High blood pressure. Causes, symptoms, treatments

Influence of organic acid excretion on cuticle pH and drug absorption by Haemonchus contortus.


We report a case of accidental thermal injury due to improper use of a laser pointer obtained outside of the United States. A 13-year-old received a laser pointer as a gift and looked at a reflection of the beam. The patient underwent full ophthalmologic examination with fundus photography, spectral domain optical coherence tomography, and fluorescein angiography. Visual acuity in the left eye was 20/100 at presentation. Fundus examination and ancillary tests were consistent with thermal macular injury. The laser pointer was analyzed and found to be a green diode laser with average power output of 154 mW.

Using univariate analyses, severe (grades 3-4) leucopenia, anaemia, thrombocytopenia, nausea and vomiting and diarrhoea occurred more frequently in patients with B symptoms. The associations between B symptoms and severe leucopenia (OR 1.7, p = 0.005) and anaemia (OR 2.3, p = 0.025) persisted after adjustment for other prognostic factors in multivariate analyses. The use of granulocyte colony stimulating factor reduced neutropenia in patients with both A and B symptoms.

One-hundred thirteen patients meeting the inclusion criteria were divided into two groups: R-CHOP (n=29) and CHOP-R (n=84). R-CHOP patients experienced numerically more CRS (65.5% vs. 42.9%, p=0.0517) and significantly more chills/rigors (p=0.0376). Maximum and minimum oxygen (O(2)) saturations were significantly lower in the R-CHOP group (p=0.0444 and 0.0165, respectively). Maximum temperature was significantly higher in the R-CHOP group (p=0.0047). There was no difference between groups in use of rescue medications (p=1). R-CHOP patients required significantly more rate reductions (p=0.0431) than CHOP-R patients, although there was no difference in final tolerated rate between groups.

We describe a rare case of atypical pyoderma gangrenosum of the dorsal hand in a patient who presented with the histopathologic diagnosis of squamous cell carcinoma (SCC). Atypical pyoderma gangrenosum is a rare variant of pyoderma gangrenosum that occurs on the upper extremities, presenting as a cutaneous ulcer. The correct treatment is nonsurgical, and surgical intervention often results in trauma-induced expansion of lesions. Pyoderma gangrenosum, most commonly mistaken for infection, has resulted in amputation. Histologic and clinical presentation 1 month after onset of symptoms in the patient reported here mimicked SCC. Awareness by hand surgeons of the possible histologic misdiagnosis of SCC at an early stage in the disease evolution and a high index of suspicion in the face of biopsy-proven SCC may prevent unnecessary digit amputation.

Both prednisone and allopurinol greatly lowered SUA rapidly. The overall SUA-lowering effect did not differ between treatment groups during the study period (P = 0.48, 2-way repeated measures analysis of variance). However, prednisone increased estimated glomerular filtration rate and daily urine output, and lowered body weights and N-terminal pro-B-type natriuretic peptide. Consequently, participants treated with prednisone had an improvement in clinical status.

Prednisone and dexamethasone are synthetic glucocorticoids widely used as anti-inflammatory and immunosuppressive drugs. Since their hydroxylated derivatives could serve as novel potential drug candidates, our aim was to investigate their biotransformation by the steroid hydroxylase CYP106A2 from Bacillus megaterium ATCC13368. In vitro we were able to demonstrate highly selective 15β-hydroxylation of the steroids with a reconstituted CYP106A2 system. The reactions were thoroughly characterized, determining the kinetic parameters and the equilibrium dissociation constant. The observed lower conversion rate in the case of dexamethasone hydroxylation was clarified by quantum chemical calculations, which suggest a rearrangement of the intermediately formed radical species. To identify the obtained conversion products with NMR, CYP106A2-based Bacillus megaterium whole-cell systems were applied resulting in an altered product pattern for prednisone, yet no significant change for dexamethasone conversion compared to in vitro. Even the MS941 control strain performed a highly selective biotransformation of prednisone producing the known metabolite 20β-dihydrocortisone. The identified novel prednisone derivatives 15β, 17, 20β, 21-tetrahydroxy-preg-4-en-3,11-dione and 15β, 17, 20β, 21-tetrahydroxy-preg-1,4-dien-3,11-dione as well as the 15β-hydroxylated variants of both drugs are promising candidates for drug-design and development approaches.

Influenza virus vaccine generated a good humoral response in RA and AS patients treated with infliximab.

The electronic records of 127 newly diagnosed RA patients presenting to the Counties Manukau District Health Board Rheumatology outpatient clinic between January 2008 and December 2010 were reviewed. Demographics, disease severity, relevant investigations, and medication use were analysed using Pearson's Chi squared test, Fisher's exact test and t-test.