A 31-Year-Old Pregnant Woman With Asthma, Presenting With Worsening Dyspnea, Wheeze, and Hoarseness.

CASE PRESENTATION: A 31-year-old woman (gravida 3 and para 1-0-1-1 at 20 weeks gestation) was admitted to the hospital for a presumed acute asthma exacerbation. She had a history of severe persistent asthma since childhood. She described her symptoms as progressively worsening since the beginning of her pregnancy. In addition to her dyspnea and wheeze, both of which occurred at rest and with exertion, she complained of worsening hoarseness and mild dysphagia of solid foods over the week before admission. Her primary care provider treated her with a combined corticosteroid and long-acting beta-agonist inhaler, albuterol inhaler and nebulizer, azithromycin, and two courses of prednisone without improvement. Her allergist performed a handheld spirometry 2 months before admission that was repeated 3 weeks later in the office. She had a social history of alcohol dependence but had been sober for 9 months. She was a former one-pack-per-day smoker but quit 20 weeks before admission and used marijuana occasionally. She had no known occupational or inhalation exposures.

Effects of copper and cadmium on development and superoxide dismutase levels in horseshoe crab (Limulus polyphemus) embryos.

Pollution by metals may adversely affect organisms through the generation of reactive oxygen species (ROS). In this study, we examined the sublethal effects of two metals, copper and cadmium, on horseshoe crab (Limulus polyphemus) embryos. Exposure to copper or cadmium at concentrations of 0.01-10 mg/L for periods of 4, 8, 16 and 24 h had minimal effect on embryo survival except at 100 mg/L Cu. However, metal-exposed embryos took significantly longer to hatch into first instar ("trilobite") larvae than seawater controls. Levels of superoxide dismutase (SOD), believed to be important in the response to oxidative stress, were determined by Western blotting. Both the Cu/Zn and Mn cofactor forms of SOD tended to be somewhat elevated in metal-exposed embryos, but the increases were neither dose nor time-dependent. Likewise, SOD enzymatic activity showed no significant differences comparing embryos exposed to metals with seawater controls. We conclude that the protective role of SOD's against ROS produced in response to metal exposure appears to be limited in horseshoe crab embryos, at least under our experimental conditions.