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The Systemic Lupus Activity Measure (SLAM) is a system proposed by rheumatologists to measure disease activity in their patients with systemic lupus erythematosus (LE). It involves scoring a group of clinical symptoms and laboratory findings, the maximum possible score being 84. In systemic LE, the mid-point is between 9 and 12. We applied SLAM to 176 patients with cutaneous LE. Ninety-seven had localized discoid LE (L-DLE), 59 had disseminated discoid LE (D-DLE) and 20 had subacute cutaneous LE (SCLE). Eighty-five patients had low activity disease (0-4 points), 72 mildly active disease (5-9 points), 15 moderately active disease (10-14 points) and only four had very active disease (>/= 15 points). The most frequent lesions in patients who scored more than 10 points were photosensitivity, cicatricial alopecia, Raynaud's phenomenon and oral ulcers. Fifty patients were followed up for more than 5 years (mean follow-up 9 years). Nine of these had an increased SLAM score. Seven had L-DLE, one D-DLE and one SCLE. Seven of the 50 patients had photosensitivity, five cicatricial alopecia, five non-cicatricial alopecia, two Raynaud's phenomenon and two oral ulcers. Three patients who started with L-DLE evolved to D-DLE. The SLAM system is useful in the monitoring of disease activity in patients with cutaneous LE. Over time, even L-DLE patients may develop active disease. Photosensitivity, alopecia, oral ulcers and Raynaud's phenomenon seem to herald a worse prognosis.

A modern fringe-pattern-analyzing interferometer with a resolution of 1 x 10(-9) and without exclusion of systematic uncertainties owing to optic effects of less than 1 nm was used to test a new method of interferometric length measurement based on a combination of the reproducible wringing and slave-block techniques. Measurements without excessive wringing film error are demonstrated for blocks with nominal lengths of 2-6 mm and with high surface flatness. The uncertainty achieved for these blocks is less than 1 nm. Deformations of steel gauge blocks and reference platens, caused by wringing forces, are investigated, and the necessary conditions for reproducible wringing are outlined. A subnanometer uncertainty level in phase-change-correction measurements has been achieved for gauge blocks as long as 100 mm. Limitations on the accuracy standard method of interferometric length measurements and shortcomings of the present definition of the length of the material artifact are emphasized.

A primary-level comparator, with a reproducibility of 0.2 nm and intended for realization of a Systeme International length unit in the range of 1-100 mm, is reported. High-precision differential measurements of phase change on reflection from blocks and end plates are demonstrated. A set of experiments has been developed to measure systematic error associated with nonideal interferometer optics and deviations from flatness of an auxiliary plate. For specially selected high-grade 6-mm blocks, reproducible wringing has been achieved with a random uncertainty in length measurements of 0.1-0.2 nm. Subnanometer wear-off of the blocks as a result of the cleaning has been detected. Under the conditions of reproducible wringing, the accuracy of the length measurements is evaluated to be in the 2-3-nm range for 6-mm blocks.

A 34-year-old woman presented with a right winged scapula 8 months after developing systemic lupus erythematosus (SLE) with subacute cutaneous manifestations. The patient experienced severe shoulder pain followed by weakness of the right arm in the typically winged scapula fashion. Electromyography of the serratus anterior showed long thoracic nerve palsy. Clinical and laboratory signs did not reveal any associated disease. Paralysis of the long thoracic nerve has never been described before in SLE.

Endovascular infection of atherosclerotic aorta is a rare event in the setting of aged patients with gram negative bacteremia of the salmonella group. Until the beginning of the 60s this meant an ominous diagnosis with an almost unavoidable fatal prognosis. Presently, this trend has been reverted, mostly due to an earlier diagnosis, the development of more sophisticated imaging techniques, the correct use of broad spectrum bactericidal antibiotics and prompt surgical management. Paradoxically, the incidence of arterial infections has increased in recent years, specially in old people with atherosclerotic abdominal aortic aneurysms, in whom infective endocarditis could not be demonstrated. We describe the case of a 65 year old man, with a history of longstanding non-insulin-dependent diabetes, presenting with protracted fever, weight loss and thigh pain. Blood cultures and serologic studies as well as several echocardiograms yielded negative results. An abdominal CT scan showed an infrarenal aortic aneurysm raising the clinical suspicion of arterial infection of abdominal aorta. The patient underwent surgery because of highly presumptive diagnosis of complicated aortic aneurysm. The resection was followed by an in situ graft. There was no evidence of disruption or gross collection. Samples of the aortic wall and perianeurysmatic fluid grew Salmonella enteritides. We describe the main etiopathogenic and clinic features of the entity highlighting the high sensitivity and specificity of the CT scan in the identification and characterization of infected aortic aneurysm. Certain features may firmly suggest this diagnosis without using preoperative aortography.