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Objectives : To assess the role of anti-heart antibodies (AHA) in postpericardiotomy syndrome (PPS) and the timing of their appearance in relation to the initial manifestations of PPS. Design and subjects : Twenty patients who were scheduled to undergo elective coronary artery bypass grafting (CABG) were enrolled in a prospective, longitudinal pilot study. Methods : Serum was sampled for AHA on the day prior to surgery and at regular intervals following surgery in all patients. In those who developed PPS, the serum AHA was determined on the day that typical clinical manifestations of PPS appeared and at regular intervals following the onset of PPS. Results : All patients were negative for AHA on the day preceding surgery. Three (15%) patients developed PPS. Their sera were negative for AHA on the day they were diagnosed as suffering from PPS and the sera became positive for AHA within 14 days from the time of diagnosis. The intensity of immunofluorescence decreased markedly 30 days afterwards and AHA had ...

Hepatotoxicity due to intravenous amiodarone (HIVAD) is a rare side effect with a distinct pattern of enzyme disturbances compared to liver damage from oral amiodarone. Intravenous amiodarone is administered for acute arrhythmias often causing heart failure. The enzyme abnormalities and clinical setting are very similar to that of ischemic hepatitis, a far more common condition.To ascertain if acute HIVAD exists as a separate entity or whether reported cases may be explained by ischemic hepatitisIn this case-control retrospective study the files of hospitalized patients with markedly elevated aminotransferases were reviewed for the diagnoses of HIVAD or ischemic hepatitis. Medline was searched for published cases of HIVAD. Pooled data of all patients with HIVAD were compared to a control group with ischemic hepatitis.There were no significant differences in the clinical characteristics, laboratory results or histological findings between HIVAD and ischemic hepatitis patients.In our opinion, there is currently insufficient data to support the existence of distinct HIVAD, and ischemic hepatitis is a more probable diagnosis in most reported cases. Withdrawing amiodarone because of assumed hepatic damage could deprive patients of a life-saving therapy.

To investigate maternal and neonatal outcome of pregnant women infected with H1N1 influenza virus.We prospectively followed all pregnant women hospitalized with positive H1N1 influenza virus nasal polymerase chain reaction tests between September 2009 and April 2010. Maternal and neonatal complications were recorded.Twenty-four women positive for H1N1 were hospitalized. Only 2 women suffered from asthma, all others had no co-morbidities. Most women were in the third trimester (14 women, 58%). Common presenting symptoms were dyspnea (83%) and Fever (79%). Eleven women (46%) had pneumonia/Adult Respiratory Distress syndrome (ARDS) on chest X-rays. Six women were actively delivered due to maternal or fetal distress. Gestational age at delivery for these women was significantly lower (34 weeks vs. 39 weeks, p = 0.005). Of women delivered, five were admitted to intensive care units (ICU), three needed mechanical ventilation, and one tracheostomy. Patients admitted to ICU had significantly higher white blood cell (WBC) and C-reactive protein (CRP) levels (p0.01, p0.01, respectively). The main neonatal complication was prematurity where delivery was indicated.H1N1 flu pandemic has the potential of causing serious maternal morbidity during pregnancy. ARDS, elevated WBC and CRP levels correlate with more severe cases. Prematurity is associated with severity of maternal disease.

Pericardial effusion from any cause may lead to decreased cardiac output and blood pressure, causing heart failure and reduced renal blood flow. Although pericardial effusion is not uncommon, it is usually not associated with hemodynamic compromise unless the effusion causes cardiac tamponade. Acute renal failure resulting from pericardial effusion is surprisingly rare, with only six cases described to date. We describe the first case known to us of pericardial effusion without tamponade causing acute anuric renal failure. The case was characterized initially by non-specific symptoms and signs; anuria dominated the clinical picture, and was completely reversed after pericardiocentesis.

CD14, originally recognized as a lipopolysaccharide (LPS) receptor, has recently been implicated in the process of T-cell suppression and apoptosis. Its soluble form has been shown to bind, in vitro, to human T cells, a process that may carry a negative signal onto these cells. We recently described a novel lymphocyte population in human peripheral blood, a population that expresses an intracellular CD14-like antigen. This novel T-cell population, composed mainly of CD8 cells and of very few CD4 cells, was found to be greatly enhanced in asymptomatic, untreated human immunodeficiency virus (HIV)-positive individuals. In the present study, we further characterized this cell population and found that it differed from other CD8 subpopulations associated with HIV infection such as CD8/CD38. In addition, we followed HIV patients under conditions of highly active antiretroviral therapy (HAART) and observed two groups of patients: patients in whom the CD14-like positive-testing T cells returned to normal within 1 to 3 months, and patients in whom it did not, in spite of a significant plasma HIV-RNA viral load decrease. Thus, this new CD14-like positive-testing lymphocyte population may represent an interesting and important component of the cellular events associated with HIV infection. On the basis of its modulation following HAART, we speculate that it may be used, in the future, as a drug-monitoring cellular marker in antiretroviral treatment.

An estimated 300.000 migrant workers are currently living in Israel, which is about 5% of the general population. More then half of this population is undocumented and have very limited access to public health care. Due to the financial difficulties within the Israel's public health system, the entity is unable to deal with the needs of migrant workers. Hence, when these migrant workers need inpatient care, hospitals have to bear the costs and this situation creates a divergence between medical and economic considerations. The open clinic of "Physicians for Human Rights", which is operated by volunteer physicians and nurses, is able to provide medical aid for mild and transient illnesses, but not for chronic diseases. Israeli physicians are regularly confronted with ethical issues, regarding the therapy they would like to provide to undocumented migrant workers, but are unable to do so. In Europe, undocumented migrant workers have better access to public health care than in Israel. The Israeli public health system should permit all migrant workers to insure themselves at affordable prices, or another inexpensive insurance system should be created for them.

CD14, a lipopolysaccharide (LPS) receptor, is present on the surface membrane of phagocytic leukocytes; it is also present in a soluble form in serum. Recently published results confer to this molecule novel functions that are linked to T-cell activation and to apoptosis. We report here that we have defined and characterized a novel lymphocyte population in human peripheral blood, a population that expresses an intracellular antigen detectable with MO2, a monoclonal antibody directed against the human CD14 molecule. This population is composed primarily of CD8-positive T-cells. We found surprisingly that this novel MO2-positive population of lymphocytes was greatly enhanced in asymptomatic, untreated HIV-positive individuals.

acyclovir, ceftriaxone, ampicillin, doxycycline, and phenytoin. Serology tests for HIV, adenoviruses, herpes simplex, mycoplasma, and brucella were negative. Titre of antibodies against enteroviruses, tested by complement fixation test, rose from 1:32 to 1:1024. The patient made a rapid and full recovery with no detectable neurological deficit and was discharged 8 days later. Aseptic meningitis and encephalitis are increasingly recognised as a complication of non-polio enterovirus infections. They are very rare in healthy adults with intact humoral immunity. Further studies are needed to investigate whether severe encephalitis is caused by an exceptionally virulent subtype of enterovirus, perhaps in a host with an undetected defect of the immune system.