Pregnancy outcome in patients with a medical history of immunoglobulin A vasculitis: a case-control study.

OBJECTIVE: Data on obstetric outcomes in patients with a history of immunoglobulin A vasculitis (IgA-V) are lacking. The aim of this study was to assess maternal, neonatal, and vasculitis outcomes during pregnancy. METHOD: We conducted a French retrospective case-control study. Pregnancies of patients with a history of IgA-V (cases) were retrospectively studied and compared to pregnancies in women who developed IgA-V after their pregnancies and to pregnancies in healthy women (controls). RESULTS: Twenty-six pregnancies in patients with a history of IgA-V were included and compared to 15 pregnancies in women who later developed IgA-V and 52 pregnancies in healthy women. Both gestational hypertension and pre-eclampsia were more frequent in the case group than in the other groups (23% vs 0% vs 0%, p < 0.01; 12% vs 7% vs 0%, p = 0.04). Hypertensive disorder of pregnancy occurred more frequently in patients with pre-existing kidney disease (78% vs 12%, p < 0.01). Caesarean section was more often performed in the case group than in the other groups (27% vs 0% vs 10%, p = 0.04). No foetal loss or maternal deaths occurred. There were no differences in delivery term or birth weight. No vasculitis flares were observed during pregnancy. CONCLUSION: Women with a history of IgA-V appear to be at higher risk for gestational hypertension and pre-eclampsia, especially in cases with renal involvement; however, both mother and newborn outcomes appear to be favourable.

[A late onset diagnosis of giant cell arteritis in remission]. / Diagnostic tardif d'une artérite à cellules géantes en rémission.

Giant-cell arteritis (GCA) is a classical cause of chronical inflammation (CI) in the elderly, causing headaches, scalp hypersensitivity and jaw claudication. We describe a patient with a GCA revealed with a year-long biological inflammation and weight loss. Diagnosis was performed on a systematic temporal artery biopsy showing typical histological features. No treatment was intended as the patient had a spontaneous remission, maintained at one year of follow-up. This case highlights the benefit of a systematic temporal artery biopsy to explore CI and reminds us that GCA may undergo spontaneous remission.

[Prostate radiation therapy: in vivo measurement of the dose delivered by kV-CBCT]. / Radiothérapie des cancers de la prostate : évaluation in vivo de la dose délivrée par tomographie conique de basse énergie (kV).

PURPOSE: To investigate if the regular use of kV-CBCT notably increases the dose delivered to tumor and surrounding healthy tissues. MATERIAL AND METHODS: Images were obtained using a Varian equipment (OBI version 1.3, 645 to 650 projections in 370 degrees to acquire image), and patients were irradiated at source-tumor distance: 100cm. In vivo measurements were performed using radio-thermoluminescent dosimeters Harshaw-TLD700H (TLD) at skin (anterior-posterior and lateral axis crossing the rotation axis), with a fourth TLD group under the table thanks to a retrolaser. TLD's were calibrated at the kV-CBCT effective energy (64 keV), and the method validated using an anthropomorphic phantom, in which Gafchromic EBT films were also inserted. RESULTS: The phantom study showed that the dose distribution depends on the phantom position relative to the axis and that the doses measured at the phantom surface using TLD and films (good agreement) were maximum at the entrance of the anterior-posterior axis. Their arithmetic mean was equal, or a slightly greater than doses measured at mid-thickness of the phantom and at the level of the rectum (OAR). In vivo measurements performed on the five first patients (125 kV-CBCT) yield a mean skin dose per kV-CBCT varying from 5.8+/-0.1 to 7.3+/-0.2 cGy on the anterior-posterior axis. Lateral skin doses vary from 3.4+/-0.2 to 4.5+/-0.2 cGy. CONCLUSION: Doses delivered by repeated kV-CBCT are not negligible. They should be taken into account, but questions about the RBE to be applied to kilovoltage X-rays are raised.

The organum vascolosum laminae terminalis of the domestic fowl: a Golgi and ultrastructural study.

The organum vascolosum laminae terminalis (OVLT) of the fowl was studied both with the aid of the rapid Golgi method and at ultrastructural level. Small and medium-sized isodendritic neurons were observed after silver impregnation of the OVLT. Their processes often run towards the great number of blood capillaries of the organ. Small bipolar neurons were intermingled between isodendritic elements. A peculiar ultrastructural finding of the OVLT neurons was the presence of a variable amount of dense-core vesicles 90-150 nm in diameter in their cytoplasm. Numerous nerve fibers and terminals surrounded neurons, glial cells and capillaries of the OVLT. These terminals were classified into 3 main types according to the diameter of dense core vesicles observed in them. Statistical evaluations of the populations of dense core vesicles confirmed this subdivision. Type 3 terminals had ultrastructural features of monoaminergic endings, whereas type 1 and 2 terminals were probably peptidergic fibers. Neurohaemal contacts were observed. between terminals with large dense core vesicles (type 2) and blood capillaries of the OVLT.