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Volume 8, Emitir 2 (2019)

Relato de caso

Giant Cell Arteritis Overlapping with Rheumatoid Arthritis and Sjogren's Syndrome

Jing Wang, Lingyan Zhou and Jing Gao

Background: Giant cell arteritis (GCA) is an autoimmune vasculitis involving large and medium arteries, but the relationship with other autoimmune diseases is unclear. We reported a case of an 85-year-old woman who was diagnosed with GCA, Sjögren’s syndrome (SS) and rheumatoid arthritis (RA) simultaneously, and discussed the potential link between these diseases.

Case presentation: An 85-year-old Chinese woman was admitted to hospital with aggravation of pain in two knees with headache and blurred vision. She had a history of rheumatoid arthritis and rheumatoid heart disease for 30 years and atrial fibrillation for 1 year. On admission, she had bilateral temporal pain accompanied by blurred vision. Physical examination showed dry tongue and decreased coating on the tongue. Initial laboratory results showed that C-reactive protein (CRP) was 24.89 mg/L (normally 0-5), and erythrocyte sedimentation rate (ESR) was 42.4 mm/h (normally 0-20), both of them were significantly elevated.

Results: The anti-nuclear antibody (ANA) and anti-centromere antibody (ACA) was positive in serum. Color Doppler ultrasound of temporal arteries showed thickening and hardening of bilateral temporal artery wall with varying width and narrowness of lumen. She was diagnosed with GCA, SS, and RA. At the same time, she was given antiinflammatory treatment with methylprednisolone, hydroxychloroquine and tripterygium glycosides. Her condition was controlled; the mental state and inflammatory biomarkers were significantly improved (CRP < 0.5 mg/L, ESR 13.6 mm/h). She was discharged from the hospital and outpatient review regularly.

Conclusion: GCA, SS, and RA can occur simultaneously or continuously, but were rare. The combination of CRP and ESR improved the specificity and positive rate of GCA diagnosis. We speculated that there might be common pathogenic factors involved in GCA, RA and SS through the analysis of this case. Through the analysis of this case, we speculated that there may be a common virulence factor involved in GCA, RA and SS. Further exploration is needed in the future to elucidate their relationship and provide more support for early diagnosis and treatment.

Artigo de Pesquisa

Correlation between blaSHV Gene and Biofilm Formation among Beta Lactamase Producing Uropathogenic Isolates from Patients in Erbil City in Iraq

Hosan Yousif Hassan, Safaa Toma Hanna Aka and Salah Tofik Jalal

Background and objective: Bacterial resistance has been considered as one of the most serious threats in infectious disease, especially in development countries. The ability of biofilm formation is often associated with antibiotic resistance. The aim of the study is to detect the correlation between the ability of biofilm formation and SHV gene, in addition to investigate the prevalence of SHV gene among the beta-lactamase producing strains.

Methods: This cross-sectional study was carried out during the period September to December 2017 at Rizgary Teaching Hospital in Erbil. A total of 31 beta-lactamase producing uropathogens were collected, identification and antibiotic sensitivity test was done using VITEK-2 automated system. Biofilm formation was determined by 96 well flat bottom microtiter plates. Molecular detection was performed for one of the ESBL genes, the SHV gene.

Results: The prevalence of SHV gene among the beta-lactamase producing isolates was 29%. The findings showed a significant association between the presence of SHV gene and the bacterial species (p=0.001). In addition 44.4% of SHV positive isolates were K. pneumoniae pathogens with the ability of moderate or strong biofilm formation which showed to have a significant association (p=0.044). From the beta-lactamase producing strains 90.3% appeared to be multi-drug resistant isolates.

Conclusion: The SHV gene was significantly more present in K. pneumoniae in compare to E. coli strains. However, most of SHV positive isolates were K. pneumoniae pathogens with ability of moderate or strong biofilm formation.

Artigo de revisão

Drug Resistance Mechanisms and Molecular Diagnosis Methods for Tuberculosis

Tekeba Sisay, Nega Berhane and Deepak Verma

Mycobacterium tuberculosis is the main cause of death worldwide. It has been thought that one third of the world population has been infected with Mycobacterium tuberculosis (MTB). To assure effective treatment, TB is treated with a combination of anti-TB drugs in the strategy called directly observed treatment short-course (DOTS), which is a treatment regimen that may, lasts from six to eight months. Even though DOTS strategy and effective chemotherapy are used in the past decades, drug-resistant TB is the worldwide problem since the introduction of chemotherapy. Especially, drug resistance is recognized as a worldwide problem after the dramatic outbreaks of Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) strains. MDR-TB is a type of drug resistant TB which is developed when MTB strains can withstand at least two potential anti-TB antibiotics, isoniazid and rifampin. Antibiotic resistance can be developed either by natural or acquired mechanisms. Bacterium like Mycobacterium tuberculosis can acquire drug resistance by changing their genetic materials which can be targeted for drug resistance diagnosis for early and rapid diagnosis of drug resistant tuberculosis. Since early disease diagnosis can minimize the risk of transmission and improve the patients’ survival rate, now a day’s molecular techniques have madesignificant progress in the identification of genetic mutations that are related with antibiotic resistance development to offer a rapidly screening of antibiotic resistant M. tuberculosis. Such mutation screening methods include DNA sequencing, hybridization, single strand conformation polymorphism and heteroduplex analysis. The diagnosis of drug resistance with molecular techniques help to avoid unnecessary treatments and reduce health complications.

Tese

C-Banding Karyotype and Molecular Characterization on Cumin, Caraway and Coriander

Ibrahim MA, Bekhit M, Neveen Hassan, Refaat M and El-Akkad T

Our goal for this study to characterize three species germplasm of family Apiaceae, namely (cumin, caraway and coriander), to make a chromosome characterization and molecular fingerprint for the mentioned species. Results performed on Karyomorphological showed that; Cuminum cyminum L. (cumin: 2n=14), Carum carvi (caraway: 2n=20) and Coriandrum sativum (coriander: 2n=22). The total Chromatin Relative Length percentage (RL%) showed cumin ± 10.69 μm ± 19.70 μm, caraway ± 7.30 μm ± 13.40 μm and coriander ± 5.58 μm ± 12.07 μm. Satellites in all the cases were associated to short arms. The molecular characterization for the three species (caraway, cumin, and coriander) was conducted using 5 AFLP combinations and 15 anchored-ISSR primers. The total amplified bands were 330 (162 ISSR+168 AFLP), with an average 83.75% (89.5 ISSR+78 AFLP) per primer. The combined dendrogram based on both AFLP and SSR markers for the three accessions was divided into 2 main clusters; the first cluster has 2 accessions (caraway and cumin) with 60% similarity, while coriander falls in a distinct cluster.

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