Fibrinolysis parameters in Sudanese women with severe preeclampsia

Background: Although preeclampsia remains a major cause of maternal and fetal morbidity and mortality, its pathogenesis is not fully understood. Coagulation and fibrinolysis changes were suggested to have a role in the pathogenesis of preeclampsia. Objectives: A case-control study was conducted in Medani Hospital, Sudan, to investigate thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen-activated inhibitor (PAI) in women with severe preeclampsia. Obstetrics and medical history was gathered using questionnaire. TAFI, PAI-1, and PAI-2 levels were measured using ELISA. Results: In comparison with the controls, women with severe preeclampsia had significantly higher levels [mean (SD)] of TAFI [3.4 (1.1) vs. 3.0(0.7) ng/ml, P = 0.019], PAI-1 [3.2 (1.3) vs. 2.5(1.0), IU/ml, P = 0.001], and significantly lower PAI-2 level [4.2(1.3) vs. 5.8(2.6) ng/ml, P < 0.001]. In linear regression, severe preeclampsia was significantly associated with TAFI (0.408 ng/ml, P = 0.038), PAI-1 (0.722, IU/ml P = 0.003), and PAI-2 (?1.745, ng/ml, P < 0.001). Conclusion: The current study revealed a significant increase level of TAFI and PAI-1, coupled with a decrease in PAI-2 in women with severe preeclampsia in comparison with the control group.     

SIOP PODC–adapted treatment guidelines for craniopharyngioma in low- and middle-income settings

Pediatric craniopharyngioma is a rare tumor with excellent survival but significant long-term morbidities due to the loco-regional tumor growth or secondary to its treatment. Visual impairment, panhypopituitarism, hypothalamic damage, and behavioral changes are among the main challenges. This tumor should be managed under the care of a multidisciplinary team to determine the optimum treatment within the available resources. This is particularly important for low middle-income countries where resources are variable. This report provides risk-stratified management guidelines for children diagnosed with craniopharyngioma in a resource-limited setting.     

Synovial hemangioma: A rare cause of chronic knee pain

Synovial hemangioma is a rare benign vascular tumor responsible for chronic knee pain and swelling. Given its non‐specific symptoms, synovial hemangioma is often misdiagnosed. We report a case of synovial hemangioma of bilateral knee joints occurring in a young military man.     

Acute arthritis revealing Hashimoto's thyroiditis

Rheumatic manifestations can reveal hypothyroidism, such as arthritis and nonspecific musculoskeletal symptoms. We report herein the case of an acute polyarthritis revealing Hashimoto''s thyroiditis (HT). Hormone replacement therapy leads to the resolution of arthritis related to HT, suggesting the role of thyroid hormone in the pathogenesis of arthritis.     

Heterogenous expression of endocrine and progenitor cells within the neonatal porcine pancreatic lobes–Implications for neonatal porcine islet xenotransplantation

Neonatal porcine islets (NPIs) are a source of islets for xenotransplantation. In the pig, the pancreatic lobes remain separate, thus, when optimizing NPI isolation, the pancreatic lobes included in the pancreatic digest should be specified. These lobes are the duodenal (DL), splenic (SL) and connecting (CL) lobe that correspond to the head, body-tail, and uncinate process of the human pancreas. In this study we are the first to evaluate all three neonatal porcine pancreatic lobes and NPIs isolated from these lobes. We report, a significant difference in endocrine and progenitor cell composition between lobes, and observed pancreatic duct glands (PDG) within the mesenchyme surrounding exocrine ducts in the DL and CL. Following in vitro differentiation, NPIs isolated from each lobe differed significantly in the percent increase of endocrine cells and final cell composition. Compared to other recipients, diabetic immunodeficient mice transplanted with NPIs isolated from the SL demonstrated euglycemic control as early as 4 weeks (p < 0.05) and achieved normoglycemia by 6 weeks post-transplant (p < 0.01). For the first time we report significant differences between the neonatal porcine pancreatic lobes and demonstrate that NPIs from these lobes differ in xenograft function.