Treatment of Chronic Inflammatory Demyelinating Polyneuropathy

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired, immune-mediated, non–length-dependent polyradiculoneuropathy that is progressive or relapsing over a period of at least 8 weeks, often evolving over time to a relatively symmetric pattern. Although the exact pathogenesis is unclear, it is thought to be mediated by both cellular and humoral reaction to the peripheral nerve myelin sheath involving nerve roots and proximal and distal nerves. Early medical treatment of CIDP is important to prevent axonal loss occurring as a secondary effect of progressive demyelination. Only three treatments for CIDP have demonstrated benefit in randomized controlled studies: corticosteroids, plasma exchange, and intravenous immunoglobulin. About 25% of patients fail to respond to these treatments or respond inadequately. These treatments have similar efficacy but differ significantly in cost and adverse effects. These factors are considered in treatment selection.     

Association between obesity and dental caries in a group of preschool children in Mexico

Objective: The aim of this study was to determine the association between obesity and caries by utilizing the data of a cohort of preschool children aged 4‐5 years. Methods: Data were obtained from a cohort of 1,160 children. Dental caries detection was performed according to the World Health Organization criteria. The caries index was measured as the number of decayed (d), extracted (e), and filled (f) teeth (t) (deft), or surfaces (defs). The body mass index (BMI) in units of kg/m² was determined, and children were categorized according to age‐ and gender‐specific criteria as normal weight (5th‐85th percentile), at‐risk overweight (≥85th‐<95th percentile), and overweight (≥95th percentile). Odds ratios were determined for at‐risk overweight and overweight children using logistic regression. Results: The prevalence of dental caries was 17.9 percent. A slightly higher percentage of dental caries was found in boys (19.6 percent) than in girls (16.4 percent). From the total sample, the mean BMI was 17.10 ± 3.83. Approximately 53.7 percent of children were classified as normal weight, 14.2 percent as at‐risk overweight, and 32.1 percent as overweight. At‐risk overweight children were higher among girls (17.1 percent) than among boys (11.3 percent). When adjusted for covariates, the logistic regression model showed that there was a significant association between at‐risk overweight children (P < 0.001), overweight children (P < 0.001), and caries in the primary dentition. Mean (SD) deft value of the sample was 1.08 (2.34), while the corresponding defs value was 1.43 (3.29). Conclusion: Obesity appears to be associated with dental caries in the primary dentition of preschool Mexican children.     

Intrathyroidal Tumors Presenting with Extranodal Extension: What Are We Missing?

Extranodal extension (ENE) is an indicator of poor prognosis in well-differentiated thyroid cancer (WDTC). We have demonstrated that extrathyroidal extension (ETE) predicts ENE in patients with positive lymph nodes, indicating concordance between primary tumor and lymph node biology. In an effort to determine if there were other histologic features of the primary tumors that indicated an aggressive biology, we examined a subset of patients with intrathyroidal (T1/T2) disease whose lymph nodes had ENE. A review was conducted from January 2004 to March 2013. The histologic features of ETE-negative/ENE-positive tumors (group A, 12 cases) were compared with a random sample of ETE-negative/ENE-negative node-positive patients (group B, 27 cases). Cases were reviewed for size, capsule presence, infiltration, sclerosis, lymphocytic thyroiditis (LT), psammoma bodies, lymphovascular invasion (LVI), perineural invasion (PNI), architecture/cytomorphology, and focality. Size was compared using the Mann-Whitney test, while the remaining features were compared using a Fischer exact test. The breakdown of pathologic features of groups A/B were as follows: 2.28 cm/1.46 cm mean tumor size, 90 %/67 % unencapsulated, 100 %/89 % infiltrative, 100 %/89 % sclerotic, 60 %/52 % LT, 30 %/59 % positive psammoma bodies, 0 %/11 % LVI, 0 %/4 % PNI, 90 %/96 % classic architecture, 50 %/44 % multifocal. Neither size (p?=?0.072) nor the other nine histologic features examined reached statistical significance. None of the histologic features appeared to significantly predict ENE. Further examination of intrathyroidal tumors at a molecular level is necessary to determine if there are any identifiable features of intrathyroidal tumors that predict ENE and thus a more aggressive phenotype.     

Syringophilopsis davidi sp. nov. (Prostigmata, Syringophilidae) a new quill mite species parasitizing Calandrella brachydactyla (Passeriformes, Alaudidae) in Egypt

A new quill mite species Syringophilopsis davidi sp. nov. (Prostigmata, Syringophilidae) parasitizing Greater Short-toed Lark Calandrella brachydactyla (Leisler) (Passeriformes, Alaudidae) in Egypt is described. This new species is distinguishable from S. tyranni Bochkov and Galloway by 10?C13 chambers of the peritremal lateral branches, setae se located slightly anterior to c1, and by setae ag2 about twice longer than the genital setae. This is the first record of this genus from the hosts of the family Alaudidae and in the Arab Republic of Egypt.     

Protein microarray analysis reveals BAFF-binding autoantibodies in systemic lupus erythematosus

Autoantibodies against cytokines, chemokines, and growth factors inhibit normal immunity and are implicated in inflammatory autoimmune disease and diseases of immune deficiency. In an effort to evaluate serum from autoimmune and immunodeficient patients for Abs against cytokines, chemokines, and growth factors in a high-throughput and unbiased manner, we constructed a multiplex protein microarray for detection of serum factor–binding Abs and used the microarray to detect autoantibody targets in SLE. We designed a nitrocellulose-surface microarray containing human cytokines, chemokines, and other circulating proteins and demonstrated that the array permitted specific detection of serum factor–binding probes. We used the arrays to detect previously described autoantibodies against cytokines in samples from individuals with autoimmune polyendocrine syndrome type 1 and chronic mycobacterial infection. Serum profiling from individuals with SLE revealed that among several targets, elevated IgG autoantibody reactivity to B cell–activating factor (BAFF) was associated with SLE compared with control samples. BAFF reactivity correlated with the severity of disease-associated features, including IFN-α–driven SLE pathology. Our results showed that serum factor protein microarrays facilitate detection of autoantibody reactivity to serum factors in human samples and that BAFF-reactive autoantibodies may be associated with an elevated inflammatory disease state within the spectrum of SLE.