Advanced MRI techniques: biomarkers in neuropsychiatric lupus.

Objectives The objective of this study was to determine whether advanced MRI could provide biomarkers for diagnosis and prognosis in neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Our prospective study included 28 systemic lupus erythematosus (SLE) patients with primary central NPSLE, 22 patients without NPSLE and 20 healthy controls. We used visual scales to evaluate atrophy and white matter hyperintensities, voxel-based morphometry and Freesurfer to measure brain volume, plus diffusion-tensor imaging (DTI) to assess white matter (WM) and gray matter (GM) damage. We compared the groups and correlated MRI abnormalities with clinical data. Results NPSLE patients had less GM and WM than controls ( p = 0.042) in the fronto-temporal regions and corpus callosum. They also had increased diffusivities in the temporal lobe WM ( p < 0.010) and reduced fractional anisotropy in the right frontal lobe WM ( p = 0.018). High clinical scores, longstanding disease, and low serum C3 were associated with atrophy, lower fractional anisotropy and higher diffusivity in the fronto-temporal lobes. Antimalarial treatment correlated negatively with atrophy in the frontal cortex and thalamus; it was also associated with lower diffusivity in the fronto-temporal WM clusters. Conclusions Atrophy and microstructural damage in fronto-temporal WM and GM in NPSLE correlate with severity, activity and the time from disease onset. Antimalarial treatment seems to give some brain-protective effects.

Differences between clinical and laboratory findings in patients with recent diagnosis of SLE according to the positivity of anti-dsDNA by the Crithidia luciliae method.

BACKGROUND: Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIF) is considered to have the highest specificity for systemic lupus erythematosus (SLE). OBJECTIVE: The objective of this report is to evaluate whether the presence of anti-dsDNA antibodies detected by the CLIF method is associated with a specific clinical phenotype in recently diagnosed SLE. METHODS: This retrospective cross-sectional study included all patients with newly diagnosed SLE between 1990 and 2011 and followed up in our institution. Demographic, clinical and laboratory findings were assessed. Correlations between positivity of anti-dsDNA by the CLIF method, clinical and laboratory data were analyzed. RESULTS: A total of 104 patients were included in the analysis. Patients who were positive for anti-dsDNA by the CLIF method at the time of diagnosis had (statistically) significantly higher titers of anti-dsDNA by the ELISA method, antinuclear (ANA) and anticardiolipin antibodies, lymphopenia and complement consumption compared with the other two groups. Also they presented significantly more musculoskeletal symptoms at baseline. CONCLUSION: The presence of anti-dsDNA by the CLIF method in newly diagnosed SLE was associated with certain markers of increased disease activity. Its use could be a useful biomarker for a specific clinical phenotype suggestive of a more severe involvement at the time of the diagnosis.

Gastric malignant schwannoma.

One case of gastric malignant schwannoma is presented, the clinical diagnosis, the morphological particularities and the prognostication of this tumour are discussed. Personal observation. In December 1986, the patient H. R., of female sex, aged 27, was hospitalised in "The Second Medical Clinic" of "St. Spiridon Hospital" for epigastric pains accompanied by melena. After analysing the evolution of the disease, it resulted that the patient had been suffering from epigastric pains, which gave unfavourable prognosis after a symptomatic treatment for 10 years.

Giant congenital nevi. A clinical and histopathological study.

17 cases of giant congenital nevi were reported. The lesions were located on the scalp, on the back and on the shoulders. The histopathological study revealed two cellular types of giant nevus; nevus cell type and neuroid type. Two types of neuroid structures were observed in neuroid type: Verocay bodies and pseudo-Meissnerian corpuscles. The congenital nature of a benign nevus includes the presence of nevus cells, single or in nests within the follicular epithelium, eccrine ducts or glands. Essentially, all giant nevi show conspicuous nevic cell permeation not only of the reticular dermis but typically also of the subcutis and even the fascia.

[Correlations between conventional allergometry and the Palmer types in interpretation of tuberculin skin tests]. / Corelatii între alergometria conventionala si tipurile Palmer în interpretarea reactiilor cutanate la tuberculina.

In view of differentiating post-vaccinal allergy from that developing after tuberculosis infection, the authors have investigated comparatively intradermal-reactions to tuberculin according to classical allergometry, and to the 4 types described by Palmer-Edwards in a group of 1549 students and 211 patients. All the subjects were tested with 2 units of PPD IC 65. It was noted that the type I and II Palmer reactions corresponded, in the majority of the cases, to intense, or hyperergic ID reactions, while the types III and IV of Palmer corresponded to slightly positive, or to negative ID reactions. The presence of the post-vaccinal scar does not appear to influence significantly the type of the reaction, but the presence of active specific lesions is accompanied by reactions of type I and II of the Palmer classification. It is concluded that although the Palmer types do not allow to make a clear differentiation between the two variants of allergy they provide however useful indications for the interpretation of IDR in a more sophisticated manner, as compared with the conventional allergometry.

[Risk factors in infection and development of tuberculosis in students]. / Factorii de risc în infectia si îmbolnavirea prin tuberculoza la studenti.

A study was carried out in 266 571 students, examined during the 1952--1974 interval, on a series of risk factors of infection and morbidity from tuberculosis with regard to certain epidemiological, immunobiologic and peristasis parameters. In the interval studied, morbidity from tuberculosis fell sharply from 923 per 100,000 in 1952 to 83 per 100,000 in 1974. The highest proportion of infection occured in the first three years at the university, particularly among meidcal students. The risk of infection of alergic subjects with an intradermoreaction greater than 15 mm in diameter, was approximately twice that the hypo- or normoergic subjects and the proportion of vaccinates who contracted the disease three times smaller than that of the non-vaccinated subjects.