Risks of nonchromosomal birth defects,small-for-gestational age birthweight,and prematurity with in vitro fertilization: effect of number of embryos transferred and plurality at conception versus at birth

Journal of Assisted Reproduction and Genetics - Excess embryos transferred (ET) (> plurality at birth) and fetal heartbeats (FHB) at 6 weeks’ gestation are associated with reductions...     

Conjunctival nodule in rheumatoid arthritis

Conjunctival nodule is very rarely seen in patients with rheumatoid arthritis. Previously reported cases were associated with the use of methotrexate. Here, we report a conjunctival rheumatoid nodule without such prior treatment. A 49-year-old woman with seropositive rheumatoid arthritis, who was being treated only with oral steroids and hydroxychloroquine, developed diffuse anterior scleritis in the right eye. In addition, examination showed a focal raised yellow/tan conjunctival nodule. The nodule was within the bulbar conjunctiva with no attachments to the underlying tissue, which is different from nodular scleritis. The nodule was not tender on palpation. The patient underwent excisional biopsy of the nodule. Intraoperatively, the lesion was noted to be a firm nodule within substantia propria of the conjunctiva. Hematoxylin-eosin staining of the specimen revealed a central area of necrosis surrounded by palisades of histiocytes. Increased dosage of oral steroid after the biopsy resulted in resolution of the ocular symptoms and signs. In conclusion, rheumatoid nodules may be seen in the conjunctiva even without prior treatment with methotrexate. These nodules may show the severity of the underlying disease and the need for more aggressive treatment.     

HLA-B35 association with nephritis in Henoch-Schönlein purpura

OBJECTIVE: To investigate the implications of the HLA-B locus in the susceptibility to Henoch-Sch?nlein purpura (HSP) and determine if there are associations with renal and gastrointestinal (GI) manifestations of the disease. METHODS: A retrospective study was performed on an unselected population of patients with HSP from Northwest Spain. Forty-eight Caucasian patients (24 women), 11 of them older than 20 years, were studied. Patients and ethnically matched controls were HLA-B genotyped from DNA using molecular based methods. RESULTS: When patients with HSP were compared with matched controls, no differences in HLA-B frequencies were observed. No HLA-B associations with GI manifestations were observed. In contrast, an increased frequency of HLA-B35 was observed in patients with renal manifestations (10 of 31) compared to those without (0 of 17). No significant distortions in frequency were seen for any other HLA-B alleles with HSP subgroups. CONCLUSION: Our results support a role of HLA-B35 in the susceptibility for nephritis in unselected patients with HSP.     

Acute methemoglobinemia following attempted suicide by Dapson

This report describes the case of an otherwise healthy young adult female, with oral ingestion of 40 unknown tablets. Her clinical course included progressive bluish discoloration of lips and limbs, hemolysis and jaundice. A high PaO2 in the presence of cyanosis and dark blood lead to suspicion of methemoglobinemia. Laboratory results showed methemoglobin level to be 3.8 g/dL (38%). The etiology was traced to dapsone according to patient history; after 3 days it became evident that she had ingested 2 g dapsone in suicidal intent. The therapeutic and diagnostic approach in such patients is discussed. In conclusion, acute methemoglobinemia is an uncommon but potentially treatable disorder.     

Comparison of the sealing ability of mineral trioxide aggregate and Portland cement used as root-end filling materials

Inadequate apical seal is the major cause of surgical endodontic failure. The root-end filling material used should prevent egress of potential contaminants into periapical tissue. The purpose of this study was to compare the sealing ability of four root-end filling materials: white mineral trioxide aggregate (MTA), gray MTA, white Portland cement (PC) and gray PC by dye leakage test. Ninety-six human single-rooted teeth were instrumented, and obturated with gutta-percha. After resecting the apex, an apical cavity was prepared. The teeth were randomly divided into four experimental groups (A: white MTA, B: gray MTA, C: white PC and D: gray PC; n = 20) and two control groups (positive and negative control groups; n = 8). Root-end cavities in the experimental groups were filled with the experimental materials. The teeth were exposed to Indian ink for 72 hours. The extent of dye penetration was measured with a stereomicroscope at 16× magnification. The negative controls showed no dye penetration and dye penetration was seen in the entire root-end cavity of positive controls. However, there was no statistically significant difference among the four experimental groups (P > 0.05). All retrograde filling materials tested in this study showed the same microleakage in vitro. Given the low cost and apparently similar sealing ability of PC, PC could be considered as a substitute for MTA as a root-end filling material.