ABSTRACT
Kawasaki disease (KD) is a common vasculitis in childhood. To the authors' knowledge, only one case of juvenile systemic lupus erythematosus (JSLE)-like onset mimicking KD and another case of KD and JSLE association have previously been described. However, the prevalence of this association of the two diseases was not reported. Therefore, over 27 consecutive years, 5419 patients were followed at the Pediatric Rheumatology Unit and 271 (5%) of them met the ACR classification criteria for JSLE. Two (0.7%) of them were female. These also had KD according to European League against Rheumatism / Paediatric Rheumatology European Society (EULAR/PReS) consensus criteria and are described in this report. One case was a 13-year-old who presented all six KD criteria. Echocardiogram showed pericardial effusion, dilatation and tortuosity of right and left coronary, and her symptoms promptly improved after treatment with intravenous immunoglobulin (IVIG). Lupus diagnosis was established a few days later. Another case was a 4-year-old who had also met all six KD criteria, with improvement after IVIG, and lupus diagnosis was made 1 year later. In conclusion, the frequency of the association between these two autoimmune diseases was rare. The occurrence of a second autoimmune systemic disease in a patient with a history of KD should also be considered. Furthermore, the initial presentation of lupus may mimic KD.
Subject(s)
Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/physiopathology , Mucocutaneous Lymph Node Syndrome/epidemiology , Mucocutaneous Lymph Node Syndrome/physiopathology , Adolescent , Child , Child, Preschool , Comorbidity , Female , Humans , Immunoglobulins, Intravenous/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/immunology , Male , Mucocutaneous Lymph Node Syndrome/drug therapy , Mucocutaneous Lymph Node Syndrome/immunologyABSTRACT
We propose and experimentally demonstrate a hardware-efficient, feed-forward, wide-range frequency offset estimator for DSP-based optical coherent receivers. Using a simple relationship of signal spectrum, this estimator is capable to estimate offsets in a range compliant with OIF requirements. Obtained results show that this estimator has a high tolerance to spectrum asymmetry caused by electrical and optical signal filtering, even when using return-to-zero pulse shaping.
ABSTRACT
Os autores apresentam a sua experiencia inicial com a colangiografia transparieto-hepatica com a agulha de Chiba. Foram estudados 44 pacientes sendo 23 homens e 21 mulheres. A idade variou de 20 a 87 anos com media de 55.4.A arvore biliar foi contrastada 38 vezes (86,4%). Nao houve obito na serie estudada. Consideram o metodo um excelente meio de estudo no diagnostico diferencial e etiologico da ictericia.E de baixo custo, com poucas complicacoes, de excelente rendimento diagnostico e praticavel mesmo em centros de menor recurso
