RESUMO
Tumor necrosis factor alpha (TNF-α) inhibitors are widely used for the treatment of various inflammatory conditions. They are associated with an increased risk for infections. We report a case of herpes simplex virus type 1 (HSV-1) encephalitis in a patient receiving etanercept and review the literature on TNF-α and TNF-α inhibitors, and their importance in the pathophysiology of herpes simplex encephalitis.
Assuntos
Encefalite por Herpes Simples/diagnóstico , Herpesvirus Humano 1/isolamento & purificação , Imunoglobulina G/efeitos adversos , Imunossupressores/efeitos adversos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encefalite por Herpes Simples/virologia , Etanercepte , Humanos , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Radiografia , Receptores do Fator de Necrose Tumoral/uso terapêuticoRESUMO
INTRODUCTION: Recently, there have been increased reports of implantable cardioverter-defibrillator (ICD) lead perforation. Controversy exists about the safety of certain leads. CASE REPORT: A 37-year-old man with an ischemic cardiomyopathy presented four days postimplantation of an ICD lead with localized nonpleuritic chest wall pain. Imaging demonstrated proximity of the lead to the rib, suggestive of irritation of the periosteum. The lead was repositioned to the right ventricular septum without adverse effect on defibrillation. CONCLUSION: Lead perforation presenting with focal chest pain due to rib irritation is unusual. Placement of ICD leads on the right ventricular septum should be considered to improve safety.
Assuntos
Dor no Peito/etiologia , Desfibriladores Implantáveis/efeitos adversos , Eletrodos Implantados/efeitos adversos , Ventrículos do Coração/lesões , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/etiologia , Adulto , Dor no Peito/diagnóstico , Humanos , MasculinoRESUMO
The human transcription factor Sp3 has been widely studied at the translational level and has been described as a regulatory factor for a number of genes. Sp3 is currently characterized as a bifunctional transcription factor having the ability to behave as both an activator and/or a repressor in various promoter regions. Previous translational studies have attempted to determine the basis for these diverse functions with mostly contradictory evidence to date. Little data are available, however, concerning genomic structure, full-length cDNA, potential transcript variants, or location of translation initiation sites for the large isoform of the Sp3 gene. In this study, bacterial artificial chromosome (BAC) sequencing, reverse transcription-polymerase chain reaction (RT-PCR), genomic PCR, and database mining indicate that the Sp3 gene encompasses seven exons spanning more than 55 kb of genomic DNA on Chromosome 2. The 5' end of this sequence contains a large CpG island. This work also detected a processed pseudogene, psiSp3, located on Chromosome 13, spanning approximately 4.0 kb. Northern blot analysis detected three predominant transcripts at 4.0, 6.0 and 2.5 kb. Sequence analysis indicated that alternative splicing of exon 3 allows for multiple transcripts of Sp3. Each sequenced transcript possesses three to five potential translation initiation sites. This diversity at the level of gene expression will likely be key to understanding the diverse functions of Sp3.