validity. Internal consistency and reliability were acceptable, with Cronbach's alpha for the CHS, CIS and CRAI being 0.70, 0.69 and 0.74, respectively. Mean differences in test-retest scores spanned 1.6-2.4% of possible scale ranges and intra class correlations ranged from 0.72 to 0.88. Factor analysis identified two major factors corresponding to the CHS and CIS subscales of the CRAI. Eight of 10 a priori hypotheses relating the CRAI and CHS to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales. The CRAI and its helplessness subscale are valid and reliable measures of learned helplessness in Chinese-speaking SLE patients.

  2. Standard medical care of patients with systemic lupus erythematosus (SLE) in large specialised centres: data from the Russian Federation, Ukraine and Republic of Kazakhstan (ESSENCE).

    Science.gov (United States)

    Nasonov, E; Soloviev, S; Davidson, J E; Lila, A; Togizbayev, G; Ivanova, R; Baimukhamedov, Ch; Omarbekova, Zh; Iaremenko, O; Gnylorybov, A; Shevchuk, S; Vasylyev, A; Pereira, M H S

    2015-01-01

    To describe disease characteristics and treatment regimens for adult patients with systemic lupus erythematosus (SLE) with autoantibody positive disease in three countries (the Russian Federation, Ukraine and Republic of Kazakhstan). The Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q wave Coronary Events (ESSENCE) study was a 1-year, retrospective, multicentre, observational study. Data included patients' characteristics, disease activity and severity, and healthcare resource use in 2010. Twelve centres enrolled 436 eligible patients: 232 in Russia, 110 in Kazakhstan and 94 in Ukraine. Mean age ranged from 36 to 42 years and median SLE duration from 3 to 6.8 years. According to study definitions, 69.2% of patients in Russia, 72.7% in Kazakhstan and 55.4% in Ukraine had severe disease at diagnosis. SLE activity (Nasonova classification, 1972) decreased from diagnosis to the last visit in 2010 in all countries. At the last visit, mean (SD) Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index score was 13.8 (10.5) in Russia, 19.4 (16.9) in Kazakhstan and 7.2 (6.8) in Ukraine, and Systemic Lupus International Collaborative Clinics/American College of Rheumatology damage index was 2.0 (2.2), 3.3 (3.2) and 2.2 (2.0), respectively. Treatment regimens included predominantly glucocorticoids (96.7-99.1%), immunosuppressants or cytotoxic drugs, for example, azathioprine and cyclophosphamide (20.7-53.2%), and antimalarial drugs (18.3-40.8%). The study provides reliable insight into the SLE clinical profiles in the referenced countries. Patients were 4-10 years younger in the study and had 3-7 years shorter SLE duration than in Western European countries and both SLE activity and severity were higher with higher rate of hospitalisations, but decreased during treatment. Local and international scales demonstrated correlation in SLE activity and organ damage evaluation. There were differences in

  3. Effects of 1,25(OH)2D3 in immune response regulation of systemic lupus erithematosus (SLE) patient with hypovitamin D.

    Science.gov (United States)

    Wahono, Cesarius S; Rusmini, Hetti; Soelistyoningsih, Dwi; Hakim, Reza; Handono, Kusworini; Endharti, Agustina T; Kalim, Handono; Widjajanto, Edi

    2014-01-01

    Vitamin D deficiency has been associated with pathogenesis of autoimmune diseases including SLE; however, there were still lack of data about the effects of administration of vitamin D in immune regulation in SLE patients. The aim of this study was to investigate the effects of calcitriol/1,25(OH)2D3 on dendritic cells maturation and Th17 and Treg cells activation in SLE patients with hypovitamin D. The monocytes and lymphocytes of five SLE patients with hypovitamin D were divided into 4 groups, P0 (0 nM/control), P1 (1 nM), P2 (10 nM), and P3 (100 nM) as cultured samples. Flowcytometry analysis was used to evaluate dendritic cell maturation (the percentage of CD40, CD86, and HLA-DR expression) and the amount of Th17 and Treg cells (the percentage of Th17 and Treg cells). Cytokines production of IL-12, IL-17A, and TGF-β measured by ELISA. This study showed significant differences in CD40, CD86, HLA-DR expressions, and Th17 percentage in 10 nM of 1,25(OH)2D3 compared to that of control. For cytokines secretion, there was also significant difference between IL-12p70 and IL-17A levels in 10 nM of 1,25(OH)2D3 compared to that of control. The 1,25(OH)2D3 increased Treg cells and TGF-β level but not significant. Our study concluded that 1,25(OH)2D3 inhibited dendritic cells maturation and Th17 cells activation in SLE patients. The 1,25(OH)2D3 increased Treg cells but not significant.

  4. Cerebral aspergilloma in a SLE patient: A case report with short literature review

    OpenAIRE

    Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Khan, Shafiqul Kabir; Alam, Sarwar Morshed

    2014-01-01

    Aspergillosis of brain is very rare, and commonly seen in immunocompromised or immunosuppressed patient. Here, we report a cerebral aspergillosis condition in a late teen girl who is a Systemic Lupus Erythromatosis patient with steroid therapy. She developed headaches, vomitings, and convulsions. On the basis of clinical and neuroimaging, a diagnosis of cerebral tuberculoma was made, and she was put on anti-TB therapy, but she did not respond. Later, surgical partial excision biopsy confirmed...

  5. Prolactin and autoimmunity: hyperprolactinemia correlates with serositis and anemia in SLE patients.

    Science.gov (United States)

    Orbach, Hedi; Zandman-Goddard, Gisele; Boaz, Mona; Agmon-Levin, Nancy; Amital, Howard; Szekanecz, Zoltan; Szucs, Gabriella; Rovensky, Josef; Kiss, Emese; Doria, Andrea; Ghirardello, Anna; Gomez-Arbesu, Jesus; Stojanovich, Ljudmila; Ingegnoli, Francesca; Meroni, Pier Luigi; Rozman, Blaz'; Blank, Miri; Shoenfeld, Yehuda

    2012-04-01

    Evidence points to an association of prolactin to autoimmune diseases. We examined the correlation between hyperprolactinemia and disease manifestations and activity in a large patient cohort. Age- and sex-adjusted prolactin concentration was assessed in 256 serum samples from lupus patients utilizing the LIASON prolactin automated immunoassay method (DiaSorin S.p.A, Saluggia, Italy). Disease activity was defined as present if European Consensus Lupus Activity Measurement (ECLAM) > 2 or Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Lupus manifestations were grouped by organ involvement, laboratory data, and prescribed medications. Hyperprolactinemia was presented in 46/256 (18%) of the cohort. Hyperprolactinemic patients had significantly more serositis (40% vs. 32.4%, p = 0.03) specifically, pleuritis (33% vs. 17%, p = 0.02), pericarditis (30% vs. 12%, p = 0.002), and peritonitis (15% vs. 0.8%, p = 0.003). Hyperprolactinemic subjects exhibited significantly more anemia (42% vs. 26%, p = 0.02) and marginally more proteinuria (65.5% vs. 46%, p = 0.06). Elevated levels of prolactin were not significantly associated with other clinical manifestations, serology, or therapy. Disease activity scores were not associated with hyperprolactinemia. Hyperprolactinemia in lupus patients is associated with all types of serositis and anemia but not with other clinical, serological therapeutic measures or with disease activity. These results suggest that dopamine agonists may be an optional therapy for lupus patients with hyperprolactinemia.

  6. Measuring educational needs among patients with systemic lupus erythematosus (SLE) using the Dutch version of the Educational Needs Assessment Tool (D-ENAT).

    Science.gov (United States)

    Zirkzee, E J M; Ndosi, M E; Vliet Vlieland, T P M; Meesters, J J L

    2014-11-01

    The Educational Needs Assessment Tool (ENAT) was developed in the United Kingdom (UK) to systematically assess the educational needs of patients with rheumatic diseases. The aim of the present study was to describe the educational needs of Dutch patients with systemic lupus erythematosus (SLE) by means of a Dutch version of the ENAT (D-ENAT). The D-ENAT was sent to a random sample of 244 SLE patients registered at the outpatient clinic of a university hospital. D-ENAT consists of 39 items in seven domains. The D-ENAT domain scores range from 0-16 to 0-28 (higher scoring equals higher educational needs) depending of the number of items in the domain. A total D-ENAT score (0-156) is calculated by summing all 39 items. In addition, age, disease duration, gender, educational level, present information need (yes/no) and the extent of information need (1-4: nothing-everything) were recorded. Univariate regression analysis was used to examine the D-ENAT's potential determinants. The response rate was 122 out of 244 (50%). The mean (% of maximum score) educational needs scores were 56% for 'D-ENAT total score', 62% for 'Self-help measures', 60% for 'Disease process', 58% for 'Feelings', 56% for 'Treatments', 50% for 'Movement', 49% for 'Support systems' and 46% for 'Managing pain'. Being female was significantly associated with higher scoring on the D-ENAT total score (β 23.0; 95% CI 5.9, 40.3). SLE patients demonstrated substantial educational needs, especially in the domains: 'Self-help measures', 'Disease process' and 'Feelings'. The validity and practical applicability of the D-ENAT to make an inventory of SLE patients' educational needs requires further investigation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Clinical Analysis of 5 Cases of Laparoscopy in Pregnant Patients

    Institute of Scientific and Technical Information of China (English)

    杨佳欣; 冷金花; 郎景和

    2003-01-01

    @@ Five pregnant patients were given laparoscopicsurgery in PUMCH in recent two years. All the pa-tients have the indications for operation. The age ofthe patients was 25 to 33 years old. The operationwas done in the first and second trimester. The dura-tion of the operation was about 30 mins with no ma-nipulation of the cervix.

  8. Fibromyalgia, Systemic Lupus Erythematosus (SLE) and the Evaluation of SLE Activity

    Science.gov (United States)

    Wolfe, Frederick; Petri, Michelle; Alarcón, Graciela S.; Goldman, John; Chakravarty, Eliza F.; Katz, Robert S.; Karlson, Elizabeth W.; Michaud, Kaleb

    2010-01-01

    Purpose To determine if fibromyalgia or fibromyalgianess is increased in SLE compared with non-SLE patients, whether fibromyalgia or fibromyalgianess (the tendency to respond to illness and psychosocial stress with fatigue, widespread pain, general increase in symptoms and similar factors ) biases the Systemic Lupus Erythematosus Activity Questionnaire (SLAQ), and to determine if the SLAQ is overly sensitive to fibromyalgia symptoms. Method We developed a 16-item SLE symptom scale (SLESS) modeled on the SLAQ and used that scale to investigate the relation between SLE symptoms and fibromyalgianess in 23,321 rheumatic disease patients. Fibromyalgia was diagnosed by survey fibromyalgia criteria and fibromyalgianess was measured using the Symptom Intensity Scale (SI). As comparison groups, we combined patients with rheumatoid arthritis (RA) and non-inflammatory rheumatic disorders into an “arthritis” group and also utilized a physician-diagnosed group of fibromyalgia patients. Results Fibromyalgia was identified in 22.1% of SLE and 17.0% of those with arthritis. The SI scale was minimally increased in SLE. The correlation between SLAQ and SLESS was 0.738. SLESS/SLAQ scale items: Raynaud’s, rash, fever, easy bruising and hair loss were significantly more associated with SLE than fibromyalgia, while the reverse was true for headache, abdominal pain, paresthesias/stroke, fatigue, cognitive problems and muscle pain or weakness. There was no evidence of a disproportionate symptom reporting associated with fibromyalgianess. Self-reported SLE was associated with an increased prevalence of fibromyalgia when unconfirmed by physicians compared to SLE confirmed by physicians. Conclusions The prevalence of fibromyalgia in SLE is minimally increased compared with its prevalence in patients with arthritis. Fibromyalgianess does not bias the SLESS and should not bias SLE assessments, including the SLAQ. PMID:19004039

  9. The SLE heart in scintigraphic diagnostics

    CERN Document Server

    Rottensteiner, J

    2001-01-01

    Investigation of SLE-heart of 14 patients with 201Ti-SPECT and 18 FDG-SPECT and comparison with clinical and laboratory parameters. Results: SLE-patients with unspecific heart symptoms show in spite of sufficiently perfusion in 201Ti-SPECT considerable defects in 18-FDG. Interpretation: cause of the defects in FDG in a disturbed glucose metabolism independent of perfusion. (boteke)

  10. Strategies for Successful Recruitment of Pregnant Patients Into Clinical Trials.

    Science.gov (United States)

    Sutton, Elizabeth F; Cain, Loren E; Vallo, Porsha M; Redman, Leanne M

    2017-03-01

    Clinical research in the pregnant population allows for delivery of quality, evidence-based care in obstetrics. However, in recent years, the field of obstetrics has faced severe challenges in the recruitment of the pregnant population into clinical trials, a struggle also shared by several other medical disciplines. We candidly describe our failure to recruit a healthy population of overweight and obese pregnant women in their first trimester. We were then able to glean unsuccessful and successful recruitment approaches and improve our recruitment effort by autopsy of failed strategies and with guidance from a survey disseminated to improve our understanding of community feelings about participating in research while pregnant. These "lessons learned" taught us that active recruitment within this population is a necessity; that is, direct (face-to-face discussions at obstetric appointments) compared with indirect (flyers and general emails) modalities and that prenatal care provider support of the proposed research study is vital to a patient's willingness to participate. By implementation of "lessons learned," we describe how we successfully recruited a similar pregnant population 1 year later. The Clinical Trials related to our article are as follows: 1) Expecting Success: NCT01610752, https://clinicaltrials.gov/ct2/show/NCT01610752; 2) MomEE: NCT01954342, https://clinicaltrials.gov/ct2/show/NCT01954342; and 3) Participate While Pregnant Survey: NCT02699632, https://clinicaltrials.gov/ct2/show/NCT02699632.

  11. The effect of Ramadan fasting on quiescent systemic lupus erythematosus (SLE) patients' disease activity, health quality of life and lipid profile: a pilot study.

    Science.gov (United States)

    Goharifar, Hamid; Faezi, Seyedeh Tahereh; Paragomi, Pedram; Montazeri, Ali; Banihashemi, Arash Tehrani; Akhlaghkhah, Maryam; Abdollahi, Bahar Sadeghi; Kamazani, Zahra; Akbarian, Mahmood

    2015-08-01

    SLE is a common autoimmune disease with considerable morbidity. Ramadan fasting is a religious custom Muslims regularly practice. We aimed to evaluate the effect of Ramadan fasting on SLE patients' disease activity, health quality of life and lipid profile. We conducted this case control study as a pilot study in 40 quiescent SLE patients, 21 cases who decided to fast and 19 controls who decided not to have Ramadan fasting between August and November 2009 in lupus unit of Rheumatology Research Center in Tehran University of Medical Sciences, Iran. They were assessed for SLE Disease Activity Index, lipid profile and quality of life with Short-Form 36 (SF-36) Health Survey, 1 day before Ramadan, the day after and 3 months after Ramadan fasting. After 24.1 ± 5.4 (mean ± SD) days of fasting, anti-ds DNA increased for 0.34 ± 0.41 mmol/dL in cases versus 0.07 ± 0.31 in controls (P = 0.026). Likewise C3 increased more dramatically in cases (16.8 ± 17.5 vs. 2.3 ± 13.2 mg/dL, P = 0.006). Three months after fasting, anti-ds DNA was still increased 0.28 ± 0.46 mmol/dL in cases while a 0.02 ± 0.43 mmol/dL drop in controls was detected (P = 0.04). On the contrary, C3 returned to baseline. These changes were not accompanied with significant changes in disease activity and health quality of life. Ramadan fasting had no effect on lipid profile except for delayed total cholesterol decrease in cases in comparison with controls (16.4 ± 29.4 decrease vs. 4.6 ± 23.9 mg/dL decrease, P = 0.018). Ramadan fasting probably has no detrimental effect on SLE patients' disease activity and their quality of life in the quiescent phase of disease.

  12. The simultaneous incidence of acute pancreatitis and autoimmune hemolytic anemia: a rare duo in a patient with SLE.

    Science.gov (United States)

    Masoodi, Ibrahim

    2014-01-01

    A young female presented with acute abdominal pain of two days duration consistent with acute pancreatitis. During her stay in the hospital she had a sudden drop in hemoglobin to 6 g/dl without any overt blood loss. On evaluation, it was evident that she had acute pancreatitis, in addition to displaying features of autoimmune hemolytic anemia. She had been a known case of systemic lupus erythematosus (SLE) and had discontinued her treatment. She was managed with methylprednisolone pulse therapy. Her clinical condition improved, and she has been regularly attending our clinic for the last 2 years. According to a literature search in Medline, it would appear that this is the first report of a case in which SLE with autoimmune hemolytic anemia has been associated with acute pancreatitis in a single case.

  13. The simultaneous incidence of acute pancreatitis and autoimmune hemolytic anemia: a rare duo in a patient with SLE

    Directory of Open Access Journals (Sweden)

    Masoodi, Ibrahim

    2014-09-01

    Full Text Available [english] A young female presented with acute abdominal pain of two days duration consistent with acute pancreatitis. During her stay in the hospital she had a sudden drop in hemoglobin to 6 g/dl without any overt blood loss. On evaluation, it was evident that she had acute pancreatitis, in addition to displaying features of autoimmune hemolytic anemia. She had been a known case of systemic lupus erythematosus (SLE and had discontinued her treatment. She was managed with methylprednisolone pulse therapy. Her clinical condition improved, and she has been regularly attending our clinic for the last 2 years. According to a literature search in Medline, it would appear that this is the first report of a case in which SLE with autoimmune hemolytic anemia has been associated with acute pancreatitis in a single case.

  14. Long-Term Outcomes of Systemic Lupus Erythematous Patients after Pregnancy: A Nationwide Population-Based Cohort Study

    Science.gov (United States)

    Chiu, Ting-Fang; Chuang, Ya-Wen; Lin, Cheng-Li; Yu, Tung-Min; Chung, Mu-Chi; Li, Chi-Yuan; Chung, Chi-Jung; Ho, Wen-Chao

    2016-01-01

    Background Data on long-term maternal outcomes in patients with systemic lupus erythematosus (SLE) are lacking. The study aimed to explore the relationships among SLE, pregnancy, outcomes of end-stage renal disease (ESRD), and overall mortality. Methods We established a retrospective cohort study consisting of four cohorts: pregnant (case cohort) and nonpregnant SLE patients, as well as pregnant and nonpregnant non-SLE patients. One case cohort and three comparison cohorts were matched by age at first pregnancy and index date of pregnancy by using the Taiwan National Health Insurance Research Dataset. All study subjects were selected based on the index date to the occurrence of ESRD or overall death. Cox proportional hazard regression models and Kaplan–Meier curves were used in the analysis. Results SLE pregnant patients exhibited significantly increased risk of ESRD after adjusting for other important confounders, including immunosuppressant and parity (HR = 3.19, 95% CI: 1.35–7.52 for pregnant non-SLE; and HR = 2.77, 95% CI: 1.24–6.15 for nonpregnant non-SLE patients). No significant differences in ESRD incidence were observed in pregnant and nonpregnant SLE patients. Pregnant SLE patients exhibited better clinical condition at the baseline and a significantly lower risk of overall mortality than nonpregnant SLE patients. Conclusions Our data support current recommendations for SLE patients to avoid pregnancy until disease activity is quiescent. Multicenter recruitment and clinical information can be used to further examine the association of SLE and ESRD (or mortality) after pregnancy. PMID:27992461

  15. Avoidable factors associated with pregnant and postpartum patients ...

    African Journals Online (AJOL)

    The hospital records of all pregnant and postpartum patients in two public hospital ICUs ... N C Ngene,1 Dip Obst, Dip HIV Man, MMed (Fam Med), FCOG, MMed (O&G); J Moodley,2 MB ChB, FRCOG, FCOG, MD; ... 3 Department of Anaesthesia, Critical Care and Pain Management, Grey's ..... Ingestion of herbal concoction.

  16. Hepatitis B Management in the Pregnant Patient: An Update

    Science.gov (United States)

    Ayoub, Walid S.; Cohen, Erica

    2016-01-01

    Abstract Chronic hepatitis B is a worldwide disease, with significant burden on health care systems. While universal vaccination programs have led to an overall decrease in incidence of transmission of hepatitis B, unfortunately, there remain large areas in the world where vaccination against hepatitis B is not practiced. In addition, vertical transmission of hepatitis B persists as a major concern. Hepatitis B treatment of the pregnant patient requires a thorough assessment of disease activity and close monitoring for flares, regardless of initiation of antiviral therapy. We discuss, in this article, the current and emergent strategies which aim to reduce the rate of transmission of hepatitis B from the pregnant mother to the infant and we review the updated guidelines regarding management of liver disease in pregnant women with hepatitis B. PMID:27777892

  17. Sentinel lymph node biopsy in pregnant patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gentilini, Oreste; Toesca, Antonio; Sangalli, Claudia; Veronesi, Paolo; Galimberti, Viviana [European Institute of Oncology, Division of Senology, Milan (Italy); Cremonesi, Marta; Pedroli, Guido [European Institute of Oncology, Unit of Medical Physics, Milan (Italy); Colombo, Nicola [European Institute of Oncology, Unit of Cardiology, Milan (Italy); Peccatori, Fedro [European Institute of Oncology, Division of Haematology-Oncology, Milan (Italy); Sironi, Roberto [S. Pio X Hospital, Unit of Obstetrics and Gynecology, Milan (Italy); Rotmensz, Nicole [European Institute of Oncology, Division of Epidemiology and Biostatistics, Milan (Italy); Viale, Giuseppe [European Institute of Oncology, Division of Pathology, Milan (Italy); University of Milan School of Medicine, Milan (Italy); Goldhirsch, Aron [European Institute of Oncology, Department of Medicine, Milan (Italy); Veronesi, Umberto [European Institute of Oncology, Division of Senology, Milan (Italy); European Institute of Oncology, Milan (Italy); Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milano (Italy)

    2010-01-15

    Sentinel lymph node biopsy (SLNB) is currently not recommended in pregnant patients with breast cancer due to radiation concerns. Twelve pregnant patients with breast cancer received low-dose (10 MBq on average) lymphoscintigraphy using {sup 99m}Tc human serum albumin nanocolloids. The sentinel lymph node (SLN) was identified in all patients. Of the 12 patients, 10 had pathologically negative SLN. One patient had micrometastasis in one of four SLN. One patient had metastasis in the SLN and underwent axillary clearance. From the 12 pregnancies, 11 healthy babies were born with no malformations and normal weight. One baby, whose mother underwent lymphatic mapping during the 26th week of gestation, was operated on at the age of 3 months for a ventricular septal defect and at 43 months was in good health. This malformation was suspected at the morphological US examination during week 21, well before lymphoscintigraphy, and was confirmed a posteriori by a different observer based on videotaped material. No overt axillary recurrence appeared in the patients with negative SLNs after a median follow-up of 32 months. Our experience supports the safety of SLNB in pregnant patients with breast cancer, when performed with a low-dose lymphoscintigraphic technique. (orig.)

  18. Epidemiologi ved systemisk lupus erythematosus (SLE

    Directory of Open Access Journals (Sweden)

    Inge-Margrethe Gilboe

    2009-10-01

    similar prevalence. Swedish studies has implied a stable incidence and increasing prevalence, correlating with prolonged survival. Studies from Norway and the Nordic countries show a high female predominance and comparable ages at time of diagnosis. The studies imply a later age of diagnosis in Scandinavia than in the USA and the UK. The Nordic studies show that survival from SLE is good, however lower than in the general population. Survival in the Nordic and European countries is comparable. Even if survival of SLE has been greatly improved, the Danish study on mortality showed that 50% of deaths are caused by infections and active disease. Artheriosclerotic cardiovascular disease is also found to be a frequent cause of death in all the studies. Cardiovascular disease was found to be the main cause of death in SLE in a big international study including Finnish and Swedish patients, and also in other European and international studies. Increased risk of myocardial infarction among young women with SLE in Sweden as well as in international studies indicates that SLE is in itself a risk factor for artheriosclerosis. It would be desirable with more studies on the epidemiology of SLE in Norway.

  19. Acute myeloid leukemia in the pregnant patient.

    Science.gov (United States)

    Thomas, Xavier

    2015-08-01

    Although acute myeloid leukemia (AML) mostly occurs in older patients, it could be seen in women of childbearing age. It is therefore not surprising that in some patients, the management of AML will be complicated by a coexistent pregnancy. However, the association of leukemia and pregnancy is uncommon. Its incidence is estimated to be 1 in 75,000-100,000 pregnancies. During pregnancy, most leukemias are acute: two-thirds are myeloid and one-third are lymphoblastic. There is no standard approach for this clinical dilemma, in part because of variables such as the type of AML, the seriousness of the symptoms, and the patient's personal beliefs. In many cases, the diagnostic workup has to be altered because of the pregnancy, and often available treatments have varying risks to the fetus. While chemotherapy is reported to have some risks during the first trimester, it is admitted that it can be administered safely during the second and the third trimesters.

  20. Defects in the Zeta Chain Expression (ζ in a Group of Patients with SLE, Scleroderma and Late-onset Arthritis, Colombia 2014

    Directory of Open Access Journals (Sweden)

    Heber Siachoque-Montañez

    2014-09-01

    Full Text Available Introduction: Systemic Lupus Erythematosus (SLE, Scleroderma and late-onset arthritis are autoimmune inflammatory diseases (EIA characterized by autoantibody production and presence of abnormal T cells which generate defective immune response. The abnormal expression of key signaling molecules in the defective function of T-lymphocytes plays a significant role in the pathogenesis of autoimmune disease. The T-cells exhibit numerous abnormalities TCRζ1 signaling complex, these aberrations result in altered expression of cytokines and some biochemical events involved in the expression of surface molecules. Defects in the complex may be associated TCRζ to steroids used in autoimmune disease patients due to their powerful anti-inflammatory activity and immunosuppressive properties. The synthetic corticosteroids such as examethasone inhibit the transcriptional activity of some factors such as NFKB and AP-1, which regulate the synthesis of certain cytokines and could be involved in the TCRζ synthesis. Material and Methods: A case-control study, with a 1:1 ratio of cases and controls (13:13. Cases were patients with active autoimmune disease (6 patients with SLE, 5 patients with scleroderma and 2 patients with lateonset arthritis, who have not started treatment with corticosteroids. Controls were patients with no autoimmune disease. The diagnosis was made by the criteria established by the American College of Rheumatology for patients with SLE, scleroderma and late-onset arthritis. A 10 mL sample was obtained by venipuncture whole blood. Total RNA was extracted and RT-PCR was performed using a set of primers flanking a region of 138 base pairs involving exons 2, 3 and 4 of the ζ chain. Results: The values of Z chain amplification showed significant differences in patients with autoimmune disease (0.8214 } 0.1787, med = 0.7368 compared with the control group (0.9225 } 0.1272, med = 0.9830 (p = 0.045, Mann-Withney non-parametric one tailed exact

  1. Cardiac Arrest in a Pregnant Patient Diagnosed with Bochdalek Hernia

    Directory of Open Access Journals (Sweden)

    Pinar Karabacak

    2016-09-01

    Full Text Available Bochdalek hernia is thought to be the result of a defect of the pleuroperitoneal fold and the septum transversum fusion in the 8th week of gestation. The majority of these patients present with respiratory distress after delivery; asymptomatic progress until adulthood is an extremely rare clinical occurrence. The adult form of a Bochdalek hernia accompanying pregnancy is a rare entity. A 39-year-old, 24-week pregnant patient applied to Emergency service with epigastric pain and vomiting. Abdominal ultrasonography was planned due to the abdominal pain; sudden cardiopulmonary arrest occurred during the procedure. In this case report, congenital diaphragmatic hernia in a young pregnant woman who underwent cardiac arrest is presented.

  2. Management of inflammatory bowel disease in the pregnant patient

    Institute of Scientific and Technical Information of China (English)

    Flavio M Habal; Nikila C Ravindran

    2008-01-01

    Inflammatory bowel disease (IBD) is a chronic disorder affecting young adults in their reproductive years.Many young women with IBD express concern about the effect their disease will have on fertility,pregnancy course and fetal development This article presents an approach to management of IBD in the pregnant patient,including counseling and investigation,and summarizes existing data on the safety of medications used to treat IBD in pregnancy and breastfeeding.

  3. Serum antibodies to human leucocyte antigen (HLA)-E, HLA-F and HLA-G in patients with systemic lupus erythematosus (SLE) during disease flares: Clinical relevance of HLA-F autoantibodies.

    Science.gov (United States)

    Jucaud, V; Ravindranath, M H; Terasaki, P I; Morales-Buenrostro, L E; Hiepe, F; Rose, T; Biesen, R

    2016-03-01

    T lymphocyte hyperactivity and progressive inflammation in systemic lupus erythematosus (SLE) patients results in over-expression of human leucocyte antigen (HLA)-Ib on the surface of lymphocytes. These are shed into the circulation upon inflammation, and may augment production of antibodies promoting pathogenicity of the disease. The objective was to evaluate the association of HLA-Ib (HLA-E, HLA-F and HLA-G) antibodies to the disease activity of SLE. The immunoglobulin (Ig)G/IgM reactivity to HLA-Ib and β2m in the sera of 69 German, 29 Mexican female SLE patients and 17 German female controls was measured by multiplex Luminex(®)-based flow cytometry. The values were expressed as mean flourescence intensity (MFI). Only the German SLE cohort was analysed in relation to the clinical disease activity. In the controls, anti-HLA-G IgG predominated over other HLA-Ib antibodies, whereas SLE patients had a preponderance of anti-HLA-F IgG over the other HLA-Ib antibodies. The disease activity index, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000, was reflected only in the levels of anti-HLA-F IgG. Anti-HLA-F IgG with MFI level of 500-1999 was associated with active SLE, whereas inactive SLE revealed higher MFI (>2000). When anti-HLA-F IgG were cross-reactive with other HLA-Ib alleles, their reactivity was reflected in the levels of anti-HLA-E and -G IgG. The prevalence of HLA-F-monospecific antibodies in SLE patients was also associated with the clinical disease activity. Anti-HLA-F IgG is possibly involved in the clearance of HLA-F shed from lymphocytes and inflamed tissues to lessen the disease's severity, and thus emerges as a beneficial immune biomarker. Therefore, anti-HLA-Ib IgG should be considered as a biomarker in standard SLE diagnostics.

  4. [Anaesthesia in abdominal delivery in pregnant patients with hypertension].

    Science.gov (United States)

    Tolmachev, G N; Volodin, A V; Marichik, N V; Nemirovskiĭ, V B; Pivovarova, G M; Shepetovskaia, N L; Gur'ianov, V A

    2010-01-01

    A differentiated administration of calcium antagonists in preoperative preparation of pregnant patients with hypertension enabled the conversion of circulatory system state to "normal pregnancy range": a conversion of hypokinetic (including the HES solution infusion) and hyperkinetic types of haemodynamics to eukinetic one, with the decrease of total peripheral resistance and myocardium need for oxygen, autonomous nervous system state to physiological sympathicotonia. Evidence shows that continued intra-operative treatment including tranexamic acid enables to maintain those results during the surgery. In postoperational period, the clinical manifestations of SIRS in patients who has received the mentioned therapy were marked less then in control group, and the newborns have a higher Apgar score.

  5. 家庭支持对SLE患者生活质量的影响%The Influence of the Life Quality of Family-support on SLE Patients

    Institute of Scientific and Technical Information of China (English)

    何英

    2012-01-01

      Objective To discuss the relationship between the Family-support and life quality in SLE patients. Methods Questionnaire method was adopted to investigate and analyze the relationship between Family-support and life quality in 65 cases. Results The scores of Family-support can influence the patients life quality, satisfactory, health and function, with no obvious influence on the self-concept, social and economy. Conclusion Family-support influence life quality in SLE patients. Medical workers should pay attention to the important of education to the family members, in order to provide high-quality family-support and promote the increase of patients’ life quality.%  目的探讨SLE患者家庭支持与生活质量的关系.方法采用问卷调查的方式,对65例SLE患者的家庭支持状况、生活质量进行调查,并分析两者的关系.结果 SLE患者家庭支持得分高低对其总的生活质量、生活满意度、健康和功能有影响(P0.05).结论家庭支持状况直接影响SLE患者的生活质量.医护人员应重视对SLE患者家庭成员的教育,以保证高质量家庭支持的提供,促进患者生活质量的提高.

  6. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

    Directory of Open Access Journals (Sweden)

    Menon Nalini

    2015-03-01

    Full Text Available Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1 T he most common complications and their incidence . 2 M aternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study. MATERIALS AND METHODS : Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months . Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned profo r ma. RESULTS : Of the total 40 patients enrolled in the study, 45% were in the age group 26 - 30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrau terine death (25% was higher than that of neonatal deaths (10%. 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%. 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%. CONCLUSION : The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and

  7. Tuberculosis reinfection in a pregnant cystic fibrosis patient

    Directory of Open Access Journals (Sweden)

    Asween Marco

    2015-01-01

    Full Text Available Cystic Fibrosis (CF is a multisystem disease predominantly affecting the airways and predisposing patients to recurrent infections with various multidrug resistant organisms. Mycobacterium tuberculosis (MTB infection is rarely seen, but considered a potential pathogen in CF patients. We report a 26 year old pregnant CF patient on Ivacaftor who was admitted with symptoms suggestive of tuberculosis. Three years prior to the current admission, she had completed four drug anti- MTB therapy for pulmonary tuberculosis and was considered cured as her sputum cultures after six months of treatment were negative. Genotype analysis revealed the current MTB strain to be different from the strain causing the previous infection. After receiving first line anti-tuberculous regimen for nine months, the patient's condition markedly improved culminating in an uneventful pregnancy and delivery. To our knowledge, this is the only reported case of reinfection tuberculosis in a CF patient.

  8. Dermatologic conditions in patients of color who are pregnant

    Directory of Open Access Journals (Sweden)

    C. Jeon, BS

    2017-03-01

    Full Text Available Certain dermatoses that present during pregnancy have a predilection for populations with skin of color (SOC. Additionally, certain systemic diseases such as systemic lupus erythematosus tend to be more aggressive during pregnancy and confer worse prognoses in women with SOC. The purpose of this review is to highlight the unique implications of selected diseases during pregnancy as it relates to SOC. Dermatologists should be vigilant for the unique clinical variations of dermatological conditions in patients of color who are pregnant to ensure correct diagnoses and optimize treatment outcomes.

  9. Outcome of Anesthesia and Open Heart Surgery in Pregnant Patients

    Directory of Open Access Journals (Sweden)

    Golamali Mollasadeghi

    2007-06-01

    Full Text Available Background: Cardiovascular disease is an important non-obstetric cause of maternal and fetal /neonatal morbidity and mortality during pregnancy. For a pregnant woman with cardiac disease, the potential inability of the maternal cardiovascular system to contend with normal pregnancy-induced physiologic changes may produce deleterious effects on both mother and fetus. To determine the most frequent surgical indications of maternal and fetal mortality, we studied 15 cases of severe cardiac disease in pregnant women who required cardiac surgical procedures. Methods: In this descriptive study, fifteen pregnant women who underwent cardiac surgery were studied. Maternal age ranged from 27 to 36 years, and gestational age varied from 4 to 22 weeks. Most of the patients were in New York Heart Association Classes II and III. Opioid- based anesthesia with fentanyl citrate (50µ/kg or sufentanil (5µ/kg plus low dose of thiopental were used for the induction of anesthesia. During non-pulsatile cardio-pulmonary bypass, core temperature was between 28-36 °C, average CBP time was 61.2±22 min, average aortic cross-clamp time was 34.13±14 min, and mean pump pressure was maintained between 65-80 mmHg. Results: Ten patients had severe mitral valve disease (66.6%, three had aortic valve disease (20%, one had subvalvular aortic stenosis (6.7%, and the remaining one had left atrial myxoma (6.7%. There were five fetal deaths (33.3% and one maternal death (6.7%. Conclusion: It seems that open heart surgery in the first trimester is very hazardous for the fetus and may lead to fetal death. If possible, surgery should be carried out in the second trimester of pregnancy. The recommendations are simply guidelines because research data and clinical experience in this area are limited.

  10. Role and Importance of Chlamydia Trachomatis in Pregnant Patients

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    Mariya Angelova Angelova

    2016-08-01

    Full Text Available AIM: The aim of this study was to assess the prevalence of chlamydial infection among pregnant women and to determine the role of this infection in the fetus. MATERIAL AND METHODS: In the first phase of this study were reported 58 pregnant women with a positive test for active chlamydial infection by applying immunofluorescence. In the second phase of the study were reported pregnant with premature burst membranes (PBM, postnatal complications associated with chlamydial infection as puerperal endometritis, and newborns are monitored for low birth weight and growth retardation at birth. RESULTS: With a positive test are 58 patients in the first trimester or pregnancy registration in our consultation. After regimen with Sumamed (2 x 500 mg for three days and after 10 days again same scheme for them and their partner at the beginning of the third trimester, the PCR test was made again. Of these, 5 were positive again, participants are between 20 and 30 years old. With premature rupture of OM are 20 patients. There was no increased incidence of premature births. Infants born to infected mothers have a higher risk of developing respiratory symptoms in the first 60 days of life. 3 of them have low for his age bodyweight. CONCLUSIONS: The scarcity of data on manifestations of chlamydial infection during pregnancy and neonatal outcomes justifies this study. Early diagnosis for registration of pregnancy and timely treatment of chlamydial infection as well as scrutinising the infection during the third trimester of pregnancy can prevent infection of the newborn. Therefore, preventive examinations should be considered as a priority for early detection of asymptomatic chlamydial infection in the conduct of antenatal care.

  11. Pharmacokinetics of metronidazole in pregnant patients with bacterial vaginosis.

    Science.gov (United States)

    Wang, Xin; Nanovskaya, Tatiana N; Zhan, Ying; Abdel-Rahman, Susan M; Jasek, Marlo; Hankins, Gary D V; Ahmed, Mahmoud S

    2011-03-01

    The present study was undertaken to investigate the pharmacokinetics of metronidazole in pregnant patients with bacterial vaginosis. Twenty patients received metronidazole (Flagyl ®, Pfizer, 235 East 42nd Street, NY, NY 10017) oral dose 500 mg twice a day for 3 consecutive days. Pharmacokinetic analyses of metronidazole were performed after a single oral dose on the morning of day 4. Although absolute estimates of metronidazole total body exposure were highest in women during early term pregnancy, weight-corrected estimates of exposure maximum plasma drug concentration (C(max)) and the area under the plasma concentration-versus-time curve (AUC(0-12)), along with apparent oral clearance and distribution volume, were not significantly different between women at early, middle, and late stages of pregnancy and were in the range of reported values for nonpregnant patients receiving a similar dose. The pharmacokinetic profile of metronidazole did not change at the different time points assessed during pregnancy.

  12. Biologics in SLE: towards new approaches.

    Science.gov (United States)

    van Vollenhoven, Ronald F; Parodis, Ioannis; Levitsky, Adrian

    2013-06-01

    In recent years the use of biologic therapies in the management of systemic lupus erythematosus (SLE) has increased, and a number of clinical trials have highlighted both the potential and the pitfalls in the development of such agents. Many investigators reported that the off-label use of rituximab seemed promising in patients with refractory disease, but randomised trials with this agent failed. Likewise, the theoretical appeal of the co-stimulation blocker abatacept could not be confirmed in two clinical trials. Various considerations and post hoc analyses nonetheless suggest that these two biologics might have a role in the treatment of SLE. The anti-B-lymphocyte stimulator (anti-Blys) antibody belimumab demonstrated efficacy and safety in two large randomised trials and became the first approved biologic for lupus. Use in clinical practice has increased slowly, in part, due to uncertainty over which patients should be treated with this agent and in what stage of the disease. Finally, several other biologic agents are currently in advanced stages of clinical development for SLE. The overall picture that emerges is one of optimism that advances in SLE therapy will be realised through the targeted use of an increasing number of biologics.

  13. Folic acid use in pregnant patients presenting to the emergency department

    OpenAIRE

    Steenblik, Jacob; Schroeder, Erika; Hatch, Burke; Groke, Steven; Broadwater-Hollifield, Camille; Mallin, Michael; Ahern, Matthew; Madsen, Troy

    2011-01-01

    Background The US Preventive Services Task Force has recommended daily folic acid supplementation for women planning on becoming pregnant in an effort to prevent fetal neural tube defects. We evaluated pregnant patients presenting to the emergency department to determine rates of folic acid supplementation. Methods We surveyed a convenience sample of pregnant patients who presented to the University of Utah Emergency Department (ED) between 1 January 2008, and 30 April 2009, regarding pregnan...

  14. Dicty_cDB: SLE286 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available rial 4.0 %: vacuolar 4.0 %: vesicles of secretory system >> prediction for SLE286...SL (Link to library) SLE286 (Link to dictyBase) - G01954 DDB0188159 - SLE286P (Link to Original site) SLE...286F 562 SLE286Z 632 SLE286P 1194 - - Show SLE286 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-D/SLE286Q.Seq.d/ Representative seq. ID SLE...286P (Link to Original site) Representative DNA sequence >SLE286 (SLE286Q) /CSM/SL/SLE2-D/SLE

  15. RNA-Seq for enrichment and analysis of IRF5 transcript expression in SLE.

    Directory of Open Access Journals (Sweden)

    Rivka C Stone

    Full Text Available Polymorphisms in the interferon regulatory factor 5 (IRF5 gene have been consistently replicated and shown to confer risk for or protection from the development of systemic lupus erythematosus (SLE. IRF5 expression is significantly upregulated in SLE patients and upregulation associates with IRF5-SLE risk haplotypes. IRF5 alternative splicing has also been shown to be elevated in SLE patients. Given that human IRF5 exists as multiple alternatively spliced transcripts with distinct function(s, it is important to determine whether the IRF5 transcript profile expressed in healthy donor immune cells is different from that expressed in SLE patients. Moreover, it is not currently known whether an IRF5-SLE risk haplotype defines the profile of IRF5 transcripts expressed. Using standard molecular cloning techniques, we identified and isolated 14 new differentially spliced IRF5 transcript variants from purified monocytes of healthy donors and SLE patients to generate an IRF5 variant transcriptome. Next-generation sequencing was then used to perform in-depth and quantitative analysis of full-length IRF5 transcript expression in primary immune cells of SLE patients and healthy donors by next-generation sequencing. Evidence for additional alternatively spliced transcripts was obtained from de novo junction discovery. Data from these studies support the overall complexity of IRF5 alternative splicing in SLE. Results from next-generation sequencing correlated with cloning and gave similar abundance rankings in SLE patients thus supporting the use of this new technology for in-depth single gene transcript profiling. Results from this study provide the first proof that 1 SLE patients express an IRF5 transcript signature that is distinct from healthy donors, 2 an IRF5-SLE risk haplotype defines the top four most abundant IRF5 transcripts expressed in SLE patients, and 3 an IRF5 transcript signature enables clustering of SLE patients with the H2 risk haplotype.

  16. Dicty_cDB: SLE810 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE810 (Link to dictyBase) - - - Contig-U16540-1 SLE810P (Link to Original site) SLE...810F 361 SLE810Z 263 SLE810P 624 - - Show SLE810 Library SL (Link to library) Clone ID SLE... URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-A/SLE810Q.Seq.d/ Representative seq. ID SLE...810P (Link to Original site) Representative DNA sequence >SLE810 (SLE810Q) /CSM/SL/SLE8-A/SLE8...QIPSCRLPSNSNEDYNNKPNGYNDN --- ---MMMSLMDMMIMKMRVMDYQFHVAQLXLVN*ikfvy*ynhvvphyvnl*nvhqelnvl liqle

  17. Dicty_cDB: SLE367 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE367 (Link to dictyBase) - - - Contig-U16462-1 SLE367P (Link to Original site) SLE...367F 417 SLE367Z 547 SLE367P 964 - - Show SLE367 Library SL (Link to library) Clone ID SLE... URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-C/SLE367Q.Seq.d/ Representative seq. ID SLE...367P (Link to Original site) Representative DNA sequence >SLE367 (SLE367Q) /CSM/SL/SLE3-C/SLE3...LARGLKNALIAN--- ---LSANNKASVLVDLVTKYFWGFRDSAIYKGKQVGFYKRAQIFVGDLWGAYQGRGLGKF DDIKQLTMFADYRVPQILEELKVIEYSPELKEMIKNKVEIPVGSEMELE

  18. Dicty_cDB: SLE210 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE210 (Link to dictyBase) - - - Contig-U10780-1 SLE210P (Link to Original site) SLE...210F 675 SLE210Z 660 SLE210P 1315 - - Show SLE210 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-A/SLE210Q.Seq.d/ Representative seq. ID SLE...210P (Link to Original site) Representative DNA sequence >SLE210 (SLE210Q) /CSM/SL/SLE2-A/SLE...DRVLILPIDEQIKDLFAFKPYELQKYFKVGDHVKAIGGRYEGETGMVLRVDDLQ VVLLSDLTMSEIKVKPQDLQECTEVATGRLELGNYELHDLVQIGPHKVGVIIK

  19. COMPARISON OF COGULATION PROFILE IN PRE ECLAMPTIC AND ECLAMPTIC PATIENTS WITH NORMOTENSIVE PREGNANT PATIENTS

    Directory of Open Access Journals (Sweden)

    Priyanka

    2014-03-01

    Full Text Available AIM: To compare the coagulation parameters in patients with preeclampsia and eclampsia with normotensive pregnant patients in Nainital district of Uttarakhand state. MATERIAL AND METHODS: From January 2012 to June 2013, coagulation indices including platelet count, prothrombin time (PT, activated partial thromboplastin time (aPTT, bleeding time (BT and clotting time (CT were measured in 100 patients with preeclampsia and eclampsia and compared with 100 normotensive pregnant women. The patients with coagulopathies were excluded. RESULT: In pre-eclampsia and eclampsia, decrease in platelet count (157.18±56.66 lacs/cumm was highly significant (p<0.001. PT, aPTT and CT were normal but BT (322.46±171.39 sec was significantly prolonged (p<0.001 in pre eclampsia and eclampsia patients. CONCLUSION: The abnormalities pertaining to coagulation parameters in hypertensive disorders of pregnancy indicate the intravascular coagulation.

  20. A 10-year restrospective evaluation of ultrasound in pregnant abdominal trauma patients.

    Science.gov (United States)

    Meisinger, Quinn C; Brown, Michele A; Dehqanzada, Zia A; Doucet, Jay; Coimbra, Raul; Casola, Giovanna

    2016-04-01

    The pregnant abdominal trauma patient presents a unique diagnostic challenge. This study aimed to evaluate the accuracy of abdominal sonography for the detection of clinically important injuries in pregnant abdominal trauma patients. A retrospective review was performed of a trauma center database from 2001 to 2011. Medical records were reviewed to determine initial abdominal imaging test results and clinical course. Sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound for detection of traumatic injury were calculated. Of 19,128 patients with suspected abdominal trauma, 385 (2 %) were pregnant. Of these, 372 (97 %) received ultrasound as the initial abdominal imaging test. All 13 pregnant patients who did not receive ultrasound received abdominal CT. Seven pregnant patients underwent both ultrasound and CT. Seven ultrasound examinations were positive, leading to one therapeutic Cesarean section and one laparotomy. One ultrasound was considered false positive (no injury was seen on subsequent CT). There were 365 negative ultrasound examinations. Of these, 364 were true negative (no abdominal injury subsequently found). One ultrasound was considered false negative (a large fetal subchorionic hemorrhage seen on subsequent dedicated obstetrical ultrasound). Sensitivity and positive predictive value were 85.7 %. Specificity and negative predictive value were 99.7 %. Abdominal sonography is an effective and sufficient imaging examination in pregnant abdominal trauma patients. When performed as part of the initial assessment using an abbreviated trauma protocol with brief modifications for pregnancy, ultrasound minimizes diagnostic delay, obviates radiation risk, and provides high sensitivity for injury in the pregnant population.

  1. Post-steroid neuropsychiatric manifestations are significantly more frequent in SLE compared with other systemic autoimmune diseases and predict better prognosis compared with de novo neuropsychiatric SLE.

    Science.gov (United States)

    Shimizu, Yuka; Yasuda, Shinsuke; Kako, Yuki; Nakagawa, Shin; Kanda, Masatoshi; Hisada, Ryo; Ohmura, Kazumasa; Shimamura, Sanae; Shida, Haruki; Fujieda, Yuichiro; Kato, Masaru; Oku, Kenji; Bohgaki, Toshiyuki; Horita, Tetsuya; Kusumi, Ichiro; Atsumi, Tatsuya

    2016-08-01

    In patients with systemic lupus erythematosus (SLE), neuropsychiatric (NP) symptoms sometimes occur after administration of corticosteroids, making differential diagnosis between NPSLE and steroid-induced psychosis challenging for clinicians. The aim of this study was to clarify the characteristics of post-steroid NP disease (PSNP) in patients with SLE. Clinical courses of 146 patients with SLE and 162 with other systemic autoimmune diseases, all in the absence of NP manifestations on admission, were retrospectively analyzed. Forty-three NPSLE patients on admission (de novo NPSLE) were also investigated. All patients were consecutively recruited and treated with 40mg/day or more of prednisolone in Hokkaido University Hospital between April 2002 and March 2015. The prevalence of PSNP was strikingly higher in SLE patients than other systemic autoimmune diseases (24.7% vs. 7.4%, OR 4.09, 95% CI 2.04-8.22). As independent risk factors to develop PSNP in SLE patients, past history of mental disorder and the presence of antiphospholipid syndrome were identified using multiple logistic regression analysis. In patients with PSNP-SLE, mood disorder was significantly more frequent than in de novo NPSLE (47.2% vs. 20.9%, OR 3.38, 95% CI 1.26-9.04). Of PSNP-SLE patients, two-thirds were with one or more abnormal findings in cerebrospinal fluid, electroencephalogram, MRI or SPECT. Majority of our PSNP-SLE patients received intensified immunosuppressive treatments and experienced improvement in most cases. PSNP-SLE had better relapse-free survival than de novo NPSLE (p<0.05, log rank test). In conclusion, PSNP frequently occurred in patients with SLE and treated successfully with immunosuppressive therapy, indicating that NPSLE is likely to harbor patients with PSNP-SLE.

  2. Anticoagulant therapy in pregnant patients with metabolic syndrome: a review.

    Science.gov (United States)

    Mierzynski, Radzisław; Poniedzialek-Czajkowska, Elzbieta; Kimber-Trojnar, Zaneta; Leszczynska-Gorzelak, Bozena; Oleszczuk, Jan

    2014-01-01

    Pregnancy is a specific state of heightened coagulability related to the increase in procoagulant agents and to the reduced fibrinolysis. Pregnancy is associated with a 4-fold increased risk of developing venous thromboembolism (VTE) and this risk still increases to 14-fold during puerperium. A correlation between the metabolic syndrome and development of cardiovascular events and cerebrovascular incidents has been described. Such a relationship is referred to a hypercoagulable state due to increased serum levels of the plasminogen activator inhibitor-1 (PAI-1), fibrinogen, factor (F) VII and VIII, von Willebrand factor and from endothelial activation, caused by increased circulating adhesion molecules. As to the risk of VTE, the probability for its association with cardiovascular incidents is increased by common underlying mechanisms such as the activation of platelets and the blood coagulation. A correlation between idiopathic VTE and the metabolic syndrome has been reported. The anticoagulant therapy may be recommended during the pregnancy for the treatment or the prophylaxis of VTE and, in women with artificial heart valves, for the prevention of the valve thrombosis and systemic embolisation. There are also specific conditions during pregnancy which benefit from anticoagulant use, such as recurrent fetal loss, thrombophilia and assisted reproductive technology. There are no published specific data about using of anticoagulant agents in pregnant patients with the metabolic syndrome except for a few articles addressing reproductive problems. The mechanisms of anticoagulant action were studied with the focus on heparinoids, because of their safety not only for the patient but also for the fetus. The new oral anticoagulants were also shortly described although they have been contraindicated during the pregnancy.

  3. Acute Pulmonary Edema in an Eclamptic Pregnant Patient: A Rare Case of Takotsubo Syndrome

    Science.gov (United States)

    Karamchandani, Kunal; Bortz, Brandon; Vaida, Sonia

    2016-01-01

    Patient: Female, 35 Final Diagnosis: Takotsubo cardiomyopathy Symptoms: Seizures Medication: — Clinical Procedure: Cesarean section Specialty: Critical Care Medicine Objective: Rare co-existance of disease or pathology Background: Acute pulmonary edema in a pregnant patient is associated with significant morbidity and mortality. Takotsubo syndrome, or stress-induced cardiomyopathy, is a rare cause of acute pulmonary edema in a pregnant patient, especially prior to delivery of the fetus. Case Report: We describe a case of a pregnant patient who presented with acute pulmonary edema and eclampsia and was found to have Takotsubo syndrome. To the best of our knowledge, eclampsia as a precipitating factor for Takotsubo syndrome has not been described in literature. Conclusions: Clinicians taking care of pregnant patients should be aware of the potential link between eclampsia and Takotsubo cardiomyopathy. Prompt correction of the precipitating cause along with supportive management as described is the key to a successful outcome. PMID:27658947

  4. Dicty_cDB: SLE314 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available mitochondrial 8.0 %: Golgi 4.0 %: vesicles of secretory system >> prediction for SLE...SL (Link to library) SLE314 (Link to dictyBase) - - - Contig-U00319-1 SLE314Z (Link... to Original site) - - SLE314Z 671 - - - - Show SLE314 Library SL (Link to library) Clone ID SLE314 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-A/SLE314Q.Seq.d/ Representative seq. ID SLE31...4Z (Link to Original site) Representative DNA sequence >SLE314 (SLE314Q) /CSM/SL/SLE3-A/SLE314Q.Seq.d/ XXXXX

  5. Dicty_cDB: SLE112 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE112 (Link to dictyBase) - G24165 DDB0231700 Contig-U16394-1 SLE...112F (Link to Original site) SLE112F 615 - - - - - - Show SLE112 Library SL (Link to library) Clone ID SLE...riginal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-A/SLE112Q.Seq.d/ ...Representative seq. ID SLE112F (Link to Original site) Representative DNA sequence >SLE112 (SLE112Q) /CSM/SL/SLE1-A/SLE...QLQQQQQHQM QQPQHQQMLQPSKVIYVPKGSPYM--- Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE

  6. Dicty_cDB: SLE448 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available mic reticulum 4.0 %: cytoskeletal >> prediction for SLE448 is cyt 5' end seq. ID ...SL (Link to library) SLE448 (Link to dictyBase) - - - Contig-U15567-1 SLE448Z (Link... to Original site) - - SLE448Z 639 - - - - Show SLE448 Library SL (Link to library) Clone ID SLE448 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-B/SLE448Q.Seq.d/ Representative seq. ID SLE44...8Z (Link to Original site) Representative DNA sequence >SLE448 (SLE448Q) /CSM/SL/SLE4-B/SLE448Q.Seq.d/ XXXXX

  7. Adherence to cervical cancer screening in an Italian SLE cohort

    Directory of Open Access Journals (Sweden)

    R. Talarico

    2011-06-01

    Full Text Available Objective: Papanicolau (Pap smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients’ behavior. Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. Results: 140 SLE patients (mean age 48.3±12 years and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4% declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs while 47 (33.6% did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally. No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviours and disease-related variables. Conclusions: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures.

  8. Acute Pulmonary Edema in an Eclamptic Pregnant Patient: A Rare Case of Takotsubo Syndrome.

    Science.gov (United States)

    Karamchandani, Kunal; Bortz, Brandon; Vaida, Sonia

    2016-09-23

    BACKGROUND Acute pulmonary edema in a pregnant patient is associated with significant morbidity and mortality. Takotsubo syndrome, or stress-induced cardiomyopathy, is a rare cause of acute pulmonary edema in a pregnant patient, especially prior to delivery of the fetus. CASE REPORT We describe a case of a pregnant patient who presented with acute pulmonary edema and eclampsia and was found to have Takotsubo syndrome. To the best of our knowledge, eclampsia as a precipitating factor for Takotsubo syndrome has not been described in literature. CONCLUSIONS Clinicians taking care of pregnant patients should be aware of the potential link between eclampsia and Takotsubo cardiomyopathy. Prompt correction of the precipitating cause along with supportive management as described is the key to a successful outcome.

  9. Inflammation associated anemia and ferritin as disease markers in SLE

    Science.gov (United States)

    2012-01-01

    Introduction In a recent screening to detect biomarkers in systemic lupus erythematosus (SLE), expression of the iron storage protein, ferritin, was increased. Given that proteins that regulate the storage, transfer and release of iron play an important role in inflammation, this study aims to determine the serum and urine levels of ferritin and of the iron transfer protein, transferrin, in lupus patients and to correlate these levels with disease activity, inflammatory cytokine levels and markers of anemia. Methods A protein array was utilized to measure ferritin expression in the urine and serum of SLE patients and healthy controls. To confirm these results as well as the role of the iron transfer pathway in SLE, ELISAs were performed to measure ferritin and transferrin levels in inactive or active SLE patients and healthy controls. The relationship between ferritin/transferrin levels and inflammatory markers and anemia was next analyzed. Results Protein array results showed elevated ferritin levels in the serum and urine of lupus patients as compared to controls, which were further validated by ELISA. Increased ferritin levels correlated with measures of disease activity and anemia as well as inflammatory cytokine titers. Though active SLE patients had elevated urine transferrin, serum transferrin was reduced. Conclusion Urine ferritin and transferrin levels are elevated significantly in SLE patients and correlate with disease activity, bolstering previous reports. Most importantly, these changes correlated with the inflammatory state of the patients and anemia of chronic disease. Taken together, altered iron handling, inflammation and anemia of chronic disease constitute an ominous triad in SLE. PMID:22871034

  10. Thoracic epidural analgesia to control malignant pain until viability in a pregnant patient

    OpenAIRE

    Mehta JH; Gibson ME; Amaro-Driedger D; Hussain MN

    2016-01-01

    Jaideep H Mehta,1 Mary Elizabeth Gibson,2 David Amaro-Driedger,3 Mahammad N Hussain1 1Department of Anesthesiology, UT Health, McGovern Medical School, Houston, TX, 2Orlando Health, Orlando, FL, 3UT Health, McGovern Medical School, Houston, TX, USA Abstract: Management of nonobstetric pain in the pregnant patient presents unique challenges related to transplacental fetal exposure to opioids and the subsequent risk of neonatal withdrawal syndrome. We present the case of a pregnant patient suff...

  11. Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery

    OpenAIRE

    2015-01-01

    Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerat...

  12. Dicty_cDB: SLE263 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE263 (Link to dictyBase) - - - Contig-U16455-1 SLE263Z (Link... to Original site) - - SLE263Z 486 - - - - Show SLE263 Library SL (Link to library) Clone ID SLE263 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-C/SLE263Q.Seq.d/ Representative seq. ID SLE26...3Z (Link to Original site) Representative DNA sequence >SLE263 (SLE263Q) /CSM/SL/SLE2-C/SLE263Q.Seq.d/ XXXXX...936 0.0 SLG782 (SLG782Q) /CSM/SL/SLG7-D/SLG782Q.Seq.d/ 936 0.0 SLE701 (SLE701Q) /CSM/SL/SLE7-A/SLE701Q.Seq.d/ 936 0.0 SLE555 (SLE

  13. Dicty_cDB: SLE678 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE678 (Link to dictyBase) - - - Contig-U16137-1 SLE678Z (Link... to Original site) - - SLE678Z 547 - - - - Show SLE678 Library SL (Link to library) Clone ID SLE678 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-D/SLE678Q.Seq.d/ Representative seq. ID SLE67...8Z (Link to Original site) Representative DNA sequence >SLE678 (SLE678Q) /CSM/SL/SLE6-D/SLE678Q.Seq.d/ XXXXX...(SSI206Q) /CSM/SS/SSI2-A/SSI206Q.Seq.d/ 1084 0.0 SLE686 (SLE686Q) /CSM/SL/SLE6-D/SLE686Q.Seq.d/ 1084 0.0 SLE678 (SLE

  14. Monitoring of disease biomarkers activity and immunophenotyping as important factors in SLE clinical management.

    Science.gov (United States)

    Subasic, Djemo; Karamehic, Jasenko; Delic-Sarac, Marina; Kasumovic, Mersija; Mekic, Mevludin; Eminovic, Izet; Hasanagic, Nermina

    2012-01-01

    The highly specific biomarkers for monitoring of SLE disease activity are not yet defined up to date, due to existing of different clinical SLE phenotypes caused by individual genetic variation. Basically, numerous clinical complications follow SLE patients such as nephritis, atherosclerosis and cardial, CNS, gastrointestinal and ophthalmological complications, as well. Their monitoring in clinical SLE management can be evaluated by analysing of specific biochemical parameters and require permanent clinical observation. The presence of ANAs and anti-ds-DNAs are usual diagnostic SLE autoimmunity parameters, while SLE disease activity biomarkers are C3 and C4 level, anticardiolipin antibodies, anti-Sm/RNPs and, recently level of CD4 and CD8 lymphocytes. However, the number of TCR molecules on the T-cells surface at SLE patients is lower then in normal condition, and otherwise for these receptors CD molecules make specific connection. On the other hand, the T lymphocytes can be also, therapeutical targets at SLE patients, because of their clear direct involving in SLE pathogenesis. The SLE phenotypes are characterized by double CD negativity ( CD3 +/-, CD4-) caused by abnormal level of IL-2 and IL-17. T-lymphocytes have usually alpha-beta and gamma-delta TCR receptors, but for SLE patients is characteristic lower number gama-delta TCR molecules, detected in the peripheral blood specimens. Taking into account all of the facts, we investigated the level of specific usual SLE activity biomarkers (anti-ds-DNAs, C3, C4, anticardiolipin antibodies (beta-2-IgG, beta-2-IgM, ACA-G, ACA-M, CD4 and CD8 level) in serum specimens of SLE patients who underwent to the corresponding chemotherapy in combination with other biochemical and clinical parameters. Once again proved to be, that SLE biomarker monitoring, could be useful aproach for SLE activity disease and prediction organ damage, as well. In our investigation we used the following methods: immunofluorescence microscopy (IFA

  15. Dicty_cDB: SLE437 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE437 (Link to dictyBase) - - - - SLE437F (Link to Original site) SLE...437F 427 - - - - - - Show SLE437 Library SL (Link to library) Clone ID SLE437 (Link to dictyBase) At...las ID - NBRP ID - dictyBase ID - Link to Contig - Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-B/SLE...437Q.Seq.d/ Representative seq. ID SLE437F (Link to Original site) R...epresentative DNA sequence >SLE437 (SLE437Q) /CSM/SL/SLE4-B/SLE437Q.Seq.d/ GTTTTTAAAAAATTTATAAAAATAAAAATTATT

  16. Dicty_cDB: SLE518 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE518 (Link to dictyBase) - - - Contig-U16430-1 SLE518Z (Link... to Original site) - - SLE518Z 657 - - - - Show SLE518 Library SL (Link to library) Clone ID SLE518 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-A/SLE518Q.Seq.d/ Representative seq. ID SLE51...8Z (Link to Original site) Representative DNA sequence >SLE518 (SLE518Q) /CSM/SL/SLE5-A/SLE518Q.Seq.d/ XXXXX...ranslated Amino Acid sequence ---LPKEGLKLDETEDEKKKAEQDKAANEELLKQVKDVLGDKVEKVVLSTRLANSPCVLV TSEYGWSANMERIMKAQALRDSSMSSYMSSKKTLE

  17. Dicty_cDB: SLE460 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE460 (Link to dictyBase) - - - Contig-U15272-1 SLE460Z (Link... to Original site) - - SLE460Z 618 - - - - Show SLE460 Library SL (Link to library) Clone ID SLE460 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-C/SLE460Q.Seq.d/ Representative seq. ID SLE46...0Z (Link to Original site) Representative DNA sequence >SLE460 (SLE460Q) /CSM/SL/SLE4-C/SLE460Q.Seq.d/ XXXXX...GPI LTPGIVVTMSTKHLVIYLSEYNLEVSSDRSDFLSLSQHHSSPIDDDEEIEISKQLSVFLS VEPFVLFRSNLVPKIK

  18. Dicty_cDB: SLE380 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE380 (Link to dictyBase) - - - Contig-U16382-1 SLE380Z (Link... to Original site) - - SLE380Z 698 - - - - Show SLE380 Library SL (Link to library) Clone ID SLE380 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-D/SLE380Q.Seq.d/ Representative seq. ID SLE38...0Z (Link to Original site) Representative DNA sequence >SLE380 (SLE380Q) /CSM/SL/SLE3-D/SLE380Q.Seq.d/ XXXXX...TERGYSFTTTAEREIVRDIKEKL AYVALDFEAEMQTAASSSALEKSYELPDGQVITIGNERFRCPEALFQPSFLGMESAG

  19. Dicty_cDB: SLE563 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE563 (Link to dictyBase) - - - Contig-U16269-1 SLE563Z (Link... to Original site) - - SLE563Z 663 - - - - Show SLE563 Library SL (Link to library) Clone ID SLE563 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-C/SLE563Q.Seq.d/ Representative seq. ID SLE56...3Z (Link to Original site) Representative DNA sequence >SLE563 (SLE563Q) /CSM/SL/SLE5-C/SLE563Q.Seq.d/ XXXXX...SRLNLLKLAPGGHLGRFIIWTKSAFEQLDSTFGTFAKSSAQKKGYTLPR PMIVTLILSDSSTLMKSKLPLEPAKSSSNVQ

  20. Dicty_cDB: SLE656 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE656 (Link to dictyBase) - - - Contig-U16357-1 SLE656Z (Link... to Original site) - - SLE656Z 423 - - - - Show SLE656 Library SL (Link to library) Clone ID SLE656 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-C/SLE656Q.Seq.d/ Representative seq. ID SLE65...6Z (Link to Original site) Representative DNA sequence >SLE656 (SLE656Q) /CSM/SL/SLE6-C/SLE656Q.Seq.d/ XXXXX...*ietmyflwynfltrvekrsswkskfm*clwsifckigkkrsilnlettkc slc**simcwkrsktikynksinnlykfc*t*panfptttttttttttttttpttt

  1. Dicty_cDB: SLE429 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE429 (Link to dictyBase) - - - Contig-U11650-1 SLE429Z (Link... to Original site) - - SLE429Z 442 - - - - Show SLE429 Library SL (Link to library) Clone ID SLE429 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-B/SLE429Q.Seq.d/ Representative seq. ID SLE42...9Z (Link to Original site) Representative DNA sequence >SLE429 (SLE429Q) /CSM/SL/SLE4-B/SLE429Q.Seq.d/ XXXXX...slated Amino Acid sequence ---QYIVESEKTRDYSKSTLNRLLNNQPYGKNAYKPSPTLHFLNVPLNFTEKQLIDEFTN FGTHTPTHCKFFPTKPESTKLMGLLE

  2. Dicty_cDB: SLE731 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE731 (Link to dictyBase) - - - Contig-U16252-1 SLE731Z (Link... to Original site) - - SLE731Z 651 - - - - Show SLE731 Library SL (Link to library) Clone ID SLE731 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-B/SLE731Q.Seq.d/ Representative seq. ID SLE73...1Z (Link to Original site) Representative DNA sequence >SLE731 (SLE731Q) /CSM/SL/SLE7-B/SLE731Q.Seq.d/ XXXXX...kmignhtln*qhqlifkllvmiyllptqkelrlvlkrkhvmlfy*kltklvqslnqfvp lltqrmhhgvswlaivqvklkipslli*llv*vlvklklvlhvdqkd*pntinlle

  3. Dicty_cDB: SLE293 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE293 (Link to dictyBase) - - - Contig-U11611-1 SLE293Z (Link... to Original site) - - SLE293Z 661 - - - - Show SLE293 Library SL (Link to library) Clone ID SLE293 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-D/SLE293Q.Seq.d/ Representative seq. ID SLE29...3Z (Link to Original site) Representative DNA sequence >SLE293 (SLE293Q) /CSM/SL/SLE2-D/SLE293Q.Seq.d/ XXXXX...PGGKFDHKKEMYHPYPMVTPTTNPYAKYD TFGYPPPQDRYGKTQGGKPQQSKYRFSPY*fclrtkkktkkk Frame C: ---vqmmmenhqqpkyyllgele

  4. Dicty_cDB: SLE450 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE450 (Link to dictyBase) - - - Contig-U16382-1 SLE450Z (Link... to Original site) - - SLE450Z 709 - - - - Show SLE450 Library SL (Link to library) Clone ID SLE450 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-C/SLE450Q.Seq.d/ Representative seq. ID SLE45...0Z (Link to Original site) Representative DNA sequence >SLE450 (SLE450Q) /CSM/SL/SLE4-C/SLE450Q.Seq.d/ XXXXX...LDLAGRDLTDYMMKILTERGYSFTTTAEREIVRD IKEKLAYVALDFEAEMQTAASSSALEKSYELPDGQVITIGNERFRC

  5. Dicty_cDB: SLE561 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE561 (Link to dictyBase) - - - Contig-U10780-1 SLE561Z (Link... to Original site) - - SLE561Z 500 - - - - Show SLE561 Library SL (Link to library) Clone ID SLE561 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-C/SLE561Q.Seq.d/ Representative seq. ID SLE56...1Z (Link to Original site) Representative DNA sequence >SLE561 (SLE561Q) /CSM/SL/SLE5-C/SLE561Q.Seq.d/ XXXXX...kimtkklnhniglvqrlk*slrilvnmp*f* iisliqplelkc*tpkk*limfhnlnsiwfhqlkkivssllkvnyvvkvvifsfllmkil vslk*iqtlilkfsk

  6. Dicty_cDB: SLE589 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE589 (Link to dictyBase) - - - Contig-U04044-1 SLE589F (Link to Original site) SLE...589F 632 - - - - - - Show SLE589 Library SL (Link to library) Clone ID SLE589 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-D/SLE589Q.Seq.d/ Representative seq. ID SLE58...9F (Link to Original site) Representative DNA sequence >SLE589 (SLE589Q) /CSM/SL/SLE5-D/SLE589Q.Seq.d/ AGTTA...TINRLSFGNDF--- Frame C: lhyisqlifimnyl*iqlvvkn*kliwillftiyhvhi*v*mqwmfqvninlm*hiiylr kdyhqqdnqllkhhqle

  7. Dicty_cDB: SLE196 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE196 (Link to dictyBase) - - - Contig-U16453-1 SLE196Z (Link... to Original site) - - SLE196Z 667 - - - - Show SLE196 Library SL (Link to library) Clone ID SLE196 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-D/SLE196Q.Seq.d/ Representative seq. ID SLE19...6Z (Link to Original site) Representative DNA sequence >SLE196 (SLE196Q) /CSM/SL/SLE1-D/SLE196Q.Seq.d/ XXXXX...98. 5.18 Translated Amino Acid sequence ---LTLEGIRQFYVNVGVEQGKFEVLTDLYETLSITQSVIFCNTRRKVDWLTSKMTEQKF TVSSTHG

  8. Dicty_cDB: SLE407 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ATAAAAAA AATAAAAATTAAAATAAAAAATAAATTATTTA Length of connected seq. 1282 Full length Seq ID SLE407E Full length Seq. >SLE...SL (Link to library) SLE407 (Link to dictyBase) - - - Contig-U09973-1 SLE407E (Link to Original site) SLE...407F 607 SLE407Z 675 SLE407P 1282 SLE407E 715 Show SLE407 Library SL (Link to library) Clone ID SLE...inal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-A/SLE407Q.Seq.d/ Representative seq. ID SLE...407E (Link to Original site) Representative DNA sequence >SLE407 (SLE407Q) /CSM/SL/SLE4-A/SLE

  9. Dicty_cDB: SLE226 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available %: vacuolar 4.0 %: mitochondrial 4.0 %: nuclear >> prediction for SLE226 is exc 5' end seq. ID SLE226F 5' end seq. >SLE...SL (Link to library) SLE226 (Link to dictyBase) - - - Contig-U16540-1 SLE226P (Link to Original site) SLE...226F 643 SLE226Z 655 SLE226P 1298 - - Show SLE226 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-B/SLE226Q.Seq.d/ Representative seq. ID SLE...226P (Link to Original site) Representative DNA sequence >SLE226 (SLE226Q) /CSM/SL/SLE2-B/SLE

  10. Dicty_cDB: SLE532 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available TAAAATATATATATTTGTTTTTTTAATT Length of connected seq. 1339 Full length Seq ID SLE532E Full length Seq. >SLE5...SL (Link to library) SLE532 (Link to dictyBase) - - - Contig-U15315-1 SLE532E (Link to Original site) SLE...532F 671 SLE532Z 668 SLE532P 1339 SLE532E 686 Show SLE532 Library SL (Link to library) Clone ID SLE...inal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-B/SLE532Q.Seq.d/ Representative seq. ID SLE...532E (Link to Original site) Representative DNA sequence >SLE532 (SLE532Q) /CSM/SL/SLE5-B/SLE

  11. Reduced complement-mediated immune complex solubilizing capacity and the presence of incompletely solubilized immune complexes in SLE sera

    DEFF Research Database (Denmark)

    Baatrup, Gunnar; Petersen, I; Jensenius, J C

    1983-01-01

    Reduced complement-mediated solubilization (CMS) of pre-formed immune complexes (IC) was demonstrated in sera from 11 out of 12 SLE patients. The presence of incompletely solubilized endogeneous IC in SLE sera was indicated by the following findings: (1) When IC positive SLE sera with reduced CMS...

  12. 46,X,del(X)(q13) Turner's Syndrome Female with Systemic Lupus Erythematosus in a Pedigree Multiplex for SLE

    OpenAIRE

    2009-01-01

    Systemic lupus erythematosus (SLE) disproportionately affects females. Recent work demonstrates that men with Klinefelter's syndrome (47,XXY males) have a similar risk of developing SLE as do genotypic females. We present an unusual case of an African American family with two SLE affected individuals in which one of the SLE patients also has Turner's syndrome [46,X,del(X)(q13)]. While not definitive, this family raises interesting questions regarding the role of genes located on the X chromos...

  13. Dicty_cDB: SLE347 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE347 (Link to dictyBase) - - - Contig-U16455-1 SLE347Z (Link... to Original site) - - SLE347Z 473 - - - - Show SLE347 Library SL (Link to library) Clone ID SLE347 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-B/SLE347Q.Seq.d/ Representative seq. ID SLE34...7Z (Link to Original site) Representative DNA sequence >SLE347 (SLE347Q) /CSM/SL/SLE3-B/SLE347Q.Seq.d/ XXXXX...M/SL/SLG7-D/SLG782Q.Seq.d/ 932 0.0 SLG541 (SLG541Q) /CSM/SL/SLG5-B/SLG541Q.Seq.d/ 932 0.0 SLE701 (SLE701Q) /CSM/SL/SLE7-A/SLE

  14. Dicty_cDB: SLE137 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE137 (Link to dictyBase) - - - Contig-U15038-1 SLE137Z (Link... to Original site) - - SLE137Z 528 - - - - Show SLE137 Library SL (Link to library) Clone ID SLE137 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-B/SLE137Q.Seq.d/ Representative seq. ID SLE13...7Z (Link to Original site) Representative DNA sequence >SLE137 (SLE137Q) /CSM/SL/SLE1-B/SLE137Q.Seq.d/ XXXXX...40 (VSA140Q) /CSM/VS/VSA1-B/VSA140Q.Seq.d/ 1001 0.0 SLE137 (SLE137Q) /CSM/SL/SLE1-B/SLE137Q.Seq.d/ 1001 0.0

  15. Dicty_cDB: SLE165 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE165 (Link to dictyBase) - - - Contig-U16510-1 SLE165Z (Link... to Original site) - - SLE165Z 679 - - - - Show SLE165 Library SL (Link to library) Clone ID SLE165 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-C/SLE165Q.Seq.d/ Representative seq. ID SLE16...5Z (Link to Original site) Representative DNA sequence >SLE165 (SLE165Q) /CSM/SL/SLE1-C/SLE165Q.Seq.d/ XXXXX... /CSM/SL/SLH3-A/SLH314Q.Seq.d/ 654 0.0 SLG594 (SLG594Q) /CSM/SL/SLG5-D/SLG594Q.Seq.d/ 654 0.0 SLE435 (SLE435Q) /CSM/SL/SLE4-B/SLE

  16. Dicty_cDB: SLE718 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE718 (Link to dictyBase) - - - Contig-U11926-1 SLE718Z (Link... to Original site) - - SLE718Z 590 - - - - Show SLE718 Library SL (Link to library) Clone ID SLE718 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-A/SLE718Q.Seq.d/ Representative seq. ID SLE71...8Z (Link to Original site) Representative DNA sequence >SLE718 (SLE718Q) /CSM/SL/SLE7-A/SLE718Q.Seq.d/ XXXXX... significant alignments: (bits) Value SLE718 (SLE718Q) /CSM/SL/SLE7-A/SLE718Q.Seq.d/ 1104 0.0 SLB280 (SLB280

  17. Dicty_cDB: SLE765 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE765 (Link to dictyBase) - - - Contig-U16451-1 SLE765Z (Link... to Original site) - - SLE765Z 567 - - - - Show SLE765 Library SL (Link to library) Clone ID SLE765 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-C/SLE765Q.Seq.d/ Representative seq. ID SLE76...5Z (Link to Original site) Representative DNA sequence >SLE765 (SLE765Q) /CSM/SL/SLE7-C/SLE765Q.Seq.d/ XXXXX...*nlkk Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE765 (SLE765Q) /CSM/SL/SLE7-C/SLE

  18. Dicty_cDB: SLE663 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE663 (Link to dictyBase) - - - Contig-U16455-1 SLE663Z (Link... to Original site) - - SLE663Z 712 - - - - Show SLE663 Library SL (Link to library) Clone ID SLE663 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-C/SLE663Q.Seq.d/ Representative seq. ID SLE66...3Z (Link to Original site) Representative DNA sequence >SLE663 (SLE663Q) /CSM/SL/SLE6-C/SLE663Q.Seq.d/ XXXXX...nt alignments: (bits) Value SLE663 (SLE663Q) /CSM/SL/SLE6-C/SLE663Q.Seq.d/ 1306 0.0 VSD740 (VSD740Q) /CSM/VS

  19. Dicty_cDB: SLE607 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE607 (Link to dictyBase) - - - Contig-U15069-1 SLE607F (Link to Original site) SLE...607F 584 - - - - - - Show SLE607 Library SL (Link to library) Clone ID SLE607 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-A/SLE607Q.Seq.d/ Representative seq. ID SLE60...7F (Link to Original site) Representative DNA sequence >SLE607 (SLE607Q) /CSM/SL/SLE6-A/SLE607Q.Seq.d/ CAAAA...lignments: (bits) Value SLE607 (SLE607Q) /CSM/SL/SLE6-A/SLE607Q.Seq.d/ 1158 0.0 VSD755 (VSD755Q) /CSM/VS/VSD

  20. Dicty_cDB: SLE502 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE502 (Link to dictyBase) - - - Contig-U16382-1 SLE502F (Link to Original site) SLE...502F 661 - - - - - - Show SLE502 Library SL (Link to library) Clone ID SLE502 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-A/SLE502Q.Seq.d/ Representative seq. ID SLE50...2F (Link to Original site) Representative DNA sequence >SLE502 (SLE502Q) /CSM/SL/SLE5-A/SLE502Q.Seq.d/ GGATG...865Q) /CSM/VF/VFL8-C/VFL865Q.Seq.d/ 1310 0.0 SLE502 (SLE502Q) /CSM/SL/SLE5-A/SLE5

  1. Dicty_cDB: SLE419 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE419 (Link to dictyBase) - - - Contig-U11514-1 SLE419Z (Link... to Original site) - - SLE419Z 642 - - - - Show SLE419 Library SL (Link to library) Clone ID SLE419 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-A/SLE419Q.Seq.d/ Representative seq. ID SLE41...9Z (Link to Original site) Representative DNA sequence >SLE419 (SLE419Q) /CSM/SL/SLE4-A/SLE419Q.Seq.d/ XXXXX...nces producing significant alignments: (bits) Value SLE419 (SLE419Q) /CSM/SL/SLE4-A/SLE419Q.Seq.d/ 1128 0.0

  2. Dicty_cDB: SLE439 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available %: cytoplasmic 4.0 %: cytoskeletal 4.0 %: nuclear 4.0 %: vacuolar >> prediction for SLE439 is end 5' end seq...d seq. ID - Connected seq. - Length of connected seq. - Full length Seq ID SLE439E Full length Seq. >SLE...SL (Link to library) SLE439 (Link to dictyBase) - - - Contig-U16366-1 SLE439E (Link... to Original site) - - - - - - SLE439E 223 Show SLE439 Library SL (Link to library) Clone ID SLE439 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-B/SLE439Q.Seq.d/ Representative seq. ID SLE43

  3. Dicty_cDB: SLE645 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 8 ) Dictyostelium discoideum slug cDNA, clone SLE645. 1088 0.0 1 ( AY160093 ) Dictyostelium discoideum nucle... - Connected seq. ID - Connected seq. - Length of connected seq. - Full length Seq ID SLE645E Full length Seq. >SLE...SL (Link to library) SLE645 (Link to dictyBase) - - - Contig-U04054-1 SLE645E (Link... to Original site) - - - - - - SLE645E 549 Show SLE645 Library SL (Link to library) Clone ID SLE645 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-B/SLE645Q.Seq.d/ Representative seq. ID SLE64

  4. Results of Detecting Auto-antibodis in SLE patients%SLE患者自身抗体检测结果观察

    Institute of Scientific and Technical Information of China (English)

    唐红; 钟白玉; 唐书谦

    2002-01-01

    @@ 本研究应用免疫印迹技术(IBT)检测可抗取的核抗原(Extractable nuclear antigen,ENA)、短毛虫涂片法检测dsDNA及间接免疫荧光法检测抗核抗原抗体(Antibody to nuclear antigen,ANA)共75例系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者.目的是观察SLE患者血清中的ENA多肽抗体谱的特征与ANA和DNA三者之间的关系.

  5. Needle and catheter colonization in pregnant diabetic patients using the continuous subcutaneous insulin infusion pump.

    Science.gov (United States)

    Rivera-Alsina, M E; Willis, S

    1984-01-01

    The incidence of bacterial colonization and risk of infection associated with the use of continuous insulin infusion pump (CIIP) was examined in 11 pregnant diabetic patients. All patients received instruction on specific aspects of CIIP and needle insertion technique according to the protocol used in our institution. A total of 220 cultures was performed on the subcutaneous needle and connective tubing. There was no clinical evidence of infection. In conclusion, the risk of infectious cutaneous complications in the pregnant diabetic patient using CIIP is not increased over the nonpregnant diabetic population.

  6. Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Pregnant Cervical Cancer Patients.

    Science.gov (United States)

    Papadia, Andrea; Mohr, Stefan; Imboden, Sara; Lanz, Susanne; Bolla, Daniele; Mueller, Michael D

    2016-02-01

    We present cases of 2 pregnant patients with early-stage cervical cancer who have undergone indocyanine green (ICG) sentinel lymph node (SLN) mapping followed by laparoscopic SLN biopsy, pelvic lymphadenectomy, and cervical conization. Eight milliliters of ICG were injected in the 4 quadrants of the cervix after having obtained an adequate pneumoperitoneum and having inspected the abdominal cavity. SLNs were identified in both hemipelvises in both patients. In the final pathologic analysis, both SLNs and non-SLNs were negative for metastatic disease. No adverse events from ICG injection were recorded. ICG SLN mapping seems to be feasible in pregnant cervical cancer patients.

  7. Defects in germinal center selection in SLE

    Directory of Open Access Journals (Sweden)

    Megan eWoods

    2015-08-01

    Full Text Available Germinal centers (GCs are the primary site at which clonal expansion and affinity maturation of B cells occurs. B cells encounter antigen and receive T cell help in the GC light zone (LZ and then migrate to the dark zone where they proliferate and undergo somatic mutation before cycling back to the LZ for further rounds of selection. Tolerance to autoantigens is frequently lost de novo as GC B cells undergo class switching and somatic mutation. This loss of tolerance is regulated by a variety of mechanisms including cell death, failure to compete for T cell help and failure to differentiate into effector cells. Systemic Lupus Erythematosus (SLE is characterized by loss of tolerance to nucleic acid antigens. While defects in tolerance occur in the naïve repertoire of SLE patients, pathogenic autoantibodies also arise in the GC as a result of failure to exclude autoreactive B cells from the GC and by somatic mutation from non-autoreactive precursors. Several B cell defects contribute to the loss of GC tolerance in SLE, including polymorphisms of genes that regulate BCR signaling, excess TLR7 signaling, defects in FcRIIB expression or defects of B cell apoptosis. Extrinsic soluble factors such as Type1 IFN or an imbalance between the number of TFH cells and regulatory T cells in the GC can also alter B cell negative selection. Finally, defects in macrophage clearance of apoptotic debris within the GC result in BCR mediated internalization of nucleic acid containing material and stimulation of autoantibody production by endosomal TLR driven mechanisms.

  8. The renal scan in pregnant renal transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  9. Autoimmune Hepatitis as an Initial Presentation of SLE

    Directory of Open Access Journals (Sweden)

    Hassas Yeganeh

    2016-05-01

    Full Text Available An 11-year-old female patient with autoimmune hepatitis (AIH was referred to our rheumatology clinic due to her current musculoskeletal manifestations. The patient had been diagnosed with AIH 3 months previously, based on jaundice and impaired liver function tests, and she had been treated with low-dose prednisolone and azathioprine. She presented with malaise, arthritis, a malar rash on the face, and oral ulcers. Laboratory tests revealed a positive ANA/anti-dsDNA test. Liver biopsy showed chronic hepatitis with severe inflammatory activity, in favor of a diagnosis of definite AIH. She fulfilled the international criteria for both SLE and AIH. The clinical symptoms and laboratory findings of SLE improved with ongoing treatment with corticosteroids and azathioprine, accompanied with hydroxychloroquine sulfate. The present case indicates that AIH can be the first manifestation of SLE in children.

  10. Dicty_cDB: SLE757 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 1.00 32.0 %: mitochondrial 32.0 %: nuclear 28.0 %: cytoplasmic 4.0 %: cytoskeletal 4.0 %: plasma membrane >> prediction for SLE...SL (Link to library) SLE757 (Link to dictyBase) - - - Contig-U13482-1 SLE757P (Link to Original site) SLE...757F 599 SLE757Z 673 SLE757P 1272 - - Show SLE757 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-C/SLE757Q.Seq.d/ Representative seq. ID SLE...757P (Link to Original site) Representative DNA sequence >SLE757 (SLE757Q) /CSM/SL/SLE7-C/SLE

  11. Dicty_cDB: SLE543 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE543 (Link to dictyBase) - - - Contig-U16510-1 SLE543Z (Link... to Original site) - - SLE543Z 616 - - - - Show SLE543 Library SL (Link to library) Clone ID SLE543 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-B/SLE543Q.Seq.d/ Representative seq. ID SLE54...3Z (Link to Original site) Representative DNA sequence >SLE543 (SLE543Q) /CSM/SL/SLE5-B/SLE543Q.Seq.d/ XXXXX...fsl*fln*i*nk Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE543 (SLE543Q) /CSM/SL/SLE

  12. Dicty_cDB: SLE471 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 12.0 %: mitochondrial 8.0 %: Golgi 4.0 %: vesicles of secretory system >> prediction for SLE471 is nuc 5' end seq. ID SLE...ATAACAATACTTTTTTTTAATATTCAAAGACTTTACAAAAAA Length of connected seq. 1130 Full length Seq ID SLE471E Full length Seq. >SLE...SL (Link to library) SLE471 (Link to dictyBase) - - - Contig-U16236-1 SLE471E (Link to Original site) SLE...471F 582 SLE471Z 548 SLE471P 1130 SLE471E 584 Show SLE471 Library SL (Link to library) Clone ID SLE...inal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-C/SLE471Q.Seq.d/ Representative seq. ID SLE

  13. Dicty_cDB: SLE839 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE839 (Link to dictyBase) - - - Contig-U01297-1 SLE839Z (Link... to Original site) - - SLE839Z 570 - - - - Show SLE839 Library SL (Link to library) Clone ID SLE839 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-B/SLE839Q.Seq.d/ Representative seq. ID SLE83...9Z (Link to Original site) Representative DNA sequence >SLE839 (SLE839Q) /CSM/SL/SLE8-B/SLE839Q.Seq.d/ XXXXX...ekekkkeknknv Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE839 (SLE839Q) /CSM/SL/SLE

  14. Dicty_cDB: SLE391 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 1.00 40.0 %: cytoplasmic 36.0 %: nuclear 12.0 %: mitochondrial 8.0 %: cytoskeletal 4.0 %: Golgi >> prediction for SLE...SL (Link to library) SLE391 (Link to dictyBase) - - - Contig-U16460-1 SLE391P (Link to Original site) SLE...391F 604 SLE391Z 690 SLE391P 1294 - - Show SLE391 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-D/SLE391Q.Seq.d/ Representative seq. ID SLE...391P (Link to Original site) Representative DNA sequence >SLE391 (SLE391Q) /CSM/SL/SLE3-D/SLE

  15. Dicty_cDB: SLE274 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 16.0 %: mitochondrial 8.0 %: vesicles of secretory system 4.0 %: vacuolar >> prediction for SLE...SL (Link to library) SLE274 (Link to dictyBase) - - - Contig-U12305-1 SLE274P (Link to Original site) SLE...274F 703 SLE274Z 333 SLE274P 1036 - - Show SLE274 Library SL (Link to library) Clone ID SLE...e URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-D/SLE274Q.Seq.d/ Representative seq. ID SLE...274P (Link to Original site) Representative DNA sequence >SLE274 (SLE274Q) /CSM/SL/SLE2-D/SLE

  16. Prevalence of hepatitis B virus serologic markers in pregnant patients in Antananarivo, Madagascar.

    Science.gov (United States)

    Randriamahazo, T R; Raherinaivo, A A; Rakotoarivelo, Z H; Contamin, B; Rakoto Alson, O A; Andrianapanalinarivo, H R; Rasamindrakotroka, A

    2015-01-01

    Hepatitis B virus (HBV) infection is a major public health problem in Madagascar. Its severity is related to the risk of chronicity, especially in case of neonatal contamination. Our objectives were to investigate the prevalence of HBV infection among pregnant patients at the Befelatanana obstetrics and gynecology teaching hospital department (BOGTH) by detecting HBsAg and to evaluate the risk of HBV mother to child transmission by screening for HBeAg. We conducted a 6-month prospective study in the BTHOGD from February 2012 to July 2012. All pregnant patients consulting for antenatal care were screened for HBV serologic markers. The prevalence of HBsAg was 1.9% (20 out 1050 screened patients). The average age was 26.51 years (25-30 years). Most patients tested were unaware of their hepatitis B status and only 0.38% had been vaccinated before pregnancy. Only 1 (5%) of the 20 patients with HBsAg was positive for HBeAg. Hepatitis B is very frequent in pregnant patients in Madagascar and it is recommended that all pregnant patients be routinely screened for HBsAg. This screening of maternal infection would allow applying prophylactic measures to neonates to decrease the risk of disease chronicity. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Local anaesthetic toxicity in a pregnant patient undergoing lignocaine-induced intravenous regional anaesthesia.

    LENUS (Irish Health Repository)

    Coleman, M

    2012-02-03

    A pregnant patient at 38 weeks\\' gestation developed symptoms of local anaesthetic toxicity following intravenous regional anaesthesia (IVRA) for hand surgery, using a standard dose of lignocaine. Reports suggest that a number of factors, both physiological and pharmacological, combine to increase the likelihood of local anaesthetic (LA) toxicity in pregnancy despite employment of a conventional "safe" IVRA technique. It is suggested that for IVRA, pregnant patients are premedicated with a benzodiazepine, the tourniquet time is increased and the concentration of LA is decreased to reduce the risks of LA toxicity.

  18. ENA抗体与 SLE

    Institute of Scientific and Technical Information of China (English)

    张冬梅

    1998-01-01

    @@ 为了探讨抗ENA抗体在系统性红斑狼疮(SLE)患者中的临床意义,我们以猪脾制备了提取性核抗原(ENA),采用免疫参比电泳来鉴定不同的抗体,对466例抗核抗体(ANA)阳性患者,40例ANA阴性患者及140例正常人同时作ANA、抗ds-DNA及ENA对照比较.现总结报告如下:

  19. Dicty_cDB: SLE744 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ytoplasmic 8.0 %: plasma membrane 4.0 %: Golgi 4.0 %: vesicles of secretory system >> prediction for SLE...GATGAAATTATTTTTCATCTTTTAATAAA AAAAAAAAAAAGATATATTTTATACTATTTGAAAAAAAAAAA Length of connected seq. 1232 Full length Seq ID SLE...744E Full length Seq. >SLE744E.Seq CCACCACAACAAGGTTACCCACCACAACAAGGCTACCCACCACAACAGCCAGCATA...SL (Link to library) SLE744 (Link to dictyBase) - G24181 DDB0190183 Contig-U16478-1 SLE...744E (Link to Original site) SLE744F 538 SLE744Z 694 SLE744P 1232 SLE744E 788 Show SLE744 Library SL (Li

  20. Standardised incidence ratios (SIRs) for cancer after renal transplant in systemic lupus erythematosus (SLE) and non-SLE recipients.

    Science.gov (United States)

    Ramsey-Goldman, Rosalind; Brar, Amarpali; Richardson, Carrie; Salifu, Moro O; Clarke, Ann; Bernatsky, Sasha; Stefanov, Dimitre G; Jindal, Rahul M

    2016-01-01

    We investigated malignancy risk after renal transplantation in patients with and without systemic lupus erythematosus (SLE). Using the United States Renal Data System from 2001 to 2009, 143 652 renal transplant recipients with and without SLE contributed 585 420 patient-years of follow-up to determine incident cancers using Medicare claims codes. We calculated standardised incidence ratios (SIRs) of cancer by group using age, sex, race/ethnicity-specific and calendar year-specific cancer rates compared with the US population. 10 160 cancers occurred at least 3 months after renal transplant. Overall cancer risk was increased in both SLE and non-SLE groups compared with the US general population, SIR 3.5 (95% CI 2.1 to 5.7) and SIR 3.7 (95% CI 2.4 to 5.7), respectively. Lip/oropharyngeal, Kaposi, neuroendocrine, thyroid, renal, cervical, lymphoma, liver, colorectal and breast cancers were increased in both groups, whereas only melanoma was increased in SLE and lung cancer was increased in non-SLE. In Cox regression analysis, SLE status (HR 1.1, 95% CI 0.9 to 1.3) was not associated with increased risk of developing cancer, adjusted for other independent risk factors for developing cancer in renal transplant recipients. We found that smoking (HR 2.2, 95% CI 1.2 to 4.0), cytomegalovirus positivity at time of transplant (HR 1.3, 95% CI 1.2 to 1.4), white race (HR 1.2, 95% CI 1.2 to 1.3) and older recipient age at time of transplantation (HR 1.0 95% CI 1.0 to 1.2) were associated with an increased risk for development of cancer, whereas shorter time on dialysis, Epstein-Barr virus or HIV were associated with a lower risk for development of cancer. Cancer risk in renal transplant recipients appeared similar in SLE and non-SLE subjects, aside from melanoma. Renal transplant recipients may need targeted counselling regarding surveillance and modifiable risk factors.

  1. Targeting the BLyS-APRIL signaling pathway in SLE.

    Science.gov (United States)

    La Cava, Antonio

    2013-09-01

    The B lymphocyte stimulator (BLyS)-A PRoliferation-Inducing Ligand (APRIL) signaling pathway has an important role in the selection, maturation and survival of B cells and plays a significant role in the pathogenesis of systemic lupus erythematosus (SLE). The inhibition of BLyS, a survival factor for transitional and mature B cells, has recently proven to be successful in large phase III clinical trials that led to the approval of an anti-BLyS monoclonal antibody (belimumab) for the treatment of SLE. Yet, there is currently a need to both understand better the mechanisms of action of belimumab in SLE and better define the subsets of patients that are more likely to respond to the drug.

  2. Dicty_cDB: SLE710 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 0.00 m3b: 0.00 m_ : 1.00 60.0 %: cytoplasmic 36.0 %: nuclear 4.0 %: mitochondrial >> prediction for SLE710 ...SL (Link to library) SLE710 (Link to dictyBase) - G24179 DDB0183969 Contig-U01273-1 SLE...710P (Link to Original site) SLE710F 170 SLE710Z 562 SLE710P 732 - - Show SLE710 Library SL (Link to library) Clone ID SLE...ontig-U01273-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-A/SLE...710Q.Seq.d/ Representative seq. ID SLE710P (Link to Original site) Representative DNA sequence >SLE710 (SLE710Q) /CSM/SL/SLE

  3. Dicty_cDB: SLE582 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE582 (Link to dictyBase) - - - Contig-U01267-1 | Contig-U16394-1 SLE...582P (Link to Original site) SLE582F 653 SLE582Z 173 SLE582P 826 - - Show SLE582 Library SL (Link to library) Clone ID SLE...67-1 | Contig-U16394-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-D/SLE...582Q.Seq.d/ Representative seq. ID SLE582P (Link to Original site) Representative DNA sequence >SLE582 (SLE...582Q) /CSM/SL/SLE5-D/SLE582Q.Seq.d/ ATGTTTACATCATTTCCTCTCGATGACCGATATTGATATACGTATGATTTACATTCTATT

  4. Dicty_cDB: SLE323 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE323 (Link to dictyBase) - G01955 DDB0203766 Contig-U09185-1 SLE...323P (Link to Original site) SLE323F 624 SLE323Z 587 SLE323P 1211 - - Show SLE323 Library SL (Link to library) Clone ID SLE...Contig-U09185-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-A/SLE...323Q.Seq.d/ Representative seq. ID SLE323P (Link to Original site) Representative DNA sequence >SLE323 (SLE323Q) /CSM/SL/SLE...3-A/SLE323Q.Seq.d/ CATTTTGAAAAAAGGTGAAAAAAAAAATGGAAGAAAATAATATTGTACAACCTCAATGTA ATAATGA

  5. Dicty_cDB: SLE341 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available of connected seq. - Full length Seq ID SLE341E Full length Seq. >SLE341E.Seq GGGTATTCATGCCTATATGGCACATAATCT...SL (Link to library) SLE341 (Link to dictyBase) - - - Contig-U14686-1 SLE341E (Link... to Original site) - - - - - - SLE341E 520 Show SLE341 Library SL (Link to library) Clone ID SLE341 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-B/SLE341Q.Seq.d/ Representative seq. ID SLE34...1E (Link to Original site) Representative DNA sequence >SLE341 (SLE341Q) /CSM/SL/SLE3-B/SLE341Q.Seq.d/ GGGTA

  6. Dicty_cDB: SLE552 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available q. - Connected seq. ID - Connected seq. - Length of connected seq. - Full length Seq ID SLE552E Full length Seq. >SLE...SL (Link to library) SLE552 (Link to dictyBase) - - - Contig-U13959-1 SLE552E (Link... to Original site) - - - - - - SLE552E 543 Show SLE552 Library SL (Link to library) Clone ID SLE552 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-C/SLE552Q.Seq.d/ Representative seq. ID SLE55...2E (Link to Original site) Representative DNA sequence >SLE552 (SLE552Q) /CSM/SL/SLE5-C/SLE552Q.Seq.d/ AACAA

  7. Dicty_cDB: SLE637 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 12.0 %: mitochondrial 8.0 %: cytoskeletal 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE637 (Link to dictyBase) - G01962 DDB0220637 Contig-U09190-1 SLE...637P (Link to Original site) SLE637F 373 SLE637Z 689 SLE637P 1062 - - Show SLE637 Library SL (Link to library) Clone ID SLE...Contig-U09190-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-B/SLE...637Q.Seq.d/ Representative seq. ID SLE637P (Link to Original site) Representative DNA sequence >SLE637 (SLE637Q) /CSM/SL/SLE

  8. Dicty_cDB: SLE889 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available of connected seq. - Full length Seq ID SLE889E Full length Seq. >SLE889E.Seq CTCG...SL (Link to library) SLE889 (Link to dictyBase) - - - Contig-U16272-1 SLE889E (Link... to Original site) - - - - - - SLE889E 418 Show SLE889 Library SL (Link to library) Clone ID SLE889 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-D/SLE889Q.Seq.d/ Representative seq. ID SLE88...9E (Link to Original site) Representative DNA sequence >SLE889 (SLE889Q) /CSM/SL/SLE8-D/SLE889Q.Seq.d/ CTCGG

  9. Dicty_cDB: SLE330 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available %: mitochondrial 4.0 %: vesicles of secretory system >> prediction for SLE330 is cyt 5' end seq. ID SLE...SL (Link to library) SLE330 (Link to dictyBase) - - - Contig-U16382-1 SLE330F (Link to Original site) SLE...330F 691 - - - - - - Show SLE330 Library SL (Link to library) Clone ID SLE330 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-B/SLE330Q.Seq.d/ Representative seq. ID SLE33...0F (Link to Original site) Representative DNA sequence >SLE330 (SLE330Q) /CSM/SL/SLE3-B/SLE330Q.Seq.d/ AAATT

  10. Dicty_cDB: SLE571 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE571 (Link to dictyBase) - - - Contig-U15434-1 SLE571Z (Link... to Original site) - - SLE571Z 701 - - - - Show SLE571 Library SL (Link to library) Clone ID SLE571 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-C/SLE571Q.Seq.d/ Representative seq. ID SLE57...1Z (Link to Original site) Representative DNA sequence >SLE571 (SLE571Q) /CSM/SL/SLE5-C/SLE571Q.Seq.d/ XXXXX...e SLH831 (SLH831Q) /CSM/SL/SLH8-B/SLH831Q.Seq.d/ 1374 0.0 SLH447 (SLH447Q) /CSM/SL/SLH4-B/SLH447Q.Seq.d/ 1374 0.0 SLE894 (SLE

  11. Dicty_cDB: SLE626 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE626 (Link to dictyBase) - G01961 DDB0192113 Contig-U13337-1 | Contig-U15930-1 SLE...626P (Link to Original site) SLE626F 480 SLE626Z 166 SLE626P 646 - - Show SLE626 Libra...ry SL (Link to library) Clone ID SLE626 (Link to dictyBase) Atlas ID - NBRP ID G01961 dictyBase ID DDB019211...cdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-B/SLE626Q.Seq.d/ Representative seq. ID SLE626P (Link to Original site) R...epresentative DNA sequence >SLE626 (SLE626Q) /CSM/SL/SLE6-B/SLE626Q.Seq.d/ ATTCAACTTTTACATAACAATAATCAAGTTTTA

  12. Dicty_cDB: SLE194 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE194 (Link to dictyBase) - - - Contig-U16510-1 SLE194Z (Link... to Original site) - - SLE194Z 495 - - - - Show SLE194 Library SL (Link to library) Clone ID SLE194 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-D/SLE194Q.Seq.d/ Representative seq. ID SLE19...4Z (Link to Original site) Representative DNA sequence >SLE194 (SLE194Q) /CSM/SL/SLE1-D/SLE194Q.Seq.d/ XXXXX...kk*y*kspfylynf*ikykin Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE194 (SLE

  13. Dicty_cDB: SLE128 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE128 (Link to dictyBase) - G22436 DDB0217614 Contig-U15957-1 SLE...128P (Link to Original site) SLE128F 647 SLE128Z 305 SLE128P 952 - - Show SLE128 Library SL (Link to library) Clone ID SLE...ontig-U15957-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-B/SLE...128Q.Seq.d/ Representative seq. ID SLE128P (Link to Original site) Representative DNA sequence >SLE128 (SLE128Q) /CSM/SL/SLE...1-B/SLE128Q.Seq.d/ AAAATATAATTGGGATAAATTAATAAATGGTGAGAGTGGAATTAAAAGATTTGAAGGATT TGAAGATA

  14. Imunidade na gestação normal e na paciente com lúpus eritematoso sistêmico (LES Immunity in the normal pregnancy and in the patient with systemic lupus erythematosus (SLE

    Directory of Open Access Journals (Sweden)

    Alessandra Cardoso Pereira

    2005-06-01

    Full Text Available A gravidez é uma condição fisiológica na qual ocorrem várias mudanças imunoendócrinas com a finalidade de facilitar a imunossupressão e a tolerância aos antígenos paternos e fetais. Na gravidez humana normal existe uma relativa supressão de citocinas tipo Th1 na resposta dos linfócitos, levando a uma prevalência na resposta do tipo Th2. No LES, onde prevalece a resposta imune do tipo Th2, a gravidez pode estar relacionada com a ativação da doença. Este artigo é uma revisão dessas alterações relacionadas com a resposta imune durante a gestação normal e na da paciente com LES.Pregnancy is a physiologic condition where several immuno-endocrine changes take place with the aim of facilitating immunosuppression and tolerance towards paternal and fetal antigens. In normal human pregnancy there is a relative suppression of Th1 type cytokines in response to lymphocytes, leading to a Th2 type response. In SLE, where a Th2 type response prevails, pregnancy may exacerbate the disease. This article reviews the alterations related to the immune response during normal pregnancy and in SLE patients.

  15. Rivaroxaban in antiphospholipid syndrome (RAPS) protocol: a prospective, randomized controlled phase II/III clinical trial of rivaroxaban versus warfarin in patients with thrombotic antiphospholipid syndrome, with or without SLE.

    Science.gov (United States)

    Cohen, H; Doré, C J; Clawson, S; Hunt, B J; Isenberg, D; Khamashta, M; Muirhead, N

    2015-09-01

    The current mainstay of the treatment of thrombotic antiphospholipid syndrome (APS) is long-term anticoagulation with vitamin K antagonists (VKAs) such as warfarin. Non-VKA oral anticoagulants (NOACs), which include rivaroxaban, have been shown to be effective and safe compared with warfarin for the treatment of venous thromboembolism (VTE) in major phase III prospective, randomized controlled trials (RCTs), but the results may not be directly generalizable to patients with APS. The primary aim is to demonstrate, in patients with APS and previous VTE, with or without systemic lupus erythematosus (SLE), that the intensity of anticoagulation achieved with rivaroxaban is not inferior to that of warfarin. Secondary aims are to compare rates of recurrent thrombosis, bleeding and the quality of life in patients on rivaroxaban with those on warfarin. Rivaroxaban in antiphospholipid syndrome (RAPS) is a phase II/III prospective non-inferiority RCT in which eligible patients with APS, with or without SLE, who are on warfarin, target international normalized ratio (INR) 2.5 for previous VTE, will be randomized either to continue warfarin (standard of care) or to switch to rivaroxaban. Intensity of anticoagulation will be assessed using thrombin generation (TG) testing, with the primary outcome the percentage change in endogenous thrombin potential (ETP) from randomization to day 42. Other TG parameters, markers of in vivo coagulation activation, prothrombin fragment 1.2, thrombin antithrombin complex and D-dimer, will also be assessed. If RAPS demonstrates i) that the anticoagulant effect of rivaroxaban is not inferior to that of warfarin and ii) the absence of any adverse effects that cause concern with regard to the use of rivaroxaban, this would provide sufficient supporting evidence to make rivaroxaban a standard of care for the treatment of APS patients with previous VTE, requiring a target INR of 2.5. © The Author(s) 2015.

  16. Intrauterine exposure and pharmacology of conventional thiopurine therapy in pregnant patients with inflammatory bowel disease

    NARCIS (Netherlands)

    Jharap, Bindia; de Boer, Nanne K. H.; Stokkers, Pieter; Hommes, Daniel W.; Oldenburg, Bas; Dijkstra, Gerard; van der Woude, C. Janneke; de Jong, Dirk J.; Mulder, Chris J. J.; van Elburg, Ruurd M.; van Bodegraven, Adriaan A.

    2014-01-01

    Objective Several studies have demonstrated a favourable safety profile for thiopurine use for inflammatory bowel disease (IBD) during pregnancy. We performed a study in pregnant patients with IBD who were using thiopurines, in order to determine the influence of pregnancy on thiopurine metabolism a

  17. ACTION DURATION OF ATRACURIUM IN HYPERTENSIVE PREGNANT PATIENTS WHO RECEIVED MAGNESIUM SULFATE

    Directory of Open Access Journals (Sweden)

    P SAJEDI

    2000-03-01

    Full Text Available Introduction. Usually, infusion of intermittent doses of succinylcholin is used for relaxation of muscles in the preeclamptic pregnant women treated with magnesium sulfate during cesarian. section This drug has complications such as hyperkalemia, phase 11block, etc. On the other hand non depolarizing muscle relaxant in these patients should be used only in the presence of nerve stimulator and with careful titration. Methods. Duration of clinical action of a medium acting non depolarizing muscle relaxant "atracurium" with succinylcolin's infusion was studied in 86 preeclamptic pregnant women who received therapeutic doses of magnesium sulfate. Findings. Magnesium sulfate did not prolong clinical action of atracurium. Conclusion. Based on this study it can be concluded that administration of atracurium in the pregnant women who received therapeutic dose of magnesium sulfate in the absence of peripheral nerve stimulator is not contraindicated.

  18. Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar Bhatia

    2016-01-01

    Full Text Available Physiological changes of pregnancy imposes higher risk of acute respiratory failure (ARF with even a slight insult and remains an important cause of maternal and fetal morbidity and mortality. Although pregnant women have different respiratory physiology and different causes of ARF, guidelines specific to ventilatory settings, goals of oxygenation and weaning process could not be framed due to lack of large-scale randomized controlled trials. During the 2009 H1N1 pandemic, pregnant women had higher morbidity and mortality compared to nonpregnant women. During this period, alternative strategies of ventilation such as high-frequency oscillatory ventilation, inhalational of nitric oxide, prone positioning, and extra corporeal membrane oxygenation were increasingly used as a desperate measure to rescue pregnant patients with severe hypoxemia who were not improving with conventional mechanical ventilation. This article highlights the causes of ARF and recent advances in invasive, noninvasive and alternative strategies of ventilation used during pregnancy.

  19. Dicty_cDB: SLE265 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available m3a: 0.00 m3b: 0.00 m_ : 1.00 48.0 %: cytoplasmic 36.0 %: nuclear 8.0 %: cytoskeletal 8.0 %: mitochondrial >> prediction for SLE...SL (Link to library) SLE265 (Link to dictyBase) - - - Contig-U16276-1 SLE265Z (Link... to Original site) - - SLE265Z 611 - - - - Show SLE265 Library SL (Link to library) Clone ID SLE265 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-C/SLE265Q.Seq.d/ Representative seq. ID SLE26...5Z (Link to Original site) Representative DNA sequence >SLE265 (SLE265Q) /CSM/SL/SLE2-C/SLE265Q.Seq.d/ XXXXX

  20. Dicty_cDB: SLE726 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 0 m3b: 0.00 m_ : 1.00 88.0 %: cytoplasmic 8.0 %: mitochondrial 4.0 %: nuclear >> prediction for SLE726 is cy...SL (Link to library) SLE726 (Link to dictyBase) - - - Contig-U16272-1 SLE726Z (Link... to Original site) - - SLE726Z 707 - - - - Show SLE726 Library SL (Link to library) Clone ID SLE726 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-B/SLE726Q.Seq.d/ Representative seq. ID SLE72...6Z (Link to Original site) Representative DNA sequence >SLE726 (SLE726Q) /CSM/SL/SLE7-B/SLE726Q.Seq.d/ XXXXX

  1. Dicty_cDB: SLE182 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ulum 32.0 %: plasma membrane 16.0 %: mitochondrial 8.0 %: cytoplasmic 4.0 %: cytoskeletal 4.0 %: nuclear >> prediction for SLE...SL (Link to library) SLE182 (Link to dictyBase) - - - Contig-U16709-1 SLE182Z (Link... to Original site) - - SLE182Z 630 - - - - Show SLE182 Library SL (Link to library) Clone ID SLE182 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-D/SLE182Q.Seq.d/ Representative seq. ID SLE18...2Z (Link to Original site) Representative DNA sequence >SLE182 (SLE182Q) /CSM/SL/SLE1-D/SLE182Q.Seq.d/ XXXXX

  2. Dicty_cDB: SLE847 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 36.0 %: cytoplasmic 20.0 %: cytoskeletal 4.0 %: mitochondrial >> prediction for SLE847...SL (Link to library) SLE847 (Link to dictyBase) - - - Contig-U16276-1 SLE847Z (Link... to Original site) - - SLE847Z 602 - - - - Show SLE847 Library SL (Link to library) Clone ID SLE847 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-B/SLE847Q.Seq.d/ Representative seq. ID SLE84...7Z (Link to Original site) Representative DNA sequence >SLE847 (SLE847Q) /CSM/SL/SLE8-B/SLE847Q.Seq.d/ XXXXX

  3. Dicty_cDB: SLE481 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available _ : 1.00 40.0 %: cytoplasmic 36.0 %: nuclear 16.0 %: cytoskeletal 4.0 %: mitochondrial 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE481 (Link to dictyBase) - G24174 DDB0218432 Contig-U14028-1 SLE...481Z (Link to Original site) - - SLE481Z 602 - - - - Show SLE481 Library SL (Link to library) Clone ID SLE...riginal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE4-D/SLE481Q.Seq.d/ ...Representative seq. ID SLE481Z (Link to Original site) Representative DNA sequence >SLE481 (SLE481Q) /CSM/SL/SLE4-D/SLE

  4. Dicty_cDB: SLE249 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available oideum slug cDNA, clone SLE249. 1205 0.0 1 ( AF066071 ) Dictyostelium discoideum SP85 (pspB) gene, comple...SL (Link to library) SLE249 (Link to dictyBase) - - - Contig-U16325-1 SLE249Z (Link... to Original site) - - SLE249Z 668 - - - - Show SLE249 Library SL (Link to library) Clone ID SLE249 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-C/SLE249Q.Seq.d/ Representative seq. ID SLE24...9Z (Link to Original site) Representative DNA sequence >SLE249 (SLE249Q) /CSM/SL/SLE2-C/SLE249Q.Seq.d/ XXXXX

  5. Dicty_cDB: SLE255 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 0 %: cytoplasmic 20.0 %: mitochondrial 8.0 %: cytoskeletal 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE255 (Link to dictyBase) - - - Contig-U16381-1 SLE255Z (Link... to Original site) - - SLE255Z 683 - - - - Show SLE255 Library SL (Link to library) Clone ID SLE255 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-C/SLE255Q.Seq.d/ Representative seq. ID SLE25...5Z (Link to Original site) Representative DNA sequence >SLE255 (SLE255Q) /CSM/SL/SLE2-C/SLE255Q.Seq.d/ XXXXX

  6. Dicty_cDB: SLE372 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available gi 4.0 %: mitochondrial 4.0 %: plasma membrane 4.0 %: vesicles of secretory system 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE372 (Link to dictyBase) - - - Contig-U15030-1 SLE372Z (Link... to Original site) - - SLE372Z 694 - - - - Show SLE372 Library SL (Link to library) Clone ID SLE372 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-C/SLE372Q.Seq.d/ Representative seq. ID SLE37...2Z (Link to Original site) Representative DNA sequence >SLE372 (SLE372Q) /CSM/SL/SLE3-C/SLE372Q.Seq.d/ XXXXX

  7. Dicty_cDB: SLE826 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available %: Golgi 8.0 %: plasma membrane 4.0 %: extracellular, including cell wall 4.0 %: vesicles of secretory system >> prediction for SLE...SL (Link to library) SLE826 (Link to dictyBase) - - - Contig-U16510-1 SLE826Z (Link... to Original site) - - SLE826Z 361 - - - - Show SLE826 Library SL (Link to library) Clone ID SLE826 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-B/SLE826Q.Seq.d/ Representative seq. ID SLE82...6Z (Link to Original site) Representative DNA sequence >SLE826 (SLE826Q) /CSM/SL/SLE8-B/SLE826Q.Seq.d/ XXXXX

  8. Dicty_cDB: SLE173 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available Length of 3' end seq. - Connected seq. ID - Connected seq. - Length of connected seq. - Full length Seq ID SLE173E Full le...SL (Link to library) SLE173 (Link to dictyBase) - - - Contig-U13955-1 SLE173E (Link... to Original site) - - - - - - SLE173E 407 Show SLE173 Library SL (Link to library) Clone ID SLE173 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-D/SLE173Q.Seq.d/ Representative seq. ID SLE17...3E (Link to Original site) Representative DNA sequence >SLE173 (SLE173Q) /CSM/SL/SLE1-D/SLE173Q.Seq.d/ AGAAT

  9. Dicty_cDB: SLE239 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available m_ : 1.00 48.0 %: cytoplasmic 40.0 %: nuclear 4.0 %: vacuolar 4.0 %: mitochondrial 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE239 (Link to dictyBase) - - - Contig-U16455-1 SLE239Z (Link... to Original site) - - SLE239Z 598 - - - - Show SLE239 Library SL (Link to library) Clone ID SLE239 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE2-B/SLE239Q.Seq.d/ Representative seq. ID SLE23...9Z (Link to Original site) Representative DNA sequence >SLE239 (SLE239Q) /CSM/SL/SLE2-B/SLE239Q.Seq.d/ XXXXX

  10. Dicty_cDB: SLE879 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE879 (Link to dictyBase) - - - Contig-U16463-1 SLE879Z (Link... to Original site) - - SLE879Z 674 - - - - Show SLE879 Library SL (Link to library) Clone ID SLE879 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-D/SLE879Q.Seq.d/ Representative seq. ID SLE87...9Z (Link to Original site) Representative DNA sequence >SLE879 (SLE879Q) /CSM/SL/SLE8-D/SLE879Q.Seq.d/ XXXXX...*c**chqirc*iklvnqyiknnkkikk*kkikn*isiff*l Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value SLE

  11. Dicty_cDB: SLE786 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available um 12.0 %: mitochondrial 8.0 %: vacuolar 4.0 %: Golgi 4.0 %: cytoplasmic 4.0 %: nuclear >> prediction for SLE...SL (Link to library) SLE786 (Link to dictyBase) - - - Contig-U15527-1 SLE786Z (Link... to Original site) - - SLE786Z 345 - - - - Show SLE786 Library SL (Link to library) Clone ID SLE786 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-D/SLE786Q.Seq.d/ Representative seq. ID SLE78...6Z (Link to Original site) Representative DNA sequence >SLE786 (SLE786Q) /CSM/SL/SLE7-D/SLE786Q.Seq.d/ XXXXX

  12. Dicty_cDB: SLE865 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ndrial 4.0 %: vacuolar 4.0 %: vesicles of secretory system 4.0 %: extracellular, including cell wall >> prediction for SLE...SL (Link to library) SLE865 (Link to dictyBase) - - - Contig-U16450-1 SLE865Z (Link... to Original site) - - SLE865Z 414 - - - - Show SLE865 Library SL (Link to library) Clone ID SLE865 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-C/SLE865Q.Seq.d/ Representative seq. ID SLE86...5Z (Link to Original site) Representative DNA sequence >SLE865 (SLE865Q) /CSM/SL/SLE8-C/SLE865Q.Seq.d/ XXXXX

  13. Dicty_cDB: SLE775 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available olar 8.0 %: endoplasmic reticulum 4.0 %: mitochondrial 4.0 %: vesicles of secretory system >> prediction for SLE...SL (Link to library) SLE775 (Link to dictyBase) - - - Contig-U11431-1 SLE775F (Link to Original site) SLE...775F 466 - - - - - - Show SLE775 Library SL (Link to library) Clone ID SLE775 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-D/SLE775Q.Seq.d/ Representative seq. ID SLE77...5F (Link to Original site) Representative DNA sequence >SLE775 (SLE775Q) /CSM/SL/SLE7-D/SLE775Q.Seq.d/ CCCAC

  14. Dicty_cDB: SLE359 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 8.0 %: cytoskeletal 8.0 %: mitochondrial 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE359 (Link to dictyBase) - - - Contig-U15835-1 SLE359Z (Link... to Original site) - - SLE359Z 699 - - - - Show SLE359 Library SL (Link to library) Clone ID SLE359 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE3-C/SLE359Q.Seq.d/ Representative seq. ID SLE35...9Z (Link to Original site) Representative DNA sequence >SLE359 (SLE359Q) /CSM/SL/SLE3-C/SLE359Q.Seq.d/ XXXXX

  15. Dicty_cDB: SLE618 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available : cytoplasmic 32.0 %: nuclear 16.0 %: mitochondrial 12.0 %: cytoskeletal 4.0 %: Golgi >> prediction for SLE6...SL (Link to library) SLE618 (Link to dictyBase) - - - Contig-U16131-1 SLE618F (Link to Original site) SLE...618F 558 - - - - - - Show SLE618 Library SL (Link to library) Clone ID SLE618 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-A/SLE618Q.Seq.d/ Representative seq. ID SLE61...8F (Link to Original site) Representative DNA sequence >SLE618 (SLE618Q) /CSM/SL/SLE6-A/SLE618Q.Seq.d/ ACCGA

  16. Dicty_cDB: SLE147 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available Length of 3' end seq. - Connected seq. ID - Connected seq. - Length of connected seq. - Full length Seq ID SLE147E Full le...SL (Link to library) SLE147 (Link to dictyBase) - - - Contig-U16382-1 SLE147E (Link... to Original site) - - - - - - SLE147E 382 Show SLE147 Library SL (Link to library) Clone ID SLE147 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-B/SLE147Q.Seq.d/ Representative seq. ID SLE14...7E (Link to Original site) Representative DNA sequence >SLE147 (SLE147Q) /CSM/SL/SLE1-B/SLE147Q.Seq.d/ CGGTA

  17. Dicty_cDB: SLE774 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 0 %: cytoplasmic 40.0 %: nuclear 8.0 %: cytoskeletal 8.0 %: mitochondrial 4.0 %: endoplasmic reticulum >> prediction for SLE...SL (Link to library) SLE774 (Link to dictyBase) - - - Contig-U15434-1 SLE774Z (Link... to Original site) - - SLE774Z 566 - - - - Show SLE774 Library SL (Link to library) Clone ID SLE774 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE7-D/SLE774Q.Seq.d/ Representative seq. ID SLE77...4Z (Link to Original site) Representative DNA sequence >SLE774 (SLE774Q) /CSM/SL/SLE7-D/SLE774Q.Seq.d/ XXXXX

  18. Rationale for B cell targeting in SLE

    Science.gov (United States)

    Sanz, Iñaki

    2014-01-01

    B cells are central pathogenic players in Systemic Lupus Erythematosus and multiple other autoinmune diseases through antibody production as well as antibody independent functiona. At the same time, B cells are known to play important regulatory functions that may protect against autoimmune manifestations. Yet, the functional role of different B cell populations and their contribution to disease remain to be understood. The advent of agents that specifically target B cells, in particular anti-CD20 and ant-BLyS antibodies, have demonstrated the efficacy of this approach for the treatment of human autoimmunity. The analysis of patients treated with these and other B cell agents provide a unique opportunity to understand the correlates of clinical response and the significance of different B cell subsets. Here we discuss this information and how it could be used to better understand SLE and improve the rational design of B cell directed therapies in this disease. PMID:24763533

  19. Dicty_cDB: SLE149 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 8.0 %: cytoskeletal 8.0 %: mitochondrial 4.0 %: peroxisomal >> prediction for SLE1...SL (Link to library) SLE149 (Link to dictyBase) - - - - SLE149Z (Link to Original site) - - SLE...149Z 556 - - - - Show SLE149 Library SL (Link to library) Clone ID SLE149 (Link to dictyBase) At...las ID - NBRP ID - dictyBase ID - Link to Contig - Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE1-C/SLE...149Q.Seq.d/ Representative seq. ID SLE149Z (Link to Original site) R

  20. 系统性红斑狼疮患者合并妊娠的临床研究%Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus:a retrospective study

    Institute of Scientific and Technical Information of China (English)

    温艳芳; 李懿莎; 罗卉; 左晓霞; 周亚欧

    2010-01-01

    Objective To determine the safety, pregnancy outcome and the affect on neonates in pregnant patients with systemic lupus erythematosus(SLE).Methods Sixty-two pregnant patients with SLE were evaluated retrospectively from 1999 to 2009 in our hospital. These patients were divided into two groups:selective pregnancy group and nonselective pregnancy group. The pregnancy outcomes, fetal outcomes, and lupus activity during pregnancy were compared between the two groups. The children of the SLE patients were followed up. Results There were 43 patients in the selective pregnancies group and 19 patients in nonselective pregnancies group. In the selective pregnancies group, lupus flare occurred in 10 pregnancies(23%), 35(81%)had a live birth, 7 had low birth weight infants and 7 had premature delivery; however, in the nonselective pregnancies group, lupus flare occurred in 16 pregnancies(84%), 13(68%) had abortion,6 had a live birth, but all neonates were low birth weight infants. The rates of lupus flare and pregnancy loss in the nonselective pregnancy group were higher than those of the selective pregnancy group(P<0.05). None of the 22 children had SLE during the follow-up period. Conclusion Both selective and nonselective pregnancy may adversely affectmaternal and fetal outcomes, but patients with selective pregnancy have better outcomes either in lupus flare or maternal and fetal outcomes compared with those of the nonselective pregnancy.%目的 探讨系统性红斑狼疮(SLE)患者妊娠的安全性、妊娠结局及对子代的影响.方法 回顾性分析1999年6月至2009年10月我院收治的SLE合并妊娠的患者的妊娠情况,比较选择性妊娠和非选择性妊娠组患者的SLE疾病活动情况、产科并发症情况、胎儿情况.并对SLE患者的子代进行随访.统计学处理采用x2检验和t检验.结果 SLE合并妊娠的患者共62例,选择性妊娠组43例,非选择性妊娠组19例;选择性妊娠组中10例(23%)患者在妊

  1. Anesthetic management of a pregnant patient with a pure red cell aplasia

    Directory of Open Access Journals (Sweden)

    Channabasavaraj S Sanikop

    2013-01-01

    Full Text Available Pure red cell disorder is an uncommon disorder in which maturation arrest occurs in the maturation of erythrocytes. Erythroblats are virtually absent in the bone marrow. Surgery poses a very high-risk for these patients because of the several complications that can occur in the perioperative period. In this case report, we report a pregnant patient with a pure red cell aplasia who was optimized pre-operatively and underwent cesarean section under sub-arachnoid block.

  2. A framework for remission in SLE

    DEFF Research Database (Denmark)

    van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George

    2017-01-01

    OBJECTIVES: Treat-to-target recommendations have identified 'remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE....

  3. Targeting the RhoA-ROCK pathway to reverse T-cell dysfunction in SLE.

    Science.gov (United States)

    Rozo, Cristina; Chinenov, Yurii; Maharaj, Reena Khianey; Gupta, Sanjay; Leuenberger, Laura; Kirou, Kyriakos A; Bykerk, Vivian P; Goodman, Susan M; Salmon, Jane E; Pernis, Alessandra B

    2017-04-01

    Deregulated production of interleukin (IL)-17 and IL-21 contributes to the pathogenesis of autoimmune disorders such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Production of IL-17 and IL-21 can be regulated by ROCK2, one of the two Rho kinases. Increased ROCK activation was previously observed in an SLE cohort. Here, we evaluated ROCK activity in a new SLE cohort, and an RA cohort, and assessed the ability of distinct inhibitors of the ROCK pathway to suppress production of IL-17 and IL-21 by SLE T cells or human Th17 cells. ROCK activity in peripheral blood mononuclear cells (PBMCs) from 29 patients with SLE, 31 patients with RA and 28 healthy controls was determined by ELISA. SLE T cells or in vitro-differentiated Th17 cells were treated with Y27632 (a pan-ROCK inhibitor), KD025 (a selective ROCK2 inhibitor) or simvastatin (which inhibits RhoA, a major ROCK activator). ROCK activity and IL-17 and IL-21 production were assessed. The transcriptional profile altered by ROCK inhibitors was evaluated by NanoString technology. ROCK activity levels were significantly higher in patients with SLE and RA than healthy controls. Th17 cells exhibited high ROCK activity that was inhibited by Y27632, KD025 or simvastatin; each also decreased IL-17 and IL-21 production by purified SLE T cells or Th17 cells. Immune profiling revealed both overlapping and distinct effects of the different ROCK inhibitors. ROCK activity is elevated in PBMCs from patients with SLE and RA. Production of IL-17 and IL-21 by SLE T cells or Th17 cells can furthermore be inhibited by targeting the RhoA-ROCK pathway via both non-selective and selective approaches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. [General anesthesia for a pregnant patient with PAPA syndrome].

    Science.gov (United States)

    Ohno, Seika; Ariyama, Jun; Tsujita, Miki; Ueshima, Hironobu; Imanishi, Hirokazu; Terao, Kazuhisa; Mieda, Tsutomu; Kitamura, Akira

    2014-08-01

    A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. To obliterate the aneurysm and prevent rupture, the patient underwent coil embolization via an endovascular approach under general anesthesia because the procedure under sedation with local anesthesia was too risky for re-bleeding. The patient has been diagnosed as PAPA syndrome. Although the arthritis was now stable and she was taking no drug, remarkable osteoarthritis was observed. The cervical spine X ray demonstrated no cervical ankylosis. As patient was sedated with propofol, airway examination could not be done except noticing thyromental distance of seven centimeters. Patient's trachea was intubated using Macintosh size #3 laryngoscope blade and a 7.0 non-styletted tracheal tube at the first attempt without any problems (Cormack grade I). Anesthesia was maintained with sevoflurane, fentanyl and remifentanil. After the end of endovascular surgery, the patient was transferred to the intensive care unit under mechanical ventilation. She was weaned from mechanical ventilation 2 days later but consciousness was unclear. Right incomplete paralysis was also observed. MRI revealed vasospasm on the bilateral internal carotid artery. The patient underwent percutaneous tansluminalangioplasty coil and intraarterial injection of fasudil hydrochloride under local anesthesia. The consciousness recovered fully and the paralysis was improved. The patient delivered the baby by Caesarean sections under combined spinal and epidural anesthesia at 36 weeks without any problems with both the mother and baby.

  5. Successful Chemotherapy on a Pregnant Non-Hodgkin's Lymphoma Patient

    Directory of Open Access Journals (Sweden)

    Toki,Hironobu

    1990-12-01

    Full Text Available We report a case of a non-Hodgkin's lymphoma (NHL patient treated successfully with combination chemotherapy during pregnancy who delivered a full-term baby. A 29 year-old patient with cervical and inguinal lymphadenopathy in the 27th week of gestation was referred to our hospital. The diagnosis of lymph node biopsy was NHL (diffuse, large cell type with B-cell phenotype. Three courses of CHOP regimen (adriamycin, cyclophosphamide, vincristine and prednisolone were given before delivery. The patient has been in complete remission for three years and her baby has been in normal development. Our case supports previous reports that chemotherapy in the third trimester may be given safely on NHL patients.

  6. Update on the management of non-obstetric acute abdomen in pregnant patients.

    Science.gov (United States)

    Barber-Millet, Sebastián; Bueno Lledó, José; Granero Castro, Pablo; Gómez Gavara, Immaculada; Ballester Pla, Neus; García Domínguez, Rafael

    2016-05-01

    Acute abdomen is a rare entity in the pregnant patient, with an incidence of one in 500-635 patients. Its appearance requires a quick response and an early diagnosis to treat the underlying disease and prevent maternal and fetal morbidity. Imaging tests are essential, due to clinical and laboratory masking in this subgroup. Appendicitis and complicated biliary pathology are the most frequent causes of non-obstetric acute abdomen in the pregnant patient. The decision to operate, the timing, and the surgical approach are essential for a correct management of this pathology. The aim of this paper is to perform a review and update on the diagnosis and treatment of non-obstetric acute abdomen in pregnancy. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Trauma in the pregnant patient: an evidence-based approach to management.

    Science.gov (United States)

    Smith, Kurt A; Bryce, Suzanne

    2013-04-01

    The management of acute trauma in the pregnant patient relies on a thorough understanding of the underlying physiology of pregnancy. This issue reviews the evidence regarding important considerations in pregnant trauma patients, including the primary and secondary survey as well as the possibility for Rh exposure, placental abruption, uterine rupture, and the need for a prompt perimortem cesarean section in the moribund patient. Because ionizing radiation is always a concern in pregnancy, the circumstances where testing provides benefits that outweigh risks to the fetus are discussed. Emergency clinicians are encouraged to advocate for trauma prevention, including proper safety restraints for motor vehicles and screening for domestic violence, as these measures have been shown to be effective in reducing morbidity and mortality in this population. Recommendations for monitoring, admission, discharge, and follow-up are also noted.

  8. IMRT in a pregnant patient: how to reduce the fetal dose?

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Nyström, Håkan; Kjaer-Kristoffersen, Flemming

    2008-01-01

    was the greatest contributor to the peripheral dose. Therefore, the shielding used for the IMRT treatment of our patient could also be used when shielding in conventional radiotherapy. It is important for a radiation therapy department to be prepared for treatment of a pregnant patient to shield the fetus......The purpose of our study was to find a solution for fetal dose reduction during head-and-neck intensity modulated radiation therapy (IMRT) of a pregnant patient. The first step was optimization of the IMRT treatment plan with as few monitor units (MUs) as possible, while maintaining an acceptable...... peripheral dose was divided into leakage, and internal and collimator scatter, to find the degree to which each component influences the peripheral dose to build an appropriate shield. Collimator scatter was the greatest contributor to the peripheral dose throughout the range of the growing fetus. A shield...

  9. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models.

    Science.gov (United States)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra; Becker, Christoph D; Zaidi, Habib

    2017-09-08

    This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks. To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans. The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDIvol varies between 0.85 and 1.63 with an average of 1.17. The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. • In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates of foetal organ-level dose. • The foetal brain and skeleton doses present significant correlation with gestational age. • The conceptus dose normalised to CTDI vol varies between 0.85 and 1.63. • The developed methodology is adequate for patient-specific CT radiation dosimetry.

  10. Dicty_cDB: SLE875 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE875 (Link to dictyBase) - - - Contig-U15434-1 SLE875Z (Link... to Original site) - - SLE875Z 323 - - - - Show SLE875 Library SL (Link to library) Clone ID SLE875 (Link to...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE8-D/SLE875Q.Seq.d/ Representative seq. ID SLE87...5Z (Link to Original site) Representative DNA sequence >SLE875 (SLE875Q) /CSM/SL/SLE8-D/SLE875Q.Seq.d/ XXXXX...0820 |pid:none) Frankia sp. EAN1pec, complete ge... 150 1e-35 ( O13639 ) RecName: Full=Adenosylhomocysteinas

  11. Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations.

    Science.gov (United States)

    Patel, Shital J; Reede, Deborah L; Katz, Douglas S; Subramaniam, Raja; Amorosa, Judith K

    2007-01-01

    Use of diagnostic imaging studies for evaluation of pregnant patients with medical conditions not related to pregnancy poses a persistent and recurring dilemma. Although a theoretical risk of carcinogenesis exists, there are no known risks for development of congenital malformations or mental retardation in a fetus exposed to ionizing radiation at the levels typically used for diagnostic imaging. An understanding of the effects of ionizing radiation on the fetus at different gestational stages and the estimated exposure dose received by the fetus from various imaging modalities facilitates appropriate choices for diagnostic imaging of pregnant patients with nonobstetric conditions. Other aspects of imaging besides radiation (ie, contrast agents) also carry potential for fetal injury and must be taken into consideration. Imaging algorithms based on a review of the current literature have been developed for specific nonobstetric conditions: pulmonary embolism, acute appendicitis, urolithiasis, biliary disease, and trauma. Imaging modalities that do not use ionizing radiation (ie, ultrasonography and magnetic resonance imaging) are preferred for pregnant patients. If ionizing radiation is used, one must adhere to the principle of using a dose that is as low as reasonably achievable after a discussion of risks versus benefits with the patient.

  12. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models

    DEFF Research Database (Denmark)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra

    2017-01-01

    PURPOSE: This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks. MATERIALS AND METHODS: To produce realistic biological and physical representations of ...

  13. FSAP-mediated nucleosome release from late apoptotic cells is inhibited by autoantibodies present in SLE.

    Science.gov (United States)

    Marsman, Gerben; Stephan, Femke; de Leeuw, Karina; Bulder, Ingrid; Ruinard, Jessica T; de Jong, Jan; Westra, Johanna; Bultink, Irene E M; Voskuyl, Alexandre E; Aarden, Lucien A; Luken, Brenda M; Kallenberg, Cees G M; Zeerleder, Sacha

    2016-03-01

    Inefficient clearance of apoptotic cells and the subsequent exposure of the immune system to nuclear contents are crucially involved in the pathogenesis of systemic lupus erythematosus (SLE). Factor VII-activating protease (FSAP) is activated in serum upon contact with dead cells, and releases nucleosomes from late apoptotic cells into the extracellular environment. We investigated whether FSAP-mediated nucleosome release from late apoptotic cells is affected in SLE patients. Nucleosome release in sera of 27 SLE patients and 30 healthy controls was investigated by incubating late apoptotic Jurkat cells with serum and analyzing the remaining DNA content by flow cytometry. We found that nucleosome release in sera of SLE patients with high disease activity was significantly decreased when compared with that in SLE sera obtained during low disease activity or from healthy individuals. Upon removal of IgG/IgM antibodies from SLE sera, nucleosome release was restored. Similarly, monoclonal antinuclear antibodies inhibited nucleosome release in healthy donor serum or by plasma-purified FSAP. This inhibition was lost when Fab fragments were used, suggesting that antigen cross-linking is involved. In conclusion, FSAP-mediated nucleosome release from late apoptotic cells is greatly impaired in SLE patient sera, possibly hampering the clearance of these cells and thereby propagating inflammation.

  14. Apoptosis of lymphocytes in SLE: the level, correlation with ...

    African Journals Online (AJOL)

    Adefect in apoptosis may thus contribute to the development of autoimmune disease. Patients and methods: The study included 34 Russian children patients with SLE in age between 6-17 years ... 25.3±5.6); and in CD20+ B-cells (9.7±8.9 vs. ... This phenotypes disbalance was associated with significant increased in the ...

  15. Simultaneous cesarean delivery and craniotomy in a term pregnant patient with traumatic brain injury

    OpenAIRE

    Mohamed Mohamed Tawfik; Basma Abed Badran; Ahmed Amin Eisa; Rafik Ibrahim Barakat

    2015-01-01

    The management of pregnant patients with traumatic brain injury is challenging. A multidisciplinary team approach is mandatory, and management should be individualized according to the type and extent of injury, maternal status, gestational age, and fetal status. We report a 27-year-old term primigravida presenting after head injury with Glasgow coma scale score 11 and anisocoria. Depressed temporal bone fracture and acute epidural hematoma were diagnosed, necessitating an urgent neurosurgery...

  16. Evaluation of pregnant patients admitted to the emergency department with suicide attempt

    Directory of Open Access Journals (Sweden)

    Yılmaz Zengin

    2015-06-01

    Full Text Available Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods. Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared. Results: In this study, 15 (26.7% patients in the violent suicide attempt group, and 41 (73.3% patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively. Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2: 115-120

  17. Differentiation between eclampsia and cerebrovascular disorders by brain CT scan in pregnant patients with convulsive seizures

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Katsuto; Lin, Yaw-Tyng; Noda, Kiyofumi; Saeki, Kazuhiko; Yonezawa, Masaru; Sekiba, Kaoru; Ochiai, Youji

    1987-06-01

    Six pregnant women with convulsions between 25 to 40 weeks of gestation were experienced. Among them, 4 patients were diagnosed as having intracranial hemorrhage and two as simple eclampsia. With the aid of brain CT scan, one case of arteriovenous malformation was detected and treated surgically with good prognosis for both the mother and the fetus. Two patients were diagnosed to have cerebral hemorrhage with subsequent penetration into the lateral ventricles and were treated conservatively. Their fetuses were delivered alive by cesarean section, but the mothers expired. The other patient with cerebral hemorrhage was treated surgically, and both the mother and the fetus survived. One of the simple eclampsia patients was noted to have a growth retarded fetus at 32 weeks of pregnancy with subsequent intra-uterine death, but the mother recovered after conservative treatment. Another patient at 40 weeks of pregnancy was also treated conservatively and both the fetus and the mother survived. Brain CT scan findings differed between these two eclampsia patients; local brain edema for the second patient and generalized brain edema for the first patient. Thus more active application of brain CT scan is recommended in managing pregnant patients with convulsions.

  18. Guidelines for the Management of a Pregnant Trauma Patient.

    Science.gov (United States)

    Jain, Venu; Chari, Radha; Maslovitz, Sharon; Farine, Dan; Bujold, Emmanuel; Gagnon, Robert; Basso, Melanie; Bos, Hayley; Brown, Richard; Cooper, Stephanie; Gouin, Katy; McLeod, N Lynne; Menticoglou, Savas; Mundle, William; Pylypjuk, Christy; Roggensack, Anne; Sanderson, Frank

    2015-06-01

    Objectif : Une femme enceinte sur 12 en vient à subir des traumatismes physiques et ceux-ci exercent des effets importants sur la mortalité et la morbidité maternelles, ainsi que sur l’issue de la grossesse. La mise en œuvre d’une approche multidisciplinaire s’avère justifiée pour assurer l’optimisation des issues, et ce, tant pour la mère que pour son fœtus. Le présent document a pour but d’offrir, aux fournisseurs de soins obstétricaux, une approche systématique factuelle qu’ils pourront utiliser pour assurer la prise en charge des patientes enceintes ayant subi un traumatisme. Issues : Issues sanitaires et économiques considérables, par comparaison avec les pratiques de rechange. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans Medline, CINAHL et The Cochrane Library entre octobre 2007 et septembre 2013 au moyen d’un vocabulaire contrôlé (« pregnancy », « Cesarean section », « hypotension », « domestic violence », « shock ») et de mots clés (« trauma », « perimortem Cesarean », « Kleihauer-Betke », « supine hypotension », « electrical shock ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre janvier 1968 et septembre 2013. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en février 2014. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualit

  19. Giant Condyloma Acuminata in Indonesian Females with SLE under Immunosuppressant and Steroid Therapy

    Directory of Open Access Journals (Sweden)

    Andhika Rachman

    2016-01-01

    Full Text Available Introduction. Immunosuppressant and steroid therapy in systemic lupus erythematosus (SLE increases the risk of human papillomavirus (HPV infections, one of which is giant condyloma acuminata (GCA. To our knowledge, there is no report evaluating the correlation between immunosuppressive and steroid therapy in patients with SLE and the prevalence of GCA. Case Report. A 42-year-old female was diagnosed with SLE a year ago and has been treated with steroids and immunosuppressive drugs. In the last few months she presented GCA involving the genital area recurring almost every two months. Type 6 and 11 HPVs were identified in vulva, vagina, and cervix. Methods. PubMed, EBSCO, and Cochrane Library literature were searched from inception to July 2015. Authors screened all titles and abstracts and read full text article, and two case-control studies were found relevant. Results. SLE patients in both studies were under immunosuppressive and steroid therapy. Condyloma acuminata was diagnosed at 108 months (latest and 1 month (earliest after SLE. Type 6, 11, 16, 42, and oncogenic group of HPV were identified. Conclusions. GCA is a type of HPV infection seldom observed in SLE patients. Therefore, their correlation is still unclear. Period of time since SLE was diagnosed and GCA varies from months to years. A more thorough physical and laboratory examination leading to HPV and other infectious disease is recommended.

  20. Giant Condyloma Acuminata in Indonesian Females with SLE under Immunosuppressant and Steroid Therapy

    Science.gov (United States)

    2016-01-01

    Introduction. Immunosuppressant and steroid therapy in systemic lupus erythematosus (SLE) increases the risk of human papillomavirus (HPV) infections, one of which is giant condyloma acuminata (GCA). To our knowledge, there is no report evaluating the correlation between immunosuppressive and steroid therapy in patients with SLE and the prevalence of GCA. Case Report. A 42-year-old female was diagnosed with SLE a year ago and has been treated with steroids and immunosuppressive drugs. In the last few months she presented GCA involving the genital area recurring almost every two months. Type 6 and 11 HPVs were identified in vulva, vagina, and cervix. Methods. PubMed, EBSCO, and Cochrane Library literature were searched from inception to July 2015. Authors screened all titles and abstracts and read full text article, and two case-control studies were found relevant. Results. SLE patients in both studies were under immunosuppressive and steroid therapy. Condyloma acuminata was diagnosed at 108 months (latest) and 1 month (earliest) after SLE. Type 6, 11, 16, 42, and oncogenic group of HPV were identified. Conclusions. GCA is a type of HPV infection seldom observed in SLE patients. Therefore, their correlation is still unclear. Period of time since SLE was diagnosed and GCA varies from months to years. A more thorough physical and laboratory examination leading to HPV and other infectious disease is recommended. PMID:27843658

  1. Targeting B cells for the treatment of SLE: The beginning of the end or the end of the beginning?

    OpenAIRE

    Calero, Ismael; Sanz, Iñaki

    2010-01-01

    Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease for which therapeutic advances in immunosuppressive and support therapy have significantly improved survival over the last 5 decades. Unfortunately, SLE still carries substantially increased rates of mortality and end stage renal disease which are even more elevated in younger patients. No new drugs have been approved for SLE in over 50 years. Hence, a lot of hope and excitement has been generated by the development of biolog...

  2. Simultaneous presentation of acute disseminated encephalomyelitis (ADEM) and systemic lupus erythematosus (SLE) after enteroviral infection: can ADEM present as the first manifestation of SLE?

    Science.gov (United States)

    Kim, J-M; Son, C-N; Chang, H W; Kim, S-H

    2015-05-01

    Central Nervous System (CNS) involvement of Systemic Lupus Erythematosus (SLE) includes a broad range of neuropsychiatric syndromes. Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating CNS disorder characterized by encephalopathy and multifocal lesions predominantly involving the white matter on brain magnetic resonance imaging. ADEM associated with SLE has been only rarely reported. We report an unusual case of a 17-year-old girl who developed ADEM after enteroviral infection as the first manifestation of SLE. The authors emphasize that the patient's illness was preceded by enteroviral infection and that ADEM occurred before any other symptoms of SLE, which makes this case unique. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Dicty_cDB: SLE160 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available cell wall 32.0 %: endoplasmic reticulum 12.0 %: cytoplasmic 12.0 %: vacuolar 4.0 %: Golgi 4.0 %: nuclear >> prediction for SLE...SL (Link to library) SLE160 (Link to dictyBase) - - - - SLE160P (Link to Original site) SLE160F 651 SLE...160Z 588 SLE160P 1239 - - Show SLE160 Library SL (Link to library) Clone ID SLE160 (Link... to dictyBase) Atlas ID - NBRP ID - dictyBase ID - Link to Contig - Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE...1-C/SLE160Q.Seq.d/ Representative seq. ID SLE160P (Link to

  4. Dicty_cDB: SLE573 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available ar 20.0 %: mitochondrial 4.0 %: cytoskeletal 4.0 %: peroxisomal >> prediction for SLE...SL (Link to library) SLE573 (Link to dictyBase) - G20545 DDB0219651 Contig-U13335-1 | Contig-U16528-1 SLE...573P (Link to Original site) SLE573F 635 SLE573Z 413 SLE573P 1048 - - Show SLE573 Libr...ary SL (Link to library) Clone ID SLE573 (Link to dictyBase) Atlas ID - NBRP ID G20545 dictyBase ID DDB02196...ycdb.biol.tsukuba.ac.jp/CSM/SL/SLE5-D/SLE573Q.Seq.d/ Representative seq. ID SLE573P (Link to Original site)

  5. Dicty_cDB: SLE695 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available GAAGCTCCTGCTCCACAAGCTGATACAATTTCGATGACTCATAATTTA CCACATTCTGATT Length of connected seq. 1443 Full length Seq ID SLE695E Full le...SL (Link to library) SLE695 (Link to dictyBase) - G22454 DDB0231470 Contig-U10229-1 SLE...695E (Link to Original site) SLE695F 714 SLE695Z 729 SLE695P 1443 SLE695E 1351 Show SLE695 Library SL (L...ink to library) Clone ID SLE695 (Link to dictyBase) Atlas ID - NBRP ID G22454 dictyBase ID DDB0231470 Link t...o Contig Contig-U10229-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/SL/SLE6-D/SLE

  6. The safety of hydroxychloroquine in pregnant patients with systemic lupus erythematosus%羟氯喹治疗系统性红斑狼疮合并妊娠24例临床研究

    Institute of Scientific and Technical Information of China (English)

    章璐; 马丽; 林冰; 吴东海; 王国春

    2011-01-01

    目的 评价羟氯喹治疗系统性红斑狼疮(SLE)患者合并妊娠的疗效与安全性.方法 回顾性分析2006年5月至2011年2月中日友好医院风湿免疫科收治的24例妊娠期间使用羟氯喹治疗SLE患者的疾病控制和新生儿安全情况,并对其子代进行随访.结果 24例患者中22例在妊娠期间持续应用羟氯喹治疗,21例患者SLE病情平稳,无复发.2例患者妊娠后停用羟氯喹,在妊娠中期出现SLE活动,增加糖皮质激素剂量并再度加用羟氯喹,SLE病情稳定至分娩和产后.3例患者诊断妊娠高血压,3例患者早产.副作用:2例患者在妊娠期加用羟氯喹后,分别出现一过性厌食和脱发,未予特殊治疗,症状大约持续3周后自行缓解.所有患者均未出现眼部不适及视野缺损症状.至目前为止,患者在我院眼科门诊定期复查视野及眼底均无异常发现.新生儿听力筛查和身高、体重均在正常范围内,未发现心肺异常及生长发育异常.结论 羟氯喹对SLE妊娠期妇女及胎儿具有良好的安全性,应在妊娠期间持续使用.%Objective To evaluate the efficacy and safety of hydroxychloroquine(HCQ) in pregnant patients with systemic lupus erythematosus (SLE).Methods Twenty-four pregnant patients with SLE treated with HCQ during pregnancy from May,2006 to February,2011 were studied retrospectively.All babies were followed up during early infancy for growth development.Results Of them,22 patients were treated with HCQ throughout the whole pregnancy with no lupus flare occurred in 21 patients (95.4%),while temporary discontinuation of HCQ precipitated a flare of disease in two patients.Three patients ( 12.5% ) had premature delivery,and pregnancy induced hypertension happened in 3 patients (12.5% ).No congenital abnormalities occurred and mean follow-up of 26 months ( range 1 - 47 months) revealed no abnormalities in these children.Conclusion Our findings reinforce the safety of HCQ therapy during

  7. [Two cases with SLE and MCTD developed after a long period of chronic arthritis that was initially diagnosed as JRA].

    Science.gov (United States)

    Takei, S; Maeno, N; Shigemori, M; Nakae, Y; Mori, H; Nerome, Y; Imanaka, H; Hokonohara, M; Miyata, K

    1997-10-01

    In order to discuss the diversity of clinical features and the difficulty in diagnosis of children with juvenile rheumatoid arthritis (JRA), we present two cases who have documented the development of systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) after a long period of disease characterized only by arthritis that was initially diagnosed as JRA. The first case was a girl diagnosed for her arthritic joints as polyarticular JRA at 15 years of age. At onset, she had Raynaud phenomenon but autoantibodies such as anti-nuclear antibody (ANA), anti-DNA antibody, and rheumatoid factor were negative. Five years after onset, she became ANA positive and 3 years later she became pregnant. During her pregnancy, she became positive for anti-DNA antibody without any signs of nephritis. One month after the delivery, however, she developed butterfly rash, carditis, nephritis, and was diagnosed as SLE. No destructive changes were observed in her joints though arthritis continued for 8 years form onset to pregnancy. The second case was a 3 years old girl who was diagnosed as polyarticular JRA. Treatment by aspirin induced complate remission after one year from the onset. However, 10 years after that remission, she developed Raynaud phenomenon and arthralgia in her knees and hip joints. Her laboratory findings showed hypergammaglobulinemia, positive ANA, positive anti-DNA antibody, positive anti-RNP antibody. She was eventually diagnosed as MCTD when she was found to have polymyositis by EMG and serum CK. In the present paper, two cases imply the difficulty in diagnosing JRA and diversity of rheumatic diseases such as JRA, SLE and MCTD. Closer and longer period of observation is essential for the JRA patients with nondestructive arthritis.

  8. Pulsed radiofrequency treatment of piriformis syndrome in a pregnant patient with malignant mesenchymal tumor.

    Science.gov (United States)

    Pirbudak, Lütfiye; Sevinç, Alper; Kervancıoğlu, Selim; Kervancıoğlu, Piraye; Ateş, Deniz

    2016-10-01

    Cancer is frequently seen in women of reproductive age. Diagnosis, management of treatment, and safety of the therapeutic approach are particularly important for these patients. Presently described is pain management in a case of pregnancy with malignant mesenchymal tumor. A 23-year-old woman in 30th gestational week presented with severe pain in right hip and back of the right thigh. Piriformis block successfully decreased pain and was followed by pulsed radiofrequency (PRF) to the piriformis muscle. PRF, as a non-neurodestructive method, is a safe and effective method to treat cancer pain in a pregnant patient.

  9. Simultaneous cesarean delivery and craniotomy in a term pregnant patient with traumatic brain injury.

    Science.gov (United States)

    Tawfik, Mohamed Mohamed; Badran, Basma Abed; Eisa, Ahmed Amin; Barakat, Rafik Ibrahim

    2015-01-01

    The management of pregnant patients with traumatic brain injury is challenging. A multidisciplinary team approach is mandatory, and management should be individualized according to the type and extent of injury, maternal status, gestational age, and fetal status. We report a 27-year-old term primigravida presenting after head injury with Glasgow coma scale score 11 and anisocoria. Depressed temporal bone fracture and acute epidural hematoma were diagnosed, necessitating an urgent neurosurgery. Her fetus was viable with no signs of distress and no detected placental abnormalities. Cesarean delivery was performed followed by craniotomy in the same setting under general anesthesia with good outcome of the patient and her baby.

  10. Simultaneous cesarean delivery and craniotomy in a term pregnant patient with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Mohamed Mohamed Tawfik

    2015-01-01

    Full Text Available The management of pregnant patients with traumatic brain injury is challenging. A multidisciplinary team approach is mandatory, and management should be individualized according to the type and extent of injury, maternal status, gestational age, and fetal status. We report a 27-year-old term primigravida presenting after head injury with Glasgow coma scale score 11 and anisocoria. Depressed temporal bone fracture and acute epidural hematoma were diagnosed, necessitating an urgent neurosurgery. Her fetus was viable with no signs of distress and no detected placental abnormalities. Cesarean delivery was performed followed by craniotomy in the same setting under general anesthesia with good outcome of the patient and her baby.

  11. Autoantibodies and Neuropsychiatric events at diagnosis of SLE

    Science.gov (United States)

    Hanly, J. G.; Urowitz, M. B.; Siannis, F.; Farewell, V.; Gordon, C.; Bae, S.C.; Isenberg, D.; Dooley, M.A.; Clarke, A.; Bernatsky, S.; Gladman, D.; Fortin, P.R.; Manzi, S.; Steinsson, K.; Bruce, I.; Ginzler, E.; Aranow, C.; Wallace, D.J.; Ramsey-Goldman, R.; Van Vollenhoven, R.; Sturfelt, G.; Nived, O.; Sanchez-Guerrero, J.; Alarcón, G.S.; Petri, M.; Khamashta, M.; Zoma, A.; Kalunian, K.; Douglas, J.; Qi, Qiufen; Merrill, J. T.

    2015-01-01

    Objective To examine the association between neuropsychiatric (NP) events with antiphospholipid antibodies (lupus anticoagulant, anticardiolipin), anti-β2 glycoprotein-I, anti-ribosomal P and anti-NR2 glutamate receptor antibodies in an international inception cohort. Methods NP events were identified using the ACR case definitions and clustered into central/peripheral and diffuse/focal events. Attribution of NP events was determined using decision rules of different stringency (model A and model B). Autoantibodies were measured without knowledge of NP events or their attribution. Results 412 patients (87.3% female; mean (± SD) age of 34.9 ± 13.5 years; mean disease duration 5.0 ± 4.2 months) were studied. There were 214 NP events in 133 (32.3%) patients. NP events attributed to SLE varied from 15% (model A) to 36% (model B). There was no association between autoantibodies and NP events from all causes. However the frequency of anti-ribosomal P antibodies in patients with NP events due to SLE (model A) was 4/24 (16.6%) compared to 3/109 (2.8%) for all other NP events and 24/279 (8.6%) with no NP events (P=0.07). Furthermore anti-ribosomal P antibodies in patients with central NP events attributed to SLE (model A) was 4/20 (20%) vs. 3/107 (2.8%) for other NP events and 24/279 (8.6%) with no NP events (P = 0.04). For diffuse NP events the antibody frequencies were 3/11 (27%) compared to 4/111 (3.6%) and 24/279 (8.6%) respectively (P=0.02). Conclusion NP events at onset of SLE were associated with anti-ribosomal P antibodies, suggesting a pathogenetic role for this autoantibody. There was no association with other autoantibodies. PMID:18311802

  12. Migraine in SLE: role of antiphospholipid antibodies and Raynaud’s phenomenon

    Directory of Open Access Journals (Sweden)

    Serena D'Agostini

    2011-09-01

    Full Text Available Objectives: To determine the role of antiphospholipid antibodies (aPL and of Raynaud’s phenomenon (RP in the development of migraine in patients with systemic lupus erythematosus (SLE. Methods: 50 unselected SLE patients and 20 rheumatoid arthritis (RA controls underwent an interview to define the presence of migraine according to the guidelines of the International Headache Society (1988. Serological tests for aPL were performed in all patients. SLE patients were divided according to positivity for RP and/or aPL into 4 subsets: R-/aPL-, R-/aPL+, R+/aPL- and R+/aPL+. Data were analysed using Fisher’s exact test, Chi-square test and U Mann-Whitney test. Results: SLE and RA patients were similar for demographic and clinical features; aPL positivity was found in a greater proportion of SLE patients versus RA controls (68% vs 25%, p=0.0036. 31 of the 50 lupic patients (62% and 7 of the 20 RA controls (35% suffered from migraine (OR=3, CI:1-8.9. Among SLE and RA patients, migraine was associated with aPL positivity (p=0.027 and p=0.019. Analysing the combined effect of aPL and RP on migraine, in R+/aPL+ patients we detected an higher frequency of migraine (85.7% with respect to the patients negative for these two features (27%, p=0.0051, OR=16, CI:2.2-118 and to the patients positive only for aPL (65%, p=0.0031, OR=6.2, CI:1.2-32. Conclusions: Migraine in SLE and RA associates with aPL positivity. The simultaneous presence of RP increases by 2,5 times the probability of having migraine, suggesting that cerebral vasospasm might be more common in patients with peripheral vasospasm, given the presence of aPL.

  13. 羟氯喹对系统性红斑狼疮妊娠患者疗效及安全性的前瞻性研究%Prospective study of efficacy and safety of hydroxychloroquine in pregnant patients with systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    郝冬林; 徐东; 刘晶; 金笛儿; 赵岩; 高忠恩

    2014-01-01

    目的 评价羟氯喹对系统性红斑狼疮(SLE)妊娠患者的疗效及安全性.方法 对象为北京协和医院风湿免疫科和妇产科在2010年1月至2012年12月诊治的妊娠合并SLE患者,共48例,妊娠前SLE病情稳定和重要脏器功能正常至少6个月,并且停用免疫抑制剂半年以上.所有患者妊娠期间服用泼尼松≤15 mg/d和羟氯喹0.2g/次,2次/d.分析SLE患者妊娠前后的疾病活动情况及妊娠结局.结果 48例中9例(18.8%)在妊娠期间出现SLE疾病活动,2例(4.2%)在妊娠后出现;48例中无死亡者,44例(91.7%)成功妊娠,早产儿12例(27.3%),低体重儿13例(29.6%),新生儿除1例因为早产发育迟缓,其余均未出现生长发育异常及病理情况.所有患者视野及眼底均未见明显异常.结论 羟氯喹可能改善SLE患者妊娠及胎儿结局,并对孕妇及胎儿具有良好的安全性,妊娠中后期较易复发,应加强监测随诊.%Objective To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in pregnant patients with systemic lupus erythematosus (SLE).Methods A total of 48 pregnant patients with SLE were prospectively recruited from January 2010 to December 2012 at Peking Union Medical College Hospital.Diseases were stable,functions of important organs normal and immunosupressants were discontinued for at least 6 months.Predisone (≤ 15mg qd) and HCQ (0.2 bid) were taken during the whole pregnancy.SLE disease activity before,during and after pregnancy and pregnancy outcome were analyzed.Results SLE relapsed in 9 (18.8%) patients during pregnancy and 2 (4.2%) cases relapsed after delivery.There was no mortality.And 44 cases (91.7%) had successful pregnancy with 12(27.3%) preterm infants and 13(29.6%) infants with low birth weight.All neonates grew healthily,except one with hypoevolutism because of premature growth.Neither visual field nor fundus showed any abnormality.Conclusion HCQ may be effective in improving the pregnancy and

  14. Cryptogenic Organising Pneumonia As The Initial Presenting Manifestation of SLE

    Directory of Open Access Journals (Sweden)

    Neena Mampilly

    2015-07-01

    Full Text Available Cryptogenic Organising Pneumonia (COP, also called idiopathic Bronchiolitis Obliterans Organising Pneumonia( BOOP, is a distinct entity among the idiopathic interstitial pneumonias defined histopathologically by intraalveolar buds of granulation tissue. The etiology includes idiopathic, infectious, drug induced radiation induced and connective tissue diseases. Organising pneumonia occurs particularly in patients with dermatomyositis-polymyositis where it may be the presenting manifestation, and rarely in SLE, rheumatoid arthritis, scleroderma and other connective tissue diseases. We describe a 30 yr old lady who initially presented with respiratory symptoms, not responding to antibiotics. She was subsequently diagnosed as SLE and HRCT thorax showed consolidation involving both lung fields. A percutaneous lung biopsy revealed features of Cryptogenic Organising Pneumonia.

  15. Dicty_cDB: SLE425 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available SL (Link to library) SLE425 (Link to dictyBase) - - - Contig-U15692-1 SLE425F (Link... to Original site) SLE425F 688 - - - - - - Show SLE425 Library SL (Link to library) Clone ID SLE425 (Link to dict...yBase) Atlas ID - NBRP ID - dictyBase ID - Link to Contig Contig-U15692-1 Original site URL http://dict...VELASDPQLLFLD EPTSGLDSSAALKVMNLIKKIASSGRSIICTIHQPSTSIFKQFDHLLLLKRGGETVYFGP TGDKSA...SDMPNEEKIKFVENIIETLNLLKIQNKQIGHGEEGLSLSQRKRVNIGVELASDPQLLFLD EPTSGLDSSAALKVMNLIKKIASSGRSIICTIHQPSTSIFKQFDHLL

  16. Fetus absorbed dose evaluation in head and neck radiotherapy procedures of pregnant patients

    Energy Technology Data Exchange (ETDEWEB)

    Camargo da C, E.; Ribeiro da R, L. A.; Santos B, D. V., E-mail: etieli@ird.gov.br [Instituto de Radioprotecao e Dosimetria / CNEN, Av. Salvador Allende s/n, Barra de Tijuca, 22783-127 Rio de Janeiro (Brazil)

    2014-08-15

    Each year a considerable amount of pregnant women needs to be submitted to radiotherapeutic procedures to combat malignant tumors. Radiation therapy is often a treatment of choice for these patients. It is possible to use shielding and beam positioning such that the potential dose to the fetus can be minimized. In this work the head and neck cancer treatment of a pregnant patient was experimentally simulated. The patient was simulated by an anthropomorphic Alderson phantom and the absorbed dose to the fetus was evaluated using micro-rod TLD-100 detectors in two conditions, namely protecting the patients abdomen with a 7 cm lead layer and using no abdomen shielding. The aim of this experiment was to evaluate the efficiency of the abdomen protection in reducing the fetus absorbed dose. Irradiations were performed with a Trilogy linear accelerator using x-rays of 6 MV. A total dose of 50 Gy to the target volume was delivered. The fetus doses evaluated with and without the lead shielding were, respectively, 0.52±0.039 and (0.88±0.052) c Gy, corresponding to a dose reduction of 59%. The dose (0.52±0.039) c Gy is within the zone of biological tolerance for the fetus. (Author)

  17. Anesthesia management for pregnant patient with Arnold-Chiari malformation type I: A case report

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    Şaban Yalçın

    2012-06-01

    Full Text Available The Arnold-Chiari I malformation (ACM is a congenitalanomaly characterized by downward herniation of thecerebellar tonsils into the spinal canal. The anomaly maypresent in a variety of ways with vague symptoms suchas head and limb pains, vertigo, hypoesthesia, weaknessin the extremities. Diagnosis is often difficult and thereforedelayed. Measurement of intracranial pressure in thesepatients is an important measure thus precautions shoulbe taken for avoidance of increased intracranial pressure.In this case report, we discussed the anesthetic managementof a pregnant patient with Arnold Chiari I malformationwho underwent an emergency caesarean section.

  18. Pulmonary hydatid cyst in a pregnant patient causing acute respiratory failure

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    Hijazi Mohammed

    2007-01-01

    Full Text Available A 21-year-old primigravida, at 32 weeks of gestation, presented with acute onset of respiratory failure and circulatory shock. Chest imaging showed findings suggestive of ruptured hydatid cyst, which was confirmed by histology post-thoracotomy. Tissue cultures from the removed cyst grew Mycobacterium tuberculosis also. She was successfully managed in the intensive care unit and was then discharged home on antituberculosis medications in addition to albendazole after prolonged hospitalization and a need for chest tube for bronchopleural fistula. Acute respiratory failure and anaphylactic shock secondary to ruptured pulmonary hydatid cyst and superimposed pulmonary tuberculosis in a pregnant lady should be considered in patients living in endemic areas.

  19. Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus.

    Science.gov (United States)

    Hashimoto, Kunihiko; Koga, Masafumi

    2015-07-25

    Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus (GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c (HbA1c); however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.

  20. Breast cancer in systemic lupus erythematosus (SLE): receptor status and treatment.

    Science.gov (United States)

    Chan, K; Clarke, A E; Ramsey-Goldman, R; Foulkes, W; Tessier Cloutier, B; Urowitz, M B; Gladman, D; Nived, O; Romero-Diaz, J; Petri, M; Ginzler, E; Fortin, P R; Bae, S C; Wallace, D J; Yelin, E H; Bernatsky, S

    2017-01-01

    Objective There is a decreased risk of breast cancer in systemic lupus erythematosus (SLE) versus the general population; little is known regarding the receptor status of breast cancers in SLE, or treatment. Methods Breast cancer cases occurring after SLE diagnosis were ascertained through linkage with tumor registries. We determined breast cancer positivity for estrogen receptors (ER), progesterone receptors (PR), and/or Human Epidermal Growth Factor Receptor 2 (HER2), as well as cancer treatment. Results We obtained information on ER, PR, and/or HER2 status for 63 SLE patients with breast cancer. Fifty-three had information on ER and/or PR status; 36 of these (69%) were ER positive. Thirty-six of the 63 had information on HER2 status; of these, 26 had complete information on all three receptors. Twenty-one of these 26 (81%) were HER2 negative; seven of 26(27%) were triple negative. All but one patient underwent surgery; 11.5% received both non-tamoxifen chemotherapy and radiotherapy, 16.4% radiotherapy without non-tamoxifen chemotherapy, and 14.7% received non-tamoxifen chemotherapy without radiotherapy. Conclusion ER positivity was similar to historical general population figures, with a trend toward a higher proportion of triple-negative breast cancers in SLE (possibly reflecting the relatively young age of our SLE patients).

  1. Choice of laxatives and colonoscopic preparation in pregnant patients from the viewpoint of obstetricians and gastroenterologists

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use for flexible sigmoidoscopy or colonoscopy, as well as which laxatives can be used safely.METHODS: Surveys were mailed to all attending gastroenterologists (n = 53) and obstetricians (n = 99)at our institution. Each survey consisted of the 14 most common laxative or motility agents used in pregnancy and inquired about the physician's prescribing habits in the past as well as their willingness to prescribe each medication in the future. The survey also listed four common bowel preparations used prior to colonoscopy and sigmoidoscopy and asked the physician to rank the order of the preferred agent in each case.RESULTS: With regard to common laxatives, both gastroenterologists and obstetricians favor the use of Metamucil, Colace, and Citrucel. Both groups appear to refrain from using Fleets Phosphosoda and Castor oil. Of note, obstetricians are less inclined to use PEG solution and Miralax, which is not the case with gastroenterologists. In terms of comparing bowel preparations for colonoscopy, 50% of gastroenterologists prefer to use PEG solution and 50% avoid the use of Fleets Phosphosoda. Obstetricians seem to prefer Fleets Phosphosoda (20%) and tend to avoid the use of PEG solution (26%). With regard to bowel preparation for sigmoidoscopy, both groups prefer Fleets enema the most (51%), while magnesium citrate is used least often (38%).CONCLUSION: It is clear that preferences in the use of bowel cleansing preparations between the two groups exist, but there have not been many case controlled human studies in the pregnant patient that give clear cut indications for using one versus another drug. In light of the challenge of performing controlled trials in pregnant women, more extensive surveys should be undertaken to gather a larger amount of data on

  2. Technical management of a pregnant patient undergoing radiation therapy to the head and neck.

    Science.gov (United States)

    Podgorsak, M B; Meiler, R J; Kowal, H; Kishel, S P; Orner, J B

    1999-01-01

    The fetal dose in a pregnant patient undergoing radiation therapy to the head and neck region was investigated. Implicit in this study was the design and evaluation of a shield used to minimize the fetal dose. To evaluate the fetal dose, a phantom was irradiated with the fields designed for this patient's therapy. The peripheral dose was measured for each field individually, both without and with a custom shield designed to be placed about the patient's abdominal and pelvic regions. The total dose at the location of the fetus over the course of this patient's radiation therapy was then estimated from peripheral dose rate measurements made at several points within the simulated uterus. With no shielding, the total dose within the uterus of the patient would have ranged from 13.3 cGy at the cervix to 28 cGy at the fundus. With the shield applied, the uterine dose was significantly less: 3.3 cGy at the cervix to 8.6 cGy at the fundus. In fact, at every measurement point, the peripheral dose with the shield in place was 30% to 50% of the dose without the shield. Some data suggest that the rate of significant abnormalities induced by irradiation in utero increases with increasing dose within the range of total peripheral doses incurred during most radiation treatment courses. It is therefore prudent to make reasonable attempts at minimizing the dose to the lower abdominal and pelvic regions of any pregnant patient. The shield designed in this work accomplished this goal for this patient and is flexible enough to be used in the treatment of almost all tumor volumes.

  3. Anti-DNA antibodies--quintessential biomarkers of SLE.

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    Pisetsky, David S

    2016-02-01

    Antibodies that recognize and bind to DNA (anti-DNA antibodies) are serological hallmarks of systemic lupus erythematosus (SLE) and key markers for diagnosis and disease activity. In addition to common use in the clinic, anti-DNA antibody testing now also determines eligibility for clinical trials, raising important questions about the nature of the antibody-antigen interaction. At present, no 'gold standard' for serological assessment exists, and anti-DNA antibody binding can be measured with a variety of assay formats, which differ in the nature of the DNA substrates and in the conditions for binding and detection of antibodies. A mechanism called monogamous bivalency--in which high avidity results from simultaneous interaction of IgG Fab sites with a single polynucleotide chain--determines anti-DNA antibody binding; this mechanism might affect antibody detection in different assay formats. Although anti-DNA antibodies can promote pathogenesis by depositing in the kidney or driving cytokine production, they are not all alike, pathologically, and anti-DNA antibody expression does not necessarily correlate with active disease. Levels of anti-DNA antibodies in patients with SLE can vary over time, distinguishing anti-DNA antibodies from other pathogenic antinuclear antibodies. Elucidation of the binding specificities and the pathogenic roles of anti-DNA antibodies in SLE should enable improvements in the design of informative assays for both clinical and research purposes.

  4. Osteosarcoma in a pregnant patient with McCune-Albright syndrome.

    Science.gov (United States)

    Kanazawa, Ippei; Yamauchi, Mika; Yano, Shozo; Imanishi, Yasuo; Kitazawa, Riko; Nariai, Yoshiki; Araki, Asuka; Kobayashi, Keisuke; Inaba, Masaaki; Maruyama, Riruke; Yamaguchi, Toru; Sugimoto, Toshitsugu

    2009-09-01

    Malignant transformation of fibrous dysplasia is very rare and has not been previously described in patients with McCune-Albright syndrome in the absence of radiation treatment during gestation. Here, we report a 38-year-old pregnant woman with McCune-Albright syndrome and acromegaly accompanied by osteosarcoma. The patient was in the 6th week of pregnancy, when she visited our hospital. She had multiple fibrous dysplasia, skin pigmentation, and acromegaly. The markedly high bone turnover rate during pregnancy tended to decrease after a normal delivery. Fibrous dysplasia of the lower jaw rapidly increased in the 37th week of pregnancy, and the tumor was surgically resected after delivery. Pathological examination of the resected tumor revealed fibrous dysplasia admixed with osteosarcoma containing chondroblastic and osteoblastic tissue. We firstly reported a case of osteosarcoma in a patient with McCune-Albright syndrome, which rapidly progressed during pregnancy.

  5. Evaluation of Stress urinary incontinence among non pregnant female patients in a tertiary care hospital

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    Shraddha Agarwal

    2016-03-01

    Full Text Available Background: Urinary incontinence has been defined by the international continence society as a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable. Stress urinary incontinence is the most common form of transurethral urinary incontinence in women. Objective: To study the probable etiological factors in diagnosed cases of Stress urinary incontinence among non pregnant female patients attending outpatient department of Gynecology in SMIMER, Surat and to evaluate the cure rate of non-surgical and surgical treatment among them. Method:This study was conducted in the department of Obst amd Gynec, SMIMER, Surat from May2010 to december2012. Non pregnant patients demonstrating SUI with full bladder were included in the study. Total 40 patients were studied. Observation: Out of 40 cases 32 (80% cases belonged to the age group of 40 to 59 years, 22 (55% were in peri-menopausal age group and the median parity of the patients was 3. Other important observation was that 29(54.7% patients had associated utero-vaginal prolapse with SUI and maximum had third degree prolapsed. Both non-surgical and surgical treatment was offered to patients with good results. Conclusion: This study indicates that SUI is quite common in peri-menopausal age group, it has strong association with multi parity and UV prolapse. Non-surgical management is still the acceptable mode of treatment. The TVT-O appears to be safe and effective surgical treatment for SUI. [Natl J Med Res 2016; 6(1.000: 73-76

  6. [Barriers to Addressing Pregnant Patients' Cigarette and Alcohol Use: A Focus Group Study with Gynecologists].

    Science.gov (United States)

    Stiegler, A; Bieber, L; Karacay, K; Wernz, F; Batra, A

    2016-12-01

    Objectives/Purpose: Alcohol drinking and tobacco smoking pose high health risks for the unborn child. Even though routine testing during the course of pregnancy facilitates early intervention, addressing substance use in pregnancy seems to be more difficult. The aim of the study was to identify barriers to addressing pregnant patients' cigarette and alcohol use. Methods: 2 focus groups (in total N=10 participants) were conducted with gynaecologists. The transcripts of the discussions were analysed using Mayring's approach of qualitative text analysis. Results: Avoidance of addressing substance abuse directly, the social and educational background of patients influencing the communication in this matter and the physicians' ambivalence about their limits of responsibility were barriers often mentioned by the participants. Conclusion: In view of the several structural and individual barriers among gynaecologists identified in this study, gynaecologists obviously cannot be the only health professionals taking responsibility for coping with substance abuse among pregnant women. Strategies should be designed, e. g., to standardise the identification, counselling and referral process. Physicians should receive more support in improving their competences, and effective low-threshold treatment programmes for the women affected are required. © Georg Thieme Verlag KG Stuttgart · New York.

  7. The beneficial role of vitamin D in systemic lupus erythematosus (SLE).

    Science.gov (United States)

    vinh quốc Luong, Khanh; Nguyễn, Lan Thi Hoàng

    2012-10-01

    Patients with systemic lupus erythematosus (SLE) have a high prevalence of abnormal bone metabolism and vitamin D deficiency. Genetic studies have provided the opportunity to determine the specific proteins linking vitamin D to SLE pathology [i.e., major histocompatibility complex (MHC) class II molecules, the vitamin D receptor (VDR), microRNAs (miRNAs), the renin-angiotensin system (RAS), apolipoprotein E (ApoE), liver X receptor (LXR), and toll-like receptors (TLRs)]. Vitamin D also exerts protective effects against SLE through non-genomic factors, such as ultraviolet radiation (UV) exposure, matrix metalloproteinase (MMPs), heme oxygenase-1 (HO-1), the prostaglandins (PGs), cyclooxygenase-2 (COX-2), and oxidative stress. Thus, vitamin D may play a beneficial role in SLE. Moreover, the use of calcitriol or 1α,25-dihydroxyvitamin D(3) is optimal for the treatment of SLE patients because this active form of the vitamin D(3) metabolite can modulate inflammatory cytokine production. However, further investigation into the effects of calcitriol with SLE is warranted.

  8. Contrasting genetic association of IL2RA with SLE and ANCA – associated vasculitis

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    Todd John A

    2009-03-01

    Full Text Available Abstract Background Autoimmune diseases are complex and have genetic and environmental susceptibility factors. The objective was to test the genetic association of systemic lupus erythematosus (SLE and anti-neutrophil cytoplasmic antibody (ANCA – associated systemic vasculitis (AAV with SNPs in the IL2RA region and to correlate genotype with serum levels of IL-2RA. Methods Using a cohort of over 700 AAV patients, two SLE case-control studies and an SLE trio collection (totalling over 1000 SLE patients, and a TaqMan genotyping approach, we tested 3 SNPs in the IL2RA locus, rs11594656, rs2104286 & rs41295061, each with a prior association with autoimmune disease; rs11594656 and rs41295061 with type 1 diabetes (T1D and rs2104286 with multiple sclerosis (MS and T1D. Results We show that SLE is associated with rs11594656 (P = 3.87 × 10-7 and there is some evidence of association of rs41295061 with AAV (P = 0.0122, which both have prior association with T1D. rs2104286, an MS and T1D – associated SNP in the IL2RA locus, is not associated with either SLE or AAV. Conclusion We have confirmed a previous suggestion that the IL2RA locus is associated with SLE and showed some evidence of association with AAV. Soluble IL-2RA concentrations correlate with rs11594656 genotype in quiescent disease in both AAV and SLE. Differential association of autoimmune diseases and SNPs within the IL2RA locus suggests that the IL2RA pathway may prove to play differing, as yet undefined, roles in each disease.

  9. Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program.

    Science.gov (United States)

    Haskins, I N; Rosen, M J; Prabhu, A S; Amdur, R L; Rosenblatt, S; Brody, F; Krpata, D M

    2017-07-22

    Umbilical hernias present commonly during pregnancy secondary to increased intra-abdominal pressure. As a result, umbilical hernia incarceration or strangulation may affect pregnant females. The purpose of this study is to detail the operative management and 30-day outcomes of umbilical hernias in pregnant patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). All female patients undergoing umbilical hernia repair during pregnancy were identified within the ACS-NSQIP. Preoperative patient variables, intraoperative variables, and 30-day patient morbidity and mortality outcomes were investigated using a variety of statistical tests. A total of 126 pregnant patients underwent umbilical hernia repair from 2005 to 2014; 73 (58%) had incarceration or strangulation at the time of surgical intervention. The majority of patients (95%) underwent open umbilical hernia repair. Superficial surgical site infection was the most common morbidity in patients undergoing open umbilical hernia repair. Based on review of the ACS-NSQIP database, the incidence of umbilical hernia repair during pregnancy is very low; however, the majority of patients required repair for incarceration of strangulation. When symptoms develop, these hernias can be repaired with minimal 30-day morbidity to the mother. Additional studies are needed to determine the long-term recurrence rate of umbilical hernia repairs performed in pregnant patients and the effects of surgical intervention and approach on the fetus.

  10. Vegan-vegetarian low-protein supplemented diets in pregnant CKD patients: fifteen years of experience.

    Science.gov (United States)

    Attini, Rossella; Leone, Filomena; Parisi, Silvia; Fassio, Federica; Capizzi, Irene; Loi, Valentina; Colla, Loredana; Rossetti, Maura; Gerbino, Martina; Maxia, Stefania; Alemanno, Maria Grazia; Minelli, Fosca; Piccoli, Ettore; Versino, Elisabetta; Biolcati, Marilisa; Avagnina, Paolo; Pani, Antonello; Cabiddu, Gianfranca; Todros, Tullia; Piccoli, Giorgina B

    2016-09-20

    Pregnancy in women with advanced CKD becoming increasingly common. However, experience with low-protein diets in CKD patients in pregnancy is still limited. Aim of this study is to review the results obtained over the last 15 years with moderately restricted low-protein diets in pregnant CKD women (combining: CKD stages 3-5, proteinuria: nephrotic at any time, or > =1 g/24 at start or referral; nephrotic in previous pregnancy). CKD patients on unrestricted diets were employed for comparison. January, 2000 to September, 2015: 36 on-diet pregnancies (31 singleton deliveries, 3 twin deliveries, 1 pregnancy termination, 1 miscarriage); 47 controls (42 singleton deliveries, 5 miscarriages). The diet is basically vegan; since occasional milk and yoghurt are allowed, we defined it vegan-vegetarian; protein intake (0.6-0.8 g/Kg/day), keto-acid supplementation, protein-unrestricted meals (1-3/week) are prescribed according to CKD stage and nutritional status. Statistical analysis was performed as implemented on SPSS. Patients and controls were similar (p: ns) at baseline with regard to age (33 vs 33.5), referral week (7 vs 9), kidney function (CKD 3-5: 48.4 % vs 64.3 %); prevalence of hypertension (51.6 % vs 40.5 %) and proteinuria >3 g/24 h (16.1 % vs 12.2 %). There were more diabetic nephropathies in on-diet patients (on diet: 31.0 % vs controls 5.3 %; p 0.007 (Fisher)) while lupus nephropathies were non-significantly higher in controls (on diet: 10.3 % vs controls 23.7 %; p 0.28 (Fisher)). The incidence of preterm delivery was similar (vegan-vegetarian supplemented diet is confirmed as a safe option in the management of pregnant CKD patients.

  11. Herpes Zoster Infections in SLE in a University Hospital in Saudi Arabia: Risk Factors and Outcomes

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    Afsar Sayeeda

    2010-01-01

    (0/23. None of the patients had postherpetic neuralgia or bacterial super infection. Immunosuppressive medications were discontinued at the time of diagnosis of Zoster in 19 of 32 patients and all patients received antiviral medications.There were no permanent neurologic deficits or deaths. We conclude that Herpes Zoster infections occur at increased frequency among patients with SLE and carry significant morbidity. Immunosuppressive therapy and severe manifestations of lupus may be risk factors for the development of Herpes Zoster although not necessarily at the time of disease flare or immunosuppressive therapy. Our study suggests that although Herpes Zoster occurs frequently in patients with SLE, it has a relatively benign course.

  12. [TOTAL PARENTERAL NUTRITION IN A PREGNANT PATIENT WITH ACUTE PANCREATITIS AND LIPOPROTEIN LIPASE DEFICIENCY].

    Science.gov (United States)

    Contreras-Bolívar, Victoria; González-Molero, Inmaculada; Valdivieso, Pedro; Olveira, Gabriel

    2015-10-01

    We present a case of severe acute pancreatitis induced by hypertriglyceridemia secondary to lipoprotein lipase (LPL) deficiency in a pregnant patient with gestational diabetes, initially maneged with diet but it was later necessary to carry out artificial nutricional support measures: total parenteral nutrition. LPL deficiency might cause severe hypertriglyceridemia, repetition acute pancreatitis which is an unwieldy and severe situation during pregnancy. Acute familial hypertriglyceridemia pancreatitis accounts for 5% of cases, including LPL deficiency. The goal of treatment is to reach triglycerides levels below 500 mg/dl, being very low fat diet the treatment of choice, drugs or plasmapheresis techniques can also be associated. TPN enriched in ω3 fatty acids and glutamine was safe and effective in our patient with significant decrease in triglyceride levels.

  13. Anti-malarials exert a protective effect while Mestizo patients are at increased risk of developing SLE renal disease: data from a Latin-American cohort

    Science.gov (United States)

    Pons-Estel, Guillermo J.; Alarcón, Graciela S.; Hachuel, Leticia; Boggio, Gabriela; Wojdyla, Daniel; Pascual-Ramos, Virginia; Soriano, Enrique R.; Saurit, Verónica; Cavalcanti, Fernando S.; Guzman, Renato A.; Guibert-Toledano, Marlene; Sauza del Pozo, Maria J.; Amigo, Mary-Carmen; Alva, Magaly; Esteva-Spinetti, Maria H.

    2012-01-01

    Objective. To examine the role of ethnicity and the use of anti-malarials (protective) on lupus renal disease. Methods. A nested case–control study (1:2 proportion, n = 265 and 530) within GLADEL's (Grupo Latino Americano De Estudio de Lupus) longitudinal inception cohort was carried out. The end-point was ACR renal criterion development after diagnosis. Cases and controls were matched for follow-up time (end-point or a comparable time, respectively). Renal disease predictors were examined by univariable and multivariable analyses. Additional analyses were done to determine if the protective effect of anti-malarials persisted after adjusting for intake-associated confounders. Results. Of the cases, 233 (87.9%) were women; their mean (s.d.) age at diagnosis was 28.0 (11.9) years and their median (Q3–Q1 interquartile range) follow-up time for cases and controls was 8.3 months (Q3–Q1: 23.5); 56.6% of the cases and 74.3% of the controls were anti-malarial users. Mestizo ethnicity [odds ratio (OR) 1.72, 95% CI 1.19, 2.48] and hypertension (OR 2.26, 95% CI 1.38, 3.70) were independently associated with a higher risk of renal disease, whereas anti-malarial use (OR 0.39, 95% CI 0.26, 0.58), older age at disease onset (OR 0.98, 95% CI 0.96, 0.99) and female gender (OR 0.56, 95% CI 0.32, 0.99) were negatively associated with such occurrence. After adjusting for variables associated with their intake, the protective effect of anti-malarials on renal disease occurrence persisted (OR 0.38, 95% CI 0.25, 0.58). Conclusion. Mestizo patients are at increased risk of developing renal disease, whereas anti-malarial use protects patients from such an occurrence. PMID:22389125

  14. Anti-DNA antibodies in SLE

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    Voss, E.W.

    1988-01-01

    This book contains 8 chapters. Some of the titles are: Anti-DNA Antibodies in SLE: Historical Perspective; Specificity of Anti-DNA Antibodies in Systemic Lupus Erythematosus; Monoclonial Autoimmune Anti-DNA Antibodies; and Structure--Function Analyses of Anti-DNA Autoantibodies.

  15. Soroprevalência e genótipos do vírus da hepatite C em pacientes com lúpus eritematoso sistêmico (LES em Goiânia, Brasil Hepatitis C virus seroprevalence and genotypes in patients with systemic lupus erythematosus (SLE in Goiânia, Brazil

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    Vitalina de Souza Barbosa

    2005-08-01

    (HCV infection is a source of concern in rheumatology because of its extrahepatic manifestations. Many studies have reported association between HCV infection and rheumatological manifestations such as: musculoskeletal pain, essential mixed cryoglobulinemia, rheumatoid arthritis, Sjögren's syndrome, vasculitis, glomerulonephritis, Raynaud's phenomenon, polyarteritis nodosa, myositis, autoantibody and other connective tissue diseases. In previous studies developed in our region, prevalences of 0.9%, 1.4%, 1.8% and 2.0% were detected among pregnant women, blood donors, leprosy patients and health professionals, respectively. OBJECTIVE: to investigate the prevalence of hepatitis C virus infection among patients with systemic lupus erythematosus (SLE in Goiânia, Brazil. METHODS: 175 patients were interviewed and had blood samples tested for HCV antibodies (anti-HCV by a third generation enzyme linked immunosorbant assay (ELISA. RNA-HCV was detected by polymerase chain reaction (PCR with primers complementary the 5' non-coding region of the HCV genoma, in all anti-HCV positive serum samples and genotyped by a line probe assay. RESULTS: an overall HCV infection prevalence of 2.3% (4/175 was found. Genotyping of RNA-HCV positive samples revealed HCV type 1 in 3 (75% and type 3 in 1 (25% patient. Clinical course was favorable in all HCV positive patients, except one, who died due to renal insuficiency related to lupus nephritis. CONCLUSIONS: anti-HCV prevalence among patients with SLE was slitghly higher than the prevanlence observed in pregnant women, healthy blood donors and leprosy patients, and similar to health professionals.

  16. TMA secondary to SLE: rituximab improves overall but not renal survival.

    Science.gov (United States)

    Sun, Fangfang; Wang, Xiaodong; Wu, Wanlong; Wang, Kaiwen; Chen, Zhiwei; Li, Ting; Ye, Shuang

    2017-08-30

    Thrombotic microangiopathy (TMA) includes a series of life-threatening disorders. Systemic lupus erythematosus (SLE) is one of the most common acquired causes. To identify predictors of prognosis in patients with TMA secondary to SLE, we conducted a single-center historical study. From January 2013 to June 2016, of 2182 SLE hospitalized patients in the Ren Ji Hospital, a total of 21 consecutive patients with TMA secondary to SLE were identified. The 90-day short-term mortality was 33.3%. The kidney involvement (66.7%) was associated with poor prognosis, while the administration of rituximab (n = 13) was an independent protective factor according to logistic regression analysis. Compared to conventional treatment, i.e., plasma exchange, high-dose glucocorticoids, and intravenous immunoglobulin, the overall survival is significantly higher among patients receiving rituximab add-on (92.2 vs 33.3%, p = 0.0173); however, five out of seven patients with renal involvement in the rituximab group were eventually hemodialysis dependent. Our data indicated that add-on rituximab in the background of conventional therapy may improve the overall but not the renal survival in SLE-TMA patients.

  17. Anesthesic treatment for an urgent cesarean in a pregnant patient suffering from morbid obesity. A case report.

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    Bárbara Cabezas Poblet

    2008-04-01

    Full Text Available Morbid obesity is not a condition frequently found in patients under surgical treatment. However, its prevalence in the last decades tends to rise which may have a profound impact in the anesthetic morbid-mortality. These risks are increased in the case of pregnant patients. For these reasons a case of a pregnant woman is presented. She is suffering from morbid obesity when was announced to be surgically treated in emergency due to a cesarean at the University Hospital Dr. Gustavo Aldereguía Lima in Cienfuegos.

  18. Anesthesic treatment for an urgent cesarean in a pregnant patient suffering from morbid obesity. A case report.

    OpenAIRE

    Bárbara Cabezas Poblet; Rolando Espin González; Práxedes Rojas Santana

    2008-01-01

    Morbid obesity is not a condition frequently found in patients under surgical treatment. However, its prevalence in the last decades tends to rise which may have a profound impact in the anesthetic morbid-mortality. These risks are increased in the case of pregnant patients. For these reasons a case of a pregnant woman is presented. She is suffering from morbid obesity when was announced to be surgically treated in emergency due to a cesarean at the University Hospital Dr. Gustavo Aldereguía ...

  19. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report

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    Márcio Luiz Benevides

    Full Text Available Abstract Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day.

  20. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report.

    Science.gov (United States)

    Benevides, Márcio Luiz; Brandão, Verônica Cristina Moraes; Lovera, Jacqueline Ivonne Arenas

    2016-01-01

    The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50kg/m(2), who underwent cesarean section under general anesthesia. Pregnant woman in labor, 35 years of age, body mass index 59.8kg/m(2). Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2min) and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. [Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report].

    Science.gov (United States)

    Benevides, Márcio Luiz; Brandão, Verônica Cristina Moraes; Lovera, Jacqueline Ivonne Arenas

    2016-01-01

    The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index > 50 kg/m(2), who underwent cesarean section under general anesthesia. Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m(2). Caesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 minutes, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1(st) minute (received positive pressure ventilation by mask for about 2 minutes) and 8 in the 5(th) minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4(th) postoperative day. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. A Case of Nuclear Protein in Testis Midline Carcinoma Arising From the Submandibular Gland Duct in a Pregnant Patient.

    Science.gov (United States)

    Cho, Younghoon; Keam, Bhum Suk; Jung, Kyeong Cheon; Kim, Bo Hae

    2017-09-01

    This report describes the first reported case of a nuclear protein in testis midline carcinoma (NMC) arising from the submandibular gland (SMG) duct in a pregnant woman. A 29-year-old pregnant woman presented with a left-side mass in the floor of the mouth. An NMC arising from the SMG duct was confirmed by excisional biopsy examination. Intensive treatment, including surgery and chemotherapy, was provided without termination of the pregnancy. Additional chemotherapy and radiotherapy were provided after delivery. The treatment was successful. Neither the patient nor her infant had any complications and the patient remained disease free 20 months after her initial surgery. This report describes the successful diagnosis and treatment of a rare presentation of an NMC of the SMG duct in a pregnant woman. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Neurocognitive Impairment in Children and Adolescents with SLE

    OpenAIRE

    2009-01-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease in which neuropsychiatric manifestations are a common cause of significant morbidity. The American College of Rheumatology (ACR) has identified 19 distinct neuropsychiatric syndromes of SLE although the 1982 ACR classification criteria for SLE recognize only two: seizures and psychosis.1 Neurocognitive impairment (NCI) is one of the most common and clinically challenging of all SLE manifestations, however, its pathophysiol...

  4. Thyroid disease in pregnant women with systemic lupus erythematosus: increased preterm delivery.

    Science.gov (United States)

    Stagnaro-Green, A; Akhter, E; Yim, C; Davies, Terry F; Magder, Ls; Petri, M

    2011-06-01

    Thyroid disease is common in pregnancy and is associated with miscarriage, preterm delivery and postpartum thyroiditis (PPT). Systemic lupus erythematosus (SLE) is associated with miscarriage and preterm delivery. The hypotheses of the study are (1) pregnant women with SLE will have a high prevalence of undiagnosed hypothyroidism and a high prevalence of PPT, and (2) women with SLE and thyroid disease will have an increased incidence of adverse pregnancy outcomes as compared with pregnant women with SLE who do not have thyroid disease. This was a retrospective study of the Hopkins Lupus Cohort. All women had thyroid-stimulating hormone and thyroid antibodies assayed on frozen sera. In total, 63 pregnant women who met the ACR classification for SLE were evaluated. Outcome measures were the prevalence of thyroid disease during pregnancy and postpartum, and pregnancy outcomes. Some 13% of the women were on thyroid hormone prior to becoming pregnant, 11% were diagnosed with hypothyroidism during pregnancy, and 14% developed PPT. The prevalence of preterm delivery was 67% in women with thyroid disease and 18% in women who were thyroid disease free (p = 0.002). The presence of thyroid antibodies was not correlated with preterm delivery. Pregnant women with SLE have an increased prevalence of thyroid disease. Women with SLE and thyroid disease have an increased prevalence of preterm delivery.

  5. CLINICAL AND MORPHOLOGICAL CHARACTERIZATION OF FETOPLACENTAL COMPLEX IN PREGNANT PATIENTS WITH DIFFUSE TOXIC GOITER

    Directory of Open Access Journals (Sweden)

    V. A. Petrukhin

    2015-01-01

    Full Text Available Background: The course of pregnancy and delivery in patients with diffuse toxic goiter (DTG is often complicated by preeclampsia, fetoplacental insufficiency, placental abruption and associated with higher maternal and perinatal mortality. Aim: To study particulars of fetoplacental complex functioning in DTG. Materials and methods: We assessed pregnant patients with DTG (n = 92 and their newborns (n = 94. By the time of delivery, 86 of patients were clinically and biochemically euthyroid. Functions of fetoplacental complex (by levels of placental lactogen, α-fetoprotein, estriol, progesterone and cortisol were assessed by radioimmune and immunoenzyme assays. Fetometrical parameters of fetuses were studied by ultrasound method. Complex assessment of placentas was done by light and electronic microscopy. Results: Eighty seven (94,6% patients with DTG had combined complications of pregnancy. The most frequent were: the threat of termination of pregnancy, in 68 (73.9% of cases, low placenta placement, in 23 (25%, anemia, in 56 (60.9%, pre-eclampsia, in 56 (60.9%. In 59 of patients (64.1%, fetoplacental insufficiency was diagnosed, with predominance of strain or exhaustion reactions. Critical status of fetoplacental complex was found in pregnant patients with uncontrolled DTG and duration of control of less than 20 weeks, as well as in pregnant patients with DTG relapses. The values of main hormones (placental lactogen, α-fetoprotein and progesterone were below 10th percentile.According to the results of the ultrasound assessments, fetuses from mothers with DTG during gestation demonstrated decrease of the majority or percentile parameters, such as biparietal cranial size, fetal femoral length, abdomen diameter, that was especially prominent in the groups with relapsing DTG.Eighty eight of 94 newborns (93.6% were born full-term. In total, every third baby (29.3% had some degree of intrauterine developmental delay at birth. Among the cases with

  6. Breast Cancer Diagnosed During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients.

    Science.gov (United States)

    Loibl, Sibylle; Schmidt, André; Gentilini, Oreste; Kaufman, Bella; Kuhl, Christine; Denkert, Carsten; von Minckwitz, Gunter; Parokonnaya, Anastasia; Stensheim, Hanne; Thomssen, Christoph; van Calsteren, Kristel; Poortmans, Philip; Berveiller, Paul; Markert, Udo R; Amant, Frederic

    2015-11-01

    Breast cancer during pregnancy (BCP), although rare, is becoming more common and treatment should be as similar as possible to that for nonpregnant young patients with breast cancer. A group of specialists convened to review current guidelines and provide guidance on how recent advances in breast cancer diagnosis and treatment can be adapted for pregnant patients. The majority of patients with BCP will be considered for treatment during the pregnancy. Premature delivery should be avoided whenever possible. Most treatments, including sentinel lymph node biopsy, systemic therapy with taxanes, platinum agents, or dose-dense treatment can be safely given during pregnancy, after careful risk/benefit assessment for mother and child. Chemotherapy is contraindicated during the first trimester because of a higher risk of fetal malformations but is feasible in the second and third trimesters. Other treatments such as radiation therapy or anti-human epidermal growth receptor 2 treatment are in general not indicated during pregnancy but might be considered in some instances. Patient data should be collected in a systematic way whenever possible.

  7. Laparoscopy in the morbidly obese pregnant patient using a modified foley lap-lift technique: case report.

    Science.gov (United States)

    Chohan, Lubna; Ramirez, Mildred M; Martinez, Carla A; Kilpatrick, Charlie C

    2011-01-01

    Obesity in women of reproductive age is increasing. Gynecologic laparoscopy in the morbidly obese pregnant patient presents challenges, and is not often attempted. Herein is reported a successful case using a modified Foley lap-lift technique, which improved visualization and facilitated mechanical ventilation. Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.

  8. Pathways: Strategies for Susceptibility Genes in SLE

    Science.gov (United States)

    Kelley, James M.; Edberg, Jeffrey C.; Kimberly, Robert P.

    2010-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disorder marked by an inappropriate immune response to nuclear antigens. Recent whole genome association and more focused studies have revealed numerous genes implicated in this disease process, including ITGAM, Fc gamma receptors, complement components, C-reactive protein, and others. One common feature of these molecules is their involvement in the immune opsonins pathway and phagocytic clearing of nuclear antigens and apoptotic debris which provide excessive exposure of lupus-related antigens to immune cells. Analysis of gene-gene interactions in the opsonin pathway and its relationship to SLE may provide a systems-based approach to identify additional candidate genes associated with disease able to account for a larger part of lupus susceptibility. PMID:20144911

  9. Glucocorticoid use and abuse in SLE.

    Science.gov (United States)

    Ruiz-Irastorza, Guillermo; Danza, Alvaro; Khamashta, Munther

    2012-07-01

    Glucocorticoids (GCs) are potent anti-inflammatory and immunosuppressive agents. They act by two different mechanisms: the genomic and the non-genomic pathways. The genomic pathway is considered responsible for many adverse effects of GCs, most of them are time and dose dependent. Observational studies support a relationship between GCs and damage in SLE. GCs have been associated with the development of osteoporosis, osteonecrosis, cataracts, hyperglycaemia, coronary heart disease and cognitive impairment, among others. Although no clinical trial has compared high vs low doses of GCs, some studies have shown the efficacy of medium doses in severe forms of SLE. The dose below which treatment can be considered safe has not been defined, but daily doses <7.5 mg of prednisone seem to minimize adverse effects. Combination therapy with HCQ and the judicious use of immunosuppressive drugs help to keep prednisone therapy within those limits.

  10. Prenatal Radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

    Energy Technology Data Exchange (ETDEWEB)

    Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.; Hellman, S. [Dept of Radiation Physics, Faculty of Health Sciences, Linkoeping University, Linkoeping(Sweden); Helmrot, E. [Radiology Dept, County Hospital Ryhov, Joenkoeping (Sweden); Persliden, J. [Dept of Medical Physics, Oerebro Univ Hospital, Oerebro (Sweden); Cederlund, T. [Swedish Radiation Protection Authority, Stockholm (Sweden)

    2003-06-01

    Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has a right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data has shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% up to 0.14% per 10 mSv. In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy, and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period. The frequency of foetus exposure is not well documented. In Sweden, there are well-established routines to track down pregnant patients before examinations are being performed. However, there are no general obligations or routines to document the cases either (i) when

  11. Utility of the NavX® Electroanatomic Mapping System for Permanent Pacemaker Implantation in a Pregnant Patient with Chagas Disease

    Directory of Open Access Journals (Sweden)

    Alejandro Velasco, MD

    2013-01-01

    Full Text Available Chagas disease is a highly prevalent zoonosis in Mexico, Central, and South America. Early cardiac involvement is one of the most serious complications of this disease, and conduction disturbances may occur at an early age. We describe a young pregnant woman with Chagas disease and a high degree atrioventricular block, who required implantation of a permanent dual chamber pacemaker. Using an electroanatomic navigation EnSite NavX® system the pacemaker was successfully implanted with minimal fluoroscopic exposure. This case demonstrates the safety and feasibility of using an electroanatomic navigation system to guide permanent pacemaker implantation minimizing x-ray exposure in pregnant patients.

  12. Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom.

    Directory of Open Access Journals (Sweden)

    Ozbek S

    2003-08-01

    Full Text Available Despite the current diagnostic and serologic testing for SLE, the interval between the onset of symptoms and the diagnosis is still long. In this study, we aimed to show the interval between the initial symptoms and the diagnosis of SLE and to investigate the presence of any relationship between the interval and the initial symptoms. One hundred and thirty-six patients were diagnosed with SLE using the 1982 ARA criteria. The mean age of the patients at diagnosis was 29.9 +/- 10.5 years. The mean interval between the onset of symptoms and the diagnosis of SLE was 21.82 +/- 30.32 months. The subjects were evaluated twice, at intervals of < or = 3 and < or = 12 months after the onset of symptoms. Although arthritis and/or arthralgia were the most common initial symptoms (60.3%, only 26.8% of the patients with these symptoms were diagnosed earlier than 3 months after the onset. If the first initial symptoms were butterfly rash or pericarditis, pleuritis, spontaneous abortion or cognitive dysfunction, they led to early diagnosis. In conclusion, since arthritis and/or arthralgia are the most common initial symptoms of the disease, every young woman with these symptoms should be carefully evaluated for SLE.

  13. Sistemic Lupus Eritematosus (SLE) sedang dengan hipertiroid

    OpenAIRE

    Pase, M. Aron; Nasution, Melati Silvanni; Syafril, Santi; Lindarto, Dharma; Fiblia

    2016-01-01

    Sistem imun- neuroendokrin berpartisipasi pada patogenesis dan klinis dari penyakit autoimun salah satunya adalah penyakit SLE. Selama stimulasi inflamasi dan aktivitas penyakit aktif, terjadi interaksi secara jelas antara hipotalamic-pituitary-adrenal, hipotalmaic-pituitary gonadal, hipotalamic pituitary – thyroid dan prolactin dengan sistem imun. Hal ini yang menyebabkan respon abnormal dari sistem –imun- neuroendokrin dapat menyebabkan gangguan toleransi sel imun. Disfungsi tiroid sering d...

  14. Structural integration-based fascial release efficacy in systemic lupus erythematosus (SLE): two case studies.

    Science.gov (United States)

    Ball, Tanya M

    2011-04-01

    Auto-immune conditions such as Scleroderma and SLE induce fascial sclerosis and fibrosis, with related vascular, lymphatic, neural, joint, and visceral compression. Ensuing ischaemic pain, necrosis, autonomic and immune dysfunction in turn account for much of patients' pain, functional impairment, and psychological distress. Fascial Release Therapy (FRT) is a hands-on therapeutic model focused on restoring postural and functional integrity by addressing fascial imbalance, with hypothesized efficacy for SLE patients in: Two SLE patients who received FRT treatment along KMI® SI methodology, reported improvements to seven symptoms, namely: While 'spontaneous recovery' cannot be ruled out without controls, these anecdotal results support further, broader-based clinical research with stringent evaluation tools to enhance outcome validity. Therapeutic mechanisms may includefascial relaxation as key to decreasing myofascial pain; myofibroblast response to 'stress'; inter- and trans-fascial plane transfer of enhanced 'ease' and 'glide'. Psycho-neuro-immunological factors reversing adverse auto-immune response.

  15. CXCL13 Promotes Proliferation of Mesangial Cells by Combination with CXCR5 in SLE

    Science.gov (United States)

    You, Bo; Shan, Ying; Shi, Si

    2016-01-01

    As a CXC subtype member of the chemokine superfamily, CXCL13 is considered to be involved in systemic lupus erythematosus (SLE), especially in lupus nephritis (LN). To determine the effect of CXCL13 on SLE and explore the potential mechanisms, we tested serum concentrations of CXCL13 in patients and healthy individuals and found that CXCL13 expression was high in SLE patients especially in LN patients. When we treated human renal mesangial cells (HRMCs) in vitro with recombinant human CXCL13, the cell proliferation was accelerated, which was tested by Cell Counting Kit-8 assay and flow cytometry. Western blot and immunofluorescence assay revealed that CXCL13 would lead to phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2). However, the effect was weakened after the silence of CXCR5. The results of our study elaborated that high expression of CXCL13 could be involved in the pathogenesis of LN. PMID:27672667

  16. Management of full term pregnant patient with paroxysmal hypertension due to incidental pheochromocytoma

    Directory of Open Access Journals (Sweden)

    S. Sahu*

    2013-12-01

    Case Description: A 25-year-old, full-term pregnant woman diagnosed with pre-eclampsia was referred to our tertiary care hospital with severe resistant hypertension. Her blood pressure remained labile despite the usual medications, which led to the suspicion of an underlying endocrinological problem. Further biochemical and radiological investigations confirmed the diagnosis of pheochromocytoma. The patient was invasively monitored and treated with alpha blockade, beta blocker, and vasodilators in ICU. On the fifth day, she went into spontaneous labour with confirmed rupture of the membranes. The labour was augmented with intravenous oxytocin 2U in 500 ml solution of Ringer’s lactate. A nitro-glycerine basal infusion was started and titrated to control BP during labour to keep the blood pressure below 160/90 mmHg. An injection of Phentolamine drip and beta blocker esmolol was kept ready, to control the wide fluctuation of blood pressure. She delivered a live, healthy, male infant weighing 2.5 Kg. She was kept in the ICU for 72 h with epidural patient-controlled analgesia (EPCA. The patient was not keen for a resection of the adrenal tumour immediately after delivery. She was discharged with medical management, with a further plan for surgery in due course. With a multidisciplinary team approach (gynaecologist, anaesthesiologist, endocrinologist, and surgeon, proper planning, and adequate preoperative medical management; pheochromocytoma in pregnancy can be managed successfully.

  17. The use of laboratory tests in the diagnosis of SLE.

    Science.gov (United States)

    Egner, W

    2000-06-01

    ANA IIF is an effective screening assay in patients with clinical features of SLE and will detect most anti-ssDNA, anti-dsDNA, ENAs, and other autoantibodies. False positives are common. The clinical importance cannot be extrapolated from the ANA titre or pattern, although higher titres (> 1/160) are more likely to be important. HEp-2 cells are the most sensitive substrate for ANA detection, but this must be balanced against an increased incidence of insignificant positivity. ANA positive samples should be subjected to more specific assays for the diagnosis of SLE. A combination of ENA (Ro/La/Sm/RNP) and dsDNA assays will detect most patients with SLE as long as the characteristics of the assays used are well understood. ESR and CRP measurements provide useful additional information. Sjogren's syndrome and MCTD will produce overlapping serology with SLE, and anti-dsDNA titres are sometimes seen in autoimmune hepatitis and rheumatoid arthritis. All results should be reported in the light of the clinical details, by an experienced immunologist. A suggested diagnostic protocol is outlined in fig 1. The type of assay used crucially influences the predictive value of the tests. ELISA technology dominates routine laboratory practice, but tends to produce more false positive and true weak positive results, which may reduce the PPV of the test. This can be minimised by using IgG specific conjugates and careful assay validation. The NPV for SLE [figure: see text] is high for most assays but the PPV varies. Where necessary, laboratories should use crithidia or Farr dsDNA assays to confirm dubious ELISA dsDNA results, and ID/IB to confirm dubious ENA results. For monitoring, a precise, quantitative assay is required. It is unclear whether the detection of IgM or low affinity antibodies has a role here. A combination of anti-dsDNA, C3, C4, CRP, and ESR assays provides the most useful clinical information. Anti-ssDNA assays are likely to be useful, and are potentially more

  18. Expression of BAFF in the trophoblast and decidua of normal early pregnant women and patients with recurrent spontaneous miscarriage

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background BAFF,the B cell activation factor,is a member of the tumor necrosis factor(TNF)ligand family that binds to BCMA,TACI,and BAFF-R.Previous studies have shown that members of the TNF family are detected in human placental trophoblast cells,but the expression patterns of BAFF involved in human decidua and the differential expression of BAFF between normal pregnancy and miscarriage are still incompletely documented or unknown.This study was designed to investigate the expression of BAFF and BAFF-R in the trophoblast and decidua of normal early pregnant women and recurrent spontaneous abortion(RSA)patients.Methods Forty-five patients with RSA and 45 normal pregnant women were included in this study.By reverse transcriptase-polymerase chain reaction(RT-PCR),Western blotting and immunohistochemical experiments,we explored the expression of BAFF and BAFF-R in the maternal-fetal interface of normal early pregnant women and RSA patients.Results Analysis by RT-PCR and Western blotting revealed that BAFF was detected in both trophoblast and decidua of all the samples,and the expression level was higher in the tissues of normal early pregnant women(P<0.05)than that of recurrent spontaneous abortion patients under the same gestational weeks.Messages for BAFF-R were absent.Immunohistochemical experiments showed that expression of BAFF was cell-specific which was localized to villous cytotrophoblast and syncytiotrophoblast cells in trophoblast and to stromal cells in decidua.Whereas BAFF was prominent on the trophoblast and decidua of normal early pregnant women,it was decreased in the tissues of RSA patients.Conclusions BAFF might steer maternal leukocytes away from a harmful immune response and toward a favorable one and play a potentially vital role for successful pregnancy.

  19. Diagnostic significance of the radiologic appearances of the hands in systemic lupus erythematosus (SLE)

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, P.; Baenkler, H.W.; Pfuhl, E.; Gutmann, W.

    1980-09-01

    40 patients with SLE were assessed, the diagnoses being made according to modified ARA-criteria; the hand films of 25 of these patients were analysed. The most important roentgenologic findings consisted of reducible deformities with mild or absent articular changes in the deformed MCP and PIP joints. As these changes often occur late in the course of SLE, a primary radiological diagnosis was possible in only three cases (8%), whereas hand films provided confirmatory evidence of disease in a further seven patients. These roentgenological characteristics of SLE were found significantly less often in patients with definite RA; this group tended to have positive ANF (antinuclear factors). Antibodies against DNA may be absent, especially in a less active phase of disease. ANF is non-specific, and SLE simulates RA in 10-20% of cases. It is, therefore, very important in individual cases to consider the diagnosis of SLE in the presence of deformity without corresponding articular changes. Direct comparison of both the p.a. and oblique views is essential in the evaluation of reducible deformities, although this point has not been stressed in the literature. Reducible deformities may be overlooked in physical examination, when the patient gives no history of functional disability. The main differential diagnosis is Jaccoud's arthropathy, which is rarely seen in a general hospital. Most of these patients give a history of recurrent rheumatic fever, a minority complain about joint pain or disability, approximately 90% show signs indicating a valvular lesion of the heart, over 75% have a normal ESR and a positive rheumatoid or antinuclear factor is very rarely found. The distinction from SLE or rheumatoid arthritis is therefore easily established on additional non-radiological criteria.

  20. Safety of tacrolimus treatment during pregnancy and lactation in systemic lupus erythematosus: a report of two patients.

    Science.gov (United States)

    Izumi, Yasumori; Miyashita, Taiichiro; Migita, Kiyoshi

    2014-01-01

    Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects women of childbearing years. Pregnancy with SLE is associated with an increase risk of adverse maternal and fetal outcomes. Recently, tacrolimus has been used for steroid-resistant SLE. However, because of limited information regarding the use of immunosuppressants during pregnancy, many SLE patients give up pregnancy. We report two SLE patients receiving tacrolimus who hoped to become pregnant. Patient 1 was a 31-year-old woman diagnosed with SLE 6 years earlier and treated with tacrolimus for 3 years because her symptoms were not controlled with other immunosuppressants. Patient 2 was a 28-year-old woman diagnosed with SLE 13 years earlier and treated with tacrolimus for 3 years because her symptoms were not controlled with prednisolone alone. The medical ethics board in our hospital approved the use of tacrolimus during pregnancy and lactation, and informed consent was obtained from the patients. Both patients were well controlled during pregnancy with prednisolone (Patient 1: 12 mg/day and Patient 2: 10 mg/day) and tacrolimus therapy (3 mg/day). They had healthy newborns and continued breastfeeding with tacrolimus therapy. The blood concentrations of tacrolimus 12 hours after taking tacrolimus was 3.0 ng/ml in Patient 1 and 2.9 ng/ml in Patient 2, and their newborns' blood concentrations of tacrolimus 1 hour after breastfeeding were 0.2 ng/ml and 0.5 ng/ml, respectively. Both newborns are healthy for at least 3 years after birth. This is the first report on the safety of tacrolimus for pregnancy and lactation in patients with SLE.

  1. A RARE CASE: SLE WITH LIBMAN - SACKS ENDOCARDITIS

    Directory of Open Access Journals (Sweden)

    Chakrandhar Rao

    2015-01-01

    Full Text Available Libman - Sacks endocarditis is the characteristic cardiac manifestation of autoimmune disease Systemic Lupus Erythematosus. The condition most commonly involves the mitral and aortic valves, but all the four cardiac valves and the endocardial surfa ces can be involved 1 . Persons with Libman - Sacks endocarditis are usually asymptomatic., but become symptomatic due to cardiac failure, cerebrovascular embolism, systemic thromboembolism and secondary infective endocarditis. 2D Echocardiography should be pe rformed when it is suspected. With introduction of steroid therapy for SLE, improved longevity of patients appears to have changed the spectrum of valvular disease. Herewith, we are reporting a 35 year old female who presented at Department of General Medi cine, GGH, Guntur with seven day history of anasarca, shortness of breath, cough and fever of long duration. ECHO was suggestive of Libman - Sachs endocarditis and further investigations revealed SLE. On addition of steroids, there was good response and the patient was improving, but she had sudden cardio - respiratory arrest 5 days later.

  2. Evaluation on the diagnostic value of serum Cys-C, hs-CRP and urine mALB for early kidney functional injury in newly diagnosed SLE patients%血清胱抑素C、超敏CRP和尿微量白蛋白对初诊SLE患者早期肾功能损伤的诊断价值

    Institute of Scientific and Technical Information of China (English)

    任传路; 沈红石; 蒋天如; 高纯

    2012-01-01

    OBJECTIVE To explore the diagnostic value of serum Cys C, hs-CRP and urine mALB for early kidney functional injury in newly diagnosed systemic lupus erythematosus (SLE) patients. METHODS Sixty newly diagnosed SLE patinets and 30 healthy volunteers (HV) were divided into group SLE and group HV respectively. Serum Cys C, hs-CRP urine creatinine were detected by automatic chemistry analyzer and urine mALB by Imraunofluorometer equipment, then comparative analysis of test results were made. RESULTS The results of mALB/Cr, hs-CRP (mg/L) and Cys-Cin were (13.25 ± 4.26), (2.55 ± 0.85) mg/(g-Cr) , and (13.05 ± 4.85) in SLE group, respectively, and were (1.95 ± 0.88) mg/L; (4.15 ± 0.95) and (0.85 ± 0.20) mg/L in HV, respectively. The results above three in SLE group were significantly higher than those in HV (P < 0.001). The abnormal rate of hs-CRP+ Cys-C +mALB was 90% in all LN patients. CONCLUSION Combined detection of mAlb, hs-CRP and Cys-C may have guided significance of early diagnosis and predictions for kidney functional injury in SLE patients.%目的 探讨血清胱抑素C、超敏CRP和尿微量白蛋白对初诊系统性红斑狼疮(SLE)患者早期肾功能损伤的诊断价值.方法 分别将60例初诊SLE患者和30例健康志愿者分成SLE、HV两组;采用全自动生化仪检测各组研究对象血清超敏C反应蛋白(hs-CRP)、胱抑素C(Cys-C)和尿肌酐(Cr)水平,用免疫荧光分析仪测定尿微量白蛋白(mALB),分析各组检测结果.结果 SLE、HV两组的mALB/Cr、hs-CRP和Cys-C分别为:(13.25+4.26)、(2.55±0.85) /mg/(g·Cr); (13.05±4.85)、(1.95±0.88) mg/L; (4.15±0.95)、(0.85±0.20) mg/L. SLE组mALB/Cr、hs-CRP和Cys-C均高于HV组,差异有统计学意义(P<0.05);90%的SLE初诊患者hs-CRP+Cys-C+mALB联合检测异常.结论 联合测定mALB、hs-CRP、Cys-C可能有助于评判SLE患者早期肾功能损伤.

  3. Grand rounds from international lupus centres cardiac abnormalities in SLE : pancarditis

    NARCIS (Netherlands)

    Bijl, M; Brouwer, J; Kallenberg, GGM

    2000-01-01

    Many patients with systemic lupus erythematosus (SLE) develop cardiac manifestations during the course of their disease. Pericarditis is most commonly seen, with a reported prevalence of 60%. Myocardial involvement is present in only a minority of patients. In recent years, due to better noninvasive

  4. Interpersonal Nurse-Patient Relationship With a Young Schizophrenic Pregnant Woman

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    Renata Marques de Oliveira

    2016-12-01

    Full Text Available The objective of this study was to investigate elements of the personal and psychiatric history, as well as the challenges related to motherhood, of a young schizophrenic female, through person-centered therapeutic interaction. The investigation had an exploratory scope, undertaken in a teaching hospital and data were collected during nondirective interaction on the part of the nurse with a young schizophrenic woman who had been treated in the institution for 10 years. Thematic analysis of the content was undertaken, with emphasis on the nuclei of meaning, identification of the themes and definition of the categories. The patient, called L. in this study, was 30 years old, had a two-year-old child and was three months pregnant when data were collected. Her trajectory was characterized by doubts, fears and uncertainties. The episodes of hospitalization, the coexistence with other patients, and the medications promoted insight into the symptoms, and acceptance of the diagnosis. The main challenge was experiencing pregnancy and the puerperium concomitantly with the psychiatric treatment. The interpersonal relationship established evidenced that, the young woman felling understood and that her needs were attended, overcame several difficulties she had reported and felt fulfilled and integrated into her social environment.

  5. Acupuncture benefits a pregnant patient who has Bell's palsy: a case study.

    Science.gov (United States)

    Lei, Hong; Wang, Wei; Huang, Guangying

    2010-09-01

    Here we report the complete recovery from Bell's palsy (BP) of a 27-year-old woman, 27 weeks pregnant, after 2 weeks of acupuncture treatment. BP in pregnancy is an acute idiopathic peripheral facial paralysis of unknown etiology. Treatment and management have not been well evaluated or documented in the literature. The patient was exposed to wind and cold weather before the rapid onset of BP on December 26, 2008. She was treated with acupuncture without co-intervention. During the first week, needles were gently manipulated at local and distal acupoints to induce the qi sensation, and direct moxibustion with moxa sticks was performed at two points, Yangbai (GB14) and Dicang (ST4). During the second week, needles were manipulated without inducing the qi sensation, and moxibustion was performed as previously explained. To document progress, the patient was videotaped before, during, and after each treatment. Outcome assessments included the House-Brackmann facial nerve grading system (HBS), the Nottingham facial nerve grading system, and the Facial Disability Indexes (FDIP). Prior to treatment, her HBS was II, Nottingham was 50.88%, and FDIP was 90. After 2 weeks, her symptoms had disappeared, her face was restored to normal, HBS was I, Nottingham was 96.46%, and FDIP was 100. These results suggest that acupuncture may be a safe, alternative treatment for BP in pregnancy.

  6. Objective and Personalized Longitudinal Assessment of a Pregnant Patient with Post Severe Brain Trauma

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    Elizabeth B Torres

    2015-03-01

    Full Text Available Background: Following severe trauma to the brain (whether internally generated by seizures, tumors or externally caused by collision with or penetration of objects individuals may experience initial coma state followed by slow recovery and rehabilitation treatment. At present there is no objective biometric to track the daily progression of the person for extended periods of time.Objective: We introduce new analytical techniques to process data from physically wearable sensors and help track the longitudinal progression of motions and physiological states upon the brain trauma. Settings and Participant: The data used to illustrate the methods were collected at the hospital settings from a pregnant patient in coma state. The patient had brain trauma from a large debilitating seizure due to a large tumor in the right pre-frontal lobe.Main Measures: We registered the wrist motions and the surface-skin-temperature across several daily sessions in four consecutive months. A new statistical technique is introduced for personalized analyses of the rates of change of the stochastic signatures of these patterns.Results: We detected asymmetries in the wrists’ data that identified in the dominant limb critical points of change in physiological and motor control states. These patterns could blindly identify the time preceding the baby’s delivery by C-section when the patient systematically brought her dominant hand to her abdominal area. Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist’s micro-movements more systematically reliable and predictable than those of the non-dominant wrist.Conclusions: The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

  7. Preferential binding to Elk-1 by SLE-associated IL10 risk allele upregulates IL10 expression.

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    Daisuke Sakurai

    Full Text Available Immunoregulatory cytokine interleukin-10 (IL-10 is elevated in sera from patients with systemic lupus erythematosus (SLE correlating with disease activity. The established association of IL10 with SLE and other autoimmune diseases led us to fine map causal variant(s and to explore underlying mechanisms. We assessed 19 tag SNPs, covering the IL10 gene cluster including IL19, IL20 and IL24, for association with SLE in 15,533 case and control subjects from four ancestries. The previously reported IL10 variant, rs3024505 located at 1 kb downstream of IL10, exhibited the strongest association signal and was confirmed for association with SLE in European American (EA (P = 2.7×10⁻⁸, OR = 1.30, but not in non-EA ancestries. SNP imputation conducted in EA dataset identified three additional SLE-associated SNPs tagged by rs3024505 (rs3122605, rs3024493 and rs3024495 located at 9.2 kb upstream, intron 3 and 4 of IL10, respectively, and SLE-risk alleles of these SNPs were dose-dependently associated with elevated levels of IL10 mRNA in PBMCs and circulating IL-10 protein in SLE patients and controls. Using nuclear extracts of peripheral blood cells from SLE patients for electrophoretic mobility shift assays, we identified specific binding of transcription factor Elk-1 to oligodeoxynucleotides containing the risk (G allele of rs3122605, suggesting rs3122605 as the most likely causal variant regulating IL10 expression. Elk-1 is known to be activated by phosphorylation and nuclear localization to induce transcription. Of interest, phosphorylated Elk-1 (p-Elk-1 detected only in nuclear extracts of SLE PBMCs appeared to increase with disease activity. Co-expression levels of p-Elk-1 and IL-10 were elevated in SLE T, B cells and monocytes, associated with increased disease activity in SLE B cells, and were best downregulated by ERK inhibitor. Taken together, our data suggest that preferential binding of activated Elk-1 to the IL10 rs3122605-G allele

  8. Preferential binding to Elk-1 by SLE-associated IL10 risk allele upregulates IL10 expression.

    Directory of Open Access Journals (Sweden)

    Daisuke Sakurai

    Full Text Available Immunoregulatory cytokine interleukin-10 (IL-10 is elevated in sera from patients with systemic lupus erythematosus (SLE correlating with disease activity. The established association of IL10 with SLE and other autoimmune diseases led us to fine map causal variant(s and to explore underlying mechanisms. We assessed 19 tag SNPs, covering the IL10 gene cluster including IL19, IL20 and IL24, for association with SLE in 15,533 case and control subjects from four ancestries. The previously reported IL10 variant, rs3024505 located at 1 kb downstream of IL10, exhibited the strongest association signal and was confirmed for association with SLE in European American (EA (P = 2.7×10⁻⁸, OR = 1.30, but not in non-EA ancestries. SNP imputation conducted in EA dataset identified three additional SLE-associated SNPs tagged by rs3024505 (rs3122605, rs3024493 and rs3024495 located at 9.2 kb upstream, intron 3 and 4 of IL10, respectively, and SLE-risk alleles of these SNPs were dose-dependently associated with elevated levels of IL10 mRNA in PBMCs and circulating IL-10 protein in SLE patients and controls. Using nuclear extracts of peripheral blood cells from SLE patients for electrophoretic mobility shift assays, we identified specific binding of transcription factor Elk-1 to oligodeoxynucleotides containing the risk (G allele of rs3122605, suggesting rs3122605 as the most likely causal variant regulating IL10 expression. Elk-1 is known to be activated by phosphorylation and nuclear localization to induce transcription. Of interest, phosphorylated Elk-1 (p-Elk-1 detected only in nuclear extracts of SLE PBMCs appeared to increase with disease activity. Co-expression levels of p-Elk-1 and IL-10 were elevated in SLE T, B cells and monocytes, associated with increased disease activity in SLE B cells, and were best downregulated by ERK inhibitor. Taken together, our data suggest that preferential binding of activated Elk-1 to the IL10 rs3122605-G allele

  9. 联合检测AnuA、ANA、抗ds-DNA、ENA在SLE患者中的临床应用%Clinical Application of Combined Detection of AnuA,ANA,anti ds-DNA and anti-ENA in SLE Patients

    Institute of Scientific and Technical Information of China (English)

    罗媛

    2009-01-01

    目的 联合检测SLE患者的多种自身抗体,为临床诊疗提供依据.方法 免疫印迹法检测120例SLE患者AnuA、抗Sm、抗SSA、抗SSB、抗Rib,间接免疫荧光法(IIF)检测抗ds-DNA和ANA,60例健康体检者做为对照组.结果 SLE患者ANA、抗ds-DNA、AunA、抗Sm、抗SSA、抗SSB和抗Rib阳性率分别为69.2%、70.8%、74.2%、35.0%、42.5%、11.7%和26.7%.活动期ANA、抗ds-DNA和AunA阳性率分别为90.7%、98.1%和83.3%,非活动期分别为51.5%、48.5%和66.7%,三项指标差异均有统计学意义(P<0.01、P<0.01和P<0.05). 60例对照组各项检测结果均为阴性.结论 联合检测SLE多种自身抗体在提高SLE的诊断分型及疗效评价等方面具有重要意义.%Objective To combine detection of SLE patients with a variety of autoantibodies, provide a basis for clinical diagnose and treat-ment. Methods AnuA,anti-Sm,anti-SSA,anti-SSB and anti-Rib were determined by western blotting,and anti-ds-DNA and ANA were determined by indirect immunofluorescence(IIF) in 120 cases of SLE patients and 60 controls. Results The positive rates of ANA,anfi ds-DNA, AunA, anti-Sm, anti-SSA, anti-SSB and anti-Rib was 69.2%, 70.8%, 74.2%, 35%, 42.5%, 11.7% and 26.7% in SLE patients. The positive rates of ANA,anti ds-DNA and AunA was 90.7%,98.1% and 83.3% in patients with active stage of SLE. The positive rates of ANA, anti ds-DNA and AunA was 51.5%,48.5% and 66.7% in patients with inactive stage of SLE. Three indicators had statistically signitieance in active stage and inactive stage(P<0.01,P< 0.01 and P< 0.05). All of the test results of 60 controls were negative. Conclusion Combined detection of several autoantibody was important to diagnosis and curative evaluation in SLE.

  10. Aberrant Low Expression of A20 in Tumor Necrosis Factor-α-stimulated SLE Monocytes Mediates Sustained NF-κB Inflammatory Response.

    Science.gov (United States)

    Shi, Xiaowei; Qian, Tian; Li, Min; Chen, Fangru; Chen, Yan; Hao, Fei

    2015-01-01

    The aberrantly activated monocytes and nuclear factor-kappaB (NF-κB) pathway contribute to the pathogenesis of systemic lupus erythematosus (SLE), and the aberrantly activated NF-κB is associated with defects in the anti-inflammatory A20 in SLE. However, whether SLE monocytes express A20 and whether the A20 expression under sustained proinflammatory stimulation is altered to contribute to the uncontrolled NF-κB inflammatory response are unclear. In this study, we found that the freshly isolated monocytes from SLE patients and healthy controls did not differ in expression levels of IL-1β, IκBα and A20. After TNF-α stimulation for 48 h, the monocytes from both groups expressed higher levels of IL-1β and IκBα than the monocytes without TNF-α treatment. Although the increased levels of NF-κB were observed in the nucleus of both the SLE and control monocytes after 24 h of TNF-α stimulation, the enhancement in SLE monocytes was significantly more robust than in the control monocytes. In addition, while the p-IκBα level in healthy monocytes was increased, the p-IκBα level in SLE monocytes was slightly decreased after TNF-α stimulation. Interestingly, after TNF-α treatment, the A20 expression in SLE monocytes was not markedly altered compared with the untreated SLE monocytes; moreover, the SLE monocytes expressed significantly lower A20 than healthy monocytes with TNF-α treatment at each time point. Results in this study demonstrate that TNF-α activates a significant NF-κB inflammatory response in SLE monocytes, which is at least partially mediated by the aberrantly low expression of A20 upon TNF-α stimulation, contributing to the prolonged inflammatory response in SLE.

  11. CCSDS SLE Service Management: Real-World Use Cases

    Science.gov (United States)

    Barkley, Erik; Pechkam, Paul; Pietras, John; Quintela, Paula

    2006-01-01

    The purpose of this paper is to illustrate how the standard SLE-SM services can be applied to the operations of current TT&C providers. It begins with a brief overview of the scope and operating environment of the SLE-SM services, then describes several use cases in which SLE-SM services can be applied to existing operational situations. The paper also addresses how SLE-SM services can be adopted in an evolutionary fashion. The paper concludes with a brief identification of additions to SLE-SM that are under consideration to make SLE-SM applicable to an even broader range of network operations concepts, policies, and procedures.

  12. Depressive symptoms are prevalent in childhood-onset systemic lupus erythematosus (cSLE).

    Science.gov (United States)

    Kohut, S Ahola; Williams, T S; Jayanthikumar, J; Landolt-Marticorena, C; Lefebvre, A; Silverman, E; Levy, D M

    2013-06-01

    Depressive symptoms are common in adolescence and young adulthood; however, their prevalence in childhood-onset systemic lupus erythematosus (cSLE) is unknown. The objective of this study was to examine the prevalence of depressive symptoms and their association with disease characteristics in children, adolescents, and young adults with cSLE. A cross-sectional sample of patients with cSLE between 10 to 24 years old completed standardized depression inventories. Demographics and disease characteristics were collected. Total depression inventory scores reported were below standard cut-off values for depression. However, 26% (10/38) of children and adolescents, and 44% (seven of 16) of young adults had scores at or above established cut-offs for elevated depression symptoms. Physical symptoms of depression were endorsed most frequently. There were no differences in depressive symptoms by disease characteristics including disease duration, health-related quality of life inventory scores, antiphospholipid antibody status, and a history of renal involvement or neuropsychiatric SLE (NPSLE). However, two patients had a history of depression as an NPSLE manifestation of their SLE. In the children and adolescents, prednisone dose was associated with negative self-esteem (r = 0.37, p = 0.04) and somatic depressive symptoms (r = 0.39, p = 0.02), but we did not observe a significant association in the young adults. Depressive symptoms in cSLE are frequent, although similar to the high prevalence rates in the general population. Physical symptoms are most frequently endorsed. Further study will determine if serial evaluations are recommended for early detection in this at-risk population.

  13. Autoantibodies in SLE: Specificities, Isotypes and Receptors

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    Barbara Dema

    2016-01-01

    Full Text Available Systemic Lupus Erythematosus (SLE is characterized by a wide spectrum of auto-antibodies which recognize several cellular components. The production of these self-reactive antibodies fluctuates during the course of the disease and the involvement of different antibody-secreting cell populations are considered highly relevant for the disease pathogenesis. These cells are developed and stimulated through different ways leading to the secretion of a variety of isotypes, affinities and idiotypes. Each of them has a particular mechanism of action binding to a specific antigen and recognized by distinct receptors. The effector responses triggered lead to a chronic tissue inflammation. DsDNA autoantibodies are the most studied as well as the first in being characterized for its pathogenic role in Lupus nephritis. However, others are of growing interest since they have been associated with other organ-specific damage, such as anti-NMDAR antibodies in neuropsychiatric clinical manifestations or anti-β2GP1 antibodies in vascular symptomatology. In this review, we describe the different auto-antibodies reported to be involved in SLE. How autoantibody isotypes and affinity-binding to their antigen might result in different pathogenic responses is also discussed.

  14. CD86嵌合抗体对系统性红斑狼疮患者自身反应性B细胞的作用及影响研究%Effects of an anti-CD86 chimeric antibody (ch1D1) on autoreactive B lymphocytes isolated from pa-tients with SLE

    Institute of Scientific and Technical Information of China (English)

    刘玉华; 陈兆军; 韩杰; 潘峰; 鄢巨振; 张腊红; 郑小银; 刘杨

    2016-01-01

    目的:探讨CD86嵌合抗体ch1D1对系统性红斑狼疮( systemic lupus erythematosus, SLE)患者自身反应性B细胞的作用及影响。方法利用流式细胞术分析SLE患者B细胞表面CD86的表达水平及ch1D1对SLE患者CD4+T细胞活化的影响;利用磁珠法分选出健康志愿者和SLE患者外周血单个核细胞( PBMC)中的B细胞、NK细胞以及CD4+T细胞用于后续实验;利用LDH释放法检测ch1D1介导对SLE患者B细胞的抗体依赖的细胞介导的细胞毒作用( antibody dependent cell medi-ated cytotoxicity,ADCC)及补体依赖的细胞介导的细胞毒作用( complement dependent cell mediated cy-totoxicity,CDC),利用ELISA法检测ch1D1对SLE患者B细胞分泌自身抗体的影响,利用3H掺入法分析ch1D1对SLE患者CD4+T细胞增殖的影响。结果 SLE患者B细胞上CD80(68.08±14.28 vs 46.10±12.14,n=24,P<0.0001)和CD86(44.72±14.90 vs 13.99±10.74,n=24,P<0.0001)的表达水平显著高于健康志愿者,提示B细胞异常活化;与对照组相比,ch1D1能更有效介导对SLE患者B细胞的ADCC和CDC作用(P=0.0172,P=0.0388);活化的T细胞显著增强SLE患者B细胞产生自身抗体,ch1D1显著抑制了SLE患者自身抗体的分泌(P=0.0019);SLE患者CD4+T细胞活化和增殖水平显著高于健康志愿者,而ch1D1显著抑制 SLE患者 CD4+T细胞的增殖和活化( P=0.0024,P=0.0495)。结论 CD86嵌合抗体能更有效地介导对SLE患者自身反应性B细胞的ADCC和CDC作用,抑制其自身抗体的分泌,抑制自身反应性CD4+T细胞的增殖和活化,有望成为治疗SLE的新型免疫制剂。%Objective To investigate the effects of ch1D1, an anti-CD86 chimeric antibody, on autoreactive B lymphocytes isolated from patients with systemic lupus erythematosus ( SLE) . Methods Flow cytometry analysis was performed to measure the expression of CD86 on the surface of B cells isolated from patients with SLE and to analyze the effects of ch1D1 on the activation of CD4+T cells

  15. Influence of Atg5 mutation in SLE depends on functional IL-10 genotype.

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    Patricia López

    Full Text Available Increasing evidence supports the involvement of autophagy in the etiopathology of autoimmune diseases. Despite the identification of autophagy-related protein (Atg-5 as one of the susceptibility loci in systemic Lupus erythematosus (SLE, the consequences of the carriage of these mutations for patients remain unclear. The present work analyzed the association of Atg5 rs573775 single nucleotide polymorphism (SNP with SLE susceptibility, IFNα, TNFα and IL-10 serum levels, and clinical features, in 115 patients and 170 healthy individuals. Patients who where carriers of the rs573775 T* minor allele presented lower IFNα levels than those with the wild genotype, whereas the opposite result was detected for IL-10. Thus, since IL-10 production was regulated by rs1800896 polymorphisms, we evaluated the effect of this Atg5 mutation in genetically high and low IL-10 producers. Interestingly, we found that the rs573775 T* allele was a risk factor for SLE in carriers of the high IL-10 producer genotype, but not among genetically low producers. Moreover, IL-10 genotype influences SLE features in patients presenting the Atg5 mutated allele. Specifically, carriage of the rs573775 T* allele led to IL-10 upregulation, reduced IFNα and TNFα production and a low frequency of cytopenia in patients with the high IL-10 producer genotype, whereas patients with the same Atg5 allele that were low IL-10 producers presented reduced amounts of all these cytokines, had a lower prevalence of anti-dsDNA antibodies and the latest onset age. In conclusion, the Atg5 rs573775 T* allele seems to influence SLE susceptibility, cytokine production and disease features depending on other factors such as functional IL-10 genotype.

  16. Membrane-bound complement regulatory proteins as biomarkers and potential therapeutic targets for SLE.

    Science.gov (United States)

    Das, Nibhriti; Biswas, Bintili; Khera, Rohan

    2013-01-01

    For the last two decades, there had been remarkable advancement in understanding the role of complement regulatory proteins in autoimmune disorders and importance of complement inhibitors as therapeutics. Systemic lupus erythematosus is a prototype of systemic autoimmune disorders. The disease, though rare, is potentially fatal and afflicts women at their reproductive age. It is a complex disease with multiorgan involvement, and each patient presents with a different set of symptoms. The diagnosis is often difficult and is based on the diagnostic criteria set by the American Rheumatology Association. Presence of antinuclear antibodies and more specifically antidouble-stranded DNA indicates SLE. Since the disease is multifactorial and its phenotypes are highly heterogeneous, there is a need to identify multiple noninvasive biomarkers for SLE. Lack of validated biomarkers for SLE disease activity or response to treatment is a barrier to the efficient management of the disease, drug discovery, as well as development of new therapeutics. Recent studies with gene knockout mice have suggested that membrane-bound complement regulatory proteins (CRPs) may critically determine the sensitivity of host tissues to complement injury in autoimmune and inflammatory disorders. Case-controlled and followup studies carried out in our laboratory suggest an intimate relation between the level of DAF, MCP, CR1, and CD59 transcripts and the disease activity in SLE. Based on comparative evaluation of our data on these four membrane-bound complement regulatory proteins, we envisaged CR1 and MCP transcripts as putative noninvasive disease activity markers and the respective proteins as therapeutic targets for SLE. Following is a brief appraisal on membrane-bound complement regulatory proteins DAF, MCP, CR1, and CD59 as biomarkers and therapeutic targets for SLE.

  17. Optimizing anticancer drug treatment in pregnant cancer patients : pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel

    NARCIS (Netherlands)

    van Hasselt, J G C; van Calsteren, K; Heyns, L; Han, S; Mhallem Gziri, M; Schellens, J H M; Beijnen, J H; Huitema, A D R; Amant, F

    2014-01-01

    BACKGROUND: Pregnant patients with cancer are increasingly treated with anticancer drugs, although the specific impact of pregnancy-induced physiological changes on the pharmacokinetics (PK) of anticancer drugs and associated implications for optimal dose regimens remains unclear. Our objectives wer

  18. Optimizing anticancer drug treatment in pregnant cancer patients : pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel

    NARCIS (Netherlands)

    van Hasselt, J G C; van Calsteren, K; Heyns, L; Han, S; Mhallem Gziri, M; Schellens, J H M|info:eu-repo/dai/nl/073926272; Beijnen, J H|info:eu-repo/dai/nl/071919570; Huitema, A D R; Amant, F

    2014-01-01

    BACKGROUND: Pregnant patients with cancer are increasingly treated with anticancer drugs, although the specific impact of pregnancy-induced physiological changes on the pharmacokinetics (PK) of anticancer drugs and associated implications for optimal dose regimens remains unclear. Our objectives

  19. Optimizing anticancer drug treatment in pregnant cancer patients : pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel

    NARCIS (Netherlands)

    van Hasselt, J G C; van Calsteren, K; Heyns, L; Han, S; Mhallem Gziri, M; Schellens, J H M; Beijnen, J H; Huitema, A D R; Amant, F

    2014-01-01

    BACKGROUND: Pregnant patients with cancer are increasingly treated with anticancer drugs, although the specific impact of pregnancy-induced physiological changes on the pharmacokinetics (PK) of anticancer drugs and associated implications for optimal dose regimens remains unclear. Our objectives wer

  20. Case Report of S1Q3T3 Electrocardiographic Abnormality in a Pregnant Asthmatic Patient During Acute Bronchospasm

    Science.gov (United States)

    Arshad, Hafiza; Khan, Rana Rahel; Khaja, Misbahuddin

    2017-01-01

    Patient: Female, 33 Final Diagnosis: S1Q3T3 electrocardiographic abnormality in a pregnant asthmatic during acute bronchospasm Symptoms: Cough • shortness of breath Medication: — Clinical Procedure: EKG Specialty: Pulmonology Objective: Rare co-existance of disease or pathology Background: Asthma is the most common chronic pulmonary disease during pregnancy. Several previous reports have documented reversible electrocardiographic changes during severe acute asthma attacks, including tachycardia, P pulmonale, right bundle branch block, right axis deviation, and ST segment and T wave abnormalities. Case Report: We present the case of a pregnant patient with asthma exacerbation in which acute bronchospasm caused S1Q3T3 abnormality on an electrocardiogram (ECG). The complete workup of ECG findings of S1Q3T3 was negative and correlated with bronchospasm. The S1Q3T3 electrocardiographic abnormality can be seen in acute bronchospasm in pregnant women. The other causes like pulmonary embolism, pneumothorax, acute lung disease, cor pulmonale, and left posterior fascicular block were excluded. Conclusions: Asthma exacerbations are of considerable concern during pregnancy due to their adverse effect on the fetus, and optimization of asthma treatment during pregnancy is vital for achieving good outcomes. Prompt recognition of electrocardiographic abnormality and early treatment can prevent adverse perinatal outcomes. PMID:28144025

  1. Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery [v2; ref status: indexed, http://f1000r.es/5oo

    Directory of Open Access Journals (Sweden)

    Rashmi Vandse

    2015-07-01

    Full Text Available Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

  2. Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery [v2; ref status: indexed, http://f1000r.es/5oo

    OpenAIRE

    2015-01-01

    Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerat...

  3. ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia.

    Science.gov (United States)

    Zhao, Melissa

    2016-01-01

    Background. Systemic lupus erythematosus (SLE) is a chronic, inflammatory, connective tissue disease that commonly affects the joints and a variety of organs due to an overactivation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. Case Presentation. We report a case of atypical manifestation of SLE in a 53-year-old man who presented with neutropenic fever. Physical findings of interest included oral ulcers on the lower lip, a malar-like rash across the bridge of the nose, and a discoid-like rash on extensor surfaces of the elbows and knees. Labs include ANC ANA, ferritin 1237 ng/mL, low C3/C4, and positive direct Coombs' test. A thorough workup for infection and hematologic malignancy was negative. Two days after initiation of therapy with 25 mg IV solumedrol twice a day, the patient's daily fevers resolved. ANC drastically improved to 2000 after two weeks of steroid treatment. He was later found to have a high titer of anti-neutrophil antibodies. Discussion. Autoimmune leukopenia is a common presentation in SLE, occurring in 50-60% of patients. Severe autoimmune neutropenia is uncommon and may correlate with high anti-neutrophil antibody activity despite a negative ANA. As neutropenia is usually mild, there are currently no guidelines for therapy. For our patient, we started him on low dose IV solumedrol and found that he responded drastically to treatment. Given strongly positive nonspecific anti-neutrophil antibodies in the setting of a negative ANA noted in our patient, it is likely that there are other currently unknown antibodies associated with SLE which may correlate strongly with autoimmune neutropenia.

  4. SLE or hypothyroidism: who can triumph in cardiac tamponade?

    Science.gov (United States)

    Chaudhari, Sameer Sadashiv; Wankhedkar, Kashmira Pramod; Mushiyev, Savi

    2015-01-01

    A 36-year-old Hispanic woman with a history of systemic lupus erythaematosus (SLE) in remission presented with progressive dyspnoea, bilateral leg swelling and increasing fatigue with rapid weight gain over the past few months. Her physical examination showed mildly tender thyromegaly and pericardial rub. Investigations showed new onset marked hypothyroidism as well as an active lupus serology with echocardiogram confirming severe pericardial effusion and a tamponade phenomenon. Urgent pericardiocentesis relieved her acute symptoms, and prompt treatment with thyroxine replacement and immunosuppression for lupus disease was initiated. Pericardial fluid analysis remained negative for any malignancy and/or infection/s. The patient had a gradual and consistent improvement with this treatment. She was discharged and appeared to be clinically stable at subsequent follow-up visits. However, the case remained a diagnostic dilemma over whether the tamponade was being driven by hypothyroidism versus lupus, leaving us with an opportunity to explore further. PMID:25750217

  5. SLE or hypothyroidism: who can triumph in cardiac tamponade?

    Science.gov (United States)

    Chaudhari, Sameer Sadashiv; Wankhedkar, Kashmira Pramod; Mushiyev, Savi

    2015-03-06

    A 36-year-old Hispanic woman with a history of systemic lupus erythaematosus (SLE) in remission presented with progressive dyspnoea, bilateral leg swelling and increasing fatigue with rapid weight gain over the past few months. Her physical examination showed mildly tender thyromegaly and pericardial rub. Investigations showed new onset marked hypothyroidism as well as an active lupus serology with echocardiogram confirming severe pericardial effusion and a tamponade phenomenon. Urgent pericardiocentesis relieved her acute symptoms, and prompt treatment with thyroxine replacement and immunosuppression for lupus disease was initiated. Pericardial fluid analysis remained negative for any malignancy and/or infection/s. The patient had a gradual and consistent improvement with this treatment. She was discharged and appeared to be clinically stable at subsequent follow-up visits. However, the case remained a diagnostic dilemma over whether the tamponade was being driven by hypothyroidism versus lupus, leaving us with an opportunity to explore further.

  6. The Current Treatment for SLE Nephritis

    Directory of Open Access Journals (Sweden)

    Davut Akın

    2008-01-01

    Full Text Available Renal involvement in systemic lupus erythematosus (SLE is a serious and common complication of the disease that significantly worsens morbidity and mortality. However, the optimal treatment of lupus nephritis remains unclear. Treatment may be divided into immunologic and non-immunologic categories. Non-immunologic treatment consists of anti-hypertensive, anti-proteinüric, and anti-hyperlipidemic options. Immunologic treatment must be designed according to the classification by International Society of Nephrology/Renal Pathology Society (ISN/RPS in induction and remission topics. New regimens consisting mycophenolate are successful in induction and remission. The potential of other new therapeutic agents is discussed together with results of studies performed with commonly used drugs. As a conclusion, treatment must be based histological classification of ISN/RPS and individualized.

  7. Plasmatic levels of N-terminal pro-atrial natriuretic peptide in preeclamptic patients and healthy normotensive pregnant women.

    Science.gov (United States)

    Reyna-Villasmil, Eduardo; Mejia-Montilla, Jorly; Reyna-Villasmil, Nadia; Mayner-Tresol, Gabriel; Herrera-Moya, Pedro; Fernández-Ramírez, Andreina; Rondón-Tapía, Marta

    2017-08-31

    To compare plasma N-terminal pro-atrial natriuretic peptide concentrations in preeclamptic patients and healthy normotensive pregnant women. A cases-controls study was done with 180 patients at Hospital Central Dr. Urquinaona, Maracaibo, Venezuela, that included 90 preeclamptic patients (group A; cases) and 90 healthy normotensive pregnant women selected with the same age and body mass index similar to group A (group B; controls). Blood samples were collected one hour after admission and prior to administration of any medication in group A to determine plasma N-terminal pro-atrial natriuretic peptide and other laboratory parameters. Plasma N-terminal pro-atrial natriuretic peptide concentrations in group A (mean 1.01 [0.26] pg/mL) showed a significant difference when compared with patients in group B (mean 0.55 [0.07] pg/mL; P<.001]. There was no significant correlation with systolic and diastolic blood pressure values in preeclamptic patients (P=ns). A cut-off value of 0.66ng/mL had an area under the curve of 0.93, sensitivity of 87.8%, specificity of 83.3%, a positive predictive value of 84.0% and a negative predictive value of 87.2%, with a diagnostic accuracy of 85.6%. Preeclamptic patients have significantly higher concentrations of plasma N-terminal pro-atrial natriuretic peptide compared with healthy normotensive pregnant women, with high predictive values for diagnosis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  8. MHC associations with clinical and autoantibody manifestations in European SLE.

    Science.gov (United States)

    Morris, D L; Fernando, M M A; Taylor, K E; Chung, S A; Nititham, J; Alarcón-Riquelme, M E; Barcellos, L F; Behrens, T W; Cotsapas, C; Gaffney, P M; Graham, R R; Pons-Estel, B A; Gregersen, P K; Harley, J B; Hauser, S L; Hom, G; Langefeld, C D; Noble, J A; Rioux, J D; Seldin, M F; Vyse, T J; Criswell, L A

    2014-04-01

    Systemic lupus erythematosus (SLE) is a clinically heterogeneous disease affecting multiple organ systems and characterized by autoantibody formation to nuclear components. Although genetic variation within the major histocompatibility complex (MHC) is associated with SLE, its role in the development of clinical manifestations and autoantibody production is not well defined. We conducted a meta-analysis of four independent European SLE case collections for associations between SLE sub-phenotypes and MHC single-nucleotide polymorphism genotypes, human leukocyte antigen (HLA) alleles and variant HLA amino acids. Of the 11 American College of Rheumatology criteria and 7 autoantibody sub-phenotypes examined, anti-Ro/SSA and anti-La/SSB antibody subsets exhibited the highest number and most statistically significant associations. HLA-DRB1*03:01 was significantly associated with both sub-phenotypes. We found evidence of associations independent of MHC class II variants in the anti-Ro subset alone. Conditional analyses showed that anti-Ro and anti-La subsets are independently associated with HLA-DRB1*0301, and that the HLA-DRB1*03:01 association with SLE is largely but not completely driven by the association of this allele with these sub-phenotypes. Our results provide strong evidence for a multilevel risk model for HLA-DRB1*03:01 in SLE, where the association with anti-Ro and anti-La antibody-positive SLE is much stronger than SLE without these autoantibodies.

  9. ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia

    Directory of Open Access Journals (Sweden)

    Melissa Zhao

    2016-01-01

    Full Text Available Background. Systemic lupus erythematosus (SLE is a chronic, inflammatory, connective tissue disease that commonly affects the joints and a variety of organs due to an overactivation of the body’s immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. Case Presentation. We report a case of atypical manifestation of SLE in a 53-year-old man who presented with neutropenic fever. Physical findings of interest included oral ulcers on the lower lip, a malar-like rash across the bridge of the nose, and a discoid-like rash on extensor surfaces of the elbows and knees. Labs include ANC <100, weakly positive anti-dsDNA, negative ANA, ferritin 1237 ng/mL, low C3/C4, and positive direct Coombs’ test. A thorough workup for infection and hematologic malignancy was negative. Two days after initiation of therapy with 25 mg IV solumedrol twice a day, the patient’s daily fevers resolved. ANC drastically improved to 2000 after two weeks of steroid treatment. He was later found to have a high titer of anti-neutrophil antibodies. Discussion. Autoimmune leukopenia is a common presentation in SLE, occurring in 50–60% of patients. Severe autoimmune neutropenia is uncommon and may correlate with high anti-neutrophil antibody activity despite a negative ANA. As neutropenia is usually mild, there are currently no guidelines for therapy. For our patient, we started him on low dose IV solumedrol and found that he responded drastically to treatment. Given strongly positive nonspecific anti-neutrophil antibodies in the setting of a negative ANA noted in our patient, it is likely that there are other currently unknown antibodies associated with SLE which may correlate strongly with autoimmune neutropenia.

  10. Predictors of peripheral arterial disease in SLE change with patient’s age

    Science.gov (United States)

    Erdozain, Jose-Gabriel; Villar, Irama; Nieto, Javier; Ruiz-Arruza, Ioana

    2017-01-01

    Objective To analyse the differential influence of risk factors of peripheral artery disease (PAD) according to age in patients with SLE. Methods 216 patients from the Lupus-Cruces cohort were divided in three age groups: ≤34 years, 35–49 years and ≥50 years. A low ankle–brachial index defined PAD. Significant variables were identified by univariant and multivariant analysis in each age group. Results Different factors were identified in different age groups: antiphospholipid antibodies/antiphospholipid syndrome and glucocorticoids in patients ≤34 years; in patients 35–49 years old, hypertension was the only statistically significant predictor, although a trend was observed for fibrinogen levels; a trend was observed for hypercholesterolaemia in those ≥50 years. Conclusions Age may modulate the influence of risk factors for PAD in patients with SLE. PMID:28123770

  11. Postoperative monitoring in pregnant patients undergoing surgery for advanced malignancy in last trimester: How long is enough?

    Directory of Open Access Journals (Sweden)

    Arushi Gupta

    2014-01-01

    Full Text Available Surgery for advanced breast malignancy in the last trimester of pregnancy is uncommon. We present successful management of a 32-year-old woman, 30 weeks pregnant with stage 3 breast malignancy, for surgery followed by normal labor and chemotherapy. Surgery and intraoperative period were uneventful. Patient had uterine contractions 36 h postsurgery, which were managed timely with active interventions and tocolytics. Risk of premature labor following nonobstetric surgery in pregnant patients is estimated to be 8.3%, but majority of the studies have been carried out in second trimester following appendectomy. There is insufficient data in literature regarding the estimation and duration of persistence of risk of premature labor in these patients. No guidelines are available regarding how long they need to be monitored for premature labor. There is some evidence, although little that risk of premature labor persists for 7 days postsurgery. In the absence of convincing studies and guidelines, we recommend postoperative monitoring for at least 7 days in patients undergoing major surgeries for malignancies in last trimester. Multidisciplinary approach is required to manage these patients.

  12. The lupus susceptibility locus Sle1 facilitates the peripheral development and selection of anti-DNA B cells through impaired receptor editing.

    Science.gov (United States)

    Chang, Soog-Hee; Kim, Tae-Joo; Kim, Young-Joo; Liu, Yang; Min, So-Youn; Park, Min-Jung; Park, Hyun-Sil; Lee, Sun-Kyung; Nam, Ki-Hoan; Kim, Ho-Youn; Mohan, Chandra; Kim, Hang-Rae

    2014-06-15

    Systemic lupus erythematosus is characterized by the spontaneous production of IgG autoantibodies in patients and lupus-prone mice. In this study, we investigated the effect of the Sle1 lupus susceptibility locus on the peripheral development of 56R(+) anti-DNA transgenic B cells by tracking 56R(+) B cells in mice without (B6.56R) or with (B6.Sle1.56R) the Sle1 locus. Compared with B6.56R mice, B6.Sle1.56R mice exhibited increased class-switched IgG2a anti-DNA Abs in their serum, encoded by the transgene. Interestingly, within the spleen, Sle1 facilitated the development of these cells into clusters of IgG2a class-switched B cells juxtaposed to CD4(+) T cells within extrafollicular sites. Through sequence analysis of B cell hybridomas, we also found that B cells from B6.Sle1.56R mice are inefficient at Ig H and L chain editing. Thus, the Ig H chains in Sle1.56R(+) B cells are partnered more often with cationic L chains that facilitate DNA binding. Taken together, these findings indicate that the Sle1 lupus-susceptibility locus may facilitate the emergence of anti-DNA B cells by subduing BCR revision and possibly by shaping the extrafollicular development of effector B cells, although the precise molecular mechanisms await further study.

  13. Damage in the Multiethnic Malaysian Systemic Lupus Erythematosus (SLE) Cohort: Comparison with Other Cohorts Worldwide.

    Science.gov (United States)

    Shaharir, Syahrul Sazliyana; Hussein, Heselynn; Rajalingham, Sakthiswary; Mohamed Said, Mohd Shahrir; Abdul Gafor, Abdul Halim; Mohd, Rozita; Mustafar, Ruslinda

    2016-01-01

    Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease and despite the improvement in the survival in the past few decades, the morbidity due to disease damage remains significant. The objectives of this study were to investigate the disease damagepattern and determine the associated factors of damage in the multi-ethnic Malaysian SLE patients. We consecutively 424SLE patients who attended a consistent follow-up at the National University of Malaysia Medical Centre and Putrajaya Hospital were recruited. Disease damage was assessed using the SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index (SDI) scores. Information on their demographics and disease characteristics were obtained from the clinical record. Univariate analysis was performed and the best model of independent predictors of disease damage was determined by multivariate logistic regression analysis. A total of 182 patients (42.9%) had disease damage (SDI ≥1). A significantly higher number of Indian patients had disease/organ damage and they predominantly developed steroid-induced diabetes mellitus (SDM). Patients with corticosteroid-induced osteoporosis (CIOP) were more likely to be Malayswhile majority of patients who developed malignancy were Chinese (plupus (NPSLE), and antiphospholipid syndrome (APLS). Patients who had ever and early treatment with hydroxychloroquine(HCQ)were less likely to develop disease damage while more patients who had received oral prednisolone ≥1mg/kg daily over 2 weeks had disease damage (p<0.05). In conclusion, there were inter-ethnic differences in the damage pattern and risks among SLE patients.

  14. Damage in the Multiethnic Malaysian Systemic Lupus Erythematosus (SLE) Cohort: Comparison with Other Cohorts Worldwide

    Science.gov (United States)

    Shaharir, Syahrul Sazliyana; Hussein, Heselynn; Rajalingham, Sakthiswary; Mohamed Said, Mohd Shahrir; Abdul Gafor, Abdul Halim; Mohd, Rozita; Mustafar, Ruslinda

    2016-01-01

    Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease and despite the improvement in the survival in the past few decades, the morbidity due to disease damage remains significant. The objectives of this study were to investigate the disease damagepattern and determine the associated factors of damage in the multi-ethnic Malaysian SLE patients. We consecutively 424SLE patients who attended a consistent follow-up at the National University of Malaysia Medical Centre and Putrajaya Hospital were recruited. Disease damage was assessed using the SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index (SDI) scores. Information on their demographics and disease characteristics were obtained from the clinical record. Univariate analysis was performed and the best model of independent predictors of disease damage was determined by multivariate logistic regression analysis. A total of 182 patients (42.9%) had disease damage (SDI ≥1). A significantly higher number of Indian patients had disease/organ damage and they predominantly developed steroid-induced diabetes mellitus (SDM). Patients with corticosteroid-induced osteoporosis (CIOP) were more likely to be Malayswhile majority of patients who developed malignancy were Chinese (pantiphospholipid syndrome (APLS). Patients who had ever and early treatment with hydroxychloroquine(HCQ)were less likely to develop disease damage while more patients who had received oral prednisolone ≥1mg/kg daily over 2 weeks had disease damage (p<0.05). In conclusion, there were inter-ethnic differences in the damage pattern and risks among SLE patients. PMID:27846298

  15. Serum ferritin level correlates with SLEDAI scores and renal involvement in SLE.

    Science.gov (United States)

    Tripathy, R; Panda, A K; Das, B K

    2015-01-01

    Ferritin is an acute-phase reactant that is elevated in various autoimmune disorders. Serum ferritin levels have been positively correlated with disease activity scores of rheumatoid arthritis and systemic lupus erythematosus (SLE). Further, enhanced levels of ferritin have also been reported in lupus nephritis. However, there are no reports from the Indian subcontinent. Seventy-six female SLE patients, diagnosed on the basis of revised ACR criteria, and 50 healthy females, age matched from similar geographical areas, were enrolled in the present study. Serum levels of ferritin, IFN-α and IL-6 were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical, biochemical, serological and other markers of disease activity (C3, C4 and anti-dsDNA) were measured by standard laboratory procedure. Serum ferritin levels were significantly higher in SLE patients compared to healthy controls (p Ferritin levels positively correlated with SLE Disease Activity Index (SLEDAI) (p = 0.001, r = 0.35), anti-dsDNA (p = 0.001, r = 0.35), IFN-α (p serum levels of ferritin were positively associated with proteinuria (p = 0.001, r = 0.36), serum urea (p = 0.0004, r = 0.39) and serum creatinine (p = 0.0006, r = 0.38). Serum ferritin is an excellent marker of disease activity and renal dysfunction in SLE. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. A special radiation shielding for the radiotherapy of a pregnant patient; Eine Spezialabschirmung fuer die Strahlentherapie von Schwangeren

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    Buchgeister, M.; Mondry, A. [Bereich Medizinische Physik, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany); Spillner, P.; Paulsen, F.; Belka, C.; Bamberg, M. [Strahlentherapie, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany)

    2008-02-15

    Purpose: measurement of the radiation dose of different radiotherapy techniques with a phantom at the position of the uterus of a pregnant patient with and without a special radiation shielding. Material and methods: a special radiation shielding for the radiation therapy of a pregnant patient was constructed in the shape of a tunnel over the abdomen from 1 cm thick lead to reduce scatter radiation to the uterus and the fetus therein. The reduction of the scatter radiation to the lower abdomen was measured for three typical cases (cerebrum with lateral opposed fields, 6-MV photons; tangential fields for mamma irradiation, 6 MV; and anteroposterior-posteroanterior [AP-PA] opposed fields of 15 MV for treatment of the mediastinum) at an anthropomorphic Alderson phantom with thermoluminescence dosimeters in different depths and with an ionization chamber positioned in an RW3 solid water phantom. In the case of lateral opposed fields, a movable lead wall was additionally positioned next to the accelerator's head to reduce the scatter radiation from this source. Results: depending on the geometry of the radiation fields and on the photon energy, a reduction of the dose to the lower abdomen averaged over the depths of 6, 9, and 12 cm from 16% (15 MV, mediastinum case) to 51% (6 MV, cerebrum with additional lead wall) was achieved. The absolute scattered dose with shielding in place for a 2-Gy fraction dose results to 3.85 mGy and 0.27 mGy, respectively. Conclusion: national and international recommendations on the radiation dose to a fetus of a pregnant patient state limits of 200 mSv (DGMP report no. 7) and 100 mGy (ICRP 84), below which an abortion should not be considered and above which an indication for termination of the pregnancy could be given, respectively. The dose to the fetus can be kept below these limits with the shielding described in this work. Therefore, a radiation therapy of a pregnant patient is possible when these special precautions to reduce

  17. Monogenic forms of systemic lupus erythematosus: new insights into SLE pathogenesis

    Directory of Open Access Journals (Sweden)

    Belot Alexandre

    2012-08-01

    Full Text Available Abstract The pathogenesis of Systemic Lupus Erythematosus (SLE is complex and remains poorly understood. Infectious triggers, genetic background, immunological abnormalities and environmental factors are all supposed to interact for the disease development. Familial SLE as well as early-onset juvenile SLE studies make it possible to identify monogenic causes of SLE. Identification of these rare inherited conditions is of great interest to understand both SLE pathogenesis and molecular human tolerance mechanisms. Complement deficiencies, genetic overproduction of interferon-α and apoptosis defects are the main situations that can lead to monogenic SLE. Here, we review the different genes involved in monogenic SLE and highlight their importance in SLE pathogenesis.

  18. Pregnancy in patients with rheumatic diseases: obstetric management and monitoring.

    Science.gov (United States)

    Branch, D W

    2004-01-01

    The obstetric management of the pregnant rheumatic patient is largely dictated by the specific disease and the degree to which it is associated with recognizable and treatable adverse obstetric outcomes, maternal or fetal. This review will cover the obstetric management of women with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), rheumatoid arthritis (RA) and systemic sclerosis (SSc). Most experts agree that a co-ordinated management effort on the part of obstetricians and rheumatologists will likely yield the optimal achievable results.

  19. Targeting B cells for the treatment of SLE: the beginning of the end or the end of the beginning?

    Science.gov (United States)

    Calero, Ismael; Sanz, Iñaki

    2010-11-01

    Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease for which therapeutic advances in immunosuppressive and support therapy have significantly improved survival over the last 5 decades. Unfortunately, SLE still carries substantially increased rates of mortality and end stage renal disease which are even more elevated in younger patients. No new drugs have been approved for SLE in over 50 years. Hence, a lot of hope and excitement has been generated by the development of biological agents designed to eliminate B cells either through direct killing (anti-B cell antibodies such as rituximab) or attrition by inhibition of survival (anti-BLyS/BAFF agents such as belimumab). Indeed a strong rationale for targeting B cells in SLE is supported by the major pathogenic roles they play in SLE through both autoantibody production and multiple antibody-independent functions. These hopes, however, have been darted by the failure of two different phase III randomized placebo-controlled trials of rituximab. Yet, clinicians continue to use rituximab off-label with the belief that it provides significant benefit and can rescue patients with disease that is refractory to current modalities. Moreover, recent positive results of two large controlled trials of belimumab have restored confidence that B cell targeting may after all be of benefit in SLE. In this review we discuss the background and rationale for the use of anti-B cell agents in SLE, review the available results, and provide models that could help reconcile the opposing results observed in different studies. These models could also help frame the design and evaluation of current and future B cell therapies.

  20. Blimp-1在系统性红斑狼疮患者外周血B细胞中的表达和临床意义%The expression of Blimp-1 in peripheral blood B cells from patients with SLE and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    王曼茹; 孔菲菲; 厉小梅; 金莉; 方璇; 李向培; 汪国生; 钱龙

    2014-01-01

    Objective To detect the mRNA expression of B lymphocyte induced maturation protein-1 ( Blimp-1 ) in peripheral blood CD19 + B cells from patients with systemic lupus erythromatosus( SLE) and healthy people,and ex-plore its clinical significance. Methods Expression level of Blimp-1 mRNA in peripheral blood CD19 + B cells was determined by real-time PCR in 40 SLE patients and 20 healthy controls. The ratio of CD19 -CD138 + plasma cells and CD19 + B cells and the ratio of CD19 +CD27 -memory B cells and CD19 + Bcells were studied by flow cytometry in peripheral blood from two groups. Results ① The expression level of Blimp-1 mRNA in peripheral blood CD19 +B cells from SLE patients group was higher than that in normal control group(P0.05 ) .③The expression level of Blimp-1 was positively correlated with the CD19 -CD138 + plasma cells/CD19 + B cells ratio(rs=0.336,P=0.034),not correlated with the CD19 +CD27 -memory B cells/CD19 + B cells ratio(rs=-0.271,P=0.116),positively correlated with anti-dsDNA antibody and immunoglobulin G(rs =0.493,P =0.006;rs =0.527,P =0.004),positive correlated with anti-nucleosome antibody and anti-C1q antibody(rs =0.452,P =0.040;rs=0.522,P =0.015),negatively correlated with white blood cell count and platelet count(rs= -0.367,P=0.046;rs = -0.386,P=0.035). Conclusion Blimp-1 expression is up-regulated in SLE pa-tients and significantly correlated with plasma cells,which suggests that Blimp-1 might be involved in the pathogene-sis of SLE by promoting plasma cell differentiation.%目的检测系统性红斑狼疮( SLE)患者和健康者外周血CD19+ B细胞中B淋巴细胞诱导成熟蛋白-1(Blimp-1) mRNA的表达,并探讨Blimp-1在SLE的临床意义。方法应用实时荧光定量PCR技术检测40例SLE患者和20例健康者外周血CD19+ B细胞中Blimp-1 mRNA的表达水平,应用流式细胞术检测外周血中CD19-CD138+浆细胞/CD19+B细胞比例、CD19+CD27+记忆性B细胞/CD19+ B细胞比例,分析SLE患者Blimp-1表达与B

  1. Effect of sera from SLE patients on senescence of bone marrow-derived mesenchymal stem cells and its mechanism%SLE患者血清对骨髓间充质干细胞衰老的作用及机制研究

    Institute of Scientific and Technical Information of China (English)

    陈海凤; 姚根宏; 陈纬纬; 李霞; 冯学兵; 孙凌云

    2014-01-01

    目的:探讨系统性红斑狼疮( SLE)患者血清对间充质干细胞( MSC)衰老的作用及机制。方法:收集性别、年龄匹配6例健康对照者及6例SLE患者血清,灭活补体后-80℃保存备用;分离培养3例健康对照及3例SLE患者骨髓MSC,传代至第3~4代备用;以含10%SLE或对照血清的DMEM/F12模拟机体全身血液微环境,培养不同来源骨髓MSC;SA-β-gal染色并计数阳性细胞比例;Real time PCR法检测MSC p53、p21基因水平;Western blot法分别检测p53、p21蛋白及核蛋白NF-κB(p65)表达水平;CCK8测细胞增殖。结果:SLE患者血清增加健康人骨髓MSC的β-半乳糖苷酶阳性比例[(26.6±2.1)%vs (11.8±1.9)%,P<0.05],对SLE患者骨髓MSC的促进作用更为显著[(58.8±2.8)% vs.(31.2±2.2)%,P<0.05];SLE患者血清可同时上调健康对照及SLE患者骨髓MSC的p53及p21水平;SLE患者血清既能够抑制健康骨髓MSC增殖[(0.7±0.1) vs (1.1±0.1),P<0.01],又能抑制SLE患者骨髓MSC增殖能力[(0.5±0.2) vs (0.8±0.3),P<0.05]。此外,SLE患者血清还可显著上调两种来源骨髓MSC核内NF-κB( p65)的蛋白水平。结论:SLE患者血清能够促进骨髓MSC衰老,该过程可能与其胞内NF-κB信号通路的活化有关。%Objective:To explore whether sera from patients with systemic lupus erythematosus affect the senescence of MSCs, and which signaling pathway might be involved in.Methods: Human sera were collected from sex-matched,age-matched active SLE patients (n=6) and healthy volunteers (n=6).Then the complement was inactivated at 56℃ for 30 min.MSCs were cultured in DMEM/F12 containing 10% SLE or normal serum.Three days later MSCs were stained with SA-β-gal.The percentages of SA-β-gal positive cells were evaluated.The mRNA levels of p53 and p21 were detected by Real time PCR.The protein levels of p53/p21 and NF-κB ( p65) were examined by

  2. Hypercortisolism and pregnancy upregulate von Willebrand factor through different mechanisms: report on a pregnant patient with Cushing's syndrome.

    Science.gov (United States)

    Casonato, Alessandra; Daidone, Viviana; Pontara, Elena; Albiger, Nora; Cattini, Maria G; Scaroni, Carla

    2010-07-01

    Von Willebrand factor (VWF) is reportedly increased in pregnancy and Cushing's syndrome, inducing a hypercoagulable state. In Cushing's syndrome, VWF gene promoter polymorphisms modulate cortisol-dependent VWF upregulation, haplotype 1 (GCAG) and short GT-repeats (GT)(S) being the susceptible, and haplotype 2 (CTGA) and long GT-repeats (GT)(L) the protective pattern. We report on a Cushing's syndrome patient who became pregnant under hypercortisolism, in whom we monitored the evolution of her hypercoagulable state. During the active phase of Cushing's syndrome, the patient's VWF and factor VIII concentrations were normal, despite high urinary-free cortisol levels consistent with the presence of haplotype 2 and (GT)(L) alleles in the VWF gene promoter. VWF and factor VIII increased significantly and progressively after she became pregnant and peaked just before delivery, returning to normal 5 months later, while her hypercortisolism persisted. Our data indicate that two different mechanisms upregulate VWF under hypercortisolism and pregnancy, the latter being independent of the VWF promoter haplotypes sensitive to cortisol excess.

  3. Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy.

    Science.gov (United States)

    Shetti, Akshaya N; Dhulkhed, Vithal K; Gujarati, Amrish; Swetha, G S

    2014-01-01

    Non-obstetric diseases during pregnancy are not uncommon. The presence of systemic disease may further insult the pregnancy leading to alteration in the normal function of other system. Hence, it is important to treat the disease depending upon the severity and type of urgency. Several systemic diseases in pregnancy and management have been reported earlier but it is necessary to report a rare pathology, treatment option and its anesthetic management. We report anesthetic management of a rare case of pseudo pancreatic cyst in a pregnant lady operated for cysto-gastrostomy and also highlighting the recent guidelines for non-obstetric surgery in pregnancy.

  4. Heightened cleavage of Axl receptor tyrosine kinase by ADAM metalloproteases may contribute to disease pathogenesis in SLE.

    Science.gov (United States)

    Orme, Jacob J; Du, Yong; Vanarsa, Kamala; Mayeux, Jessica; Li, Li; Mutwally, Azza; Arriens, Cristina; Min, Soyoun; Hutcheson, Jack; Davis, Laurie S; Chong, Benjamin F; Satterthwaite, Anne B; Wu, Tianfu; Mohan, Chandra

    2016-08-01

    Systemic lupus erythematosus (SLE) is characterized by antibody-mediated chronic inflammation in the kidney, lung, skin, and other organs to cause inflammation and damage. Several inflammatory pathways are dysregulated in SLE, and understanding these pathways may improve diagnosis and treatment. In one such pathway, Axl tyrosine kinase receptor responds to Gas6 ligand to block inflammation in leukocytes. A soluble form of the Axl receptor ectodomain (sAxl) is elevated in serum from patients with SLE and lupus-prone mice. We hypothesized that sAxl in SLE serum originates from the surface of leukocytes and that the loss of leukocyte Axl contributes to the disease. We determined that macrophages and B cells are a source of sAxl in SLE and in lupus-prone mice. Shedding of the Axl ectodomain from the leukocytes of lupus-prone mice is mediated by the matrix metalloproteases ADAM10 and TACE (ADAM17). Loss of Axl from lupus-prone macrophages renders them unresponsive to Gas6-induced anti-inflammatory signaling in vitro. This phenotype is rescued by combined ADAM10/TACE inhibition. Mice with Axl-deficient macrophages develop worse disease than controls when challenged with anti-glomerular basement membrane (anti-GBM) sera in an induced model of nephritis. ADAM10 and TACE also mediate human SLE PBMC Axl cleavage. Collectively, these studies indicate that increased metalloprotease-mediated cleavage of leukocyte Axl may contribute to end organ disease in lupus. They further suggest dual ADAM10/TACE inhibition as a potential therapeutic modality in SLE.

  5. Association between killer cell immunoglobulin-like receptor (KIR) polymorphisms and systemic lupus erythematosus (SLE) in populations

    Science.gov (United States)

    Liang, Hui-ling; Ma, Shu-juan; Tan, Hong-zhuan

    2017-01-01

    Abstract Background: Recently, a growing number of studies show that the killer cell immunoglobulin-like receptor (KIR) gene polymorphisms may play a role in the systemic lupus erythematosus (SLE) susceptibility. Nonetheless, the results were inconsistent. Thus, a meta-analysis was carried out by integrating multiple research to clarify the association between KIR polymorphisms and SLE susceptibility. Methods: The Web of Science, Embase (Ovid), PubMed, Elsevier Science Direct, the Chinese Biomedical Database and CNKI, Wanfang databases (last search was updated on May 15, 2016) were systematically searched to select studies on addressing the association between the KIR polymorphisms and susceptibility to SLE in populations. The odds ratio (OR) with 95% confidence interval (95% CI) was calculated. Results: A total of 10 published case-control studies involving 1450 SLE patients and 1758 controls were available for this meta-analysis. Results suggested that KIR2DL1 might be a risk factor for SLE (OR 2DL1 =1.047, 95% CI=1.011–1.083) in all subjects. The KIR2DL3, KIR2DL5 were identified as protective factors for SLE in Asian populations (OR2DL3= 0.215, 95% CI = 0.077–0.598; OR2DL5 = 0.588, 95% CI = 0.393–0.881), but not in Caucasians. Conclusions: The meta-analysis results suggested that 2DL1 might be a potential risk factor and 2DL3, 2DL5 might be protective factors for SLE in Asians but not in Caucasians. PMID:28272205

  6. Optimizing outcome in SLE: treating-to-target and definition of treatment goals.

    Science.gov (United States)

    Doria, Andrea; Gatto, Mariele; Zen, Margherita; Iaccarino, Luca; Punzi, Leonardo

    2014-07-01

    Patients affected with systemic lupus erythematosus (SLE) display poor-long term prognosis and increased mortality in respect of general population. This may be due to continuous organ damage accrual which is fostered both by persistent disease activity (mainly in the short term) and prolonged corticosteroid exposure (mainly in the long term). The effort of defining novel therapeutic goals to which patients should be treated in order to have their prognosis improved is named treat-to-target. Remission in SLE was shown to be associated with better outcome and prolonged survival; in clinical practice, patients may experience either complete or clinical remission, which are defined as complete clinical/serological healing or no clinical signs of lupus with active serology, respectively. The main treat-to-target in SLE is complete remission, however since longitudinal observations suggest that clinical remission or low disease activity even with minimal corticosteroid intake do improve patients prognosis and survival as well, they may be assumed as acceptable alternative targets. Suitable therapeutic strategies have to be defined in order for these goals to be achieved including early diagnosis, effective treatment and proper corticosteroid tapering which in turn require development of more reliable serum biomarkers for early disease detection and less toxic targeted therapies with a steroid-sparing potential.

  7. Simulated learning environment (SLE) in audiology education: A systematic review.

    Science.gov (United States)

    Dzulkarnain, Ahmad Aidil Arafat; Wan Mhd Pandi, Wan Mahirah; Rahmat, Sarah; Zakaria, Nur 'Azzah

    2015-01-01

    To systematically review the relevant peer-review literature investigating the outcome of simulated learning environment (SLE) training in audiology education. A systematic review research design. Fifteen databases were searched with four studies meeting the inclusion criteria. Three of the four studies revealed positive findings for the use of an SLE (that is, the SLE group showed a higher post-training score compared to the traditional training group or a significantly higher post-training score than the non-training groups). One study revealed negative findings where the traditional training group showed a significantly higher post-training score than the SLE group. In addition, both the studies comparing post- and pre-training scores reported significantly higher post-training scores than the pre-training scores of the participants that underwent SLE training. Overall, this review supports the notions that SLE training is an effective learning tool and can be used for basic clinical training. This conclusion should be treated with caution, considering the limited numbers of studies published in this area and future research should be conducted to cope with the gaps highlighted in this review.

  8. [Pregnancy complications in a patient with systemic lupus erythematosus and lupus nephritis].

    Science.gov (United States)

    Bisgaard, Helene; Jacobsen, Søren; Tvede, Niels; Langhoff-Roos, Jens

    2014-07-14

    A woman with systemic lupus erythematosus (SLE) and lupus nephritis had two pregnancies which both resulted in complications known to be associated with SLE, i.e. late abortion, preterm delivery and pre-eclampsia. We conclude that disease quiescence is important for a successful outcome and that pregnant women with SLE should be followed in a multidisciplinary setting.

  9. Análise de sobrevida global e fatores de risco para óbito em 509 pacientes com Lúpus Eritematoso Sistêmico (LES Analysis of global survival and risk factors for death in 509 Systemic Lupus Erythematosus (SLE patients

    Directory of Open Access Journals (Sweden)

    Simone Appenzeller

    2004-06-01

    Full Text Available Estudos epidemiológicos com análise multivariada de fatores prognósticos em pacientes com lúpus eritematoso sistêmico (LES são fundamentais para avaliar a sobrevida e demonstrar estratégias de diagnóstico e tratamento. OBJETIVO: analisar os fatores de risco para a mortalidade em uma coorte de 509 pacientes com LES. MÉTODOS: os pacientes foram acompanhados em um hospital terciário, por um período de 27 anos (1974-2001, de acordo com um protocolo previamente padronizado. Inicialmente, foi realizada a análise de sobrevida global até o óbito dos 509 pacientes e, posteriormente, foi verificada a diferença entre as probabilidades de sobrevida global para pacientes com início da doença antes dos 16 anos e após os 16 anos. RESULTADOS: a taxa de sobrevida para os 509 pacientes com LES após 1, 5, 10 e 20 anos foram respectivamente de 96%, 88%, 80% e 75%. Os fatores prognósticos para o óbito dos pacientes com LES foram a ausência de artrite ao diagnóstico (p=0,007; OR=0,45; 95%IC= 0,25-0,8, a ausência do uso de antimaláricos (p=0,0001; OR=0,3; 95%IC=0,2-0,5, a presença de hipertensão arterial (p=0,002; OR=2,2; 95%IC=1,1-4,5, a presença de infecções (p=0,003; OR=2,3; 95%IC=1,3-4,1 e a idade ao diagnóstico menor que 16 anos (p=0,004; OR=2,6; 95%IC=1,4-5,0. CONCLUSÕES: este trabalho mostra uma excelente taxa de sobrevida nesta casuística de 509 pacientes com LES, observando-se proporção de pacientes que sobreviveram após 1, 5, 10 e 20 anos de seguimento, respectivamente, de 96%, 88%, 80% e 75%, comparável às maiores séries que tratam de sobrevida.Epidemiological studies using multivariate analysis of risk factors in Systemic Lupus Erythematosus (SLE patients are essential to determinate survival and to demonstrate diagnosis and treatment strategies. OBJECTIVE: To analyse the risk factors of mortality in 509 SLE patients who were followed over a 27-year period (from 1974 to 2001 according to a standard protocol in a

  10. [The course of recurrent urinary tract infections in non-pregnant women of childbearing age, the consequences for daily life and the ideas of the patients

    NARCIS (Netherlands)

    Groen, S.; Lagro-Janssen, A.L.M.

    2005-01-01

    OBJECTIVE: To investigate the natural history of recurrent urinary tract infections in women of childbearing age and to gain insight into their consequences and the ideas of the patients. DESIGN: Historical cohort-study and interviews with patients. METHOD: All non-pregnant women in the age-range 15

  11. [The course of recurrent urinary tract infections in non-pregnant women of childbearing age, the consequences for daily life and the ideas of the patients

    NARCIS (Netherlands)

    Groen, S.; Lagro-Janssen, A.L.M.

    2005-01-01

    OBJECTIVE: To investigate the natural history of recurrent urinary tract infections in women of childbearing age and to gain insight into their consequences and the ideas of the patients. DESIGN: Historical cohort-study and interviews with patients. METHOD: All non-pregnant women in the age-range

  12. Combination therapy with steroids and mizoribine in juvenile SLE: a randomized controlled trial.

    Science.gov (United States)

    Tanaka, Yuriko; Yoshikawa, Norishige; Hattori, Shinzaburo; Sasaki, Satoshi; Ando, Takashi; Ikeda, Masahiro; Honda, Masataka

    2010-05-01

    The initial treatment of childhood-onset systemic lupus erythematosus (SLE) is not standardized. Although corticosteroids are the first-line therapy for SLE, long-term, high-dose steroid therapy is associated with various side effects in children. The Japanese Study Group for Renal Disease in Children (JSRDC) has carried out a multi-center, randomized, controlled trial to evaluate the efficacy and safety of corticosteroid and mizoribine (MZB) therapy as an initial treatment for newly diagnosed juvenile SLE. Twenty-eight patients were treated with a combination steroid and MZB (4-5 mg/kg/day) (group S+M) drug therapeutic regimen, while 29 patients were treated with steroid only (group S); both groups were followed up for 1 year. The time to the first flare from treatment initiation was not significantly different between the two groups (Kaplan-Meier method, p = 0.09). During the period when the steroid was given daily (day 0-183), the time to the first flare from treatment initiation was significantly longer in the patients of group S+M than in those of group S (log-rank test, p = 0.02). At the end of the study period, there were no differences in the severity of proteinuria and renal function impairment between the two groups. No patients dropped out of the trial due to adverse events. In conclusion, our combined steroid and MZB drug therapeutic regimen was not shown to be significantly better than the steroid-only therapy as initial treatment for juvenile SLE. Whether MZB administered in a higher dose would be therapeutically advantageous can only be answered by further studies.

  13. Estimating rate of insulin resistance in patients with preeclampsia using HOMA-IR index and comparison with nonpreeclampsia pregnant women.

    Science.gov (United States)

    Abhari, Farideh Rezaei; Ghanbari Andarieh, Maryam; Farokhfar, Asadollah; Ahmady, Soleiman

    2014-01-01

    Women with preeclampsia, independent of obesity and glucose intolerance, exhibit insulin resistance during pregnancy. The purpose of the present study is to determine whether early diagnosis of insulin resistance during pregnancy can predict preeclampsia. Through a case-control study, 675 pregnant women were selected and their first trimester blood was taken. Their fasting blood glucose and insulin were also measured after diagnosis of preeclampsia by 20 weeks of pregnancy. Based on the experiments conducted on 675 women who were 20 weeks past their pregnancy, 375 cases with preeclampsia were selected and assigned to the case group. 35 other pregnant women were put in the control group. Diagnosis criteria for the participants included blood pressure above 140/90 and proteinuria above 300 mg or above +1. Both groups were matched according to age, parity, gestational age, and BMI. Homa-Irand rate of insulin resistance was calculated by HOMA-IR and patients were followed up. Homeostatic model assessments (HOMA-IR) revealed that the average insulin resistance increased during pregnancy among both the case and control groups. There was a significant difference between insulin resistance of these two groups in both first trimester and third trimester and after developing preeclampsia (P insulin resistance in first trimester may be useful in predicting the risk of preeclampsia.

  14. Subcutaneous NPH Insulin for Severe Hypertriglyceridemia in a Pregnant Patient with Type V Hyperlipoproteinemia: a Case Report

    Directory of Open Access Journals (Sweden)

    Mustafa Kemal Balcı

    2012-06-01

    Full Text Available An increase in triglyceride levels in familial hyperlipidemia during pregnancy has been reported. Severe hypertriglyceridemia can lead to complications such as acute pancreatitis, preeclampsia, maternal and fetal complications. Because of the teratogenic effects associated with fibrate therapy in pregnancy, alternative treatment strategies such as insulin as a rapid and potent activator of lipoprotein lipase are required during pregnancy. We report a case of hypertriglyceridemia in a 33-year-old pregnant woman in whom treatment with merely single one time administration of Neutral Protamine Hagedorn insulin was accompanied by a reduction in the serum triglyceride level; to the best of our knowledge, this has never been reported in the literature. Her triglyceride level was 3616 mg/dL before insulin treatment and 1246 mg/dL after insulin treatment. Although this regimen was used safely and effectively in our patient, comprehensive studies are required to evaluate the effectiveness and safety of subcutaneously intermediate-acting Neutral Protamine Hagedorn insulin for the treatment of severe hypertriglyceridemia in non-diabetic pregnant women.

  15. Understanding and Managing Pregnancy in Patients with Lupus

    Directory of Open Access Journals (Sweden)

    Guilherme Ramires de Jesus

    2015-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a chronic, multisystemic autoimmune disease that occurs predominantly in women of fertile age. The association of SLE and pregnancy, mainly with active disease and especially with nephritis, has poorer pregnancy outcomes, with increased frequency of preeclampsia, fetal loss, prematurity, growth restriction, and newborns small for gestational age. Therefore, SLE pregnancies are considered high risk condition, should be monitored frequently during pregnancy and delivery should occur in a controlled setting. Pregnancy induces dramatic immune and neuroendocrine changes in the maternal body in order to protect the fetus from immunologic attack and these modifications can be affected by SLE. The risk of flares depends on the level of maternal disease activity in the 6–12 months before conception and is higher in women with repeated flares before conception, in those who discontinue useful medications and in women with active glomerulonephritis at conception. It is a challenge to differentiate lupus nephritis from preeclampsia and, in this context, the angiogenic and antiangiogenic cytokines are promising. Prenatal care of pregnant patients with SLE requires close collaboration between rheumatologist and obstetrician. Planning pregnancy is essential to increase the probability of successful pregnancies.

  16. Detection and significance of CD4+ CD25+ CD127low/-Treg cells in patients with SLE%系统性红斑狼疮患者外周血CD4+CD25+CD127low/-调节性T细胞的检测及意义

    Institute of Scientific and Technical Information of China (English)

    韦月梅; 邹洪才; 崔俊; 孔建忠; 田安国; 葛建英

    2013-01-01

    Objective To investigate the feasibility of application of CD4+ CD25+ CD127low/- as an Treg cells new marker in patients with systemic lupus erythematosus (SLE). Methods The proportions of CD4+CD25+CD127low-/and CD4+CD25+ FoxP3+Treg cells in peripheral blood of SLE patients(group A) and healthy people(group B) were determined by flow cytometry. The correlation between CD4+ CD25+ CD127low/- Treg cells and CD4+ CD25+ FoxP3+ Treg cells was analyzed. Results The proportions of CD4+CD25+CD127low/- Treg cells and CD4+ CD25+ FoxP3+Treg cells in group A were significantly lower than those in group B [(3. 31 + 0. 82)% and (2. 28 + 0. 47)% vs. (6. 07 + 1. 59)% and (5. 01 + 1. 09)%](P<0. 01). The proportion of CD4+ CD25+ CD127 low/- Treg cells was positively correlated to that of CD4+ CD25+ FoxP3+ T cells in both groups(r=0. 713 and r=0. 709, P<0. 01). Conclusion The surface marker CD4+ CD25+ CD127low/- can be used to identify Treg cells. The decreases of CD4+CD25+CD127low/- Treg cells may play an important role in the pathogenesis of SLE.%目的 探讨用膜表面标志CD4+ CD25+ CD127low/-作为检测调节性T(Treg)细胞标记的可行性,并探讨其在系统性红斑狼疮(SLE)中的临床意义.方法 用流式细胞术检测SLE组及健康对照组外周血CD4+ CD25+ CD127low/-Treg细胞及CD4+ CD25+ FoxP3+ Treg细胞的比例,并分析两组CD4+ CD25+ CD127low/-Treg细胞与CD4+ CD25+ FoxP3+ Treg细胞比例之间的相关性.结果 SLE组外周血CD4+ CD25+ CD127low/-Treg细胞比例为(3.31±0.82)%CD4+ CD25+ FoxP3+ Treg细胞比例为(2.28±0.47)%,均显著低于健康对照组的(6.07±1.59)%和(5.01±1.09)%(P<0.01).SLE组及健康对照组外周血CD4+ CD25+ CD127low/-Treg细胞比例与CD4+ CD25+FoxP3+ Treg细胞比例之间呈显著正相关(r=0.713、r=0.709,P<0.01).结论 膜表面标志CD4+ CD25+ CD127low/-可以用来鉴定Treg细胞;SLE患者外周血CD4+ CD25+ CD127low/-Treg细胞的显著减少可能与SLE的发病有关.

  17. Multi-User Space Link Extension (SLE) System

    Science.gov (United States)

    Perkins, Toby

    2013-01-01

    The Multi-User Space (MUS) Link Extension system, a software and data system, provides Space Link Extension (SLE) users with three space data transfer services in timely, complete, and offline modes as applicable according to standards defined by the Consultative Committee for Space Data Systems (CCSDS). MUS radically reduces the schedule, cost, and risk of implementing a new SLE user system, minimizes operating costs with a lights-out approach to SLE, and is designed to require no sustaining engineering expense during its lifetime unless changes in the CCSDS SLE standards, combined with new provider implementations, force changes. No software modification to MUS needs to be made to support a new mission. Any systems engineer with Linux experience can begin testing SLE user service instances with MUS starting from a personal computer (PC) within five days. For flight operators, MUS provides a familiar-looking Web page for entering SLE configuration data received from SLE. Operators can also use the Web page to back up a space mission's entire set of up to approximately 500 SLE service instances in less than five seconds, or to restore or transfer from another system the same amount of data from a MUS backup file in about the same amount of time. Missions operate each MUS SLE service instance independently by sending it MUS directives, which are legible, plain ASCII strings. MUS directives are usually (but not necessarily) sent through a TCP-IP (Transmission Control Protocol Internet Protocol) socket from a MOC (Mission Operations Center) or POCC (Payload Operations Control Center) system, under scripted control, during "lights-out" spacecraft operation. MUS permits the flight operations team to configure independently each of its data interfaces; not only commands and telemetry, but also MUS status messages to the MOC. Interfaces can use single- or multiple-client TCP/IP server sockets, TCP/IP client sockets, temporary disk files, the system log, or standard in

  18. Medical genetics, public understanding and patient experiences: An exploratory qualitative study of recently pregnant women

    Science.gov (United States)

    Garman, Jamie L.

    The purpose of the study was to document how individuals' experiences and understanding of genetics concepts affects their medical experiences. Recently pregnant women were interviewed because they represent a population that needs to comprehend biological and genetic information to understand their health. Three women were designated as science experts (SE) defined as having extensive university level science education and three women were designated as science non-experts (SNE). In general, SEs described a more positive pregnancy experience. Both SEs and SNEs demonstrated a basic understanding of genetic concepts but varied in the application of concepts to personal medical issues. Participants' views and experiences of pre and postnatal tests were linked to their understanding of nature of science components such as recognition that tests have limitations. Results from this study indicate an incomplete understanding of the nature of science among participants may have led to unsatisfactory medical experiences.

  19. Prevalence, risk factors, and molecular epidemiology of hepatitis B and hepatitis delta virus in pregnant women and in patients in Mauritania.

    Science.gov (United States)

    Mansour, Wael; Malick, F-Zahra Fall; Sidiya, Ahmad; Ishagh, Elkhalil; Chekaraou, Mariama Abdou; Veillon, Pascal; Ducancelle, Alexandra; Brichler, Ségolène; Le Gal, Frédéric; Lo, Baidy; Gordien, Emmanuel; Lunel-Fabiani, Françoise

    2012-08-01

    No recent data are available on hepatitis B virus (HBV) and hepatitis Delta virus (HDV) prevalence in Mauritania. One thousand twenty pregnant women and 946 patients visiting for routine checkups were screened for HBV and HDV infection. Demographic, epidemiological, ethnic, clinical, and biological data were recorded. HBV and HDV genotypes were determined by sequencing and phylogenetic analyses. In the pregnant women and patients cohorts, respectively, the prevalence of HBsAg (10.7% and 18.3%) and anti-HBcAb (66.3% and 76.5%) indicated high HBV endemicity. In pregnant women, exposure to HBV was significantly associated in multivariate analysis with education level, ethnicity, blood transfusion, and occupation. HDV antibodies (HDVAb) were found in 14.7% of pregnant women. In patients, HBsAg was found less frequently in females than in males. Again in multivariate analysis, exposure to HBV was significantly correlated with gender (males), and HDVAb positivity with age and gender. The HBV DNA viral load was >3 log IU/ml in only 10.1% of pregnant women and in 17.3% of patients. HDV-RNA was detectable in 21 (67.7%) of the 31 patients positive for HDVAb, and in 11 of the 16 pregnant women positive for HDVAb (68.8%). The most frequent HBV genotypes were: HBV/D, 53%; HBV/E, 35%; and HBV/A, 12%. Sub-genotyping revealed HBV/D1,/D7, and the recently described/D8. HDV genotypes were: HDV-1, 90.3% and HDV-5, 9.7%. This study confirms the high prevalence of HBV and HDV infections in Mauritania and demonstrates the high genetic diversity of HBV in this country. Copyright © 2012 Wiley Periodicals, Inc.

  20. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  1. Depression with psychotic features in a child with SLE: successful therapy with psychotropic medications--case report.

    Science.gov (United States)

    Milovancevic, Milica Pejovic; Miletic, Vladimir; Deusic, Smiljka Popovic; Gajic, Saveta Draganic; Tosevski, Dusica Lecic

    2013-04-01

    Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune disease of unknown etiology, which affects multiple organ systems, including the central nervous system (CNS). Neuropsychiatric manifestations are seen in 13-75% of all SLE patients, with equal frequency in children and adults. Despite a high prevalence of psychiatric manifestations, there is no consensus on the proper treatment of such cases. We report here a case of an 11-year-old girl diagnosed with a severe depressive episode with psychotic features, treated successfully with risperidone and sertraline as an adjunct to immunosuppressive therapy.

  2. Toxocara seroprevalence among clinically healthy individuals, pregnant women and psychiatric patients and associated risk factors in Shandong Province, Eastern China.

    Directory of Open Access Journals (Sweden)

    Wei Cong

    2014-08-01

    Full Text Available Toxocarosis is a widespread zoonosis caused by the ascarid nematodes Toxocara canis and Toxocara cati, which primarily infect dogs and cats, respectively. Most human infections with Toxocara are asymptomatic; however, some infected individuals may develop a serious illness and even death. Nevertheless, epidemiological knowledge regarding the prevalence and risks associated with Toxocara infection is limited in China. Therefore, we performed a cross-sectional pilot study and estimated the seroprevalence of Toxocara infection in humans in Shandong Province, eastern China for the first time, from June 2011 to July 2013, involving clinically healthy individuals, pregnant women and psychiatric patients, aiming to attract public attention to Toxocara infection.Seroprevalence of Toxocara was determined using an enzyme-linked immunosorbent assay based on a cross-sectional study conducted in Qingdao and Weihai, Shandong Province, eastern China. Factors potentially associated with Toxocara infection were identified by logistic regression analysis. The overall Toxocara seroprevalence among the study population (n = 2866 was 12.25%, and a significantly higher seroprevalence in psychiatric patients (16.40%, 73/445 than that in clinically healthy individuals (13.07%, 187/1431 and pregnant women (9.19%, 91/990 was revealed. Univariate analyses suggested that keeping dogs at home (OR = 0.06, 95% CI 0.05-0.08, P<0.001, contact with cats and dogs (OR = 0.42, 95% CI 0.33-0.53, P<0.001 and exposure with soil (OR = 0.37, 95% CI 0.28-0.49, P<0.001 were risk factors associated with Toxocara infection.The present study revealed, for the first time, that human infection with Toxocara is common in eastern China, posing a significant public health concern. Increasing human and dog populations, population movements and climate change all will serve to increase the importance of this zoonosis. Further studies under controlled conditions are necessary to define potential

  3. The multifaceted balance of TNF-α and type I/II interferon responses in SLE and RA: how monocytes manage the impact of cytokines.

    Science.gov (United States)

    Smiljanovic, Biljana; Grün, Joachim R; Biesen, Robert; Schulte-Wrede, Ursula; Baumgrass, Ria; Stuhlmüller, Bruno; Maslinski, Wlodzimierz; Hiepe, Falk; Burmester, Gerd-R; Radbruch, Andreas; Häupl, Thomas; Grützkau, Andreas

    2012-11-01

    Many cytokines are involved in the pathogenesis of autoimmune diseases and are recognized as relevant therapeutic targets to attenuate inflammation, such as tumor necrosis factor (TNF)-α in rheumatoid arthritis (RA) and interferon (IFN)-α/γ in systemic lupus erythematosus (SLE). To relate the transcriptional imprinting of cytokines in a cell type- and disease-specific manner, we generated gene expression profiles from peripheral monocytes of SLE and RA patients and compared them to in vitro-generated signatures induced by TNF-α, IFN-α2a, and IFN-γ. Monocytes from SLE and RA patients revealed disease-specific gene expression profiles. In vitro-generated signatures induced by IFN-α2a and IFN-γ showed similar profiles that only partially overlapped with those induced by TNF-α. Comparisons between disease-specific and in vitro-generated signatures identified cytokine-regulated genes in SLE and RA with qualitative and quantitative differences. The IFN responses in SLE and RA were found to be regulated in a STAT1-dependent and STAT1-independent manner, respectively. Similarly, genes recognized as TNF-α regulated were clearly distinguishable between RA and SLE patients. While the activity of SLE monocytes was mainly driven by IFN, the activity from RA monocytes showed a dominance of TNF-α that was characterized by STAT1 down-regulation. The responses to specific cytokines were revealed to be disease-dependent and reflected the interplay of cytokines within various inflammatory milieus. This study has demonstrated that monocytes from RA and SLE patients exhibit disease-specific gene expression profiles, which can be molecularly dissected when compared with in vitro-generated cytokine signatures. The results suggest that an assessment of cytokine-response status in monocytes may be helpful for improvement of diagnosis and selection of the best cytokine target for therapeutic intervention.

  4. When one drug affects 2 patients: a review of medication for the management of nonlabor-related pain, sedation, infection, and hypertension in the hospitalized pregnant patient.

    Science.gov (United States)

    Bulloch, Marilyn N; Carroll, Dana G

    2012-06-01

    One of the most difficult challenges health care providers encounter is drug selection for pregnant patients. Drug selection can be complex as efficacy and maternal side effects must be weighed against potential risk to the embryo or fetus. Verification of an individual drug's fetal safety is limited as most evidence is deduced from epidemiologic, prospective cohort, or case-control studies. Medication selection for the pregnant inpatient is a particularly complex task as the illnesses and conditions that require hospitalization mandate different medications, and the risk versus benefit ratio can vary significantly compared to the outpatient setting. Some degree of acute pain is not uncommon among inpatients. Acetaminophen is generally considered the drug of choice in pregnancy for mild to moderate acute pain, while most opioids are thought to be safe for short-term use to manage moderate to severe pain. Providing sedation is particularly challenging as the few options available for the general population are further limited by either known increased risk of congenital malformations or very limited human pregnancy data. Propofol is the only agent recommended for continuous sedation, which has a Food and Drug Administration classification as a pregnancy category B medication. Treatment of infections in hospitalized patients requires balancing the microbiology profile against the fetal risk. Older antimicrobials proven generally safe include beta-lactams, and those with proven fetal risks include tetracyclines. However, little to no information regarding gestational use is available on the newer antimicrobials that are frequently employed to treat resistant infections more commonly found in the inpatient setting. Management of maternal blood pressure is based on the severity of blood pressure elevations and not the hypertensive classification. Agents generally considered safe to use in hypertensive pregnant patients include methyldopa, labetolol, and hydralazine

  5. Effects of Sera from Patients with SLE on ICAM - 1 and MCP- 1 Expression in HUVEC and Fluvastatin Intervention%SLE患者血清对人脐静脉内皮细胞ICAM-1和MCP-1表达的影响及氟伐他汀的干预作用

    Institute of Scientific and Technical Information of China (English)

    梁倩; 李霞; 刘伏友; 刘虹; 许向青; 彭佑铭

    2009-01-01

    Objective: To investigate the effect of ANA- positive and anti - dsDNA antibody - positive sera from patients with SLE on intercellular adhesion molecule - 1 ( ICAM - 1 ) and monocyte chemoattractant protein - 1 (MCP-1 ) released from cul-tured human umbilical vein endothdial cells (HUVEC) and whether fluvastatin can attenuate these effect. Methods:Confluent mono-layers of culturad HUVEC with serum samples (diluted 1:5) were from 15 female patients and 5 normal female controls or with both serum samples and solution of fluvastatin for 24 hours. ICAM- 1 and MCP- 1 concentrations in the culture supernatant were mea-sured by EL1SA and intracellular expressions of ICAM- 1 and MCP- 1 were measured by immunocytochemistry. Results: The ex-pression of ICAM - 1 and MCP - 1 incubated with ANA-positive and anti - dsDNA antibody - positive sera from patient with SLE were higher than HUVEC incubated with ANA-negative sera from patients with SLE(P < 0.01 ) and normal controls( P < 0.01 ).Fluvaststin showed significant inhibition of ANA - positive and anti - dsDNA antibody- positive sera induced ICAM- 1 and MCP - 1expression on HUVEC(P<0.01 ,and P<0.05). Conclusion:ANA- pcsitive and anti- dsDNA antibody- positive sera's ability to activate HUVEC is evidenced by induction of ICAM- 1 and MCP- 1 expression in vitro. Fluvastatin can inhibit up- reguhtion of ICAM- 1 and MCP- 1 on HUVEC by ANA- positive and anti- dsDNA antibody- positive sera from patients with SLE in vitro.%目的:观察抗核抗体(ANA)和抗ds-DNA抗体对人脐静脉血管内皮细胞(HUVEC)细胞间黏附分子-1(ICAM-1)、单核细胞趋化因子-1(MCP-1)表达的影响及他汀类药物氟伐他汀(fluvastatin,flu)干预后的变化,以探讨ANA和抗ds-DNA抗体在系统性红斑狼疮(SLE)血管炎中的致病机制和flu对血管内皮保护作用.方法:体外培养HUVEC,收集女性SLE患者血清(以抗核抗体全套为依据,分3组:ANA阴性、ANA滴度1:80、ANA滴度1:80和抗ds-DNA抗

  6. Effect of Interferon-alpha in systemic lupus erthematosus (SLE) serum on the differentiation and maturation of dendritic cells derived from CD34+ hematopoietic precursor cells

    Institute of Scientific and Technical Information of China (English)

    Rong Zhang; Meifen Xing; Weiwen Wang; Xiaofan Yang; Xiaohui Ji

    2009-01-01

    Objective: To study the effect of interferon-alpha IFN-a in the serum of SLE patients on the differentiation and maturation of dendritic cells (DCs) derived from CD34+ hematopoietic precursor cells (HPCs). Methods: Serum samples from SLE patients and normal controls were collected and the concentration of IFN-a detected by ELISA. CD34+HPCs were purified from cord blood by a magnetic cell sorting system (MACS), and cultured to differentiate to DCs. Normal serum, normal serum with exogenous IFN-α, SLE serum with raised levels of IFN-α, or SLE serum with anti-IFN-α neutralizing antibody was added to the culture medium. The phenotype of DCs was analyzed by flow cytometry (FCM) and the capacity of DCs to stimulate allogenic T lymphocyte proliferation was evaluated in a mixed lymphocyte reaction by the Cell Counting Kit-8. Cytokine production was assessed by ELISA. Results: Serum levels of IFN-a were significantly higher in SLE patients than in normal controls and this correlated positively with disease activity. Cultured in SLE serum with raised levels of IFN-α, CD34+HPCs could differentiate into DCs that expressed higher levels of HLA-DR, CD80 and CD86, and showed an enhanced allogenic T-cell stimulatory capacity, while producing lower levels of IL-12 and higher amounts of IL-10 compared with those DCs cultured in normal serum. Conclusion: Increased levels of IFN-a in SLE serum promotes the differentiation and maturation of DCs derived from CD34+ HPCs and could contribute to the pathogenesis of SLE.

  7. Disseminated tuberculosis in a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    J. Harikrishna

    2012-10-01

    Full Text Available Systemic lupus erythematosus (SLE is a systemic autoimmune disorder. Intercurrent infections and nephritis are important causes of mortality in SLE. Among infections, tuberculosis (TB is of particular importance as SLE patients are more susceptible to develop active TB, prior TB can precipitate SLE in genetically susceptible individuals and similar clinical presentations of SLE flare and TB may lead to delayed diagnosis. We report a patient with SLE, who developed disseminated TB. The present case highlights the importance of a high index of suspicion and focussed evaluation in the diagnosis of intercurrent infections, particularly TB in patients with SLE.

  8. Estimating Rate of Insulin Resistance in Patients with Preeclampsia Using HOMA-IR Index and Comparison with Nonpreeclampsia Pregnant Women

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    Farideh Rezaei Abhari

    2014-01-01

    Full Text Available Women with preeclampsia, independent of obesity and glucose intolerance, exhibit insulin resistance during pregnancy. The purpose of the present study is to determine whether early diagnosis of insulin resistance during pregnancy can predict preeclampsia. Through a case-control study, 675 pregnant women were selected and their first trimester blood was taken. Their fasting blood glucose and insulin were also measured after diagnosis of preeclampsia by 20 weeks of pregnancy. Based on the experiments conducted on 675 women who were 20 weeks past their pregnancy, 375 cases with preeclampsia were selected and assigned to the case group. 35 other pregnant women were put in the control group. Diagnosis criteria for the participants included blood pressure above 140/90 and proteinuria above 300 mg or above +1. Both groups were matched according to age, parity, gestational age, and BMI. Homa-Irand rate of insulin resistance was calculated by HOMA-IR and patients were followed up. Homeostatic model assessments (HOMA-IR revealed that the average insulin resistance increased during pregnancy among both the case and control groups. There was a significant difference between insulin resistance of these two groups in both first trimester and third trimester and after developing preeclampsia (P < 0.001, P = 0.021. Insulin-resistance of the group with preeclampsia was higher in first trimester prior to diagnosis as well as the third trimester after diagnosis compared to natural pregnancy under similar conditions. Measurement of insulin resistance in first trimester may be useful in predicting the risk of preeclampsia.

  9. Midwifery students training in oral care of pregnant patients: an interventional study.

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    Simin Zahra Mohebbi

    2014-10-01

    Full Text Available Midwives may play an important role in oral health promotion of pregnant women, whom they are in close contact with. Our aim was to evaluate an educational intervention on the oral health attitude and practices among the junior midwifery students of Tehran University of Medical Sciences in 2010.The junior midwifery students were divided into intervention (n=29 and control (n=33 groups. The intervention group was first educated about general oral health, oral hygiene practices during pregnancy, and tooth brushing and flossing on models. Subsequently, the students performed role playing to ensure they understood the aforementioned lessons correctly. Before and three months after the training course the students filled out a validated self-administered questionnaire and a simplified plaque index was recorded. Statistical analysis was done by Mann-Whitney test and linear regression models.Before the intervention, the mean scores of attitude in general oral health for the intervention and control groups were 5.8 and 5.4, respectively, which improved to 8.9 and 5.4 after the intervention (P<0.001. The mean score of oral health attitude in pregnancy was 20.4 in the intervention group and increased to 30.9 (P<0.001. The intervention group demonstrated much better oral health practices in pregnancy and lower plaque index score after the intervention.The promising finding about attitude and practice improvement in midwifery students after participating in a short course on oral health promotion in pregnancy shows the necessity to enrich their training program by including this subject.

  10. Management of the Pregnant Inflammatory Bowel Disease Patient on Antitumour Necrosis Factor Therapy: State of the Art and Future Directions

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    Yvette PY Leung

    2014-01-01

    Full Text Available Antitumour necrosis factor (anti-TNF therapy has been a major advance in the treatment of inflammatory bowel disease (IBD by improving rates of mucosal healing, steroid-free remission, and decreasing rates of hospitalization and surgery. Because IBD affects women in their reproductive years, clinicians have and will continue to be asked in the future about the safety profile of these agents and their potential impact on pregnancy, the developing fetus and newborn. Immunoglobulin G transfer from the mother to fetus begins in the second trimester, with an elevation starting at 22 weeks of gestation and the largest amount transferred in the third trimester. Although research investigating the long-term outcomes of children exposed to anti-TNF therapy in utero is limited, there is no known adverse effect on either pregnancy or newborn outcomes including infectious complications with this class of drugs. The World Congress of Gastroenterology consensus statement on biological therapy for IBD considered infliximab and adalimumab to be low risk and compatible with use during conception and during pregnancy in at least the first two trimesters. Based on a clinical algorithm used at the University of Calgary Pregnancy and IBD clinic (Calgary, Alberta, recommendations have been provided on the management of pregnant patients on anti-TNF therapy, particularly with regard to third-trimester dosing, taking into account disease characteristics of individual patients. When educated about the safety of anti-TNF therapy during pregnancy, patients often choose to continue on therapy during the third trimester.

  11. The hypothalamic-pituitary response in SLE. Regulation of prolactin, growth hormone and cortisol release.

    Science.gov (United States)

    Rovenský, J; Blazícková, S; Rauová, L; Jezová, D; Koska, J; Lukác, J; Vigas, M

    1998-01-01

    It has been suggested that neuroendocrine regulation plays an important role in the pathogenesis and activation of autoimmune diseases. The aim of this investigation was to clarify the hypothalamic-pituitary response to a well-defined stimulus under standardised conditions in patients with SLE. Plasma concentrations of prolactin (PRL), growth hormone (GH) and cortisol were determined in venous blood drawn through an indwelling cannula during insulin-induced hypoglycaemia (0.1 U/kg b.w., i.v.) in ten patients and in 12 age-, gender- and weight-matched healthy subjects. Basal PRL concentrations were higher in patients vs healthy controls (12 vs 6 ng/ml, P < 0.01), though still within the physiological range. Insulin-induced plasma PRL and GH were significantly increased both in patients and healthy subjects; however, the increments or areas under the curves were not different in the two groups. Plasma cortisol response showed moderate attenuation in patients. Sensitivity of pituitary lactotrothrops to thyrotropin-releasing hormone (TRH) administration (200 microg, i.v.) was the same in patients and control subjects. In SLE patients with low activity of the disease the sensitivity of pituitary PRL release to TRH administration remained unchanged. The hypothalamic response to stress stimulus (hypoglycaemia) was comparable in patients and healthy subjects.

  12. Podocyturia as a Diagnostic Marker for Preeclampsia amongst High-Risk Pregnant Patients

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    Belinda Jim

    2012-01-01

    Full Text Available Urinary podocyte (podocyturia has been studied as a diagnostic marker for preeclampsia. We sought to validate its use in preeclampsia and in differentiating it from other high risk pregnancy states. We studied an obstetric population at high risk to develop preeclampsia (study group and uncomplicated pregnancies (control group by analyzing their urine sediment for podocytes within 24 hours of delivery. Podocytes were identified by immunohistochemistry using the podocyte-specific protein synaptopodin. Of the 56 patients who were enrolled, 29 patients were diagnosed with preeclampsia, 9 patients had hypertensive conditions such as chronic and gestational hypertension, 6 patients had Type I/II and gestational diabetes mellitus, 3 patients were classified as others, and 9 patients exhibited uncomplicated pregnancies. Podocyturia was identified in 11 out of 29 (38% of patients with preeclampsia/eclampsia, 3 out of 9 (33% with gestational and chronic hypertension, and 3 out of 6 (50% with Type I/II and gestational diabetes mellitus. None of the 9 patients (0% with uncomplicated pregnancies demonstrated podocyturia. The sensitivity and specificity of podocyturia for preeclampsia were found to be 38% and 70%. Our study showed that podocyturia does not appear to be a sensitive nor a specific marker to diagnose preeclampsia.

  13. Outcome of pregnancy in patients with inactive systemic lupus erythromatosus and minimal proteinuria

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    Alshohaib Saad

    2009-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem disease. This study was under-taken to assess the outcome of pregnancies in patients with inactive SLE. We prospectively studied 20 female patients with diagnosis of stable class IV Lupus nephritis followed up at King Abdul Aziz University Hospital, in Jeddah, Saudi Arabia between 1998 and 2008. Before each pregnancy all the patients had their blood pressure, serum creatinine, creatinine clearance, serology for SLE and 24-hour urine protein excretion measured and then repeated at monthly intervals during the pregnancy. Statistical analysis was performed using the Wilcoxon signed-rank test. Despite having negative antinuclear antibody (ANA significant complications were observed during pregnancy. The daily proteinuria during 34-36 weeks′ gestation was significantly higher (P< 0.05 than during 32 weeks. Two patients had abortions one stillbirth and 2 required termination of the pregnancy; one due to severe hypertension, and other due to renal impairment. One patient developed HELLP (hemolysis, elevated liver enzymes, low platelets syndrome. 14 patients had a successful preg-nancy, including 4 requiring a cesarian section. In conclusion, although no clinical evidence of lupus disease activity was demonstrated pre-conception proteinuria significantly increased during pregnancy along with maternal and fetal complications. Pregnant females with diagnosis of SLE need a multidisciplinary care during the pregnancy and post-partum period.

  14. The relationship between the internal oxidation-reduction system and fetal distress on pregnant patients with intrahepatic cholestasis.

    Science.gov (United States)

    Zhou, B; Wang, C-H; Ding, R-B; Chen, J-G; Che, Y-H; Deng, Y-X

    2015-10-01

    To discuss the relationship between the internal oxidation-reduction system and fetal distress in pregnant patients with intrahepatic cholestasis in order to provide a new basis for clinical treatment and research. From March 2012 to March 2015, eighty patients with intrahepatic cholestasis of pregnancy (ICP) were selected and divided into two groups: the distressed group (n = 31) and non-distressed group (n = 49). We compared the two groups for differences in MDA, SOD, NO level, GSH level, venous blood and total bile acid level. The relevance of the oxidation-reduction system indicators and the venous blood and total bile acid levels, as well as the differences in the delivery outcome and fetal distress, were compared between the two groups. The serum MDA level of the distressed group was higher than the non-distressed group while the SOD, NO, and GSH levels were lower than the non-distressed group. All differences were statistically significant (p intrahepatic cholestasis, which are MDA, SOD, NO and GSH levels, may contribute to the occurrence of fetal distress.

  15. Holocord spinal epidural abscess in a pregnant patient presenting as premature labour: a rare presentation of an unusual diagnosis.

    Science.gov (United States)

    Burton, Kirsteen R; Wang, Xi; Dhanoa, Deljit

    2014-07-01

    Spinal epidural abscess (SEA) is a rare clinical entity. It is less common when the entire epidural space is involved, known as a holocord or panspinal SEA, and it is even less common in a pregnant patient. We report a case of methicillin-resistant Staphylococcus aureus holocord SEA in a 30-year-old female at approximately 22 weeks' gestational age who presented with lumbar pain and pelvic pressure and the urge to bear down. Magnetic resonance imaging of the spine demonstrated extensive SEA and meningitis from the foramen magnum to the lumbar spine that was treated both medically and surgically. The incidence of, clinical presentation of, and risk factors for developing SEA are discussed. If untreated, expanding SEAs produce sensory symptoms and signs, motor dysfunction, and, eventually, paralysis and death. The medical and surgical management of SEA is also discussed. SEA can have an insidious and atypical presentation despite extensive involvement of the epidural space. Therefore, the diagnosis of SEA should always be considered in patients who present to the emergency department with back pain.

  16. A retrospective study of pregnancy outcomes in patients with systemic lupus erythematosus%妊娠合并系统性红斑狼疮患者孕期狼疮病情活动与妊娠结局的关系

    Institute of Scientific and Technical Information of China (English)

    王慧英; 叶艺璇; 屠京慧; 于莎莎; 赵锦松

    2016-01-01

    目的:探讨妊娠期系统性红斑狼疮( SLE)患者病情发展情况及其对妊娠结局的影响。方法根据妊娠期SLE病情活动情况将2010-01~2015-12首都医科大学附属北京世纪坛医院收治的20例SLE孕妇分为活动性SLE妊娠患者13例及非活动性SLE妊娠患者7例,对比分析两组患者妊娠并发症情况及妊娠结局。结果非活动性SLE妊娠患者的足月产率高于活动性SLE妊娠患者(P<0.05);非活动性SLE患者的早产发生率低于活动性SLE妊娠患者(P<0.05);非活动性SLE患者新生儿体重、平均分娩孕周均高于活动性SLE妊娠患者(P<0.01);非活动性SLE患者的妊娠并发症发生率低于活动性SLE患者(P<0.01),其中非活动性SLE患者中有0例发生子痫前期,活动性SLE患者中有10例患者发生子痫前期。结论系统性红斑狼疮患者活动期妊娠不良妊娠结局及妊娠并发症的发生率均高于非活动期妊娠。%Objective To explore the maternal and fetal outcomes of pregnancy in patients with systemic lupus erythematosus( SLE) . Methods The clinical data of 20 cases of pregnancy complicated with SLE were retrospectively analyzed. Twenty pregnant women complicated with SLE were divided into active phase(n=13) and inactive phase(n=7) according to the progression condition of SLE. The maternal and infantile complications and pregnancy outcomes in the two groups were compared and analyzed. Results The rate of full-term birth in pregnancy with inactive SLE was significantly higher than that in pregnancy with active SLE(P<0. 05), and the incidence of prematurity in pregnancy with inactive SLE was significantly lower than that in pregnancy with active SLE(P<0. 05). The fetal birth gestational age and body weight in pregnancy with inactive SLE were significantly higher than that in pregnancy with active SLE(P<0. 01), and the incidence of complications in pregnancy with inactive SLE was significantly lower than that in pregnancy with

  17. Drug repositioning in SLE: crowd-sourcing, literature-mining and Big Data analysis.

    Science.gov (United States)

    Grammer, A C; Ryals, M M; Heuer, S E; Robl, R D; Madamanchi, S; Davis, L S; Lauwerys, B; Catalina, M D; Lipsky, P E

    2016-09-01

    Lupus patients are in need of modern drugs to treat specific manifestations of their disease effectively and safely. In the past half century, only one new treatment has been approved by the US Food and Drug Administration (FDA) for systemic lupus erythematosus (SLE). In 2014-2015, the FDA approved 71 new drugs, only one of which targeted a rheumatic disease and none of which was approved for use in SLE. Repositioning/repurposing drugs approved for other diseases using multiple approaches is one possible means to find new treatment options for lupus patients. "Big Data" analysis approaches this challenge from an unbiased standpoint whereas literature mining and crowd sourcing for candidates assessed by the CoLTs (Combined Lupus Treatment Scoring) system provide a hypothesis-based approach to rank potential therapeutic candidates for possible clinical application. Both approaches mitigate risk since the candidates assessed have largely been extensively tested in clinical trials for other indications. The usefulness of a multi-pronged approach to drug repositioning in lupus is highlighted by orthogonal confirmation of hypothesis-based drug repositioning predictions by "Big Data" analysis of differentially expressed genes from lupus patient samples. The goal is to identify novel therapies that have the potential to affect disease processes specifically. Involvement of SLE patients and the scientists that study this disease in thinking about new drugs that may be effective in lupus though crowd-sourcing sites such as LRxL-STAT (www.linkedin.com/in/lrxlstat) is important in stimulating the momentum needed to test these novel drug targets for efficacy in lupus rapidly in small, proof-of-concept trials conducted by LuCIN, the Lupus Clinical Investigators Network (www.linkedin.com/in/lucinstat). © The Author(s) 2016.

  18. Uterine Incarceration: Rare Cause of Urinary Retention in Healthy Pregnant Patients

    Directory of Open Access Journals (Sweden)

    Richard Slama

    2015-10-01

    Full Text Available Gravid uterine incarceration (GUI is a condition that is well discussed in literature; however, there are few acute diagnoses in the emergency department (ED. We present a case series where three multiparous females presented to the ED with non-specific urinary symptoms. On bedside ultrasound, each patient was noted to have a retroverted uterus and inferior bladder entrapment under the sacral promontory. GUI is a rare condition that can lead to uremia, sepsis, peritonitis, and ultimately maternal death. Emergency physicians should include GUI in their differential diagnosis in this patient population and use bedside ultrasound as an adjunct to diagnosis.

  19. 基于SOA的SLE API系统设计%Design of an SOA-based SLE API Svstem

    Institute of Scientific and Technical Information of China (English)

    王喆; 鲍忠贵; 高三红; 苑刚

    2011-01-01

    介绍了CCSDS(空间数据系统咨询委员会)标准下的SLE(空间链路扩展)系统中API(应用程序接口)系统的概念和模型,并基于SOA(面向服务的体系结构)思想深入分析了SLE API系统的设计模式.SOA模型具有松耦合、重用性高、扩展性强等特点,这与我国提出的建立系统间“互联、互通、互操作”的新一代测控网的目标相吻合.本文在SOA模型框架下,针对我国测控网的现状,提出新型测控网可能的发展方向.%This paper introduces the concept and model of SLE API (Space Link Extension Application Program Interface) systems in CCSDS recommendations and analyzes SLE API system design based on SOA (Service Oriented Architecture). SOA model has the characteristics of loose coupling, great reusability and scalability. These are consistent with the interconnectivity and interoperability objectives of China's next generation TT&-C networks. Furthermore, the paper puts forward a probable approach for a new TT&.C management system.

  20. Breast Cancer Diagnosed During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients

    NARCIS (Netherlands)

    Loibl, S.; Schmidt, A.; Gentilini, O.; Kaufman, B.; Kuhl, C.; Denkert, C.; Minckwitz, G. von; Parokonnaya, A.; Stensheim, H.; Thomssen, C.; Calsteren, K. van; Poortmans, P.; Berveiller, P.; Markert, U.R.; Amant, F.

    2015-01-01

    Breast cancer during pregnancy (BCP), although rare, is becoming more common and treatment should be as similar as possible to that for nonpregnant young patients with breast cancer. A group of specialists convened to review current guidelines and provide guidance on how recent advances in breast ca

  1. ANAESTHETIC MANAGEMENT OF PREGNANT PATIENT WITH UNCONTROLLED HYPERTHYROIDISM FOR EMERGENCY CAESARIAN SECTION

    Directory of Open Access Journals (Sweden)

    Bala Subramanya

    2014-09-01

    Full Text Available The anaesthetic management of patient with uncontrolled hyperthyroidism requiring emergency cesarean section is presented here. Elevated free T3 and T4 and severely suppressed TSH levels confirmed the diagnosis. Propyl thio uracil was started preoperatively. IV Metoprolol was used to control the pre-operative heart rate. After adequate preloading with crystalloids, spinal anaesthesia was administered. There were three episodes of hypotension and tachycardia which were successfully managed with small dose of IV Phenylephrine. Post-operative anaelgesia was administered through epidural catheter. Patient was observed in intensive care unit for congestive cardiac failure and thyroid storm. Anti-thyroid drugs, Propranolol and Dexamethasone were given in the post-operative period.

  2. Indicators of glycemic control in patients with gestationaldiabetes mellitus and pregnant women with diabetesmellitus

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Recently, it has become clear that mild abnormal glucosetolerance increases the incidence of perinatal maternalinfantcomplications, and so the definition and diagnosticcriteria of gestational diabetes mellitus (GDM) havebeen changed. Therefore, in patients with GDM andpregnant women with diabetes mellitus, even stricterglycemic control than before is required to reduce theincidence of perinatal maternal-infant complications.Strict glycemic control cannot be attained without anindicator of glycemic control; this review proposesa reliable indicator. The gold standard indicator ofglycemic control in patients with diabetes mellitus ishemoglobin A1c (HbA1c); however, we have demonstratedthat HbA1c does not reflect glycemic controlaccurately during pregnancy because of iron deficiency.It has also become clear that glycated albumin, anotherindicator of glycemic control, is not influenced by irondeficiency and therefore might be a better indicator ofglycemic control in patients with GDM and pregnantwomen with diabetes mellitus. However, largepopulationepidemiological studies are necessary inorder to confirm our proposal. Here, we outline themost recent findings about the indicators of glycemiccontrol during pregnancy including fructosamine and1,5-anhydroglucitol.

  3. An unusual case of disseminated toxoplasmosis in a previously healthy pregnant patient: radiographic, CT, and MRI findings.

    Science.gov (United States)

    Paruthikunnan, Samir; Shankar, Balasubramanyam; Kadavigere, Rajagopal; Prabhu, Mukhyaprana; Narayanan, Ramakrishna; Jain, Harshwardhan

    2014-11-01

    Toxoplasmosis is a ubiquitous protozoal infection that during pregnancy commonly affects the fetus severely, with maternal infection usually being mild self-limiting. Disseminated toxoplasmosis in a healthy pregnant woman has, to the best of our knowledge, not been reported before. We present a case of disseminated toxoplasmosis involving pulmonary, central nervous system, and lymph nodes in a pregnant woman and imaging findings on radiography, computed tomography, and magnetic resonance imaging.

  4. Maternal and neonatal complications in pregnant patients adolescents and older than 35 years for july to september 2008. San Jose Universitary Hospital Popayan, Colombia.

    Directory of Open Access Journals (Sweden)

    Fernando Caicedo

    2010-06-01

    Full Text Available Introduction: The maternal and neonatal complications, presented a high morbidity and mortality, in the pregnant of the extreme ages, especially in developing countries. Objective: To determinate maternal and neonatal complications in pregnant patients teenagers and older 35, during of July to September of 2008. Materials and methods: Retrospective, descriptive and transversal study. It included 88 patients, 40 teenagers, younger’s 18, and 48 patients older 35, those who attended the delivery in the HUSJ between July to September of 2008. We reviewed every history and the information has documented in an instrument. Results: We found that average of delivery in teenagers was 16.1 years, and the oldest women was 38.27, the oldest women has a higher percent of pathological background 18.7% vs 15%. The complications incidence during the pregnancy in teenagers patients 77.5% and oldest women 68.8%, During the delivery and post-delivery, we show that teenagers had incidence major of complications 43% vs 31.25% in oldest woman. Conclusions: The pregnant in extreme ages are a population of high risk obstetric, determined for high incidence of pathologies during the pregnancy, delivery, post delivery and neonatal complications.

  5. Significance of Immune Indexes in Predicting Pregnancy Outcomes of Pregnant Patients With Systemic Lupus ;Erythematosus%免疫指标对妊娠合并系统性红斑狼疮患者妊娠结局的指导意义研究

    Institute of Scientific and Technical Information of China (English)

    王慧英; 叶艺璇; 于莎莎; 赵绵松; 张蕊

    2016-01-01

    Objective To investigate the significance of immune indexes in predicting pregnancy outcomes of pregnant patients with systemic lupus erythematosus(SLE). Methods From January 2003 to December 2015,we enrolled 20 pregnant SLE patients who received treatment in Beijing Shijitan Hospital Affiliated to Capital Medical University. The patients all received regular examination and treatment during pregnancy. Antinuclear antibodies, serum complement level and erythrocyte sedimentation rate were selected as immune indexes. Pregnancy outcomes and the incidence of pregnancy complications were compared among patients with different positive conditions of immune indexes. Results Among the 20 patients,there were 13 patients with positive antinuclear antibodies, 5 patients whose serum complement level decreased, and 5 patients whose erythrocyte sedimentation rate increased. Compared with patients who had negative antinuclear antibodies,patients with positive antinuclear antibodies had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns( P﹤0. 05);the number of cases of stillbirth was not significantly different(P﹥0. 05). Compared with patients with normal serum complement level,patients whose serum complement level decreased had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns(P﹤0. 05);the number of cases of stillbirth was not significantly different(P﹥0. 05) . Compared with patients with normal erythrocyte sedimentation rate, patients whose erythrocyte sedimentation rate increased had more cases of premature delivery and stillbirth,less gestational weeks and lighter average body weight of newborns ( P﹤0. 05 ) . Patients with different titers of antinuclear antibodies, serum complement levels, and erythrocyte sedimentation rate were not significantly different in the incidence of complications(P﹥0. 05). Conclusion Pregnant patients with SLE have higher incidence of unfavorable

  6. Effects of metformin use in pregnant patients with polycystic ovary syndrome

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    Pratap Kumar

    2012-01-01

    Full Text Available Use of metformin throughout pregnancy in women with polycystic ovary syndrome (PCOS has shown to reduce the rates of early pregnancy loss, preterm labor, and prevention of fetal growth restriction. Metformin has been shown to have encouraging effects on several metabolic aspects of polycystic ovarian syndrome, such as insulin sensitivity, plasma glucose concentration and lipid profile and since women with PCOS are more likely than healthy women to suffer from pregnancy-related problems like early pregnancy loss, gestational diabetes mellitus and hypertensive states in pregnancy, the use of metformin therapy in these patients throughout pregnancy may have beneficial effects on early pregnancy loss and development of gestational diabetes.

  7. 孕期系统性红斑狼疮患者用药安全护理指导%Systemic medication during pregnancy in SLE patients safety nursing instruction

    Institute of Scientific and Technical Information of China (English)

    王常玲

    2014-01-01

    ]Objective To investigate the pregnancy in systemic lupus erythematosus patients medication safetynursing instruction. Methods From 2012 June~2013 year in June in our hospital 80 cases of pregnancy in systemic lupus erythematosus patients were randomly divided into control group and study group, 40 cases in each group, the control group used routine nursing care, Research group were given medication safety nursing instruction, On medication knowledge and treatment compliance were compared between two groups. Results The study group patients on medication knowledge range and treatment compliance were higher than the control group, withsignificant difference (P<0.05). Conclusion Maternal systemic lupus patients applied medication safety nursing, can signiifcantly improve the cognition and treatment compliance of patients with medication knowledge, Protection of drug safety, and improve quality of life, Has a positive clinical value.%目的:探讨孕期系统性红斑狼疮(SLE)患者用药安全护理指导。方法选取2012年6月~2013年6月我院收治的80例孕期系统性红斑狼疮患者随机分为对照组和研究组,每组40例,对照组使用常规护理,研究组予以用药安全护理指导,对比两组患者对用药知识的认知度和治疗依从性。结果研究组患者对用药知识的认知度和治疗依从性均显著高于对照组,差异具有统计学意义(P<0.05)。结论孕期系统性红斑狼疮患者应用用药安全护理,可显著提高患者对用药知识的认知度及治疗依从性,保障用药安全,改善生活质量,具有积极的临床使用价值。

  8. The Effect of Prolonged Treatment with Belimumab on B cells in Human SLE

    Science.gov (United States)

    Jacobi, Annett M; Huang, Weiqing; Wang, Tao; Freimuth, William; Sanz, Inaki; Furie, Richard; Mackay, Meggan; Aranow, Cynthia; Diamond, Betty; Davidson, Anne

    2010-01-01

    Objectives To understand the effects of prolonged BLyS inhibition in human SLE. Methods 17 SLE patients enrolled in a clinical trial of belimumab, a BLyS-specific inhibitor, plus standard of care therapy were studied. Phenotypic analysis of lymphocytes was performed using flow cytometry. Circulating antibody-secreting cells were enumerated using ELISpot assay. Serum was analyzed by ELISA using an antibody that recognizes products of the VH4-34 gene. Lymphocyte counts, Ig levels and anti-dsDNA antibody levels were available as part of the clinical trial analyses. Results Samples were collected at days 0, 84, 168, 365, 532 and >730. The total B cell number decreased from baseline starting between days 84–168. This was due to a decrease in naïve and transitional B cells. CD27+/IgD+memory B cells and plasmablasts decreased only after 532 days, whereas CD27+/IgD− memory B cells were not affected, and there were no changes in T cells. Serum IgM levels began to decline between days 84–168, but there were no changes in serum levels of IgG, IgG anti-DNA antibodies or VH4-34 antibodies during the study. SLE patients had more IgM-, IgG-, and autoantibody-producing B cells than normal controls at Day 0. There was only a modest decrease in the frequency of total IgM-producing but not IgG-producing cells at Days 365 and 532, consistent with the phenotypic and serologic data. Conclusions Our data confirm the dependence of newly formed B cells on BLyS for survival in humans. In contrast, memory B cells and plasma cells are less susceptible to selective BLyS inhibition. PMID:20039404

  9. Maternal Plasma Concentration of the Pro-Inflammatory Adipokine Pre-B-Cell Enhancing Factor (PBEF)/ Visfatin Is Elevated In Pregnant Patients with Acute Pyelonephritis

    Science.gov (United States)

    Mazaki-Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan-Chang, Chia-Ling; Gomez, Ricardo; Yoon, Bo H.; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.

    2012-01-01

    Problem Visfatin/pre-B-cell enhancing factor (PBEF) has been implicated in the regulation of the innate immune system, as well as in glucose metabolism. Specifically, visfatin plays a requisite role in delayed neutrophil apoptosis in patients with sepsis. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma visfatin concentration in normal weight and overweight/obese patients. Methods of Study This cross-sectional study included the following groups: 1) normal pregnant women (n=200); and 2) pregnant women with pyelonephritis (n=40). Maternal plasma visfatin concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results 1) The median maternal plasma visfatin concentration was significantly higher in patients with pyelonephritis than in those with a normal pregnancy; 2) among overweight/obese pregnant women, those with pyelonephritis had a significantly higher median plasma visfatin concentration than women with a normal pregnancy; and 3) pyelonephritis was independently associated with higher maternal plasma visfatin concentrations after adjustment for maternal age, pre-gestational BMI, smoking status, gestational age at sampling, and birthweight. Conclusions Acute pyelonephritis during pregnancy is associated with a high circulating maternal visfatin concentration. These findings suggest that visfatin/PBEF may play a role in the regulation of the complex and dynamic crosstalk between inflammation and metabolism during pregnancy. PMID:20085562

  10. Targeting Toll-Like Receptors for Treatment of SLE

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    Christopher G. Horton

    2010-01-01

    Full Text Available Toll-like receptors (TLRs are important innate immune receptors for the identification and clearance of invading pathogens. Twelve TLRs that recognize various conserved components of microorganisms are currently known. Among these, the endosomal TLRs 3, 7/8, and 9 recognize dsRNA, ssRNA, and CpG DNA, respectively. Nucleic acid-sensing TLRs, TLR 7 in particular, have been implicated in systemic lupus erythematosus (SLE and are thought to exacerbate disease pathology. Activation of these TLRs results in the production of inflammatory cytokines and type I interferon. Genome-wide association studies, single nucleotide polymorphism analyses as well as experimental mouse models have provided evidence of TLR signaling involvement in SLE and other autoimmune diseases. Since activation of these receptor pathways promotes autoimmune phenotypes, inhibitory drugs that target these pathways constitute important new therapeutic strategies for the treatment of systemic autoimmunity.

  11. Endocrinology in pregnancy: management of the pregnant patient with a prolactinoma.

    Science.gov (United States)

    Molitch, Mark E

    2015-05-01

    A woman with a prolactinoma is usually infertile. Dopamine agonists usually restore ovulation and fertility and such treatment generally is preferred over transsphenoidal surgery because of higher efficacy and safety. Cabergoline is usually preferred over bromocriptine because of its better efficacy with fewer adverse effects. Either drug increases the rates of spontaneous abortions, preterm deliveries, multiple births, or congenital malformations over what may be expected. However, the number of pregnancies reporting such experience is about sevenfold greater for bromocriptine. Tumor growth causing significant symptoms and requiring intervention has been reported to occur in 2.4% of those with microadenomas, 21% in those with macroadenomas without prior surgery or irradiation, and 4.7% of those with macroadenomas with prior surgery or irradiation. Visual fields should be assessed periodically during gestation in women with macroadenomas. If significant tumor growth occurs, most patients respond well to reinstitution of the dopamine agonist. Delivery of the baby and placenta can also be considered if the pregnancy is sufficiently advanced. Transsphenoidal debulking of the tumor is rarely necessary.

  12. Hemangiopericytoma of the foramen magnum in a pregnant patient: A case report and literature review

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    Silvia Hernández-Durán

    2014-01-01

    Full Text Available Background: The presentation of intracranial hemangiopericytomas is very rare, and only one case of a hemangiopericytoma during pregnancy has been reported in the literature. The management of these lesions poses a great challenge to the neurosurgeon, since the physiological and hormonal changes of pregnancy can exacerbate the symptoms of this highly vascularized neoplasm and pose different risks to both the mother and the fetus. We report the case of a patient who had sudden onset of intracranial hypertension at the ninth week of gestation due to a hemangiopericytoma of the foramen magnum and review the literature in this regard. Case Description: A 23-year-old female who presented with signs and symptoms of intracranial hypertension at the ninth week of gestation was initially thought to have hyperemesis gravidarum. Because her symptoms persisted, she was found to have intracranial hypertension due to a tumor in the foramen magnum. She was treated by means of derivative surgery to allow for her pregnancy to progress beyond the first trimester, and at the 22 nd week of gestation she underwent a sub-occipital craniotomy with partial tumor removal. Pathology was consistent with hemangiopericytoma. Both the mother and the fetus had positive outcomes. Conclusions: To our knowledge, this is the second intracranial hemangiopericytoma presenting during pregnancy to be reported in the literature, and it is the first one of its kind to be located in the foramen magnum and causing severe intracranial hypertension.

  13. Influence of Conception Timing on Lupus Flares and Pregnancy Outcomes in Pregnant Women with Systemic Lupus Erythematosus%妊娠时机对妊娠合并系统性红斑狼疮病情及妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    尹玉竹; 周水生; 吴玲玲; 黄建林; 张培珍

    2011-01-01

    目的:探讨妊娠时机对妊娠合并系统性红斑狼疮(SLE)患者孕期病情及妊娠结局的影响.方法:对46例妊娠合并SLE孕妇的临床资料进行回顾性分析,按妊娠时机的不同分为两组:SLE控制期和缓解期达6个月以上怀孕者为指导性妊娠组(32例);SLE活动期怀孕者以及孕期新发SLE的病例为非指导性妊娠组(14例),比较两组患者孕期SLE的病情和妊娠结局的不同.结果:①指导性妊娠组孕期SLE的活动率和泼尼松用量分别为15.6%和9.6±1.1 mg/d明显低于非指导性妊娠组100%和24.1±18.2 mg/d(P =0.000,P=0.012).②指导性妊娠组24小时尿蛋白定量、肌酐、抗dsDNA抗体等指标的异常率均较非指导性妊娠组明显降低(P=0.003,P=0.004,P=0.021).③指导性妊娠组无一例母婴死亡;非指导性妊娠组产妇死亡1例,胎儿丢失5例.指导性妊娠组的活产率(100%)较非指导性妊娠组(64.3%)明显升高(P=0.001);胎儿丢失和胎儿生长受限发生率分别为0和18.8%,较非指导性妊娠组35.7%和50.0%明显降低(P=0.001,P=0.030).结论:妊娠时机对妊娠合并SLE患者孕期是否出现狼疮活动以及妊娠结局,尤其是胎儿结局影响较大,选择在SLE病情稳定半年以上计划怀孕,妊娠结局较好.%Objective:To explore the influence of conception timing on lupus flares and pregnancy outcomes in pregnant women with systemic lupus erythematosus (SLE). Methods:The clinical data of 46 pregnant women with SLE were retrospectively analyzed. According to the different conception timing, 46 gravi-das with SLE were divided into two groups: 32 patients who had controlled SLE and remission duration over 6 months before conception belonged to guidance pregnant group. Active lupus disease before conception and new onset SLE during pregnancy belonged to nonguidance pregnant group (n = 14). The rate of lupus flares and pregnancy outcomes were compared between two groups. Results:①The rate of lupus

  14. Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases

    Science.gov (United States)

    Sperber, Kirk; Hom, Christine; Chao, Chun Peng; Shapiro, Deborah; Ash, Julia

    2009-01-01

    Objective The purpose of this study is to compare the incidence of congenital defects, spontaneous abortions, number of live births, fetal death and pre-maturity in women with autoimmune diseases taking HCQ during pregnancy. Methods The authors searched MEDLINE, Cochrane data base, Ovid-Currents Clinical Medicine, Ovid-Embase:Drugs and Pharmacology, EBSCO, Web of Science, and SCOPUS using the search terms HCQ and/or pregnancy. We attempted to identify all clinical trials from 1980 to 2007 regardless of language or publication status. We also searched Cochrane Central Library and for clinical trials of HCQ and pregnancy. Data were extracted onto standardized forms and were confirmed. Results The odds ratio (OR) of congenital defects in live births of women taking HCQ during pregnancy was 0.66, 95% confidence intervals (CI) 0.25, 1.75. The OR of a live birth for women taking HCQ during pregnancy was 1.05 (95% CI 0.58, 1.93). The OR of spontaneous abortion in women taking HCQ during pregnancy was 0.92 (95% CI 0.49, 1.72). The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54). The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61). Conclusion HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases. PMID:19439078

  15. Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases

    Directory of Open Access Journals (Sweden)

    Shapiro Deborah

    2009-05-01

    Full Text Available Abstract Objective The purpose of this study is to compare the incidence of congenital defects, spontaneous abortions, number of live births, fetal death and pre-maturity in women with autoimmune diseases taking HCQ during pregnancy. Methods The authors searched MEDLINE, Cochrane data base, Ovid-Currents Clinical Medicine, Ovid-Embase:Drugs and Pharmacology, EBSCO, Web of Science, and SCOPUS using the search terms HCQ and/or pregnancy. We attempted to identify all clinical trials from 1980 to 2007 regardless of language or publication status. We also searched Cochrane Central Library and http://www.Clinical trials.gov for clinical trials of HCQ and pregnancy. Data were extracted onto standardized forms and were confirmed. Results The odds ratio (OR of congenital defects in live births of women taking HCQ during pregnancy was 0.66, 95% confidence intervals (CI 0.25, 1.75. The OR of a live birth for women taking HCQ during pregnancy was 1.05 (95% CI 0.58, 1.93. The OR of spontaneous abortion in women taking HCQ during pregnancy was 0.92 (95% CI 0.49, 1.72. The OR of fetal deaths in women taking HCQ during pregnancy was 0.97 (95% CI 0.14, 6.54. The OR of pre-mature birth defined as birth before 37 weeks in women taking HCQ during pregnancy was 1.10 (95% CI 0.75, 1.61. Conclusion HCQ is not associated with any increased risk of congenital defects, spontaneous abortions, fetal death, pre-maturity and decreased numbers of live births in patients with auto-immune diseases.

  16. Blood tests and analysis of patients with anemia in pregnant women%妊娠期贫血患者的血常规检验分析

    Institute of Scientific and Technical Information of China (English)

    黄和明; 谢世营; 林楚楚; 邢园园; 马杰彦

    2014-01-01

    Objective To investigate the clinical effect analysis of blood routine examination of patients with anemia in pregnant women. Methods One hundred and thirty-eight cases of anemia in pregnant women treated obstetrics and gynecology department in our hospital form February 2012 to September 2013 were included into this study. At the same time,120 healthy pregnant women were selected as a control group at the same period. Blood test results were observed in pregnant women. The indexes including HB,RBC,MCH,MCV,MCHC,RDW were sta-tistical analyzed to detect indicators. Results Trimester pregnant women,rate of small-cell anemia was 76. 32%,large cell anemia incidence 15. 79%. At the second trimester,small-cell anemia was 76. 60%,large cell anemia incidence 14. 89%. The third trimester of small cell lines anemia was 35. 85%,large cell anemia incidence 60. 38%. Pregnant women in the first trimester and second trimester are mostly small-cell ane-mia. With the development of pregnancy,the third trimester pregnant women are mostly large-cell anemia. Small-cell anemia in pregnant women with healthy pregnant women did not show significant difference in RBC mean number. RDW mean is higher than healthy pregnant women. The Hb,MCV,MCH,MCHC mean are lower than those of healthy pregnant women. Large-cell anemia in pregnant women,pregnant women and health of its MCHC did not show statistical difference. The RDW,MCV,MCH mean were higher than healthy pregnant women. The Hb,RBC are lower than the average healthy pregnant women. Conclusion Higher probability of occurrence was found in anemia during pregnancy. Trimester and second trimester is mainly small-cell anemia. Third trimester is mainly large-cell anemia. Pregnant women regularly carrying Hb,RBC, MCH,MCV,MCHC,RDW and other routine testing is important. The degree of anemia can be detected early to prevent the occurrence of adverse events.%目的:探讨分析血液常规检查对妊娠期贫血患者

  17. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years.

    Science.gov (United States)

    Kiani, Adnan N; Magder, Laurence S; Petri, Michelle

    2012-09-01

    Accelerated atherosclerosis is a major cause of mortality in SLE. Mycophenolate mofetil (MMF) has been shown to suppress growth factor-induced proliferation of vascular smooth muscle and endothelial cells in animal models. We hypothesized that MMF might modify the inflammatory component of atherosclerosis in SLE. We examined the effect of MMF on atherosclerosis as measured by changes in carotid intima-media thickness (IMT) or coronary artery calcium (CAC) over 2 years. CAC and carotid IMT were measured at baseline and 2 years later in a cohort of 187 patients with SLE. The cohort was 91% women, 59% Caucasian, and 35% African-American, with a mean age of 45 ± 11 years. Of these, 12.5% (n = 25) received MMF during follow-up. The daily dose ranged from 500 to 3,000 mg/day, and duration ranged from 84 days to the entire 2 years. We divided MMF users into three groups: low exposure (MMF (MMF: 1.17-1.28, low MMF: 1.02-1.13, high MMF: 1.44-1.61, and any MMF: 1.21-1.34 log-Agatston units. Compared to no MMF, there was no statistically different change between the three groups (p = 0.99, 0.87, and 0.91). Similarly, mean carotid IMT increased in all four groups: no MMF: 0.58-0.66, low MMF: 0.55-0.60, high MMF: 0.56-0.71, and any MMF: 0.56-0.66. We then adjusted for statin use, lupus nephritis, body mass index, systolic blood pressure, cholesterol, and age during the 2-year follow-up. The association between MMF exposure and change in CAC or carotid IMT was not statistically significant (p = 0.63 for CAC, and p = 0.085 for carotid IMT). There was no evidence that MMF slowed or decreased the progression of atherosclerosis as measured by carotid IMT or CAC. Because the number of patients taking MMF was only twenty-five, larger studies for longer time periods are needed to explore any effect of MMF on subclinical atherosclerosis in SLE.

  18. A case series discussing the anaesthetic management of pregnant patients with brain tumours [v1; ref status: indexed, http://f1000r.es/y7

    Directory of Open Access Journals (Sweden)

    Alaa A Abd-Elsayed

    2013-03-01

    Full Text Available Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old. Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, management of brain tumours in pregnant women is mainly reliant on case reports and the doctor’s personal experience. Therefore, close communication between the neurosurgeon, neuroanaesthetist, obstetrician and the patient is crucial. General anaesthesia, propofol, dexmedetomidine and remifentanil were used in our study and were safe. Although this may not agree with previous studies, desflurane and isoflurane were used in our patients with no detectable complications.

  19. Investigation of conformal and intensity-modulated radiation therapy techniques to determine the absorbed fetal dose in pregnant patients with breast cancer

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    Öğretici, Akın, E-mail: akinogretici@gmail.com; Akbaş, Uğur; Köksal, Canan; Bilge, Hatice

    2016-07-01

    The aim of this research was to investigate the fetal doses of pregnant patients undergoing conformal radiotherapy or intensity-modulated radiation therapy (IMRT) for breast cancers. An Alderson Rando phantom was chosen to simulate a pregnant patient with breast cancer who is receiving radiation therapy. This phantom was irradiated using the Varian Clinac DBX 600 system (Varian Medical System, Palo Alto, CA) linear accelerator, according to the standard treatment plans of both three-dimensional conformal radiation therapy (3-D CRT) and IMRT techniques. Thermoluminescent dosimeters were used to measure the irradiated phantom's virtually designated uterus area. Thermoluminescent dosimeter measurements (in the phantom) revealed that the mean cumulative fetal dose for 3-D CRT is 1.39 cGy and for IMRT it is 8.48 cGy, for a pregnant breast cancer woman who received radiation treatment of 50 Gy. The fetal dose was confirmed to increase by 70% for 3-D CRT and 40% for IMRT, if it is closer to the irradiated field by 5 cm. The mean fetal dose from 3-D CRT is 1.39 cGy and IMRT is 8.48 cGy, consistent with theoretic calculations. The IMRT technique causes the fetal dose to be 5 times more than that of 3-D CRT. Theoretic knowledge concerning the increase in the peripheral doses as the measurements approached the beam was also practically proven.

  20. Correlation between rapid HIV testing and fourth-generation ELISA results for HIV detection among pregnant patients in the delivery room.

    Science.gov (United States)

    Almaguer, Alejandro G; Mendoza-Flores, Lidia; Sánchez-López, Luis A; Palau-Dávila, Laura A; Padilla-Orozco, Magaly; Camacho-Ortiz, Adrián

    2017-04-01

    To analyze the usefulness of rapid HIV testing in pregnant patients in the delivery room. This prospective study compared a rapid test and a fourth-generation enzyme-linked immunoassay (ELISA) for HIV screening among pregnant patients admitted in labor with an unknown HIV status at a university hospital in Mexico between July 2015 and February 2016. Pearson correlation analysis was performed, and the diagnostic accuracy of the two tests was assessed with HIV RNA polymerase chain reaction (PCR) as the reference method. Overall, 534 patients were included. With a signal-to-cutoff (S/CO) value of 1.0 or more as a diagnostic criterion, 6 (1.1%) patients had a positive ELISA result. Three had a negative rapid test and three had a positive test (r=0.705). With an S/CO value of 2.0 or more as cutoff, 4 (0.7%) patients had a positive ELISA result. Three had a positive rapid test and one had a negative test (r=0.865). Only three of six patients with an S/CO of 1.0 or more were confirmed to have HIV by RNA PCR. The rapid test showed a strong correlation with the fourth-generation ELISA. Therefore, rapid testing is a useful tool in the delivery room for patients with unknown HIV status. © 2017 International Federation of Gynecology and Obstetrics.

  1. Immunization with hepatitis B vaccine accelerates SLE-like disease in a murine model.

    Science.gov (United States)

    Agmon-Levin, Nancy; Arango, María-Teresa; Kivity, Shaye; Katzav, Aviva; Gilburd, Boris; Blank, Miri; Tomer, Nir; Volkov, Alex; Barshack, Iris; Chapman, Joab; Shoenfeld, Yehuda

    2014-11-01

    Hepatitis-B vaccine (HBVv) can prevent HBV-infection and associated liver diseases. However, concerns regarding its safety, particularly among patients with autoimmune diseases (i.e. SLE) were raised. Moreover, the aluminum adjuvant in HBVv was related to immune mediated adverse events. Therefore, we examined the effects of immunization with HBVv or alum on SLE-like disease in a murine model. NZBWF1 mice were immunized with HBVv (Engerix), or aluminum hydroxide (alum) or phosphate buffered saline (PBS) at 8 and 12 weeks of age. Mice were followed for weight, autoantibodies titers, blood counts, proteinuria, kidney histology, neurocognitive functions (novel object recognition, staircase, Y-maze and the forced swimming tests) and brain histology. Immunization with HBVv induced acceleration of kidney disease manifested by high anti-dsDNA antibodies (p < 0.01), early onset of proteinuria (p < 0.05), histological damage and deposition of HBs antigen in the kidney. Mice immunized with HBVv and/or alum had decreased cells counts mainly of the red cell lineage (p < 0.001), memory deficits (p < 0.01), and increased activated microglia in different areas of the brain compare with mice immunized with PBS. Anxiety-like behavior was more pronounced among mice immunized with alum. In conclusion, herein we report that immunization with the HBVv aggravated kidney disease in an animal model of SLE. Immunization with either HBVv or alum affected blood counts, neurocognitive functions and brain gliosis. Our data support the concept that different component of vaccines may be linked with immune and autoimmune mediated adverse events.

  2. Development of manual procedures for care of pregnant patients in radiotherapy service; Desarrollo de manual de procedimentos para atencion de pacientes embarazadas en servicio de radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Scarabino, M.L., E-mail: maliscarabino@gmail.com [Hospital Italiano de Buenos Aires (HIBA), Buenos Aires (Argentina); Ruggeri, R.M.; Colombo, S.; Mairal, L.; Sardi, M.E., E-mail: ricardoruggeri@gmail.com [Mevaterapia Centro Medico, Buenos Aires (Argentina)

    2013-11-01

    The work involves the creation of a manual of procedures for the care of pregnant patients in a radiotherapy center in which each instance of treatment is included, from the obstetrician-oncology comprehensive assessment during admission to establishing controls newborn and its subsequent development in multidisciplinary team. For the preparation of the manual had to design an anthropomorphic phantom that resembles a pregnant woman, which was used to carry out internal and external dosimetry. In turn imparted calculations fetal doses using TPS, imaging tests with MRI, avoiding the use of the tomograph and adapted to the resonator involved were carried immobilizer. All experiences and progress made during the treated cases are introduced in the procedures manual, making it a dynamic tool for continuous improvement for the institution.

  3. A SURVEY OF ANTIBODIES FOR THE EXTRACTABLE NUCLEAR ANTIGENS AND THEIR ROLE IN THE CLINICAL DIAGNOSIS AND PROGNOSIS OF SLE

    Directory of Open Access Journals (Sweden)

    Shahnaz Rafiei Tehrani

    1993-06-01

    Full Text Available Fifty-seven patients suffering from systemic lupus erythematosus with different clinical features were studied from various aspects of immunological abnormalities, including anti-nuclear antibodies; anti-DNA; anti-Sm (Smith's antigen; and, other extractable nuclear antigens."nThe tests employed were microhemagglutination, counter immunoelecterphoresis, and radio immunoassay (RIA."nThe comparison between the two techniques for detectiong anti-DNA titers showed a significant correlation between them. There was also a significant positive correlation between the presence of anti-DNA and lupus nephritis (P>O.05. However, lupus nephritis has a negative association with anti-Sm."nWe will discuss anti-Sm in SLE patients that may have an inhibitory effect on developing the lupus nephritis. The association of anti-Sm in SLE may help the physicians to prognose the disease and manipulate the treatment.

  4. A case series discussing the anaesthetic management of pregnant patients with brain tumours [v2; ref status: indexed, http://f1000r.es/2hn

    Directory of Open Access Journals (Sweden)

    Alaa A Abd-Elsayed

    2013-12-01

    Full Text Available Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old. Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, good knowledge of the variable anesthetic agents and their effects on the fetus is very important in managing those patients.

  5. Investigations of a rabbit (Oryctolagus cuniculus model of systemic lupus erythematosus (SLE, BAFF and its receptors.

    Directory of Open Access Journals (Sweden)

    Jiahui Yang

    Full Text Available B-cell activation factor belonging to the tumor necrosis factor family (BAFF is a major contributor to survival of B lymphocytes during development and maturation. A relationship between circulating BAFF levels and disease activity has been reported in patients with the autoimmune disease Systemic Lupus Erythematosus (SLE. Clinical trials targeting BAFF or its receptors are currently in progress. In order to further characterize a rabbit (Oryctolagus cuniculus model of SLE, we investigated the expression of BAFF and its receptors in non-inbred, pedigreed rabbits derived from breeding and selection based on autoantibody responses. We immunized rabbits related to previous groups that developed autoantibodies and inflammatory responses after immunizations with peptides synthesized on multiple antigen-branched polylysine backbones. Blood and sera collected before immunization and after boosts were used for health monitoring, analyses of serum autoantibody responses by ELISA and immunofluorescence. Peripheral blood mononuclear cells (PBMC were studied by flow cytometry and were the source of mRNA for quantitative PCR analyses. We hypothesized that BAFF mRNA expression and serum BAFF levels measured indirectly through BAFF receptor binding might increase in autoantibody-producing rabbits. Immunized rabbits developed elevated levels of leucocyte populations, anti-nuclear, anti-dsDNA and other autoantibodies. BR3 mRNA levels in total PBMC decreased and BAFF levels remained low and unchanged in most immunized rabbits. By flow cytometry, percentages of BAFF positive cells decreased. Percentages of transmembrane activator and CAML interactor (TACI decreased in most rabbits from all the immunized groups. The rabbit is an important model for human autoimmune and infectious diseases, and a high quality draft rabbit genome assembly was recently completed. Human disease models developed in non-inbred pedigreed animals are better able to reflect the complexities

  6. A framework for remission in SLE : Consensus findings from a large international task force on definitions of remission in SLE (DORIS)

    NARCIS (Netherlands)

    van Vollenhoven, Ronald F.; Voskuyl, Alexandre E.; Bertsias, George K.; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent; Askanase, Anca; Balazova, Petra; Bonfa, Eloisa; Bootsma, Hendrika; Boumpas, Dimitrios T.; Bruce, Ian N.; Cervera, Ricard; Clarke, Ann; Coney, Cindy; Costedoat-Chalumeau, Nathalie; Czirjak, Laszlo; Derksen, Ronald; Doria, Andrea; Doerner, Thomas; Fischer-Betz, Rebecca; Fritsch-Stork, Ruth; Gordon, Caroline; Graninger, Winfried; Gyori, Noemi; Houssiau, Frederic A.; Isenberg, David A.; Jacobsen, Soren; Jayne, David; Kuhn, Annegret; Le Guern, Veronique; Lerstrom, Kirsten; Levy, Roger; Machado-Ribeiro, Francinne; Mariette, Xavier; Missaykeh, Jamil; Morand, Eric; Mosca, Marta; Inanc, Murat; Navarra, Sandra; Neumann, Irmgard; Olesinska, Marzena; Petri, Michelle; Rahman, Anisur; Rekvig, Ole Petter; Rovensky, Jozef; Shoenfeld, Yehuda; Smolen, Josef S.; Tincani, Angela; Urowitz, Murray; van Leeuw, Bernadette; Vasconcelos, Carlos; Voss, Anne; Werth, Victoria P.; Zakharova, Helena; Zoma, Asad; Schneider, Matthias; Ward, Michael

    Objectives Treat-to-target recommendations have identified `remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE.

  7. SU-F-I-36: In-Utero Dose Measurements Within Postmortem Subjects for Estimating Fetal Doses in Pregnant Patients Examined with Pulmonary Embolism, Trauma, and Appendicitis CT

    Energy Technology Data Exchange (ETDEWEB)

    Lipnharski, I; Quails, N; Carranza, C; Correa, N; Bidari, S; Bickelhaup, M; Rill, L; Arreola, M [University of Florida, Gainesville, FL (United States)

    2016-06-15

    Purpose: The imaging of pregnant patients is medically necessary in certain clinical situations. The purpose of this work was to directly measure uterine doses in a cadaver scanned with CT protocols commonly performed on pregnant patients in order to estimate fetal dose and assess potential risk. Method: One postmortem subject was scanned on a 320-slice CT scanner with standard pulmonary embolism, trauma, and appendicitis protocols. All protocols were performed with the scan parameters and ranges currently used in clinical practice. Exams were performed both with and without iterative reconstruction to highlight the dose savings potential. Optically stimulated luminescent dosimeters (OSLDs) were inserted into the uterus in order to approximate fetal doses. Results: In the pulmonary embolism CT protocol, the uterus is outside of the primary beam, and the dose to the uterus was under 1 mGy. In the trauma and appendicitis protocols, the uterus is in the primary beam, the fetal dose estimates were 30.5 mGy for the trauma protocol, and 20.6 mGy for the appendicitis protocol. Iterative reconstruction reduced fetal doses by 30%, with uterine doses at 21.3 for the trauma and 14.3 mGy for the appendicitis protocol. Conclusion: Fetal doses were under 1 mGy when exposed to scatter radiation, and under 50 mGy when exposed to primary radiation with the trauma and appendicitis protocols. Consistent with the National Council on Radiation Protection & Measurements (NCRP) and the International Commission on Radiological Protection (ICRP), these doses exhibit a negligible risk to the fetus, with only a small increased risk of cancer. Still, CT scans are not recommended during pregnancy unless the benefits of the exam clearly outweigh the potential risk. Furthermore, when possible, pregnant patients should be examined on CT scanners equipped with iterative reconstruction in order to keep patient doses as low as reasonable achievable.

  8. Apheresis and intravenous immunoglobulins used in addition to conventional therapy to treat high-risk pregnant antiphospholipid antibody syndrome patients. A prospective study.

    Science.gov (United States)

    Ruffatti, Amelia; Favaro, Maria; Hoxha, Ariela; Zambon, Alessandra; Marson, Piero; Del Ross, Teresa; Calligaro, Antonia; Tonello, Marta; Nardelli, Giovanni B

    2016-06-01

    Pregnant women with triple antibody positive antiphospholipid syndrome (APS) who have had thrombosis or a history of early, severe pregnancy complications are generally considered at high risk of pregnancy loss. The objectives of this study were to investigate the efficacy and safety of a relatively new treatment protocol used in addition to conventional therapy in high-risk pregnant patients affected with primary APS. The study's two inclusion criteria were: (1) the presence of triple antiphospholipid positivity, (2) previous thrombosis and/or a history of one or more early, severe pregnancy complications. Eighteen pregnancies occurring between 2002 and 2015 in 14 APS patients, (mean age 34.8±3.6 SD) were monitored. All 14 (100%) patients had triple antiphospholipid positivity. In addition, six of them (42.8%) had a history of thrombosis, four (28.6%) had one or more previous early and severe pregnancy complications, and four (30.8%) met both clinical study criteria. The study protocol included weekly plasmapheresis or immunoadsorption and fortnightly 1g/kg intravenous immunoglobulins. Seventeen of the pregnancies (94.4%) produced live neonates, all born between the 26th and 37th weeks of gestation (mean 33.1±3.5 SD). One female (5.5%), born prematurely at 24 weeks, died of sepsis a week after birth. There were two cases (11.1%) of severe pregnancy complications. No treatment side effects were registered. Given the high live birth rate and the safety associated to it, the study protocol described here could be taken into consideration by medical teams treating high-risk APS pregnant patients.

  9. Multiple-SLE connectivity weights for rectangles, hexagons, and octagons

    OpenAIRE

    Flores, Steven M.; Simmons, Jacob J. H.; Kleban, Peter

    2015-01-01

    In a previous article, we define "connectivity weights" to be functions with these two properties: 1) They solve the three conformal Ward identities of conformal field theory (CFT) and a system of $2N$ null-state differential equations governing a CFT $2N$-point function of $\\phi_{1,2}$ or $\\phi_{2,1}$ primary Kac operators. 2) They satisfy a certain "duality" condition. In that same article, we argue that these functions are in fact pure partition functions for a multiple-SLE$_\\kappa$ proces...

  10. Functional promoter haplotypes of the human FAS gene are associated with the phenotype of SLE characterized by thrombocytopenia

    DEFF Research Database (Denmark)

    Nolsøe, R L; Kelly, J A; Pociot, F;

    2005-01-01

    to SLE or subphenotypes in 126 multiplex American SLE pedigrees and found association of the FAS codon214 AC(C/T) as well as the FAS-670G>A'-codon214 AC(C/T)' haplotype to thrombocytopenia in SLE. Furthermore we have functionally characterized the FAS/FASL promoter polymorphisms associated with SLE...... variant, determines the promoter activity. We conclude that the FAS/FASL promoter haplotypes are functional and that polymorphisms in FAS may contribute to thrombocytopenia in SLE....

  11. 系统性红斑狼疮合并妊娠患者孕期病情的变化及其对母儿结局的影响%The impact of lupus flares on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    尹玉竹; 周水生; 黄建林; 吴玲玲; 余芹

    2012-01-01

    Objective To determine the impact of lupus flares on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE).Methods Data was obtained from 46 pregnancies of 44 pregnant women with SLE.The relationship between lupus flares and pregnant outcomes,and the risk factors for adverse maternal and fetal prognosis were analyzed.T-test,X2 test or Fisher's exact test and Logistic regression were used for statistical analysis.Results ① Lupus flares occurred in 19 (41%)pregnancies (group A) and stable lupus disease was observed in 27 (59%) pregnancies (group B) during pregnancy.Compared to pregnancies in patients with stable lupus disease at the conception (n=32),pregnancies in patients with unstable lupus disease at the conception (n=8) had higher lupus flare during pregnancy ( 100% vs 16%,P<0.05).(②) The common manifestations of lupus flares during pregnancy were lupus nephritis (LN) (11 cases),skin rashes (10 cases),arthritis (7 cases),and the common complication was infection ( 11 cases).(③) The incidence of premature labor,fetal growth retardation (FGR) and fetal loss in group A was 42%,47% and 26% respectively,which was significantly higher than that of the group B (7%,15% and 0 respectively) (P<0.05).There was no difference in the incidence of preeclampsia,fetal distress and neonatal asphyxia between the two groups ( 16% vs 7%,16% vs 19%,5% vs O,respectively,P>0.05).The incidence of premature labor and FGR in patients with active LN was higher than that of patients without active LN (55% vs 11%,64% vs 17%,respectively,P<0.05).(④)The binary Logistic regression analysis showed that renal impairment,hypocomplementemia,aPL and serum urea nitrogen level were independent risk factors for premature delivery,FGR,fetal loss and fetal distress.Conclusion (①) Lupus flares during pregnancy increase the incidence of premature labor,FGR and fetal loss.Active LN during pregnancy can increase the

  12. The Blood Nucleome in the Pathogenesis of SLE

    Science.gov (United States)

    Pisetsky, David S.; Ullal, Anirudh J.

    2010-01-01

    Systemic lupus erythematosus (SLE) is prototypic autoimmune disease characterized by the production of autoantibodies to DNA among other nuclear molecules. These antibodies can form immune complexes that promote pathogenesis by stimulating cytokine production and depositing in the kidney to instigate nephritis. The antigens that form these complexes arise from the blood nucleome, a pool of circulating macromolecules comprised of DNA, RNA and nuclear proteins released from cells. Cell death is a major source of these molecules, releasing DNA in a process that can be modeled in mice by the administration of cells killed ex vivo. In the mouse model, the appearance of blood DNA requires macrophages and differs between males and females. This finding raises the possibility that augmented levels of extracellular DNA and other nuclear antigens can contribute to the increased frequency of SLE in females. Extracellular DNA can occur in both a soluble and particulate form, with microparticles generated in vitro displaying antigenically active DNA. Together, these findings suggest that cell death is an important event in lupus pathogenesis and can provide a supply of blood DNA essential for immune complex formation. PMID:20659590

  13. Regulatory and pathogenetic mechanisms of autoantibodies in SLE.

    Science.gov (United States)

    Radic, Marko; Herrmann, Martin; van der Vlag, Johan; Rekvig, Ole Petter

    2011-08-01

    In the 53 years since the discovery of anti-DNA autoantibodies in lupus [1, 2, 3] , recalcitrant questions have been pondered and possible answers have been debated. The discovery of anti-DNA autoantibodies presented many puzzles: How is immunological tolerance to native B-form DNA broken? What elicits characteristic systemic lupus erythematosus (SLE) autoantibodies? Which of the diverse anti-nuclear reactivities are pathogenic? What is the role of autoantibodies in the clinical presentation of disease? How do genetic predisposition and environmental triggers contribute to SLE? These questions were brought into focus by Professor David Stollar in an introductory presentation to an intense, three-day meeting set among the rugged and inspiring scenery of the Norwegian arctic coastline (the Scientific Program is included as supplemental File 1). Other participants presented and discussed topics directed to understanding the origin and clinico-pathological impact of autoantibodies to chromatin and phospholipid antigens. In the following, several aspects of the workshop are discussed.

  14. The physiologic increase in expression of some type I IFN-inducible genes during pregnancy is not associated with improved disease activity in pregnant patients with rheumatoid arthritis.

    Science.gov (United States)

    Weix, Janine; Häupl, Thomas; Raio, Luigi; Villiger, Peter Matthias; Förger, Frauke

    2013-06-01

    During pregnancy, most patients with rheumatoid arthritis (RA) experience a spontaneous improvement in their condition. Since type I interferons (IFN) have immunomodulatory properties, we investigated whether type I IFN-inducible genes are upregulated in pregnant patients with RA. Peripheral blood mononuclear cells were evaluated using quantitative real-time polymerase chain reaction for type I IFN-inducible genes (IFI 35, IFI44, IFI44L, IFIT3, OAS1, and Siglec1) in patients with RA and healthy women during and after pregnancy as well as in nonpregnant controls. IFN-alpha and IFN-beta levels in sera of patients and healthy donors were analyzed by enzyme linked immunosorbent assay. It was found that healthy women did not show a change of gene expression levels from the second trimester until postpartum, yet some type I IFN-inducible genes were significantly upregulated in pregnant and postpartum women compared with nonpregnant individuals. In patients with RA, a pronounced upregulation of IFI35 and IFI44 at the second trimester and a peak expression of Siglec1 at the third trimester were observed. Pregnancy levels of IFI35 and IFI44 in patients with RA were higher than those of nonpregnant patients with RA. No significant association of gene expression levels with disease activity was found. In the sera of patients and healthy women, IFN-beta was undetectable and IFN-alpha levels remained stable throughout pregnancy and postpartum. Thus, pregnancy can give rise to an increased expression of type I IFN-inducible genes, reflecting an upregulation of the innate immune system. However, an association of type I IFN-inducible genes with pregnancy induced disease amelioration seems unlikely.

  15. "Pulmonary embolism diagnostics of pregnant patients: What is the recommended clinical pathway considering the clinical value and associated radiation risks of available imaging tests?"

    Science.gov (United States)

    Papadakis, Georgios Z; Karantanas, Apostolos H; Perisinakis, Kostas

    2017-07-28

    Pulmonary embolism (PE) during pregnancy remains the leading preventable cause of maternal morbidity and mortality in the developed countries. Diagnosis of PE in pregnant patients is a challenging clinical problem, since pregnancy-related physiologic changes can mimic signs and symptoms of PE. Patient mismanagement may result into unjustified anticoagulant treatment or unnecessary imaging tests involving contrast-related or/and radiation-related risks for both the expectant mother and embryo/fetus. On the other hand, missing or delaying diagnosis of PE could lead to life-threatening conditions for both the mother and the embryo/fetus. Thus, a timely and accurate diagnostic approach is required for the optimal management of pregnant patients with suspected PE. Aim of the current review is to discuss a pregnancy-specific clinical pathway for the early diagnosis of PE with non-ionizing radiation- and ionizing radiation-based imaging modalities taking into account previously reported data on diagnostic value of available imaging tests, and radiation related concerns. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Estudo retrospectivo das manifestações mlínicas e laboratoriais de 104 pacientes com Lúpus Eritematoso Sistêmico (LES, em Belém, PA, Brasil (1990-1999 Retrospective analysis of clinical and laboratorial aspects of 104 Systemic Lupus Erythematosus (SLE patients in Belém, PA, Brazil(1990-1999

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Lobato da Cunha Sauma

    2004-06-01

    êutica.OBJECTIVE: To perform a retrospective analysis of clinical and laboratorial aspects of 104 Systemic Lupus Erythematosus (SLE patients attended in a medical office in the city of Belém, Pará, Brazil, in the period between 1990 and 1999. METHODS: A medical record review was done through the Latin American Study of Systemic Lupus Erythematosus (ELALES adapted for this specific region and 104 patients were eligible. The following parameters were analyzed: clinical and laboratorial aspects, sex, race, age, age at onset of disease, evolution time, manifestations at the beginning and during the evolution of the disease. Statistical tests were applied to the data and compared with the literature. RESULTS: From those 104 patients identified, 91,53% were female, with predominance of white race (53.85%. Concerning the age of onset 25.96%patients were from 26-30 years, being that also the most frequent age of the last consultation registered in medical records (24.04%. The initial and evolutive more common clinical symptoms were arthritis/joint pain (77.88% and 78.85% respectively. Low prevalence of photosensitivity was observed (34.62% in comparision with literature, representing a paradox once in tropical areas there is a greater exposition to ultraviolet rays. Tests for antinuclear antibodies were positive in 83.84% of the patients. CONCLUSIONS: This report provides a partial understanding of SLE in this specific city, therefore a prospective study would be of great value to identify factors that contribute to the typical characteristics of this region in order to have a better diagnosis and therapeutical approach.

  17. Multiple Changes of Gene Expression and Function Reveal Genomic and Phenotypic Complexity in SLE-like Disease.

    Directory of Open Access Journals (Sweden)

    Maria Wilbe

    2015-06-01

    Full Text Available The complexity of clinical manifestations commonly observed in autoimmune disorders poses a major challenge to genetic studies of such diseases. Systemic lupus erythematosus (SLE affects humans as well as other mammals, and is characterized by the presence of antinuclear antibodies (ANA in patients' sera and multiple disparate clinical features. Here we present evidence that particular sub-phenotypes of canine SLE-related disease, based on homogenous (ANA(H and speckled ANA (ANA(S staining pattern, and also steroid-responsive meningitis-arteritis (SRMA are associated with different but overlapping sets of genes. In addition to association to certain MHC alleles and haplotypes, we identified 11 genes (WFDC3, HOMER2, VRK1, PTPN3, WHAMM, BANK1, AP3B2, DAPP1, LAMTOR3, DDIT4L and PPP3CA located on five chromosomes that contain multiple risk haplotypes correlated with gene expression and disease sub-phenotypes in an intricate manner. Intriguingly, the association of BANK1 with both human and canine SLE appears to lead to similar changes in gene expression levels in both species. Our results suggest that molecular definition may help unravel the mechanisms of different clinical features common between and specific to various autoimmune disease phenotypes in dogs and humans.

  18. Lymphocytic interstitial pneumonia as a manifestation of SLE and secondary Sjogren's syndrome.

    Science.gov (United States)

    Garcia, Daniel; Young, Lary

    2013-08-02

    A 47-year-old woman with systemic lupus erythematosus (SLE) diagnosed at age of 35 years was admitted for dyspnoea, substernal chest pain, dry mucosas and difficulty in swallowing. Physical examination revealed vesicular breath sounds bilaterally. Laboratory work showed antinuclear antibody (ANA) (speckled pattern, 1:40), positive anti-Sjogren's syndrome antigen (SSA) and antisingle side band (SSB) and negative double-strand DNA (dsDNA), with normal C3,C4,C50. A high-resolution chest CT scan demonstrated multiple bronchial cysts and diffuse interstitial infiltrates. Surgical lung biopsy revealed emphysematous changes and mild lymphocytic infiltrate around the bronchioles compatible with lymphocytic interstitial pneumonia diagnosis. This case illustrates a patient with primary SLE overlapped by initial manifestations of secondary Sjogren's syndrome (SS) presenting with associated autoimmune interstitial lung disease. Antibody markers, high-resolution chest CT scan and surgical lung biopsy were essential in evaluating this patient, confirming the interstitial lymphocytic infiltration of the lung. Primary SS (pSS) is the most commonly associated disease to lung interstitial pneumonia (LIP) (25%). High-resolution chest CT scan demonstrates areas of ground-glass attenuation, suggestive of interstitial disease. Surgical lung biopsy shows pathologic increase of mature lymphocyte cells and histiocytes. Most of the cases have a benign presentation and shortly relapse. Superimposed infection, pulmonary fibrosis and lymphoma develop in less than 20% of cases. Corticosteroids are the primary therapy. While pSS is commonly associated with interstitial lung involvement, secondary Sjogren's syndrome (sSS) is only rare. It has been described the initial sSS presentation by Sica symptoms development only, and our case is the first report of LIP presentation as initial manifestation of sSS. Our patient remained stable after corticosteroids and hydoxychloroquine therapy and no

  19. Murine lupus susceptibility locus Sle1a requires the expression of two sub-loci to induce inflammatory T cells.

    Science.gov (United States)

    Cuda, C M; Zeumer, L; Sobel, E S; Croker, B P; Morel, L

    2010-10-01

    The NZM2410-derived Sle1a lupus susceptibility locus induces activated autoreactive CD4(+) T cells and reduces the number and function of Foxp3(+) regulatory T cells (Tregs). In this study, we first showed that Sle1a contributes to autoimmunity by increasing antinuclear antibody production when expressed on either NZB or NZW heterozygous genomes, and by enhancing the chronic graft versus host disease response indicating an expansion of the autoreactive B-cell pool. Screening two non-overlapping recombinants, the Sle1a.1 and Sle1a.2 intervals that cover the entire Sle1a locus, revealed that both Sle1a.1 and Sle1a.2 were necessary for the full Sle1a phenotype. Sle1a.1, and to a lesser extent Sle1a.2, significantly affected CD4(+) T-cell activation as well as Treg differentiation and function. Sle1a.2 also increased the production of autoreactive B cells. As the Sle1a.1 and Sle1a.2 intervals contain only 1 and 15 known genes, respectively, this study considerably reduces the number of candidate genes responsible for the production of autoreactive T cells. These results also show that the Sle1 locus is an excellent model for the genetic architecture of lupus, in which a major obligate phenotype results from the coexpression of multiple genetic variants with individual weak effects.

  20. Assessment of endothelium: Dependent vasodilation with a non-invasive method in patients with preeclampsia compared to normotensive pregnant women

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Allameh

    2014-01-01

    Full Text Available Background: To assess the endothelial function via noninvasive method, in pregnant women with preeclampsia compared to to normotensive pregnant women. Materials and Methods: Brachial artery diameter was measured via ultrasound, in 28 women with preeclampcia in case group and normotensive pregnant women in control group, at rest, after inflation of sphygmomanometer cuff up to 250-300 mmHg, immediately after deflation of the cuff, 60-90 minutes later and 5 min after administration of sublingual trinitroglycerin (TNG. Results of these measurements as well as demographic characteristics of participants in both groups were recorded in special forms. Data were analyzed via Statistical Package for Social Sciences (SPSS version 16, using t-test and repeated measures analysis of variance (ANOVA. P-value < 0.05 was considered statistically significant. The results were presented as mean ± standard deviation (SD. Results: The mean of brachial artery diameter at rest in the case and control groups was 4.49 ± 0.39 and 4.08 ± 0.38 mm, respectively (P = 0.1. Also the results showed that the brachial artery diameter, immediately after deflation of the cuff, was 4.84 ± 0.4 and 4.37 ± 0.30 mm in the case and control groups (P < 0.001, respectively. The mean brachial artery diameter, 60-90 s after deflation of the cuff, was 4.82 ± 0.41 and 4.42 ± 0.38 mm in the case and control groups (P < 0.00, respectively. The brachial artery diameter, 5 min after sublingual NO administration, was 4.95 ± 0.6 and 4.40 ± 0.45 mm in case and control groups (P < 0.001, respectively. Applying of repeated measures ANOVA showed that the mean difference between case and control groups was statistically significant (P < 0.001. Conclusion: Current study concluded that there is no difference in endothelium-dependent vasodilation between women with preeclampsia and pregnant women with normal blood pressure.

  1. [Vaginal colonization by genital mycoplasmas in pregnant and non-pregnant women].

    Science.gov (United States)

    Castellano-González, Maribel; Ginestre-Pérez, Messaria; Perozo-Mena, Armindo; Alaña, Freddy; Fernández-Bravo, Marisol; Rincón-Villalobos, Gresleida

    2007-12-01

    To compare vaginal colonization by genital micoplasmas in pregnant and non pregnant women and to determine the association between pregnancy and colonization by these microorganisms, samples of exocervix an endocervix from pregnant (n = 80) and non pregnant (n = 65) women, from two health centers of Maracaibo, Zulia State, Venezuela were processed. The Mycoplasma-Lyo kit (bioMérieux laboratories) was used for the culture and identification of genital micoplasmas. In pregnant women, prevalences of 10% for M. hominis and 26.25% for Ureaplasma spp. were found; 35.38% for M. hominis and 20% for Ureaplasma spp. in non-pregnant, were obtained. Among the pregnant, Ureaplasma spp. was the most frequently isolated micoplasma, in symptomatic and asymptomatic; while in the non pregnant group, M. hominis was more common among the symptomatic patients; only one case (1.54%) was an asymptomatic carrier of Ureaplasma spp. The highest positivity percentages were obtained in primigravidas (48.71%) and during the second gestational trimester (34.21%). No statistically significant differences were found between vaginal colonization by genital micoplasmas according to age, number of pregnancy and gestational trimester; but they were found between the presented symptomatology and vaginal colonization by genital micoplasmas. Genital micoplasmas were isolated from gravid women at approximately the same recovery rate as in non-pregnant women; being M. hominis the most frequently isolated in non-pregnant women and Ureaplasma spp. in the pregnant group.

  2. Recurrent herpes zoster in a child with SLE

    Directory of Open Access Journals (Sweden)

    Jain C

    1995-01-01

    Full Text Available A 12-year-old girl had systemic lupus erythematosus (SLE and type IV lupus nephritis since three-and-a-half years. She was treated with prednisolone and cyclophosphamide. She had first attack of herpes zoster (HZ involving eighth and ninth thoracic segments on right side at the age of nine years. Second attack occurred on the same segments on same side at the age of twelve years. The second attack of herpes zoster was treated with oral acyclovir 400 mg five times a day for seven days plus analgesics and multi-vitamins. Most probably this is the first case of recurrent herpes zoster (RHZ in a child in Indian literature.

  3. Pharmaceutical care of asthma in pregnant patients%妊娠期合并哮喘患者药学监护要点

    Institute of Scientific and Technical Information of China (English)

    杨勇; 童荣生

    2012-01-01

    Objective To explore the critical points of monitoring pregnant asthmatic patients by clinical pharmacist.Methods The characteristics of gestational asthma from the literature analysis was analyzed.Through clinical practice and case studies,summed up the approach to pharmaceutical care for pregnant women with asthma patients points.Result Through studying the features of asthma in pregnancy and combining pharmaceutical care in practice,the compliance of the patients was improved.Conclusion Conducting pharmaceutical care for asthmatic patients in pregnancy is an important jobs for clinical pharmacist.%目的 探索临床药师在病区对妊娠期合并哮喘患者实施药学监护的要点.方法 从文献分析中,得出妊娠期哮喘特点,通过临床实践及案例分析,总结出适合妊娠期合并哮喘患者的药学监护要点.结果 临床药师通过对妊娠期哮喘特点的学习,并对患者实施药学监护,可增加患者依从性,使哮喘得到有效控制,体现临床药师的专业价值.结论 对妊娠期合并哮喘患者实施药学监护是临床药师参与临床工作的重要内容,临床药师应掌握药学监护要点,有效开展工作.

  4. Appearance of Systemic Lupus Erythematosus in Patients with Myasthenia Gravis following Thymectomy: Two Case Reports

    OpenAIRE

    2004-01-01

    We report two cases of systemic lupus erythematosus (SLE) in myasthenia gravis (MG) patients who had undergone thymectomy. SLE developed in the patients 3 months or 13 yr after thymectomy, and polyarthritis was the main clinical manifestation of SLE. Both patients fulfilled at least four of the revised criteria for the classification of SLE. In this report, we describe two postthymectomy lupus patients and perform a comparative review of previous cases.

  5. Appearance of systemic lupus erythematosus in patients with myasthenia gravis following thymectomy: two case reports.

    Science.gov (United States)

    Park, Mi Jeong; Kim, Yun A; Lee, Shin Seok; Kim, Byeong Chae; Kim, Myeong Kyu; Cho, Ki Hyun

    2004-02-01

    We report two cases of systemic lupus erythematosus (SLE) in myasthenia gravis (MG) patients who had undergone thymectomy. SLE developed in the patients 3 months or 13 yr after thymectomy, and polyarthritis was the main clinical manifestation of SLE. Both patients fulfilled at least four of the revised criteria for the classification of SLE. In this report, we describe two postthymectomy lupus patients and perform a comparative review of previous cases.

  6. The prevalence and incidence of systemic lupus erythematosus (SLE) in selected cities from three Commonwealth of Independent States countries (the Russian Federation, Ukraine and Kazakhstan).

    Science.gov (United States)

    Nasonov, E; Soloviev, S; Davidson, J E; Lila, A; Ivanova, R; Togizbayev, G; Omarbekova, Z; Shevchuk, S; Iaremenko, O; Gnylorybov, A; Smailova, Z; Chernogolov, V; Malynovska, K; Vasylyev, A; Pereira, M H S

    2014-02-01

    We assessed the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in 2010 in adults from four cities in Russia, Kazakhstan and Ukraine. Individuals with SLE were identified retrospectively from the medical records of specialized centers. Prevalent SLE patients were nondeceased city residents, diagnosed prior to December 31, 2010; incident patients were residents newly diagnosed between January 1 and December 31, 2010. Population size was obtained from official census data. The observed prevalence rates (per 100,000, 95% CI) were 9.0 (7.1-11.2) in Kursk and Yaroslavl, Russian Federation; 20.6 (15.4-27.0) in Semey, Kazakhstan; and 14.9 (10.9-19.9) in Vinnitsa, Ukraine. The cumulative incidence rates (per 100,000, 95% CI) were 1.4 (0.7-2.4); 1.6 (0.4-4.1) and 0.3 (0.0-1.8), correspondingly. All rates were higher among females compared to males, and incidence peaked in the population aged 25-44. These rates appear slightly lower than those reported from Western Europe and the USA. This could be because of study design (case-ascertainment), local health care practices or true differences in disease risk. Case age and sex distribution was similar to the known epidemiology of SLE. The rates were highest in Kazakhstan, likely because of a predominantly ethnic Asian population.

  7. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru.

    Science.gov (United States)

    Zhong, Qiu-Yue; Gelaye, Bizu; Rondon, Marta B; Sánchez, Sixto E; Simon, Gregory E; Henderson, David C; Barrios, Yasmin V; Sánchez, Pedro Mascaro; Williams, Michelle A

    2015-12-01

    We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.

  8. Small Cell Carcinoma of the Uterine Cervix in a Pregnant Patient Diagnosed with Liquid Based Cytology and Cell Block Immunocytochemistry

    Directory of Open Access Journals (Sweden)

    Mawuli F. Attipoe

    2014-01-01

    Full Text Available Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.

  9. Radiation safety concerns for pregnant or breast feeding patients. The positions of the NCRP and the ICRP

    Energy Technology Data Exchange (ETDEWEB)

    Meinhold, C.B. [Brookhaven National Lab., Upton, NY (United States)

    1997-01-01

    For many years, protecting the fetus has been a concern of the National Council on Radiation Protection and Measurements (NCRP) and the International Commission on Radiological Protection (ICRP). Early recommendations focused on the possibility of a wide variety of detrimental developmental effects while later recommendations focused on the potential for severe mental retardation and/or reduction in the intelligence quotient (I.Q.). The latest recommendations also note that the risk of cancer for the fetus is probably two to three times greater per Sv than in the adult. For all these reasons, the NCRP and the ICRP have provided guidance to physicians on taking all reasonable steps to ascertain whether any woman requiring a radiological or nuclear medicine procedure is pregnant or nursing a child. The NCRP and the ICRP also advise the clinician to postpone such procedures until after delivery or cessation of nursing, if possible.

  10. Vaccinations for pregnant women.

    Science.gov (United States)

    Swamy, Geeta K; Heine, R Phillips

    2015-01-01

    In the United States, eradication and reduction of vaccine-preventable diseases through immunization has directly increased life expectancy by reducing mortality. Although immunization is a public priority, vaccine coverage among adult Americans is inadequate. The Institute of Medicine, the Community Preventive Services Task Force, and other public health entities have called for the development of innovative programs to incorporate adult vaccination into routine clinical practice. Obstetrician-gynecologists are well suited to serve as vaccinators of women in general and more specifically pregnant women. Pregnant women are at risk for vaccine-preventable disease-related morbidity and mortality and adverse pregnancy outcomes, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. In addition to providing direct maternal benefit, vaccination during pregnancy likely provides direct fetal and neonatal benefit through passive immunity (transplacental transfer of maternal vaccine-induced antibodies). This article reviews: 1) types of vaccines; 2) vaccines specifically recommended during pregnancy and postpartum; 3) vaccines recommended during pregnancy and postpartum based on risk factors and special circumstances; 4) vaccines currently under research and development for licensure for maternal-fetal immunization; and 5) barriers to maternal immunization and available patient and health care provider resources.

  11. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel.

    Science.gov (United States)

    van Hasselt, J G C; van Calsteren, K; Heyns, L; Han, S; Mhallem Gziri, M; Schellens, J H M; Beijnen, J H; Huitema, A D R; Amant, F

    2014-10-01

    Pregnant patients with cancer are increasingly treated with anticancer drugs, although the specific impact of pregnancy-induced physiological changes on the pharmacokinetics (PK) of anticancer drugs and associated implications for optimal dose regimens remains unclear. Our objectives were to quantify changes in PK during pregnancy for four frequently used anticancer agents doxorubicin, epirubicin, docetaxel and paclitaxel, and to determine associated necessary dose adjustments. A pooled analysis of PK data was carried out for pregnant (Pr) and nonpregnant (NPr) patients for doxorubicin (n = 16 Pr/59 NPr), epirubicin (n = 14 Pr/57 NPr), docetaxel (n = 3 Pr/32 NPr) and paclitaxel (n = 5 Pr/105 NPr). Compartmental nonlinear mixed effect models were used to describe the PK and gestational effects. Subsequently, we derived optimized dose regimens aiming to match to the area under the concentration-time curve (AUC) in nonpregnant patients. The effect of pregnancy on volumes of distribution for doxorubicin, epirubicin, docetaxel and paclitaxel were estimated as fold-change of change of 1.1 (RSE 9%), 1.19 (RSE 7%) and 1.92 (RSE 21%) were, respectively, estimated on CL. Calculated dose adjustment requirements for doxorubicin, epirubicin, docetaxel and paclitaxel were +5.5%, +8.0%, +16.9% and +37.8%, respectively. Estimated changes in infusion duration were marginal (changes during pregnancy. The suggested dose adaptations should only be implemented after conduct of further confirmatory studies of the PK during pregnancy. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia in a patient with systemic lupus erythematosus and lupus nephritis

    OpenAIRE

    Akyol, Lütfi; Önem, Soner; Özgen, Metin; Sayarlıoğlu, Mehmet

    2015-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by several immunological abnormalities. We wish to communicate the case of a patient with SLE and lupus nephritis (LN) who developed pseudothrombocytopenia. Pseudothrombocytopenia can occur in patients with SLE and LN and should be considered when diagnosing patients with thrombocytopenia without bleeding.

  13. In a SLE mouse model the production of IgG autoantibody requires expression of activation-induced deaminase in early developing B cells

    Science.gov (United States)

    Umiker, Benjamin R.; McDonald, Gabrielle; Larbi, Amma; Medina, Carlos O.; Reth, Michael; Imanishi-Kari, Thereza

    2014-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of pathogenic IgG anti-nuclear antibodies. Pathogenic IgG autoantibody production requires B-cell activation, leading to the production of activation-induced deaminase (AID) and class switching of IgM genes to IgG. To understand how and when B cells are activated to produce these IgG autoantibodies, we studied cells from 564Igi, a mouse model of SLE. 564Igi mice develop a disease profile closely resembling that found in human SLE patients, including the presence of IgG anti-nucleic acid antibodies. We have generated 564Igi mice that conditionally express an activation-induced cytidine deaminase transgene (Aicdatg), either in all B cells or only in mature B cells. Here we show that class-switched pathogenic IgG autoantibodies were produced only in 564Igi mice in which AID was functional in early developing B cells, resulting in loss of tolerance. Furthermore, we show that the absence of AID in early developing B cells also results in increased production of self-reactive IgM, indicating that AID, through somatic hypermutation (SHM), contributes to tolerance. Our results suggest that the pathophysiology of clinical SLE might also be dependent on AID expression in early developing B cells. PMID:25044405

  14. Asymptomatic bacteriuria in pregnant women.

    Science.gov (United States)

    Thakur, Achala; Baral, Ratna; Basnet, Pritha; Rai, Rubina; Agrawal, Ajay; Regmi, Mohan Chandra; Uprety, Dhruba Kumar

    2013-01-01

    Asymptomatic bacteriuria is the significant presence of bacteria in urine of an individual without symptoms. The aim of the study is to determine the prevalence of asymptomatic bacteriuria in pregnant women. This study was a prospective study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences. The duration of the study was six months from January to June 2012. A total of 600 pregnant women were enrolled. All women were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into a sterile vial. The urine samples were examined for microscopic and culture sensitivity test. Out of 600 pregnant women, 52 were positive for significant bacteriuria with a prevalence rate of 8.7%. There was a significant difference in prevalence of asymptomatic bacteriuria with respect to trimester (p=0.005). Age did not show any significant difference in the prevalence of asymptomatic bacteriuria (p=0.807). There was not any significant difference in the prevalence of asymptomatic bacteriuria with respect to parity (p=0.864) and booking status (p=0.397). Escherichia coli (35%), Acinetobacter species (15%), Enterococcus species (12%) and Klebsiella pneumoniae (10%) were the common isolates. Most of the isolates were sensitive either to Nitrofurantoin, Norfloxacin or Amikacin. Asymptomatic bacteriuria is common in pregnancy. Urine culture sensitivity should be carried out routinely on all pregnant patients in order to prevent the dangerous complications associated with it.

  15. Effect of Systemic Lupus Erythematosus on some Biochemical Parameters in Female Patients

    OpenAIRE

    Eman G.E Helal*, Medhat El- Shafaey**, Hala Rahoma

    2004-01-01

    It has been noticed that there is an increase in the number of women suffering from SLE. Most studies confirmed that serum DHEA (dehydroepiandrosterone) and DHEA sulphate are lower among patients with SLE than among controls even- during phases of inactive disease so we performed this study to detect the level of DHEA-S in the female patients with SLE. The overall results confirm that DHEA treatment was well- tolerated, significantly reduced the number of SLE flares, and improved patient's gl...

  16. 威利坦缓释片在孕妇急性贝尔面瘫中的应用%Venostan for Bell's palsy in pregnant patients

    Institute of Scientific and Technical Information of China (English)

    李健东; 刘永亮

    2011-01-01

    目的 孕妇面瘫是临床棘手的难题,由于患者处于特殊生理阶段,用药选择时需考虑胎儿的安全.本研究的目的旨在寻找一个能在孕期使用的有效治疗面瘫的药物.方法 对2007年3月至2010年6月我院接诊的孕妇急性贝尔面瘫患者,给予威利坦缓释片每次800 mg、每日2次口服治疗,能坚持服药10天者共计21人,治疗前后用Sunnybrook评分系统进行评分,对疗效和不良反应进行记录和统计分析.结果 本组威利坦缓释片面瘫治愈率达76.2%,另有5人疗效较差,仅有1例出现胃肠道不良反应.结论 孕妇急性贝尔面瘫患者使用威利坦缓释片治疗10天是安全有效的,可以作为一种新的保守治疗方法.%Objective Facial paralysis in pregnant women is a difficult clinical problem. The purpose of this investigation was to find a safe and effective medicine for acute Bell's Palsy in pregnancy. Methods From March 2007 to June 2010,21 pregnant women with acute Bell's palsy were treated with Vesoatan sustained-release tablets (800 mg, po, bid, 10 days). Sunny brook Facial Grading System was used to evaluate facial function before and after treatment, and adverse reactions were recorded and analyzed. Results After 10 days of treatment, the Sunnybrook score was over 60 in 14 patients , 55 in 1 patient and 44 in 1 patient. These 16 patients (76.2%) showed complete recovery at follow ups. The remaining 5 patients had poor outcomes and one of them underwent a facial nerve decompression surgery. One patient experienced gastrointestinal adverse reactions which were alleviated by taking the medicine with meals. Conclusion Vesoatan sustained-release tablet appears safe and effective for acute Bell's palsy in pregnancy.

  17. Pathogenic and Epiphenomenal Anti-DNA Antibodies in SLE

    Directory of Open Access Journals (Sweden)

    Mirjana Pavlovic

    2010-01-01

    Full Text Available The discoveries of natural and the development of manufactured highly efficient catalytic antibodies (abzymes opens the door to many practical applications. One of the most fascinating is the use of such antibodies in human therapy and prevention (vaccination, of cancer, AIDS, autoimmune diseases. A special entity of naturally occurring DNA hydrolytic anti-DNA antibodies is emerging within past decades linked to autoimmune and lymphoproliferative disorders, such as systemic lupus erythematosus (SLE, multiple sclerosis (MS, Sjogren Syndrome (SS, B - Chronic lymphocytic leucosis (B-CLL, and Multiple Myeloma (MM. The origin of the antibodies is unknown. The underlying mechanisms of these activities are suggested to be penetration into the living cells and translocation in the nucleus, with recognition of the specific binding sites at particular (ss or ds DNA. There are controversies in the literature whether hydrolysis is a sequence-specific event. The interplay between anti-DNA antibodies and DNA is not yet elucidated. This molecular “twist” also suggests that anti-DNA antibodies with DNA hydrolytic capacity could be the organism's immune response to a microbial attack, with microbial DNA, or specific genes within microbial DNA sequence, as a target for neutralization. The catalytic antibody-based approach can become a key tool in selective chemotherapeutic strategies.

  18. Successful treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) in systemic lupus erythematosus (SLE) with oral cyclophosphamide.

    Science.gov (United States)

    Jasmin, R; Sockalingam, S; Shahrizaila, N; Cheah, T-E; Zain, A A; Goh, K-J

    2012-09-01

    Peripheral neuropathy is a known manifestation of systemic lupus erythematosus. However, the association of primary autoimmune inflammatory neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP) with SLE is uncommon. We report a 26-year-old man who simultaneously presented with severe CIDP and photosensitive rash, but was unresponsive to intravenous immunoglobulin infusion and continued to progress. He was found to have underlying SLE and improved with combined corticosteroid and immunosuppressive therapy with oral cyclophosphamide. CIDP with underlying SLE may be more resistant to conventional therapy with IVIG, requiring the addition of other immunosuppressive agents.

  19. Clinical analysis of complications and outcome of pregnant women with systemic lupus erythematosus%系统性红斑狼疮合并妊娠14例临床分析

    Institute of Scientific and Technical Information of China (English)

    李莉敏; 王芳; 程永静; 黄慈波

    2011-01-01

    Objective To investigate complications and perinatal outcome of pregnant women with systemic lupus erythematosus( SLE). Methods Retrospective analysis of 14 cases of pregnant women with SLE was done. The factors that may influence complications and perinatal outcome were studied. Results Among the 14 cases,3(21% ) were diagnosed as SLE for the first time, and disease activity index elevated in 4 (29% ), while the other 7 (50% ) keeped stable. As for the outcome of pregnancy,3(21% )experienced miscarriage,while the other 11 delivered successfully. 4 of those 11 cases had no complications, while the other 7 experienced complications either in neonates or mothers. Complications in neonates included placenta perfusion(1 case) ,fetal distress(2 cases)and low birth weight (1 case). Mothers with complications included 1 case with heart failure, 1 with gestational hypertension and 2 with a-nemia and postpartum bleeding. The SLEDAI max and complications in mothers and neonates in the disease activity group were much higher than those in the disease stable group (P <0.05). Conclusion Pregnant women with SLE should be considered as a high risk group,even those condition was stable before pregnancy. A close monitoring for SLE patients during pregnancy should be necessary.%目的 分析并探讨系统性红斑狼疮(SLE)患者的妊娠情况,孕期产期并发症及妊娠结局.方法 回顾性分析卫生部北京医院收治的14例系统性红斑狼疮合并妊娠患者的临床资料,分析妊娠对SLE患者病情的影响及对母亲胎儿的影响.结果 14例患者中,3例(21%)患者妊娠诱发系统行红斑狼疮发病,5例(36%)患者妊娠诱发系统性红斑狼疮活动,其余6例病情稳定(43%).14例患者中,3(21%)例流产,11(79%)例分娩.在11例(72%)成功分娩者中,有4例(29%)患者母婴平安.7例(50%)出现围生期母婴并发症,新生儿出现1例胎盘血流灌注,2例宫内窘迫,1例低体质量儿;产妇1

  20. Glutamate receptor antibodies in neurological diseases: anti-AMPA-GluR3 antibodies, anti-NMDA-NR1 antibodies, anti-NMDA-NR2A/B antibodies, anti-mGluR1 antibodies or anti-mGluR5 antibodies are present in subpopulations of patients with either: epilepsy, encephalitis, cerebellar ataxia, systemic lupus erythematosus (SLE) and neuropsychiatric SLE, Sjogren's syndrome, schizophrenia, mania or stroke. These autoimmune anti-glutamate receptor antibodies can bind neurons in few brain regions, activate glutamate receptors, decrease glutamate receptor's expression, impair glutamate-induced signaling and function, activate blood brain barrier endothelial cells, kill neurons, damage the brain, induce behavioral/psychiatric/cognitive abnormalities and ataxia in animal models, and can be removed or silenced in some patients by immunotherapy.

    Science.gov (United States)

    Levite, Mia

    2014-08-01

    pathological effects: they activate glutamate/AMPA receptors, kill neurons by 'Excitotoxicity', and/or by complement activation modulated by complement regulatory proteins, cause multiple brain damage, aggravate chemoconvulsant-induced seizures, and also induce behavioral/motor impairments. Some patients with 'Autoimmune Epilepsy' that have anti-AMPA-GluR3B antibodies respond well (although sometimes transiently) to immunotherapy, and thanks to that have reduced seizures and overall improved neurological functions. (2) Anti-NMDA-NR1 antibodies are present in patients with autoimmune 'Anti-NMDA-receptor Encephalitis'. In humans, in animal models and in vitro the anti-NMDA-NR1 antibodies can be very pathogenic since they can cause a pronounced decrease of surface NMDA receptors expressed in hippocampal neurons, and also decrease the cluster density and synaptic localization of the NMDA receptors. The anti-NMDA-NR1 antibodies induce these effects by crosslinking and internalization of the NMDA receptors. Such changes can impair glutamate signaling via the NMDA receptors and lead to various neuronal/behavior/cognitive/psychiatric abnormalities. Anti-NMDA-NR1 antibodies are frequently present in high levels in the CSF of the patients with 'Anti-NMDA-receptor encephalitis' due to their intrathecal production. Many patients with 'Anti-NMDA receptor Encephalitis' respond well to several modes of immunotherapy. (3) Anti-NMDA-NR2A/B antibodies are present in a substantial number of patients with Systemic Lupus Erythematosus (SLE) with or without neuropsychiatric problems. The exact percentage of SLE patients having anti-NMDA-NR2A/B antibodies varies in different studies from 14 to 35%, and in one study such antibodies were found in 81% of patients with diffuse 'Neuropshychiatric SLE', and in 44% of patients with focal 'Neuropshychiatric SLE'. Anti-NMDA-NR2A/B antibodies are also present in subpopulations of patients with Epilepsy of several types, Encephalitis of several types (e

  1. Antibodies against C1q Are a Valuable Serological Marker for Identification of Systemic Lupus Erythematosus Patients with Active Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Shuhong Chi

    2015-01-01

    Full Text Available Objective. An early diagnosis of lupus nephritis (LN has an important clinical implication in guiding treatments of systemic lupus erythematosus (SLE in clinical settings. In this study, the diagnostic values of circulating autoantibodies to C1q alone or in combination with other markers for accessing active SLE and LN were evaluated. Methods. The diagnostic value of anti-C1q autoantibodies for identification of patients with active SLE disease and LN was evaluated by analyzing the level of anti-C1q antibodies in sera from 95 SLE patients, 40 non-SLE patients, and 34 healthy cohorts. Results. The prevalence of anti-C1q antibodies was significantly higher in patients with SLE (50/95, 52.6%, active SLE (40/51, 78.4%, and LN (30/35, 85.7% in comparison with non-SLE patient controls, patients with inactive SLE, and non-LN, respectively. A combination of anti-C1q with anti-dsDNA and/or levels of complements C3 and C4 exhibited an increased specificity but a decreased sensitivity for identification of patients with active SLE and LN diseases relative to each of these markers alone. Conclusion. Anti-C1q antibodies were strongly associated with disease activity and LN in SLE patients, suggesting that it may be a reliable serological marker for identification of SLE patients with active LN and active SLE disease.

  2. [Mid-stream versus bladder puncture urine in the diagnosis of urinary tract infection in pregnant patients].

    Science.gov (United States)

    Retzke, U; Waitz, I; Loth, M; Liebetrau, B

    1988-01-01

    150 healthy women being pregnant in the 1st, 2nd and 3rd trimester were examined. From the same content of urinary bladder suprapubic puncture urine (BPU) and mid-stream urine (MSU) were collected. The results concerning microbiological and microscopical analysis of urine proofs were compared. For qualitative and quantitative germ analysis MSU is sufficiently clean enough. In 95.3 there is a good correspondence of the microbiological results of both proofs. Exceptionally in 4.7% the MSU-results were not confirmed by BPU. With respect to the findings in sediment there is no good correspondence of the results. In case of sterile bladder content the BPU sediment - findings are significantly more frequent normal and significantly more seldom abnormal than in MSU. The sediment findings in MSU are more frequent false positive than in BPU. In case of an infected bladder content there are no significant differences in the sediment findings of both techniques in taking urine proofs. The rate of normal sediment findings in case of an infected bladder content is unrealistic high: In MSU in 11% and in BPU in 26%. For microbiologic germ diagnosis MSU and BPU proofs are equivalent. But, for detection or for exclusion of urinary tract infections the sediment finding is poorly pathognomonic for a urinary tract infection. A normal sediment finding does not exclude the existance of an urinary tract infection. Therefore, in the system of prenatal care we should waive of the sediment finding as a guide for the diagnosis of urinary tract infections.

  3. Effect of the cortex-lytic enzyme SleC from non-food-borne Clostridium perfringens on the germination properties of SleC-lacking spores of a food poisoning isolate.

    Science.gov (United States)

    Paredes-Sabja, Daniel; Sarker, Mahfuzur R

    2010-11-01

    The hallmark of bacterial spore germination is peptidoglycan cortex hydrolysis by cortex-lytic enzymes. In spores of Clostridium perfringens wild-type strain SM101, which causes food poisoning, the sole essential cortex-lytic enzyme SleC is activated by a unique serine protease CspB. Interestingly, the non-food-borne wild-type strain F4969 encodes a significantly divergent SleC variant (SleCF4969) and 3 serine proteases (CspA, CspB, and CspC). Consequently, in this study we evaluated the functional compatibility of SleCF4969 and SleCSM101 by complementing the germination phenotypes of SM101ΔsleC spores with sleCF4969. Our results show that although pro-SleCF4969 was processed into mature SleCF4969 in the SM101ΔsleC spores, it partially restored spore germination with nutrient medium, with a mixture of ʟ-asparagine and KCl, or with a 1:1 chelate of Ca2+ and dipicolinic acid. While the amount of dipicolinic acid released was lower, the amount of hexosamine-containing material released during germination of SM101ΔsleC(sleCF4969) spores was similar to the amount released during germination of SM101 wild-type spores. The viability of SM101ΔsleC(sleCF4969) spores was 8- and 3-fold lower than that of SM101 and F4969 spores, respectively. Together, these data indicate that the peptidoglycan cortex hydrolysis machinery in the food poisoning isolate SM101 is functionally divergent than that in the non-food-borne isolate F4969.

  4. Early life factors associated with adult onset systemic lupus erythematosus (SLE in women

    Directory of Open Access Journals (Sweden)

    Christine Gibson Parks

    2016-03-01

    Full Text Available Background: Exposure early in life can influence adult disease and immunity, but the role of early life exposures in risk of SLE is not established.Methods: Women in a national cohort (ages 35-74 provided data on perinatal, maternal and sociodemographic factors, longest residence to age 14 and residential farm history of at least 12 months to age 18. Cases (N=124 reported SLE diagnosed age 16 years or older with use of disease modifying anti-rheumatic drugs. Non-cases (N=50,465 did not report lupus. Odds ratios (OR and 95% confidence intervals (CI were estimated by logistic regression adjusting for age and race/ethnicity. Results: SLE was associated with low birthweight (data on 84 cases and 36,477 non-cases; 4 weeks early vs. full-term; OR=3.4; 95%CI 1.6, 7.4. Considering longest childhood residence to age 14, SLE was associated with more frequent pesticide use (e.g., at least monthly OR=2.3; 95%CI 1.3, 4.1. SLE was associated with having an early and extended childhood farm residence (i.e., prenatal/maternal farm exposure and longest childhood farm residence; OR=1.8; 95%CI 1.1, 3.0 versus neither. In those with a childhood-only farm residence of 12+ months, agricultural pesticide use was associated with SLE, with the strongest associations for direct personal exposures. Conclusions: The association of SLE with premature birth is consistent with studies in other populations, and with an observed association with low birthweight. The associations of SLE with childhood exposure to residential and agricultural pesticides warrant further study.INTRODUCTIONSystemic lupus erythematosus (SLE is an autoimmune disease characterized by immune reactivity to multiple nuclear components and inflammation, resulting in diverse clinical features and multiple organ involvement. The causes of SLE are generally not known. Racial disparities and increased familial risk suggest a genetic predisposition. It is believed that environmental factors may contribute to

  5. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years

    OpenAIRE

    KIANI, ADNAN N.; Magder, Laurence S.; Petri, Michelle

    2011-01-01

    Accelerated atherosclerosis is a major cause of mortality in SLE. Mycophenolate mofetil (MMF) has been shown to suppress growth factor-induced proliferation of vascular smooth muscle and endothelial cells in animal models. We hypothesized that MMF might modify the inflammatory component of atherosclerosis in SLE. We examined the effect of MMF on atherosclerosis as measured by changes in carotid intima–media thickness (IMT) or coronary artery calcium (CAC) over 2 years. CAC and carotid IMT wer...

  6. Conformal weldings of random surfaces: SLE and the quantum gravity zipper

    CERN Document Server

    Sheffield, Scott

    2010-01-01

    We construct a conformal welding of two Liouville quantum gravity random surfaces and show that the interface between them is a random fractal curve called the Schramm-Loewner evolution (SLE), thereby resolving a variant of a conjecture of Peter Jones. We also demonstrate some surprising symmetries of this construction, which are consistent with the belief that (path decorated) random planar maps have (SLE-decorated) Liouville quantum gravity as a scaling limit. We present several precise conjectures and open questions.

  7. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Sudha Biradar Kerure

    2013-04-01

    Full Text Available Background: Urinary tract infections (UTIs are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens. Methods: A total of 500 pregnant women were studied over a period of one year. Clean catch midstream urine sample was collected into a sterile container & then subjected to culture method. Results: Significant bacteriuria was noted in 45 patients (9%. 3% patients had insignificant bacteriuria. Growth of contaminants was noted in 8%. 80% samples were sterile with no growth. E. coli was the most common etiological agent, followed by Staphylococcus aureus. Conclusions: Asymptomatic bacteriuria is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt UTI & other complications in both mother & fetus. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 213-216

  8. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-06-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  9. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-01-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  10. Space Link Extension (SLE) Emulation for High-Throughput Network Communication

    Science.gov (United States)

    Murawski, Robert W.; Tchorowski, Nicole; Golden, Bert

    2014-01-01

    As the data rate requirements for space communications increases, significant stress is placed not only on the wireless satellite communication links, but also on the ground networks which forward data from end-users to remote ground stations. These wide area network (WAN) connections add delay and jitter to the end-to-end satellite communication link, effects which can have significant impacts on the wireless communication link. It is imperative that any ground communication protocol can react to these effects such that the ground network does not become a bottleneck in the communication path to the satellite. In this paper, we present our SCENIC Emulation Lab testbed which was developed to test the CCSDS SLE protocol implementations proposed for use on future NASA communication networks. Our results show that in the presence of realistic levels of network delay, high-throughput SLE communication links can experience significant data rate throttling. Based on our observations, we present some insight into why this data throttling happens, and trace the probable issue back to non-optimal blocking communication which is sup-ported by the CCSDS SLE API recommended practices. These issues were presented as well to the SLE implementation developers which, based on our reports, developed a new release for SLE which we show fixes the SLE blocking issue and greatly improves the protocol throughput. In this paper, we also discuss future developments for our end-to-end emulation lab and how these improvements can be used to develop and test future space communication technologies.

  11. Is lipstick associated with the development of systemic lupus erythematosus (SLE)?

    Science.gov (United States)

    Wang, Jun; Kay, Ashley B; Fletcher, Jeremiah; Formica, Margaret K; McAlindon, Timothy E

    2008-09-01

    Lipstick use has been hypothesized to be a risk factor of developing systemic lupus erythematosus (SLE). The objective of this study was to investigate the association between lipstick use and risk of SLE. We performed an Internet-based case-control study of SLE with Google users searching on medical key terms as the source population. Cases were diagnosed within 5 years and met > or =4 ACR criteria for SLE by medical record review. Controls were matched to cases on age, gender, race, ethnicity, region of residence, reference year, education, and income using propensity score. Demographic characteristics and lifestyle factors were collected using an online questionnaire. Conditional logistic regression models were used for the analyses with smoking, alcohol consumption, permanent hair dye use, and chemical hair straightener use adjusted. The analysis included 124 cases and 248 matched controls of whom 96% were females and 81% were whites. The median of disease duration was 2 years (range 0-4 years). Using lipstick at least 3 days/week was significantly associated with increased risk of SLE (adjusted OR = 1.71, 95%CI = 1.04-2.82). There was a trend of greater risk with earlier age of initiation of lipstick use (lipsticks absorbed across the buccal mucosa and confounding from unmeasured lifestyle factors could be the explanation of this association. Epidemiologic studies of SLE should include this exposure in exploring its environmental triggers.

  12. Azathioprine during pregnancy in systemic lupus erythematosus patients is not associated with poor fetal outcome.

    Science.gov (United States)

    Saavedra, Miguel Ángel; Sánchez, Antonio; Morales, Sara; Ángeles, Ulises; Jara, Luis Javier

    2015-07-01

    The objective of this study was to evaluate the risk of adverse fetal outcome in systemic lupus erythematosus (SLE) women exposed to azathioprine during pregnancy. We reviewed the medical records of SLE pregnant women followed from January 2005 to April 2013. The patients were evaluated at least once in each trimester and postpartum. Relevant fetal outcomes were extracted, such as rate of liveborns, fetal loss (spontaneous abortion and stillbirth), term delivery, preterm birth, neonatal death, low birth weight, low birth weight at term, and congenital malformations. A detailed history of drug use during pregnancy was obtained. We studied 178 pregnancies (in 172 women), 87 of them were exposed to azathioprine (AZA-group) and the remaining 91 were not exposed (NO AZA-group). Exposure to other drugs was similar in both groups. The rate of live births, spontaneous abortions mean birth weight, weeks of gestation, rate of birth weight lupus flare, and anti-DNA positive were associated with an increased risk of poor fetal outcome. Our study suggests that the use of azathioprine is safe and lacks of teratogenity in patients with SLE and pregnancy. Exposure to azathioprine during pregnancy is not associated with poor fetal outcome.

  13. Pleuro-pulmonary abnormalities in patients with systemic lupus erythematosus assessment with high resolution computed tomography, chest radiography and pulmonary function tests

    Energy Technology Data Exchange (ETDEWEB)

    Sant, S.M.; Doran, M.; Fenelon, H.M.; Breatnach, E.S. [University of Michigan (United States)

    1998-04-01

    The objective has to assess the nature of pleuro-pulmonary abnormalities, with particular reference to interstitial lung disease (ILD), in patients with systemic lupus erythematosus (SLE) In conclusion, HRCT is more sensitive than PFTs or CXR in the evaluation of pleuro-pulmonary disease in SLE. We report an unusually high prevalence of HRCT appearances suggestive of ILD in patients with SLE. subclinical lung disease is common in patients with SLE. (author)

  14. 重度血小板减少对妊娠合并狼疮患者的影响%Effect of severe lupus-associated thrombocytopenia on pregnant women with systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    张建瑜; 屈谦; 唐加明; 罗冰; 黄凯清

    2012-01-01

    Objective To investigate the effect of severe thrombocytopenia ( STP ) on pregnancy outcomes andobstetric complications in pregnant women with systemic lupus erythematosus ( SLE ).Methods The clinical dats on 11pregnant women with SLE-associated STP who had treated during the period of 2006 to 2011 were analyzed retrospectively.Results 11 of 49 pregnant women with SLE met the criteria for platelet count of less than 40× 109/L,with a median count of 21 × 109/L,ranging from 5 to 38× 109/L.STP mainly occurred in the third trimester,which was always complicated with multiple organ damage.Cesarean sections were performed in all patients.Fetal loss occurred in 4 women,premature labor in 5,and low neonatal weight in 4.The median neonatal weight was 2212 g.ConCltsions Even though the systemic symptoms were severe,the women with thrombocytopenia induced by lupus have a better pregnancy outcome under the conditions of proper treatment and close supervision during the perinatal period.%目的 探讨重度血小板减少症( sever thrombocytopenia,STP)对狼疮合并妊娠患者妊娠结局、产科并发症影响.方法 对2006至201 1年收治的11例妊娠合并SLE性STP患者临床资料进行回顾性分析.结果 49例妊娠合并狼疮患者中,重度血小板减少(血小板低于40× 109/L)11例(中位数为28×109/L,范围为5~38×109/L).STP主要发生在妊娠晚期,常常合并多脏器损害.该组病例中4例胎儿丢失(包括治疗性引产3例.治疗性流产1例),余7例活产,其中早产儿5例,低体重儿4例,新生儿体重中位数为2212 9.结论 SLE相关的STP患者全身系统性病变严重,经过及时处理,在严密的围产期监测下,注意防治妊娠并发症,可获得较好的妊娠结局.

  15. Poly(hydroxyethyl methacrylate) based affinity membranes for in vitro removal of anti-dsDNA antibodies from SLE plasma.

    Science.gov (United States)

    Uzun, Lokman; Yavuz, Handan; Osman, Bilgen; Celik, Hamdi; Denizli, Adil

    2010-07-01

    The preparation of polymeric membrane using affinity technology for application in blood filtration devices is described here. DNA attached poly(hydroxyethyl methacrylate) (PHEMA) based microporous affinity membrane was prepared for selective removal of anti-dsDNA antibodies from systemic lupus erythematosus (SLE) patient plasma in in vitro. In order to further increase blood-compatibility of affinity membrane, aminoacid based comonomer N-methacryloyl-L-alanine (MAAL) was included in the polymerization recipe. PHEMAAL membrane was produced by a photopolymerization technique and then characterized by swelling tests and scanning electron microscope (SEM) studies. Blood-compatibility tests were also performed. The water swelling ratio of PHEMAAL membrane increased significantly (133.2%) compared with PHEMA (58%). PHEMAAL membrane has large pores around in the range of 5-10 microm. All the clotting times increased when compared with PHEMA membrane. Loss of platelets and leukocytes was very low. DNA loading was 7.8 mg/g. There was a very low anti-dsDNA-antibody adsorption onto the plain PHEMAAL membrane, about 78 IU/g. The PHEMAAL-DNA membrane adsorbed anti-dsDNA-antibody in the range of 10-68 x 10(3)IU/g from SLE plasma. Anti-dsDNA-antibody concentration decreased significantly from 875 to 144 IU/ml with the time. Anti-dsDNA-antibodies could be repeatedly adsorbed and eluted without noticeable loss in the anti-dsDNA-antibody adsorption amount.

  16. PKK deficiency in B cells prevents lupus development in Sle lupus mice.

    Science.gov (United States)

    Oleksyn, D; Zhao, J; Vosoughi, A; Zhao, J C; Misra, R; Pentland, A P; Ryan, D; Anolik, J; Ritchlin, C; Looney, J; Anandarajah, A P; Schwartz, G; Calvi, L M; Georger, M; Mohan, C; Sanz, I; Chen, L

    2017-05-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies that can result in damage to multiple organs. It is well documented that B cells play a critical role in the development of the disease. We previously showed that protein kinase C associated kinase (PKK) is required for B1 cell development as well as for the survival of recirculating mature B cells and B-lymphoma cells. Here, we investigated the role of PKK in lupus development in a lupus mouse model. We demonstrate that the conditional deletion of PKK in B cells prevents lupus development in Sle1Sle3 mice. The loss of PKK in Sle mice resulted in the amelioration of multiple classical lupus-associated phenotypes and histologic features of lupus nephritis, including marked reduction in the levels of serum autoantibodies, proteinuria, spleen size, peritoneal B-1 cell population and the number of activated CD4 T cells. In addition, the abundance of autoreactive plasma cells normally seen in Sle lupus mice was also significantly decreased in the PKK-deficient Sle mice. Sle B cells deficient in PKK display defective proliferation responses to BCR and LPS stimulation. Consistently, B cell receptor-mediated NF-κB activation, which is required for the survival of activated B cells, was impaired in the PKK-deficient B cells. Taken together, our work uncovers a critical role of PKK in lupus development and suggests that targeting the PKK-mediated pathway may represent a promising therapeutic strategy for lupus treatment. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  17. Comparison of Ankle Proprioception Between Pregnant and Non Pregnant Women

    OpenAIRE

    Preetha R; John Solomon M

    2011-01-01

    Pregnant women report falls especially during their third trimester. Physiological changes along with ligament laxity can affect the joint proprioception in this population. This study was conducted to compare the ankle proprioception between pregnant and non pregnant women. Thirty pregnant and 30 non pregnant women were included in the study and the position of ankles were recorded by a digital camera placed 60 cms away from the feet of the subject. UTHSCSA Image tool software version 3.0. w...

  18. Anesthetic Considerations for Neuraxial Anesthesia in Pregnant Patients With Pityriasis Rosea With Skin Lesions Covering the Lumbar Spine.

    Science.gov (United States)

    Werntz, Megan; Chun, Carlene; Togioka, Brandon Michael

    2016-10-15

    Pityriasis rosea (PR) is an acute exanthematous skin disease that is likely due to reactivation of human herpesviruses (HHVs) 6b and 7. In contrast to herpes simplex and zoster (alphaherpesviruses), HHV-6b and -7 (betaherpesviruses) are not found predominantly in skin lesions. This difference in virion location may decrease the possibility of causing central nervous system infection through skin contamination, but the risk for hematogenous spread likely remains the same. This article uses the first-known epidural placement through active PR to illustrate risk-benefit considerations when deciding between neuraxial and general anesthesia for obstetric patients with PR.

  19. 妊娠期高血压疾病患者产后抗高血压治疗的探讨%A preliminary study on postpartum anti-hypertension treatment in patients with pregnant hypertension syndrome

    Institute of Scientific and Technical Information of China (English)

    胡旭; 李东野; 陈南娥; 李晓峰

    2012-01-01

    目的 探讨妊娠期高血压疾病患者产后抗高血压治疗意义.方法 对2010~2011年中3 231例分娩产妇进行观察.对其中的424例合并有妊娠期高血压的产妇进行前瞻性对照观察.根据产妇对抗高血压治疗的依从性分为对照组和非对照组,对两组产妇产后高血压的转归进行分析,经统计学处理,探讨其意义.结果 治疗组产后高血压恢复正常时间短,尿蛋白转阴快,高血压遗留率低.结论 妊娠期高血压孕妇产后高血压及蛋白尿并未恢复正常,产后继续抗高血压治疗可加快妊娠期高血压疾病患者的早日康复,降低高血压遗留率.%Objective To discuss the significance of postpartum anti - hypertension treatment in patients with pregnant hypertension syn-drome. Methods The clinical data of 3231 cases of postpartum puerperants during 2010 to 2011 were retrospectively analyzed. Among them, 424 patients with pregnant hypertension syndrome were undergone prospective control observation. According to maternal compliance to the treatment, they were divided into trial group and control group, the outcome of postpartum hypertension in patients of these 2 groups were statistically compared and analyzed. Results Among patients in trial group, the duration for high blood pressure returned to normal after treatment was short, u-rine protein quickly returned to normal, and the residual rate of high blood pressure was low. Conclusion Among pregnant women with pregnant hypertension syndrome, their high blood pressure and proteinuria were usually not returned to normal during postpartum period, hence anti - hypertension treatment should be continued, thus it can speed up the recovery of pregnant women with pregnant hypertension syndrome and reduce the residual rate of high blood pressure.

  20. Targeted therapeutics in SLE: emerging strategies to modulate the interferon pathway

    Science.gov (United States)

    Oon, Shereen; Wilson, Nicholas J; Wicks, Ian

    2016-01-01

    Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by impaired immune tolerance, resulting in the generation of pathogenic autoantibodies and immune complexes. Although autoreactive B lymphocytes have been the first targets for biologic therapies in SLE, the importance of the innate immune system, and in particular, pathways involved in interferon (IFN) signaling, has emerged. There are now data supporting a central role for a plasmacytoid dendritic cell-derived type I IFN pathway in SLE, with a number of biologic therapeutics and small-molecule inhibitors undergoing clinical trials. Monoclonal antibodies targeting IFN-α have completed phase II clinical trials, and an antibody against the type I IFN receptor is entering a phase III trial. However, other IFNs, such as IFN gamma, and the more recently discovered type III IFNs, are also emerging as targets in SLE; and blockade of upstream components of the IFN signaling pathway may enable inhibition of more than one IFN subtype. In this review, we discuss the current understanding of IFNs in SLE, focusing on emerging therapies. PMID:27350879

  1. Disease-specific quality indicators, guidelines, and outcome measures in systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Mosca, M; Bombardieri, S

    2007-01-01

    The assessment of quality of care is becoming increasingly important, but as yet no standard set of measures to assess quality has been developed. The ACR Quality Measures Committee has selected the following areas of study to develop quality indicators: diagnostic/classification criteria, outcome measures/response criteria, treatment guidelines/management recommendations, definition of quality indicators, and definition of data collection systems. The aim of the present review is to evaluate existing guidelines and outcome measures concerning disease/activity monitoring, autoantibody and laboratory assessment, outcomes, and therapy in systemic lupus erythematosus (SLE) that could be used to define disease-specific quality indicators. Much data is available in the literature that could serve to define a starter set of quality indicators for SLE. Monitoring issues are discussed in the ACR and EULAR recommendations. As far as therapy is concerned, the ACR has provided indicators for rheumatoid arthritis that could also be applied to SLE, as well as indications for anti-malarial monitoring. The outcomes measures most frequently used in SLE are damage and death, but organ-specific definitions of outcome and response are being evaluated. The development of quality measures for SLE is just beginning; existing information could serve to construct a starter set of indicators such as the one proposed here. Certainly much progress will be made in the near future. A practical, user-friendly tool for physicians that will help them deliver high quality care to populations is also needed.

  2. Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

    OpenAIRE

    Holloway, Laura; Humphrey, Louise; Heron, Louise; Pilling, Claire; Kitchen, Helen; Højbjerre, Lise; Strandberg-Larsen, Martin; Hansen, Brian Bekker

    2014-01-01

    Background Despite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humanistic and economic burden of SLE, and review the patient-reported outcomes (PROs) used to measure such concepts in SLE clinical trials. Methods A conceptual model for SLE was developed from structured review of published articles from 2007 to ...

  3. Acute respiratory distress syndrome in a pregnant woman with systemic lupus erythematosus: a case report.

    Science.gov (United States)

    Chen, Y-J A; Tseng, J-J; Yang, M-J; Tsao, Y-P; Lin, H-Y

    2014-12-01

    When the disease activity of systemic lupus erythematosus (SLE) is controlled appropriately, a pregnant woman who has lupus is able to carry safely to term and deliver a healthy infant. While the physiology of a healthy pregnancy itself influences ventilatory function, acute pulmonary distress may decrease oxygenation and influence both mother and fetus. Though respiratory failure in pregnancy is relatively rare, it remains one of the leading conditions requiring intensive care unit admission in pregnancy and carries a high risk of maternal and fetal morbidity and mortality, not to mention the complexity caused by lupus flare. We report a case of SLE complicated with lupus pneumonitis and followed by acute respiratory distress during pregnancy. Though there is a high risk of maternal and fetal morbidity and mortality, maternal respiratory function improved after cesarean section and treatment of the underlying causes. The newborn had an extremely low birth weight but was well at discharge.

  4. Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water

    Energy Technology Data Exchange (ETDEWEB)

    Kilburn, K.H.; Warshaw, R.H. (Univ. of Southern California, Los Angeles (United States))

    1992-02-01

    Criteria for the recognition of systemic lupus erythematosus (SLE) were applied to 362 subjects exposed to trichloroethylene, trichloroethane, inorganic chromium, and other chemicals in water obtained from wells in an industrially contaminated aquifer in Tucson, Arizona. Their antinuclear autoantibodies were measured by fluorescence (FANA) in serum. Ten patients with clinical SLE and/or other collagen-vascular diseases were considered separately. Results were compared to an Arizona control group, to published series, and to laboratory controls. Frequencies of each of 10 ARA symptoms were higher in exposed subjects than in any comparison group except those with clinical SLE. The number of subjects with 4 or more symptoms was 2.3 times higher compared to referent women and men. FANA titers > 1:80 was approximately 2.3 times higher in women but equally frequent in men as in laboratory controls. ARA score and FANA rank were correlated with a coefficient (cc) of .1251, r{sup 2} = .0205 in women and this correlation was almost statistically significant in men cc = .1282, r{sup 2} = .0253. In control men and women neither correlation was significant. Long-term low-dose exposure to TCE and other chemicals in contaminated well water significantly increased symptoms of lupus erthematosus as perceived by the ARA score and the increased FANA titers.

  5. Recruiting Pregnant Patients for Survey Research: A Head to Head Comparison of Social Media-Based Versus Clinic-Based Approaches.

    Science.gov (United States)

    Admon, Lindsay; Haefner, Jessica K; Kolenic, Giselle E; Chang, Tammy; Davis, Matthew M; Moniz, Michelle H

    2016-12-21

    Recruiting a diverse sample of pregnant women for clinical research is a challenging but crucial task for improving obstetric services and maternal and child health outcomes. To compare the feasibility and cost of recruiting pregnant women for survey research using social media-based and clinic-based approaches. Advertisements were used to recruit pregnant women from the social media website Facebook. In-person methods were used to recruit pregnant women from the outpatient clinic of a large, tertiary care center. In both approaches, potential respondents were invited to participate in a 15-minute Web-based survey. Each recruitment method was monitored for 1 month. Using bivariate statistics, we compared the number, demographic characteristics, and health characteristics of women recruited and the cost per completed survey for each recruitment method. The social media-based approach recruited 1178 women and the clinic-based approach recruited 219 women. A higher proportion of subjects recruited through social media identified as African American (29.4%, 207/705 vs 11.2%, 20/179), reported household incomes survey, compared with US $23.51 for clinic-based recruitment. Web-based recruitment through a social networking platform is a feasible, inexpensive, and rapid means of recruiting a large, diverse sample of pregnant women for survey research.

  6. Lymphopaenia, anti-Ro/anti-RNP autoantibodies, renal involvement and cyclophosphamide use correlate with increased risk of herpes zoster in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Hu, Stephen Chu-Sung; Lin, Chi-Ling; Lu, Yi-Wei; Chen, Gwo-Shing; Yu, Hsin-Su; Wu, Ching-Shuang; Lan, Cheng-Che E

    2013-05-01

    Herpes zoster occurs with increased frequency in patients with systemic lupus erythematosus (SLE). The aim of this study was to identify and evaluate clinical and laboratory risk factors associated with development of herpes zoster in patients with SLE. A retrospective case-control study was performed in a population of patients with SLE. Patients were identified as cases if their first episode of herpes zoster occurred after diagnosis of SLE. Patients with SLE who never developed herpes zoster were enrolled as controls. Medical charts and laboratory data for both cases and control patients were comprehensively reviewed. A total of 65 cases and 105 controls were included. Risk factors associated with the development of herpes zoster in patients with SLE were found to be lymphopaenia, anti-Ro antibodies, anti-RNP antibodies, neuropsychiatric manifestations, renal involvement and cyclophosphamide use. Therefore, the presence of certain disease manifestations in patients with SLE represents risk factors for the development of herpes zoster.

  7. Increased serum ß2-microglobulin is associated with clinical and immunological markers of disease activity in systemic lupus erythematosus patients

    DEFF Research Database (Denmark)

    Hermansen, M-L F; Hummelshøj, L; Lundsgaard, Dorte

    2012-01-01

    The objective of this study was to explore the relationship between serum levels of ß2-microglobulin (ß2MG), which some studies suggest reflect disease activity in systemic lupus erythematosus (SLE), and various clinical and immunological markers of disease activity in SLE. Twenty-six SLE patients...

  8. Processing of SLE API Encoding and Decoding by Using Traits Generalization%基于Traits泛化技术的SLE API编译码处理

    Institute of Scientific and Technical Information of China (English)

    张军朋; 李晓伟; 唐卫涛; 李大鹏

    2015-01-01

    在对CCSDS(Consultative Committee for Space Data Systems,空间数据咨询委员会)制定的SLE(Space Link Extension,空间链路扩展)的标准API(Application Program Interface,应用程序接口)设计开发过程中,需要对各种不同服务类型的操作进行ASN.1(Abstract Syntax Notation One,抽象语法标记1)编码译码,使用一般方法处理会存在大量的冗余且可扩展性不强.因此,设计了基于Traits技术的SLE API编码译码泛化模型,该模型从服务、协议数据单元、操作等3个层级,以及编码、译码这2个方向分别定义模板,并进行特化、偏特化以及萃取,从而实现了对编码、译码过程的泛化,并通过实例描述了应用过程.该模型有效提高了SLE API设计的灵活性、层次性、通用性,以及SLE服务的可拓展性.

  9. Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Overlap Syndrome in Patients With Biopsy-Proven Glomerulonephritis

    OpenAIRE

    2016-01-01

    Abstract The aim of the study was to report the clinical, biological, and pathological characteristics of patients with glomerulonephritis (GN) secondary to systemic lupus erythematosus (SLE)/antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) overlap syndrome. A nationwide survey was conducted to identify cases of SLE/AAV overlap syndrome. Data were collected from SLE and AAV French research groups. Inclusion criteria were diagnosis of both SLE and AAV according to inter...

  10. CTLA-4 polymorphisms and systemic lupus erythematosus (SLE): a meta-analysis.

    Science.gov (United States)

    Zhai, Jin-Xia; Zou, Li-Wei; Zhang, Zhao-Xiang; Fan, Wen-Jing; Wang, Han-Yong; Liu, Ting; Ren, Zheng; Dai, Rui-Xue; Ye, Dongqing

    2013-09-01

    The aim of this study was to summarize results on the association of cytotoxic T-lymphocyte antigen-4 (CTLA-4) promoter exon-1 +49 and 1722T/C polymorphism with systemic lupus erythematosus (SLE) susceptibility by using the meta-analysis. We searched all the publications about the association between CTLA-4) promoter exon-1 +49 and 1722T/C polymorphism and SLE from PubMed, Elsevier Science Direct, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wanfang (Chinese). Previous CTLA-4 association studies with SLE, however, have produced inconsistent results. We have performed a meta-analysis to better assess the purported associations. A total of 17 independent studies (to June 2012) testing association between one or more CTLA-4 polymorphisms and SLE were used in this analysis. We have compared allele and genotype frequencies at two polymorphic sites found in exon-1 (at +49) and the promoter region (at -1722). The data demonstrate that the exon-1 +49 polymorphism is associated with SLE susceptibility in Asian population. The overall risk, measured by odds ratio (OR), stratification by ethnicity indicates the exon-1 +49 GG+GA genotype is associated with SLE, at least in Asians (OR = 0.85, 95 % CI = 0.73-0.99, P = 0.04 for GG+GA vs. AA; OR = 0.85, 95 % CI = 0.72-1.00, P = 0.05 for AG vs. AA). Similar trends are found in allele-specific risk estimates and disease association. Overall, there was significant association between the 1722T/C polymorphism and overall SLE risks (OR = 0.78, 95 % CI = 0.63-0.97, P = 0.04 for GG+GA vs. AA, OR = 0.87, 95 % CI = 0.76-0.99, P = 0.04 for G vs. A) in Asian population.In summary, this meta-analysis demonstrates that the CTLA-4 promoter +49A/G and promoter -1722C/T polymorphism may confer susceptibility to SLE, especially in Asian-derived population.

  11. Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

    Directory of Open Access Journals (Sweden)

    Feijen-de Jong Esther I

    2013-01-01

    Full Text Available Abstract Background Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of pregnant women with those of non-pregnant women. Methods Data were retrieved from the Netherlands Information Network of General Practice (LINH, a nationally representative register. This register holds longitudinal data on consultations, prescriptions and the referrals of all patients listed at 84 practices in the Netherlands in 2007–2009, including 15,123 pregnant women and 102,564 non-pregnant women in the same age-range (15 to 45 years. We compared consultation rates (including all contacts with the practice, diagnoses (ICPC-1 coded, medication prescriptions (coded according to the Anatomical Therapeutic Chemical classification system, and rate and type of referrals from the start of the pregnancy until six weeks postpartum (336 days. Results Pregnant women contacted their GP on average 3.6 times, compared to 2.2 times for non-pregnant women. The most frequently recorded diagnoses for pregnant women were ‘pregnancy’ and ‘cystitis/urinary infection’, and ‘cystitis/urinary infection’ and ‘general disease not otherwise specified’ for non-pregnant women. The mean number of prescribed medications was lower in pregnant women (2.1 against 4.4. For pregnant women, the most frequent referral indication concerned obstetric care, for non-pregnant women this concerned physiotherapy. Conclusions GP consultation rates in pregnancy and postpartum shows that GPs are important providers of care for pregnant women. Therefore, the involvement of GPs in collaborative care during pregnancy and postpartum should be reinforced.

  12. Diagnostic Value of Anti-nucleosome Antibody in SLE Patients: A Systematic Review%ELISA法检测血清抗核小体抗体诊断系统性红斑狼疮价值的系统评价

    Institute of Scientific and Technical Information of China (English)

    秦莉; 吴丽娟; 王兰兰; 白杨娟

    2007-01-01

    目的 评价ELISA法检测血清中抗核小体抗体(anti-nucleosome antibody,AnuA)诊断系统性红斑狼疮(systemic lupus erythematosus,SLE)的价值.方法 检索MEDLINE、EMbase、Cochrane图书馆等数据库,检索时间为1990~2005年,收集关于AnuA诊断SLE价值的相关研究文献,进行质量评价,利用Cochrane协作网提供的RevMan软件进行异质性分析,MetaDisc进行Meta分析及绘制SROC曲线.结果 共纳入文献25篇,合计7 289例,其中经金标准确认的SLE患者2 459例,非SLE者5 030例.Meta分析结果显示,各纳入研究均存在不同程度的质量问题,导致各研究间存在高度异质性(P<0.00001,I2=87.2%),合并敏感度为64.9%,95%CI 63.0%~66.8%,合并特异度为92.6%,95%CI 91.8%~93.3%;SROC曲线下面积0.918,SE 0.021 2.结果 表明其平均漏诊率较高(35.1%),平均误诊率较低(7.4%),有一定的诊断价值.结论 目前ELISA法检测抗核小体抗体诊断SLE具有一定诊断价值,可作为诊断SLE的诊断指标.

  13. Myocardial infarction in a patient with systemic lupus erythematosus and antiphospholipid syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHANG Bo; JIANG Da-ming; ZHOU Xu-chen; QI Guo-xian

    2011-01-01

    This case report we presented aims to report a-31-year-old man with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) who developed myocardial infarction (Ml) and also aims to discuss the possible mechanisms. The results showed that traditional risk factors alone do not cause coronary heart disease with SLE, and SLE-related factors influence the atherogenic process. We found that although SLE patients with acute Ml benefit from percutaneous coronary intervention (PCI) therapy, it is very important to choose the reasonable antithrombotic strategies in patients with SLE and APS undergoing PCI who require oral anticoagulant therapy.

  14. Assessment of Macular Peripapillary Nerve Fiber Layer and Choroidal Thickness Changes in Pregnant Women with Gestational Diabetes Mellitus, Healthy Pregnant Women, and Healthy Non-Pregnant Women.

    Science.gov (United States)

    Acmaz, Gokhan; Atas, Mustafa; Gulhan, Ahmet; Acmaz, Banu; Atas, Fatma; Aksoy, Huseyin; Zararsiz, Gokmen; Gokce, Gokcen

    2015-06-18

    Gestational diabetes mellitus (GDM) is a risk factor for the development of type II diabetes and it causes maternal and child morbidity. Screening for diabetic retinopathy (DR) is important because patients who develop DR have no symptoms until macular edema and/or proliferative diabetic retinopathy (PDR) are already present. The aim of this study was to determine the early retinal findings of GDM. This study was conducted in a tertiary research center. We conducted a prospective cross-sectional study with 3 groups: Group 1 consisted of 36 pregnant women with GDM, Group 2 consisted of 24 healthy pregnant women, and Group 3 consisted of 38 healthy non-pregnant women of reproductive age. Spectralis optical coherence tomography (OCT) was used for the assessment. Macular, choroid, and retinal nerve fiber layer (RNFL) thicknesses were evaluated in patients with GDM and comparisons were made among pregnant women with GDM, healthy pregnant women, and healthy non-pregnant women for these parameters. The nasal part of the RNFL was significantly thinner in the GDM group than in the healthy pregnant group. None of the patients had retinopathy or macular edema at the time of examination. Decreased nasal part of RNFL thickness may be the first retinal change in patients with GDM. Our study suggests that OCT should be performed for the patients with GDM for detection of early retinal changes associated with GDM.

  15. Quality of life in patients with systemic lupus erythematosus

    OpenAIRE

    Елена Александровна Асеева; V. N. Amirdzhanova; ЛИСИЦЫНА Т.А.; M V Zavalskaya

    2013-01-01

    The recent rise in survival rates and therefore in the degree of organ damages due to both disease itself and performed therapy increasingly gives a reason to think about health-related quality of life (QL) in patients with systemic lupus erythematosus (SLE). Numerous studies initiated in the 1980s to asses QL in patients with SLE have revealed considerable impairments in physical, emotional functioning in this category of patients. SLE leads to social dysadaptation, chronic stress, anxiety, ...

  16. Quality of life in patients with systemic lupus erythematosus

    OpenAIRE

    Елена Александровна Асеева; V N Amirdzhanova; Т А Лисицына; M V Zavalskaya

    2013-01-01

    The recent rise in survival rates and therefore in the degree of organ damages due to both disease itself and performed therapy increasingly gives a reason to think about health-related quality of life (QL) in patients with systemic lupus erythematosus (SLE). Numerous studies initiated in the 1980s to asses QL in patients with SLE have revealed considerable impairments in physical, emotional functioning in this category of patients. SLE leads to social dysadaptation, chronic stress, anxiety, ...

  17. serum lipid profile in non-pregnant and pregnant hausa

    African Journals Online (AJOL)

    DR. AMINU

    Body weight and height of each subject were taken to calculate body mass index ... contribute in unraveling the serum lipid profile among pregnant and non pregnant Hausa - Fulani women in ... Changes in loudness were not considered.

  18. Systemic lupus erythematosus (SLE) in the eastern region of Saudi Arabia. A comparative study.

    Science.gov (United States)

    Abid, N; Khan, A Sattar; Al Otaibi, F Huzam

    2013-12-01

    This retrospective study aimed to collect data related to the clinical manifestations and laboratory investigations of systemic lupus erythematosus (SLE) patients in the eastern part of Saudi Arabia, in one of the tertiary-care centers, King Fahd Hospital Al-Hasa, and to compare it with other regions of Saudi Arabia. Forty-six patients fulfilling the American College of Rheumatology 1997 criteria (ACR) were collected over a period from January 2004 to December 2008. The results showed an average age of onset of 26.17 (±9.17). The most common clinical features were nonspecific constitutional symptoms (fever, fatigue and malaise) seen in 44 patients (95.7%). Musculoskeletal features seen were mostly arthralgias (91.3%) and arthritis (76.1%). Nephritis was seen in 58.7% and hypertension in 52.2%. Mucocutaneous involvement included oral ulcers (71.7%), hair loss (65.2%), butterfly rashes (67.4%), photosensitivity (47.8%) and discoid lupus (13%). Neurologic manifestations showed psychosis in 17.4%, depression in 15.2% and headache in 28.3%. The most common hematologic presentation was leukopenia (58.7%) followed by hemolytic anemia and anemia of chronic disease (47.8%). Antinuclear antibodies were positive in 44 (95.7%), anti-dsDNA in 38 (42.6%), anti-Ro SSA and La SSB in 38 (82.6%). Anticardiolipin antibodies and lupus anticoagulant were positive in eight (17.4%). Low complement levels (C3 and C4) were seen in 41 (89.1%) of the patients with active disease. The drugs used in treatment were NSAIDs (100%), antimalarials (97.8%), steroids (100%), intermittent cyclophosphamide and other immunosuppressive drugs (71.7%). We found that the age of onset and sex distributions were different from other areas of Saudi Arabia, while clinical manifestations were the same as in other areas. The prognosis of lupus was good overall despite the multi-organ involvement. However, further studies based on larger number of patients are needed.

  19. Role of CCR5 Delta 32 bp deletion in RA and SLE

    NARCIS (Netherlands)

    Martens, H. A.; Kallenberg, C. G. M.; Bijl, M.

    2009-01-01

    CCR5 and its ligands play important roles in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). A deletion of 32 bp in its gene leads to the production of a non-functional receptor. Although a protective effect of CCR5 Delta 32 for the development of RA has been suggested, future stud

  20. New insights into the pathogenesis of systemic lupus erythematosus (SLE) : the role of apoptosis

    NARCIS (Netherlands)

    Bijl, M; Limburg, PC; Kallenberg, CGM

    2001-01-01

    In recent years disturbances in the process of apoptosis and the clearance of apoptotic cells have been put forward as fundamental in the development of autoimmunity. In this review we will discuss the data which supply evidence for this theory. We will focus on SLE as the prototype of autoimmune di

  1. Genetics of SLE: Functional Relevance for Monocytes/Macrophages in Disease

    Directory of Open Access Journals (Sweden)

    Jennifer C. Byrne

    2012-01-01

    Full Text Available Genetic studies in the last 5 years have greatly facilitated our understanding of how the dysregulation of diverse components of the innate immune system contributes to pathophysiology of SLE. A role for macrophages in the pathogenesis of SLE was first proposed as early as the 1980s following the discovery that SLE macrophages were defective in their ability to clear apoptotic cell debris, thus prolonging exposure of potential autoantigens to the adaptive immune response. More recently, there is an emerging appreciation of the contribution both monocytes and macrophages play in orchestrating immune responses with perturbations in their activation or regulation leading to immune dysregulation. This paper will focus on understanding the relevance of genes identified as being associated with innate immune function of monocytes and macrophages and development of SLE, particularly with respect to their role in (1 immune complex (IC recognition and clearance, (2 nucleic acid recognition via toll-like receptors (TLRs and downstream signalling, and (3 interferon signalling. Particular attention will be paid to the functional consequences these genetic associations have for disease susceptibility or pathogenesis.

  2. Clinical significance of C4d in SLE and antiphospholipid syndrome

    NARCIS (Netherlands)

    Cohen, Danielle

    2012-01-01

    This thesis describes the clinical significance of thebiomarker C4d, a split product of the complement system, in several manifestations of systemic autoimmunediseases such as SLE and antiphospholipid syndrome. The findings in this thesis suggest that this biomarker might be of use in unraveling dis

  3. 系统性红斑狼疮及其合并自身免疫性甲状腺疾病患者甲状腺功能的研究%Clinical analysis of thyroid function in 72systemic lupus erythematosus(sle)patients

    Institute of Scientific and Technical Information of China (English)

    蔡茂文; 吴侗; 龙丽; 周彬

    2013-01-01

    目的 探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)及其合并自身免疫性甲状腺疾病(autoimmune thyroidism disease,AITD)患者的甲状腺功能.方法 检测并分析比较72例SLE患者(SLE组)与80例健康体检者(健康对照组)甲状腺激素水平及合并AITD情况;对SLE合并AITD患者分别行抗双链DNA抗体(Anti-dsDNA)阳性、Anti-dsDNA及抗核小体抗体(ANuA)双阳性分组对比,并进行Anti-dsDNA定量与甲状腺功能和甲状腺自身抗体的相关性分析.结果 ①SLE患者FT3、FT4、TT3、TT4水平明显低于健康体检人群,AITD发病率、甲状腺自身抗体阳性率和促甲状腺素(TSH)明显高于健康体检人群,差异均有统计学意义(P<0.05).②中高度活动SLE患者FT3、FT4、TT3、TT4明显低于轻度活动患者,TSH明显高于轻度活动患者,差异均有统计学意义(P<0.05).③49例合并AITD的SLE患者中,Anti-dsDNA阳性(30例)与阴性(19例)、Anti-dsDNA及ANuA双阳性(24例)与非双抗体阳性(25例)的甲状腺素水平差异均无统计学意义(P>0.05).④Anti-dsDNA定量与FT3、FT4、TT3、TT4、TSH、Anti-TPO、Anti-TG均无相关性(P>0.05).结论 SLE患者易并发AITD,特别是甲状腺功能减退.甲状腺功能及甲状腺自身抗体与Anti-dsDNA、ANuA以及Anti-dsDNA定量无相关性.

  4. Anti-erythropoietin receptor antibodies in systemic lupus erythematosus patients with anemia.

    Science.gov (United States)

    Luo, X-Y; Yang, M-H; Peng, Ping; Wu, L-J; Liu, Q-S; Chen, L; Tang, Z; Liu, N-T; Zeng, X-F; Liu, Y; Yuan, G-H

    2013-02-01

    Anemia is a common hematologic abnormality in systemic lupus erythematosus (SLE). An inadequate erythropoietin (EPO) response in SLE patients with anemia has been described that may be due to the presence of antibodies to EPO in SLE patients. However, whether anemia in patients with SLE is related to antibodies to EPO receptor (EPOR) has not yet been investigated. We enlisted 169 consecutive patients with SLE and 45 normal individuals to investigate the existence and importance of circulating autoantibodies to EPOR in sera from patients with SLE. In all patients with SLE, the disease activity was evaluated by using the SLE disease activity index SLEDAI. Anti-EPOR antibodies were detected by using an enzyme-linked immunosorbent assay (ELISA). A higher frequency of anti-EPOR antibodies was observed in SLE patients than in healthy controls (18.3% vs 2.2%, p = 0.007). Moreover, anti-EPOR antibodies were detected in 22 of 69 (31.9%) SLE patients with anemia and in only nine of 100 (9.0%, p antibodies exhibited more severe anemia and often presented as microcytic anemia (p = 0.001). Finally, anti-EPOR antibodies seemed more likely to occur in patients with rash (p = 0.008), lower levels of C(3) component (p = 0.01), higher titer of anti-dsDNA antibodies (p antibodies might play a vital role in SLE patients developing anemia because of the higher incidence of antibodies to EPOR found in SLE patients with anemia. Thus, there might be clinical value in detecting anti-EPOR antibodies in SLE patients with anemia. Therefore, the pathologic role of the antibodies in inducing anemia needs to be established in future studies.

  5. Travelers' Health: Pregnant Travelers

    Science.gov (United States)

    ... Zika is present and take precautions to avoid sexual transmission of the virus. If travel cannot be avoided, pregnant women should strictly follow steps to prevent mosquito bites. Additional information, including the most current list of countries and territories where Zika virus is a risk, ...

  6. 孕妇自控硬膜外镇痛分娩知识调查分析%Investigation and analysis about parturition related knowledge of patient-controlled epidural analgesia among pregnant women

    Institute of Scientific and Technical Information of China (English)

    王丽敏; 燕美琴; 胡燕利

    2015-01-01

    Objective To know the awareness level of patient-controlled epidual analgesia in labor related knowledge,and to provide evidence for health education,develop a comprehensive intervention program to reduce the rate of cesarean section.Methods Investigation on knowledge of patient controlled epidural analgesia during labor for a total of 400 pregnant women on Maternal and Child Health Hospital of Taiyuan City,MCH Hospital of Shanxi Province by questionnaire.Compared different characteristics of the pregnant women's scores about control epidural analgesia childbirth knowledge by nonparametric test,knowledge score of multi-factor analysis by multiple linear regression analysis.Results The maximum score of pregnant women-controlled epidural analgesia delivery knowledge was 13,the minimum score was 0,the median score was 4,range interquartile was 5.Different pregnant women with different age,education level,number of weeks of gestation,pregnancy,family income,and condition of parnatal care had different scores of knowledge of patient-controlled epidural analgesia,the difference was significant,P<0.05.Multiple linear regression analysis showed that:pregnant women's education,gestational age,the average monthly household income can be explained by maternal knowledge score of 61.4% of the variation.Conclusions The level of pregnant women-controlled epidural analgesia childbirth knowledge is low,we need to strengthen the natural childbirth education,and take a variety of modes of propaganda and increase their level of knowledge,enhance confidence of natural childbirth in pregnant women,so as to achieve the purpose of reducing cesarean section rate.%目的 了解孕妇自控硬膜外镇痛(patient-controlled epidural analgesia,PCEA)分娩相关知识的知晓水平,为更好地开展健康教育、制订降低剖宫产率的综合干预方案提供依据.方法 采用问卷调查法对山西省妇幼保健院、太原市妇幼保健院共410名孕妇进行PCEA分娩相

  7. Prevalence of HIV and anemia among pregnant women

    Directory of Open Access Journals (Sweden)

    Bankole Henry Oladeinde

    2011-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV prevalence is high among rural dwellers and pregnant women. Aims: This study aims to determine the prevalence of HIV and anemia among pregnant women attending antenatal clinic in rural community of Okada, Edo State, Nigeria. Patients and Methods: Anticoagulated blood and sera samples were obtained from 480 women consisting of 292 pregnant and 188 non-pregnant women. Antibodies to HIV were detected in the sera samples and hemoglobin concentration of the anticoagulated blood specimens were determined using standard techniques. Anemia was defined as hemoglobin concentration <11g/dl for pregnant women and <12g/dl for non-pregnant women. Results: Pregnancy was not a risk factor for acquiring HIV infection (pregnant vs. non-pregnant: 10.2% vs. 13.8%; OR=0.713, 95% CI=0.407, 1.259, P = 0.247. The prevalence of HIV was significantly (P = 0.005 and P = 0.025 higher in the age group 10-20 years and 21 - 30 years among pregnant and non-pregnant women respectively. Pregnancy was a risk factor for acquiring anemia (OR=1.717, 95% CI=1.179, 2.500, P = 0.006. Only the age of pregnant women significantly (P = 0.004 affected the prevalence of anemia inversely. Conclusion: The prevalence of HIV and anemia among pregnant women were 10.2% and 49.3% respectively. Pregnancy was associated with anemia. Interventions by appropriate agencies are advocated to reduce associated sequelae.

  8. Lupus Headaches in 55 Childhood-Onsets SLE

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Moradinejad

    2007-05-01

    Full Text Available Objective: Although headache is a common complaint among patients with lupus, no universally accepted explanation was available until the International Headaches Society adopted Lupus headache as a Nomenclature in its classification recently. Few studies indicate that lupus patients with positive anti-nuclear antibody (ANA and positive antiphospholipid antibodies (aPL experience more frequent headaches. The aim of this study was to determine the correlation between headache frequencies and ANA, anti-double strand DNA (anti-ds-DNA and aPL positivity. Material & Methods: In this prospective multicenter study were enrolled 55 children, 45 girls and 10 boys (F/M ratio:4.5, aged 3-16 years (mean 11.5 years, with neuropsychiatric lupus complaining of headache, that where followed-up for 5 years.. Whether lupus headache is a sign of progressive nature of the disease and how it should be treated is not clear yet. Those with active disease, hypertension, or tension headache were not included in this study. Findings: We studied 55 children with definite lupus. Twenty three (43% of our patients developed new or significantly worse, persistent headaches that sometimes were similar to migraine in the early course of their disease. However their headaches were not accompanied with disease flare up and the headaches were not found to be related to hypertension or use of other medications either. Accordingly, we came to a diagnosis of lupus headache for these patients. Among them 19/55 cases (35% had a positive aPL and 53/55 cases (96% had a positive ANA. Conclusion: Lupus headaches are most likely multifactorial, and probably only a small proportion of them truly represent active lupus. The above data highlights probable correlation between aPL, ANA, an anti-ds-DNA and lupus headache. However, more research is required to find better treatments and to establish a definitive correlation among them.

  9. Central sleep apnea in pregnant women with sleep disordered breathing.

    Science.gov (United States)

    Bourjeily, Ghada; Sharkey, Katherine M; Mazer, Jeffrey; Moore, Robin; Martin, Susan; Millman, Richard

    2015-09-01

    Physiologic changes in the cardiac, respiratory, and renal systems in pregnancy likely impact ventilatory control. Though obstructive sleep apnea and snoring are common in the pregnant population, the predisposition to central respiratory events during sleep and the prevalence of such events is less well studied. The aim of this study was to assess the presence of central apneas during sleep in pregnant women and non-pregnant controls suspected of sleep disordered breathing. Twenty-five pregnant women referred for polysomnography for sleep disordered breathing were compared with non-pregnant controls matched for age, body mass index, gender, and apnea hypopnea index (AHI). Central apnea index was defined as the number of central apneas per hour of sleep, and mixed apnea index was defined as the number of mixed apneas per hour of sleep. Sixty-four percent of pregnant women had a respiratory disturbance index >5 events per hour of sleep. Mean body mass index was 44.1 ± 6.9 kg/m(2) pregnant compared to 44.0 ± 7.3 kg/m(2) in controls. The total number of central apneas observed during sleep in the pregnant group consisted of two central apneas in one patient, and of 98 central apneas in 11 patients in the control group (p = 0.05). Median central apnea index was low in both groups (pregnant 0, interquartile range (IQR) 0, 0 vs. non-pregnant 0, IQR 0, 0.2, p = 0.04). Mixed apnea index was similarly low in both groups. Despite some physiologic changes of pregnancy that impact ventilatory control, the prevalence of central sleep apnea was low in our sample of overweight pregnant women with sleep-disordered breathing.

  10. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

    Science.gov (United States)

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

    2017-06-01

    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Impact analysis of autoantibody level and NR2 antibody level in neuropsychiatric SLE treated by methylprednisolone combined with MTX and DXM intrathecal injection.

    Science.gov (United States)

    Wang, Jingyuan; Zhao, Yinhuan; Zhang, Jihui; Lei, Hongwei; Zhu, Guiqi; Fu, Bingbing

    2014-11-01

    The objective is to explore the clinical curative effects of methylprednisolone combined with MTX and DXM intrathecal injection in treating neuropsychiatric systemic lupus erythematosus (NPSLE) and its effects on autoantibody level and anti-N-methyl-D-aspartate receptor subtype NR2a/2b antibody (anti-NR2 antibody) level. Thirty six admitted NPSLE patients were treated by methylprednisolone combined with MTX and DXM intrathecal injection. Thirty six SLE patients without neuropsychiatric symptoms were selected as non-NPSLE group. Clinical indexes including SLE activity index, erythrocyte sedimentation rate (ESR), cerebrospinal fluid pressure (CSFP), cerebrospinal fluid protein were observed before and after treatment. Autoantibodies including anti-nuclear antibody (ANA), anti-double stranded DNA antibody (anti-dsDNA antibody), anti-extractable nuclear antigen antibody (ENA-Ab) were detected before and after treatment. Enzyme linked immunosorbent assay was used to detect NR2 antibody level before and after treatment in two groups. Upon treatment of methylprednisolone combined with MTX and DXM intrathecal injection, SLE activity index, ESR, CSFP, cerebrospinal fluid protein of 36 NPSLE patients were significantly decreased. Before treatment, positive rates of ANA, anti-dsDNA antibody, and anti-ENA antibody in both NPSLE group and non-NPSLE group had no significant difference. However, positive rate of anti-NR2 antibody in NPSLE group was significantly higher than that of non-NPSLE group. After treatment, positive rates of autoantibodies and anti-NR2 antibody in both NPSLE and non-NPSLE group were significantly decreased. Anti-NR2 antibody can be a screening index of NPSLE, and methylprednisolone combined with MTX and DXM intrathecal injection has significant curative effects and can effectively decrease autoantibody level and anti-NR2 antibody level.

  12. Scorpion envenomation symptoms in pregnant women

    Directory of Open Access Journals (Sweden)

    H. Ben Nasr

    2007-01-01

    Full Text Available Scorpion envenomation is common in many countries; however, its effects on pregnancy are still unclear. In the present paper, we described the effects of scorpion envenomation on pregnant patients. A retrospective study was carried out considering the clinical and laboratory exams of patients admitted to the emergency room of Habib Bourguiba Hospital, Sfax, Tunisia, from 1990 to 2004. Variability of these clinical and laboratory profiles according to maternal age, gestational age and number of previous parities was also discussed. Among 167 scorpion-envenomed women, age ranged from 17 to 42 years, 7.18% were pregnant. These presented symptoms similar to those of non-pregnant women envenomed by scorpions. Two pregnant patients developed intense pelvic pain and one manifested vaginal bleeding. Although the studied parameters showed non-significant differences, we could conclude that scorpion envenomation may lead to abnormal uterine contraction probably causing preterm delivery. Maternal disturbances induced by scorpion envenomation may influence the fetus development. The effects were more severe in the second trimester of pregnancy.

  13. Is chronic periodontitis premature in systemic lupus erythematosus patients?

    Science.gov (United States)

    Calderaro, Débora Cerqueira; Ferreira, Gilda Aparecida; Corrêa, Jôice Dias; Mendonça, Santuza Maria Souza; Silva, Tarcília Aparecida; Costa, Fernando Oliveira; Lúcio Teixeira, Antônio

    2017-03-01

    The aim of this study was to compare the frequency and severity of chronic periodontitis (CP) in systemic lupus erythematosus (SLE) patients with individuals without rheumatic diseases. Seventy-five patients with SLE were compared to 75 individuals without rheumatic diseases (control group) matched for age, educational level, and income. The activity of SLE was assessed with the Systemic Lupus Erythematosus Disease Activity Index 2000. Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus evaluated SLE-related damage. Dental evaluation included measuring plaque index and parameters of periodontal disease (probing depth, clinical attachment level, and bleeding on probing). Fifty-one (68 %) SLE patients and 42 (56 %) control individuals had CP (p = 0.13). Periodontal status was similar in both groups. Considering only individuals with CP, SLE patients were younger than controls (40.7 ± 9.8 versus 46.14 ± 12.5 years of age, p = 0.02). CP was not associated with activity or therapeutics in SLE patients. Severity of periodontal parameters was similar in SLE patients and control subjects; however, CP occurred earlier in SLE patients.

  14. INCIDENCE OF URINARY TRACT INFECTION BOTH SYMPTOMATIC AND ASYMP T OMATIC PATIENTS AMONG PREGNANT WOMEN RELATING TO ISOLATION AND IDENTIFICATION WITH ANTIBIOGRAM

    Directory of Open Access Journals (Sweden)

    Shoukat Jahan

    2015-05-01

    Full Text Available Urinary tract infections are the most common bacterial infections during pregnancy . Asymptomatic bacteriuria is a common problem in pregnancy and is associated with risk of preterm birth and pyelonephritis if untreated . AIMS & OBJECTIVES: The present s tudy was aimed to evaluate the incidence of urinary tract infection in S ymptomatic & A symptomatic bacteriuria in pregnant women . STUDY TYPE: Prospective Study . STUDY POPULATION: Group A consists of 200 pregnant women with confirmed diagnosis of pregnancy and of all trimester with apparent signs and symptoms of UTI . Group B consists of 100 women with confirmed diagnosis of pregnancy and of all trimesters without any signs and sy mptoms of UTI and Group C consist of 20 healthy non pregnant women . MATERIAL & METHOD: Mid stream urine samples were collected from all women and processed by culture method . Isolates were identified based on colony characteristic and biochemical reactio n and antibiotic susceptibility testing was done by modified Kirby - Bauer’s disc diffusion method . RESULT: The incidence of significant bacteriuria in Group A is 15(7 . 5%, Group B is 10(10% and Group C is 1(5% . E . coli was the commonest organism isolate d from all cases . Nitrofurantoin was the most sensitive drug followed by Ciprofloxacin for gram negative bacteria . CONCLUSION: Asymptomatic bacteriuria is common among antenatal women in the study . E . coli is the most frequent isolated pathogen .

  15. Discerning Risk of Disease Transition in Relatives of Systemic Lupus Erythematosus Patients Utilizing Soluble Mediators and Clinical Features.

    Science.gov (United States)

    Munroe, Melissa E; Young, Kendra A; Kamen, Diane L; Guthridge, Joel M; Niewold, Timothy B; Costenbader, Karen H; Weisman, Michael H; Ishimori, Mariko L; Wallace, Daniel J; Gilkeson, Gary S; Karp, David R; Harley, John B; Norris, Jill M; James, Judith A

    2017-03-01

    Systemic lupus erythematosus (SLE) and other autoimmune diseases cause significant morbidity. Identifying populations at risk of developing SLE is essential for curtailing irreversible inflammatory damage. The aim of this study was to identify factors associated with transition to classified disease that would inform our understanding of the risk of SLE. Previously identified blood relatives of patients with SLE, who had information, including the SLE-specific portion of the Connective Tissue Disease Screening Questionnaire (SLE-CSQ). Serum and plasma samples were tested for the presence of lupus-associated autoantibodies and 52 soluble mediators. Generalized estimating equations (GEEs) were applied to identify factors predictive of disease transition. Of the 409 unaffected relatives of SLE patients, 45 (11%) had transitioned to classified SLE at follow-up (mean time to follow-up 6.4 years). Relatives who transitioned to SLE displayed more lupus-associated autoantibody specificities and higher SLE-CSQ scores (P < 0.0001) at baseline than did relatives who did not transition. Importantly, those who had developed SLE during the follow-up period also had elevated baseline plasma levels of inflammatory mediators, including B lymphocyte stimulator, stem cell factor (SCF), and interferon-associated chemokines (P ≤ 0.02), with concurrent decreases in the levels of regulatory mediators, transforming growth factor β (TGFβ), and interleukin-10 (P ≤ 0.03). GEE analyses revealed that baseline SLE-CSQ scores or ACR scores (number of ACR criteria satisfied) and plasma levels of SCF and TGFβ, but not autoantibodies, were significant and independent predictors of SLE transition (P ≤ 0.03). Preclinical alterations in levels of soluble mediators may predict transition to classified disease in relatives of SLE patients. Thus, immune perturbations precede SLE classification and can help identify high-risk relatives for rheumatology referral and potential

  16. Recruiting Pregnant Patients for Survey Research: A Head to Head Comparison of Social Media-Based Versus Clinic-Based Approaches

    Science.gov (United States)

    Haefner, Jessica K; Kolenic, Giselle E; Chang, Tammy; Davis, Matthew M; Moniz, Michelle H

    2016-01-01

    Background Recruiting a diverse sample of pregnant women for clinical research is a challenging but crucial task for improving obstetric services and maternal and child health outcomes. Objective To compare the feasibility and cost of recruiting pregnant women for survey research using social media-based and clinic-based approaches. Methods Advertisements were used to recruit pregnant women from the social media website Facebook. In-person methods were used to recruit pregnant women from the outpatient clinic of a large, tertiary care center. In both approaches, potential respondents were invited to participate in a 15-minute Web-based survey. Each recruitment method was monitored for 1 month. Using bivariate statistics, we compared the number, demographic characteristics, and health characteristics of women recruited and the cost per completed survey for each recruitment method. Results The social media-based approach recruited 1178 women and the clinic-based approach recruited 219 women. A higher proportion of subjects recruited through social media identified as African American (29.4%, 207/705 vs 11.2%, 20/179), reported household incomes pregnant women for survey research. PMID:28003174

  17. Periodontal disease in Chinese patients with systemic lupus erythematosus.

    Science.gov (United States)

    Zhang, Qiuxiang; Zhang, Xiaoli; Feng, Guijaun; Fu, Ting; Yin, Rulan; Zhang, Lijuan; Feng, Xingmei; Li, Liren; Gu, Zhifeng

    2017-08-01

    Disease of systemic lupus erythematosus (SLE) and periodontal disease (PD) shares the common multiple characteristics. The aims of the present study were to evaluate the prevalence and severity of periodontal disease in Chinese SLE patients and to determine the association between SLE features and periodontal parameters. A cross-sectional study of 108 SLE patients together with 108 age- and sex-matched healthy controls was made. Periodontal status was conducted by two dentists independently. Sociodemographic characteristics, lifestyle factors, medication use, and clinical parameters were also assessed. The periodontal status was significantly worse in SLE patients compared to controls. In univariate logistic regression, SLE had a significant 2.78-fold [95% confidence interval (CI) 1.60-4.82] increase in odds of periodontitis compared to healthy controls. Adjusted for potential risk factors, patients with SLE had 13.98-fold (95% CI 5.10-38.33) increased odds against controls. In multiple linear regression model, the independent variable negatively and significantly associated with gingival index was education (P = 0.005); conversely, disease activity (P periodontitis of SLE in multivariate logistic regression (OR 1.348; 95% CI: 1.183-1.536, P < 0.001). Chinese SLE patients were likely to suffer from higher odds of PD. These findings confirmed the importance of early interventions in combination with medical therapy. It is necessary for a close collaboration between dentists and clinicians when treating those patients.

  18. Current approach for urinary system stone disease in pregnant women

    Directory of Open Access Journals (Sweden)

    Orcun Celik

    2016-01-01

    Full Text Available Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

  19. Current approach for urinary system stone disease in pregnant women.

    Science.gov (United States)

    Celik, Orcun; Türk, Hakan; Cakmak, Ozgur; Budak, Salih; Ekin, Rahmi Gokhan; Keskin, Mehmet Zeynel; Yildiz, Guner; Ilbey, Yusuf Ozlem

    2016-01-14

    Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

  20. Behavioral Deficits Are Accompanied by Immunological and Neurochemical Changes in a Mouse Model for Neuropsychiatric Lupus (NP-SLE)

    DEFF Research Database (Denmark)

    Li, Yan; Eskelund, Amanda; Zhou, H

    2015-01-01

    Neuropsychiatric symptoms of systemic lupus erythematosus (NP-SLE) have been understudied compared to end-organ failure and peripheral pathology. Neuropsychiatric symptoms, particularly affective and cognitive indications, may be among the earliest manifestations of SLE. Among the potential...... pathophysiological mechanisms responsible for NP-SLE are increased peripheral pro-inflammatory cytokines, subsequent induction of indoleamine-2,3-dioxygenase (IDO) and activation of the kynurenine pathway. In the MRL/MpJ-Faslpr (MRL/lpr) murine model of lupus, depression-like behavior and cognitive dysfunction...

  1. [A case of late-onset SLE complicated with EDTA-dependent pseudothrombocytopenia].

    Science.gov (United States)

    Irisawa, A; Kaise, S; Kumada, Y; Sato, Y; Nishimaki, T; Kasukawa, R; Moritoh, T

    1992-10-01

    A 57-year-old man was admitted to our clinic with complaints of proximal myalgia in extremities. He was diagnosed as late-onset SLE based on the findings of pleuritis, pericarditis, arthritis and antibodies to DNA and cardiolipin. Aggregation of the platelets and the decreased counts of platelets were observed when EDTA was used as anticoagulant for the blood tests. However, the platelet aggregation was not noted with normal counts of platelets when Heparin-Theophylline was used as anticoagulant. From this observation, EDTA-dependent pseudothrombocytopenia was diagnosed and IgM class of EDTA-dependent anti-platelet antibody was detected by means of flow cytometry. Administration of prednisolone at 40mg/day reduced the symptoms and EDTA-dependent pseudothrombocytopenia, and EDTA-dependent anti-platelet antibody disappeared. His clinical course suggested that EDTA-dependent pseudothrombocytopenia was closely associated with the disease activity of SLE.

  2. Localization of radiolabeled anti-DNA monoclonal antibodies in murine systemic lupus erythematosus (SLE)

    Energy Technology Data Exchange (ETDEWEB)

    Wahl, R.; Hahn, B.; Ebling, F.

    1984-01-01

    The diagnosis of SLE can be extremely difficult. This multi-system disease is characterized by the deposition of DNA-anti-DNA antibody (Ab) complexes in many tissues, producing glomerulonephritis and systemic vasculitis. This study evaluates an IGG monoclonal (Mo) Ab directe3d against DNA (MrSSl) for potential radioimmunodiagnosis of SLE. Six 15 wk. old F-1 female hybrids of NZB+NZW mice (an animal SLE model that develops vasculitis and nephritis) were injected with 50 ..mu..Cl of I-131 MrSSl and 15 ..mu..Cl of I-125 isotype-matched control mouse myeloma (LPC-1) (non-reactive with DNA). Imaging and tissue distribution were studied. Two animals were also imaged using I-131 LPC Ab. Images at 2 and 9 days showed no clear differences in scan patterns using MrSSl or LPC-1 Ab. Tissue distribution studies at six days, however, showed a significantly higher accumulation of MrSSl in the kidneys vs. control Ab (2.7% vs. 1.8% of injected dose) (p < .04). Similarly, higher levels of MrSS were also seen in the spleen, liver and lungs (p < .03). Blood levels tended to be higher with the specific antibody as well. These differences were not apparent at 3 days post injection. The increased concentration of MrSSl present at 9 days in several organs may be secondary to MrSSl binding to DNA containing immune complexes present in diseased tissues. Blocked clearance by immune complexes or DNA, or differences in electrical charges of the antibodies could be contributing to the higher MrSSl levels seen. Images did not suggest deiodination as responsible. Further studies are necessary to determine if the amount of MrSSl retained by diseased animals is indicative of SLE disease activity.

  3. PLASMA ADIPONECTIN CONCENTRATIONS IN NON PREGNANT, NORMAL PREGNANCY AND OVERWEIGHT PREGNANT WOMEN

    Science.gov (United States)

    Nien, Jyh Kae; Mazaki-Tovi, Shali; Romero, Roberto; Erez, Offer; Kusanovic, Juan Pedro; Gotsch, Francesca; Pineles, Beth L.; Gomez, Ricardo; Edwin, Samuel; Mazor, Moshe; Espinoza, Jimmy; Yoon, Bo Hyun; Hassan, Sonia S.

    2008-01-01

    Aims Adiponectin is an adipokine that has anti-diabetic, anti-atherogenic, anti-inflammatory and angiogenic properties. This hormone has been implicated in both the physiological adaptation to normal pregnancy and obstetrical complications. The aims of this study were to determine normal maternal plasma concentrations of adiponectin throughout gestation and to explore the relationships between plasma adiponectin concentration, pregnancy, and maternal overweight. Study design A cross-sectional study was designed to include normal pregnant women (normal weight and overweight; 11–42 weeks of gestation), and non-pregnant women. Plasma adiponectin concentration was determined by immunoassay. Non-parametric statistics were used for analysis. Results (1) Adiponectin was detectable in the plasma of all patients; (2) there was no significant difference in the median adiponectin concentrations between pregnant and non-pregnant women; (3) plasma adiponectin concentrations were negatively correlated with gestational age only among normal weight pregnant women; and (4) overweight patients had significantly lower adiponectin concentrations than normal weight women. Conclusion Consistent with the increased insulin resistance and weight gain that occur in pregnancy, adiponectin concentrations were negatively correlated with gestational age. The results of this study and the nomogram herein presented can serve as the basis to explore the relationship between adiponectin and pregnancy complications and facilitate the clinical use of this important adipokine. Condensation Plasma adiponectin concentrations decrease with advancing gestational age only in nonobese women. PMID:17919116

  4. Bacillus thuringiensis peptidoglycan hydrolase SleB171 involved in daughter cell separation during cell division.

    Science.gov (United States)

    Li, Hua; Hu, Penggao; Zhao, Xiuyun; Yu, Ziniu; Li, Lin

    2016-04-01

    Whole-genome analyses have revealed a putative cell wall hydrolase gene (sleB171) that constitutes an operon with two other genes (ypeBandyhcN) of unknown function inBacillus thuringiensisBMB171. The putative SleB171 protein consists of 259 amino acids and has a molecular weight of 28.3 kDa. Gene disruption ofsleB171in the BMB171 genome causes the formation of long cell chains during the vegetative growth phase and delays spore formation and spore release, although it has no significant effect on cell growth and the ultimate release of the spores. The inseparable vegetative cells were nearly restored through the complementation ofsleB171expression. Real-time quantitative polymerase chain reaction analysis revealed thatsleB171is mainly active in the vegetative growth phase, with a maximum activity at the early stationary growth phase. Western blot analysis also confirmed thatsleB171is preferentially expressed during the vegetative growth phase. These results demonstrated that SleB171 plays an essential role in the daughter cell separation during cell division.

  5. Prevalence of toxoplasmosis in pregnant women and vertical transmission of Toxoplasma gondii in patients from basic units of health from Gurupi, Tocantins, Brazil, from 2012 to 2014.

    Directory of Open Access Journals (Sweden)

    Marcos Gontijo da Silva

    Full Text Available Toxoplasmosis is a parasitary disease that presents high rates of gestational and congenital infection worldwide being therefore considered a public health problem and a neglected disease.To determine the prevalence of toxoplasmosis amongst pregnant women and vertical transmission of Toxoplasma gondii in their newborns attended in the Basic Units of Health (BUH from the city of Gurupi, state of Tocantins, Brazil.A prevalence study was performed, including 487 pregnant women and their newborns attended in the BUH of the urban zone of the city of Gurupi, state of Tocantins, Brazil, during the period from February 2012 to February 2014. The selection of the pregnant women occurred by convenience. In the antenatal admission they were invited to participate in this study. Three samples of peripheral blood were collected for the detection of specific anti-T. gondii IgG, IgM and IgA through ELISA, for the polimerase chain reaction (PCR and IgG avidity during pregnancy. When IgM antibodies were detected the fetal and newborn infection investigation took place. The newborn was investigated right after birth and after one year of age through serology and PCR to confirm/exclude the vertical transmission. The analyses were performed in the Studies of the Host-Parasite Relationship Laboratory (LAERPH, IPTSP-UFG, Goiania, state of Goias, Brazil. The results were inserted in a data bank in Epi-Info 3.3.2 statistic software in which the analysis was performed with p≤5%.The toxoplasmosis infection was detected in 68.37% (333/487, CI95%: 64.62-72.86. The toxoplasmosis chronic infection prevalence was of 63.03% (307/487, CI95%: 58.74-67.32. The prevalence of maternal acute infection was of 5.33% (26/487; CI95%: 3.3-7.3 suspected by IgM antibodies detection in the peripheral blood. The prevalence of confirmed vertical transmission was of 28% (7/25; CI95%: 10.4-45.6.These results show an elevated prevalence of toxoplasmosis in pregnant women and vertical

  6. Antibodies to annexin-5 in pregnant women with systemic lupus erythematosus

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    Z. S. Alekberova

    2007-01-01

    Full Text Available Objective. To assess change of annexin-5 antibodies (AA5 level and AA5 influence on gestation outcome in pregnant women with systemic lupus erythematosus (SLE.Material and methods. 15 pregnant women with SLE who fulfilled 1997 ACR criteria (4 of them with concomitant antiphospholipid syndrome – APS were included. Median age of pts was 28,0 (23- 33 years, median SLE duration – 4,0 (3-9 years. SLEDAI activity score at the beginning of gestation was 2 (2-11. All but one pts received metypred from 2 to 20 mg/day. The women were examined in every trimester of gestation. AA5 and anticardiolipine antibodies (ACLA were evaluated with immunoenzyme assay.Results. AA5 elevation was revealed in 7 women (group 1: 6 of them were only IgG AA5 positive, 1 had both IgG and IgM AA5. Isolated IgM AA5 elevation was absent. 4 pts had borderline IgG AA5 values (from 5,3 to 7,4 U/ml. 3 pts had respectively 9,6, 12,1 and 168,5 U/ml. The last pt was also positive for IgM AA5 (till 14,4 U/ml. AA5 elevation was more frequent and more prominent during the II trimester of gestation. 8 pts with SLE (group 2 did not have AA5 elevation. 11 from 15 gestations ended with birth of viable baby, the rest 4 had unfavorable outcome. Median terms of delivery did not differ in both groups and came to 36 weeks. 3 pts with normal AA5 and 1 pt with elevated AA5 had gestation lost. 3 from these 4 pts were ACLA positive and APS was earlier diagnosed in 2 from them.Conclusion. Almost half of pregnant women with SLE (7 from 15 had AA5 elevation mainly during the II trimester of gestation. Unfavorable gestation outcomes were not associated with AA5 elevation. Possibly low levels of AA5 positivity and small sample size could influence the results.

  7. In vitro and in vivo analyses of the Bacillus anthracis spore cortex lytic protein SleL

    OpenAIRE

    2012-01-01

    The bacterial endospore is the most resilient biological structure known. Multiple protective integument layers shield the spore core and promote spore dehydration and dormancy. Dormancy is broken when a spore germinates and becomes a metabolically active vegetative cell. Germination requires the breakdown of a modified layer of peptidoglycan (PG) known as the spore cortex. This study reports in vitro and in vivo analyses of the Bacillus anthracis SleL protein. SleL is a spore cortex lytic en...

  8. THE PREGNANT MAN

    Directory of Open Access Journals (Sweden)

    M.Arulmani

    2014-09-01

    Full Text Available This scientific research article focus that the “Human Ancestor” lived in “Mars Planet‟ in the early universe shall be considered having distinguished genetic characteristics compared to “Modern Human” living in earth Planet especially in reproduction of population. This research further focus that MALE PARENT shall be considered as “become pregnant” and responsible for child birth. During the course of “Space” and “Time” of expanding universe the mars populations consider have descended to Earth planet due to varied climatic condition and FEMALE PARENT become pregnant and responsible for child birth at later stage of “Nuclear age”

  9. Percutaneous Ethanol Sclerotherapy of Symptomatic Nodules Is Effective and Safe in Pregnant Women: A Study of 13 Patients with an Average Follow-Up of 6.8 Years

    Directory of Open Access Journals (Sweden)

    Tamas Solymosi

    2015-01-01

    Full Text Available Background. Because of the increased risk of surgery, thyroid nodules causing compression signs and/or hyperthyroidism are concerning during pregnancy. Patients and Methods. Six patients with nontoxic cystic, four with nontoxic solid, and three with overt hyperthyroidism caused by toxic nodules were treated with percutaneous ethanol injection therapy (PEI. An average of 0.68 mL ethanol per 1 mL nodule volume was administered. Mean number of PEI treatments for patients was 2.9. Success was defined as the shrinkage of the nodule by more than 50% of the pretreatment volume (V0 and the normalization of TSH and FT4 levels. The average V0 was 15.3 mL. Short-term success was measured prior to labor, whereas long-term success was determined during the final follow-up (an average of 6.8 years. Results. The pressure symptoms decreased in all but one patient after PEI and did not worsen until delivery. The PEI was successful in 11 (85% and 7 (54% patients at short-term and long-term follow-up, respectively. Three patients underwent repeat PEI which was successful in 2 patients. Conclusions. PEI is a safe tool and seems to have good short-term results in treating selected symptomatic pregnant patients. Long-term success may require repeat PEI.

  10. Research on CCSDS SLE System Prototype Program%CCSDS SLE系统原型方案研究

    Institute of Scientific and Technical Information of China (English)

    冯炜; 朱宏涛; 贾林巧

    2012-01-01

    基于测控系统数据在SLE(空间链路扩展)服务提供方与使用方的传输包括2个流向——前向遥控指令和返向遥测数据——这一特点,从总体方案、软件体系结构和传输协议等3个方面对SLE系统提出设计方案.通过对CCSDS(空间数据系统咨询委员会)SLE系统的研究和CCSDS SLE传输协议原型软件的实施验证,利于将此协议应用于今后的工作中,便于实现与国外航天机构的相互合作.%A design of SLE (Space Link Extension) system in terms of top-level system scheme, software architecture and transmission protocol is presented c