ORBITAL PSEUDOTUMOR CAN MIMIC GRAVES' OPHTHALMOPATHY.

CONTEXT: Orbital pseudotumor (OP) is a benign inflammatory process of the orbit with a large polymorphous lymphoid infiltrate, associated with fibrosis in variable amounts, localized or diffuse. Graves' ophthalmopathy (GO) is the most common cause of proptosis, unilateral or bilateral. CASE REPORT: We report a patient with unilateral proptosis who was initially treated with antithyroid drugs for an euthyroid Graves disease, but the extension of the investigation infirmed this. The MRI findings (inflammation of fat, muscle and the left lacrimal gland) in conjunction with the biopsy infirmed the initial diagnostic and confirmed the OP. CONCLUSIONS: Orbital pseudotumor is a rare disorder that can image and clinically mimics some inflammatory disease especialy Graves' ophthalmopathy. Orbital MRI represents the most important test for diagnostic. A negative TRAb in euthyroid cases of proptosis can be a serious starting point for investigating an OP.

CORRELATIONS BETWEEN THE PRESENCE OF HÜRTHLE CELLS AND CYTOMORPHOLOGICAL FEATURES OF FINE-NEEDLE ASPIRATION BIOPSY IN THYROID NODULES.

INTRODUCTION: The presence of Hürthle cells (HC) in fine needle thyroid biopsy (FNAB) is a real concern for a cytologist and also for an endocrinologist. We aimed to demonstrate if the presence of HC is associated with specific cytological features in FNAB results. MATERIAL AND METHODS: This retrospective study analyzed 89 patients diagnosed with thyroid nodules, with FNAB; were two groups of patients: the study group A (HC+) (22 patients) with HC and control group B (HC-) (67 patients) with no HC; for both groups we analyzed the presence of 9 cytomorphologic features: overall cellularity, background colloid, lymphocyte infiltration, chronic inflammation, large nucleoli, small nucleoli, syncytial infiltration, nuclear pleomorphism/atypia, cellular pleomorphism. RESULTS: We found no statistical differences between age and gender. Nodules with diameter greater than 2 cm were present, more frequently in the group without HC, 43 (64.18%). The presence of HC is correlated with cellular pleomorphism (p=0.042) and nuclear pleomorphism (p < 0.0001) with no correlation between the other investigated parameters. The presence of colloid was correlated with the absence of HC (p= 0.014). In group with HC was a positive correlation with cellular pleomorphism and fibrosis. In the presence of fibrosis, HC was correlated with nuclear pleomorphism (p=0.03). In the group with HC without fibrosis there are more characteristic the sets with positive nuclear pleomorphism, positive large nucleoli and negative small nucleoli (p= 0.002). CONCLUSIONS: The presence of HC in FNAB results is associated with colloid in small amounts, associated with nodules smaller than 2 cm, correlated with cellular pleomorphism and nuclear pleomorphism. Fibrosis can be a protective feature against malignancy because cellular parameters were not significantly associated with HC except the cellular pleomorphism.

Trapping of vesicles on patterned surfaces by physisorption for potential biosensing applications.

The pre-defined selective positioning of a controlled number of vesicles on a rigid substrate is crucial in many potential applications such as diagnostics, biosensors, lab-on-a chip, microanalyses and reaction chambers. In this paper, the vesicles made up of block copolymer using Poly [-(2-methyloxazoline) -poly- (dimethylsiloxane)-poly- (2-methyloxazoline)] (ABA) with dimensions of 100-200 nm are trapped by physisorption on hydrophilic surfaces. We discuss the protocols established for vesicle trapping. The optimum conditions obtained for physisorption is 15 minutes incubation followed by one cycle of DI water rinse. Trapping of 1-10 vesicles in lobe shape micro-wells fabricated by photo lithography using photoresist on UltraStick(™) slides was demonstrated. To overcome the issue of amalgamation of emitted light from optically sensitive photoresist and fluorescently tagged vesicles, an alternative approach of Si/SiO(2) microwell array coupled with APTES (3-AminoPropylTriEthoxySilane) treated bottom surfaces was developed.

Variation in the ATP-binding cassette transporter 2 gene is a separate risk factor for systemic lupus erythematosus within the MHC.

The ATP-binding cassette transporter (TAP) proteins are functionally relevant candidates for predisposition to systemic lupus erythematosus (SLE) by virtue of their role in autoantigen presentation and location in the major histocompatibility complex (MHC). We tested if variation in the TAP genes (TAP1 and TAP2) is associated with SLE. We genotyped tag single nucleotide polymorphisms (SNPs) and performed family-based association analysis on 390 Caucasian pedigrees. We found significant evidence of association between TAP2 and SLE (rs241453, P=1.33 x 10(-6)). Conditional logistic regression analysis suggests that this TAP2 effect is separate from the HLA-DRB1 alleles. Our analyses show that both rs241453 (P=1.6 x 10(-4)) and HLA-DRB1*03xx (P=2.3 x 10(-4)) have significant autonomous effects not due to linkage disequilibrium. Moreover, these loci exhibit a significant statistical interaction (P<1.0 x 10(-6)), demonstrated by an increase in the odds ratio for the TAP2 association from OR=2.00 (95% confidence interval (CI)=1.17-3.42) in HLA-DRB1*03xx-negative subjects to OR=4.29 (CI=1.88-9.76) in the subjects with at least one HLA-DRB1*03xx allele group. We report the largest association study of the TAP genes with SLE to date, and the first to test for its separate effect and interaction with the HLA alleles consistently associated with SLE.

Improving glycaemic control of patients with Type 2 diabetes in a primary care setting: a French application of the Staged Diabetes Management programme.

AIMS: To assess the impact of a French adaptation of the Staged Diabetes Management (SDM) programme on glycaemic control of people with Type 2 diabetes in primary care. Secondary endpoints were blood pressure, blood lipids, healthcare costs and quality of life. METHODS: Prospective, randomized controlled study, of 1 years' duration. General practitioners (GPs) were recruited in four separate districts of a French region. They enrolled consecutive patients with Type 2 diabetes. GPs in the intervention group were educated in the SDM programme. GPs in the control group were asked to provide usual care. Healthcare costs were collected by medical departments of the Health Insurance systems. Quality of life was assessed with the Duke Health Profile. RESULTS: Three hundred and forty patients enrolled by 57 GPs completed the study, 192 in the intervention group and 148 in the control group. Patients in the intervention group were managed more adequately in accordance with the guidelines (P < 0.05 for nine out of 10 items). HbA(1c) decreased by 0.31% in the intervention group and increased by 0.56% in the control group, resulting in a difference of 0.87% by the end of the study (P = 0.001). Blood pressure and blood lipids did not differ between groups. Occurrence of major complications was low and identical in both groups. Incremental costs during the study in the intervention group were 35 euros per patient per month, and this was not significantly different in comparison with the control group. Quality of life was not affected by the intervention. CONCLUSIONS: Educating GPs in the French adaptation of the SDM programme improves glycaemic control in a primary care setting, without significantly increasing healthcare costs.