Epidemiology,characterization, and diagnosis of neuropsychiatric events in systemic lupus erythematosus

Introduction: Neuropsychiatric systemic lupus erythematosus (NPSLE) is characterized by a heterogeneity of clinical manifestations. The absence of diagnostic criteria and the lack of clinical trials is a challenge in clinical practice.

Areas covered: A literature review was performed to describe epidemiology, characterization (clinical, immunological, and imaging), diagnosis and treatment of NPSLE. Classification criteria have been the first step towards a uniform definition. More recently, different attribution models have been developed to help to determine if the NP event is due to SLE. Disease activity is a major risk factor for NP events. Cytokines and autoantibodies are associated with NP events, however, only a few studies have identified risk factors for individual NP events.

Expert opinion: Further research needs to search for and validate biomarkers for NPSLE and individual NP events, including neuroimaging findings, attribution models, and serologic markers. This will be a fundamental step in planning randomized control trials in the treatment of NPSLE to improve outcome.     

Post-traumatic diffuse brain swelling: isolated or associated with cerebral axonal injury

Eighteen children with severe head injuries and diffuse brain swelling were studied. They were separated into two groups based on the computed tomography (CT) findings. Seven patients had small ventricles in the normal location and small or absent cisterns. Eleven had these signs plus small deep-seated intraparenchymal hemorrhagic foci and/or intraventricular hemorrhage. Patients in the first group were in relatively good neurological condition; their intracranial pressure was easily controlled and all had a favourable outcome. On contrast, children in the second group had a more severe clinical presentation, frequently had uncontrollable intracranial hypertension, and more than 50% died.     

Bilateral brain abscesses complicating the use of crutchfield tongs

The case of a 4-year-old girl who developed bilateral brain abscesses complicating skull traction is reported. Crutchfield tongs were used to reduce a fracture dislocation at C2–3. Presenting symptoms consisted of headaches and focal seizures. Surgical treatment and antibiotics using serial CT led to a satisfactory outcome. This is the first reported case of this complication in a child. The current literature is reviewed.To whom offprint requests should be addressed at Avda. Pio Baroja 4, 30011 Murcia, Spain     

Penetrating ocular injuries in young patients. Initial injuries and visual results

Penetrating injuries are a leading cause of unilateral visual loss in young patients. We reviewed the records of 197 patients aged 18 years or younger who underwent primary repair of a penetrating ocular injury at the Wilmer Ophthalmological Institute from January 1970 through December 1981. The injury was caused by sharp objects in 49% of cases, missiles in 35%, and blunt trauma in 14%. Of 159 patients with at least 6 months follow-up, 110 (69%) achieved final vision of 5/200 or better, and 77 patients (48%) achieved final visual acuity of 20/50 or better. The prognosis after a penetrating injury is strongly influenced by the nature of the injury and the extent of initial damage. Several factors were found to correlate with an unfavorable visual outcome, including: initial preoperative visual acuity of worse than 5/200, injuries due to blunt trauma, wounds involving the sclera, double penetrating injuries, dense vitreous hemorrhage, and wounds associated with an intraocular "BB" pellet.     

Predictors of health-related quality of life in Parkinson’s disease: the impact of overlap between health-related quality of life and clinical measures

Quality of Life Research - This study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after...     

Improving Postpartum Care: Identifying Opportunities to Reduce Postpartum Emergency Room Visits Among Publicly-Insured Women of Color

Maternal and Child Health Journal - The purpose of this study was to explore the postpartum experiences of publicly-insured women of color, and identify how postpartum care can be improved to...     

进展期胃癌多药耐药基因表达的临床意义

目的 探讨多药耐药基因（MDR1基因）在人胃癌组织中的表达及其与临床病理的关系。方法 采用逆转录－多聚酶链反应（RT－PCR）法检测了215例手术切除的进展期胃癌组织中的MDR1基因的表达。实验数据采用SAS软件中的χ^2检验和Fisher’s exact P做统计学处理。结果 MDRI基因的阳性率为31．63％（68／215）,与年龄、性别、组织学类型、分化程度、淋巴结转移、Borromann分型及TNM分期等无关,但在分化差的肿瘤中有增高趋势,如黏液腺癌及印戒细胞癌中达41．67％及50．00％。结论 化疗前胃癌组织中MDRI基因即存在较高的表达率,这为选用化疗药物和MDR逆转剂提供了参考指标,但不能作为制定化疗方案的唯一指标。