Biological therapy has changed the course of inflammatory rheumatic diseases. The safety is well documented in national and international studies. Neurological manifestations are uncommon and it is ...difficult to establish a clear causal relationship. The neurological signs and symptoms that may appear are multiple and sometimes mimic demyelinating neurological diseases and/or neurodegenerative diseases. Knowledge and disclosure of these cases is essential for a comprehensive management of biological therapy in our patients.
La terapia biológica ha cambiado el curso de las enfermedades reumáticas inflamatorias. La seguridad de la misma está más que documentada en diferentes estudios nacionales e internacionales. La baja frecuencia de las manifestaciones neurológicas dificulta en muchas ocasiones el establecer una relación causal clara entre el tratamiento biológico y la clínica neurológica propiamente dicha. Los síntomas y signos neurológicos que pueden aparecer son múltiples, y en ocasiones simulan enfermedades neurológicas desmielinizantes y/o neurodegenerativas. El conocimiento y el reporte de los mismos es fundamental para realizar un manejo exhaustivo de la terapia biológica en nuestros pacientes.
Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy ...about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure.
Aim. In this study, we aimed to evaluate cord blood mannose binding levels (MBL), to evaluate possible relationship between cord blood MBL levels with neonatal sepsis and culture confirmed neonatal ...sepsis in preterm newborn with gestational age below 34 weeks with fetal inflammatory response syndrome (FIRS).
Methods. Forty-four randomly selected ≤34 weeks gestational age newborns with FIRS were evaluated. MBL deficiency was described as cord blood levels were below 400 ng/ml.
Results. Mean value of umbilical cord MBL was significantly lower in newborns with culture confirmed sepsis (p < 0.01) and also all cases with sepsis (including culture negative or positive) (p < 0.05) than newborns without sepsis. Culture-confirmed sepsis was statistically common in MBL deficient premature newborns with FIRS. Univariate analysis showed that gestational age, birth weight, low serum MBL level and poor obstetric history were all significantly associated with the risk of neonatal sepsis. A subsequent multivariate analysis showed that the association between serum MBL level and the risk of suspected sepsis and culture confirmed sepsis independently from gestational age and birth weight.
Conclusion. Here in, we report firstly lower MBL levels were found related with sepsis in neonates, especially in newborns with culture proven sepsis. Low MBL levels may help to identify neonates with FIRS at high risk of developing sepsis.
Abstract According to the literature, the use of tumor necrosis factor (TNF) inhibitors in patients with chronic hepatitis C infection is safe and effective. There have been no reports, however, of ...primary infection with the hepatitis C virus during treatment with a biologic agent. We report the case of a patient with long-standing moderate to severe psoriasis who developed acute hepatitis C while being treated with etanercept. Biologic therapy was continued and the infection was successfully treated with pegylated interferon, which achieved a sustained virologic response. Etanercept did not have a negative impact on disease outcome or on response to antiviral treatment.
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