ABSTRACT
Systemic lupus erythematosis (SLE) is defined on the basis of its various clinical manifestations, and by the presence of circulating antibodies directed against one or more components of cell nuclei. Over 80 percent of all cases occur during the fertile life of the woman, where incidence may reach one in 1000 women. Pregnancy in patients with active SLE, especially those which show nephritis or hypertension , associates with substantial risk of exacerbation of the disease, and poor prognosis for the fetus as well as the mother. A case is presented of a patient treated at our maternity clinic who had an SLE syndrome which was reactivated during pregnancy. Comments are given on management of the case, perinatal results, and future therapeutic implications.
El lupus eritematoso sistémico se define en base a sus muy variadas manifestaciones clínicas, y por la presencia de anticuerpos en sangre directamente dirigidos contra uno o más componentes del núcleo celular. Sobre el 80 por ciento de todos los casos ocurren durante la vida fértil de la mujer principalmente, en donde se pueden alcanzar tasas de 1 en 1000 mujeres. El embarazo en pacientes con LES activo, especialmente en aquellos que tiene nefritis o hipertensión, se asocian con un riesgo sustancial de exacerbación de la enfermedad y un pobre pronóstico del feto y también de la madre. Se presenta el caso de una paciente atendida en la maternidad del Hospital Clínico Regional de Antofagasta con un cuadro de LES, que se reactiva durante el embarazo. Se comenta el manejo, el resultado perinatal, y las implicancias terapéuticas futuras.
Subject(s)
Humans , Female , Pregnancy , Adult , Lupus Erythematosus, Systemic/pathology , Pregnancy Complications , Lupus Erythematosus, Systemic/diagnosisABSTRACT
Groundwater and surface water were collected using trace metal clean techniques from the upper glacial aquifer of West Neck Bay (Shelter Island) in eastern Long Island, NY, during the late spring and summer of 1999. The collection sites on Shelter Island are located in an area that is primarily residential and believed to have uncontaminated groundwater. Ultrafiltration was used to size-fractionate the dissolved (<0.45 microm) fraction into colloidal (1 kDa - 0.45 microm) and low molecular weight (<1 kDa) size pools. These fractions were analyzed for trace metals (Al, Ag, Cd, Cu, Mn, Pb, and Zn), organic carbon, and inorganic nutrients (NH4, NO3, PO4). The levels of metals and organic carbon in the groundwater were as low as those found in the open ocean, far removed from anthropogenic inputs. These findings corroborate the need to apply trace metal clean techniques in the determination of metal levels in uncontaminated groundwater. A significant fraction of dissolved metals (22-96%) and organic carbon (approximately 40%) in the groundwater and in surface waters of the Bay was found to be associated with colloids. The significance of the metal association with the colloidal fraction decreased in the order of Al > Cu > Ag > Zn = Cd = Mn and appeared to be dependent on the affinities of these metals for humic substances. In contrast, NO3 and NH4 were found to be almost entirely (approximately 98-99%) in the low molecular weight size fraction. Metal/aluminum and metal/carbon ratios measured in the colloids were similar to those reported for humic substances and significantly different from those of soils. This suggests that colloidal particles might originate from humic materials as opposed to purely inorganic minerals. These results indicate the need to consider the colloidal fraction in the fate and mobility of metals in groundwater and that, despite the low levels of organic matter (<50 microM of DOC) measured in groundwater, some groundwater colloids appear to be organic in nature.
