Circulating anti-skin basement membrane zone antibodies in a patient with Goodpasture''s syndrome

We report the case of a patient with atypical bullous pemphigoid and haemoptysis in whom circulating IgG skin basement membrane zone antibodies were demonstrated. Six years later she developed acute renal failure due to Goodpasture's syndrome. This is the first case to raise the possibility of a link between epidermal and glomerular basement membrane antibodies.     

ANALYSIS OF TSH RECEPTORS AND MICROSOMAL ANTIGEN IN DIFFERENT HUMAN THYROID TISSUE SPECIMENS

Affinity labelling with a 125I-labelled photoactive derivative of TSH (HSAB-TSH) was used to analyse TSH receptor size in the following specimens of human thyroid tissue: (1) cold nodules; (2) autonomous nodules; (3) papillary carcinoma; (4) medullary carcinoma; (5) metastasis of papillary carcinoma to lymph node; (6) anaplastic carcinoma, and (7) Graves' thyroid. In addition, a sample of histologically normal thyroid tissue surrounding specimens 1-4 was analysed in each case. Thyroid microsomes were also prepared from the tissue samples, solubilized using 1% deoxycholate and labelled with 125I. The preparations were immunoprecipitated using microsomal autoantibodies and protein A and analysed by SDS-PAGE and autoradiography. These studies indicated that no differences in the characteristics of the TSH receptor or of microsomal antigen were observed in the tissue samples 1-3 and 7. Neither protein was detected in tissue specimens 4-6.     

The incidence and magnitude of fibrinolytic activation in trauma patients

Summary. Background:  Trauma is a global disease, with over 2.5 million deaths annually from hemorrhage and coagulopathy. Overt hyperfibrinolysis is rare in trauma, and is associated with massive fatal injuries. Paradoxically, clinical trials suggest a much broader indication for antifibrinolytics. Objective: To determine the incidence and magnitude of fibrinolytic activation in trauma patients and its relationship to clot lysis as measured by thromboelastometry. Methods: A prospective cohort study of 303 consecutive trauma patients admitted between January 2007 and June 2009 was performed. Blood was drawn on arrival for thromboelastometry (TEM) and coagulation assays. Follow‐up was until hospital discharge or death. TEM hyperfibrinolysis was defined as maximum clot lysis of > 15%. Fibrinolytic activation (FA) was deterined according to plasmin–antiplasmin (PAP) complex and D‐dimer levels. Data were collected on demographics, mechanism, severity of injury, and baseline vital signs. The primary outcome measure was 28‐day mortality. The secondary outcome measures were 28‐day ventilator‐free days and 24‐h transfusion requirement. Results: Only 5% of patients had severe fibrinolysis on TEM, but 57% of patients had evidence of ‘moderate’ fibrinolysis, with PAP complex levels elevated to over twice normal (> 1500 μg L^?1) without lysis on TEM. TEM detected clot lysis only when PAP complex levels were increased to 30 times normal (P < 0.001) and antiplasmin levels were < 75% of normal. Patients with FA had increased 28‐day mortality as compared with those with no FA (12% vs. 1%, P < 0.001), fewer ventilator‐free days, and longer hospital stay. Conclusions: FA occurs in the majority of trauma patients, and the magnitude of FA correlates with poor clinical outcome. This was not detected by conventional TEM, which is an insensitive measure of endogenous fibrinolytic activity.     

How pre‐school children learn to brush their teeth in Sharjah,United Arab Emirates

International Journal of Paediatric Dentistry 2010; 20: 230–234 Objective. The objective of this cross‐sectional study was to assess tooth brushing habits of pre‐school children and to determine the role and amount of supervision given to them by their parents. Method. One hundred pre‐school children below 6 years were selected from Maternal and Child Health Center, Sharjah (United Arab Emirates, UAE). A standard piloted questionnaire was used to collect socio‐demographic details and information on oral hygiene practise. Results. Tooth brushing was stared at a mean age of 16 months. Thirty‐seven per cent of the pre‐schoolers used a toothbrush for cleaning their teeth and the brushing habits were mainly (70%) introduced by mothers. The majority (80%) of children’s tooth brushing at the age of 3 years and above was supervised by mothers. Younger children were frequently supervised in tooth brushing than older children (P < 0.05) Conclusions. In summary, pre‐school children of Sharjah (UAE) were introduced to tooth brushing at a mean age of 16 months. Mothers played a pivotal role in introducing and teaching the child how to brush. There was no positive correlation between the brushing behaviour of the mothers and their children. In most cases, the children’s brushing was supervised by their mother when they were above 25 months of age. In children less than 12 months of age tooth brushing was not started at all.     

Characterization of influenza antibodies by serum absorption

Absorptions of sera from groups of persons, both normal and after vaccination, resulted in complete removal of antibody to all strains of influenza virus within a type when a strain of antigenic configuration similar to that presumed to be the strain of first experience was employed. Absorption of these sera with strains encountered after the primary antigenic stimulus, removed antibody to strains recently experienced, but failed to absorb the primary antibody. By these methods, three age groups could be distinguished whose characteristic principal antibody was oriented to react with maximal efficiency either with FM1 or PR8 or Swine/1976 influenza viruses. Persons in these age groups had an initial experience with strains of the respective antigenic characteristics found in the variants of influenza virus mentioned. Basis for understanding these results was obtained with sera from successively infected ferrets, when serum absorptions demonstrated all type-specific antibody was oriented to react only with the strain of first infection. In view of this evidence there can now be little doubt as to the marked persistent influence an antigenic experience with influenza virus has upon the antibody-forming mechanisms of the virgin host.