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Background Guidance for intensified diuretic therapy in acute heart failure (AHF) is mainly based on body weight measurement, frequently leading to a short episode of dehydration with kidney failure after recompensation. In addition, patients often present immobilized due to severe health issues making weight measurement stressful. Purpose Bioelectrical impedance analysis (BIA) may be a more direct approach to guide intensified diuretic therapy analysing patient's body composition. We hypothesized that patient's weight loss during therapy correlates with loss of body water measured by BIA. Therefore, we tested if this method could be an alternative to daily weight measurement. Methods We conducted an observational, single-centre study to evaluate and monitor body composition of patients hospitalised with AHF, adjudicated according to current ESC/HFA guidelines by a cardiologist. We used an eight-electrode, segmental, multi-frequency body composition analyser, previously validated against air displacement plethysmography, whole body MRI, deuterium and sodium bromide dilution. We investigated patients until hospital discharge or latest one day after ending intensified diuretic therapy. Disease specific properties, BIA and weight measurement were assessed daily. Furthermore, we investigated BIA raw data. Results 390 BIA were applied on 76 patients (47 men; 29 women; mean age 76±11 years; mean weight 75.6±15.7 kg). 34 patients presented with global, 27 with left-heart, 8 with right-heart and 7 with not specified AHF. 44 patients presented with pleural effusion. Pearson correlations showed that total body water (r=0.737, p≤0.001) and extracellular water (r=0.69, p≤0.001) correlated each with total body weight. Changes in total body water accurately (within a range of ± 1kg) reflected changes in total body weight in 40.28% of the patients and changes in extracellular water showed a similarly accurate reflection of total body weight change in 68.06% of the patients. BIA raw-data analysis showed significant changes using Wilcoxon test between measurements at the beginning of intensified diuretic therapy and at its end. We found a significant increase of resistance (mean from 334.6±67.5 to 362.8±69.5 Ohm/m; p=0.021) and reactance (mean from 21.3±7.1 to 24.1±6.2 Ohm/m; p=0.009) standardized to patients height and a non-significant increase of phase angle (mean from 3.6±0.9 to 3.8±0.8 °; p=0.149) during hospitalisation. Conclusion BIA is able to estimate changes in total body weight by analysing changes in extracellular body water in patients under intensified diuretic therapy and raw data analysis seems even more accurate and promising. This data derive from a heterogeneous AHF patient group, needing further investigation. Once validated, wearable BIA connected to an automated device monitoring system would enable an easy to use diuretic therapy monitoring for impaired patients or outpatients and could help reducing care efforts.

Background: Centeredness Theory (CT) is proposed as a new mental health paradigm that focuses on well-being at a systems-level, across the core life domains of the self, the family unit, relationships, community, and work. The current studies aimed to validate the psychometric properties of a new scale that measures CT against existing well-being and mental health measures. Methods: Study 1 included 488 anonymous online respondents (46% females, 28% males, 25% unknown with median age between 31 and 35 years) across 38 countries who completed the CT scale. Study 2 included 49 first-year psychology students (90% females, mean age of 19 years) from Sydney Australia that completed the CT scale and other well-being and mental health questionnaires at baseline and 2-weeks follow-up. Results: Exploratory and confirmatory factor analyses resulted in a refined 60-item CT scale with five domains, each with four sub-domains. The CT scale demonstrated good internal consistency reliability and test-retest reliability, and showed evidence of convergent validity against other well-being measures (e.g., COMPAS-W Wellbeing Scale, SWLS scale, and Ryff's Psychological Well-being scale). Conclusions: The CT scale appears to be a reliable measure of well-being at a systems-level. Future studies need to confirm these findings in larger heterogeneous samples.

R. Reifarth et al: ; 12 págs.; 9 figs.; Open Access funded by Creative Commons Atribution Licence 3.0 ; Nuclear Physics in Astrophysics VI (NPA6), The nucleosynthesis of elements beyond iron is dominated by neutron captures in the s and r processes. However, 32 stable, proton-rich isotopes cannot be formed during those processes, because they are shielded from the s-process ow and r-process -decay chains. These nuclei are attributed to the p and rp process. For all those processes, current research in nuclear astrophysics addresses the need for more precise reaction data involving radioactive isotopes. Depending on the particular reaction, direct or inverse kinematics, forward or time-reversed direction are investigated to determine or at least to constrain the desired reaction cross sections. The Facility for Antiproton and Ion Research (FAIR) will oer unique, unprecedented opportunities to investigate many of the important reactions. The high yield of radioactive isotopes, even far away from the valley of stability, allows the investigation of isotopes involved in processes as exotic as the r or rp processes., This project was supported by the HGF Young Investigators Project VH-NG-327, EMMI, H4F, HGS-HIRe, JINA, NAVI, DFG and ATHENA.

Tumorzapfen in abfuhrenden Venen bei bosartigen Tumoren sind insbesondere von Nierenzellkarzinomen bekannt. Es finden sich jedoch nur wenige Beschreibungen von Tumorzapfen in Halsvenen, wie sie bei einer 91-jahrigen Patientin auftraten, die in unserer Behandlung war. Die Ausbildung von Tumorzapfen ist fur Thymus- und Schilddrusenkarzinome beschrieben, doch finden sich keine entsprechenden Hinweise bei Plattenepithelkarzinomen im Kopf-Hals-Gebiet. Metastasen von Plattenepithelkarzinomen der Kopf- und Gesichtshaut weisen eine hohe Aggressivitat und eine hohe Tumorangiogeneseneigung auf. Neben einem moglichen Gefaseinbruch uber mechanische Mechanismen, ware auch ein Einwachsen uber eine tumorose Gefasneubildung denkbar.

4 pags., 2 figs. -- INPC 2013 – International Nuclear Physics Conference, The investigation of the excitation energies of the 21+ –states in the neutron-rich Cd isotopes shows an irregular behaviour when approaching the neutron shell-closure at N = 82. The energy of the 21+–state in 128Cd is lower than the one in 126Cd. The transition strength B(E2, 0gs+ → 21+) in the even isotopes 122−128Cd was measured in Coulomb excitation experiments with the high-purity germanium detector array MINIBALL at REXISOLDE (CERN). The values for 122,124Cd coincide with beyond-mean-field calculations with a resultant prolate deformation, whereas 126,128Cd are better described by shell-model calculations., This project is supported by BMBF (No. 06 DA 9036I, No. 05 P12 RDCIA, No. 05 P12 RDCIB and No. 05 P12 PKFNE), HIC for FAIR, EU through EURONS (No. 506065) and ENSAR (No. 262010) and the MINIBALL and REX-ISOLDE collaborations.

The R3B experiment (Reactions with Relativistic Radioactive Beams) at FAIR (Facility for Antiproton and Ion Research) is a versatile setup dedicated to the study of reactions induced by high-energy radioactive beams. It will provide kinematically complete measurements with high efficiency, acceptance and resolution, making possible a broad physics program with rare-isotopes. CALIFA (CALorimeter for In-Flight detection of gamma-rays and high energy charged pArticles), is a complex detector based on scintillation crystals, that will surround the target of the R3B experiment. CALIFA will act as a total absorption gamma-calorimeter and spectrometer, as well as identifier of charged particles from target residues. This versatility is its most challenging requirement, demanding a huge dynamic range, to cover from low energy gamma-rays up to 300 MeV protons. This fact, along with the high-energy of the beams determine the conceptual design of the detector, presented in this paper, together with the technical solutions proposed for its construction. © 2014 Elsevier Inc., This work was supported by: FPA2009-14604-C02-01, FPA2009-14604-C02-02, FPA2009-07387, HIC for FAIR, BMBF(06DA9040I, 05P12RDFN8, 06MT9156, 05P12WOFNF), DFG EXC153, GSI-TU Darmstadt cooperationn and EraNet NupNet GANAS.

) transition strengths [1] and thenumber of nucleons in the valence shell. The global behaviorof these quantities between the major shells as a function ofthe nucleon number is well understood in the frameworks ofboth collective and microscopic models. One could expect thatthese general trends in the collective properties between themajorshellsaremodulated bythesubshellstructure.However,it is usually thought that the pairing correlations with anenergy scale of about 2 MeV, smear out and dissolve thesubshell structure as long as the separation energies betweenthe subshells are only about a few hundred keV.The recently observed evolution of the isovectorquadrupole-collective valence-shell excitations in the

Well established in the field of scintillator detection, Caesium Iodide remains at the forefront of scintillators for use in modern calorimeters. Recent developments in photosensor technology have lead to the production of Large Area Avalanche Photo Diodes (LAAPDs), a huge advancement on traditional photosensors in terms of high internal gain, dynamic range, magnetic field insensitivity, high quantum efficiency and fast recovery time. The R 3B physics programme has a number of requirements for its calorimeter, one of the most challenging being the dual functionality as both a calorimeter and a spectrometer. This involves the simultaneous detection of ∼300MeV protons and gamma rays ranging from 0.1 to 20 MeV. This scintillator - photosensor coupling provides an excellent solution in this capacity, in part due to the near perfect match of the LAAPD quantum efficiency peak to the light output wavelength of CsI(Tl). Modern detector development is guided by use of Monte Carlo simulations to predict detector performance, nonetheless it is essential to benchmark these simulations against real data taken with prototype detector arrays. Here follows an account of the performance of two such prototypes representing different polar regions of the Barrel section of the forthcoming CALIFA calorimeter. Measurements were taken for gamma-ray energies up to 15.1 MeV (Maier-Leibnitz Laboratory, Garching, Germany) and for direct irradiation with a 180 MeV proton beam (The Svedberg Laboratoriet, Uppsala, Sweden). Results are discussed in light of complementary GEANT4 simulations. © 2013 Elsevier B.V., This work has been supported by FPA 2009, GANAS, ENSAR, HIC for FAIR, Mineco (FPA2009-14604-C02-01, FPA2009-07387), BMBF (06DA9040I, 05P12RDFN8, 06MT9156, 05P12WOFNF, 05P12WONUE), the Spanish Ministereo de Ciencia e Innovación (FP2005-00732) and the Xunta de Galicia (project number PGIDIT07PXIB206124PR).

A method that uses fuzzy clustering algorithms to achieve particle identification based on pulse shape analysis is presented. The fuzzy c-means clustering algorithm is used to compute mean (principal) pulse shapes induced by different particle species in an automatic and unsupervised fashion from a mixed set of data. A discrimination amplitude is proposed using these principal pulse shapes to identify the originating particle species of a detector pulse. Since this method does not make any assumptions about the specific features of the pulse shapes, it is very generic and suitable for multiple types of detectors. The method is applied to discriminate between photon- and proton-induced signals in CsI(Tl) scintillator detectors and the results are compared to the well-known integration method., Comment: 7 pages, 7 figures

To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness.This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness and decentering during 6-8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT, continued on antidepressants, or were switched to a placebo. In total, 84 patients (mean age = 44 years, 58% female) were randomized to 1 of these 3 prevention conditions. In addition to symptom variables, changes in mindfulness, rumination, and decentering were assessed during the phases of the study.Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences. During the maintenance phase, only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences (p.01) and Decentering (p.01) subscales of the Experiences Questionnaire and by the Toronto Mindfulness Scale. In addition, changes in Wider Experiences (p.05) and Curiosity (p.01) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up.An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness. With practice, patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery.

Background Altered cognitive processing following mood challenge is associated with elevated relapse risk in remitted unipolar depressed patients, but little is known about the neural basis of this reactivity and its link to depressive relapse and prophylaxis. Methods Remitted unipolar depressed participants ( n = 16) and healthy control subjects ( n = 16) underwent functional magnetic resonance imaging (fMRI) while viewing sad and neutral film clips. Correlations were determined between emotional reactivity (neural responses to sad vs. neutral films) in remitted patients and subsequent relapse status over an 18 month follow-up period. A receiver operating characteristic analysis was used to determine signal cutoffs for predicting relapse. Emotional reactivity in relapse prognostic areas was compared between groups. Results Within the remitted group, relapse was predicted by medial prefrontal cortical (mPFC; Brodmann's area 32) activity and contraindicated by visual cortical activity (Brodmann's area 17). mPFC reactivity predicted rumination, whereas visual cortical reactivity predicted distress tolerance (acceptance). Compared with control participants, remitted depressed patients demonstrated a more pronounced tradeoff between mPFC and visual cortex reactivity. The difference score between mPFC and visual reactivity yielded excellent prediction of depressive relapse. Conclusions Medial prefrontal cortical reactivity to mood provocation in remitted unipolar depressed patients serves as a marker of relapse risk rather than successful emotion regulation. Enduring remission is characterized by normalization of the mPFC to that of healthy control subjects. Furthermore, visual cortex reactivity predicts resilience against depressive relapse, indicating a prophylactic role for sensory rather than ruminative cognitive reactivity in the processing of negative emotion.

Cones of malignant tumors are commonly known but only a few descriptions of cones in the head and neck area exist - as seen in a 91-year-old patient under our care. Cones of thymic and thyroid cancers are described in the literature. There are no descriptions of cones of head and neck squamous cell carcinomas. Metastases of squamous cell carcinoma in the head and neck area are very aggressive and have a high potential for vascular neogenesis. A vascular cone might be possible by vascular formation or by mechanical intrusion as described elsewhere.

This paper presents a complete way of creating event-continuous models for hybrid systems. The development of the event model is formalised as well as the results, the latter being done using Petri nets. The continuous model is constructed using bond graphs with variable causality, including a suitable representation of the switch elements. >

The present study examined whether caffeine administered within a dose range previously shown to promote ethanol drinking would also alter an ethanol-induced conditioned taste aversion (CTA). The results revealed a dose-dependent interaction between caffeine and ethanol where caffeine (2.5 and 10 mg/kg) promoted an ethanol-induced CTA at a low ethanol dose (1.0 g/kg) but had no effect in blocking CTA at the higher ethanol dose (1.5 g/kg). These results were found to be unrelated to an alteration in ethanol metabolism, as caffeine had no effect in altering blood ethanol levels at the doses tested. In agreement with the reward comparison hypothesis, the present results suggest that rather than attenuate ethanol's "aversive" effects, caffeine may have promoted an ethanol-induced CTA by increasing the reinforcing efficacy of ethanol.

Rationale: The present study examined whether nicotine and caffeine, two of the most widely used psychoactive drugs, share stimulus properties in the preexposure conditioned taste aversion (CTA) procedure. Objectives: To determine whether nicotine would attenuate the formation of a caffeine-induced CTA and further assess whether pretreatment with mecamylamine, a nicotinic receptor antagonist, would reverse nicotine's attenuating effect of a caffeine-induced CTA. Methods: Male Wistar rats were preexposed with one of three doses of nicotine (0.6, 1.2 and 2.0 mg/kg, s.c.) for three consecutive days, then 24 h following the final preexposure injection were conditioned with caffeine (20 mg/kg and 30 mg/kg, i.p.) in a standard two-bottle test. There were four conditioning trials and four drug-free test days. In a follow-up study, rats were pretreated with mecamylamine (2 mg/kg, i.p.) prior to preexposure injections with nicotine (0.6 mg/kg, i.p.), then subsequently conditioned with caffeine (20 mg/kg, i.p.) as described above. Results: The lowest nicotine dose (0.6 mg/kg) attenuated the caffeine induced CTAs (20 mg/kg and 30 mg/kg) but the higher nicotine doses showed no such attenuating effect. In addition, mecamylamine reversed the nicotine-induced attenuation of the caffeine-induced CTA and also directly attenuated it. Conclusions: These results suggested that caffeine, nicotine and mecamylamine share overlapping stimulus properties and that the nature of this relationship may involve action at the nicotinic-cholinergic receptor.

Chronic compartment syndrome (CCS) is characterized by recurrent pain in and functional disability of affected muscles, and is typically encountered in the lower leg. The condition is due to physical activity causing an increased intracompartmental pressure (ICP), which subsequently impedes blood flow and thereby compromises the metabolic demands of the tissues within the compartment. After ceasing of activity the symptoms gradually disappear. The incidence of CCS is uncertain. Diagnosis can be established by measuring the ICP before and after relevant physical activity. Treatment is either restriction in activity or fasciotomy, which in most cases is curative.

Relapse and recurrence following recovery from Major Depressive Disorder (MDD) are common and debilitating outcomes that carry enormous person, familial and societal costs1. Maintenance antidepressant monotherapy (M-ADM), the current standard for depressive relapse prophylaxis2 is effective as long as it is continued, yet in practice, this plan is compromised by rates of patient noncompliance that can reach 40%3,4. Alternatives to long term antidepressant monotherapy, especially those that address mood outcomes in a broader context of well-being, may appeal to patients wary of continued intervention. One such approach involves the use of sequenced, phase-specific depression treatments within an envelope spanning both acute phase and post-remission care5. Such models involve treating patients to remission pharmacologically and then providing psychotherapy aimed at preventing relapse by teaching affect regulation and self-management skills to be used during recovery. Implicit here is the view that the mechanisms underlying the onset of a depressive episode differ from those responsible for its return6 and that unique interventions are required to address each. Prevention outcomes from the sequential treatment of mood disorders are largely supportive of the approach. Fava7,8 reported lower relapse rates at 4 year follow up and fewer multiple relapses for remitted patients who discontinued medication and received CBT, compared to clinical management. Frank et al.,9 found that time to recurrence was greater for patients who discontinued antidepressants at remission and received Interpersonal Therapy (IPT) or IPT and pill placebo (PLA) versus PLA alone. Similar findings have been obtained with Mindfulness-Based Cognitive Therapy (MBCT), a group intervention designed to train recovered, recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that increases risk for relapse/recurrence. In addition, MBCT’s emphasis on the daily practice of health enhancing behaviours such as meditation or yoga is a positive incentive for the type of long term engagement required by any maintenance therapy. To date, this intervention designed to be suitable for patients achieving remission via antidepressant treatment, has been evaluated in 3 RCTs with outcomes suggesting a 50% reduction in relapse for patients receiving MBCT compared to treatment as usual10,11 or no difference in survival compared to maintenance pharmacotherapy12. These data, while encouraging, do not address the frequently encountered clinical scenario where a remitted patient wishes, whether for reasons of preference13, side effect burden14 or suitability15, (e.g. pregnancy) to discontinue antidepressant treatment but requires additional prophylactic care. Although previous studies have enrolled patients who were already in remission, no study has explicitly treated patients to remission pharmacologically with the aim of testing MBCT’s prevention effects directly following discontinuation, against active treatment or a placebo (PLA) control. Addressing this question would help determine MBCT’s generalizability to real world clinical settings and evaluate, more broadly, the sequential staging through which both treatments are delivered. The present study was designed to test the relative efficacy of MBCT and M-ADM (versus PLA and clinical management) for prevention of relapse in patients with recurrent depression who have achieved remission through antidepressant pharmacotherapy. We predicted that both MBCT and M-ADM would offer effective protection when compared against PLA and that the level of protection achieved by MBCT would not differ from that provided by M-ADM.

A case of human pulmonary dirofilariasis is reported. This human infestation must be considered in the differential diagnosis of a pulmonary "coin" lesion, which lies adjacent to a pleural surface, especially where tissue sections reveal a pulmonary infarct.

This paper reports how 700 high school girls (grades 9-12) perceived librarians, as measured by a novel, completely nonsuggestive instrument--the Occupational Concept Test. The results indicate that high school students consider librarians helpful but do not know the level of education demanded by the profession. The more mature students are also aware of the librarian's relative independence. When the image of the librarian is measured with a nonsuggestive instrument, it is quite favorable, in contrast to some negative stereotypes found in library literature.

It is shown that when account is taken of the attenuation of incident radiation into the bulk of a photoconductor, as a result of the absorption, the expressions for the responsivity and detectivity are modified. An earlier derivation [Infrared Phys. 20, 385 (1980)] attributed the difference in the operation of the detectors in the transverse and longitudinal geometries to carefully defined ‘‘effective’’ quantum efficiencies. Here we show that a more physically motivated view attributes the difference to the different photoconductive gains for the two geometries. It is shown that the appropriate gains for the responsivity and detectivity are not the same.

Triads of occupations were given to 1300 high-school pupils of both sexes in order to find the affinities of the occupations and the values they used to arrive at the affinities. The values used to perceive occupations come from the subject; nevertheless they could be categorized into a scheme of 20 different values, with the residue category containing less than 1% of the answers. In accordance with previous research in this field, an almost universal structure of occupations was found. The following variables had no influence on the choice of occupational affinities: age, trend of study, SES, father's occupation, mother's occupation, vocational maturity, and preferred occupation. Only the pupils of one school were significantly different in affiliating the occupations in the triads. Furthermore, girls perceive the world of occupations more uniformly than boys. Underlying this universal structure of occupations there exists a latent structure, specific to each individual, which explains why the world of occupations is seen in the way it is. This latent structure of occupations is influenced by the individual's specific background.

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Giardia lamblia is a flagellated protozoan that inhabits the upper portions of the small intestine; trophozoites are the usual stage seen in duodenal aspirates, biopsies of the duodenum and jejunum and, infrequently, in stools, in which cysts are more likely to be found. A unique occurrence of G lamblia cysts and trophozoites within the peritoneal fluid of a patient with a blunt abdominal trauma is reported. Cytotechnologists and pathologists should be aware that trophozoites and cysts of G lamblia may appear in peritoneal lavage fluid from patients with blunt abdominal trauma and duodenal injury, indicating a need for exploratory laparotomy.

A review from November 1978 of high speed computer architectures is presented using the specific examples of the TI ASC, Burroughs BSP, CDC STAR-100, CRI CRAY-1, ICL DAP and FPS AP-120B. The architectural design solutions adopted by these different computers are analysed in terms of memory size and bandwidth, vector processing style, scalar processing power, input/output and context switching. Software problems and the vectorization of FORTRAN programs are briefly touched upon.

The authors describe a unique case of osteosarcoma associated with atypical mesonephric rests occurring in the right lateral wall of the uterine cervix. The tumor was examined histologically, cytologically, immunohistochemically, and ultrastructurally and was compared with another osteosarcoma that filled an entire uterine cavity. Comparison with other neoplasms of the uterine cervix indicates that the lesion should be classified separately. Previously reported neoplasms associated with mesonephric rests within the cervix are also reviewed.

Morphologic evaluation of operatively excised native cardiac valves can lead to an etiologic diagnosis in most instances using a simple 10-step approach. With few exceptions, histologic evaluation of excised cardiac valves provides little additional information beyond this proposed morphologic assessment.

This addendum brings the paper referenced up-to-date as of January 1981. The new market situation in the area of super computers is reviewed and the only really new machine, the CDC CYBER 205, is described. The CRAY-1S series is briefly described and the FPS-164 is mentioned. The fact that Burroughs discontinued the BSP project is mentioned.

We consider the low-temperature conductivity of heavily doped semiconductors which proceeds via thermally activated hopping of carriers between impurity sites. We investigate a model of an n-type semiconductor with the density of the primary donor dopant (${N}_{D}$), shallower secondary donors (${N}_{d}$), and compensating acceptors (${N}_{A}$). We calculate the hopping activation energy ${\ensuremath{\varepsilon}}_{3}$ for low compensation in the limit as the temperature T\ensuremath{\rightarrow}0. We extend a Shklovskii-Efros model [IElectronic Properties of Doped SemiconductorsR (Springer, New York, 1984)] by including ${N}_{d}$ and find ${\ensuremath{\varepsilon}}_{3}$ to be a very sensitive function of ${N}_{d}$/${N}_{A}$. .AE

A case of cervical chordoma diagnosed by fine needle aspiration (FNA) is presented. The cytologic criteria for differentiating chordoma from chondrosarcoma and metastatic adenocarcinoma, the main diagnostic problems, include the finding of physaliferous cells and the presence of bland nuclear features. Significantly, chordomas lack true signet-ring cells. FNA of these rare midline vertebral neoplasms, which produce pain and spinal cord compression, can greatly facilitate diagnosis and optimal treatment.

In this article, morphologic changes affecting the myocardium, chambers, valves, epicardial coronary arteries, and aorta in the elderly but otherwise normal heart are discussed and are compared with and differentiated from morphologic changes causing clinical cardiac dysfunction, death, or both.

A case is described of a 33-year old woman with systemic lupus erythematosus (SLE) in longterm treatment with corticosteroids who experienced spontaneous rupture of the left patellar tendon. A comparative study of 28 previously reported cases of SLE patients with spontaneous tendon rupture in weight bearing joints is performed. It is suggested that renal disease may be an etiological factor for spontaneous tendon rupture in patients with systemic lupus erythematosus.