Adenosquamous-cell carcinoma of the ovary: report of a case with positive peritoneal fluid cytology

Cytologic examination of peritoneal fluid showed only malignant squamous cells, without revealing adenocarcinomatous cell components, in a patient who had an endometrioid adenosquamous-cell carcinoma of the ovary. Histologic examination of the ovary demonstrated diffuse squamous-cell carcinoma with rare foci of endometrioid and abortive malignant glands, as well as isolated mucin-positive cells. The cytologic differential diagnosis of malignant squamous cells in peritoneal fluid and the pathogenesis of squamous-cell carcinoma of the ovary are discussed.     

Measurement characteristics of peak expiratory flow

STUDY OBJECTIVES: To evaluate features of the peak expiratory flow (PEF) test protocol, and to characterize patterns of reproducibility in multiple PEF measurements. DESIGN: Cross-sectional study. SETTING: University population. PARTICIPANTS: Two hundred twenty-three healthy adults. INTERVENTIONS: Participants recorded five PEF measurements in each of five sessions per day for 1 week. Measurements and results: Patterns of within-session variability were characterized using a reproducibility criterion based on a large percentage difference between best trials and evidence of a maneuver-induced bronchospasm (MIB) indicated by successive drops of PEF values in a session. Although the maximum PEF value in a session occurred on the fourth or fifth trial 32% of the time, the change in PEF values was small. Supervision was associated with small improvements in level and reproducibility. Using a cutoff of 5% for defining reproducibility, 15% of all sessions were not reproducible. When averaged over each subject, 9% of the cohort had a mean difference > 5%. Overall, MIB was unusual and observed in 8% of all test sessions; however, MIB was more common among asthmatics and subjects with wheeze, atopy, or allergies than subjects without. By contrast, poor reproducibility was more common among smokers and subjects with cough and phlegm. CONCLUSIONS: These results illustrate that it may be unnecessary to supervise all sessions or collect more than three efforts. Results also suggest that reproducibility reflects smoking-related abnormalities, whereas MIB may reflect airways hyperresponsiveness.     

Distribution of survival times of deliberate Plasmodium falciparum infections in tertiary syphilis patients

Survival time data of Plasmodium falciparum infections from deliberate infection of human subjects with P. falciparum between 1940 and 1963 as a treatment for neurosyphilis in the USA (Georgia) have been used to test the fits of five commonly used parametric distributions for survival times using quantile-quantile plots. Our results suggest that the best fit is obtained from the Gompertz or Weibull distributions. This result has important implications for mathematical modelling of malaria, which has for the past century exclusively assumed that the duration of malaria infections has an exponential distribution. It is desirable to know the correct distribution because its shape profoundly influences the length of monitoring needed in an intervention programme for eliminating or reducing malaria.     

The Effect of Vitamin A Supplementation on FoxP3 and TGF-β Gene Expression in Avonex-Treated Multiple Sclerosis Patients

Journal of Molecular Neuroscience - Multiple sclerosis (MS) is an autoinflammatory condition of the central nervous system with impaired T helper (Th)17 and regulatory T cell (Treg) balance that is...     

Fetuin (α2-HS-glycoprotein) opsonizes cationic macrophagedeactivating molecules

Macrophages become activated by bacterial endotoxin (lipopolysaccharide) and other stimuli to release proinflammatory cytokines and NO. To prevent release of toxic or potentially lethal quantities of these factors, the state of macrophage activation is counter-regulated by anti-inflammatory mediators (e.g., glucocorticoid hormones, interleukin 10, and transforming growth factor type β). Fetuin, a negative acute-phase protein, recently was implicated as an anti-inflammatory mediator, because it is required for macrophage deactivation by spermine. In the present studies, we found that fetuin is necessary for macrophages to respond to CNI-1493, a tetravalent guanylhydrazone inhibitor of p38 mitogen-activated protein kinase phosphorylation. Fetuin dose-dependently increases macrophage uptake of CNI-1493, which can be specifically inhibited by anti-human fetuin antibodies. Anti-human fetuin antibodies render primary human peripheral blood mononuclear cells insensitive to deactivation by CNI-1493. Thus, macrophages use fetuin as an opsonin for cationic-deactivating molecules, both endogenous (e.g., spermine) and pharmacologic (e.g., CNI-1493). This role of fetuin as an opsonic participant in macrophage-deactivating mechanisms has implications for understanding and manipulating the innate immune response.     

Antinuclear antibody screening by ELISA and IF techniques: discrepant results in juvenile idiopathic arthritis but consistency in childhood systemic lupus erythematous

Lately, many hospital laboratories are using for antinuclear antibody (ANA) screening the solid-phase immunoassays (ELISA-ANA) instead of the traditional immunofluorescence ANA test (IF-ANA). Results of previous studies that compare the two technologies show poor correlation between them in both juvenile idiopathic arthritis (JIA) and childhood lupus erythematous (SLE) patients. In this study, we investigated whether ELISA-ANA and traditional IF-ANA results are comparable in pediatric patients with different rheumatic diseases. A total of 156 consecutive patients were included in the study—90 children with JIA, 33 with reactive arthritis, 19 with SLE, 4 with idiopathic chronic uveitis, and 10 with other systemic rheumatic diseases. ANA determination was performed using both assays. The higher rate of discrepancies between the two methods of ANA screening appeared in the JIA population (19/90, p?<?0.001). All JIA patients with false-negative results by ELISA had significant or high IF-ANA titres. The prevalence of JIA-associated uveitis was higher in the group of false-negative ELISA-ANA children than in the ELISA-positive patients but without statistical significance (p?=?0.62). On the contrary, in SLE group, the consistency rate of the two assays was 100 %, and the reactivity levels of ELISA-ANA were significantly higher than in ELISA-positive JIA patients (p?<?0.001). ELISA seems to be a reliable method for screening ANA in childhood SLE, but not in JIA. Limited by the few SLE patients, our findings need further consideration.     

Epidemiology of acute kidney injury in surgical intensive care at University Hospital in Egypt. A prospective observational study

IntroductionThe acute kidney injury (AKI) incidence in ICU patients varies widely from 3% to 30%, with mortality ranging from 36% to 90%, depending on the type of ICU, study population, the period during which the study is conducted, and the criteria used to define AKI.There have been many studies about the epidemiology and risk factors of AKI in critically ill patients in the different regions of the world. However, little data on the epidemiology of AKI in critically ill patients are available in Egypt.ObjectivesThe aim of this study was to assess the incidence of AKI among critical ill patients using RIFEL [risk (R), injury (I), failure (F), loss (L), and end-stage kidney disease (E)] classification and to determine the risk factors and outcome of patients who developed AKI in our surgical ICU.MethodsWe conducted a 6-month prospective observational study in the surgical ICU. Patients were classified daily using the RIFLE criteria. Patients were considered as having new AKI if they did not have AKI on ICU admission and subsequently reached at least class risk during their follow-up. Deterioration of AKI was diagnosed if the patient had increased in RIFLE class compared to the initial classification.ResultsOne hundred and twelve patients were studied. AKI occurred in 40 (35.7%) of patients. The most common risk factors for AKI are APACHE II score (acute physiology and chronic health evaluation score, version II.) and sepsis. APACHEII was lower in non-AKI group than AKI group (17.3 ± 7.5 versus 22.4 ± 7.4, p = 0.001), and sepsis was more common in AKI patients than non-AKI patients (77.5% versus 49% p = 0.004). Patients with AKI had a mortality rate of 67.5% which was more in patients with failure compared with risk patients. APACHEII, AKI, and needs for mechanical ventilation were independent risks for mortality.