De Novo Hypertension and Decline of Renal Function in a Young Woman with Systemic Lupus Erythematosus and Antiphospholipid Syndrome

Antiphospholipid syndrome nephropathy and lupus nephritis have similar clinical and laboratory manifestations and achieving the accuracy of diagnosis required for correct treatment frequently necessitates a kidney biopsy. We report the case of a 29-year-old woman referred to the nephrology service for de novo hypertension, decline of renal function and proteinuria. She had had systemic lupus erythematosus and antiphospholipid syndrome since the age of 21 and was taking oral anticoagulation. Two weeks later, after treatment of hypertension and achievement of adequate coagulation parameters, a percutaneous renal biopsy was performed. The biopsy revealed chronic lesions of focal cortical atrophy, arterial fibrous intimal hyperplasia and arterial thromboses, which are typical features of antiphospholipid syndrome nephropathy. We describe the clinical manifestations and histopathology of antiphospholipid syndrome nephropathy and review the literature on renal biopsy in patients receiving anticoagulation.

Zinc Therapy of Neurological Wilson's Disease in a Woman with Two Foetus with Agenesis of the Corpus Callosum

8A>C>86A G:EDGI: A patient diagnosed Wilson’s disease (WD) 22 years previously, successfully treated initially with zinc, developed neuropsychiatric disease after years of irregular therapy. Reassuming zinc therapy was successful. After a normal pregnancy, she had two therapeutic abortions for corpus callosum agenesis, and a missed abortion. We review the genetics, physiopathology, clinics and imagiologic response to zinc therapy, the problems of pregnancy in WD, advising to maintain therapy. A hypothetic cause for fetus brain anomaly would be hypocupremia due to zinc therapy, confronting with two other possibilities, one related to Wilson’s disease in itself, other due to a congenital syndrome of agenesis of the corpus callosum, impossible to diagnose by our available diagnostic methods.

Fulminant Hepatitis E in a Pregnant Woman

Hepatitis E is an inflammatory liver disease caused by hepatitis E virus (HEV) infection, which is endemic in China, India, Nepal, and in several Asian and African countries, where the prevalence can be as high as 50%. In non-endemic countries, an increasing number of non-travel associated HEV has been reported in recent years, particularly in Europe. The authors describe the clinical case of a puerperal 24-year-old woman from Pakistan admitted to our Tertiary Care Medical Center with acute hepatic failure developed during the third trimester of her pregnancy. She was icteric with grade III encephalopathy and hypothermia. Laboratory values showed significant AST, ALT and LDH elevations of twelve times the upper normal limit, and total bilirubin was significantly elevated (41.20 mg/dL). Prothrombin time was prolonged (4 s) and factor V activity was diminished (15.1%). Extracorporeal albumin dialysis was initiated, but clinical deterioration occurred within 48 h, so she underwent OLT at day 4 post-admission. Severe forms of HEV are known to be more pronounced in pregnant women. Even though most of the described cases of acute hepatic failure associated to HEV during pregnancy had a favorable clinical course, some cases of fulminant liver failure and death are described. It is unknown whether liver transplant outcomes in this setting are different from other causes of acute liver failure. To our knowledge, this is the first case report in Portugal from a pregnant woman who developed hepatic failure due to fulminant hepatitis E that underwent successful liver transplantation.

A 1.2 V low noise amplifier with double feedback for high gain and low noise figure

Dissertação para obtenção do Grau de Mestre em Engenharia Eletrotécnica e de Computadores

Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.

La Cène ou la figure du banquet comme image de crise morale chez Zeng Fanzhi

Les yeux et les masques sont prévalents dans les oeuvres du peintre chinois contemporain Zeng Fanzhi (né en 1964), comme métaphore du jeu de pouvoir qui oppose les individus à l’appareil social et politique. Son oeuvre La Cène, d’après Leonard de Vinci, est un exemple frappant de cette préoccupation. Cet essai examine l’utilisation par l’artiste de cette représentation occidentale d’une crise morale (une trahison qui mène à la mort du Christ) pour exprimer la dystopie qui marque la Chine contemporaine. L’interprétation par Zeng de l’oeuvre de Vinci témoigne d’une compréhension profonde de sa signification à la Renaissance comme conflit entre le pouvoir terrestre et spirituel, auquel il surimpose la fonction du banquet dans la culture chinoise comme lieu de lutte politique. Un nihilisme détaché imprègne ce travail, à l’instar de l’interprétation métaphorique du banquet de Platon par Søren Kierkegaard, In Vino Veritas.

Clear cell adenocarcinoma of the cervix in a young woman: a diagnostic challenge

Clear cell adenocarcinoma of the cervix is a rare tumor, classically related with in utero diethylstilbestrol (DES) exposure. The authors report a rare case of clear cell adenocarcinoma of the cervix in a 21-yearold woman who had no history of in utero DES exposure, presenting with intermittent vaginal bleeding. It stresses the relevance to always clarify the etiology of abnormal genital bleeding and consider the possibility of cervicovaginal tumors.

Wonder Woman et la mythologie contemporaine des amazones

[Extrait] Notre point de départ est la constatation dans les différents médias, genres et arts de la culture populaire et médiatique de la grande quantité de personnages féminins qui défendent par la force la liberté de choisir leur destin: Wonder Woman, Lara Croft, Beatrix Kiddo (Kill Bill), Salt, Katniss Everdeen (The Hunger Games), Tris (Divergent), Lisbeth Salander (The Millenium Trilogy), Elektra, Yoko Tsuno, Marie des Dragons, Artémis Delambre (Les Pirates de Barataria), Isabellae, entre beaucoup d’autres (1). Toutes ces femmes combattent. La conjugaison des valeurs de la liberté et de la force – la force comme condition de la liberté – structure un certain profil féminin qui se réapproprie deux qualités, l’une physique, l’autre politique, qui constituent dans la tradition socioculturelle patriarcale une prérogative typiquement masculine. (...)