effect of positive family history of autoimmunity in juvenile idiopathic arthritis characteristics; a case control study

Patients with and without family history of autoimmune disease with respect to clinical features and laboratory data. Sixteen JIA patients with family history of autoimmune disease were identified during study, 32 patients were chosen for comparative group from referred patients to the rheumatology clinic according to the date of referral. Two groups were compared with respect to age of onset, sex, subtype, disease activity, duration of active disease and laboratory variables. The age of onset was significantly lower in JIA patients with family history of autoimmunity [4.7 years vs. 7.0 years; P=0.02], polyarthicular subtype was more frequent in patients with positive family history [50% vs.25%; P=0.04] most of JIA patients with positive family history were in the active phase at the time of study [64% vs 25%; P=0.02] and had a longer duration of active disease [21.0 months vs 12.3 months; P=0.04]. Patients with positive family history had more positive ANA [43.5%% vs 12.5%; P=0.01] and also more positive ADA [75% vs 20.8%; P=0.002]. Two groups were similar according to sex, and other laboratory variables. JIA patients with family history of autoimmune disease seem to have a more severe disease than patients without such family history, they are younger at the onset, and have mostly poyarthicular subtype. They also have more ANA and ADA positivity. These findings are different from familial JIA case-control studies according to active disease duration, subtype, and ANA positivity

[Transfection of PC12 cell line by pEGFPNI-NT4 and protein expression analysis]

Cloning and expression in the cells is one of the most important basic techniques to study a specific protein in molecular biology. Among gene transfer methods, non-viral methods are less expensive, easier and safer to be implemented. NT4 is an important gene with miscellaneous clinical applications. This gene is a neurotrophic that induce survival, development and function of neurons as well as inducing differentiation of progenitor cells to form neurons. The aim of this study was to construct and transfect NT4 gene, in order to use it in research and gene therapy. NT4 gene was subcloned in plasmid pcmvsport6, using PCR; then it was transformed in Escherichia coli bacteria strain DH5-alpha. The recombinant gene was extracted and restriction enzymes by NOTI, SAII. The fragment gene was legated into the PEGFP-N1 plasmid. Then by restriction enzymes HINDIII, the recombinant was detected through gel electrophosis. In order to ensure that recombinant gene is correct, it was sended for sequencing. Cell culture was prepared and the recombinant plasmid was transfected. SDS page and western blotting were used for detection of protein expression. Enzyme analysis showed that pcDNA had correct structure and sequencing, confirmed by 100% homology of the gene with reported alpha gene in Gene Bank. In the analysis of proteins isolated from transfected cells with SDS-PAGE, an approximately 45 kDa band was observed with monoclonal antibody which was confirmed by Western blot analysis. This plasmid is able to transform to Eukaryotic system and is suitable for evaluation of translation due to its proper structure

Strong Immune Responses Induced by a DNA vaccine containing HPV16 truncated E7 C-terminal linked to HSP70 gene

Vaccines capable of controlling tumor virus based infections are found difficult to develop due to the consistence latent infection in the host. DNA vaccines are attractive tools for the development of HPV vaccines and inducing antigen-specific immunity owing to the stability, simplicity of delivery, safety and cost effectiveness. However, there is a need to increase their potency by procedures such as using HSP70 gene as an adjuvant. To evaluate a DNA vaccine containing HPV16 truncated E7 C-terminal cytotoxic T-lymphocyte epitopes linked to HSP70 gene [HSP70-tE7] in an animal model. Mice were immunized with the plasmid DNA after pre-treatment with cardiotoxin. The splenocytes of immunized mice were then tested for CTL activity by detecting the apoptosis and necrosis in target cells, cytokine production by ELISA, CD4 and CD8 frequencies by flow cytometry, and lymphocyte stimulation by MTT assay. The recombinant expression vector was able to elicit immune responses close to that of full length E7 complete gene. Although the use of a small part of a target antigen can induce immune responses equivalent to the full length antigen, it fails to elicit statistically significant stronger immune responses when fused with HSP70 compared to the complete E7 gene alone. The potent immunogenicity of HPV16 E7 was preserved in the HSP70-tE7 vaccine and may represent a target of choice for the therapeutic vaccination strategies. However, to improve the immunogenicity polytope DNA vaccines which elicit multiple effector and memory CTL responses should be considered in future studies of DNA-based cancer vaccines

Fatores relacionados à internação pediátrica em um hospital universitário da região sul do Brasil / Factors related to a pediatric internment in an university hospital from the South Region of Brazil

Traçar o perfil epidemiológico de todas as crianças internadas e os fatores relacionados com a internação hospitalar. Método: Estudo prospectivo observacional tipo coorte de todas as crianças internadas no Hospital Escola da UFPel, no ano de 2007. Resultados: Foram hospitalizadas 591 crianças, sendo 56,7% de meninos. A análise demonstrou que a predominância destas crianças foi da faixa etária inferior a três meses de idade (52,9%); pertencente a família de baixa renda com menos de 2 salários mínimos (65,3%); mães com baixa escolaridade, sendo que a maioria das famílias é composta de 3 a 5 pessoas. As doenças mais prevalentes foram as causas relacionadas às doenças do recém-nascido, seguidas de problemas respiratórios. Conclusão: O conhecimento do perfil das crianças internadas pode ser útil na programação institucional referente à estratégia de atendimento adequado desta população...

To draw the epidemiologic profile of all children in the hospital and the related factors to the hospital residence. Methods: A prospective observational cohort study of all resident children in the Hospital Escola da UFPel,in the year of 2007. Results: 591 children were hospitalized, being 56.7% boys. Analyses showed that the predominance of these children was at the age of under 3 months years-old (52.9%); belonged to a low income family with less than 2 minimum wages (65.3%); mothers with low scholarship and the most families are composed of 3 to 5 people. The most prevalent disorders were the causes related to the diseases of newborn babies, followed by respiratory pathogens. Conclusion: The knowledge of the resident children’ profile can be useful for the institution program, relative to the strategy of livestock care of this population...

Acute kidney injury in patients with H1N1 admitted to ICU: Incidence, patient and renal outcomes. a multi-center perspective

Acute kidney injury [AKI] is a commonly sequel of sepsis associated with critical illness; hence, it could be anticipated to occur in H1N1 infected patients who suffer a rapidly progressive course complicated by multi-organ failure. To evaluate the rate of AKI in patients admitted to ICU with H1N1 and their outcome. We retrospectively reviewed the files of 24 consecutive patients admitted to ICU with H1N1 infection between June 1st and December 31st 2009. Signs of AKI, relevant co-morbidities and co-infections as well as outcome measures were collected. H1N1 infection was confirmed with PCR level measurements. Out of 523 patients, who presented with confirmed H1N1 infection during the study period, 24 [4.6%] were admitted to ICU. Thirteen [54%] had AKI of which 4 were previously known to have chronic renal disease, 11 had acute respiratory distress syndrome [ARDS], and 5 required hemodialysis. Four out of the 13 patients with AKI died, 5 recovered completely, 3 had partial recovery and one remained dependent on hemodialysis. Our results indicate that varying degrees of AKI occur in more than half of H1N1 patients admitted to ICU. This represents a serious complication predicting worsened outcome. Though the mortality rate was high, the majority of patients recovered partially or completely with early aggressive treatment

Carboplatin and weekly paclitaxel in metastatic and locally advanced breast cancer patients. a pilot study

Platinum complexes are active in a wide range of solid tumors. Although both cisplatin and carboplatin have shown activity in breast cancer. However, some recent reports have demonstrated encouraging results, especially carboplatin in combination with taxanes. To evaluate efficacy and safety of the combination of Carboplatin [C] and weekly paclitaxel [P] as first line therapy in metastatic [MBC] and locally advanced breast cancer [LBC] patients. Twenty two patients with MBC and LBC were included. 16 patients with MBC were treated by Anthracyclines during the adjuvant phase, 3 patients had MBC as first presentation and 3 patients has LBC. All the patients were treated with carboplatine 320mg/m [2] day one and paclitaxel 80mg[2] day 1 and 8, both repeated every 3 weeks until progression/refusal or for a maximum of 8 cycles. A dose reduction was made in case of grade 3 and 4 toxicities. From October 2005 to December 2007, 22 patients with LBC and MBC were included at Erfan Hospital Saudi Arabia. Median age was 49. Of 21 patients were assessed for response, two patients [9%] achieved complete remission [CR] and 12 patients [54.5%] had partial response [PR] giving an overall response rate of 63.5%. Time to disease progression [TTP] was 7.4 months. The median survival time was 18.7 [4-38] months. The actuarial overall survival for the first and second years were 56% and 21% respectively [Kaplan and Meier method]. The most common grade 3 and 4 toxicities were neutropenia [9%], thrombocytopenia [4.5%], anemia [9%], neuropathy [9%], fatigue [9%], mucosities [9%] and myaIgia [4.5%]. Carboplatin and Weekly paclitaxel is very effective and safe combination as first line therapy in patients with LBC and MBC

Study of the effect of gender, local anesthesia and antioxidant on myocardial performance of rats after burn injury

We have studied 80 albino rats that were divided into two main groups: Male and Female with each group subdivided into 4 subgroups: [a] control, [b] 3[rd] degree scald burn injury, [c] 3[rd] degree scald burn treated with topical lidocaine after burn, [d] 3[rd] degree scald burn receiving both vitamin C, E and A before and immediately after scald burn injury. 24 hours after the injury protocol, SBP, serum troponin and 1L 6 and left ventricular performance parameters [LVF] were measured. Burn injury resulted in significant drop in SBP, LVF parameters and significant rise in IL6 and troponin in both male and female subgroups when compared to their corresponding control subgroups. Treatment of burned animals [male or female] with topical lidocaine or antioxidants in the first 24 hours after burn injury resulted in a significant improvement in SBP and LVF parameters and significantly reduced the rise in IL6 and serum troponin in each animal subgroup when compared to their corresponding gender matched control subgroup. In all the studied subgroups, female animals showed better LVP parameters and less release of IL6 and less troponin than the corresponding male subgroup. We also found that both antioxidants and local anaesthesia offer an almost equal amount of protection after burn injury within each gender subgroup. We conclude that, oxidative stress and inflammatory mediators play an important role in how our hearts respond to injury in the first 24 hours after major scald burn injury and that this response is affected by gender. Using local anaesthesia or antioxidants might improve left ventricular function in the early post burn period

Airway resistance in irritable bowel syndrome as measured by impulse oscillometry.

BACKGROUND: Irritable bowel syndrome (IBS) is associated with bronchial asthma. However, published data on airway resistance or impedance in patients with IBS but without any respiratory symptoms are lacking. METHODS: Patients with IBS but no respiratory symptoms underwent spirometry and airway resistance measurement using impulse oscillometry; the data were compared with those from 97 historical age- and sex-matched healthy control subjects. RESULTS: Patients had lower FEV1 (3.03 [0.74] vs. 3.35 [0.80] L/min; p=0.004) and FVC (3.56 [0.85] vs. 3.88 [0.9]; p=0.01) than healthy subjects; however, the values were within the normal range. Patients had a higher resistance at 5 Hz (0.45 [0.42] vs. 0.30 [0.15] kPa L/s; p=0.003); however, reactance at this frequency was not significantly different (-0.08 [0.30] vs. -0.10 [0.09] kPa L/s; p=0.438). CONCLUSION: Patients with IBS have increased airway resistance as compared to healthy subjects, as measured by impulse oscillometry; however, reactance is unchanged, indicating no change in elastic resistance.

Translabial ultrasonic assessment of cervix compared to Bishop score for women undergoing induction of labor

To determine if translabial sonographic measurement of the cervical length is a useful method to predict successful labor induction. One hundred women indicated for induction of labor were included and examined to assess Bishop score. All were then subjected to translabial sonographic measurement of the cervical length before labor induction. Induction of labor was performed within 6h of the ultrasonographic examination, intravaginal prostaglandin E2 3mg inserted in the posterior vaginal fornix repeated if needed every 6h for up to three doses. The mean age was 27.6 years and mean parity of 1.4. While there was no statistically significant differences between the initial Bishop score among women with successful and unsuccessful labor induction, there was a highly significant difference in the mean cervical index with higher indices among women with successful induction [p<0.001]. There was a highly significant difference between women with successful labor induction who have a cervical index of 0.4- 0.8 and >0.8 [p<0.001]. After 6 hours there was a statistically significant difference in the mean Bishop score with higher values among women with successful labor induction [p<0.05]. Translabial sonographic measurement of cervical length is safe and effective predictor of a successful labor induction at term

Concomitant radiotherapy and paclitaxel as a radiosensitizer in locally advanced cancer cervix

This study aimed to evaluate the effect of concomitant radiotherapy with weekly paclitaxel as radiosensitizer in locally advanced cervical cancer on response rate, progression free survival and overall survival. In addition to evaluate the pattern of toxicity with this treatment regimen.Between June 2001 and December 2002, seventeen women with histopathologically proven squamous cell carcinoma of the uterine cervix, stages IIB, III and IVA were recruited in this study. Patients were treated with whole pelvis external beam radiotherapy 45 GY with 1.8 Gy/fraction administered five days a week concurrent with paclitaxel 50 ing/m2 administered in weekly basis. This was followed one to two weeks later with single intracavitary Cs137 insertion aiming at 30 Gy to point A and then parametrial boost [5-6 Gy] according to disease extension. Response to treatment, toxicity profile, 18-month disease free and overall survival were estimated. The median age of the patients was 56 years. The majority of patients had FIG0 stage IIIB [52.9%]. The most common histological grade was grade II [58.8%]]. The median tumor size was 5.4 cm [range 3-11 cm]. Bilateral parametrial involvement was encountered in 47% of patients. All patients had a fair performance with ECOG /<2. In general, toxicity was mild, none of the patients developed G IV toxicities. All patients completed their planned radiotherapy dose. Gaping during external radiotherapy occurred in only one patient [5.9%] for one week due to GIII diarrhea. On the other hand, chemotherapy was interrupted after the 3rd cycle for only one injection [D22] in two patients; one patient due to GIII diarrhea and the other due to GIII neutropenia. The overall response to the regimen was 94.1% with 64.7% complete response [CR]. The median progression free survival [PFS] was 12 months; however the median overall survival [OAS] was not reached. The 18 month overall survival was 76.3%, while the 18 month progression free survival was 71%

Interleukin-6 as a predictor of atherosclerosis in patients with coronary heart disease

This study was carried out to evaluate the role of interleukin-6 [IL-6] as a predictor of atherosclerosis in patients with coronary heart disease [CHD]. Forty male subjects were r and omized into this observational study: twenty healthy subjects included in the control group and twenty patients with unstable angina pectoris included in the CHD group. All subjects underwent thorough physical examination and history taking. Blood samples were obtained for assay of triglycerides [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDLc], low-density lipoprotein cholesterol [LDLc], C-reactive protein [CRP] and IL-6. Atherogenic index was calculated as the ratio of TC to HDLc. All subjects underwent color-coded carotid duplex examination. Patients in the CHD group also underwent coronary angiography. Compared to controls, patients in the CHD group were significantly older, had significantly higher body mass index [BM1], blood pressure and proportion of smokers. They also had significantly higher TG, TC, LDL, AI, CRP and IL-6, but significantly lower HDL [p<0.001 for all]. Smokers in the CHD group had significantly higher BMI, TG, TC, LDL, AI, CRP and IL-6 and significantly lower HDL compared to non-smokers. Both CRP and IL-6 correlated with BMI only in the CHD group. CRP and IL-6 correlated strongly with each other in both control and CHD groups. Both CRP and IL-6 correlated strongly with the results of carotid duplex examination. Interleukin-6 correlates strongly with CRP in patients with unstable angina. IL-6 can be used as a marker for the severity of atherosclerosis. Future research on the use of anti-inflammatory therapy may result in a new approach to treament and prevention of cardiovascular disease

High dose rate [HDR] brachytherapy in the treatment of cancer cervix: treatment results of 75 patients

Purpose: High dose rate brachytherapy [HDR] has become popular in the management of carcinoma of the uterine cervix, because it eliminate many of the problems associated with low dose-rate brachytherapy [LDR]. This study is a retrospective analysis aims to report the results of patients with cervix cancer treated by external beam radiotherapy [EBR] and HDR

Patients and Methods: From February 1992 to December 1999, 75 patients with FIGO Stage IB to IVA carcinoma of the cervix were treated by EBR 45 Gy in 25 fraction, parametrium boost 10.8 Gy in 6 fractions was performed in 68 patient [90%]. This was followed by HDR 18 Gy in three weekly fractions of 6 Gy to point A

Results: The 3 year overall survival for all group is 71. 3 years disease, free survival is 66.7%. The local failure rate at 3 years for all group is 33.3%, for Stage IB, IIA. IIB, III were 21%, 14%, 29.1%, 40% respectively. The 3 year disease free Survival from stage IB to IVA 79%. 86%, 69%, 60%, 0% respectively. The overall treatment time > 60 days [p = 0.0002], anemia [p = 0.02] and stage [p = 0.05] were poor prognostic factors for local recurrence. Severe late complication [Grade 3 and 4] in 4% of patients

Conclusion: This study suggests that treatment of carcinoma of the cervix by whole pelvis radiotherapy 45 Gy- and 3 weekly fraction of 6 Gy to point A is effective and safe scchedule. Also the overall treatment time > 60 day, anemia and stage were poor prognostic factors for local recurrence

Postradiotherapy erectile dysfunction in patients with prostate cancer: prospective study of sildenafil treatment of 31 patients

Out of 35 patients, 31 assessable ones participated in this prospective study. Using a 25-point scale based on the International Index of Sexual Function, erectile dysfunction was assessed weekly; during this time, the patients received sildenafil 50 mg orally once a week for eight consecutive weeks. The response was defined as a score of 18 or more corresponding to at least one successful attempt at sexual intercourse per week. It was concluded that oral sildenafil is safe, well-tolerated and can reverse erectile dysfunction after radiotherapy in a substantial proportion of the prostate cancer patients