Eculizumab in atypical hemolytic uremic syndrome: long-term clinical course and histological findings

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy associated with defective regulation of the alternative complement pathway. The prognosis for patients with aHUS is poor, and plasma exchange represents the first-line therapy. Eculizumab is a humanized monoclonal anti-C5 antibody that prevents the activation of the terminal complement pathway. Here, we report the case of a 9-year-old girl with frequent relapsing aHUS due to heterozygous factor H mutation who was initially treated with plasma exchange three times per week with 150% plasma exchange volume. This treatment frequently caused allergic reactions and school absences. Because any reduction in the frequency of plasma exchange immediately induced relapses of the aHUS, treatment with eculizumab, 600 mg every 2 weeks, was started and plasma exchange completely stopped. On this drug regimen the patient showed no evidence of disease activity during a period of more than 24 months. Renal function improved, proteinuria disappeared, the number of antihypertensive medications could be decreased, and the quality of life increased substantially. The inhibition of the terminal complement pathway by eculizumab was also confirmed by renal biopsy, which showed the absence of thrombotic microangiopathy 2 months after the initiation of eculizumab therapy. This case illustrates the long-term favorable outcome of aHUS with eculizumab treatment.

A Simple Visual Demonstration of Phase Diagram Concepts for an Introductory Materials Science Course Using Colored Solvents

A simple and effective demonstration to help students comprehend phase diagrams and understand phase equilibria and transformations is created using common chemical solvents available in the laboratory. Common misconceptions surrounding phase diagram operations, such as components versus phases, reversibility of phase transformations, and the lever rule are addressed. Three different binary liquid mixtures of varying compatibility create contrastive phase equilibrium cases, where colorful dyes selectively dissolved in each of corresponding phases allow for quick and unambiguous perceptions of solubility limit and phase transformations. Direct feedback and test scores from a group of students show evidence of the effectiveness of the visual and active teaching tool.

Digital signal processing and digital system design using discrete cosine transform [student course]

The discrete cosine transform (DCT) is an important functional block for image processing applications. The implementation of a DCT has been viewed as a specialized research task. We apply a micro-architecture based methodology to the hardware implementation of an efficient DCT algorithm in a digital design course. Several circuit optimization and design space exploration techniques at the register-transfer and logic levels are introduced in class for generating the final design. The students not only learn how the algorithm can be implemented, but also receive insights about how other signal processing algorithms can be translated into a hardware implementation. Since signal processing has very broad applications, the study and implementation of an extensively used signal processing algorithm in a digital design course significantly enhances the learning experience in both digital signal processing and digital design areas for the students.

Swiss multidisciplinary and multilingual experience of the Advanced Trauma Life Support course: lessons for Europe

Courses in the Advanced Trauma Life Support are a well-accepted concept throughout the world for training in the emergency treatment of polytraumatized patients. Switzerland, a multilingual country with a long tradition of multidisciplinary collaboration in trauma care, introduced its first student courses in 1998. Unlike some countries where the courses are attended only by surgeons, instructors and students in Switzerland include surgeons, anaesthetists and physicians from other specialties.

Elevated laser flare values correlate with complicated course of anterior uveitis in patients with juvenile idiopathic arthritis

To evaluate the prognostic value of anterior chamber (AC) laser flare (LF) in uveitis associated with juvenile idiopathic arthritis (JIA).

Long-term course of lung clearance index between infancy and school-age in cystic fibrosis subjects

Multiple breath washout (MBW) measurements have recently been shown to be sensitive for detection of early cystic fibrosis (CF) lung disease, with the lung clearance index (LCI) being the most common measure for ventilation inhomogeneity. The aim of this observational study was to describe the longitudinal course of LCI from time of clinical diagnosis during infancy to school-age in eleven children with CF. Elevated LCI during infancy was present in seven subjects, especially in those with later clinical diagnosis. Tracking of LCI at follow-up was evident only in the four most severe cases. We provide the first longitudinal data describing the long-term course of LCI in a small group of infants with CF. Our findings support the clinical usefulness of MBW measurements to detect and monitor early lung disease in children with CF already present shortly after clinical diagnosis.