Reduced secretion of proinflammatory cytokines of monosodium urate crystal‐stimulated monocytes in chronic renal failure: an explanation for infrequent gout episodes in chronic renal failure patients?

In gouty arthritis, monosodium urate (MSU) crystals interact with monocytes and neutrophils to produce inflammatory reactions associated with acute synovitis. In patients with end-stage renal disease (ESRD), gouty arthritis is a rare condition despite often severe hyperuricaemia. We wondered whether differences in the secretion of proinflammatory cytokines by MSU crystal-stimulated monocytes might be one explanation for the low incidence of gouty arthritis in patients with ESRD compared with healthy controls.Thirteen patients with ESRD on intermittent haemodialysis treatment, six patients with chronic renal failure not yet on dialysis, and 15 age- and sex-matched healthy controls were exami…

Pathogenic lipid‐binding antiphospholipid antibodies are associated with severity of COVID‐19

Abstract Background Coronavirus disease 19 (COVID‐19)–associated coagulopathy is a hallmark of disease severity and poor prognosis. The key manifestations of this prothrombotic syndrome—microvascular thrombosis, stroke, and venous and pulmonary clots—are also observed in severe and catastrophic antiphospholipid syndrome. Antiphospholipid antibodies (aPL) are detectable in COVID‐19 patients, but their association with the clinical course of COVID‐19 remains unproven. Objectives To analyze the presence and relevance of lipid‐binding aPL in hospitalized COVID‐19 patients. Methods Two cohorts of 53 and 121 patients from a single center hospitalized for PCR‐proven severe acute respiratory syndro…

A swallowed toothbrush

A 27-year-old woman came to the emergency department in April, 1999, after swallowing a toothbrush while cleaning her teeth 1 hour previously. She attributed the accident to clumsiness which made her slip on the wet bathroom floor, thereby forcing the toothbrush deep into her throat She reported no other illnesses. She had no pain, dysphagia, or dyspnoea. On examination she had a normal weight (body mass index of 22 kg/m). Her oropharnyx had no signs of injury and the rest of the physical examination was normal. A chest radiograph showed a toothbrush projecting towards the distal oesophagus with the head pointing to the oropharynx (figure), a finding which was not compatible with the report…

Coexistence of Cullen's and Grey Turner's Signs in Acute Pancreatitis