\n\nRESULTS\n\ncenter dot In total, 52 individuals (28 boys and 24 girls) JNK-IN-8 ic50 aged 19-41 years (median, 29 years) had follow-up.\n\ncenter dot Of these, 37 (71%) individuals had bilateral normal kidney function at follow-up; seven (14%) had normal

total renal function but unilateral deteriorated kidney, and eight individuals (15%) had deteriorated kidney function.\n\ncenter dot Adult individuals with bilateral kidney deterioration had a significant higher frequency of diagnosed detrusor overactivity at childhood urodynamics (63%) compared to those with normal function of both kidneys (24%). In total, 48% of the 52 myelomeningocele individuals were continent at follow-up.\n\ncenter dot Continence surgery was performed in eight patients, nine used anticholinergica, three had regular botulinum toxin detrusor injections, and 27 used clean intermittent catheterization.\n\nCONCLUSIONS\n\ncenter dot Overall, 15% of patients had impairment of kidney function and 48% were urinary continent.\n\ncenter dot Considering the present age distribution of the present study population, this figure appears to be comparable

to the data in the literature.\n\ncenter dot Urodynamic findings in childhood were predictive for later kidney deterioration.”
“The aim of this study is to assess patient satisfaction, success at controlling symptoms and conversion rates to open surgery in patients undergoing pharyngeal pouch surgery using an endoscopic stapler in a

second cycle of audit. The design consisted of a review of patient records augmented by an electronic search of operation check details codes in BLZ945 research buy the hospitals’ theatre records. The setting was in Worcester Royal Hospital, BUPA Southbank Hospital and Hereford Hospital, UK. Participants include all patients with pharyngeal pouches undergoing endoscopic pharyngeal pouch repair by the senior author between July 2002 and July 2007. The total number of participants was 31. All patients were undergoing treatment for the first time. The main outcome measures were pre- and postoperative symptom prevalence, conversion rates to open surgery, patient satisfaction. Endoscopic pharyngeal pouch surgery was successful in the vast majority of cases, with 97% of patients being satisfied with the result. The conversion rate to open surgery was 9.7%. These figures are improved from the last round of audit. In conclusion, endoscopic surgery to treat pharyngeal pouches is safe, effective and patient selection is improving. A modified method of endoscopy using a Negus scope rather than a Baldwin scope has allowed more patients to be treated via endoscopic methods. Open surgery is still required in some patients.”
“Synthetic biology holds promise as both a framework for rationally engineering biological systems and a way to revolutionize how we fundamentally understand them.

Both, Bay 11-7082 (20 pM) and parthenolide (100 pM) triggered eryptosis, effects again most pronounced in aged erythrocytes. Conclusion: NFKB protein abundance is lowest and spontaneous eryptosis as well as susceptibility to Bay 11-7082 and parthenolide highest in aged erythrocytes. Thus, inhibition of NFKB signalling alone is not responsible for the stimulation of eryptosis by parthenolide or Bay 11-7082. Copyright 2013 S. Karger AG, Basel”
“Optokinetic responses (OKRs) are reflexive eye movements elicited by a moving visual pattern,

and have been recognized in a variety of species. Several brainstem and cortical structures are known to be implicated in the generation of OKRs in primates, www.selleckchem.com/products/azd2014.html while the OKRs of afoveate click here mammals have been posited to be dominated by subcortical structures. To understand the subcortical mechanism underlying OKRs, the initial OKRs to horizontal quarter-wavelength steps applied to vertical grating patterns were studied in adult C57BL/6J mice under the monocular viewing conditions. The initial OKRs to sinusoidal gratings showed directional asymmetry with temporal-to-nasal predominance, a common characteristic of afoveate mammals that uses the subcortical structures to elicit OKRs. We then examined whether the OKRs of afoveate mammals are driven by the same visual features of the

moving images as those in primates. The OKRs in mice were elicited by using the missing fundamental (mf) stimuli and its variants that had been used to understand the mechanism(s) underlying the cortical control of eye movements in primates. We obtained the results indicating that the OKRs of mice are driven by the principal Fourier component of moving visual image

as in primates despite the differences in neural Selleckchem Evofosfamide circuitries. (C) 2012 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.”
“Objectives: To examine the characteristics of nailfold capillary changes in patients with glaucoma and to analyze their possible relationship to other clinical characteristics of glaucoma.\n\nMethods: One hundred eight glaucoma patients and 38 control patients were enrolled in the study. Eighty-six patients were classified as having normal tension glaucoma and 22 patients as having primary open-angle glaucoma. All patients underwent a complete ophthalmic examination and then a physical examination (in the rheumatology department) and were questioned regarding a history of systemic symptoms. Nailfold capillaroscopy was performed, and the results were analyzed by a single observer in a masked manner. Both the chi(2) test and multivariate logistic regression analysis were performed to determine which ocular characteristics were associated with the findings of nailfold capillaroscopy.\n\nResults: In the glaucoma patients, 55.6% showed dilated vessels, 35.2% showed loss of capillaries, and 19.4% showed nail bed hemorrhages by nailfold capillaroscopy.

Interestingly, MMP-13-promoted the secretion of VEGF-A

from fibroblasts and endothelial cells. By immunohistochemical analysis, we found a possible correlation between MMP-13 expression and the number of blood vessels in human cancer cases. In summary, these findings suggest that MMP-13 may directly and indirectly promote tumor angiogenesis.”
“Methylergonovine (MEV) is a semi-synthetic ergot alkaloid used in the prevention and control of postpartum hemorrhage. This report describes 12 newborns born on the same day in a local country hospital in Turkey and developed sepsis-like symptoms and encephalopathy within the first 6 h of life due to accidental administration of MEV instead of vitamin K in the delivery Torin 2 room. The major features of MEV poisoning were lethargy (41.7%), seizure (75.0%), feeding intolerance (66.6%), hypoventilation (58.3%), irritability (25%), and peripheral circulatory abnormalities (58.3%). As a conclusion, clinical findings of ergot toxicity in newborns cannot be distinguished from infectious disease or neonatal encephalopathy.”
“The autonomic nervous system plays an integral role in the modulation of normal cardiac AZD5153 inhibitor electrophysiology. This is achieved via a complex network of pre- and postganglionic sympathetic

and parasympathetic fibers that synapse on extrinsic and intrinsic cardiac ganglia and ultimately directly innervate cardiac myocytes. Alterations in autonomic tone may induce changes

in local cellular electrophysiology that may manifest clinically in a number of ways, ranging from changes in heart rate to changes in heart rhythm. These relationships between autonomic tone and the evolution of cardiac dysrhythmias are areas of evolving research, with increasing evidence for a key role for autonomic ganglia in the pathogenesis of atrial fibrillation and sympathetic nerves in the predilection toward ventricular tachycardia in areas of myocardial scar. In this review, we highlight what is known about the anatomy and physiology of the cardiac autonomic nervous system, the evidence supporting the relationship of autonomic GSK923295 research buy tone to clinically significant arrhythmias, and a variety of mechanisms (eg, direct ion channel effects) and diagnostic tools that exist to help define this relationship. Further emphasized are potential future avenues of research needed to elucidate the relationship between changes in normal autonomic tone and the pathogenesis of cardiac arrhythmias.”
“Background and objective Previous studies have shown that target-controlled infusion (TCI) was associated with increased propofol consumption as compared with manually controlled infusion (MCI). However, most studies lacked an objective measurement of anaesthetic depth. We compared TCI and MCI with regard to propofol dose requirement while monitoring depth of anaesthesia with bispectral index (BIS) and midlatency auditory-evoked potentials (MLAEPs).

However, the mechanisms of action remain unknown, but could involve autoantibody production, antigen presentation and/ or cytokine production by B cells. Another exciting line of investigation in the field of p38 protein kinase MS comes from latent infection of memory B cells by Epstein- Barr virus ( EBV). These cells are hijacked as ` Trojan horses’ and ` smuggle’ the virus into the central nervous system ( CNS). Thus, these new anti B cell treatments will also be likely to have anti- viral effects. We briefly review recent findings in the field of MS

pathogenesis, and highlight promising new targets for therapeutic intervention in MS.”
“Neuronal loss and axonal degeneration are important pathological features of many neurodegenerative diseases. The molecular mechanisms underlying the majority of axonal

degeneration conditions remain buy 17DMAG unknown. To better understand axonal degeneration, we studied a mouse mutant wabbler-lethal (wl). Wabbler-lethal (wl) mutant mice develop progressive ataxia with pronounced neurodegeneration in the central and peripheral nervous system. Previous studies have led to a debate as to whether myelinopathy or axonopathy is the primary cause of neurodegeneration observed in wl mice. Here we provide clear evidence that wabbler-lethal mutants develop an axonopathy, and that this axonopathy is modulated by Wld(s) and Bax www.selleckchem.com/products/BMS-777607.html mutations. In addition, we have identified the gene harboring the disease-causing mutations as Atp8a2. We studied three wl alleles and found that all result from mutations in the Atp8a2 gene. Our analysis shows that ATP8A2 possesses phosphatidylserine translocase activity and is involved in localization of phosphatidylserine to the inner leaflet

of the plasma membrane. Atp8a2 is widely expressed in the brain, spinal cord, and retina. We assessed two of the mutant alleles of Atp8a2 and found they are both nonfunctional for the phosphatidylserine translocase activity. Thus, our data demonstrate for the first time that mutation of a mammalian phosphatidylserine translocase causes axon degeneration and neurodegenerative disease.”
“We show that the screw sense of polyisocyanide helices can be determined in a simple manner from the vibrational circular dichroism (VCD) of their CN-stretching mode. The relation between VCD and molecular structure is obtained using the coupled-oscillator approximation. It is shown that since the C=N groups point approximately radially outward from the helical axis, the CN-stretch region of the VCD spectrum of a polyisocyanide helix consists of a single couplet, the sign of which is directly related to the screw sense of the helix. We use this method to determine the screw sense of poly(R)-2-isocyanooctane and poly(S)-2-isocyanooctane from their VCD spectrum.

Our megakaryocytic culture conditions using the cytokines SCF, TPO, IL-9, and IL-6 include nicotinamide and Rho-associated kinase (ROCK) inhibitor Y27632 as contextual additives. The potency of our novel megakaryocytic differentiation protocol was validated using cord blood and peripheral blood human hematopoietic PD0325901 stem and progenitor cells. Using this novel megakaryocytic differentiation protocol, we characterized the modulatory capacity of several miRNAs highly expressed in normal megakaryocytic cells or malignant blasts from patients with megakaryoblastic

leukemia. Overexpression of candidate microRNAs was achieved by lentiviral transduction of CD34(+)-hematopoietic stem and progenitor cells prior to differentiation. We revealed miR-125b and miR-660 as enhancers of polyploidization, as well as platelet output of megakaryocytes. The oncogene miR-125b markedly expanded the Akt cancer number of megakaryocytes during in vitro culture. Conversely, the miR-23a/27a/24-2 cluster, which is highly expressed

in normal megakaryocytes, blocked maturation and platelet formation. Our study on the utilization of microRNAs in conjunction with a highly efficient differentiation protocol constitutes another step towards ex vivo platelet manufacturing on a clinically relevant scale.”
“Previous studies have demonstrated that following intratympanic gentamicin application in the guinea pigs, vestibular evoked myogenic potentials (VEMPs) were absent regardless of PD0332991 in vitro stimulation mode using either air-conducted sound (ACS) stimuli or galvanic vestibular stimulation (GVS). Ultrastructurally, both type I hair cells and their calyx terminals were distorted in the saccular macula. However, little is known about the toxic effects of gentamicin on the vestibular ganglion (VG). In this study, absent ACS-and GVS-VEMPs were noted in all the gentamicin-treated ears (100%), which were confirmed by the substantial loss of sensory hair cells in the

saccular macula. Moreover, dramatic up-regulation of growth associated protein-43 (GAP-43) expression was detected in the ipsilateral VG neurons. The mean percentage of substance P-like immunoreactive (SP-LI) neurons in the treated VG (81.8 +/- 1.9%) was significantly higher than that in the control VG (68.6 +/- 3.3%). Conversely, the mean percentage of neuropeptide Y-like immunoreactive (NPY-LI) neurons in the treated VG (13.7 +/- 3.8%) was dramatically lower than that in the control VG (49.0 +/- 3.8%). Double labeling results shown 82% of SP-LI and 16% of NPY-LI neurons coexpressed with GAP-43, suggested that SP accumulating coincided with NPY decreasing in regenerating VG neurons after gentamicin treatment. Overall, the changes in SP and NPY expression in VG neurons after gentamicin treatment were like to those in the superior cervical ganglion following sympathectomy. (C) 2010 Elsevier B.V. All rights reserved.

Other properties such as mechanical and swelling properties were also investigated. The results showed that

a chemical bonding between organically modified LDHs Selleckchem PFTα and rubber matrix through SSS was built during vulcanization, which leads to improved interfacial strength of the cured compound. A high-performance acrylonitrile butadiene rubber/SSS-modified LDH compound, which has two times higher tensile strength than cured pure rubber without significant loss of elongation, was obtained. (c) 2012 Wiley Periodicals, Inc. J. Appl. Polym. Sci., 2013″
“Background: Despite increasing evidence implicating the pulmonary microcirculation in the pathogenesis of lung conditions such as pulmonary vascular disease, there remain few methods for its evaluation in vivo. We recently demonstrated selleck kinase inhibitor that the novel index of Doppler-derived pulmonary flow reserve (PFR(dopp) = maximal hyperaemic/basal pulmonary flow) could be reliably measured in high primates. Noting that the microvasculature is the

chief regulator of pulmonary blood flow, we hypothesised that PFRdopp may detect microcirculatory loss. We therefore studied the relationship between PFR(dopp) and experimentally induced pulmonary microvascular obstruction using microspheres in higher primates.\n\nMethods: Under ketamine anaesthesia, Doppler sensor-guidewires were placed in the segmental pulmonary artery of three adult baboons. Doppler flow velocity and haemodynamics were recorded at rest and during hyperaemia [as induced by intrapulmonary artery adenosine (200 mu g/kg/min)].

MEK phosphorylation Serial PFR(dopp) evaluations were made after cumulative intrapulmonary artery ceramic microspheres administration.\n\nResults: Cumulative microsphere administration progressively reduced PFR(dopp) (1.54 +/- 0.26, 1.48 +/- 0.20, 1.12 +/- 0.04 and 1.18 +/- 0.09; baseline, 10(4), 10(5) and 10(6) microspheres boluses; p < 0.02) without affecting pulmonary artery pressure, systemic artery pressure or heart rate.\n\nConclusions: Doppler-derived PFR can detect partial, progressive pulmonary microvascular obstruction in higher primates. PFR(dopp) may thus have a potential role in the assessment of the pulmonary microcirculation in vivo. (Heart, Lung and Circulation 2010;19:592-594) (C) 2010 Published by Elsevier Inc on behalf of Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand.”
“Embryofetoscopy is an endoscopic technique that permits a direct visualization and morphologic study of embryos during the first and early second trimester. We report the early prenatal diagnosis of a case of Pentalogy of Cantrell combining data obtained by 2-dimensional and 3-dimensional ultrasonography and embryofetoscopy. Morphologic examination focused on a large omphalocele protruding from the anterior abdominal wall as an oval pulsating mass, measuring approximately 3 cm.

Comparisons with other brachycephalid species and osteological data are provided.”
“In this work, a new test set-up was applied in order to determine cohesive zone models experimentally. A high speed camera in combination with a digital image correlation system was used to record the local displacements enabling the detailed determination of crack opening values. The J-Integral method was used to calculate the cohesive stresses. The analyzed materials were composites made of glass fiber reinforced epoxy

resin layers. Two different specimen geometries and the difference between warp and weft of the glass fiber mats were analyzed. As the specimen geometry didn’t have a significant influence, the difference between warp and weft, regarded by the loading direction, lead to considerably www.selleckchem.com/products/pp2.html different cohesive zone laws. The initial part, the linear increase to a maximum stress, was very similar, while the damage evolution was either exponential or bilinear in shape. In future work, the derived cohesive zone models will be

used to perform finite element simulations on laboratory specimens and on component scale. Thus, by comparison to the measurement result, the cohesive zone models can be evaluated.”
“Background: Atherosclerosis may be associated Duvelisib order with cognitive function; however the studies are few, especially among midlife adults.\n\nMethods: Participants in the beaver dam offspring study who had cognitive test data and gradable carotid artery ultrasound scans were included (n = 2794, mean age: 49 years). Atherosclerosis was measured by carotid intima-media thickness (IMT) and the presence of plaque. Cognitive function

was measured by the trail making test (TMT), grooved pegboard test (GPT) and mini-mental state examination (MMSE). Generalized cognitive function was defined by a summary score calculated from the TMT and GPT. Linear regression was used to evaluate the associations between carotid atherosclerosis and cognitive function tests.\n\nResults: Larger IMT was associated with lower GPT, MMSE and the summary score adjusting for multiple factors, the coefficients were: 13.8s (p < 0.0001), -0.6 (p = 0.007), and 0.47 (p = BKM120 0.01), respectively for 1 mm increase in IMT. Plaque scores were significantly associated with TMT-B, GPT, MMSE, and the summary score adjusting for age, sex and education. The associations remained statistically significant after further adjustments except for the association with TMT-B, which was attenuated and no longer significant.\n\nConclusions: Our results show the significant associations between markers of carotid atherosclerosis and cognitive function in a cohort of persons aged 21-84 years. Longitudinal studies are needed to further examine these associations. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Our results demonstrate that AK7 is neuroprotective in models of Parkinson’s disease; it ameliorates alpha-synuclein toxicity in vitro and prevents 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopamine depletion and dopaminergic neuron loss in vivo. The compound does not show beneficial effects in mouse

models of amyotrophic lateral sclerosis and cerebral ischemia. These findings underscore the specificity of protective effects observed here in models of Parkinson’s disease, and previously in Huntington’s disease, and support the development of SIRT2 inhibitors as potential therapeutics for the two neurodegenerative diseases.”
“The purpose of this study is to characterize tumor growth kinetics in patients with renal cell carcinoma (RCC) after treatment with pazopanib or placebo and to identify predictive patient-specific covariates.\n\nDifferent tumor growth models that included DAPT manufacturer patient-specific covariates were fit to tumor growth data from Phase 2 (n = 220) and Phase 3 (n = 423) clinical trials using nonlinear mixed-effects modeling. Logistic regression was

used to determine whether individual model parameters or covariates were related to occurrence of new lesions.\n\nA modified Wang model that included a quadratic growth term and a mixture model adequately described the data. Patients in Group 1 (93 %) showed treatment-dependent tumor shrinkage followed by treatment-independent regrowth. Patients in Group 2 (7 %) showed treatment-independent tumor shrinkage that did not regrow. In Group 1, pazopanib 800 mg increased the CHIR-99021 inhibitor tumor shrinkage rate by 267 % compared to placebo. Baseline tumor size was dependent on baseline

hemoglobin, baseline lactate dehydrogenase, study, and prior nephrectomy. Logistic regression analysis showed that prior radiotherapy, baseline tumor size, tumor shrinkage rate, tumor regrowth rate, study, and treatment (P < 0.01 for all) were all important predictors of new lesions. Patients treated with placebo were approximately twice as likely to develop new lesions than patients treated with pazopanib.\n\nMathematical modeling of tumor growth kinetics can quantify the effect of anticancer therapies. Pazopanib 800 mg was shown to be an effective treatment for RCC that increased the tumor shrinkage rate by 267 % compared with Adriamycin in vitro placebo and reduced the likelihood of developing new lesions.”
“In order to identify, synthesise and interpret the evidence relating to strategies to increase the proportion of low-risk patients with community-acquired pneumonia treated in the community, we conducted a systematic review of intervention studies conducted between 1981-2010.\n\nArticles were included if they compared strategies to increase outpatient care with usual care. Outcomes were: the proportion of patients treated as outpatients, mortality, hospital re-admissions, health related quality of life, return to usual activities and patient satisfaction with care.

Provided that certain oncologic and practical criteria are applied, it has the potential for allowing less invasive surgery and improved cosmetic outcomes without increased oncologic risk in appropriately selected patients. (Plast. Reconstr. Surg. 123: 1665, 2009.)”
“A genome-wide transcriptional profile of Bradyrhizobium japonicum, the nitrogen-fixing endosymbiont of the soybean plant, revealed differential expression of approximately 15% of the genome after a 1 mM treatment with the phytohormone check details indole-3-acetic acid (IAA). A total of 1,323 genes were differentially expressed (619 up-regulated and 704 down-regulated)

at a two-fold cut off with q value <= 0.05. General stress response genes were induced, such as those involved in response to heat, cold, oxidative, osmotic, and desiccation stresses and

in exopolysaccharide (EPS) biosynthesis. This suggests that IAA is effective in activating a generalized stress response in B. japonicum. The transcriptional data were corroborated by the finding that stress tolerance of B. japonicum in GSK923295 cell viability assays was enhanced when pre-treated with 1 mM IAA compared to controls. The IAA treatment also stimulated biofilm formation and EPS production by B. japonicum, especially acidic sugar components in the total EPS. The IAA pretreatment did not influence the nodulation ability of B. japonicum. The data provide a comprehensive overview of the potential transcriptional responses of the symbiotic bacterium when exposed to

the ubiquitous P5091 manufacturer hormone of its plant host.”
“A fast and simple method for the direct qualitative and semi-quantitative determination of a set of four polymer additives in plastic samples by desorption electrospray ionization time-of-flight mass spectrometry (DESI-TOF-MS) is presented. After evaluation of crucial DESI parameters such as composition of spray solutions and spray voltages, a series of lab-made polypropylene samples containing Chimassorb 81 (2-hydroxy-4-n-octoxybenzophenone), Tinuvin 328 (2-(2-hydroxy-3, 5-ditert-pentylphenyl)-benzotriazole), Tinuvin 326 (2-(2-hydroxy-3-tert-butyl-5-methylphenyl)-5-chloro benzotriazole), and Tinuvin 770 (bis(2,2,6,6,-tetramethyl-4-piperidyl)sebaceate) in concentrations between 0.02% and 0.2% were analyzed, resulting in calibration graphs with R (2) better than 0.994. To demonstrate the applicability of the developed method for the investigation of real samples, liners for in-ground swimming pools and polypropylene granules were analyzed with respect to their content in the selected polymer additives. Two alternative methods, both well established in the fields of polymer additive analysis, namely HPLC with UV detection (after previous extraction) and thermodesorption gas chromatography/mass spectrometry have been employed for evaluation of the results from the DESI experiments.”
“The microalgae. Chlorella sp.

13% (400 mg kg(-1)) and the second phase by 32.74% (200 mg kg(-1))

and 37.55% (400 mg kg(-1)). In the hot-plate test in mice, doses of 200 mg kg(-1) and 400 mg kg(-1) significantly increased the reaction time after 30, 60 and 90 min of treatment. Doses of 200 and 400 mg kg(-1) inhibited carrageenan-induced paw oedema in rats by 15.18% and 36.61%, respectively. Doses of 200 and 400 mg kg(-1) administered 4 h before intrapleural injection of carrageenan significantly reduced exudate volume (by 20.20% and 48.70%, respectively) and leucocyte mobilization VX-680 mw (by 5.88% and 17.29%, respectively). These results demonstrate that E. erythropappus has analgesic and anti-inflammatory properties, supporting the use of this plant in folk medicine.”
“Renal interstitial cells play an important role in the physiology and pathology of the kidneys. As a novel type of interstitial cell, telocytes (TCs) have been described in various tissues and organs, including the heart, lung, skeletal muscle, urinary tract, etc. (www.telocytes.com). However, it is not known if TCs are present in the kidney interstitium. We demonstrated the presence of TCs in human kidney cortex interstitium using primary cell culture, transmission electron microscopy (TEM) and in situ immunohistochemistry Kinase Inhibitor Library cell assay (IHC). Renal TCs were positive for CD34, CD117 and vimentin.

They were localized in the kidney cortex interstitial compartment, partially covering the tubules and vascular walls. Morphologically, renal TCs resemble TCs described in other organs, with very long telopodes (Tps) composed of thin segments (podomers) and dilated segments (podoms). However, their possible roles (beyond intercellular signalling) as well as their specific phenotype in the kidney remain to be established.”
“Pregnancy can create a challenge for physicians caring for women with rheumatic diseases.

LGX818 MAPK inhibitor For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission and will continue to need medication. Systemic lupus erythematosus (SLE) may remain quiet in some women, but in others may become more aggressive during pregnancy, putting both mother and foetus at risk. Women with limited scleroderma can do remarkably well, but scleroderma renal crises can be difficult to manage. A third of pregnancies in women with antiphospholipid syndrome (APS) may be refractory to our best therapy. In general, active inflammation from rheumatic diseases poses a stronger threat to the well-being of both mother and foetus than many immunosuppressant medications. Therefore, continued immunosuppression with the least risky medications will allow for the most optimal pregnancy outcomes.