Anti-cardiac troponin antibodies in clinical human disease: a systematic review.

Anti-cardiac troponin antibodies have been studied in different types of clinical diseases and in healthy populations. A systematic review of published data on anti-troponin antibodies was carried out (search performed on PubMed, ISI Web of Knowledge and Scopus databases). From title and abstract analysis, thirty-three articles were included that met the pre-specified criteria; after full-text analysis, nine articles were excluded. Most studies assessed anti-troponin I antibodies. The prevalence of anti-cardiac troponin antibodies in healthy individuals ranged from 0.0% to 20.0%. The prevalence of anti-troponin I autoantibodies in dilated cardiomyopathy (DCM) ranged from 7.0% to 22.2%. Other conditions under study were myocardial infarction, ischemic cardiomyopathy (ICM), peripartum cardiomyopathy (PPCM), Chagas disease, Emery-Dreifuss muscular dystrophy (EDMD) and renal transplantation. In the different patient populations studied, anti-cardiac troponin antibodies have been shown to be either positively or negatively associated with prognostic and clinical features. In what concerns a possible value as biomarkers, these assays have not emerged up to the present moment as important aids for practical clinical decisions in cardiac or other types of patients. In what concerns pathophysiology, anti-cardiac troponin autoantibodies may play a role in different diseases. It can be speculated that these antibodies could be involved in perpetuating some degree of cardiac injury after an event, such as myocardial infarction or PPCM.

Incidence and prevalence of upper-limb work related musculoskeletal disorders: A systematic review.

BACKGROUND: Musculoskeletal disorders are one of the most common work-related diseases. Frequently this association is thought to have a temporal cause-effect relation. The absence of accessible diagnostic criteria and ethological cause-effect demonstration are probably important reasons for the lack of good evidence data on these pathologies. OBJECTIVE: For these reasons, the authors aim to present a systematic review on prevalence and incidence of the upper limb WRMSD. METHODS: The survey was conducted for papers published between January 1st, 2000 and July 2012, according to the PRISMA statement (2009) guidelines. RESULTS: From the 2016 papers obtained, 94 met the qualitative selection criteria. From these 27 address upper-limb WRMSD, and 17 present data on prevalence or incidence on upper-limb musculoskeletal diseases, six of them with a control group. Annual incidence ranges from 0.08 to 6.3, and prevalence from 0.14 to 14.9. Rotator cuff syndrome among shoe industry workers, present the highest incidence, and cubital, radial or ulnar nerve entrapment, the highest prevalence among a miscellaneous group of workers. CONCLUSIONS: More studies are needed to clarify the relation between work and WRMSD's, especially prospective investigations from different economic sectors and work activities, but with similar, reproducible and comparable methodologies.

Hyper-IgM syndrome--a case report and a clinical perspective.

The authors describe the case of a 28-year-old woman, with a history of recurrent bacterial infections since childhood and multiple hospitalizations for pneumonia, with important pulmonary sequelae, including bronchiectasis which warranted the need to perform a left lobectomy and lingulectomia at age 13. After diagnostic work up, the diagnosis of hypogammaglobulinemia with hyper-IgM was established, and she began regular replacement i.v. immunoglobulin treatment, with good tolerance and no side effects. A sequencing of the entire coding region (exons 1-5) of the AICDA gene was performed, and a homozygous c.260G > C mutation was identified, confirming the diagnosis of type 2 hyper-IgM syndrome. This case illustrates the negative impact that a delay in diagnosis and hence delay in treatment has in patients with primary immunodeficiency since early therapy is the only way to reduce the incidence and severity of complications.

[One-week variation of cotton dust and endotoxin levels in a cotton mill. Relation with the daily variation of the expiratory flow rates]. / Níveis de empoeiramento e endotoxinas numa fiação de algodão. Relação com a variação diária dos débitos expiratórios.

UNLABELLED: The prevalence of respiratory occupational diseases in the textile industry depends on environmental factors such cotton dust (CTD) levels and gram negative bacteria endotoxin (EDX) contamination. OBJECTIVE: To assess the environmental conditions (CTD and EDX) during one week in a cotton mill with respect to FEV1 variation throughout the work shift. POPULATION AND METHODS: 47 cotton mill workers (24F, 23M); average age: 42 +/- 11 years; average exposure to cotton dust: 22.5 +/- 9.4 years; Asthma: 15 (32%), Byssinosis: 11 (23%) and Asymptomatics: 21 (45%); a past history of respiratory symptoms: 13.1 +/- 11.7 years. Clinical evaluation, skin prick tests, a metacholine challenge, lung function tests and a work-place evaluation were performed. FEV1 Shift-variation (Delta-Shift) = end-shift FEV1 - start-shift FEV1, was calculated during one week. CTD and EDX levels were measured daily for each work place throughout this week and everyday during different operation tasks (work, cleaning, maintenance). The average values of CTD and EDX were calculated according to the time spent on each of these tasks for every worker who was exposed. RESULTS: Great variability of the environment conditions was observed throughout the week with the highest levels of CTD and EDX on Friday, even in comparison with Monday (CTD = 1.01 +/- 0.31 mg/m3 vs 0.68 +/- 0.65 mg/m3; p < 0.0005 e EDX = 33.1 +/- 8.9 ng/m3 vs 20.8 +/- 9.4 ng/m3; p < 0.0001). The shift variation was -129 +/- 97 ml for all the workers. The workers with asthma had the greatest reduction in expiratory flow rates, highest BHR and Delta-Shift but there were no differences in the levels of CTD and EDX among the three groups. Delta-Shift showed an association with the levels of EDX, specially in individuals with BHR but not with CTD levels. CONCLUSION: The environmental conditions that textile workers are exposed to, varies throughout the week and are associated with variations in flow rates and so lung function tests should be performed in a serial manner for the evaluation of respiratory occupational disease. The highest levels of EDX were recorded on Friday and this confirms the low reliability of the diagnostic criteria of byssinosis and points to the necessity of more objective measures.