Neonatal alloimmune thrombocytopenia due to anti-HPA 5a in a HPA-5a homozygous neonate.

The most frequently involved antigen in severe fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the human platelet antigen 1a. Cases of FNAIT caused by HPA-5a antigen are extremely rare, and usually not severe. We report a case of FNAIT caused by anti-HPA antibodies directed to the HPA-5a antigen. The thrombocytopenia was moderate with a minimal platelet count of 36 × 109/L by day 3, and spontaneously resolved by day 10. The pregnancy had been obtained by in vitro fertilization using embryo donation, creating a complete genetic disparity between the HPA 5b5b mother and the HPA 5a5a homozygous neonate. The use of ART with gamete donation can increase the risk and the severity of alloimmune thrombocytopenia and must be considered in new and subsequent pregnancies.

The effect of melatonin on body mass and behaviour of rats during an exposure to microwave radiation from mobile phone.

BACKGROUND: Microwave radiation (MW) produced by wireless telecommunications and a number of electrical devices used in household or in healthcare institutions may cause various disorders in human organism. On the other hand, melatonin is a potent antioxidant, immunostimulator and neuromodulator. The aim of this research was to determine body mass and behaviour changes in rats after a chronic microwave exposure, as well as to determine the effects of melatonin on body mass and behaviour in irradiated rats. METHODS: Wistar rats were divided into the four experimental groups: I group (control) - rats treated with 0,9 % saline, II group (Mel) - rats treated with melatonin (2 mg/kg), III group (MW) - rats exposed to MW radiation (4 h/day), IV group (MW+Mel) - rats, which were both exposed to MW radiation and received melatonin premedication (2 mg/kg). RESULTS: A significant body mass reduction was noted in animals exposed to MW radiation when compared to controls after 20, 40 and 60 days (p<0.001). Furthermore, body weight was significantly increased (p<0.05) in irradiated rats, which received melatonin pretreatment (MW+Mel) in comparison to irradiated group (MW) after 20 days. Microwave radiation exposed animals showed an anxiety related behaviour (agitation, irritability) after 10 days of exposure. After the radiation source removal, changes in behaviour were less noticeable. Melatonin administration to irradiated rats caused a decrease in the stress induced behaviour. CONCLUSION: Microwave radiation causes body mass decrease and anxiety related behaviour in rats, however melatonin causes a reverse of those effects on both body weight and behaviour of irradiated animals (Fig. 2, Ref. 32).

Generalized granuloma annulare presenting as arcuate dermal erythema.

Generalized granuloma annulare (GGA) is an uncommon cutaneous disease of unknown origin, characterized by numerous flesh-colored to erythematous papules with or without annular configuration. Clinical associations of GGA with diabetes mellitus, thyroid diseases, malignancies, AIDS, and chronic hepatitis C virus infection have been reported. Therapy has been attempted with various modalities with moderate efficacy. We report a case of GGA presenting as arcuate dermal erythema with excellent therapeutic response to corticosteroid therapy (a short course of intramuscular corticosteroids, a prolonged low oral dose, and topical corticosteroids).

Hemodialysis modality, percentage of body fat, and patient survival.

BACKGROUND: A number of studies have reported lower mortality of overweight hemodialysis patients. This post hoc analysis of an observational prospective single-center study was aimed at elucidating whether both being overweight and surviving longer could result from changes in the hemodialysis modality. METHODS: The study included a cohort of 242 patients who were gradually switched from cuprophane membrane and acetate dialysis to polysulfone (including high-flux) membranes and bicarbonate dialysis. The analysis involved 12 months of baseline data obtained during the first calendar year after the patients entered the study (1994-2001) and repeated measurements for up to 132 months of follow-up (until 2004). Anthropometric measurements were made during the winter season and the percentage of body fat (%fat) was calculated from triceps, biceps, subscapular, and suprailiac skinfolds (K/DOQI guidelines).Kt/V, normalized protein catabolic rate, and cardiovascular comorbidity were also determined and laboratory analyses undertaken. RESULTS: Significant correlations were found between %fat and bicarbonate dialysate as well as polysulfone membrane and high-flux membrane. The linear mixed model showed dependence of %fat on polysulfone and high-flux membrane (p<0.01) Multivariate Cox regression (time-dependent covariates) found %fat to be an independent factor for longer survival, in addition to polysulfone and high-flux membranes. CONCLUSION: Changes in hemodialysis modality were followed by both higher body fat percentage and patient survival. The reverse epidemiology of overweight patients might be at least partially the result of the influence of nonnutritional factors, such as a change in hemodialysis modality (introducing biocompatible high-flux and low-flux membranes and bicarbonate dialysis).

Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases.

Rhythm and conduction disturbances and sudden cardiac death (SCD) are important manifestations of cardiac involvement in autoimmune rheumatic diseases (ARDs). In patients with rheumatoid arthritis (RA), a major cause of SCD is atherosclerotic coronary artery disease, leading to acute coronary syndrome and ventricular arrhythmias. In systemic lupus erythematosus (SLE), sinus tachycardia, atrial fibrillation and atrial ectopic beats are the major cardiac arrhythmias. In some cases, sinus tachycardia may be the only manifestation of cardiac involvement. The most frequent cardiac rhythm disturbances in systemic sclerosis (SSc) are premature ventricular contractions (PVCs), often appearing as monomorphic, single PVCs, or rarely as bigeminy, trigeminy or pairs. Transient atrial fibrillation, flutter or paroxysmal supraventricular tachycardia are also described in 20-30% of SSc patients. Non-sustained ventricular tachycardia was described in 7-13%, while SCD is reported in 5-21% of unselected patients with SSc. The conduction disorders are more frequent in ARD than the cardiac arrhythmias. In RA, infiltration of the atrioventricular (AV) node can cause right bundle branch block in 35% of patients. AV block is rare in RA, and is usually complete. In SLE small vessel vasculitis, the infiltration of the sinus or AV nodes, or active myocarditis can lead to first-degree AV block in 34-70% of patients. In contrast to RA, conduction abnormalities may regress when the underlying disease is controlled. In neonatal lupus, 3% of infants whose mothers are antibody positive develop complete heart block. Conduction disturbances in SSc are due to fibrosis of sinoatrial node, presenting as abnormal ECG, bundle and fascicular blocks and occur in 25-75% of patients.

Adamantiades-Behçet's disease, deep venous thrombosis and anticardiolipin antibodies: report of two cases.

Vascular thrombosis was found in different proportions of patients with Adamantiades-Behçet's disease (ABD), depending on the ethnicity of the population under study. Various thrombophilic factors, including the levels of anticardiolipin antibodies (ACA), were investigated for their role in the thrombotic process with conflicting results. The prevalence of ACA varies considerably in different studies, but their presence has not been associated with increased risk for vascular thrombosis. We present two cases with ABD, deep venous thrombosis (DVT) and elevated levels of ACA that fulfil the criteria for both ABD and antiphospholipid syndrome (APS).

[Contact sensitization to antioxidants in rubber industry workers]. / Kontaktna senzibilizacija na antioksidantne materije kod radnika u gumarskoj industriji.

The most frequent contact allergens in rubber industry are antioxidants, substances against again of rubber. The aim of the work is determining their role in generating of allergic contact dermatitis (ACD) in rubber industry workers depending on the kind of antioxidants, sex of workerw, lenght of working, pace of work. 68 workers (first group) with contact dermatitic and 40 of healthy workerw (second group) in rubber industry were examined. Patch tests and LIF on 5 antioxidants were done. Positive patch tests had 54,41% workers from first group and 17,50% of workers from second group. Most frequent antioxidant is IPPD (N-isopropyl-N-phenylparaphenylendiamin). More frequent sensitization to this allergen was noticed in women (61,29% : 48,65%). Sensitization to antioxidants was more found in workers with longer working experience. Indoubtful influence of workers place to formation of ACD was determined. The results of LIF are not in complete correlation with patch tests and clinical picture. It is concluded that contact sensitization to antioxidants particularly to IPPD often occurs in rubber industry, as well as depends on the length of exposure, working place, sex etc. In diagnosis of ACD to antioxidants, priority is given to clinical picture and patch tests.

[Staphylococcus and skin diseases--incidence and antibiotic sensitivity]. / Staphylococcus i obolela koza--incidenca i osetljivost na antibiotike.

Bacterial flora of the skin is influenced by several factors (moisture, occlusion, desquamation, microbial antagonism, etc). Changed conditions on diseased skin result in changes of bacterial flora. Bacterial flora was qualitatively determined both in patients with Psoriasis vulgaris, Tinea Pedis, ulcerovarice syndrome, and in the control group. Special attention was paid to Staphylococcus and its sensitivity to antibiotics. The result was as follows: the largest percentage (48%), ob: pathogenic Staphylococcus aureus was found in ulcus cruris then in psoriasis (32%), in enterdigitas areas of legs in patients with mycosis (25%) and in 5% of healthy skin of the control group. High resistance to antibiotics use for a long time (penicillin, ampicillin). and high sensitivity to new antibiotics (Visiren, Abactal), was established. It is concluded that inflamed skin offers good condition for development of Staphylococcus, and that the incidence of this bacteria depends on aetiopathogenesis of the present dermatosis and factors which regulate bacterial flora.

Lack of correlation between cortical levels of choline acetyltransferase and learning scores in rats with globus pallidus lesions.

Previous work has shown that rats with lesions of the globus pallidus (GP) exhibit a generalized learning impairment. Data are presented suggesting that this impairment is not due to inadvertent damage to the nucleus basalis magnocellularis. Rats with GP lesions evidenced a significant visual discrimination learning loss and a significant reduction in cortical choline acetyltransferase (ChAT) activity. However, there was no significant correlation between the severity of the learning loss and the amount of reduction of cortical ChAT activity.

Learning deficits in rats with early neurotoxic lesions to the globus pallidus, substantia nigra, median raphe or pontine reticular formation.

Previous studies have shown that weanling rats with electrolytic lesions of the globus pallidus (GP), substantia nigra (SN), median raphe (MR) or pontine reticular formation (PRF) are deficient in learning a wide variety of laboratory tasks. The current study was designed to investigate whether this nonspecific learning deficiency is due to destruction of cells intrinsic to these subcortical regions or to fibers passing through these regions. Accordingly, neurotoxic lesions of the GP, SN, MR or PRF were made in weanling rats using ibotenic acid. Rats were subsequently required to learn a visual discrimination, a 3-cul maze and a nonvisual (incline plane) discrimination. While those groups with GP, SN or MR lesions showed significant deficits on all three problems, only the animals with GP lesions exhibited deficits comparable in magnitude to those associated with corresponding electrolytic lesions. Animals with lesions to the PRF were impaired only on the nonvisual discrimination. These results suggest that while destruction of neurons alone within the GP, SN or MR can produce a nonspecific learning impairment, the combined destruction of neurons and fibers of passage within the SN, MR or PRF produces a more profound learning deficit.