Pulmonary arterial aneurysms in Behçet's syndrome. Report of 4 cases

Pulmonary involvement in Behcet's disease is uncommon and pulmonary arterial aneurysms are present in about 1 to 7% of patients. But despite their scarcity, they represent a life-threatening complication and are usually regarded as of a poor prognosis. Our study aims to describe the epidemiological and therapeutic aspects of this condition. Among 180 patients with Behcet's disease according to the criteria of the international study group for Behcet's disease, four were diagnosed as having pulmonary artery aneurysms (2.22%). All were male, the mean age at the time of the diagnosis of pulmonary artery aneurysms was 29.8 years and the mean disease duration was 6.6 years. Hemoptysis was the presenting symptom in all cases. The patients were treated by corticosteroid, colchicine and cyclophosphamide pulses. The outcome was good with disappearance of hemoptysis in all cases and disappearance of pulmonary aneurysms in three. One patient had recurrence of aneurysms 40 months after the first episode and died 18 months later. So, we can hope, thanks to medical treatment, a better outcome than previously reported in this complication.     

Asymptomatic seminal infection of herpes simplex virus:impact on male infertility

In more than half of infertile men,the cause of their infertility is unknown.Several studies revealed the role of viral infections in male infertility.The aim of the present study was to determine the prevalence of herpes simplex virus-1 (HSV-1) and HSV-2 in semen from asymptomatic infertile male patients,and its association with altered semen parameters.A total of 70 semen samples were collected from infertile men who attended the Research and Clinical Center for Infertility in Yazd,Iran.Semen analysis and diagnostic real-time PCR using specific primers and probes for HSV-1 and HSV-2 DNA were performed.Comparison of semen parameters between virally infected and non-infected samples were performed with independent t-test and Mann-Whitney test.Semen analysis showed that infertile men fell into two groups,the male factor group and the unexplained group.HSV-1 and HSV-2 DNA was detected in 16 (22.9%) and 10 (14.3%) of 70 semen samples,respectively.All HSV-positive samples had abnormal semen parameters (the male factor group).Although HSV infection was not associated with sperm motility and morphological defects,it was correlated with lower sperm count in the seminal fluid.The findings suggest that asymptomatic seminal infection of HSV plays an important role in male infertility by adversely affecting sperm count.     

Therapeutic potential of bevacizumab (Avastin) in herpetic stromal keratitis (HSK)

In the stromal keratitis caused by herpes simplex virus (HSV), the formation of new vessels is the essential step for the pathogenesis of keratitis. Inhibition of angiogenesis diminishes the formation of corneal lesion induced by HSV. Procedures which suppress angiogenesis are proposed as a valuable therapeutic approach to control HSK. The mechanism by which HSV ocular infection results in corneal angiogenesis is not understood. Recent reports identified anti-vascular endothelial growth factor (VEGF) as a molecule that is highly expressed in the HSV infected eye and clearly involved in angiogenesis. The advent of VEGF treatments marks a major advancement in the treatment of angiogenic eye disease. Off-label use of bevacizumab (Avastin), a recombinant humanized monoclonal antibody directed against VEGF, in some neovascular disorders of the eye has been associated with promising short term results. Based on these evidences herein we hypothesize topical application of bevacizumab could inhibit corneal neovascularization and also scarring in HSK. We propose this drug as a novel adjunct to current anti-inflammatory strategies in HSK.