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  1. Mirtazapine and mefloquine therapy for non-AIDS-related progressive multifocal leukoencephalopathy.

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    Epperla, Narendranath; Medina-Flores, Rafael; Mazza, Joseph J; Yale, Steven H

    2014-12-01

    Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the human nervous system caused by the JC virus. We report what is, to the best of our knowledge, the second reported case using a combination of mefloquine and mirtazapine in a patient with non-AIDS-related PML with a good clinical outcome. Conversely, the recent trial of mefloquine in 21 patients with AIDS and 3 without AIDS failed to show a reduction of JC viral DNA levels in the cerebral spinal fluid. However, the positive clinical response seen in our patient after the initiation of this combination therapy suggests that further studies in the form of randomized controlled trials for the treatment of non-AIDS-related PML are warranted.

  2. Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil.

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    Vidal, José E; Penalva de Oliveira, Augusto C; Fink, Maria Cristina D S; Pannuti, Cláudio S; Trujillo, J Roberto

    2008-01-01

    Few data are available about progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS) from Brazil. The objectives of this study were to describe the main features of patients with PML and estimate its frequency among AIDS patients with central nervous system (CNS) opportunistic diseases admitted to the Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, from April 2003 to April 2004. A retrospective and descriptive study was performed. Twelve (6%) cases of PML were identified among 219 patients with neurological diseases. The median age of patients with PML was 36 years and nine (75%) were men. Nine (75%) patients were not on antiretroviral therapy at admission. The most common clinical manifestations were: focal weakness (75%), speech disturbances (58%), visual disturbances (42%), cognitive dysfunction (42%), and impaired coordination (42%). The median CD4+ T-cell count was 45 cells/microL. Eight (67%) of 12 patients were laboratory-confirmed with PML and four (33%) were possible cases. Eleven (92%) presented classic PML and only one case had immune reconstitution inflammatory syndrome (IRIS)-related PML. In four (33%) patients, PML was the first AIDS-defining illness. During hospitalization, three patients (25%) died as a result of nosocomial pneumonia and nine (75%) were discharged to home. Cases of PML were only exceeded by cases of cerebral toxoplasmosis, cryptococcal meningoencephalitis, and CNS tuberculosis, the three more frequent neurologic opportunistic infections in Brazil. The results of this study suggest that PML is not an uncommon HIV-related neurologic disorder in a referral center in Brazil.

  3. Progressive multifocal leukoencephalopathy: new concepts

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    Marco A. Lima

    2013-09-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

  4. Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil Leucoencefalopatia multifocal progressiva em pacientes com aids: estudo retrospectivo em um centro de referência de São Paulo, Brasil

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    José E. Vidal

    2008-08-01

    Full Text Available Few data are available about progressive multifocal leukoencephalopathy (PML in patients with acquired immunodeficiency syndrome (AIDS from Brazil. The objectives of this study were to describe the main features of patients with PML and estimate its frequency among AIDS patients with central nervous system (CNS opportunistic diseases admitted to the Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, from April 2003 to April 2004. A retrospective and descriptive study was performed. Twelve (6% cases of PML were identified among 219 patients with neurological diseases. The median age of patients with PML was 36 years and nine (75% were men. Nine (75% patients were not on antiretroviral therapy at admission. The most common clinical manifestations were: focal weakness (75%, speech disturbances (58%, visual disturbances (42%, cognitive dysfunction (42%, and impaired coordination (42%. The median CD4+ T-cell count was 45 cells/µL. Eight (67% of 12 patients were laboratory-confirmed with PML and four (33% were possible cases. Eleven (92% presented classic PML and only one case had immune reconstitution inflammatory syndrome (IRIS-related PML. In four (33% patients, PML was the first AIDS-defining illness. During hospitalization, three patients (25% died as a result of nosocomial pneumonia and nine (75% were discharged to home. Cases of PML were only exceeded by cases of cerebral toxoplasmosis, cryptococcal meningoencephalitis, and CNS tuberculosis, the three more frequent neurologic opportunistic infections in Brazil. The results of this study suggest that PML is not an uncommon HIV-related neurologic disorder in a referral center in Brazil.Existe informação limitada sobre a presença da leucoencefalopatia multifocal progressiva (LEMP em pacientes com aids no Brasil. Os objetivos do presente estudo foram descrever as principais características dos pacientes com LEMP e estimar a freqüência desta doença em pacientes com aids e doen

  5. Imaging manifestations of progressive multifocal leukoencephalopathy

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    Shah, R. [Division of Neuroradiology, Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama (United States); Bag, A.K., E-mail: abag@uabmc.ed [Division of Neuroradiology, Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama (United States); Chapman, P.R.; Cure, J.K. [Division of Neuroradiology, Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama (United States)

    2010-06-15

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunosuppressed patients. The diagnosis is usually suggested on imaging and confirmed by cerebrospinal fluid polymerase chain reaction (PCR) for JC virus DNA. In this article, we review the imaging manifestations of PML on computed tomography (CT), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), MR spectroscopy, single photon-emission computed tomography (SPECT) and positron-emission tomography (PET), and outline the role of imaging in follow-up and prognostication.

  6. Rituximab-Associated Inflammatory Progressive Multifocal Leukoencephalopathy

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    Schofield, Christina; Harris, Penelope

    2016-01-01

    Progressive multifocal leukoencephalopathy (PML) is a rare disease of the immunosuppression that results from neurotropic invasion of the JC virus which leads to demyelination of oligodendrocytes. Immune reconstitution inflammatory syndrome (IRIS), on the other hand, is a condition of inflammation that develops as the immune system reconstitutes. This case report describes a case of a 35-year-old HIV-negative male who presented with three weeks of right lower extremity paresthesias as well as right upper extremity apraxia. He was diagnosed with PML complicated by IRIS secondary to Rituximab, which he had completed four months prior to presentation. Despite the condition's poor prognosis, the patient recovered with only minor deficits. PMID:27965904

  7. Drug-induced progressive multifocal leukoencephalopathy

    DEFF Research Database (Denmark)

    Vermeer, N S; Straus, S M J M; Mantel-Teeuwisse, A K;

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points...... in their lifecycle: natalizumab (before reapproval) and rituximab (nine years postapproval). We found that, apart from the differences in clinical characteristics (age, gender, indication, time to event, fatality), which reflect the diversity in context of use, PML reports for natalizumab were more complete and were...... received sooner after occurrence. This study serves as an important reminder that spontaneous reports should only be used with great caution to quantify and compare safety profiles across products over time. The observed variability in reporting patterns and heterogeneity of PML cases presents challenges...

  8. Progressive subretinal fibrosis and multifocal granulomatous chorioretinitis Fibrose sub-retiniana progressiva e corioretinite granulomatosa multifocal

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    Miguel Hage Amaro

    2006-06-01

    Full Text Available We describe a case of progressive subretinal fibrosis and multifocal chorioretinitis along with its findings on both fluorescein and indocyanine green angiography. The progressive subretinal fibrosis syndrome is a severe subset of multifocal choroiditis. The clustering of lesions around the nerve optic head may mean that the disease is spread through the flow in and out of the eye around the optic nerve.Descrevemos um caso de fibrose sub-retiniana progressiva e corrioretinite multifocal granulomatosa junto com os achados de angiografia fluoresceínica e com indocianina verde e propomos uma nova fisiopatologia para a fibrose em anel justa-papilar. A síndrome de fibrose sub-retiniana progressiva é uma doença grave, rara e constitui um subtipo grave da coroidite multifocal. As múltiplas lesões com fibrose circundando o disco óptico podem significar que a doença é oriunda do fluxo do líquido céfalo-raqueano, ao redor do nervo óptico.

  9. Multifocal motor neuropathy and progressive atrophy : Pathophysiological similarities and differences

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    Vlam, L.

    2015-01-01

    Progressive muscular atrophy (PMA) and multifocal motor neuropathy (MMN) share many clinical similarities. They are both characterized by progressive asymmetric muscle weakness with atrophy and fasciculations. Tendon reflexes are normally low or absent, although in some patients with MMN normal or e

  10. Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report

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    Troppmann Martina

    2012-07-01

    Full Text Available Abstract Introduction Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham virus in a case of an early stage plasmacytoma. Case presentation A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance imaging demonstrated new hyperattenuating lesions in the right thalamus and left-sided subcortically. A polymerase chain reaction test revealed 4500 copies of John Cunningham virus-deoxyribonucleic acid/ml in cerebrospinal fluid. Human immunodeficiency virus infection was ruled out. A bone marrow biopsy showed an early stage immunoglobulin G-kappa plasmacytoma. Cidofovir (5mg/kg weekly for three weeks was started. A significant improvement of her neuropsychological symptoms was achieved, but motor system and sensory symptoms did not change. Conclusions This case shows a rapid course of progressive multifocal leukoencephalopathy with severe residual deficits. In the diagnostic workup of all patients with atypical neurologic symptoms or immunodeficiency, progressive multifocal leukoencephalopathy should be included as a differential diagnosis.

  11. Progressive Multifocal Leukoencephalopathy and Systemic Lupus Erythematosus: Focus on Etiology

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    Shala Ghaderi Berntsson

    2016-03-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML caused by reactivation of the JC virus (JCV, a human polyomavirus, occurs in autoimmune disorders, most frequently in systemic lupus erythematosus (SLE. We describe a HIV-negative 34-year-old female with SLE who had been treated with immunosuppressant therapy (IST; steroids and azathioprine since 2004. In 2011, she developed decreased sensation and weakness of the right hand, followed by vertigo and gait instability. The diagnosis of PML was made on the basis of brain MRI findings (posterior fossa lesions and JCV isolation from the cerebrospinal fluid (700 copies/ml. IST was immediately discontinued. Cidofovir, mirtazapine, mefloquine and cycles of cytarabine were sequentially added, but there was progressive deterioration with a fatal outcome 1 year after disease onset. This report discusses current therapeutic choices for PML and the importance of early infection screening when SLE patients present with neurological symptoms. In the light of recent reports of PML in SLE patients treated with rituximab or belimumab, we highlight that other IST may just as well be implicated. We conclude that severe lymphopenia was most likely responsible for JCV reactivation in this patient and discuss how effective management of lymphopenia in SLE and PML therapy remains an unmet need.

  12. Progression of solitary and multifocal papillary thyroid carcinoma— a retrospective study of 368 patients

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    ZHENG Xiang-qian; WANG Chen; XU Meng; YU Yang; YUN Xin-wei; JIA Yong-sheng; WEI Song-feng; REN Xiu-bao; GAO Ming

    2012-01-01

    Background Papillary thyroid carcinoma (PTC) represents one of the most frequent endocrine malignancies.Several factors have been found to be involved in determining the outcome of treatment for patients with PTC.Large tumor size,diagnosis at an early age,extra-thyroidal invasion,aggressive histological variants,and distant metastases are the most important determinants of a poor outcome.BRAFv600E mutation has been found to be a major genetic alteration in PTC.This study aimed to evaluate progression in patients with multifocal and solitary PTC.Methods We performed a retrospective study to analyze 368 patients with PTC who underwent surgery,including 282 patients with solitary PTC and 86 patients with multifocal PTC.The status of BRAFv600E mutation in all tumor foci from multifocal PTC was detected.Results Our study suggested that multifocal PTC was more related to lymph node metastasis and vascular invasion than solitary PTC.However,the distant metastasis rate and 10-year survival rate showed no difference between these two groups.The number of tumor foci did not affect progression of disease in multifocal PTC patients.Lymph node metastasis in multifocal PTC patients was associated with larger tumors,diagnosis at early stage,and extra-thyroidal invasion.Conclusion The status of BRAFv600E mutation was more frequent in multifocal PTC patients with lymph node metastasis and diagnosis at later age.

  13. Research progress of AIDS-related cancer%艾滋病相关性肿瘤研究进展

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    龚宏霞; 刘杰; 林洪生

    2013-01-01

    Kaposi's sarcoma,non-hodgkin's lymphoma and invasive cervical was named AIDS-related cancer.This article introduces the appeal tumor research progress of modem medicine,and raises that antivirus、immune reconstitution and antitumor are the key factors in the treatment of AIDS-related cancer.Traditional Chinese medicine may play a role in the following aspect:relieve antiviral drug adverse reaction,have some antiviral effect,adjust the immune function,enhance efficacy and decrease toxicity of radiotherapy.According to the patients' immune function and the treatment phase,etc.It will contribute to improve the patients'lives and prolong the survival period to establish reasonable and comprehensive treatment strategies and to combine holistie therapy with individual therapy.%卡波西肉瘤、非霍奇金淋巴瘤及侵入性宫颈癌被命名为艾滋病相关性肿瘤,该文介绍了上述肿瘤现代医学研究进展,提出抗病毒、免疫重建及抗肿瘤是艾滋病相关性肿瘤治疗的关键因素.中医药在减轻艾滋病抗病毒药物的不良反应、发挥抗病毒作用、调节患者免疫功能、配合化放疗减毒增效以及稳定肿瘤病灶等方面能够发挥作用,根据患者免疫功能、治疗阶段等因素,制定合理的综合治疗策略,整体治疗和个体化治疗相结合,将有助于提高艾滋病相关性肿瘤患者的生存质量,延长生存期.

  14. Progressive multifocal leukoence-phalopathy presenting as homonymous hemianopia in a patient with acquired immunodeficiency syndrome

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    Amit Pandey

    2012-01-01

    Full Text Available We present a case of a Human Immunodeficiency Virus (HIV positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS. She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI scan showed features of Progressive Multifocal Leukoencephalopathy (PML. She had no other neurological symptoms or signs.

  15. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy

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    Segec, A; Keller-Stanislawski, B; Vermeer, N S

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the sa...... use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization....

  16. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

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    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  17. Progressive multifocal leukoencephalopathy after stem cell transplantation, unsuccessfully treated with cidofovir.

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    Osorio, S; de la Cámara, R; Golbano, N; Marti, E; Fedele, C G; Nieto, S; Manzanares, R; Fernández-Rañada, J M

    2002-12-01

    We report a patient with progressive multifocal leukoencephalopathy (PML) after autologous stem cell transplantation (SCT) for non-Hodgkin's lymphoma (NHL). This is an unusual association, and to date only seven cases have been reported. This is the first case of PML after SCT treated with cidofovir, and the fifth case treated with this drug in a patient without human immunodeficiency virus (HIV) infection. In the previous four patients treated with cidofovir the outcome was discouraging, as was the case in this patient.

  18. Recurrence of progressive multifocal leukoencephalopathy despite immune recovery in two HIV seropositive individuals.

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    Crossley, Kate M; Agnihotri, Shruti; Chaganti, Joga; Rodriguez, Michael L; McNally, Leon Patrick; Venna, Nagagopal; Turbett, Sarah E; Gutman, Matthew; Morey, Adrienne; Koralnik, Igor J; Brew, Bruce J

    2016-08-01

    We present two cases of recurrent progressive multifocal leukoencephalopathy (PML) in patients with long standing virally suppressed human immunodeficiency virus (HIV) and normal CD4+ T cell count who were taking stable regimens of highly active antiretroviral therapy (HAART). This has significant implications for other patients with a past history of PML, not just those with HIV but also those on medications such as natalizumab or fumarates.

  19. The effects of cidofovir on progressive multifocal leukoencephalopathy: an MRI case study

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    Cardenas, R.L.; Cheng, K.H. [Physics Dept., Texas Technical University, Lubbock (United States); Sack, K. [Mount Diablo Medical Center, Concord, CA (United States)

    2001-05-01

    MRI was used to study the effects of introducing cidofovir (HPMPC, Vistide) to the antiretroviral therapy of a 33-year-old white man diagnosed as having progressive multifocal leukoencephalopathy (PML) secondary to AIDS. In response to combined cidofovir and antiretroviral therapy he showed significant clinical improvement. MRI showed a decrease in extent of existing lesions, without new ones. Blood chemistry information obtained indicated some involvement of immunologic mechanisms: the CD4:8 ratio showed improvement from an average of 0.08 before treatment to 0.13 during therapy. (orig.)

  20. Progressive multifocal leucoencephalopathy in a patient with idiopathic CD4+ lymphocytopenia.

    LENUS (Irish Health Repository)

    Moloney, F

    2012-03-01

    Progressive multifocal leucoencephalopathy (PML) is an opportunistic, demyelinating neurological disease caused by reactivation of the JC polyomavirus. PML occurs almost exclusively in immunosuppressed individuals, with only isolated case reports of PML occurring in patients without apparent immunosuppression. Idiopathic CD4+ lymohocytopenia (ICL) is a syndrome defined by the Centre for Disease Control and Prevention as a CD4+ count <300 cells\\/uL or <20% of total T cell count on >1 occasion, with no evidence of human immunodeficiency virus (HIV) infection, and the absence of other known immunodeficiency or therapy associated with lymphocytopenia. We describe a case of PML occurring in a patient with idiopathic CD4+ lymphocytopenia.

  1. Dual Therapy with Cidofovir and Mirtazapine for Progressive Multifocal Leukoencephalopathy in a Sarcoidosis Patient

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    Jae Hyun Park

    2011-10-01

    Full Text Available Background: Progressive multifocal leukoencephalopathy (PML is a demyelinating central nervous system disease caused by JC virus (JCV reactivation in immunocompromised patients. The disease course of PML is often progressive, fatal and at present, there are few reports on successful treatment outcomes. Case Report: A 45-year-old man with systemic sarcoidosis presented with rapidly progressive dementia and right hemiparesis. The patient was diagnosed with PML as confirmed via brain biopsy and JCV PCR. With a combination treatment of cidofovir and mirtazapine, there was significant improvement of neurological symptoms without measurable functional deficit. Conclusion: This case suggests that dual therapy with cidofovir and mirtazapine might be an effective treatment option in PML patients with sarcoidosis.

  2. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica.

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    Berger, Joseph R; Neltner, Janna; Smith, Charles; Cambi, Franca

    2014-11-01

    Both progressive multifocal leukoencephalopathy (PML) and posterior reversible encephalopathy syndrome (PRES) have been reported as complications of rituximab therapy. These disorders may appear indistinguishable on magnetic resonance imaging (MRI). We report on a 42 year old woman with neuromyelitis optica (NMO) of 10 years duration who developed extensive white matter disease affecting chiefly both parietal lobes 6 months after her first and only dose of rituximab. The MRI findings suggested the diagnosis of PML, but her history was more consistent with PRES. Ultimately, a brain biopsy was performed which was consistent with the diagnosis of PRES. PRES and PML may have overlapping symptomatology and be indistinguishable on MRI. An approach to distinguishing between these two disorders is addressed.

  3. Progressive multifocal leukoencephalopathy in a patient with acquired immunodeficiency syndrome (AIDS) manifesting Gerstmann's syndrome.

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    Saito, H; Sakai, H; Fujihara, K; Fujihara, K; Itoyama, Y

    1998-11-01

    We reported a case of acquired immunodeficiency syndrome (AIDS) via multiple blood transfusions, who manifested progressive multifocal leukoencephalopathy (PML) about 18 months after the development of AIDS. PML initiated with right hemiparesis, dysphasia, and Gerstmann's syndrome and resulted in death within 2 months after the onset. Neuroimaging examinations revealed white matter lesions mainly in the left posterior parietal lobe. The cortical gray matter also showed abnormal signal intensity. Peripheral CD4+ lymphocyte count was 81/microl. Routine cerebrospinal fluid (CSF) examinations were negative. CSF antibodies against herpes simplex virus, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus as well as serum antibody against toxoplasma gondii were negative. Though autopsy or biopsy of the brain was not performed, JC virus genomes were detected in the CSF sample by a polymerase chain reaction, and their sequencing showed unique alterations of the regulatory regions, characteristic to PML-type JC virus.

  4. Mefloquine improved progressive multifocal leukoencephalopathy in a patient with immunoglobulin A nephropathy.

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    Shin, Jung-Won; Jung, Keun-Hwa; Lee, Soon-Tae; Moon, Jangsup; Lim, Jung-Ah; Byun, Jung-Ick; Park, Kyung-Il; Lee, Sang Kun; Chu, Kon

    2014-10-01

    We describe a patient with immunoglobulin A nephropathy who was diagnosed with progressive multifocal leukoencephalopathy (PML) and successfully treated with mefloquine, an antimalarial medication. A 67-year-old man with immunoglobulin A nephropathy presented to the hospital emergency room with fever and generalized tonic-clonic seizure. Cerebrospinal fluid (CSF) nested polymerase chain reaction (PCR) was positive for John Cunningham virus and brain MRI displayed high signal intensity in the white matter in the right parietal lobe without gadolinium enhancement. Tapering of prednisone did not arrest the disease progression and a new lesion was detected on the cerebellum. Administration of mefloquine stopped lesion progression and resulted in dramatic clinical improvement. The CSF nested PCR for the John Cunningham virus also became negative. In reviewing the literature, mefloquine has had a heterogeneous effect in PML patients, and P-glycoprotein polymorphism and proper dosage could contribute to the various effects seen. Mefloquine may be a favorable treatment option in some patients with PML, and P-glycoprotein polymorphism may play an important role in its efficacy. More large studies in other ethnic groups including polymorphism studies for the gene encoding P-glycoprotein (ABCB1/MDR1) and taking into account various underlying conditions with secondary immunosuppression should be carried out to investigate whether mefloquine is effective for treating PML.

  5. Progressive Multifocal Leukoencephalopathy in a 62-Year-Old Immunocompetent Woman

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    Venkata C. Gourineni

    2014-01-01

    Full Text Available Progressive multifocal encephalopathy (PML is a rare demyelinating disease that typically presents in immunodeficient patients. We report a case of a previously healthy 62-Year-Old woman who suffered from an unsteady gait, throbbing headaches, and progressive left-sided weakness and numbness. Stroke was initially suspected based on imaging and symptoms. A series of follow-up magnetic resonance images of the brain showed a right parietal lesion growing in size as the patient became unable to walk and experienced increasing lethargy and confusion. A biopsy of the lesion was positive for the John Cunningham virus (JCV. A diagnosis of PML was made and she was started on mefloquine. No improvement was seen on this treatment and her condition worsened. Although PML remains uncommon in immunocompetent individuals, it cannot be ruled out based on their immune status. Although the exact cause remains uncertain, underlying or transient states of immunosuppression may be responsible for reactivation of the JCV in these patients.

  6. Cidofovir in combination with HAART and survival in AIDS-associated progressive multifocal leukoencephalopathy.

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    Kraemer, Christoffer; Evers, Stefan; Nolting, Thorsten; Arendt, Gabriele; Husstedt, Ingo W

    2008-04-01

    Progressive multifocal leukoencephalopathy is a demyelinating disease with a high mortality caused by the JC virus and occurs in about 5% of HIV-infected patients. Highly active anti-retroviral therapy (HAART) has a proven efficacy in prolonging the survival of patients with AIDS-associated PML, but there are differing opinions about adding cidofovir to the treatment of PML. To investigate the benefit of HAART combined with cidofovir, we retrospectively analysed the survival of 33 patients with AIDS-associated PML proven by PCR in CSF, biopsy or at autopsy. Additionally, we also analysed 37 patients with probable PML. Seventeen (51.5%) of the patients with confirmed PML were treated with HAART and 14 (42.4%) with cidofovir in any combination. Of these patients, 13 (39.4%) were treated with HAART and cidofovir in combination, four (12.1%) patients received only HAART without cidofovir and one (3%) patient received only cidofovir without HAART. Fifteen patients did not receive HAART or cidofovir. The cumulative survival was significantly longer in patients with HAART than in patients without HAART (p = 0.006), independent whether cidofovir was given or not. In comparison with single therapy with HAART, the combination of HAART and cidofovir showed no significant increase in survival (p = 0.435). Therefore, a benefit for cidofovir in addition to HAART in the treatment of PML in HIV-infected patients could not be proven.

  7. Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group.

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    McGuigan, C; Craner, M; Guadagno, J; Kapoor, R; Mazibrada, G; Molyneux, P; Nicholas, R; Palace, J; Pearson, O R; Rog, D; Young, C A

    2016-02-01

    The use of natalizumab for highly active relapsing-remitting multiple sclerosis (MS) is influenced by the occurrence of progressive multifocal leukoencephalopathy (PML). Through measurement of the anti-JCV antibody index, and in combination with the presence or absence of other known risk factors, it may be possible to stratify patients with MS according to their risk of developing PML during treatment with natalizumab and detect early suspected PML using MRI including a diffusion-weighted imaging sequence. This paper describes a practical consensus guideline for treating neurologists, based on current evidence, for the introduction into routine clinical practice of anti-JCV antibody index testing of immunosuppressant-naïve patients with MS, either currently being treated with, or initiating, natalizumab, based on their anti-JCV antibody status. Recommendations for the frequency and type of MRI screening in patients with varying index-associated PML risks are also discussed. This consensus paper presents a simple and pragmatic algorithm to support the introduction of anti-JCV antibody index testing and MRI monitoring into standard PML safety protocols, in order to allow some JCV positive patients who wish to begin or continue natalizumab treatment to be managed with a more individualised analysis of their PML risk.

  8. Progressive multifocal leukoencephalopathy in common variable immunodeficiency: mitigated course under mirtazapine and mefloquine.

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    Kurmann, Rebekka; Weisstanner, Christian; Kardas, Piotr; Hirsch, Hans H; Wiest, Roland; Lämmle, Bernhard; Furrer, Hansjakob; Du Pasquier, Renaud; Bassetti, Claudio L; Sturzenegger, Mathias; Krestel, Heinz

    2015-12-01

    Demonstration of survival and outcome of progressive multifocal leukoencephalopathy (PML) in a 56-year-old patient with common variable immunodeficiency, consisting of severe hypogammaglobulinemia and CD4+ T lymphocytopenia, during continuous treatment with mirtazapine (30 mg/day) and mefloquine (250 mg/week) over 23 months. Regular clinical examinations including Rankin scale and Barthel index, nine-hole peg and box and block tests, Berg balance, 10-m walking tests, and Montreal Cognitive Assessment (MoCA) were done. Laboratory diagnostics included complete blood count and JC virus (JCV) concentration in cerebrospinal fluid (CSF). The noncoding control region (NCCR) of JCV, important for neurotropism and neurovirulence, was sequenced. Repetitive MRI investigated the course of brain lesions. JCV was detected in increasing concentrations (peak 2568 copies/ml CSF), and its NCCR was genetically rearranged. Under treatment, the rearrangement changed toward the archetype sequence, and later JCV DNA became undetectable. Total brain lesion volume decreased (8.54 to 3.97 cm(3)) and atrophy increased. Barthel (60 to 100 to 80 points) and Rankin (4 to 2 to 3) scores, gait stability, and box and block (7, 35, 25 pieces) and nine-hole peg (300, 50, 300 s) test performances first improved but subsequently worsened. Cognition and walking speed remained stable. Despite initial rapid deterioration, the patient survived under continuous treatment with mirtazapine and mefloquine even though he belongs to a PML subgroup that is usually fatal within a few months. This course was paralleled by JCV clones with presumably lower replication capability before JCV became undetectable. Neurological deficits were due to PML lesions and progressive brain atrophy.

  9. 多焦点多光子显微技术及其研究进展%Multifocal Multiphoton Microscopy and Its Research Progress

    Institute of Scientific and Technical Information of China (English)

    刘立新

    2011-01-01

    Multifocal multiphoton microscopy ( MMM) can greatly improve the utilization of the excitation light and imaging speed, and it can also acquire three-dimensional fluorescence microscopic images by multiphoton excitation with the advantages of high speed, reduced photobleaching and photodamage, enhanced penetration depth and high signal to noise ratio. The realization and research progresses of multifocal multiphoton microscopy are discussed in detail, which include simultaneous time- and spectrum-resolved multifocal multiphoton microscopy(STSR-MMM) , multifocal multiphoton microscopy based on time-correlated single photon counting( TCSPC-MMM ) , multifocal multiphoton microscopy using a field of view zoom scanning protocol and stochastic scanning multifocal multiphoton microscopy (SS-MMM) , etc.%多焦点多光子显微技术(multifocal multiphoton microscopy,MMM)提高了激发光能的利用率和成像速度,可以实现样品的三维快速多光子激发荧光显微成像,并具有对活体样品损伤小,成像深度大,图像信噪比高等优点.详细阐述了MMM的实现方法及其研究进展,包括同时时间和光谱分辨的MMM(simultaneous time- and spectrum-resolved multifocal multiphoton microscopy,STSR-MMM)、基于时间相关单光子计数技术的MMM( multifocal multiphoton microscopy based on time-correlated single photon counting,TCSPC-MMM)、基于随机扫描的MMM(stochastic scanning multifocal multiphoton microscopy,SS-MMM)、基于固定光路系统的变视场扫描的MMM等技术.

  10. Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a man with AIDS

    Directory of Open Access Journals (Sweden)

    Yoganathan K

    2012-04-01

    Full Text Available Katie Yoganathan1, David Brown2, Kathir Yoganathan31Cardiff Medical School, Cardiff, Wales, UK; 2Virus Reference Department, Microbiology Services, Health Protection Agency, London, UK; 3Singleton Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, UKAbstract: A 43-year-old Caucasian homosexual man with AIDS presented with blurring of vision, change of personality, and memory loss in March 1999. He had first been admitted 2 months previously for treatment of Pneumocystis jiroveci pneumonia. A magnetic resonance imaging scan on admission showed multiple white matter lesions involving both subcortical cerebral hemispheres and cerebellar regions, with no mass effect or surrounding edema. JC virus was detected by nested polymerase chain reaction in the cerebrospinal fluid. These findings were diagnostic of progressive multifocal leukoencephalopathy (PML. His CD4 count was 34 cells/mL, and his HIV ribonucleic acid level was 800,789 copies/mL. He was treated with a combination antiretroviral therapy. He was last reviewed in October 2011. He was fully independent socially and mentally, but he still had some residual neurologic signs with right-sided homonymous hemianopia and visual agnosia. His HIV ribonucleic acid level was undetectable, and his CD4 count was 574 cells/mm3. Although the median survival of patients with PML was poor before the antiretroviral therapy era, our patient, who is now aged 55 years, is still alive 12 years after the diagnosis. The diagnosis of PML and differential diagnosis of focal neurologic signs in HIV-positive patients are discussed in this case report.Keywords: HIV, focal neurologic signs, cerebral toxoplasmosis, primary brain lymphoma, ischaemic stroke

  11. Pre-existing T- and B-cell defects in one progressive multifocal leukoencephalopathy patient.

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    Alessandra Sottini

    Full Text Available Progressive multifocal leukoencephalopathy (PML usually occurs in patients with severe immunosuppression, hematological malignancies, chronic inflammatory conditions or receiving organ transplant. Recently, PML has also been observed in patients treated with monoclonal antibodies. By taking advantage of the availability of samples from a multiple sclerosis (MS patient treated with natalizumab, the antibody anti-α4 integrin, who developed PML and was monitored starting before therapy initiation, we investigated the fate of T and B lymphocytes in the onset of PML. Real-time PCR was used to measure new T- and B-cell production by means of T-cell receptor excision circle (TREC and K-deleting recombination excision circle (KREC analysis and to quantify transcripts for CD34, terminal-deoxynucleotidyltransferase, and V pre-B lymphocyte gene 1. T- and B-cell subsets and T-cell heterogeneity were measured by flow cytometry and spectratyping. The data were compared to those of untreated and natalizumab-treated MS patients and healthy donors. Before therapy, a patient who developed PML had a low TREC and KREC number; TRECs remained low, while KRECs and pre-B lymphocyte gene 1 transcripts peaked at 6 months of therapy and then decreased at PML diagnosis. Flow cytometry confirmed the deficient number of newly produced T lymphocytes, counterbalanced by an increase in TEMRA cells. The percentage of naive B cells increased by approximately 70% after 6 months of therapy, but B lymphocyte number remained low for the entire treatment period. T-cell heterogeneity and immunoglobulins were reduced. Although performed in a single patient, all results showed that an immune deficit, together with an increase in newly produced B cells a few months after therapy initiation, may predispose the patient to PML. These findings indicate the TREC/KREC assay is a potential tool to identify patients at risk of developing PML and may provide insights into the immunological

  12. Magnetic resonance imaging may simulate progressive multifocal leucoencephalopathy in a patient with chronic lymphocytic leukemia after fludarabine therapy

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    Kalita J

    2008-01-01

    Full Text Available A 60-year-old male with chronic lymphatic leukemia (CLL after 6 months of fludarabine therapy was admitted with status epilepticus and developed left hemiplegia. His magnetic resonance imaging revealed multiple T2 hyperintense lesions in the right frontal and left parieto-occipital lesion, simulating progressive multifocal leucoencephalopathy (PML. Cerebrospinal fluid Polymerase Chain Reaction (PCR for JC virus was negative. We suggest the possible role of fludarabine in producing PML-like lesions in patients with Chronic Lymphocytic Leukemia (CLL.

  13. Maraviroc Failed to Control Progressive Multifocal Leukoencephalopathy-Associated IRIS in a Patient with Advanced HIV Infection

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    Mónica Rodríguez

    2014-01-01

    Full Text Available Due to the lack of therapeutic options for patients with progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-associated IRIS, maraviroc has generated expectations among the medical community. However, we report a patient with advanced HIV infection, who developed PML-associated IRIS and had a fatal outcome despite the addition of maraviroc to suppressive ART. Future studies are required to define the therapeutic role of maraviroc in PML-associated IRIS and differentiate individuals who may benefit from maraviroc from those who may develop neurological deterioration.

  14. Characteristics of progressive multifocal leukoencephalopathy clarified through internet-assisted laboratory surveillance in Japan

    Directory of Open Access Journals (Sweden)

    Nakamichi Kazuo

    2012-10-01

    Full Text Available Abstract Background Progressive multifocal leukoencephalopathy (PML, a rare but fatal demyelinating disease caused by JC virus (JCV, occurs mainly in immunocompromised patients. As PML develops in individuals with various underlying disorders sporadically and infrequently, a nationwide survey of PML is difficult. This study was conducted to elucidate the characteristics of PML in Japan through an internet-assisted laboratory surveillance program. Methods A diagnostic support system for PML was established using a real-time PCR assay of JCV DNA in cerebrospinal fluid (CSF, and requests for testing were received from clinicians via specialized websites. Medical histories of patients were collected through standardized questionnaires, and a database of CSF JCV loads and clinical information was created and analyzed. Results For 4 years from April 2007 to March 2011, CSF specimens from 419 patients were tested. Forty-eight individuals were found positive for JCV DNA in their CSF and were diagnosed with PML. PML primarily occurred not only in HIV-positive patients (33.3% but also in patients with hematologic disorders after receiving stem cell transplantation, chemotherapy, and/or immunosuppressive treatment (39.6%. The frequencies of PML cases among the subjects in these two categories were 20.3% and 23.5%, respectively. Although no significant features were observed with respect to CSF JCV loads in PML patients with an HIV infection or hematologic disorder, males were predominant in both groups (100% and 89.5%, respectively. The proportion of PML cases with autoimmune disorders (6.3% or solid-organ transplants (2.1% was smaller than those with HIV infection or hematologic disorders, probably due to the limited availability of therapeutic monoclonal antibodies and transplantation from brain dead donors. Conclusions The results suggest that the internet-assisted laboratory surveillance program might be a useful strategy for collecting precise real

  15. Rituximab-associated progressive multifocal leukoencephalopathy derived from non-Hodgkin lymphoma: neuropathological findings and results of mefloquine treatment.

    Science.gov (United States)

    Sano, Yasuteru; Nakano, Yuta; Omoto, Masatoshi; Takao, Masaki; Ikeda, Eiji; Oga, Atsunori; Nakamichi, Kazuo; Saijo, Masayuki; Maoka, Takashi; Sano, Hironori; Kawai, Motoharu; Kanda, Takashi

    2015-01-01

    A 66-year-old man with non-Hodgkin lymphoma (NHL) developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab. Although the administration of mefloquine at a dose of 500 mg weekly temporarily led to a dramatic decrease in the copy number of JC Virus DNA in the cerebrospinal fluid, the patient's symptoms gradually worsened. The CD4(+) T count remained continuously low, at least until approximately five months after the last cycle of chemotherapy. A postmortem examination performed 10 months after the onset of PML disclosed a severe condition associated with rituximab-treated PML originating from NHL and a high mefloquine concentration in the brain. The accumulation of further data regarding mefloquine treatment in PML cases may help to elucidate the optimal dosage and time window for effectively treating PML.

  16. Progressive Multifocal Leukoencephalopathy in a HIV-Negative Patient with Small Lymphocytic Leukemia following Treatment with Rituximab

    Directory of Open Access Journals (Sweden)

    Subhankar Chakraborty

    2011-03-01

    Full Text Available We describe a case of progressive multifocal leukoencephalopathy (PML caused by infection with the human polyomavirus JC virus in a patient with B-cell small lymphocytic leukemia who was treated with rituximab. The first symptoms of PML appeared immediately following the last of five cycles of rituximab, cyclophosphamide and pentostatin. Magnetic resonance imaging revealed changes consistent with PML, although JC virus DNA was not detected by polymerase chain reaction assay of the cerebrospinal fluid. A stereotactic biopsy of the brain showed histological changes consistent with PML, while electron microscopy revealed JC virus particles attached to the nuclei of astrocytes. The patient was treated supportively but died 53 days after the initial onset of symptoms.

  17. 中医治疗艾滋病相关性腹泻研究进展%Research Progress of AIDS-related Diarrhea Treated by Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    杨小平; 牛清涛

    2012-01-01

    Objective: To discuss the research progress of AIDS-related diarrhea treated by traditional:Chinese medicine. Methods; Related literatures in recent years were summarized and concluded, related research situation of pathogenesis, occurrence mechanism, clinical manifestation, diagnosis and treatment of AIDS-related diarrhea from traditional Chinese medicine were summarized. Results: Pathogenesis of AIDS-related diarrhea was insufficiency of ,the spleen with overabundance of dampness and deficiency of kidney essence, and had closed relationship with lung, spleen and kidney. Therapeutic methods included set and empirical prescription, drug-using with syndrome differentiation,moxa-moxibusition treatment,psychotherapy,dietary therapy,and so on-Conclusion;Traditional Chinese medicine has affirmed curative effects in treating AIDS-related diarrhea.%目的:探讨艾滋病相关性腹泻中医治疗的研究进展.方法:总结、归纳近年来的相关文献,就中医对艾滋病相关性腹泻的病因,发生机理,临床表现,诊断和治疗的有关研究情况作一综述.结果:艾滋病腹泻病机为脾虚湿盛,肾精亏虚,并与肺、脾、肾三脏密切相关.治疗方法包括成方验方、辨证用药、艾灸治疗、心理疗法、食疗等.结论:中医治疗艾滋病相关性腹泻疗效显著.

  18. [Progressive multifocal leukoencephalopathy associated to natalizumab: the importance of magnetic resonance imaging in its early diagnosis].

    Science.gov (United States)

    Martí, Glòria; Río, Jordi; Rovira, Àlex; Auger, Cristina; Tintoré, Mar; Sastre-Garriga, Jaume; Vidal, Anka; Castilló, Joaquín; Montalban, Xavier

    2015-02-16

    Introduccion. El natalizumab es un farmaco utilizado en la esclerosis multiple (EM), cuyo principal efecto adverso es el desarrollo de una leucoencefalopatia multifocal progresiva (LMP). Como esta es potencialmente mortal o discapacitante, el tratamiento debe suspenderse inmediatamente ante su sospecha, teniendo en cuenta el posible desarrollo posterior de un sindrome de reconstitucion inmune o rebrote de la EM. Caso clinico. Se describe un caso de LMP, inicialmente asintomatico, en el contexto del tratamiento con natalizumab en una paciente con EM. Como factores de riesgo se determinaron titulos altos de anticuerpos contra el virus John Cunningham (VJC) y mas de dos años de tratamiento. La reaccion en cadena de la polimerasa para el VJC en el liquido cefalorraquideo resulto negativa en dos determinaciones. El periodo entre el diagnostico radiologico y el inicio de la clinica fue de dos meses. Durante el curso de la enfermedad, la paciente desarrollo un sindrome inflamatorio de reconstitucion inmune y rebrotes de su EM. Presento una buena respuesta tras el inicio de tratamiento con fingolimod, una vez estabilizada la LMP. Conclusion. Este caso ilustra la importancia de una estrecha vigilancia clinicorradiologica en pacientes con EM tratados con natalizumab, sobre todo cuando presentan factores de riesgo para el desarrollo de LMP, asi como su potencial incidencia en la supervivencia y estado funcional final.

  19. Failure of mefloquine therapy in progressive multifocal leukoencephalopathy: report of two Japanese patients without human immunodeficiency virus infection.

    Science.gov (United States)

    Kobayashi, Zen; Akaza, Miho; Numasawa, Yoshiyuki; Ishihara, Shoichiro; Tomimitsu, Hiroyuki; Nakamichi, Kazuo; Saijo, Masayuki; Morio, Tomohiro; Shimizu, Norio; Sanjo, Nobuo; Shintani, Shuzo; Mizusawa, Hidehiro

    2013-01-15

    Although progressive multifocal leukoencephalopathy (PML) cases showing responses to mefloquine therapy have been reported, the efficacy of mefloquine for PML remains unclear. We report on the failure of mefloquine therapy in two Japanese patients with PML unrelated to human immunodeficiency virus. One of the patients was a 47-year-old male who had been treated with chemotherapy for Waldenström macroglobulinemia, and the other was an 81-year-old male with idiopathic CD4(+) lymphocytopenia. Diagnosis of PML was established based on MRI findings and increased JC virus DNA in the cerebrospinal fluid in both patients. Mefloquine was initiated about 5 months and 2 months after the onset of PML, respectively. During mefloquine therapy, clinical and radiological progression was observed, and JC virus DNA in the cerebrospinal fluid was increased in both patients. Both patients died about 4 months and 2 months after initiation of mefloquine, respectively. Further studies are necessary to clarify the differences between mefloquine responders and non-responders in PML.

  20. A study of mefloquine treatment for progressive multifocal leukoencephalopathy: results and exploration of predictors of PML outcomes.

    Science.gov (United States)

    Clifford, David B; Nath, Avindra; Cinque, Paola; Brew, Bruce J; Zivadinov, Robert; Gorelik, Leonid; Zhao, Zhenming; Duda, Petra

    2013-08-01

    Immune reconstitution has improved outcomes for progressive multifocal leukoencephalopathy (PML), a potentially lethal brain disease caused by JC virus (JCV). However, an antiviral treatment to control JCV is needed when immune reconstitution is delayed or not possible. On the basis of in vitro efficacy, this study evaluated the effect of mefloquine on PML and factors that may predict PML outcomes. This 38-week, open-label, randomized, parallel-group, proof-of-concept study compared patients with PML who received standard of care (SOC) with those who received SOC plus mefloquine (250 mg for 3 days, then 250 mg weekly). Patients randomized to SOC could add mefloquine treatment at week 4. The primary endpoint was change from baseline to weeks 4 and 8 in JCV DNA copy number (load) in cerebrospinal fluid (CSF). Exploratory analyses evaluated factors that might correlate with clinical outcome. The majority of enrolled patients were HIV positive. Preplanned interim data analyses suggested that the study was unlikely to successfully demonstrate a significant difference between groups; therefore, the study was terminated prematurely. There was no significant difference between groups in CSF JCV DNA loads or clinical/MRI findings. Decrease in CSF JCV DNA load from baseline to week 4 was associated with a better clinical outcome at 16 weeks, as measured by Karnofsky scores. This study found no evidence of anti-JCV activity by mefloquine. An early decrease of CSF JCV DNA load appears to be associated with a better clinical outcome.

  1. Presymptomatic diagnosis with MRI and adequate treatment ameliorate the outcome after natalizumab-associated progressive multifocal leukoencephalopathy (PML.

    Directory of Open Access Journals (Sweden)

    Hans eLindå

    2013-02-01

    Full Text Available Natalizumab (Tysabri® is a monoclonal antibody that prevents inflammatory cells from binding to brain endothelial cells and passing into the brain parenchyma. Natalizumab is a highly effective treatment for relapsing-remitting multiple sclerosis (MS. Progressive multifocal leukoencephalopathy (PML is an opportunistic brain JC virus infection that has been shown to be associated with natalizumab treatment. We describe PML in a patient with MS after 44 monthly infusions of natalizumab. With the aid of a routine MRI scan, PML was detected before any unambiguous clinical manifestations had emerged. PML was treated with plasma exchange to accelerate removal of natalizumab. Mirtazapine and mefloquine was promptly added and approximately one month after plasma exchange, when an immune-reconstitution-inflammatory-syndrome (IRIS appeared, steroid treatment was initiated. Steroid treatment was then continued until no virus could be detected in the cerebrospinal fluid. The outcome was favourable. We believe that this case clearly illustrates the importance of an early, presymptomatic, detection of PML and an adequate treatment. We also propose that surveillance with MRI scans, every 3 months after 24 months of treatment, should be performed in JC virus antibody positive natalizumab-treated MS patients in order to detect PML in an early phase.

  2. Changes in JC virus-specific T cell responses during natalizumab treatment and in natalizumab-associated progressive multifocal leukoencephalopathy.

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    Molly R Perkins

    Full Text Available Progressive multifocal leukoencephalopathy (PML induced by JC virus (JCV is a risk for natalizumab-treated multiple sclerosis (MS patients. Here we characterize the JCV-specific T cell responses in healthy donors and natalizumab-treated MS patients to reveal functional differences that may account for the development of natalizumab-associated PML. CD4 and CD8 T cell responses specific for all JCV proteins were readily identified in MS patients and healthy volunteers. The magnitude and quality of responses to JCV and cytomegalovirus (CMV did not change from baseline through several months of natalizumab therapy. However, the frequency of T cells producing IL-10 upon mitogenic stimulation transiently increased after the first dose. In addition, MS patients with natalizumab-associated PML were distinguished from all other subjects in that they either had no detectable JCV-specific T cell response or had JCV-specific CD4 T cell responses uniquely dominated by IL-10 production. Additionally, IL-10 levels were higher in the CSF of individuals with recently diagnosed PML. Thus, natalizumab-treated MS patients with PML have absent or aberrant JCV-specific T cell responses compared with non-PML patients, and changes in T cell-mediated control of JCV replication may be a risk factor for developing PML. Our data suggest further approaches to improved monitoring, treatment and prevention of PML in natalizumab-treated patients.

  3. Progressive multifocal leucoencephalopathy in HIV/AIDS: Observational study from a tertiary care centre in northern India

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    S K Sharma

    2013-01-01

    Full Text Available Background & objectives: Progressive multifocal leucoencephalopathy (PML is seen mostly in advanced human immunodeficiency virus (HIV infection. Little is known about the epidemiology and disease course of these patients from India. This study was aimed to determine the frequency of PML in patients with HIV/AIDS, and the clinical features and survival of these patients. Methods: The charts of HIV/AIDS patients with PML seen over a period of five years (2006-2011 at the Antiretroviral treatment (ART centre at a tertiary care centre in New Delhi, India, were retrospectively reviewed. Results: Of 1465 patients with HIV/AIDS, 18 (1.2% were diagnosed with PML; four were laboratory confirmed and 14 had consistent clinical and radiological features. PML was the initial presentation of HIV infection in 10 (56% patients, and 16 (89% patients had CD4 count less than 200/μl. Insidious onset focal limb weakness (78% and visual disturbance (28% were common symptoms. Magnetic resonance imaging (MRI of the brain revealed characteristic white matter lesions in all the patients. The estimated median survival was 7.6 months (95% CI, 0-20 months. Interpretation & conclusions: Our results show that the patients present late to access treatment with advanced immunosuppression at presentation. PML is associated with high morbidity and mortality despite institution of highly active antiretroviral therapy (HAART. There is a need to address the lacuna in diagnostic and management services for these patients in India.

  4. 艾滋病相关病毒性肺炎的诊治研究进展%Research progress in the diagnosis and treatment of AIDS related viral pneumonia

    Institute of Scientific and Technical Information of China (English)

    蒋荣猛; 张伟; 陈志海

    2011-01-01

    肺部机会性感染是导致艾滋病发病和死亡的重要原因,涉及细菌、真菌、病毒等多种病原体.近年来的报道显示,艾滋病病毒性肺炎的比例较高,临床表现复杂,诊断与治疗难度大.文章对巨细胞病毒、单纯疱疹病毒、水痘—带状疱疹病毒、腺病毒等常见的艾滋病相关病毒性肺炎的诊断、治疗研究进展,以及目前存在的问题进行综述.%For acquired immunodeficiency syndrome (AIDS) patients, opportunistic pneumonia is a vital cause leading to AIDS morbidity and mortality . The spectrum is broad including bacteria, fungus, virus and many other pathogens. The recent reports have indicated that there is a high rate of AIDS related viral pneumonia which is complicated in its clinical manifestation and difficult to be diagnosed and treated. The article was aimed to summarize the progress in diagnosis and treatment and existing problems of common AIDS related viral pneumonias such as cyto-megalovirus, herpes simplex virus, varicella -zoster virus, adenovirus, and others.

  5. A progressive multifocal neurological syndrome in a 42-year-old woman.

    LENUS (Irish Health Repository)

    Cryan, Jane

    2012-02-01

    This is the case of a 42-year-old female who presented with transient dizziness. Her symptoms and signs progressed to include dysarthria, ataxia and cognitive decline over 2 years, such that she was unable to care for herself. She died 4 years after first presentation without a diagnosis. Investigations revealed a normochromic normocytic anaemia. Cerebrospinal fluid was normal. Serial computed tomography brain showed a wedge-shaped frontal infarct but no progressive changes. Examination at autopsy showed discoloration of the gray and white matter of the brain and spinal cord.Microscopy of leptomeningeal and parenchymal vessels showed they were filled with atypical B lymphocytes confined to the intravascular space with multiple infarcts in the brain, cerebellum and spinal cord. A diagnosis of intravascular B cell lymphoma was made and is discussed.

  6. Progressive multifocal leukoencephalopathy complicating untreated chronic lymphatic leukemia: case report and review of the literature.

    Science.gov (United States)

    Di Pauli, Franziska; Berger, Thomas; Walder, Alois; Maier, Hans; Rhomberg, Paul; Uprimny, Christian; Steurer, Michael; Stockhammer, Guenther

    2014-08-01

    A 58-year old female with a four-year history of previously untreated CLL at Binet stage A complained about word finding problems, impaired vision, and gait unsteadiness. Concerning her CLL she was asymptomatic and had never required any specific treatment. Her neurological examination disclosed cognitive alterations, homonyme hemianopia to the right, aphasia, and mild right-sided hemiparesis. Cerebral MRI showed a hyperintense lesion on T2 weighted images without contrast enhancement. CSF examination revealed normal findings, including CSF protein, cell count, cytology and PCR-analysis was negative for the presence of JC virus DNA. On follow-up MRI, performed 2 weeks later, the T2 lesion was further enlarging. Subsequent stereotactic brain biopsy was diagnostic for PML revealing abnormal oligodendrocytes staining positive against antibodies specific for simian vacuolating virus 40. In addition, repeated CSF analyses for JC-Virus DNA in the course of the disease became positive. After confirmation of diagnosis treatment with mirtazapine (30 mg/d) and mefloquine (250 mg/d) was initiated. Rapid clinical progression correlated to further worsening on MRI. Therefore this treatment was terminated after 16 days and the regime was changed to a five-day courses of cytarabine (2 mg/kg/d) combined with intrathecal administration of liposomal cytarabine (50 mg). Due to further clinical progression with global aphasia, blindness and severe right-sided hemiparesia, medication was stopped. The Patient died three and a half months after onset of symptoms.

  7. Deep-Sequence Identification and Role in Virus Replication of a JC Virus Quasispecies in Patients with Progressive Multifocal Leukoencephalopathy.

    Science.gov (United States)

    Takahashi, Kenta; Sekizuka, Tsuyoshi; Fukumoto, Hitomi; Nakamichi, Kazuo; Suzuki, Tadaki; Sato, Yuko; Hasegawa, Hideki; Kuroda, Makoto; Katano, Harutaka

    2017-01-01

    JC virus (JCV) is a DNA virus causing progressive multifocal leukoencephalopathy (PML) in immunodeficient patients. In the present study, 22 genetic quasispecies with more than 1.5% variant frequency were detected in JCV genomes from six clinical samples of PML by next-generation sequencing. A mutation from A to C at nucleotide (nt) 3495 in JCV Mad1 resulting in a V-to-G amino acid substitution at amino acid (aa) position 392 of the large T antigen (TAg) was identified in all six cases of PML at 3% to 19% variant frequencies. Transfection of JCV Mad1 DNA possessing the V392G substitution in TAg into IMR-32 and human embryonic kidney 293 (HEK293) cells resulted in dramatically decreased production of JCV-encoded proteins. The virus DNA copy number was also reduced in supernatants of the mutant virus-transfected cells. Transfection of the IMR-32 and HEK293 cells with a virus genome containing a revertant mutation recovered viral production and protein expression. Cotransfection with equal amounts of wild-type genome and mutated JCV genome did not reduce the expression of viral proteins or viral replication, suggesting that the mutation did not have any dominant-negative function. Finally, immunohistochemistry demonstrated that TAg was expressed in all six pathological samples in which the quasispecies were detected. In conclusion, the V392G amino acid substitution in TAg identified frequently in PML lesions has a function in suppressing JCV replication, but the frequency of the mutation was restricted and its role in PML lesions was limited.

  8. Progressive multifocal leucoencephalopathy in an immunocompetent patient with favourable outcome. A case report

    Directory of Open Access Journals (Sweden)

    Mørk Sverre J

    2010-05-01

    Full Text Available Abstract Background To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir. Case Presentation A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and plasmapheresis, but he deteriorated rapidly suggestive of the immune reconstitution inflammatory syndrome (IRIS. He started to recover two weeks after the initiation of treatment with cidofovir and has had no relapse at 3 1/2 years of follow-up. MRI has shown marked improvement. Conclusions PML should be considered in immunocompetent patients with a typical clinical course and MRI findings compatible with PML. Treatment with cidofovir should be considered as early as possible in the disease course.

  9. General Information about AIDS-Related Lymphoma

    Science.gov (United States)

    ... Treatment Adult NHL Treatment AIDS-Related Lymphoma Treatment Mycosis Fungoides & Sézary Syndrome Treatment Primary CNS Lymphoma Treatment ... Treatment Adult NHL Treatment AIDS-Related Lymphoma Treatment Mycosis Fungoides & Sézary Syndrome Treatment Primary CNS Lymphoma Treatment ...

  10. Treatment Options for AIDS-Related Lymphoma

    Science.gov (United States)

    ... Treatment Adult NHL Treatment AIDS-Related Lymphoma Treatment Mycosis Fungoides & Sézary Syndrome Treatment Primary CNS Lymphoma Treatment ... Treatment Adult NHL Treatment AIDS-Related Lymphoma Treatment Mycosis Fungoides & Sézary Syndrome Treatment Primary CNS Lymphoma Treatment ...

  11. Stages of AIDS-Related Lymphoma

    Science.gov (United States)

    ... Childhood Hodgkin Lymphoma Treatment Childhood NHL Treatment Research AIDS-Related Lymphoma Treatment (PDQ®)–Patient Version General Information About AIDS-Related Lymphoma Go to Health Professional Version Key ...

  12. Treatment Option Overview (AIDS Related-Lymphoma)

    Science.gov (United States)

    ... Treatment Childhood NHL Treatment Research AIDS-Related Lymphoma Treatment (PDQ®)–Patient Version General Information About AIDS-Related ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  13. Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    ... of the U.S. Food and Drug Administration. Hexadecyloxypropyl-Cidofovir (CMX001) is currently being studied as a treatment ... of the U.S. Food and Drug Administration. Hexadecyloxypropyl-Cidofovir (CMX001) is currently being studied as a treatment ...

  14. Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses.

    Directory of Open Access Journals (Sweden)

    Martha L Carvour

    Full Text Available Neurologic complications of human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS.Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population.Women (n=27 had significantly poorer outcomes than men (n=198 in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35, and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men. Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women.The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

  15. Progressive multifocal leukoencephalopathy secondary to rituximab-induced immunosuppression and the presence of John Cunningham virus: a case report and literature review.

    Science.gov (United States)

    Kelly, Deirdre; Monaghan, Bernadette; McMahon, Eileen; Watson, Geoffrey; Kavanagh, Eoin; O'Rourke, Killian; McCaffrey, John; Carney, Desmond

    2016-09-01

    We present the case of a 60-year-old man who developed subacute neurologic changes, in the setting of stage III non-Hodgkin's follicular lymphoma, and was treated with induction chemotherapy, followed by a year of maintenance rituximab. Magnetic resonance imaging of the brain with gadolinium was pathognomonic for progressive multifocal leukoencephalopathy (PML). He was treated with sequential plasmapheresis and intravenous immunoglobulin with clinical improvement. A literature review of the diagnostic workup of rituximab-induced PML was undertaken. This case and the literature review demonstrate the important role of magnetic resonance imaging of the brain in diagnosis and follow-up of rituximab-induced PML. Specific radiologic features in combination with cerebrospinal fluid can be diagnostic and avoid the morbidity and mortality of a diagnostic brain biopsy. Plasmapheresis and intravenous immunoglobulin have a therapeutic role and demonstrate symptom improvement and disease control. Follow-up imaging in combination with clinical response is important in demonstrating a treatment response.

  16. Efficient propagation of progressive multifocal leukoencephalopathy-type JC virus in COS-7-derived cell lines stably expressing Tat protein of human immunodeficiency virus type 1.

    Science.gov (United States)

    Nukuzuma, Souichi; Nakamichi, Kazuo; Kameoka, Masanori; Sugiura, Shigeki; Nukuzuma, Chiyoko; Miyoshi, Isao; Takegami, Tsutomu

    2010-12-01

    The high incidence of progressive multifocal leukoencephalopathy (PML) in AIDS patients compared with many other immunosuppressive diseases suggests that HIV-1 infection is strictly related to the activation of JC virus (JCV) propagation. In this report, propagation of PML-type JCV in COS-7-derived cell lines stably expressing HIV-1 Tat (COS-tat cells) has been examined. In COS-tat cells, production of viral particles and replication of genomic DNA were markedly increased compared to COS-7 cells, as judged by HA and real-time PCR analyses. These results demonstrate that COS-tat cells provide a useful model system for studying HIV-1 Tat-mediated propagation of PML-type JCV.

  17. [Aids-related toxoplasma-encephalitis presenting with acute psychotic episode].

    Science.gov (United States)

    Ilniczky, Sándor; Debreczeni, Róbert; Kovács, Tibor; Várkonyi, Viktória; Barsi, Péter; Szirmai, Imre

    2006-07-20

    The most frequent neurological manifestations of the Acquired Immunodeficiency Syndrome-(AIDS) are Cerebral Toxoplasmosis, Primary Central Nervous System Lymphoma (PCNSL), Progressive Multifocal Leukoencephalopathy (PML) and AIDS-encephalitis (AIDS-dementia complex, multinucleated giant cell encephalitis, HIV-encephalopathy). Neurological complications usually occur in the advanced stages of the disease, and they are uncommon in the beginning as presenting illness, but may result in life-threatening condition or in death. Rarely the disease presents as a neuropsychiatric illness in an undiagnosed AIDS patient, delaying a proper diagnosis. We present the case of a 34 years old patient treated for AIDS-related Toxoplasma-encephalitis in our department. His illness started as an acute psychosis followed by rapid mental and somatic decline, leading to death in three months. His HIV-seropositivity was not known at his admission, and the extraneural manifestations were slight. The diagnosis was established by serology, imaging methods and histopathological investigation. After presenting the medical history and results of autopsy studies of the patient we discuss the problems of the differential diagnosis, especially regarding the findings of the imaging methods.

  18. Fibrose sub-retiniana progressiva e corioretinite granulomatosa multifocal

    OpenAIRE

    Miguel Hage Amaro; Cristina Muccioli; Mario Martins dos Santos Motta

    2006-01-01

    We describe a case of progressive subretinal fibrosis and multifocal chorioretinitis along with its findings on both fluorescein and indocyanine green angiography. The progressive subretinal fibrosis syndrome is a severe subset of multifocal choroiditis. The clustering of lesions around the nerve optic head may mean that the disease is spread through the flow in and out of the eye around the optic nerve.Descrevemos um caso de fibrose sub-retiniana progressiva e corrioretinite multifocal granu...

  19. Polyomavirus JC in the Context of Immunosuppression: A Series of Adaptive, DNA Replication-Driven Recombination Events in the Development of Progressive Multifocal Leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Edward M. Johnson

    2013-01-01

    Full Text Available Polyomavirus JC (JCV is the etiological agent of progressive multifocal leukoencephalopathy (PML, a demyelinating infection of oligodendrocytes in the brain. PML, a frequently fatal opportunistic infection in AIDS, has also emerged as a consequence of treatment with several new immunosuppressive therapeutic agents. Although nearly 80% of adults are seropositive, JCV attains an ability to infect glial cells in only a minority of people. Data suggest that JCV undergoes sequence alterations that accompany this ability, and these changes can be derived from an archetype strain by mutation, deletion, and duplication. While the introductory source and primary tissue reservoir of JCV remain unknown, lymphoid cells have been identified as potential intermediaries in progression of JCV to the brain. This review is focused on sequence changes in the noncoding control region (NCCR of the virus. We propose an adaptive mechanism that involves a sequential series of DNA replication-driven NCCR recombination events involving stalled DNA replication forks at NCCR palindromic secondary structures. We shall describe how the NCCR sequence changes point to a model in which viral DNA replication drives NCCR recombination, allowing JCV adaptation to different cell types in its progression to neurovirulence.

  20. Progressive Multifocal Leukoencephalopathy (PML) Development Is Associated With Mutations in JC Virus Capsid Protein VP1 That Change Its Receptor Specificity

    Science.gov (United States)

    Reid, Carl; Testa, Manuela; Brickelmaier, Margot; Bossolasco, Simona; Pazzi, Annamaria; Bestetti, Arabella; Carmillo, Paul; Wilson, Ewa; McAuliffe, Michele; Tonkin, Christopher; Carulli, John P.; Lugovskoy, Alexey; Lazzarin, Adriano; Sunyaev, Shamil; Simon, Kenneth; Cinque, Paola

    2011-01-01

    Progressive multifocal leukoencephalopathy (PML), a fatal demyelinating disease caused by JC virus (JCV) infection of oligodendrocytes, may develop in patients with immune disorders following reactivation of chronic benign infection. Mutations of JCV capsid viral protein 1 (VP1), the capsid protein involved in binding to sialic acid cell receptors, might favor PML onset. Cerebrospinal fluid sequences from 37/40 PML patients contained one of several JCV VP1 amino acid mutations, which were also present in paired plasma but not urine sequences despite the same viral genetic background. VP1-derived virus-like particles (VLPs) carrying these mutations lost hemagglutination ability, showed different ganglioside specificity, and abolished binding to different peripheral cell types compared with wild-type VLPs. However, mutants still bound brain-derived cells, and binding was not affected by sialic acid removal by neuraminidase. JCV VP1 substitutions are acquired intrapatient and might favor JCV brain invasion through abrogation of sialic acid binding with peripheral cells, while maintaining sialic acid–independent binding with brain cells. PMID:21628664

  1. Progressive multifocal leukoencephalopathy secondary to rituximab-induced immunosuppression and the presence of John Cunningham virus: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Deirdre Kelly, MBBCH

    2016-09-01

    Full Text Available We present the case of a 60-year-old man who developed subacute neurologic changes, in the setting of stage III non-Hodgkin's follicular lymphoma, and was treated with induction chemotherapy, followed by a year of maintenance rituximab. Magnetic resonance imaging of the brain with gadolinium was pathognomonic for progressive multifocal leukoencephalopathy (PML. He was treated with sequential plasmapheresis and intravenous immunoglobulin with clinical improvement. A literature review of the diagnostic workup of rituximab-induced PML was undertaken. This case and the literature review demonstrate the important role of magnetic resonance imaging of the brain in diagnosis and follow-up of rituximab-induced PML. Specific radiologic features in combination with cerebrospinal fluid can be diagnostic and avoid the morbidity and mortality of a diagnostic brain biopsy. Plasmapheresis and intravenous immunoglobulin have a therapeutic role and demonstrate symptom improvement and disease control. Follow-up imaging in combination with clinical response is important in demonstrating a treatment response.

  2. Multifocal Congenital Hemangiopericytoma.

    Science.gov (United States)

    Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

    2017-01-01

    Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported.

  3. Disseminated Mycobacterium chelonae Infection Presenting as Progressive Multifocal Osteomyelitis: Report of Two Cases and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    David A Oelberg

    1994-01-01

    Full Text Available Two long term hospitalized patients developed disseminated infections caused by Mycobacterium chelonae, subspecies chelonae, over an eight-month period. In both cases, the disease was characterized by cutaneous and osseous involvement. The infections were indolent and marked by progressive bony destruction. These cases and a review of the literature are presented.

  4. [Treatment of multifocal motor neuropathies].

    Science.gov (United States)

    Azulay, J P; Pouget, J; Rihet, P; Serratrice, G

    1996-05-01

    Multifocal motor neuropathy is characterized by a progressive asymetrical weakness, predominantly affecting the upper limbs with persistent conduction blocks on motor but not sensory nerves. Treatment woth prednisone and plasma exchanges have failed to demonstrate any positive effects. Some improvements have been reported with cyclophosphamide. Mainly immunoglobulin therapy has been evaluated with a beneficial response in almost 70% of the cases. These benefits obtained over periods of less than six months have recently been confirmed by a long-term evaluation of 18 patients treated by repeated infusions.

  5. Aids-Related Cancers in Africa

    Science.gov (United States)

    Mbulaiteye, Sam M.

    2014-07-01

    Thank you Professor Zichichi for inviting me to give a talk about AIDS-related cancers in Africa. Let me begin by congratulating the team that organized the 46th Session of the Erice International Seminar Series, whose theme is THE ROLE OF SCIENCE IN THE THIRD MILLENIUM. I also congratulate the scientists from 38 countries who are attending these seminars. They are perpetuating the principle of SCIENCE WITHOUT SECRETS in the true spirit espoused by Archimedes, Galileo, and Fermi. It is a wonderful honor for me to be here to shed some light on the health impacts of the HIV epidemic in the area of cancer...

  6. Progressive multifocal leukoencephalopathy and natalizumab.

    Science.gov (United States)

    Hellwig, Kerstin; Gold, Ralf

    2011-11-01

    Natalizumab (TYSABRI(®)), a specific α4-integrin antagonist, is approved as a second-line treatment of relapsing-remitting MS (RRMS) patients who fail therapy with interferons or as first-line treatment of patients with highly active relapsing-remitting disease. Since the market introduction of natalizumab as a monotherapy in July of 2006, 111 cases of PML have been reported in natalizumab-treated MS patients as of April 2011. This review focuses on the available data regarding risk stratification for PML under long-term natalizumab therapy, and summarizes the current approach for PML management, as a natalizumab treatment complication is not necessarily associated with a fatal outcome. There is a need for development of surrogate markers that would help to better define the risk of PML in individual patients.

  7. Chronic recurrent multifocal osteomyelitis

    NARCIS (Netherlands)

    Wedman, Jan; van Weissenbruch, Ranny

    2005-01-01

    We report what is, to our best knowledge, the first case of chronic recurrent multifocal osteomyelitis (CRMO) in which the frontal and sphenoid bones were involved. Characterized by a prolonged and fluctuating course of osteomyelitis at different sites, CRMO is self-limited, although sequelae can oc

  8. Primary multifocal osseous Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Kohler Janice

    2008-03-01

    Full Text Available Abstract Background Hodgkin's disease (HD most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. A few children have systemic symptoms and weight loss. At the time of diagnosis, osseous involvement is uncommon Case presentation A case is described of Primary Multifocal Osseous Hodgkin's Lymphoma in a seven-year-old boy. He presented with a painful swelling in the sternum, and further investigations revealed deposits in his L1 vertebra, the left sacro-iliac joint and the right acetabulum. Conclusion The clinical, radiological and histological features of this disease can mimic other medical conditions, including Tuberculosis, making the diagnosis difficult and often leading to delays in treatment. This is a very rare condition and we believe this to be the youngest reported case in the literature.

  9. Clinical and Radiological Characterization of Progressive Multifocal Leukoencephalopathy in HIV-Infected Patients: A Retrospective Analysis and Review of the Literature.

    Science.gov (United States)

    Augusto, Luís; Neves, Nélia; Reis, Carina; Abreu, Cândida; Sarmento, António

    2015-01-01

    Introdução: A leucoencefalopatia multifocal progressiva é uma patologia desmielinizante causada pelo vírus John Cunningham, geralmente associada a estados de imunodepressão, em particular a infeção pelo vírus da imunodeficiência humana. Pode apresentar múltiplas manifestações clínicas e tem habitualmente um padrão imagiológico típico. A evolução clínica é geralmente progressiva, podendo ocorrer uma melhoria do prognóstico associada à recuperação imunológica.Material e Métodos: Foi conduzida uma análise retrospetiva dos dados clínicos e imagiológicos de doentes admitidos no nosso Hospital entre janeiro de 2005 e abril de 2014 com o diagnóstico de leucoencefalopatia multifocal progressiva (ICD10:A81.2) associado a infeção por vírus da imunodeficiência humana.Resultados: Vinte e um doentes foram incluídos, sendo 20 do sexo masculino (95,2%). A idade média na altura do diagnóstico foi 39 anos. A forma de apresentação mais frequente foi défice motor. O vírus John Cunningham foi identificado no líquido cefalorraquidiano em 20 doentes (95,2%). Nos estudos de imagem verificou-se um predomínio de lesões supratentoriais, assimétricas e bilaterais. Quatro doentes (19%) desenvolveram síndrome inflamatória de resposta imunológica. A abordagem terapêutica incluiu início ou otimização de terapêutica anti-retrovirica, associada a corticoterapia em quatro casos. Dezassete (81%) doentes morreram no período do estudo, sendo a sobrevida mediana após diagnóstico de três meses (intervalo 1 a13).Discussão: Os resultados do nosso estudo são concordantes com os dados previamente publicados relativamente à leucoencefalopatia multifocal progressiva, evidenciando a sua associação à infecção pelo vírus da imunodeficiência humana, particularmente nos doentes com imunossupressão grave, o predomínio de sinais e sintomas motores e cognitivos, e a existência de um atingimento bilateral e assimétrico evidente nas sequ

  10. Multifocal recurrent periostitis

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Anderson, R.; Tink, A.

    1981-11-01

    Two case reports of recurrent multifocal periostitis in two girls aged 15 and 16 are added to the eight cases already reported in the literature. The disease is characterised clinically by recurrent mesomelic swelling of the extremities and radiologically by periosteal thickening and sclerosis of underlying bone. Hyperglobulinaemia is the most constant biochemical finding. The bone biopsy shows no typical features. The possibility of a viral etiology is discussed.

  11. [Multifocal-motor neuropathy and motor neuropathy with multifocal conduction block (Lewis-Sumner syndrome)].

    Science.gov (United States)

    Finsterer, J; Mamoli, B

    1995-01-01

    Multifocal motor neuropathy, which mimics lower motor neuron disease, is a rare and curious demyelinating neuropathy characterised by slowly progressive, asymmetric limb weakness within the distribution of individual peripheral nerves, wasting, cramps, fasciculations and rare sensory involvement, but without upper motor neuron signs. The cardinal feature and primary pathophysiological basis for the weakness is the multifocal motor conduction block which remains stable for years at the same site and is confined to motor axons. It is defined as > 50% reduction in both the CMAP and the negative peak area on proximal stimulation, as compared with the distal stimulus response without any change in the negative peak duration. Nerves at the site of the conduction block show demyelination, endoneural edema, rudimentary onion bulbs and lymphocytic inflammation. Sensory nerves may show mild demyelination, axon loss and lymphocytic inflammation. The majority of patients shows elevated titers of anti-glycolipid antibodies, which may block the Na+ channels, produce demyelination or interfere with remyelination. However, their role in the pathogenesis of multifocal motor neuropathy remains uncertain. Multifocal motor neuropathy is regarded as the predominantly motor variant of chronic inflammatory demyelinating polyneuropathy and can be treated best with immunoglobulins and cyclophosphamide.

  12. [Chronic recurrent multifocal osteomyelitis].

    Science.gov (United States)

    Schilling, F; Eckardt, A; Kessler, S

    2000-01-01

    The aim of this paper is to give a detailed description of the so-called "chronic recurrent multifocal osteomyelitis" (CRMO). The clinical, radiological and histopathological results of an analysis of 29 cases (15 children/adolescents and 14 adults) are presented and correlated to current data from the literature. We could delinate the following points: 1. CRMO is a systemic aseptic inflammation of the bone marrow (Osteitis), it can occur polytopically and association with pustulous dermatologic symptoms is possible. 2. It is not a rare disease 3. Osteomyelitis is probably "reactive" and a plasma-cell sclerotic process with ist own characteristic histologic three-phase course. 4. We could observe 5 specific types of localization which can be documented by X-ray or bone scan. 5. Accompanying arthritis os often present, especially "sympathetic coxitis". 6. The use of drugs in treatment of CRMO (i.e. azithromycin, calcitonin, and bisphosphonates) is discussed. In conclusion we want to point out, that 1. 99mTC bone scan should always be performed when there is suspicion for CRMO to reveal the pattern of affection, 2. the rheumatologist and dermatologist should be contacted, 3. operation is normally not necessary for treatment of the mostly self-limitin disease, and 4. the term "SAPHO syndrome" should be avoided, further differentiation of the diagnosis is necessary.

  13. Chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Roderick, Marion R; Ramanan, Athimalaipet V

    2013-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease occurring primarily in children and adolescents. Episodes of systemic inflammation occur due to immune dysregulation without autoantibodies, pathogens or antigen-specific T cells. CRMO is characterised by the insidious onset of pain with swelling and tenderness over the affected bones. Clavicular involvement was the classical description; however, the metaphyses and epiphyses of long bones are frequently affected. Lesions may occur in any bone, including vertebrae. Characteristic imaging includes bone oedema, lytic areas, periosteal reaction and soft tissue reaction. Biopsies from affected areas display polymorphonuclear leucocytes with osteoclasts and necrosis in the early stages. Subsequently, lymphocytes and plasma cells predominate followed by fibrosis and signs of reactive new bone forming around the inflammation. Diagnosis is facilitated by the use of STIR MRI scanning, potentially obviating the need for biopsy and unnecessary long-term antibiotics due to incorrect diagnosis. Treatment options include non-steroidal anti-inflammatory drugs and bisphosphonates. Biologics have been tried in resistant cases with promising initial results. Gene identification has not proved easy although research in this area continues. Early descriptions of the disease suggested a benign course; however, longer-term follow up shows that it can cause significant morbidity and longer-term disability. Although it has always been thought of as very rare, the prevalence is likely to be vastly underestimated due to poor recognition of the disease.

  14. Creating social spaces to tackle AIDS-related stigma

    DEFF Research Database (Denmark)

    Campbell, C.; Skovdal, Morten; Gibbs, A.

    2011-01-01

    An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially...... be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its...... reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v...

  15. Validation of AIDS-related mortality in Botswana

    Directory of Open Access Journals (Sweden)

    Taffa Negussie

    2009-10-01

    Full Text Available Abstract Background Mortality data are used to conduct disease surveillance, describe health status and inform planning processes for health service provision and resource allocation. In many countries, HIV- and AIDS-related deaths are believed to be under-reported in government statistics. Methods To estimate the extent of under-reporting of HIV- and AIDS-related deaths in Botswana, we conducted a retrospective study of a sample of deaths reported in the government vital registration database from eight hospitals, where more than 40% of deaths in the country in 2005 occurred. We used the consensus of three physicians conducting independent reviews of medical records as the gold standard comparison. We examined the sensitivity, specificity and other validity statistics. Results Of the 5276 deaths registered in the eight hospitals, 29% were HIV- and AIDS-related. The percentage of HIV- and AIDS-related deaths confirmed by physician consensus (positive predictive value was 95.4%; however, the percentage of non-HIV- and non-AIDS-related deaths confirmed (negative predictive value was only 69.1%. The sensitivity and specificity of the vital registration system was 55.7% and 97.3%, respectively. After correcting for misclassification, the percentage of HIV- and AIDS--related deaths was estimated to be in the range of 48.8% to 54.4%, depending on the definition. Conclusion Improvements in hospitals and within government offices are necessary to strengthen the vital registration system. These should include such strategies as training physicians and coders in accurate reporting and recording of death statistics, implementing continuous quality assurance methods, and working with the government to underscore the importance of using mortality statistics in future evidence-based planning.

  16. Radio station acceptance of AIDS-related advertising messages.

    Science.gov (United States)

    Rotfeld, H J; Abernethy, A M

    1991-06-01

    Survey responses were received from the managers of 630 radio stations, who reported which type of AIDS-related commercials or public service announcements they are willing to accept for broadcast. The authors examine whether the public interest can outweigh fear of offending audience segments and discuss ways health education planners can increase acceptance of AIDS-related commercials. For planning a public health campaign, both the number and types of stations that will accept various public health messages are important if the messages are to reach high risk demographic groups.

  17. AIDS-related stigma among Black and Hispanic young adults.

    Science.gov (United States)

    Darrow, William W; Montanea, Julie E; Gladwin, Hugh

    2009-12-01

    Telephone surveys with national probability samples of English-speaking adults have suggested that popular support for punitive policies toward people living with HIV/AIDS (PLWHA) declined in the 1990s, but AIDS-related stigma persists in the United States. Our aim was to assess the prevalence and impact of AIDS-related stigma in non-Hispanic Black and Hispanic communities. A cross-sectional computer-assisted telephone-interview survey was conducted in summer 2003 with African-American, Afro-Caribbean, Haitian, and Hispanic 18-39 year-old residents of 12 high AIDS-incidence areas in Broward County, Florida. Stigma items were adopted from national surveys, but interviews were conducted in Spanish and Haitian Creole as well as in English. Stigma scores were higher than those reported for national samples, especially among Haitians interviewed in Creole. AIDS-related stigma was associated with never receiving an HIV-antibody test (adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI]: 0.62-0.99, P = .046), an elevated perception of HIV risk (AOR = 1.32, 95% CI: 1.01-1.73, P = .045) and a failure to participate in HIV-prevention efforts (AOR = 0.53, 95% CI: 0.34-0.85, P = .008). Interventions are needed to mitigate the pernicious effects of AIDS-related stigma.

  18. Marjolin ulcer with multifocal origin

    Directory of Open Access Journals (Sweden)

    Das Sudip

    2009-01-01

    Full Text Available Marjolin ulcer developed from a twenty years old post burn scar. The patient presented with chronic ulceration followed by multifocal development of squamous cell carcinoma with different growth pattern. One nodular lesion grew rapidly to produce a large lesion with history of a little bleeding after trauma but without any pain. Excision followed by skin grafting resulted in good cosmetic scar.

  19. Primary multifocal osseous lymphoma in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2008-12-15

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  20. Multifocal fibrosclerosis with intracranial pachymeningitis.

    Science.gov (United States)

    Kitano, A; Shimomura, T; Okada, A; Takahashi, K

    1995-04-01

    A 29-year-old woman with a 4-year history of multifocal fibrosclerosis showed unique neurologic complications. Episcleritis, orbital pseudotumor, and eosinophilic phlegmon preceded intracranial inflammatory pachymeningitis. The pachymeningitis was associated with disturbance of the visual field, incomplete Gerstmann's syndrome, and pseudotumor cerebri. T2-weighted magnetic resonance images revealed a high signal intensity lesion in the left temporal and occipital lobes, and gadolinium-enhanced T1-weighted images revealed the enhancement of the thickened left tentorial leaf. The laboratory data suggested that the etiology might be autoimmunological. The disease and MRI abnormalities improved following administration of corticosteroids.

  1. Multifocal Osteonecrosis Secondary to Chronic Alcohol Ingestion

    OpenAIRE

    Kazu Matsumoto; Hiroyasu Ogawa; Haruhiko Akiyama

    2015-01-01

    Multifocal osteonecrosis is a relatively rare disorder with an estimated incidence of around 3% among patients diagnosed as having osteonecrosis. Multifocal osteonecrosis is caused by the several conditions including corticosteroid treatment, coagulation disorders, connective tissue disorders including systemic lupus erythematosus (SLE), inflammatory bowel disease, renal transplantation, and underlying malignancies. Alcohol abuse is one of the risk factors for osteonecrosis, and alcohol-induc...

  2. Diagnosis and Management of AIDS-related Diarrhea

    Directory of Open Access Journals (Sweden)

    John F Johanson

    1996-01-01

    Full Text Available The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.

  3. HIV and AIDS-related knowledge among women in Iraq

    Directory of Open Access Journals (Sweden)

    Rudatsikira Emmanuel

    2008-12-01

    Full Text Available Abstract Background Individuals who are aware of the risk of infection and perceive themselves to be at risk of infection are more likely to take action to prevent HIV infection. The aim of this study was to assess the knowledge of HIV/AIDS among Iraqi women. Methods A secondary analysis of the 2000 Multiple Cluster Indicator Survey (MICS for Iraq was carried out to assess the extent of HIV/AIDS-related knowledge among Iraqi women. Results The majority of the 22,997 respondents were age 15–24 years (44.3%, currently married (51.4%, and resided in urban areas (71.7%. About 1 in 4 (26.0% of the study participants had no formal education. Only 49.9% had heard of HIV/AIDS. Overall, 60.5% did not know that HIV can be transmitted through blood transfusion. Meanwhile, 98.5% of the respondents did not know that HIV can be transmitted from mother to child through breast milk. Only 0.7% of the respondents reported that HIV cannot be transmitted through mosquito bites. The proportion of the respondents who had adequate knowledge on HIV/AIDS was 9.8%. Adequate knowledge of HIV/AIDS was negatively associated with being married, poor, having low education, and residing in rural areas. Conclusion Findings from this study indicate that adequate knowledge of HIV/AIDS among Iraqi is very limited and associated with marital status, education, wealth, and place of residence. This information may be of use in the design, targeting, monitoring and evaluation of programs aimed at improving HIV and AIDS related knowledge in Iraq.

  4. Aggressive and multifocal pulmonary inflammatory myofiberblastic tumor in young woman

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yang Sean; Chung, Myung Hee; Kim, Hyun Jung; Park, Ki Hoon; Kim, Jeanna; Kwon, Soon Suck; Yoo, Won Jong [Bucheon St. Mary' s Hospital, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-08-15

    We report a case of pulmonary inflammatory myofibroblastic tumor (IMT) showing aggressive and unusually rapid progression. A 27-year-old woman was admitted to the emergency room due to dry cough, fever and blood-tinged sputum that lasted one week. Initial chest radiograph and computed tomography scan revealed multifocal pulmonary nodules, which subsequently progressed into large necrotic masses within two months. She underwent a fine needle biopsy of the largest mass in the right middle lung zone which revealed inflammatory myofibroblastic cells consistent with IMT. The masses showed complete regression after six months of corticosteroid therapy. This unusual clinical manifestation could help explain the reactive inflammatory nature associated with IMTs.

  5. Research progress in tracking AIDS-related resources with NASA method%国家艾滋病防治支出评估(NASA)在追踪艾滋病防治资源方面的研究进展

    Institute of Scientific and Technical Information of China (English)

    李洋; 王晓春

    2012-01-01

    In order to deal with the global AIDS epidemiological situation in an effective manner, different countries in recent years have been continuously increasing AIDS-related investments. To ensure efficient use of these resources, many countries have tracked their money invested in the AIDS response through various methods. National AIDS Spending Assessment (NASA) is one of such methods. Its principles and applications in different countries and regions have been illustrated in this article for the purpose of recommending the establishment of an AIDS spending assessment system in China.%近年来,为了更加有效地应对全球的艾滋病流行形势,各国投入的艾滋病防治经费不断增加.为了更加充分和有效地使用这些资源,许多国家都使用了不同的方法追踪和评价本国经费在艾滋病领域的来源和使用情况.文章介绍了国家艾滋病防治支出评估(NASA)的基本原理以及在一些国家的使用情况,旨在为中国艾滋病资源评价体系的建立提供参考.

  6. Multifocal Osteonecrosis Secondary to Chronic Alcohol Ingestion

    Directory of Open Access Journals (Sweden)

    Kazu Matsumoto

    2015-01-01

    Full Text Available Multifocal osteonecrosis is a relatively rare disorder with an estimated incidence of around 3% among patients diagnosed as having osteonecrosis. Multifocal osteonecrosis is caused by the several conditions including corticosteroid treatment, coagulation disorders, connective tissue disorders including systemic lupus erythematosus (SLE, inflammatory bowel disease, renal transplantation, and underlying malignancies. Alcohol abuse is one of the risk factors for osteonecrosis, and alcohol-induced osteonecrosis is 5% among all the osteonecrosis. Furthermore, the overall incidence of alcohol-induced multifocal osteonecrosis was approximately 6% among all the osteonecrosis induced by the alcohol. Therefore, here, we report an extremely rare case of alcohol-induced multifocal osteonecrosis involving three joints (two knees and one hip and review the related literature.

  7. [Multifocal epileptic crises following mumps].

    Science.gov (United States)

    Parain, D; Boulloche, J

    1988-04-01

    A 15 years-old girl with no previous history of epilepsy or neurological disease presented three types of epileptic symptoms the same day: 1) clusters of rhythmic myoclonus of the left hemiface; 2) episodes of painful paresthesias of the left arm followed by secondary generalised seizures; 3) episodes of elementary visual hallucinations of the right hemifield. She had several seizures each hour and some were recorded. There were no EEG abnormalities during the facial myoclonus but rapid rhythms were seen during the sensory and visual partial seizures on the right parietal and left occipital lobes. There was no fever and no drowsiness. The CSF tap showed pleocytosis. Serological studies indicated recent mumps. The drugs were initially inefficient. The seizures disappeared after a month. The drugs were stopped after three months and the seizures had not relapsed after a one year's follow-up. Though there were no other sign of encephalitis, we believe that episode of multifocal seizures was due to mumps encephalitis.

  8. Multi-focal multiphoton lithography.

    Science.gov (United States)

    Ritschdorff, Eric T; Nielson, Rex; Shear, Jason B

    2012-03-01

    Multiphoton lithography (MPL) provides unparalleled capabilities for creating high-resolution, three-dimensional (3D) materials from a broad spectrum of building blocks and with few limitations on geometry, qualities that have been key to the design of chemically, mechanically, and biologically functional microforms. Unfortunately, the reliance of MPL on laser scanning limits the speed at which fabrication can be performed, making it impractical in many instances to produce large-scale, high-resolution objects such as complex micromachines, 3D microfluidics, etc. Previously, others have demonstrated the possibility of using multiple laser foci to simultaneously perform MPL at numerous sites in parallel, but use of a stage-scanning system to specify fabrication coordinates resulted in the production of identical features at each focal position. As a more general solution to the bottleneck problem, we demonstrate here the feasibility for performing multi-focal MPL using a dynamic mask to differentially modulate foci, an approach that enables each fabrication site to create independent (uncorrelated) features within a larger, integrated microform. In this proof-of-concept study, two simultaneously scanned foci produced the expected two-fold decrease in fabrication time, and this approach could be readily extended to many scanning foci by using a more powerful laser. Finally, we show that use of multiple foci in MPL can be exploited to assign heterogeneous properties (such as differential swelling) to micromaterials at distinct positions within a fabrication zone.

  9. Validation of the integration of HIV and AIDS related nursing competencies into the undergraduate nursing curriculum in South Africa

    Directory of Open Access Journals (Sweden)

    Regis R. Marie Modeste

    2015-07-01

    Full Text Available Background: Being in its fourth decade, HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV, increasing health care access, and strengthening the health care system. South Africa has made the fight one of its top priorities, and has developed plans to increase the role of nurses in the management of HIV, demonstrating its willingness, commitment and progress in the fight against HIV.Objective: This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa.Methods: This study adopted a constructivist paradigm, using a qualitative approach, applyingthe design step of the process model of curriculum development, to validate the inte gration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum.Results: For each competency, outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum, as well as the feasibility and practicability of the integration.Conclusion: Required resources for integration of HIV and AIDS related nursing competencies, such as human resources and nurse educators’ continued personal development were identified, as well as barriers to integration, and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated.

  10. Multifocal acquired demyelinating sensory and motor neuropathy presenting as a peripheral nerve tumor.

    Science.gov (United States)

    Allen, David C; Smallman, Clare A; Mills, Kerry R

    2006-09-01

    A man with multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), or Lewis-Sumner syndrome, presented with a progressive left lumbosacral plexus lesion resembling a neurofibroma. After 7 years he developed a left ulnar nerve lesion with conduction block in its upper segment. Treatment with intravenous immunoglobulin improved the symptoms and signs of both lesions. We conclude that inflammatory neuropathy must be considered in the differential diagnosis of peripheral nerve tumors, and that unifocal lesions may precede multifocal involvement in MADSAM by several years. In addition, we discuss the clinical features in 9 patients attending a specialist peripheral nerve clinic and review the literature.

  11. Measuring HIV/AIDS-Related Stigma across South Africa: A Versatile and Multidimensional Scale

    Science.gov (United States)

    Smith, Edward A.; Miller, Jacqueline A.; Newsome, Valerie; Sofolahan, Yewande A.; Airhihenbuwa, Collins O.

    2014-01-01

    Reducing HIV/AIDS-related stigma is critical in the fight against HIV/AIDS. Although national campaigns and prevention programs have been implemented across South Africa to address this critical concern, assessing the impact of these initiatives is difficult as it requires that measurement of HIV/AIDS-related stigma is uniform and comparable…

  12. Broadband Multifocal Conic-Shaped Metalens

    CERN Document Server

    Bao, Yanjun; Fang, Zheyu

    2016-01-01

    Compared with lens with one focal point,multifocal lens has a lower focusing quality with high background noise. This is arisen from the construction of multifocal lens, which is usually divided into several zones, with each corresponds to one focal point.Light passing through different zones cannot constructively interfere at the foci, resulting in a decreased optical performance. Here, we propose two multifocal metalenses with nanoslits arranged in an ellipse and a hyperbola, with both are able to focus incident light at their multifoci constructively, giving a better focusing properties than that designed by conventional methods.We theoretically and experimentally demonstrate that, within a broadband wavelength range (600-900 nm), the ellipse-shaped metalens (ESM) can focus the lights with opposite circular polarizations (CP) at its two focal points, respectively,while a hyperbola-shaped metalens (HSM) can only focus one particular CP light at its both foci, simultaneously.This types of conic-shaped metale...

  13. AIDS as social construction: text mining of AIDS-related information in the Italian press.

    Science.gov (United States)

    Caputo, Andrea; Giacchetta, Agnese; Langher, Viviana

    2016-09-01

    Given the relevance of AIDS as a public health problem in the Italian context and of the role of mass media in the social construction of the phenomenon, the aim of the present study is twofold: (1) to explore the main AIDS-related themes in the Italian popular press; (2) to analyse the temporal trends of AIDS representations over the last decades. For the research, we decided to consult Italian newspaper articles produced between 1985 and 1990 and between 2005 and 2010 using the archives of the main two national newspapers (La Repubblica and Corriere della Sera), resulting in an overall sample of 446 newspaper articles. A computer-aided content analysis allowed the detection of five different thematic domains (clusters), respectively focused on: Medical care (7.47%), Family support (37.03%), Science and religion debate (27%), Social exclusion (17.6%) and Healthcare policies (10.9%). These thematic domains are conceived along two main latent dimensions (factors) which explain 72.47% of the data variance which respectively deal with: (1) Attitudes towards people with AIDS (care versus avoidance) and (2) Social mandate on AIDS (powerlessness versus control). The study results also reveal the potential evolution of representations of people with AIDS over time: from stigmatised subjects who represent a risk for the entire society within a climate of social control to people progressively symbolised as frail subjects that need to be taken care of.

  14. AIDS-related tuberculosis in Rio de Janeiro, Brazil.

    Directory of Open Access Journals (Sweden)

    Antonio G Pacheco

    Full Text Available BACKGROUND: We studied the incidence of tuberculosis, AIDS, AIDS deaths and AIDS-TB co-infection at the population level in Rio de Janeiro, Brazil where universal and free access to combination antiretroviral therapy has been available since 1997. METHODOLOGY/PRINCIPAL FINDINGS: This was a retrospective surveillance database match of Rio de Janeiro databases from 1995-2004. Proportions of tuberculosis occurring within 30 days and between 30 days and 1 year after AIDS diagnosis were determined. Generalized additive models fitted with cubic splines with appropriate estimating methods were used to describe rates and proportions over time. Overall, 90,806 tuberculosis cases and 16,891 AIDS cases were reported; 3,125 tuberculosis cases within 1 year of AIDS diagnosis were detected. Tuberculosis notification rates decreased after 1997 from a fitted rate (fR per 100,000 of 166.5 to 138.8 in 2004. AIDS incidence rates increased 26% between 1995 and 1998 (30.7 to 38.7 followed by a 33.3% decrease to 25.8 in 2004. AIDS mortality rates decreased dramatically after antiretroviral therapy was introduced between 1995 (27.5 and 1999 (13.4. The fitted proportion (fP of patients with tuberculosis diagnosed within one year of AIDS decreased from 1995 (24.4% to 1998 (15.2%, remaining stable since. Seventy-five percent of tuberculosis diagnoses after an AIDS diagnosis occurred within 30 days of AIDS diagnosis. CONCLUSIONS/SIGNIFICANCE: Our results suggest that while combination ART should be considered an essential component of the response to the HIV and HIV/tuberculosis epidemics, it may not be sufficient alone to prevent progression from latent TB to active disease among HIV-infected populations. When tuberculosis is diagnosed prior to or at the same time as AIDS and ART has not yet been initiated, then ART is ineffective as a tuberculosis prevention strategy for these patients. Earlier HIV/AIDS diagnosis and ART initiation may reduce TB incidence in HIV

  15. A patient with progressive weakness and cramping of right arm and both legs. Diagnosis: persistent, multifocal, partial conduction blocks (CB) of motor axons outside the common sites of nerve entrapment.

    Science.gov (United States)

    Burakgazi, Ahmet Z; Kelly, John J

    2010-01-01

    A 44-year-old man presented with a 1-year history of progressive muscle weakness and cramping. Neurophysiology study, along with clinical presentation, was diagnostic. The differential diagnosis, diagnostic testing, treatment, and prognosis of this rare disease are discussed.

  16. Framing, agenda setting, and disease phobia of AIDS-related coverage in the South Korean mass media.

    Science.gov (United States)

    Jung, Minsoo

    2013-01-01

    There has been little research on the concrete role of the press in discourses on AIDS. This study investigated the AIDS discourses created by the major media. In particular, from the perspective of the agenda-setting theory, it examines differences in the framing of AIDS-related news depending on the political orientation and news sources of the press. This study analyzed the thematic frames and news sources implied by AIDS-related coverage. The 2 major media representing conservatism and progressivism were selected as the objects of analysis. As for the search engine for content analysis, the Korean Integrated Newspaper Database System was used, and 151 articles containing "AIDS" or "HIV" over 5 years from January 2005 to December 2010 were analyzed. According to the results of the analysis, there were the 6 following frames: aid/support, accident, human rights, risk, prevention, and biomedicine. Whereas the conservative press in South Korea continued to frame AIDS in the traditional way, the progressive press tended relatively more often to attempt new agenda setting, from the perspective of human rights and inequality. However, both newspaper companies tended mostly to select experts as the sources of AIDS news, thus continuing to exclude infectees and civil and society organizations.

  17. Postinfectious encephalitis with multifocal white matter lesions.

    Science.gov (United States)

    Boulloche, J; Parain, D; Mallet, E; Tron, P

    1989-08-01

    Two cases of multifocal white matter lesions occurring after viral illness are reported. Evoked potentials study and cranial magnetic resonance imaging (T2-weighted image) showed early abnormalities while CT scan was initially normal. Patients improved dramatically with steroid therapy. It would seem that because of a considerable responsiveness to steroids this affection should be differentiated from other types of encephalitis. Relations with multiple sclerosis are discussed.

  18. Multifocal epithelial hyperplasia. Report of nine cases.

    Science.gov (United States)

    Ledesma-Montes, Constantino; Vega-Memije, Elisa; Garcés-Ortíz, Maricela; Cardiel-Nieves, Maritza; Juárez-Luna, Claudia

    2005-01-01

    Multifocal epithelial hyperplasia (MEH) is also known as focal epithelial hyperplasia, Heck's disease or multifocal papillomavirus-induced epithelial hyperplasia. It is characterised by the presence of multiple lesions in the oral mucosa of children and it has been associated with the presence of the human papillomavirus. The aim of this study was to determine the clinico-pathological features of the cases diagnosed as MEH in the Service of Dermatology of the Hospital Manuel Gea González (SDHMGG). The files of the SDHMGG were reviewed and all cases diagnosed as MEH were retrieved. Nine MEH cases were found. Most of the patients were 20 year-old or younger (67%) and females were more commonly affected (78%). All patients presented multiple lesions and always, close relatives with similar lesions were found. Lesions were located most commonly in the buccal mucosa, lower lip and commissures. MEH is a soft tissue intraoral condition that needs treatment solely of the traumatised lesions or those with cosmetic problems. Remaining lesions will disappear with the age of the patients. It is suggested that this entity should be named multifocal epithelial hyperplasia since this name describes better the clinico-pathological and microscopic features of the disease.

  19. Imaging of chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Khanna, Geetika; Sato, Takashi S P; Ferguson, Polly

    2009-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder of children and young adults that is characterized by nonbacterial osteomyelitis. Patients typically present with multifocal bone pain secondary to sterile osseous inflammation, and the disease has a relapsing and remitting course. The cause of CRMO remains unclear, although the results of several studies have suggested a genetic component. The typical imaging findings of CRMO include lytic and sclerotic lesions in the metaphyses of long bones and the medial clavicles. Other common sites of disease are the vertebral bodies, pelvis, ribs, and mandible. CRMO is often bilateral and multifocal at presentation. Owing to the lack of a diagnostic test, CRMO remains a diagnosis of exclusion. Although generally a self-limiting disease, CRMO can have a prolonged course and result in significant morbidity. Radiologists can be the first to suggest this diagnosis given its characteristic radiographic appearance and distribution of disease. Radiologists should be familiar with the typical imaging findings of CRMO to prevent unnecessary multiple biopsies and long-term antibiotic treatment in children with CRMO.

  20. Pediatric multifocal liver lesions evaluated by MRI

    Directory of Open Access Journals (Sweden)

    Majed Almotairi

    2015-01-01

    Full Text Available Objective: The purpose of this study is to present our experience with MRI evaluation of multifocal liver lesions in children and describe the MRI characteristics of these lesions. Patients and Methods: A retrospective review of consecutive MRI exams performed for the evaluation of multiple liver lesions between 1 January 2007 and 31 December 2012 was done to note the number of lesions, the size of the largest lesion, MR signal characteristics, and background liver. Final diagnosis was assigned to each case based on pathology in the available cases and a combination of clinical features, imaging features, and follow-up in the remaining cases. Results: A total of 48 children (22 boys, 26 girls; age between 3 months and 18 years with average age 10.58 years and median age 11 years were included in the study. Totally 51 lesion diagnoses were seen in 48 children that included 17 focal nodular hyperplasia (FNH, 8 hemangiomas, 7 metastases, 6 regenerative nodules, 3 adenomas, 3 abscesses, and one each of angiomyolipoma, epithelioid hemangioendothelioma, focal fatty infiltration, hepatocellular carcinoma, hepatic infarction, nodular regenerative hyperplasia, and hepatic cyst. Background liver was normal in 33, cirrhotic in 10, fatty in 3, and siderotic in 2 children. Most FNH, hemangiomas, and regenerative nodules showed characteristic MRI features, while metastases were variable in signal pattern. Conclusion: Many commonly seen multifocal liver lesions in children have characteristic MRI features. MRI can help to arrive at reasonable differential diagnoses for multifocal liver lesions in children and guide further investigation and management.

  1. In-the-bag decentration of a hydrophilic radially asymmetric multifocal intraocular lens secondary to capsule contraction.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2013-01-01

    We report a case of in-the-bag decentration and tilt of a hydrophilic rotationally asymmetric multifocal intraocular lens (IOL) of the M Plus type secondary to capsule contraction. After uneventful surgery and follow-up for 3 months, progressive decentering and tilting of the IOL secondary to capsul

  2. Lente intra-ocular multifocal difrativa apodizada: resultados Diffractive apodized multifocal intraocular lens: results

    Directory of Open Access Journals (Sweden)

    Virgilio Centurion

    2007-12-01

    Full Text Available OBJETIVO: Mostrar os resultados visuais e refracionais com lente intra-ocular multifocal difrativa apodizada. MÉTODOS: Estudo de 100 olhos de 50 pacientes com catarata, submetidos à facoemulsificação com implante bilateral de lente intra-ocular (LIO multifocal difrativa apodizada. Foi avaliada a acuidade visual binocular sem e com correção para longe e perto, a previsibilidade refracional e a freqüência de uso de óculos. RESULTADOS: A acuidade visual sem correção para longe foi de e " 20/30 em 97,56% dos olhos operados e e" J2 em 100%, sendo que 82% dos pacientes nunca usam óculos e 16% usam de forma esporádica. CONCLUSÃO: A LIO multifocal difrativa apodizada mostrou ser uma opção previsível, reproduzível e segura na correção dos vícios de refração para longe e perto durante a cirurgia da catarata, permitindo elevado índice de independência ao uso de óculos.OBJECTIVE: To show visual and refraction results using multifocal diffractive apodized intraocular lens. METHODS: The study of 100 eyes of 50 patients with cataract, submitted to phacoemulsification with bilateral implant of multifocal diffractive apodized intraocular lens (IOL. Binocular visual acuity was evaluated with and without correction for near and distance, and refraction previsibility and frequency of wearing glasses. RESULTS: Visual acuity without correction for distance was e" 20/30 in 97.56% of eyes operated on and e" J2 in 100%, of these 82% of patients never wear glasses and 16% wear glasses sporadically. CONCLUSION: Multifocal diffractive apodized IOL proved to be a foreseeable option, reproducible and safe in the correction of refraction errors for distance and near during cataract surgery, enabling a high rate of independence from the use of glasses.

  3. Child Abuse and Aids-Related Knowledge, Attitudes and Behavior among Adolescents in Zambia

    Science.gov (United States)

    Slonim-Nevo, Vered; Mukuka, Lawrence

    2007-01-01

    Objective: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. Sample: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did…

  4. Multi-focal Vision and Gaze Control Improve Navigation Performance

    Directory of Open Access Journals (Sweden)

    Kolja Kuehnlenz

    2008-11-01

    Full Text Available Multi-focal vision systems comprise cameras with various fields of view and measurement accuracies. This article presents a multi-focal approach to localization and mapping of mobile robots with active vision. An implementation of the novel concept is done considering a humanoid robot navigation scenario where the robot is visually guided through a structured environment with several landmarks. Various embodiments of multi-focal vision systems are investigated and the impact on navigation performance is evaluated in comparison to a conventional mono-focal stereo set-up. The comparative studies clearly show the benefits of multi-focal vision for mobile robot navigation: flexibility to assign the different available sensors optimally in each situation, enhancement of the visible field, higher localization accuracy, and, thus, better task performance, i.e. path following behavior of the mobile robot. It is shown that multi-focal vision may strongly improve navigation performance.

  5. Evolving paradigms in multifocal breast cancer.

    Science.gov (United States)

    Salgado, Roberto; Aftimos, Philippe; Sotiriou, Christos; Desmedt, Christine

    2015-04-01

    The 7th edition of the TNM defines multifocal breast cancer as multiple simultaneous ipsilateral and synchronous breast cancer lesions, provided they are macroscopically distinct and measurable using current traditional pathological and clinical tools. According to the College of American Pathologists (CAP), the characterization of only the largest lesion is considered sufficient, unless the grade and/or histology are different between the lesions. Here, we review three potentially clinically relevant aspects of multifocal breast cancers: first, the importance of a different intrinsic breast cancer subtype of the various lesions; second, the emerging awareness of inter-lesion heterogeneity; and last but not least, the potential introduction of bias in clinical trials due to the unrecognized biological diversity of these cancers. Although the current strategy to assess the lesion with the largest diameter has clearly its advantages in terms of costs and feasibility, this recommendation may not be sustainable in time and might need to be adapted to be compliant with new evolving paradigms in breast cancer.

  6. Comparison of a new-generation sectorial addition multifocal intraocular lens and a diffractive apodized multifocal intraocular lens.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Velthoven, M. van; Meulen, I. van der; Nieuwendaal, C.; Mourits, M.; Lapid-Gortzak, R.

    2012-01-01

    PURPOSE: To compare visual, refractive, and satisfactory outcomes between a new-generation sectorial addition multifocal intraocular lens (IOL) (Lentis Mplus LS-312; study group) and a diffractive apodized multifocal IOL (Restor SN6AD1; control group). SETTING: Private practice, Driebergen, and Depa

  7. Strategies to reduce mortality and morbidity due to AIDS-related cryptococcal meningitis in Latin America

    Directory of Open Access Journals (Sweden)

    Jose E. Vidal

    2013-06-01

    Full Text Available Latin America is the region with the third most AIDS-related cryptococcal meningitis infections globally. Highly active antiretroviral therapy (HAART has reduced the number of infections; however, the number of deaths and the case-fatality rate continues to be unacceptable. In this review, we focus on the burden of AIDS-related cryptococcosis in Latin America and discuss potential strategies to reduce early mortality from Cryptococcus. In this review, we highlight the importance of: (1 earlier HIV diagnosis and HAART initiation with retention-in-care to avoid AIDS; (2 pre-HAART cryptococcal antigen (CRAG screening with preemptive fluconazole treatment; (3 better diagnostics (e.g. CRAG testing; and (4 optimal treatment with aggressive management of intracranial pressure and induction therapy with antifungal combination. Implementation of these strategies can reduce cryptococcal-related deaths, improve care, and reduce healthcare costs.

  8. Survey of HIV/AIDS-related Knowledge, Attitude and Determinants in Urban Residents

    Institute of Scientific and Technical Information of China (English)

    何群; 杨放; 林鹏; 王晔; 刘勇鹰; 付笑冰; 赵茜茜

    2003-01-01

    Objectives: To provide references for HIV/AIDS-re-lated health education strategies through survey on HIV/AIDS-related knowledge, attitude and determi-nants of HIV/AIDS awareness.Methods: The study subjects were selected by ran-dom interception in a downtown street of Guangzhou city on World AIDS Day-December 1,2002. The uni-form questionnaires were finished by means of self-administration.Results: Two hundred questionnaires were distrib-uted and 147 qualified questionnaires were collected.The results showed, the awareness rate of HIV/AIDS-related knowledge was 63.3%, and awareness rate of transmission routes was 76.2 %, whilst non-transmis-sion route was 60.5 %; the awareness rate of trans-mission was 59.2%; the awareness rate of prevention was 47.0%; the positive attitude to people living with HIV/AIDS was 65.6%. Multiple variable Logistic re-gression analysis showed the determinants of HIV/AIDS-related knowledge were education level, age,marital status and gender, of which people with high level of education, young age and the group of male and married had better awareness of HIV/AIDS.Conclusion: Current HIV/AIDS-related knowledge of urban residents is relativly low, especially for the non-transmission route, hence further HIV/AIDS-re-lated education should be strengthened, especially fo-cusing on non-transmission route to eliminate dis-crimination over people living with HIV/AIDS.Further, education efforts also should be put on fe-male population, unmarried population and poorly edu-cated population.

  9. US Supreme Court allows limits on AIDS-related insurance benefits.

    Science.gov (United States)

    Elliott, R

    2000-01-01

    In a ruling issued on 10 January 2000 with respect to Doe v Mutual of Omaha Insurance, the US Supreme Court refused to review a lower-court decision allowing an insurance company to limit health-care benefits for AIDS-related claims to less than one-tenth of what it pays under the same policies for expenses related to other illnesses. The lower court had ruled that anti-discrimination legislation does not apply to insurance policies.

  10. Sporadic Multifocal Malignant Peripheral Nerve Sheath Tumor-A Rare Presentation: Multifocal MPNST.

    Science.gov (United States)

    Leena, J B; Fernandes, Hilda; Swethadri, G K

    2013-06-01

    Malignant peripheral nerve sheath tumors(MPNST) are uncommon neoplasms with an incidence of 0.001% in general population. Multifocality is a rare manifestation of MPNST . A case of a 65 year old patient who presented with multiple swellings involving the neck, extremity and back without associated neurofibromatosis is reported for its rarity of presentation.. Diagnosis was made by FNAC and confirmed by peroperative findings and histopathology.

  11. Why we use AT.Lisa multifocals?

    Science.gov (United States)

    Filip, M; Nicolae, Miruna; Filip, A; Dragne, Carmen; Triantafyllidis, G; Antonescu, Cristina

    2014-01-01

    In this paper, the authors try to motivate their preference for implanting AT.Lisa Multifocals from all other premium IOL's from the market. It is emphasized, through clinical examples, that their choice comes after a long experience with this type of mul- tifocals IOL's. We make a short presentation of this particular type of MIOL's with their good but also weak points and try to motivate our decision to change from other types. We present the steps that each patient has to follow in our clinic prior to surgery itself, stressing out the idea that the discussion with the patient is very important in taking a decision regarding the implantation of a Premium IOL.

  12. Multifocal stenosing ulceration of the small intestine

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2009-01-01

    Several reports have described an apparently uncommon clinicopathological disorder that is characterized by multifocal stenosing small-intestinal ulceration. Compared to Crohn's disease, the ulcers are not transmural and typically remain shallow, and involve only the mucosa and submucosa. The disorder seems to be localized in the jejunum and proximal ileum only, and not the distal ileum or colon. Only nonspecific inflammatory changes are present without giant cells or other typical features of granulomatous inflammation. Most patients present clinically with recurrent obstructive events that usually respond to steroids, surgical resection, or both. With the development of newer imaging modalities to visualize the small-intestinal mucosa, such as double-balloon enteroscopy, improved understanding of the long-term natural history of this apparently distinctive disorder should emerge.

  13. Common Presentation with Uncommon Diagnosis: Multifocal Epithelioid Hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    Susmita Kundu

    2015-11-01

    Full Text Available A young female patient presenting with recurrent hemoptysis, neck swelling, and mediastinal mass mimicking lymphadenopathy was admitted to the Institute of Post Graduate Medical Education and Research and SSKM hospital, Kolkata, India. Clinical features, radiological studies, fibre optic bronchoscopy, and fine needle aspiration cytology from the neck swelling created a diagnostic dilemma until surgical resection and immunohistochemistry reports confirmed the diagnosis of multifocal epithelioid hemangioendothelioma, a rare vascular tumor with intermediate malignancy potential. Because it is a slow-progressing disease and due to the non-availability of standard chemotherapy, the patient, and her legal guardian, opted for palliative care only. She was asymptomatic for four years but again presented with hemoptysis, reappearance of the neck swelling on the same side, and a mediastinal mass compressing the superior vena cava and right pulmonary artery. This report describes the diagnostic problems and therapeutic challenges in the management of this rare tumor over a four-year follow-up period. The clinical course emphasizes the highly unpredictable nature of this tumor.

  14. Proliferative multifocal leukoplakia better name that proliferative verrucous leukoplakia

    OpenAIRE

    Aguirre-Urizar Jose M

    2011-01-01

    Abstract In this letter I propose the name "Proliferative Multifocal Leukoplakia" with the goal of reducing under-diagnosis of this disease, improve the early diagnosis, try to make an early therapy and control, and prevent its malignant transformation.

  15. Chronic Ocular Hypertension after Treated Multifocal Bacterial Keratitis

    Directory of Open Access Journals (Sweden)

    Theodoros Athanassios Papadopoulos

    2013-02-01

    Full Text Available Purpose: To report an unusual case of multifocal bacterial keratitis that despite success-ful treatment caused chronic ocular hypertension. Methods: A 67-year-old woman with unilateral multifocal keratitis and no previous ocular pathology was admitted to our hospital. Corneal scrapings and conjunctival samples were obtained for culture and the patient received intensive therapy with fortified vancomycin and tobramycin eye drops. Results: The cultures demonstrated two strains of Staphylococcus epidermidis, one resistant to ciprofloxacin and both sensitive to vancomycin. Treatment was effective and gradually discontinued after total cessation of the inflammatory activity. During the follow-up period, the patient developed late and persistent ocular hypertension of unknown etiology, in absence of any detectable inflammation or complication, and received permanent antiglaucoma therapy. Conclusion: Differential diagnosis between fungal and bacterial infection is critical in cases of multifocal keratitis. Patients with multifocal bacterial keratitis may need intraocular pressure monitoring, even after complete infection healing.

  16. Patient acceptability of the Tecnis® multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Sood P

    2011-03-01

    Full Text Available Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anterior prolate IOL with a diffractive multifocal lens design. The design aims to minimize spherical aberration and improve range of focus. The purpose of this review is to assess patient acceptability of the Tecnis® multifocal intraocular lens.Keywords: Tecnis®, intraocular lens, multifocal, presbyopia 

  17. Multifocal bacterial osteomyelitis in a renal allograft recipient following urosepsis.

    Science.gov (United States)

    Valson, A T; David, V G; Balaji, V; John, G T

    2014-05-01

    Non-tubercular bacterial osteomyelitis is a rare infection. We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

  18. Orthostatic intolerance in multifocal acquired demyelinating sensory and motor neuropathy.

    Science.gov (United States)

    Tramontozzi, Louis A; Russell, James A

    2012-09-01

    We report a patient with orthostatic intolerance and syncope as a major clinical manifestation of an acquired multifocal neuropathy with the clinical, electrodiagnostic, and cerebrospinal fluid features of multifocal acquired demyelinating sensory and motor neuropathy or the Lewis-Sumner syndrome. Immunomodulatory therapy led to clinical remission of both somatic and autonomic signs and symptoms. We are unaware of a previous description of symptomatic dysautonomia in this disorder.

  19. Professionalisation and social attitudes: a protocol for measuring changes in HIV/AIDS-related stigma among healthcare students

    OpenAIRE

    Ahmadi, Keivan; Reidpath, Daniel D; Allotey, Pascale; Hassali, Mohamed Azmi Ahmad

    2013-01-01

    Introduction HIV/AIDS-related stigma affects the access and utilisation of health services. Although HIV/AIDS-related stigma in the health services has been studied, little work has attended to the relationship between professional development and stigmatising attitudes. Hence, in this study, we will extend earlier research by examining the relationship between the stage of professional development and the kinds of stigmatising attitudes held about people living with HIV/AIDS. Methods and...

  20. Radiological characteristics of AIDS- related lymphoma; Aspectos radiologicos dos linfomas no paciente com SIDA

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Gloria Maria Martins G. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    1996-11-01

    The epidemic of acquired immunodeficiency syndrome (AIDS) increased the incidence of lymphoma, particularly the non-Hodgkin`s lymphoma. The lymphoma in immune deficient patients is usually high-grade, very aggressive and with poor prognostic. We report the radiologic characteristics of AIDS-related lymphoma in 19 patients and correlate with the literature. The disease was predominant in homosexual male patients, with mean age of 38 years. The radiological characteristics are nonspecific to differential diagnosis, but we must suspect of lymphoma. We found ring-enhanced lesions in the radiologic studies of central nervous system. Hylar and mediastinal lymphadenopath, nodules and alveolar infiltration were detected on thoracic examinations. Abdominal examinations showed hepatosplenomegaly, lymphadenopathy, hepatic focal lesions and thickneded with distorted mucosa in the alimentary tract. Bone involvement presented as focal and disseminated destructive lesions. (author) 41 refs., 10 figs.

  1. HIV/AIDS related deaths from three district hospitals of West Bengal:An observation

    Institute of Scientific and Technical Information of China (English)

    MK Bhattacharya; MK Saha; PS Chakraborty; A Sinha; A Bhattacharya; KK Dutta

    2014-01-01

    Data onHIV/AIDS incidence or deaths are limited in poor-resource country likeIndia and non-existent in state ofWestBengal.These data are essential for formulating policies forHIV intervention strategies to curbHIV epidemic.In present study, a descriptive analysis of all registered cases from three district hospitals(Maldah,North24Parganas andDarjeeling) during July2006-December2007was conducted.HIV/AIDS related deaths were found to be higher in Darjeeling district compare to other two districts.A comprehensive and well-coordinated survey is needed to explore furtherHIV/AIDS mortality data inIndia for providing necessary information in developingHIV prevention programs.

  2. HIV/AIDS related deaths from three district hospitals of West Bengal: An observation

    Directory of Open Access Journals (Sweden)

    MK Bhattacharya

    2014-01-01

    Full Text Available Data on HIV/AIDS incidence or deaths are limited in poor-resource country like India and non-existent in state of West Bengal. These data are essential for formulating policies for HIV intervention strategies to curb HIV epidemic. In present study, a descriptive analysis of all registered cases from three district hospitals (Maldah, North 24 Parganas and Darjeeling during July 2006-December 2007 was conducted. HIV/AIDS related deaths were found to be higher in Darjeeling district compare to other two districts. A comprehensive and well-coordinated survey is needed to explore further HIV/AIDS mortality data in India for providing necessary information in developing HIV prevention programs.

  3. Multifocal Group B Streptococcal Infection in a Newborn: Case Report

    Directory of Open Access Journals (Sweden)

    Osman Öztekin

    2011-12-01

    Full Text Available Introduction: Group B streptococci cause sepsis and other infections in newborns very early in life (early-onset sepsis and also later (late-onset sepsis in the newborn period.Case Report: A case of multifocal group B streptococcal infection with sepsis, meningitis, ventriculitis, osteomyelitis and abscesses in a newborn infant was reported. Ventriculitis is often thought of as a secondary complication of acute group B streptococcal meningitis.Conclusion: Multifocal group B streptococcal infection is rare and group B streptococcal ventriculitis should be suspected in cases that are refractory to treatment or in patients who later develop hydrocephalus. (Journal of Current Pediatrics 2011; 9: 141-4

  4. Multifocal motor neuropathy: update on clinical characteristics, pathophysiological concepts and therapeutic options.

    Science.gov (United States)

    Meuth, Sven G; Kleinschnitz, Christoph

    2010-01-01

    Multifocal motor neuropathy (MMN) is an acquired immune-mediated neuropathy characterized by chronic or stepwise progressive asymmetrical limb weakness without sensory deficits. The upper extremities are more often affected than the lower extremities with distal paresis dominating over proximal paresis. Important diagnostic features are persistent multifocal partial conduction blocks (CBs) and the presence of high-titer anti-GM1 serum antibodies. Motor neuron disease, other chronic dysimmune neuropathies, such as chronic inflammatory demyelinating polyneuropathy and the Lewis-Sumner syndrome (MADSAM neuropathy), are important differential diagnoses. While corticosteroids and plasma exchange are largely ineffective, high-dose intravenous immunoglobulins are regarded as first-line treatment. In spite of significant success in elucidating the underlying disease mechanisms in MMN during the past few years, important pathophysiological issues and the optimum long-term therapy remain to be clarified. The present review summarizes the clinical picture and current pathophysiological concepts of MMN with a special focus on the molecular and electrophysiological basis of CBs and highlights established therapies as well as possible novel treatment options.

  5. Exploration of Multifocal Rod Electroretinograms Recording in Human

    Institute of Scientific and Technical Information of China (English)

    Changzheng Chen; Lezheng Wu; De-Zheng Wu; Shixian Long; Jiongji Liang; Futian Jiang; Libing Jiang

    2002-01-01

    Purpose:To test the feasibility of recording rod multifocal electroretinograms (ERG) in humans and observe appropriate recording conditions.Methods: Multifocal rod ERG were recorded using a stimulus array of 61 equalsized hexagons in two normal subjects after the dark adaptation. Flashes were blue (W47B). Blank frames between two successive flashes of hexagons varied from 0 to 14. Length of the m-sequence, bandwidth, flash frequency, flash intensities and background intensities were changed to obtain appropriate recording conditions for the clinical use.Results:Multifocal rod ERG were clearly recordable and well formed. They had an early implicit time, very small negative wave and a late implicit time, large positive wave. The positive wave was bimodal, whose timing and waveform were similar to the full-field rod ERG. The local response amplitudes can be suppressed with increase in flash frequency or background intensity, decrease in flash intensity or the size of stimulus elements.Conclusions: Multifocal rod ERG can be recorded in human and can provide topographical maps of retinal function that have clinical usage. 212-1 m-sequence length, 3F blank frames and 3~ 300 Hz bandwidth were suggested to appropriate recording conditions.

  6. The multifocal electroretinogram (mfERG) in the pig

    DEFF Research Database (Denmark)

    Voss Kyhn, Maria; Kiilgaard, Jens Folke; Lopez, Ana Garcia;

    2007-01-01

    To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area...

  7. Diffractive multifocal intraocular lens interferes with intraoperative view

    Directory of Open Access Journals (Sweden)

    Mami Yoshino

    2010-05-01

    Full Text Available Mami Yoshino1, Makoto Inoue1,2, Nae Kitamura1, Hiroko Bissen-Miyajima11Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan; 2Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, JapanAbstract: We report an unusual finding during vitreous surgery in an eye implanted with a diffractive multifocal intraocular lens (IOL. A 70-year-old woman reported gradual visual deterioration to 20/40 in the left eye two and a half years after uneventful cataract surgery with implantation of a diffractive multifocal IOL. Funduscopic examination showed an epiretinal membrane (ERM in the left eye. Increased macular traction was believed to cause the visual deterioration. Vitreous surgery with removal of the ERM was performed and triamcinolone acetonide (TA was injected intravitreally to visualize the residual vitreous cortex. Although the ERM was peeled successfully, the ability to focus on the vitreoretinal interface through the IOL required great effort with decreased contrast sensitivity and ghost images of the intravitreal TA crystals. The vision improved to 20/25 4 months postoperatively. Macular surgery can be performed in an eye with a diffractive multifocal IOL; however, decreased contrast sensitivity and ghost images may interfere with the intraoperative view through the diffractive IOL in complicated cases.Keywords: diffractive multifocal intraocular lens, intraoperative view

  8. AIDS related thoracic lymphoma: evaluation by computed tomography; Linfoma toracico na sindrome da imunodeficiencia adquirida: avaliacao por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Siciliano, Antonio Alexandre de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Radiodiagnostico; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Curso de Pos-graduacao em Radiologia

    2000-02-01

    The authors reviewed five cases of patients with acquired immunodeficiency syndrome (AIDS) related lymphoma to describe the thoracic findings on computed tomography. The patients were followed at Hospital Universitario Clementino Fraga Filho, Hospital Universitario Antonio Pedro and Hospital da Lagoa, from November, 1989 to March 1998. Epidemiological, clinical and pathological data from these patients were quiet variable and pulmonary nodules and masses, hilar and mediastinal lymphadenopathy, and thoracic wall masses were observed. AIDS related lymphomas involving the chest are pleomorphic and most commonly extranodal. (author)

  9. A standardized algorithm for determining the underlying cause of death in HIV infection as AIDS or non-AIDS related

    DEFF Research Database (Denmark)

    Kowalska, Justyna D; Mocroft, Amanda; Ledergerber, Bruno;

    2011-01-01

    are a natural consequence of an increased awareness and knowledge in the field. To monitor and analyze changes in mortality over time, we have explored this issue within the EuroSIDA study and propose a standardized protocol unifying data collected and allowing for classification of all deaths as AIDS or non......-AIDS related, including events with missing cause of death. Methods: Several classifications of the underlying cause of death as AIDS or non-AIDS related within the EuroSIDA study were compared: central classification (CC-reference group) based on an externally standardised method (the CoDe procedures), local...

  10. AIDS- Related Knowledge, Attitudes and Behavior Survey among the "Migrant" Population in China

    Institute of Scientific and Technical Information of China (English)

    Jian-fang ZHOU; Xiao-ming SUN; Jonanne Mantell; Xiao-mei RU; Yong WEN

    2007-01-01

    Objective To realize AIDS related knowledge, attitude and behavior among floating people in China and discuss its influencial factors, and to provide the evidence for how to prevent AIDS in floating population.Methods The data were collected from the "Sex and Reproductive Health Baseline Survey among Floating People in China" conducted in March 2004. The standard questionnaires were used to interview altogether 4 900 floating people from 6 provinces.Results Nearly 95.4 % of them had heard about AIDS, but only 0.5% can judge all the transmitted ways and no-transmitted ways correctly, 45.9% believed that we need to isolate the HIV positive people. Only 65.7% knew that using condom can preventive HIV infection, 43.7% showed their understanding about the man who has long time no sexual life has sex with a sexual worker. About 13.6%floating people chose condom as FP method and among them only 34.6% used condom every time.Conclusion Chinese floating people are lack of AIDS knowledge. Most of them do not practise Safe Sex Activity. We need to give more intervention to the floating population.

  11. Survey of AIDS Related KAB Among Immigrant Female Factory Workers in Dongguan City

    Institute of Scientific and Technical Information of China (English)

    何群; 刘树芳; 王晔; 凌莉; 杨放

    2004-01-01

    Objective: To understand the HIV/AIDS-related knowledge, attitudes and behaviors (KAB) among immigrant female factory workers(IFFW). Methods: A cross-sectional study was conducted among IFFWs sampled from several joint- venture and private factories in Dongguan city. Results: Out of 175 sampled workers, 165 qualified for inclusion and the median age was 22. The resultsshowed that the IFFWs had low levels of knowledge about HIV/AIDS, and held many misconceptions. Thirty three of 76 (43.4%) unmarried IFFWs had premarital sexual contact, and more than half of these contacts were one-night stands (54.5%). More than one quarter of the women(25.9%) never used condoms, 49.4% sometimes used condoms and 24.7% used condoms every time. Twenty-eight women (31.8%) had an induced abortion because of an unexpected pregnancy. Fourteen (14.9%) had been infected with STDs, and four IFFWs(2.8%)had tried drugs before the interview. Conclusion: In order to empower the IFFWs in the city to protect themselves from HIV, and to contain the rapid spread of HIV in our province, targeted HIV/AIDS health promotion programs should be urgently implemented among IFFWs in Dongguan city. The programs should be designed to improve the knowledge of HIV, to promote condom use, and to reduce risky behaviors.

  12. HIV/AIDS-related Discrimination in Shanxi Rural Areas of China

    Institute of Scientific and Technical Information of China (English)

    YI YANG; KONG-LAI ZHANG

    2004-01-01

    In order to explore the features of discrimination against people with HIV/AIDS in rural areas, a community-based intervention was carried out in two pilot communities of X County of Shanxi Province from September 2002 to October 2003. Methods Data were collected using qualitative methods (in-depth interview and focus group discussion) and anonymously structured questionnaires. Results (1) Severe discrimination against people infected with HIV/AIDS was revealed in the target communities. However, the response to HIV/AIDS was different in each community. (2) People were reluctant to disclose their HIV status or get tested for HIV, which endangered their sexual partners to contract HIV through unprotected sexual intercourses. (3) Attitudes towards people infected with HIV/AIDS varied. (4) Public education promoted a better understanding of HIV/AIDS which in turn improved community attitudes and behaviors towards people with HIV/AIDS. Conclusion HIV/AIDS-related discrimination undermines both individuals' and communities' responses to HIV/AIDS and may be a serious obstacle towards effective HIV/AIDS prevention and control.

  13. AIDS-related illness trajectories in Mexico: findings from a qualitative study in two marginalized communities.

    Science.gov (United States)

    Castro, R; Orozco, E; Eroza, E; Manca, M C; Hernández, J J; Aggleton, P

    1998-10-01

    This paper describes findings from a recent study examining how people affected directly and indirectly by the HIV/AIDS epidemic cope with HIV-related illness in Mexico. One-hundred-and-thirteen in-depth interviews were conducted with key informants in two contrasting communities: Ciudad Netzahualcóyotl (an economically marginalized community) and the gay community in Mexico City (a sexually marginalized community). This paper describes the AIDS-related wellness/illness careers or trajectories followed by individuals in both communities, and identifies critical points for material and emotional intervention. This career comprises four stages: (1) life before infection; (2) life surrounding the discovery of seropositivity; (3) living as an HIV-positive person; and (4) facing death. Comparisons are drawn between the processes of adjustment and coping found in both communities. In Ciudad Netzahualcóyotl, wellness/illness careers are closely linked to prevailing poverty and oppression, as well as the sense of urgency in which local people live their lives. In the case of the gay community, wellness/illness careers are associated with the intolerance and social repression faced by homosexual men. The paper concludes by suggesting possible interventions to improve the lives of people with HIV/AIDS in Mexico today.

  14. Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia

    DEFF Research Database (Denmark)

    Bang, D; Emborg, J; Elkjaer, J

    2001-01-01

    The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory...

  15. The relationship between Chinese construction workers' HIV/AIDS-related knowledge, attitudes and behaviour: a structural equation model.

    Science.gov (United States)

    Qu, B; Guo, H Q; Liu, J; Zuo, T M; Zhang, Y; Sun, G

    2009-01-01

    This study explored the relationship between human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS)-related knowledge, attitudes and behaviour in migrant urban construction workers using structural equation modelling (SEM). A cross-sectional study was conducted among 428 male subjects on three building sites in Shenyang City. The SEM model of HIV/AIDS-related knowledge, attitudes and behaviour was built using LISREL version 8.5 and it fitted the data well, as shown by an adjusted goodness of fit index of 0.82 and a root mean square error of approximation of 0.094. Knowledge of HIV/AIDS was closely correlated with attitudes and behaviour. Age was an important factor affecting HIV/AIDS-related knowledge, attitudes and behaviour. These findings suggest that increasing HIV/AIDS-related knowledge could improve the attitude and behaviour of migrant urban construction workers, enabling them to avoid high-risk behaviour that increases the spread of HIV/AIDS. Any intervention used will need to take the important factor of age into consideration.

  16. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Watanabe, Toru; Ono, Hiroyuki; Morimoto, Yoshitaka; Otsuki, Yoshiro; Shirai, Masami; Endoh, Akira; Naito, Masaaki; Inoue, Yoshiya; Hongo, Teruaki

    2015-08-01

    An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.

  17. A Novel Segment Classification for Multifocal and Multicentric Breast Cancer to Facilitate Breast-Conservation Treatment.

    Science.gov (United States)

    Tan, Mona P

    2015-01-01

    Breast conservation treatment (BCT) is an appropriate alternative to mastectomy for the treatment of unifocal breast cancer. Multifocal and multicentric breast cancers (MFMCBC) challenge conventional indications for BCT and are often treated with mastectomy. Following progress in treatment strategies for unifocal tumors, there was a movement to evaluate the use of BCT for MFMCBC. Now a growing body of evidence from retrospective data has emerged, demonstrating acceptable local control and overall survival rates with BCT for MFMCBC. Prospective studies are needed to confirm these findings. One of the possible barriers to such trials is the absence of a standardized classification and nomenclature for MFMCBC at this point in time. A novel segment classification is presented in this article in an endeavor to overcome this deficiency and allow future work on this issue.

  18. Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng William [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Cleveland Clinic, Lerner College of Medicine, Cleveland, OH (United States); Hsiao, Edward C. [University of California San Francisco, Division of Endocrinology and Metabolism, and the Institute for Human Genetics, Department of Medicine, San Francisco, CA (United States); Horvai, Andrew E. [University of California San Francisco, Department of Pathology, San Francisco, CA (United States); Link, Thomas M. [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2015-09-15

    We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights that CRMO, despite being thought of as a childhood-onset disease, can present in adults as well, and also provides illustrative examples of imaging and histological findings. (orig.)

  19. Multifocal epithelioid hemangioendothelioma of the phalanges of the hand

    Energy Technology Data Exchange (ETDEWEB)

    Bruegel, Melanie; Waldt, Simone; Woertler, Klaus; Rummeny, Ernst J. [Klinikum Rechts der Isar der Technischen Universitaet Muenchen, Department of Radiology, Munich (Germany); Weirich, Gregor [Klinikum Rechts der Isar der Technischen Universitaet Muenchen, Institute of Pathology, Munich (Germany)

    2006-10-15

    Epithelioid hemangioendothelioma (EH) of bone is a rare vascular neoplasm characterized by epithelioid endothelial cells and a variable biologic behaviour. The principal sites of occurrence of this osteolytic tumor are the lower extremity and the axial skeleton. Approximately half of the cases present with multifocal disease. The latter feature can be helpful in suggesting the diagnosis of a vascular tumor; on the other hand, it strengthens the need for a skeletal survey or whole-body MRI/CT. We report on the clinical, histologic and radiologic features - including CT and MRI findings - of EH in a case of multifocal disease of the phalanges of the hand, a very uncommon anatomic site of affliction. (orig.)

  20. Triple-stimulation technique in multifocal neuropathy with conduction block.

    Science.gov (United States)

    Deroide, Nicolas; Uzenot, David; Verschueren, Annie; Azulay, Jean-Philippe; Pouget, Jean; Attarian, Shahram

    2007-05-01

    In patients with multifocal neuropathy with conduction block (CB), CBs located between the root and Erb's point are not detected in nerve conduction studies. We therefore examined whether the triple-stimulation technique (TST) might provide a useful means of detecting CB proximal to Erb's point. Clinical assessments, extensive nerve conduction studies (NCS), conventional transcranial magnetic stimulation, and TST were performed on 10 patients with multifocal motor neuropathy with CB (MMNCB) and 6 patients with Lewis-Sumner syndrome. Conduction blocks located proximal to Erb's point were detected in 9 patients. Of the CBs, 58% were associated with muscle weakness. The use of TST to detect proximal CB improved the sensitivity of the American Association of Neuromuscular and Electrodiagnostic Medicine criteria for definite or probable MMNCB from 60% to 90%. Thus, the TST is a useful means for detection of proximal CB and gives NCS considerable additional diagnostic power.

  1. Retreatments after multifocal intraocular lens implantation: an analysis

    Science.gov (United States)

    Gundersen, Kjell Gunnar; Makari, Sarah; Ostenstad, Steffen; Potvin, Rick

    2016-01-01

    Purpose To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL) implantation and to evaluate the methods and clinical outcomes of retreatment. Patients and methods A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients. Results The multifocal retreatment rate was 10.8% (45/416 eyes). The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01). The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152) and bilateral trifocal (6.9%, 14/202) IOLs, was not statistically significantly different (P=0.12). In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time. Conclusion Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. PMID:27041983

  2. Patient acceptability of the Tecnis® multifocal intraocular lens

    OpenAIRE

    Woodward, Maria; Sood,Priyanka

    2011-01-01

    Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL) designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anter...

  3. Multifocal cysticercosis with optical coherence tomography findings in a child

    Directory of Open Access Journals (Sweden)

    Manisha Agarwal

    2012-01-01

    Full Text Available We herein report a case with multifocal cysticercosis - sub-conjunctival cysticercus cyst, sub-retinal cysticercosis, and neurocysticercosis in a child. The optical coherence tomography (OCT findings of the sub-retinal cysticercus cyst are reported. He was treated with anti-helminthic drugs and oral prednisolone followed by surgical removal of the sub-retinal cyst. He subsequently underwent silicone oil removal with lens aspiration and intraocular lens implantation maintaining stable vision

  4. Survey on AIDS related knowledge and attitude among married people of childbearing age in China

    Institute of Scientific and Technical Information of China (English)

    Li Ying; Cheng Yi-min; Huang Na; Guo Xin; Wu Jun-qing; Ru Xiao-mei

    2005-01-01

    Objective: To learn about the current circumstances surrounding AIDS related knowledge, attitudes and relevant influential factors, and to provide recommendations for HIV/AIDS prevention and control.Methods: A cross sectional study was designed by the cluster sampling method, and a self-administered, closed, and anonymous questionnaire was administered. There were a total of 4,800 married people of childbearing age, from six counties, during the period November through December, 2003.Results: There were 4,693 valid questionnaires and the validity rate was 97.78%. The general correct rate of AIDS knowledge of the respondents was 63.60%. Factors such as sex, age, place of registered permanent residence and different areas had influence on the level of AIDS knowledge. Respondents knew more about AIDS transmission related knowledge than non-transmission related knowledge. Only 30.6% of respondents had heard about volunteer counseling and testing(VCT)of AIDS, and just 8.5% of them thought that they had the possibility of being infected with HIV/AIDS, 64.5% of participants were afraid of AIDS, 66.5% of them thought that HIV positive people should be quarantined, 74.1% of them held that HIV positive people should be forbidden to go to public places, and they would not like to have dinner (68.8%), shake hands (67.8%), or work (63.4%)with HIV positive people. Respondents of different sex, registered permanent residence, education and living places had different attitudes towards HIV/AIDS.Conclusion: The AIDS knowledge level of respondents is below the goal of 75% up to 2005 brought forward by National AIDS Office of China. It is very important to strengthen the Information, Education, Communication (IEC) on AIDS non-transmission related knowledge among married people of childbearing age, especially those who are younger, lower educated and female. Furthermore, the knowledge about VCT should be publicized. More than half of the respondents have negative attitudes towards

  5. An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety.

    Science.gov (United States)

    He, Liping; Lu, Zhiyan; Huang, Jing; Zhou, Yiping; Huang, Jian; Bi, Yongyi; Li, Jun

    2016-11-07

    Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses' knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre

  6. Melanoma conjuntival multifocal recidivado originado de nevus pigmentado preexistente

    Directory of Open Access Journals (Sweden)

    Marcos Leandro Pereira

    2014-06-01

    Full Text Available O melanoma conjuntival multifocal recidivado originado de nevus preexistente é extremamente raro, ocorrendo em uma pessoa para cinco milhões de habitantes. Seu estudo é de extrema relevância, devido sua potencial letalidade. Este estudo objetiva descrever um caso de melanoma conjuntival multifocal recidivado proveniente de nevus pigmentado preexistente ocorrido em Patos de Minas, MG. Este é um estudo de caso com revisão de literatura. O diagnóstico histopatológico e o estadiamento precoce da lesão conjuntival é de fundamental importância para designar a conduta frente ao paciente. O procedimento terapêutico mais utilizado nos dias atuais é a excisão cirúrgica com crioterapia adjuvante associada à mitomicina C. O prognóstico do melanoma conjuntival multifocal recidivado originado de nevus preexistente é o pior dentre todos os melanomas oculares, apresentando alta taxa de mortalidade, 12% a 20% em 5 anos e 30% em 10 anos de desenvolvimento patológico.

  7. Towards multifocal ultrasonic neural stimulation: pattern generation algorithms.

    Science.gov (United States)

    Hertzberg, Yoni; Naor, Omer; Volovick, Alexander; Shoham, Shy

    2010-10-01

    Focused ultrasound (FUS) waves directed onto neural structures have been shown to dynamically modulate neural activity and excitability, opening up a range of possible systems and applications where the non-invasiveness, safety, mm-range resolution and other characteristics of FUS are advantageous. As in other neuro-stimulation and modulation modalities, the highly distributed and parallel nature of neural systems and neural information processing call for the development of appropriately patterned stimulation strategies which could simultaneously address multiple sites in flexible patterns. Here, we study the generation of sparse multi-focal ultrasonic distributions using phase-only modulation in ultrasonic phased arrays. We analyse the relative performance of an existing algorithm for generating multifocal ultrasonic distributions and new algorithms that we adapt from the field of optical digital holography, and find that generally the weighted Gerchberg-Saxton algorithm leads to overall superior efficiency and uniformity in the focal spots, without significantly increasing the computational burden. By combining phased-array FUS and magnetic-resonance thermometry we experimentally demonstrate the simultaneous generation of tightly focused multifocal distributions in a tissue phantom, a first step towards patterned FUS neuro-modulation systems and devices.

  8. A multifocal angiosarcoma involving bones of foot: A case report

    Directory of Open Access Journals (Sweden)

    Başak DOĞAN AVŞARGİL

    2008-05-01

    Full Text Available Angiosarcomas of bone are rare tumors constituting 1% of all malignant bone tumors. They can be either solitary or multifocal and can easily be misinterpreted as multiple myeloma or metastasis radiologically. We present a case of multifocal angiosarcoma arrising in foot bones, the diagnosis of which was difficult clinically, radiologically and pathologically. The histologic findings observed in both bioptic and amputation specimens were provided.The patient was a 56 years-old man who has undergone coronary by-pass and saphenous vein surgery 3 months ago. He has been suffering from pain and swelling on left foot since then. The lesion was suspicious for atypical fungal infection, metastasis or lymphoma radiologically. “Tru-cut” biopsy revealed extensive necrosis and the lesion resembled an inflammatory and reactive process at first glance. Morphologic mimickers of the lesion like lymphoma, metastasis and small round cell tumors were excluded immunohistochemically and the diagnosis of “malignant vasculary tumor” was made upon CD- 31 positivity of tumor cells, presence of erytrocytes, cells with intracytoplasmic lumina and increased mitotic activity. In amputation specimen a multifocal tumor having areas of necrosis and hemorrhages was observed involving predominantly calcaneus but also infiltrating talus, distal tibia and achilles tendon. The maximum diameter of tumor was 5 cm in calcaneus. Adjuvant chemotherapy could not be given because of cardiac problems.The case was presented to increase awareness on this rare, diagnostically problematic issue, the classification of which is controversial.

  9. The Preliminary Clinical Observation of Array Multifocal lntraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Zhende Lin; Bo Feng; Yizhi Liu; Bing Cheng

    2001-01-01

    Purpose: To evaluate the clinical effects of implantation of Array multifocal intraocular lenses. Methods: Thirty-one cases (37 eyes) of cataract patients, including 15 males( 19 eyes)and 16 females( 18 eyes), were involved in this study. All patients underwent standard phacoemulsification with Array multifocal intraocular lens implantation. The complications during operation, postoperative distant visual acuity, near visual acuity,corneal curvature and visual symptoms were observed. Results: the mean value of best postoperative visual acuity was recorded as follows:uncorrected distant visual acuity was 0.8, the best-corrected distant visual acuity was 0.9, uncorrected near visual acuity was 0.5, near visual acuity with distant-corrected was 0.6, the best-corrected near visual acuity wss 0.9. The astigmatism of cornea was less than 1.5 D pre-operatively and post-operatively. One patient complained of glare. Conclusion: Array multifocal intraocular lens can provide good distant and near visual acuity. With observation of more cases and follow-up of longer time, we can draw a further conclusion. Eye Science 2001; 17: 57 ~ 60.

  10. Primary multifocal gliosarcoma of the spinal cord

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    Ramesh M. Kumar

    2016-03-01

    Full Text Available Gliosarcoma (GS is a rare and exceedingly malignant neoplasm of the central nervous system. It displays clinical features similar to glioblastoma, yet is histologically unique as it harbors both gliomatous and sarcomatous cellular components. Involvement of the neuroaxis is predominantly limited to the cerebral parenchyma and meninges. Primary GS of the spinal cord is rarely encountered. We report a case of a 54 year old male who presented with 2 months of progressive, bilateral lower extremity sensory deficits. Magnetic resonance imaging of the neuro-axis revealed multiple intradural lesions involving the cervical and thoracic spinal cord without evidence of intracranial involvement. Surgical resection of a dural based, extramedullary cervical lesion and two exophytic, intramedullary thoracic lesions revealed gliosarcoma, WHO grade IV. The patient died approximately 11 months after presentation. This report confirms that GS is not limited to supratentorial involvement and can primarily affect the spinal cord.

  11. Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia

    DEFF Research Database (Denmark)

    Bang, D.; Emborg, J.; Elkjaer, J.;

    2001-01-01

    The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory...... failure requiring MV amongst patients with PCP treated in the era of adjunctive corticosteroid therapy. Furthermore, we studied factors associated with survival in relation to MV. Of 170 consecutive patients with AIDS-related PCP, 18 (11%) required MV. Thirteen of 18 ventilated patients died (72......-term mortality remained high after the introduction of adjunctive corticosteroid therapy. BAL neutrophilia may be a useful prognostic marker to identify patients at high risk of requiring mechanical ventilation Udgivelsesdato: 2001/8...

  12. AIDS-Related Pancreatic Burkitt?S Lymphoma. EUS-FNA Enhanced Diagnosis with Fluorescence in Situ Hybridization (FISH)

    OpenAIRE

    Carlos Marra-López Valenciano; Tania Hernaez Alsina; Maria Begoña Atares; Virginia Moreno Nieto; Leire Urtasun Arlegui; Francisco J Zozaya-Larequi; Ana Belen Fernandez Laso; Daniela Fernández de la Hoz Múgica; Carlos Enciso Coloma; Begoña Sacristan Terroba; Aitor Orive-Calzada

    2015-01-01

    Context Non-Hodgkin's lymphoma is a common complication in HIV-patients that most frequently affects the gastrointestinal tract. Primary pancreatic lymphomas and Burkitt Lymphoma involving the pancreas are uncommon. It is important to recognize them because can mimic an adenocarcinoma or pancreatitis, but their management is completely different. Case report We report a case of a forty-seven-year-old man who presented with an AIDS-related Burkitt Lymphoma with acute pancreatitis as initial ma...

  13. Direct and indirect effects of enablers on HIV testing, initiation and retention in antiretroviral treatment and AIDS related mortality

    Science.gov (United States)

    2017-01-01

    Background An enabling environment is believed to have significant and critical effects on HIV and AIDS program implementation and desired outcomes. This paper estimates the paths, directionality, and direct and indirect associations between critical enablers with antiretroviral treatment (ART) coverage and to AIDS-related mortality. Methods Frameworks that consider the role of enablers in HIV and AIDS programs were systematically reviewed to develop a conceptual model of interaction. Measurements for constructs of the model were pooled from the latest publicly available data. A hypothetical model, including latent/unobserved factors and interaction of enablers, program activities and outcomes, was analyzed cross-sectionally with structural equation modeling. Coefficients of the model were used to estimate the indirect associations of enablers to treatment coverage and the subsequent associated impact on AIDS related mortality. Findings The model’s fit was adequate (RMSEA = 0·084, 90% CI [0·062, 0·104]) and the indirect effects of enablers on outcomes were measured. Enablers having significant associations with increased ART coverage were social/financial protection, governance, anti-discrimination, gender equality, domestic AIDS spending, testing service delivery, and logistics. Interpretation Critical enablers are significantly correlated to outcomes like ART coverage and AIDS related mortality. Even while this model does not allow inference on causality, it provides directionality and magnitude of the significant associations. PMID:28225790

  14. Progressive Neurologic Dysfunction in a Psoriasis Patient Treated With Dimethyl Fumarate

    OpenAIRE

    Bartsch, Thorsten; Rempe, Torge; Wrede, Arne; Leypoldt, Frank; Brück, Wolfgang; Adams, Ortwin; Rohr, Axel; Jansen, Olav; Wüthrich, Christian; Deuschl, Günther; Koralnik, Igor J.

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has recently been described in psoriasis or multiple sclerosis patients treated with fumaric acid esters (fumarates), who had developed severe and long-standing lymphocytopenia (

  15. Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Warmuth-Metz Monika

    2007-01-01

    Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

  16. Multifocal fixed drug eruption with COX-2 inhibitor-celecoxib

    Directory of Open Access Journals (Sweden)

    Shikha Chugh

    2013-01-01

    Full Text Available Cyclooxygenase-2 (COX-2 inhibitors are rapidly becoming the first choice nonsteroidal anti-inflammatory drugs (NSAIDs for various rheumatological and other painful conditions. However, they might not be as safe or free of side effects as they are considered to be. These COX-2inhibitors may cause a variety of dermatological and systemic side effects of which we should be aware to avoid their indiscriminate use. We hereby report a case of multifocal fixed drug eruption (FDE with celecoxib which has not yet been reported in Indian settings.

  17. Multifocal Fixed Drug Eruption with COX-2 Inhibitor-Celecoxib

    Science.gov (United States)

    Chugh, Shikha; Sarkar, Rashmi; Garg, Vijay K; Singh, Avninder; Keisham, Chitralekha

    2013-01-01

    Cyclooxygenase-2 (COX-2) inhibitors are rapidly becoming the first choice nonsteroidal anti-inflammatory drugs (NSAIDs) for various rheumatological and other painful conditions. However, they might not be as safe or free of side effects as they are considered to be. These COX-2inhibitors may cause a variety of dermatological and systemic side effects of which we should be aware to avoid their indiscriminate use. We hereby report a case of multifocal fixed drug eruption (FDE) with celecoxib which has not yet been reported in Indian settings. PMID:23716804

  18. Chronic recurrent multifocal osteomyelitis--report of eight patients.

    Science.gov (United States)

    Handrick, W; Hörmann, D; Voppmann, A; Schille, R; Reichardt, P; Tröbs, R B; Möritz, R P; Borte, M

    1998-12-01

    The authors undertook a retrospective review of the clinical records and radiologic findings of eight children with chronic, recurrent multifocal osteomyelitis (CRMO). This disease is a recognized clinicopathologic entity with typical radiographic findings, mostly in the metaphyses of the long bones. The diagnosis is one of exclusion without pathognomonic findings. The patients were treated with non-steroidal anti-inflammatory drugs. There was no evidence of altered bone growth or abnormal joint development. It is concluded that CRMO is a distinct clinical entity that is different from acute or subacute bacterial osteomyelitis. Recognition of this condition is important to avoid treatment with antibiotics and repeated operations.

  19. Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder.

    Science.gov (United States)

    Aygun, Deniz; Barut, Kenan; Camcioglu, Yildiz; Kasapcopur, Ozgur

    2015-08-25

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory bone disease of unknown aetiology. CRMO mainly affects the metaphyses of long bones and spine in children and young adolescents. It presents with recurrent episodes of bone pain and fever, resembling bacterial osteomyelitis, but cultures of lesions are sterile and it is unresponsive to antibiotic therapy. We report a case of a 3-year-old boy diagnosed with CRMO, who was initially treated for bacterial osteomyelitis, and received prolonged antibiotic therapy for chronic pain, and swelling of mandible and ulna. CRMO should be kept in mind in the differential diagnosis of chronic bone pain and osteomyelitis unresponsive to antibiotic treatment.

  20. [Chronic recurrent multifocal osteomyelitis of the spine : Children and adolescent].

    Science.gov (United States)

    von der Höh, N H; Völker, A; Jeszenszky, D; Heyde, C-E

    2016-06-01

    Chronic non-bacterial osteomyelitis (CNO) in childhood and adolescence is a non-infectious autoinflammatory disease of the bone with partial involvement of adjacent joints and soft tissue. The etiology is unknown. The disease can occur singular or recurrent. Individual bones can be affected and multiple lesions can occur. Chronic recurrent multifocal osteomyelitis (CRMO) shows the whole picture of CNO. Accompanying but temporally independent of the bouts of osteomyelitis, some patients show manifestations in the skin, eyes, lungs and the gastrointestinal tract. The article gives an overview of the clinical manifestations, diagnostic procedures, and treatment options for CRMO involvement of the spine based on the current literature and our own cases.

  1. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?; L`osteite chronique recurrente multifocale. Un diagnostic qu`il faut savoir evoquer

    Energy Technology Data Exchange (ETDEWEB)

    Saint-Martin, Ch. [UCL Cliniques Saint-Luc, Bruxelles (Belgium); Kurelovic, I.; Soler, C.; Geoffray, A. [Fondation Laval, 06 - Nice (France); Durckel, J. [Hopital Hautepierre, 67 - Strasbourg (France)

    1997-09-01

    Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmo-plantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remissions occurring for 6 to 10 years. Treatment based on non steroid anti-inflammatory drugs is usually effective. (authors). 17 refs.

  2. Comparison of ocular straylight after implantation of multifocal intraocular lenses

    NARCIS (Netherlands)

    Łabuz, Grzegorz; Reus, Nicolaas J; van den Berg, Thomas J T P

    2016-01-01

    UNLABELLED: A comprehensive review of the effect of multifocal intraocular lens (IOL) designs on postoperative ocular straylight was performed. Studies reporting straylight values obtained with the natural pupil using the C-Quant device after uneventful multifocal IOL implantation were included. The

  3. Comparison of a hydrophilic and a hydrophobic apodized diffractive multifocal intraocular lens.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2013-01-01

    To compare outcomes between a new design apodized diffractive hydrophilic multifocal intraocular lens (IOL) (Seelens MF; study group), and a well-known apodized diffractive hydrophobic multifocal IOL (SN6AD1; control group). A comparative case series comparing refractive and visual outcomes at dista

  4. Whole body MRI in the diagnosis of chronic recurrent multifocal osteomyelitis.

    LENUS (Irish Health Repository)

    Kennedy, M T

    2012-06-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion primarily in children and adolescents. As part of the essential criteria for the diagnosis of CRMO, multifocal lesions must be identified. We present the case of an 11-year-old boy with CRMO, whose diagnosis was facilitated by the use of whole body magnetic resonance imaging (WBMR), but not isotope bone scanning.

  5. Multifocality as a prognostic factor in breast cancer patients registered in Danish Breast Cancer Cooperative Group (DBCG) 1996-2001

    DEFF Research Database (Denmark)

    Joergensen, L.E.; Gunnarsdottir, K.A.; Lanng, C.;

    2008-01-01

    The purpose of this study was to investigate the prognostic influence of multifocality in breast cancer patients. In a cohort of 7196 patients there were 945 patients with multifocality. We found no prognostic influence of multifocality on overall survival when controlling for known prognostic......, Gunnarsdottir KA, Rasmussen BB, Moeller S, Lanng C. The prognostic influence of multifocality in breast cancer patients. Breast 2004;13:188-193]....

  6. Salvage Therapy for Refractory Aids-Related Primary Central Nervous System Lymphoma

    Science.gov (United States)

    Ferro, Hugo; Parino, Eduardo

    2012-01-01

    A 27-year-old male patient presented with speech disorders and multiple brain masses on MRI evaluation. He tested positive for HIV. A sterotactic biopsy diagnosed primary central nervous system lymphoma (diffuse large B-cell lymphoma). After two cycles of high-dose metotrexate (HD-MTX-)-based chemotherapy, the tumor progressed. He underwent whole brain radiotherapy achieving complete response. Six cycles of consolidating immunochemotherapy with rituximab-temozolomide were administered after radiation. Forty-three months after remission, he has not recurred and his neurological status is optimal. Younger HIV patients with refractory PCNSL and preserved immune function can face salvage therapy successfully achieving long term remissions with no remarkable neurotoxicity. PMID:23029628

  7. Multifocal electroretinogram in normal emmetropic subjects: Correlation with optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Rajvardhan Azad

    2012-01-01

    Full Text Available Aim of the Study: To establish the normative database for multifocal electroretinogram (mfERG parameters in a normal emmetropic population. To correlate the data so obtained with the central macular thickness obtained using the optical coherence tomography (OCT scan. Materials and Methods: mfERG data were obtained from 222 eyes of 111 emmetropic subjects. The amplitude (nv/deg 2 and implicit times (ms of the first-order kernel mfERG responses (N1, P1, and N2 waves were obtained and grouped into five rings (Ring 1: Central 2°, Ring 2: 2-5°, Ring 3: 5-10°, Ring 4: 10-15°, Ring 5: >15°. The central macular thickness (CMT was obtained using the macular thickness scan protocol of the OCT. Results: The mfERG data obtained were used to create a normative database. The amplitudes of the mfERG waves were maximum in the fovea and progressively decreased with increasing eccentricity (P = 0.0001. The latencies of the P1 and N2 waves were longest in the central ring and progressively shortened with eccentricity (P = 0.0001. No statistically significant correlations were observed between central ring 1 parameters and the CMT. Conclusion: This study establishes normative database for mfERG parameters in an emmetropic population. No statistically significant correlation was noted between CMT and mfERG parameters.

  8. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia

    Directory of Open Access Journals (Sweden)

    Kazhila C. Chinsembu

    2016-01-01

    Full Text Available Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond. Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach. Milne-Redh., Dichrostachys cinerea (L. Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd. Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants.

  9. Recruiting Chinese American adolescents to HIV/AIDS-related research: a lesson learned from a cross-sectional study.

    Science.gov (United States)

    Lee, Yi-Hui; Salman, Ali; Wang, Fan

    2012-02-01

    The purpose of this article was to report identified barriers and challenges experienced in the recruiting process of Chinese American adolescents to a cross-sectional HIV/AIDS-related study. Snowball sampling method was used to recruit Chinese American adolescents from Chinese American communities in a U.S. Midwestern state. Barriers and challenges to recruitment were reviewed and analyzed from Chinese cultural perspectives in the hope of aiding researchers and health care providers understand and facilitate future recruitment of Chinese Americans for HIV/AIDS prevention studies. Barriers to recruitment were found related to the taboo topic of sexual issues in Chinese culture, unawareness and denial of HIV/AIDS risks, authoritarian parenting style in Chinese culture, and the required active consents. Facilitating factors of recruiting Chinese American adolescents to future HIV/AIDS prevention research or intervention programs are discussed. Information provided in this article may increase nurses' awareness of various barriers that they might encounter when they conduct research or address HIV/AIDS-related topics of Chinese American adolescents.

  10. A rare case of multifocal pseudomyogenic hemangioendothelioma, involving soft tissues and bone, misdiagnosed as a rhabdomyosarcoma: Diagnostic and treatment implications

    Directory of Open Access Journals (Sweden)

    Bharat Rekhi

    2016-01-01

    Full Text Available Pseudomyogenic hemangioendothelioma (PHE is an uncommon, but distinctive soft tissue tumor, characterized by multifocality. A 17-year-old male referred to us with progressively increasing multiple subcutaneous nodular lesions over his left leg and foot, reported elsewhere as a spindle cell rhabdomyosarcoma. On review, microscopy showed a cellular tumor comprising plump spindle cells arranged in loose fascicles with interspersed inflammatory cells. Tumor cells exhibited mild nuclear variation. Immunohistochemically, tumor cells expressed AE1/AE3, CD31, Fli-1, and smooth muscle actin (SMA, confirming diagnosis of PHE. Whole-body positron emission tomography–computed tomography (PET-CT scan revealed multiple, metabolically active, subcutaneous nodular lesions over the left lower leg and in the distal tibia. Subsequently, resection specimens from the various lesions and bone curettage also revealed features of PHE. Three months later, the patient developed multiple lesions over his fourth toe and left foot, for which he underwent tumor resections. At present, he is disease-free. PHE is a locally aggressive soft tissue tumor characterized by multifocality, rarely bony involvement and can be misdiagnosed as a high-grade sarcoma.

  11. Multifocal Renal Cell Carcinoma: Clinicopathologic Features and Outcomes for Tumors ≤4 cm

    Directory of Open Access Journals (Sweden)

    Paul L. Crispen

    2008-01-01

    Full Text Available A significant increase in the incidental detection of small renal tumors has been observed with the routine use of cross-sectional abdominal imaging. However, the proportion of small renal tumors associated with multifocal RCC has yet to be established. Here then, we report our experience with the treatment of multifocal RCC in which the primary tumor was ≤4 cm. In our series of 1113 RCC patients, 5.4% (60/1113 had multifocal disease at the time of nephrectomy. Discordant histology was present in 17% (10/60 of patients with multifocal RCC. Nephron sparing surgery was utilized more frequently in patients with solitary tumors. Overall, cancer-specific, and distant metastasis-free survival appeared to be similar between multifocal and solitary tumors. These findings are consistent with previous series which evaluated multifocal RCC with tumors >4 cm. With the known incidence of multifocality RCC, careful inspection of the entire renal unit should be performed when performing nephron sparing surgery.

  12. Reassignment of scattered emission photons in multifocal multiphoton microscopy.

    Science.gov (United States)

    Cha, Jae Won; Singh, Vijay Raj; Kim, Ki Hean; Subramanian, Jaichandar; Peng, Qiwen; Yu, Hanry; Nedivi, Elly; So, Peter T C

    2014-06-05

    Multifocal multiphoton microscopy (MMM) achieves fast imaging by simultaneously scanning multiple foci across different regions of specimen. The use of imaging detectors in MMM, such as CCD or CMOS, results in degradation of image signal-to-noise-ratio (SNR) due to the scattering of emitted photons. SNR can be partly recovered using multianode photomultiplier tubes (MAPMT). In this design, however, emission photons scattered to neighbor anodes are encoded by the foci scan location resulting in ghost images. The crosstalk between different anodes is currently measured a priori, which is cumbersome as it depends specimen properties. Here, we present the photon reassignment method for MMM, established based on the maximum likelihood (ML) estimation, for quantification of crosstalk between the anodes of MAPMT without a priori measurement. The method provides the reassignment of the photons generated by the ghost images to the original spatial location thus increases the SNR of the final reconstructed image.

  13. Spontaneous rupture of multifocal hepatocellular carcinoma: case report

    Directory of Open Access Journals (Sweden)

    Özen Ö

    2015-08-01

    Full Text Available Özkan Özen, Alptekin Tosun, Çiğdem Akgül Department of Radiology, Faculty of Medicine, Giresun University, Giresun, Turkey Abstract: Hemoperitoneum due to nontraumatic liver rupture is rare. The most common cause of nontraumatic rupture of the liver is hepatocellular carcinoma (HCC. The other causes of nontraumatic liver ruptures are peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus, preeclampsia, metastatic carcinoma, and other primary liver tumors. In this report, we present the computed tomography findings of spontaneous liver rupture in a 52-year-old male patient due to multifocal HCC, with the diagnosis proven by surgical specimen. Keywords: computed tomography, hemoperitoneum, liver, nontraumatic liver rupture

  14. Relatively spared central multifocal electroretinogram responses in acute quinine toxicity

    Science.gov (United States)

    Saeed, Muhammad Usman; Noonan, Carmel; Hagan, Richard; Brown, Malcolm

    2011-01-01

    A 71-year-old man was investigated with electrodiagnostic testing 4 months after a deliberate quinine overdose. Initially he was admitted to intensive care unit with visual acuity (VA) of perception of light in both eyes. VA recovered to 6/6 right eye and 6/12 left eye, though severely constricted fields were noted. Slow stimulus (base period of 83 ms) multifocal electroretinogram (ERG) showed electronegative responses outside the inner 5 degrees, with a reduced but electropositive response seen in this central area. It appears that in this case of bilaterally negative ERGs that the macula/fovea (which has a vascular supply through the choroid) is relatively spared as is seen in bilateral vascular electronegative ERGs. This may indicate that quinine toxicity to the retina may be secondary to effects similar to vascular occlusion or severe ischemia during the acute phase of quinine poisoning. PMID:22693278

  15. [Diagnosis and treatment of multifocal motor neuropathy (Lewis-Sumner)].

    Science.gov (United States)

    Kaji, R

    1999-01-01

    We made a retrospective long-term follow-up study of 25 patients with multifocal motor neuropathy (Lewis-Sumner). The diagnosis was based upon criteria modified from those of AAEM (Sumner 1997). The electrophysiological findings indicating conduction block or focal demyelinative lesions were more diagnostic than anti-GM 1 antibody titers, which were elevated in only 40% of these patients. Demonstration of definite conduction block was not always possible in those patients who responded favorably to intravenous immunoglobulins (IVIg), whereas indirect pieces of evidence such as F-wave abnormalities or focal conduction delay or dispersion were equally helpful. IVIg had superior outcome to cyclophosphamide, which sometimes caused serious adverse effects. Three patients with severe axonal involvement showed elevated monospecific antibodies to GalNAc-GD1a.

  16. Cryptogenic Multifocal Ulcerous Stenosing Enteritis: An Exceptionally Rare Disease

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    Amandeep Kaur

    2016-01-01

    Full Text Available Cryptogenic Multifocal Ulcerous Stenosing Enteritis (CMUSE is a rare idiopathic disease of the small bowel. Its origin and pathophysiology has not been well described. Clinicopathologic features include unexplained ileal strictures with supercial ulceration. We present a case of a 31-year-old HIV positive lady who was admitted with complaints of recurrent abdominal pain and constipation. Laboratory investigations revealed iron deciency anemia. Ultrasonography of the abdomen showed dilated bowel loops and a subsequent barium follow through showed ve strictures in the ileum. Segmental small bowel resection with end-to-end anastomosis was performed. Grossly ileum showed ve ileal strictures. The diagnosis of CMUSE was made on histopathology after ruling out other causes of strictures. The present case highlights the importance of considering CMUSE in patients with chronic or recurrent episodes of intestinal obstruction with multiple small intestinal ulcers and strictures after other common causes have been ruled out.

  17. Practical rules for electrodiagnosis in suspected multifocal motor neuropathy.

    Science.gov (United States)

    Bromberg, Mark B; Franssen, Hessel

    2015-03-01

    Multifocal motor neuropathy (MMN) with conduction block (CB) is a rare chronic immune-mediated neuropathy, but important to diagnose as it is treatable. The key features in prototypic MMN are electrodiagnostic demonstration of focal CB away from common sites of entrapment and normal sensory conduction across these sites. However, there are challenges in distinguishing CB from the effects of abnormal temporal dispersion. Consensus electrodiagnostic criteria, reinforced by modeling studies, are available to support definite or probable CB. In addition, consideration of technical issues can guard against false-positive and false-negative conclusions. These include limb temperature, stimulus site, inadvertent stimulating electrode movement, and supramaximal and submaximal responses, as well as the possibility of Martin-Gruber anastamosis. Robust evidence supports the treatment of MMN with intravenous immunoglobulin, and guidelines have been developed. Application of practical and simple rules including a 4-step diagnostic algorithm can help practitioners correctly diagnose this treatable condition and improve patient outcomes.

  18. Power Profiles of Commercial Multifocal Soft Contact Lenses

    Science.gov (United States)

    Kim, Eon; Bakaraju, Ravi C.; Ehrmann, Klaus

    2017-01-01

    ABSTRACT Purpose To evaluate the optical power profiles of commercially available soft multifocal contact lenses and compare their optical designs. Methods The power profiles of 38 types of multifocal contact lenses—three lenses each—were measured in powers +6D, +3D, +1D, −1D, −3D, and −6D using NIMO TR1504 (Lambda-X, Belgium). All lenses were measured in phosphate buffered saline across 8 mm optic zone diameter. Refractive index of each lens material was measured using CLR 12-70 (Index Instruments, UK), which was used for converting measured power in the medium to in-air radial power profiles. Results Three basic types of power profiles were identified: center-near, center-distance, and concentric-zone ring-type designs. For most of the lens types, the relative plus with respect to prescription power was lower than the corresponding spectacle add. For some lens types, the measured power profiles were shifted by up to 1D across the power range relative to their labeled power. Most of the lenses were designed with noticeable amounts of spherical aberration. The sign and magnitude of spherical aberration can either be power dependent or consistent across the power range. Conclusions Power profiles can vary widely between the different lens types; however, certain similarities were also observed between some of the center-near designs. For the more recently released lens types, there seems to be a trend emerging to reduce the relative plus with respect to prescription power, include negative spherical aberration, and keep the power profiles consistent across the power range. PMID:27748699

  19. MULTIFOCAL BILATERAL METACHRONOUS BREAST CANCER IN MAN. CLINICAL CASE

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    E. K. Saribekyan

    2015-01-01

    Full Text Available Multifocal malignant tumors (MMT represent a comprehensive and multifaceted problem of clinical oncology.Today, as far as observations are accumulated, there are attempts to determine a real incidence rate of multifocal tumors. Research of MMT problem becomes more and more actual and significant in oncology. Several dozen thousands of MMT observations have been described all over the world for the recent 30 years. There is a stable trend towards the increase of the number of patients with such pathology. This is primarily concerned with the improvement of diagnostics, medical treatment and increased expectation of life.The increase in incidence of MMT is due to such factors as increased average expectation of life, increased intensity of carcinogenic effects, urbanization, accumulation of hereditary loading and improved diagnostics of oncologic diseases. Detection and record of such pathology are based first on detection of simultaneous tumors, second – on diagnostics of tumor and retrospective determination according to life record data of the first neoplasm, third – on determination of further tumor at regular follow-up, which requires prolonged and high quality examination of the patients.MMT most commonly develop in patients elder than 50 y. o., even in elder age in men than in women. The article describes a case of bilateral breast cancer in man. Clinicopathologic and immunohistochemical characteristics of the tumor were studied, the genetic polymorphisms were investigated by the method of polymerase chain reaction, associated with the risk of breast cancer development, genetic analysis of BRCA1 and BRCA2, blood cancer markers was done. Full equivalence of clinicopathologic and biological properties of tumor of the right and left mammae, witnessing the common etiology and pathogenesis of neoplastic process, was established. Each case of bilateral breast cancer in men shall be studied with particular care and referred in international

  20. Isolated neurosarcoidosis mimicking multifocal meningiomas: a diagnosis pitfall

    Science.gov (United States)

    Wang, Kun; He, Xiaoying; Wang, Wei; Niu, Huanjiang; Wang, Yirong; Cai, Xiujun; Yang, Shuxu

    2016-01-01

    Abstract Introduction: Neurosarcoidosis accounts for approximately 5% of the sarcoidosis, which develops exclusively in the nervous system and is always difficult to diagnose. We describe a rare case of isolated neurosarcoidosis mimicking as multifocal meningiomas. A 27-year-old male was admitted to our hospital with a history of unconsciousness and convulsion 1 month ago, which was suspected as a seizure. The results showed no abnormalities in complete blood count; serum electrolytes; erythrocyte sedimentation rate and ultrasonography of the liver, pancreas, spleen, kidney and parotid gland, and so on. Chest radiograph and electroencephalogram were also normal. Serum-angiotensin-converting enzyme slightly increased. Normal opening pressure was shown in cerebrospinal fluid sampling, which includes 8/μL white blood cells, 0.93 g/L protein, and 3.03 mmol/L glucose. Enhanced magnetic resonance imaging revealed multifocal enhancement lesions, including left sphenoid wing region, left temporal and bilateral occipitoparietal region, which were suspected as multiple “meningioma”. A left frontotemporal craniotomy was further performed. Both necrotizing and non-necrotizing granulomas were revealed in the pathological specimen, most of which were associated with multinucleated giant cells and macrophages. We could also see the fibrosis and inflammatory reaction in the sample composed of lymphocytes, histiocytes, and plasma cells. Histopathological examination showed that the cells were positive for human CD68 (KP1), CD68 (PGM1), and CD163; however, they were negative for the AF, epithelial membrane antigen, and glial fibrillary acidic protein. Tuberculosis-deoxyribonucleic acid test and special stains for acid-fast bacilli and fungi were negative. The diagnosis was finally made as isolated neurosarcoidosis. Then the patient was treated with additional corticosteroid therapy. Serial imaging examination 4 months later revealed that the lesions extremely decreased

  1. Successful treatment of chronic recurrent multifocal osteomyelitis with indomethacin: a preliminary report of five cases.

    Science.gov (United States)

    Abril, Juan Carlos; Ramirez, Ana

    2007-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a disease of children and young adults. Clinically, the disease is characterized by the insidious onset of local pain and swelling in affected bones. Its course is one of intermittent periods of exacerbation and remission with successive bones affected. The pathogenesis of CRMO remains unknown, although an autoinflammatory disorder may be the cause, with inflammation of bone. This lesion is radiologically characterized as multiple lucencies surrounded by defined zones of patchy but dense sclerosis, cortical thickening from periosteal new bone formation, and increased bone size with different bones involved. Multiple therapeutic regimens had shown only a partial or temporary response. Because indomethacin has been successfully applied in inhibition of ossification and inflammatory processes, we initiated therapy with indomethacin in patients with CRMO. We report on the cases of 5 patients who responded dramatically to treatment with indomethacin. All underwent progressive clinical improvement (mean, 2.8 months). Radiological lesions disappeared after a mean period of 10.5 months. In 1 case where treatment was started late, small osteolytic zones persisted but with no clinical consequences. There were no additional recurrences or new bones affected during follow-up period (mean, 4 years). Our observation indicates that indomethacin may be an effective treatment for CRMO.

  2. Multifocal brain damage due to lacquer sniffing: the first case report of Thailand.

    Science.gov (United States)

    Poungvarin, N

    1991-07-01

    The first patient of multifocal brain damage due to lacquer sniffing was reported in Thailand. He was a 24-year-old man who had a 5 year history of lacquer sniffing (toluene abuse). He had difficulty in walking and had tremor for 1 year which became progressively worse and he was finally confined to bed. Examination revealed marked cerebellar signs of both upper and lower extremities with scanning speech. Five of his friends who were lacquer abusers also had similar symptoms and were confined to bed. Investigations showed marked atrophy of both cerebellar hemispheres, vermis, brainstem and less atrophy of both cerebral hemispheres in both computerized brain scanning and magnetic resonance imaging. Diffuse toxic demyelination of white matter and excess iron deposition over both thalami, basal ganglia and cerebral cortex were demonstrated on magnetic resonance imaging. Brainstem evoked response showed abnormal response of both sides. Nerve conduction velocity, electromyographic study and electroencephalogram were normal. Psychometric tests revealed dull normal or below average IQ-test of 82. He was admitted for 2 months with gradual recovery of neurological deficits. After six months of abstinence from lacquer and daily physical rehabilitation. This report of toluene abuse is not only public health problem but also reflects the socioeconomic status as well as political unawareness of this condition in the Thai community.

  3. Recurrent multifocal chronic osteitis in children; Osteite chronique multifocale recurrente de l`enfant

    Energy Technology Data Exchange (ETDEWEB)

    Quelquejay, C.; Hamidou, A.; Benosman, A.; Adamsbaum, C. [Hopital Saint-Vincent-de-Paul, 75 - Paris (France); Job-Deslandre, Ch. [Hopital Cochin, 75 - Paris (France)

    1997-09-01

    We have studied retrospectively a series of 10 children presenting with chronic multifocal osteomyelitis (8 girls, 2 boys, 7 to 16 years). All patients had plain films, bone scintigraphies and histological studies. Three had CT scan and/or MRI. Compared with literature data, we observed only one case of palmo-plantar pustulosis and only 2 cases of lysis of the medial extremity of the clavicle; in addition, we report one case of lateral extremity of the clavicle and 2 vertebral locations. The radiological pattern was typical: at the beginning of the disease, plain films showed lytic areas which became progressively osteosclerotic with enlargement of the bone. In all the cases, bone scintigraphy revealed high uptake areas which were often infra-clinical. The diagnosis was delayed from 3 months to 3 years. This emphasizes the difficulty of the diagnosis which relies on the association of clinical, biological and radiological elements. Biopsies are required to rule out an infectious bacterial osteomyelitis or a tumoral process. The pathogenesis of OCMR remains unknown, but the relation with the SAPHO (synovitis, acne, pustulosis, Hyperostosis, osteitis) syndrome is general accepted because of the similar features of the osteitis. The long term follow up appears to be uncertain: 6 of our patients are still symptomatic after five years despite anti inflammatory treatment. (authors). 22 refs.

  4. Osteomielite crônica multifocal recorrente da mandíbula: relato de três casos Chronic recurrent multifocal osteomyelitis of the mandible: report of three cases

    Directory of Open Access Journals (Sweden)

    Luciana B. Paim

    2003-10-01

    absence of isolated microorganisms in affected areas. DESCRIPTION: The first case is a 13 year-old female presenting with pain and fever after dental treatment. The patient received antibiotic treatment for osteomyelitis, but developed progressive enlargement of the mandible and palmoplantar pustulosis. Bone scintigraphy showed intense and diffuse uptake in the mandible. The swelling decreased after indomethacin and hyperbaric oxygen therapy. Case 2 is a 9 year-old female patient with recurrent pain and edema of the right mandible for three years. The diagnosis of osteomyelitis was established and amoxicillin introduced. After three months, tomography showed diffuse mandible osteolysis. Indomethacin and hyperbaric oxygen therapy were introduced, however the patient presented a relapse and was treated with prednisone, rofecoxib and methotrexate. Patient 3, a 10 year-old male, had palmoplantar pustulosis and recurrent enlargement of the mandible. Tomography showed diffuse mandible osteolysis and scintigraphy revealed intense and diffuse uptake in the mandible. The patient was treated with prednisone. Rofecoxib was replaced after two relapses. COMMENTS: Chronic recurrent multifocal osteomyelitis of the mandible is often associated with prolonged pain periods and periods of activity and remission of the inflammatory process. Its recognition is important to prevent the patient from being submitted to prolonged antibiotic therapy and unnecessary invasive procedures.

  5. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

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    Escott S

    2013-02-01

    Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

  6. Multifocal inflammatory leukoencephalopathy induced by accidental consumption of levamisole: A case report.

    Science.gov (United States)

    Sariaslani, Payam; Ghanbari, Ali; Ghanbari, Parvin

    2012-01-01

    Levamisole is an anthelmintic agent and also immunostimulant drug which is used to treat colorectal cancer. The present study aimed to show accidental consumption of levamisole alone induced multifocal inflammatory leukoencephalopathy. A 53-year-old male was admitted to the Neurology Department of Farabi Hospital (Kermanshah, Iran) with walking inability and recognition disorder. Following clinical examinations, the patient diagnosed as multifocal inflammatory leukoencephalopathy following levamisole consumption.The patient was treated with intravenous methylprednisolone followed by prednisolone. The magnetic resonance imaging (MRI) was done 1 month later and did not show a reduction or remission in the lesions. History of the patient showed that he had accidentally consumed levamisole 8 months ago. It seems that the consumption of levamisole can induce multifocal inflammatory leukoencephalopathy and delayed treatment of the patient with corticosteroid cannot diminish the neurotoxicity of levamisole. In addition, the cytotoxic dose of levamisole induces irreversible multifocal inflammatory leukoencephalopathy.

  7. Multifocal inflammatory leukoencephalopathy induced by accidental consumption of levamisole: A case report

    Science.gov (United States)

    Sariaslani, Payam; Ghanbari, Parvin

    2012-01-01

    Levamisole is an anthelmintic agent and also immunostimulant drug which is used to treat colorectal cancer. The present study aimed to show accidental consumption of levamisole alone induced multifocal inflammatory leukoencephalopathy. A 53-year-old male was admitted to the Neurology Department of Farabi Hospital (Kermanshah, Iran) with walking inability and recognition disorder. Following clinical examinations, the patient diagnosed as multifocal inflammatory leukoencephalopathy following levamisole consumption.The patient was treated with intravenous methylprednisolone followed by prednisolone. The magnetic resonance imaging (MRI) was done 1 month later and did not show a reduction or remission in the lesions. History of the patient showed that he had accidentally consumed levamisole 8 months ago. It seems that the consumption of levamisole can induce multifocal inflammatory leukoencephalopathy and delayed treatment of the patient with corticosteroid cannot diminish the neurotoxicity of levamisole. In addition, the cytotoxic dose of levamisole induces irreversible multifocal inflammatory leukoencephalopathy. PMID:24250864

  8. Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2006-06-15

    A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

  9. Multifocal Dysembryoplastic Neuroepithelial Tumour with Intradural Spinal Cord Lipomas: Report of a Case

    Directory of Open Access Journals (Sweden)

    Richard D. White

    2011-01-01

    Full Text Available We report a case of temporal lobe epilepsy and incomplete Brown-Sequard syndrome of the thoracic cord. Computed tomography and magnetic resonance (MR imaging showed multiple supratentorial masses with the classical radiological appearances of multifocal dysembryoplastic neuroepithelial tumour (DNET. Spinal MR imaging revealed intradural lipomas, not previously reported in association with multifocal DNET. Presentation and imaging findings are discussed along with classification and natural history of the tumour.

  10. Multi-focal spherical media and geodesic lenses in geometrical optics

    CERN Document Server

    Sarbort, Martin

    2013-01-01

    This paper presents a general approach to designing the isotropic spherical media with complex spatial structure that provide different types of imaging for different light rays. It is based on equivalence of the spherical medium and the corresponding geodesic lens. We use this approach to design multi-focal gradient- index lenses embedded into an optically homogeneous region and multi-focal absolute instruments that provide perfect imaging of three-dimensional domains.

  11. Unusual multifocal granulomatous disease caused by actinomycetous bacteria in a nestling Derbyan parrot (Psittacula derbiana).

    Science.gov (United States)

    Park, F J; Jaensch, S

    2009-01-01

    A nestling Derbyan parrot (Psittacula derbiana) was presented with unusual subcutaneous swellings of the thigh regions, and poor growth. Histological examination revealed actinomycetous bacteria associated with multifocal systemic granulomas. The clinical and pathological findings of the case are presented, and some relevant aspects of actinomycetous bacterial infections in mammals and birds are discussed. Although granulomatous disease is encountered at times in avian species, the actinomycetous bacteria (Nocardia and Actinomyces spp.) have rarely been reported in association with multifocal granulomatous disease in birds.

  12. Detection of multifocal osteonecrosis in an adolescent with dermatomyositis using whole-body MRI

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Tania C.M.; Terreri, Maria Teresa A.; Hilario, Maria Odete E. [Federal University of Sao Paulo, Department of Pediatrics, Division of Allergy, Clinical Immunology and Rheumatology, Sao Paulo, SP (Brazil); Lederman, Henrique [Federal University of Sao Paulo, Image Diagnosis Department, Sao Paulo (Brazil); Kaste, Sue C. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Division of Diagnostic Imaging, Memphis, TN (United States)

    2010-09-15

    Osteonecrosis is a well-recognized complication of corticosteroid use resulting in significant morbidity, often requiring surgical intervention. Whole-body MRI is a promising method that allows imaging of the whole patient in a reasonable time without the use of ionizing radiation. This technique has the potential for evaluating nonmalignant multifocal skeletal disease like osteonecrosis. This case highlights the value of whole-body MR in an adolescent with dermatomyositis who developed multifocal osteonecrosis. (orig.)

  13. Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era.

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    Beatriz Grinsztejn

    Full Text Available INTRODUCTION: We describe temporal trends in the mortality rates and factors associated with AIDS and non-AIDS related mortality at the Evandro Chagas Clinical Research Institute (IPEC, Oswaldo Cruz Foundation (FIOCRUZ. METHODS: Adult patients enrolling from 1986 through 2009 with a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients' medical charts, through active contact with individuals and family members and by linkage with the Rio de Janeiro Mortality database using a previously validated algorithm. The CoDe protocol was used to establish the cause of death. Extended Cox proportional hazards models were used for multivariate modeling. RESULTS: A total of 3530 individuals met the inclusion criteria, out of which 868 (24.6% deceased; median follow up per patient was 3.9 years (interquartile range 1.7-9.2 years. The dramatic decrease in the overall mortality rates was driven by AIDS-related causes that decreased from 9.19 deaths/100PYs n 1986-1991 to 1.35/100PYs in 2007-2009. Non-AIDS related mortality rates remained stable overtime, at around 1 death/100PYs. Immunodeficiency significantly increased the hazard of both AIDS-related and non-AIDS-related causes of death, while HAART use was strongly associated with a lower hazard of death from either cause. CONCLUSIONS: Our results confirm the remarkable decrease in AIDS-related mortality as the HIV epidemic evolved and alerts to the conditions not traditionally related to HIV/AIDS which are now becoming more frequent, needing careful monitoring.

  14. Multifocal atherosclerosis in patient after acute first degree radiation sickness.

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    Metlyaeva N.A.

    2014-12-01

    Full Text Available Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress and physiological (somatic by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place.

  15. Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review)

    Science.gov (United States)

    BASCONES-MARTÍNEZ, A.; COK, S.; BASCONES-ILUNDÁIN, C.; ARIAS-HERRERA, S.; GOMEZ-FONT, R.; BASCONES-ILUNDÁIN, J.

    2012-01-01

    Multifocal epithelial hyperplasia (MEH), also known as Heck’s disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported. PMID:22740890

  16. Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

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    Alexander Armstrong

    2013-01-01

    Full Text Available Study Design. A Case Report. Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO. Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine. Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved. Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding. Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

  17. Multifocal Toric Intraocular Lens for Traumatic Cataract in a Child

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    Yanfeng Zeng

    2016-10-01

    Full Text Available A child suffering from traumatic cataract and corneal astigmatism of 2.14 D had a phacoemulsification operation and implantation of a ReSTOR Toric intraocular lens (IOL to correct the astigmatism. The primary outcome measurements were the uncorrected distance visual acuity (UDVA, uncorrected near vision at 40 cm, intraocular pressure, spherical equivalent refraction, residual astigmatism, corneal astigmatism, presence of unusual optical phenomena, and use of spectacles. At 7 months postoperatively, UDVA was maintained between 16/20 and 24/20, near vision was between J1 and J3, residual spherical refraction was 0–0.37 D, and residual refractive cylinder was between 0 and 0.67 D. A multifocal toric IOL can provide the possibility of satisfactory vision for both distant and near conditions without the use of spectacles to meet children’s needs when studying and doing sports. Additionally, binocular vision can be reconstructed. This intervention, therefore, seems to be a satisfactory alternative.

  18. Case report: Multifocal chronic paracoccidioidomycosis in an adult

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    Karen Zapata

    2011-06-01

    Full Text Available Paracoccidioides brasiliensis es el agente causal de una de las micosis sistémicas con mayor prevalencia en Latinoamérica. Existen alrededor de 10 millones de afectados y la mayor incidencia se presenta en Brasil y se han observado casos en Venezuela, Colombia, Ecuador y Argentina. Se presenta el caso de un hombre de 56 años con lesiones de un año de evolución en labios, mucosa oral y pulmón. El estudio histopatológico con hematoxilina-eosina informó la presencia de granulomas y células gigantes multinucleadas. Los estudios micológicos (KOH y tinción de Gomori Grocott mostraron blastoconidias con gemación múltiple. Las pruebas serológicas para paracoccidioidina fueron reactivas. Se diagnosticó un caso de paracoccidioidomicosis multifocal crónica y se inició tratamiento anfotericina B 0.7 mg/kg/día durante 15 días, luego itraconazol 400 mg diarios. Las lesiones cutáneas y pulmonares mejoraron; sin embargo, presentaba una fibrosis residual importante en la región oral y no continuó el seguimiento. Se resalta la importancia de realizar un diagnóstico temprano y disminuir las posibles secuelas que van a repercutir directamente sobre la calidad de vida del paciente.

  19. Multifocal fatty infiltration of the liver; Report of six cases

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Hiromi; Nakatsuka, Haruki; Tsubakimoto, Mitsuo; Ogawa, Ryuhei; Kashihara, Takeshi (Itami City Hospital, Osaka (Japan)); Murata, Katsuko; Nakamura, Kenji; Tamaoka, Koichi; Onoyama, Yasuto

    1990-09-01

    Images of computed tomography (CT), ultrasonography (US), angiography and radionuclide imaging were analyzed in six cases of multifocal fatty infiltration of the liver. Histologic confirmation of fatty infiltration was obtained in one patient by percutaneous biopsy. In the remaining patients, presumptive confirmation of the diagnosis was based on the CT number in one patient and partial or complete resolution of the lesions on repeat CT scans or US in 4 patients. CT and US were performed in all six patients. CT scans demonstrated multiple round areas of low attenuation within both lobes of the liver in all cases. US studies showed hyperechoic foci in three cases and diffuse inhomogeneous hyperechogenicity in three cases. Hepatic arteriograms in five cases and liver scintigrams in four cases showed evidence of space-occupying lesions. In all no cases, the lesions completely or partially resolved in follow-up CT and US, and in four cases the lesions disappeared within two months, so follow-up examinations within about 2 months are necessary to differentiate them from liver neoplasms. (author).

  20. Lewis-Sumner syndrome and multifocal motor neuropathy.

    Science.gov (United States)

    Verschueren, Annie; Azulay, Jean Philippe; Attarian, Shahram; Boucraut, José; Pellissier, Jean François; Pouget, Jean

    2005-01-01

    We compared the clinical, electrophysiological, laboratory, and pathological features of 13 patients with Lewis-Sumner syndrome (LSS) with those of 20 patients with multifocal motor neuropathy (MMN). LSS and MMN patients have several common clinical features: age at onset, weakness in the distribution of individual peripheral nerves, mild wasting, cramps and fasciculations, partial areflexia, and frequent stepwise disease course. Cerebrospinal fluid protein level was normal or slightly elevated, but always less than 100 mg/dl. Conduction blocks are the electrophysiological hallmarks of these two neuropathies, and no differences in distribution and number of blocks were found. Contrary to MMN, lower-limb involvement at onset was frequent in LSS but extension to the upper limbs was a frequent later feature of the disease. Cranial nerve involvement was noted in 4 LSS patients during relapses and absent in all MMN patients. The major distinguishing features were the clinical and electrophysiological sensory involvement in LSS, and the lack of anti-GM1 antibodies in LSS, whereas IgM anti-GM1 were found in 40% of MMN patients. Some LSS patients responded to steroid therapy, whereas this was ineffective in MMN. From these features, LSS can be considered an entity distinct from MMN, with its own clinical, laboratory, and electrophysiological characteristics, and as an intermediate link between chronic inflammatory demyelinating polyneuropathy and MMN.

  1. Multifocal Electroretinography after High Dose Chloroquine Therapy for Malaria

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    Aline Correa de Carvalho

    2013-01-01

    Full Text Available Purpose: To investigate changes in multifocal electroretinography (mfERG parameters associated with high dose chloroquine therapy for treatment of malaria in the Amazonia region of Brazil. Methods: Forty-eight subjects who had received chloroquine treatment for single or multiple malaria infections with a cumulative dose ranging from 1,050 to 27,000mg were included. The control group consisted of 37 healthy aged-matched subjects. Data was collected on amplitude and implicit time of the N1, P1 and N2 waves in the central macular hexagon (R1 and in five concentric rings at different retinal eccentricities (R2-R6. Results: No significant difference was observed in any mfERG parameter between chloroquine treated patients and control subjects. A comparison with previous data obtained from patients with rheumatologic disorders in the same region of Brazil who had received larger cumulative doses of chloroquine and had displayed mfERG changes, indicated that retinal toxicity seems to be dependent on cumulative dose. Conclusion: Lack of mfERG changes in the current study suggests that intensive high dose chloroquine therapy for treatment of malaria is not associated with retinal toxicity.

  2. Multifocal motor neuropathy: a review of pathogenesis, diagnosis, and treatment

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    Lawson VH

    2014-04-01

    Full Text Available Victoria H Lawson,1 W David Arnold1,2 1Division of Neuromuscular Disorders, Department of Neurology, 2Department of Physical Medicine and Rehabilitation, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA Abstract: Multifocal motor neuropathy (MMN is an uncommon, purely motor neuropathy associated with asymmetric deficits with predilection for upper limb involvement. Even in the early descriptions of MMN, the associations of anti-GM1 antibodies and robust response to immunomodulatory treatment were recognized. These features highlight the likelihood of an underlying autoimmune etiology of MMN. The clinical presentation of MMN can closely mimic several neurological conditions including those with more malignant prognoses such as motor neuron disease. Therefore early and rapid recognition of MMN is critical. Serological evidence of anti GM-1 antibodies and electrodiagnostic findings of conduction block are helpful diagnostic clues for MMN. Importantly, these diagnostic features are not universally present, and patients lacking these characteristic findings can demonstrate similar robust response to immunodulatory treatment. In the current review, recent research in the areas of diagnosis, pathogenesis, and treatment of MMN and needs for the future are discussed. The characteristic findings of MMN and treatment implications are reviewed and contrasted with other mimicking disorders. Keywords: autoimmune, conduction block, electrodiagnosis, motor neuron, nerve, inflammatory

  3. AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach

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    Peter M. Mwamba

    2012-01-01

    Full Text Available Today AIDS-related non-Hodgkin's lymphoma (AR-NHL is a significant cause of morbidity and mortality in HIV-infected patients the world over, and especially in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence of combination antiretroviral therapy (cART era has declined, the occurrence of this disease appears to have stabilized. In regions where access to cART is challenging, the impact on disease incidence is less clear. In the resource-rich environment it is clinically recognized that it is no longer appropriate to consider AR-NHL as a single disease entity and rather treatment of AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive therapeutic strategies in the resource-rich world are clearly improving outcome, in AIDS epicenters of the world and especially in sub-Saharan Africa there is a paucity of data on treatment and outcomes. In fact, only one prospective study of dose-modified oral chemotherapy and limited retrospective studies with sufficient details provide a window into the natural history and clinical management of this disease. The scarcities and challenges of treatment in this setting provide a backdrop to review the current status and realities of the therapeutic approach to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic approaches are needed.

  4. Differences of HIV/AIDS Related Knowledge, Attitudes and Practices Between Commercial Sex Workers and Their Clients

    Institute of Scientific and Technical Information of China (English)

    张世英; 张顺祥; AbdullahASM

    2001-01-01

    Objective: To compare the HIV/AIDS related knowledge,attitudes and pratices (KAP) among the commercial sex workers (CSWs) with that of their clients in Shenzhen. Methods: A total of 124 female CSWs and 155 men,detained for selling or purchasing sexual services, were interviewed using a structured questionnaire. Results: CSWs scored higher than their clients on AIDS/HIV knowledge scores, though the difference was not significant and both groups only scored near 50%. ""Almost always""condom use rates were significantly higher for CSWs. Most of the women but fewer men knew condom use could prevent HIV/AIDS infection. The main reason for not using condoms among the women was the unwillingness of their customers. A higher proportion of the CSWs (9.7%) than men (2.6%) had ever used illegal drugs. The mean age of first sexual intercourse (18.2±2.1) and first commercial sex (20.2±3.9)among the CSWs were lower than that of the men (22.2±0.3and 27.1 ± 0.6, respectively). Conclusion: New health education programs promoting condom use should be developed to raise awareness about HIV/AIDS, particularly among men. CSWs and clients are high-risk groups for HIV/AIDS infection and transmission.

  5. Comparison of visual performance of multifocal intraocular lenses with same material monofocal intraocular lenses.

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    Tomofusa Yamauchi

    Full Text Available PURPOSE: To compare the visual performance of multifocal intraocular lenses (IOLs and monofocal IOLs made of the same material. METHODS: The subjects included patients implanted with either Tecnis® monofocal IOLs (ZA9003 or ZCB00 or Tecnis® multifocal IOLs (ZMA00 or ZMB00 bilaterally. We conducted a retrospective study comparing the two types of IOLs. The multifocal group included 46 patients who were implanted with Tecnis® multifocal IOLs bilaterally. The monofocal group was an age- and sex-matched control group, and included 85 patients who were implanted with Tecnis® monofocal IOLs bilaterally. Lens opacity grading, the radius of corneal curvature, corneal astigmatism, axial length and the refractive status were measured preoperatively. Pupil size, ocular aberrometry, distance, intermediate and near visual acuity, contrast sensitivity with and without glare and the responses to a quality-of-vision questionnaire were evaluated pre- and postoperatively. RESULTS: The uncorrected near visual acuity was significantly better in the multifocal group, whereas both the corrected intermediate and near visual acuity were better in the monofocal group. Contrast sensitivity (with and without glare was significantly better in the monofocal group. The rate of spectacle dependency was significantly lower in the multifocal group. There were no significant differences between the two groups regarding most items of the postoperative quality-of-vision questionnaire (VFQ-25, with the exception that the patients in the monofocal group reported fewer problems with nighttime driving. CONCLUSIONS: The multifocal IOLs used in this study reduced spectacle dependency more so than monofocal IOLs and did not compromise the subjective visual function, with the exception of nighttime driving.

  6. Inner retinal contributions to the multifocal electroretinogram: patients with Leber's hereditary optic neuropathy (LHON). Multifocal ERG in patients with LHON.

    Science.gov (United States)

    Kurtenbach, Anne; Leo-Kottler, Beate; Zrenner, Eberhart

    2004-05-01

    In this study we examine the multifocal electroretinogram (mfERG) recorded from patients suffering from Leber's hereditary optic neuropathy (LHON), a degeneration of the ganglion cell and nerve fibre layers of the retina. We compared the mfERGs recorded from 11 patients with LHON, to those from 11 control subjects. The pattern ERG (PERG) was additionally performed with 9 of the patients. MfERGs were recorded and analysed using the VERIS 3.01 system with a stimulus of 103 equal-sized hexagons. For analysis, hexagons were grouped according to distance from the optic nerve head (ONH) and according to distance from the fovea. Two significant differences were found between the waveforms of the two groups: In the first order kernel, the control group showed a component around 34 ms that decreased with distance from the ONH. This component was reduced in the LHON group of subjects. In the second order (first slice) kernel, the patient group was missing features that decrease with distance from the fovea in the control group. PERG amplitudes showed a significant correlation with the amplitude of the second order mfERG kernel. The results show that the damage to ganglion cells and nerve fibres caused by LHON can be detected in mfERG recordings and indicate that activity from the inner retina can contribute significantly to first and second order waveforms.

  7. Lymphocyte transformation response to pokeweed mitogen as a predictive marker for development of AIDS and AIDS related symptoms in homosexual men with HIV antibodies

    DEFF Research Database (Denmark)

    Hofmann, B; Lindhardt, B O; Gerstoft, J

    1987-01-01

    To identify factors that may predict the development of the acquired immune deficiency syndrome (AIDS) or AIDS related symptoms various immunological measurements were studied in a group of homosexual men attending screening clinics for AIDS in Copenhagen. Fifty seven men whose ratio of T helper...

  8. The development of AIDS or AIDS-related conditions in a cohort of HIV antibody-positive homosexual men during a 3-year follow-up period

    DEFF Research Database (Denmark)

    Pedersen, C; Kolby, P; Sindrup, J

    1989-01-01

    One hundred and thirty-three homosexual men seropositive for the antibody against human immunodeficiency virus (HIV) were enrolled in a prospective study in 1984-85. The 3-year cumulative incidences of the acquired immunodeficiency syndrome (AIDS) and AIDS-related conditions, by life-table analyses...

  9. The unfinished nature of rights-informed HIV- and AIDS-related education: an analysis of three school-based initiatives

    NARCIS (Netherlands)

    E. Miedema; C. Maxwell; P. Aggleton

    2015-01-01

    Over the past 25 years, there has been growing investment in concepts of rights in the areas of HIV prevention, care and treatment, including HIV- and AIDS-related education delivered in schools. Despite this increasing commitment to the notion of rights, few efforts appear to have been made to unde

  10. The effect of treatment with zidovudine with or without acyclovir on HIV p24 antigenaemia in patients with AIDS or AIDS-related complex

    DEFF Research Database (Denmark)

    Pedersen, C; Cooper, D A; Brun-Vézinet, F;

    1992-01-01

    with AIDS, AIDS-related complex (ARC) or Kaposi's sarcoma (KS). DESIGN: Double-blind, placebo-controlled randomized clinical trial of less than or equal to 6 months' therapy. SETTING: Samples were obtained from patients attending teaching hospital outpatient clinics in seven European countries and Australia...

  11. Comparison of outcomes with multifocal intraocular lenses: a meta-analysis

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    Béatrice Cochener

    2011-01-01

    Full Text Available Béatrice Cochener1, Antoine Lafuma2, Babak Khoshnood2, Laurène Courouve2, Gilles Berdeaux3,41Centre Hospitalier Universitaire Brest, Brest, France; 2Cemka Eval, Bourg la Reine, France; 3Alcon France, Rueil-Malmaison, France; 4Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To compare the clinical outcome of different multifocal intraocular lenses (IOLs based on information reported in the international literature.Methods: All comparative clinical trials that involved implanting at least one multifocal IOL in patients with cataract or presbyopia were extracted from the literature. Clinical outcomes included uncorrected near visual acuity, uncorrected distance visual acuity, visual acuity, spectacle independence, and halos. Random effects meta-analyses were conducted to compare outcomes for the different IOL types.Results: Twenty papers were identified describing 11 monofocal IOLs and 35 multifocal IOLs (19 diffractive, including 12 ReSTOR®, 14 refractive, and two accommodative patient cohorts. Multifocal and monofocal uncorrected distance visual acuity was 0.165 (0.090–0.240 and 0.093 (0.088–0.098, respectively. Compared with monofocal IOLs, multifocal IOLs produced better uncorrected near visual acuity (0.470 [0.322–0.618] versus 0.141 [0.131–0.152]; P < 0.0001, resulting in higher spectacle independence (incidence rate ratio [IRR] 3.62 [2.90–4.52]; P < 0.0001. Compared with refractive multifocal IOLs, diffractive multifocal IOLs produced a similar uncorrected distance visual acuity (0.105 [0.098–0.111] versus 0.085 [0.029–0.140]; P ≤ 0.78, not significant and better uncorrected near visual acuity (0.217 [0.118–0.317] versus 0.082 [0.067–0.098]; P < 0.0001 resulting in higher spectacle independence (IRR 1.75 [1.24–2.48]; P < 0.001. Compared with other multifocal IOLs, ReSTOR produced a better uncorrected distance visual acuity (0.067 [0.059–0.076] versus 0.093 [0.088–0.098]; P < 0.0001 and better

  12. Sensitivity of imaging for multifocal-multicentric breast carcinoma

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    Viale Giuseppe

    2008-09-01

    Full Text Available Abstract Background This retrospective study aims to determine: 1 the sensitivity of preoperative mammography (Mx and ultrasound (US, and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC, defined by pathology on surgical specimens, and 2 to analyze the characteristics of both detected and undetected foci on Mx and US. Methods Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. Results Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive. Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%; scattered fibroglandular density in 40 (24.3%, heterogeneously dense in 91 (55.1% and dense in 31 (18.8% cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45

  13. Association between multifocal soft contact lens decentration and visual performance

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    Fedtke C

    2016-06-01

    Full Text Available Cathleen Fedtke,1 Klaus Ehrmann,1,2 Varghese Thomas,1 Ravi C Bakaraju1,2 1The Brien Holden Vision Institute, Clinical Trial Research Centre, 2School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia Purpose: The aim of this study was to assess the association between decentration of several commercial multifocal soft contact lenses (MFCLs and various objective and subjective visual performance variables in presbyopic and non-presbyopic participants. Materials and methods: All presbyopic (age >40 years, near add ≥+1.25 D and non-presbyopic (age ≥18 years, no near add requirements, spherical equivalent ≤-0.50 D participants were each fitted bilaterally with six and two MFCLs (test lens, respectively, and with one single vision lens (control lens. Lens decentration, ie, the x- and y-differences between the contact lens and pupil centers, was objectively determined. Third-order aberrations were measured and compared. Visual performance (high- and low-contrast acuities and several subjective variables was analyzed for any associations (Pearson’s correlation, r with MFCL decentration. Results: A total of 17 presbyopic (55.1±6.9 years and eight non-presbyopic (31.0±3.3 years participants completed the study. All lenses displayed a temporal–inferior decentration (x=-0.36±0.29 mm, y=-0.28±0.28 mm, mean ± SD. Compared to the control, a significant inferior decentration was found for the Proclear® MFCL Near lens in both groups (ypresbyopic =-0.26 mm, ynon-presbyopic =-0.70 mm and for the Proclear® MFCL Distance lens in the non-presbyopic group (ynon-presbyopic =-0.69 mm. In both groups, lens-induced vertical coma (C(3, -1 was, by at least tenfold, significantly more positive for the Proclear® MFCL Distance lens and significantly more negative for the Proclear® MFCL Near lens. In the presbyopic group, the correlation of total MFCL decentration with vision variables was weak (r<|0

  14. Utility of clinical assessment, imaging, and cryptococcal antigen titer to predict AIDS-related complicated forms of cryptococcal meningitis

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    Kandel Sean

    2010-08-01

    Full Text Available Abstract Background This study aimed to evaluate the prevalence and predictors of AIDS-related complicated cryptococcal meningitis. The outcome was complicated cryptococcal meningitis: prolonged (≥ 14 days altered mental status, persistent (≥ 14 days focal neurologic findings, cerebrospinal fluid (CSF shunt placement or death. Predictor variable operating characteristics were estimated using receiver operating characteristic curve (ROC analysis. Multivariate analysis identified independent predictors of the outcome. Results From 1990-2009, 82 patients with first episode of cryptococcal meningitis were identified. Of these, 14 (17% met criteria for complicated forms of cryptococcal meningitis (prolonged altered mental status 6, persistent focal neurologic findings 7, CSF surgical shunt placement 8, and death 5. Patients with complicated cryptococcal meningitis had higher frequency of baseline focal neurological findings, head computed tomography (CT abnormalities, mean CSF opening pressure, and cryptococcal antigen (CRAG titers in serum and CSF. ROC area of log2 serum and CSF CRAG titers to predict complicated forms of cryptococcal meningitis were comparable, 0.78 (95%CI: 0.66 to 0.90 vs. 0.78 (95% CI: 0.67 to 0.89, respectively (χ2, p = 0.95. The ROC areas to predict the outcomes were similar for CSF pressure and CSF CRAG titers. In a multiple logistic regression model, the following were significant predictors of the outcome: baseline focal neurologic findings, head CT abnormalities and log2 CSF CRAG titer. Conclusions During initial clinical evaluation, a focal neurologic exam, abnormal head CT and large cryptococcal burden measured by CRAG titer are associated with the outcome of complicated cryptococcal meningitis following 2 weeks from antifungal therapy initiation.

  15. HIV/AIDS-related stigma and discrimination: accounts of HIV-positive Caribbean people in the United Kingdom.

    Science.gov (United States)

    Anderson, Moji; Elam, Gillian; Gerver, Sarah; Solarin, Ijeoma; Fenton, Kevin; Easterbrook, Philippa

    2008-09-01

    This paper explores the effects of HIV/AIDS-related stigma and discrimination (HASD) on HIV-positive Caribbean people in the Caribbean and the UK. In-depth, semi-structured interviews were held with a purposively selected group of 25 HIV-positive people of Caribbean origin, using primary selection criteria of sex, age, sexuality and country of birth. Interviews with respondents revealed that they are keenly aware of the stigma surrounding HIV/AIDS, which some attribute to a particularly Caribbean combination of fear of contamination, homophobia, and ignorance, reinforced by religious beliefs. In fact, religion serves a double role: underpinning stigma and assisting in coping with HIV. HASD has usually occurred where respondents have lost or do not have control over disclosure. Compared to UK-born respondents, the accounts of Caribbean-born respondents, most of whom were born in Jamaica, include more reports of severe HASD, particularly violence and employment discrimination. All respondents mobilise a variety of strategies in order to avoid HASD, which have implications for their social interactions and emotional well being. While some manage to avoid the "spoiled identity" of the stigmatised, thereby creating their own understandings of HIV infection, these may remain individual-level negotiations. HASD affects HIV-positive Caribbean people at home and in the diaspora in a variety of ways: emotionally, mentally, financially, socially and physically. Interventions specifically addressing stigma and discrimination must be formulated for the UK's Caribbean population. Tackling stigma and discrimination requires more than education; it requires "cultural work" to address deeply entrenched notions of sexuality.

  16. Primary pulmonary AIDS-related lymphoma Linfoma primario de pulmón en un paciente con sida

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    Marcelo Corti

    2005-08-01

    Full Text Available Extranodal involvement is common in lymphomas associated with human immunodeficiency virus infection (HIV and acquired immunodeficiency syndrome (AIDS. However, primary pulmonary AIDS-related non-Hodgkin's lymphoma is very rare and only few reports were published in the medical literature. Clinical presentation is nonspecific, with "B" and respiratory symptoms. Also, patients were with advanced immunodeficiency at the time of diagnosis. Generally, chest radiography showed peripheral nodules or cavitary masses. Primary pulmonary lymphoma associated with AIDS is generally a high-grade B-cell non-Hodgkin lymphoma and Epstein-Barr virus is strongly associated with the pathogenesis of these tumors. We report a patient with AIDS and primary pulmonary lymphoma which clinical presentation was a total atelectasis of the left lung.El compromiso extranodal es frecuente en los linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana y su consecuencia, el síndrome de inmunodeficiencia adquirida. Sin embargo, el linfoma pulmonar primario es muy raro y solo existen pocos casos publicados en la literatura. La presentación clínica de esta complicación es inespecífica, con síntomas "B" y manifestaciones respiratorias. Generalmente, la radiografía de tórax muestra nódulos periféricos o masas que pueden cavitarse y los pacientes presentan inmunodeficiencia severa al momento del diagnóstico. El linfoma pulmonar primario asociado con el sida es un tumor de alto grado, de células B y asociado en su patogenia con el virus de Epstein-Barr. Se relata un caso de linfoma primario de pulmón que se presentó bajo la forma radiológica de una atelectasia global del pulmón izquierdo.

  17. Ultrasound screening of multifocal atherosclerosis: markers for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Lachezar Grozdinski; Mario Stankev; Alexander Doganov

    2009-01-01

    Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening for MFA in patients with coronary atherosclerosis and make evaluation of the sensitivity and significance of different atherosclerosis markers. Methods Using Color Dupplex Ultrasound (CDU), we studied 32 clinically healthy persons and 87 patients of the city of B with clinical data for CHD where we also performed coronarography. Results In patients with coronary atherosclerosis we found high frequency of carotid atherosclerosis (93%) and peripheral artery disease (PAD) (81%). We established verifiable thickening of the intima-media (IMT) of the common carotid artery (CCA) and common femoral artery (CFA) in patients with CHD. There is a correlation between the frequency of carotid and femoral stenoses and CHD proven by coronarography. Patients with CHD had a high relative risk to develop carotid (RR = 5) and peripheral atherosclerosis (RR=3.5) and high frequency of asymptomatic stenoses and thromboses of the internal carotid artery (86.9%) and femoral artery (78.3%), as well as aneurisms of the abdominal aorta (8.1%). Markers for CAD with high sensitivity were the atherosclerotic plaques of ICA (0.93) and CFA (0.81) as well as IMT of the CFA (0.84). Conclusions MFA are common among patients with CHD. Ultrasound diagnosis is the method of choice for simultaneous non-invasive screening of carotid, peripheral and MFA and provides sensitive markers for coronary atherosclerosis. The most sensitive and specific markers for CHD are the combination of the IMT and atherosclerotic plaques of CCA, ICA and CFA (100% sensitivity and 0.92 specificity).

  18. Conservative surgery for multifocal/multicentric breast cancer.

    Science.gov (United States)

    Nijenhuis, Matthijs V; Rutgers, Emiel J Th

    2015-11-01

    Multifocal (MF) and multicentric (MC) breast cancer is regularly considered a relative contraindication for breast-conserving therapy (BCT). There are two reasons for this wide spread notion: However, we concur that if optimal 'cytoreductive surgery' is achieved this will result in good local control (i.e. in-breast relapse breast irradiation and systemic treatments as indicated by primary cancer biology. Careful planning and adaptive application of oncoplastic techniques will result in an optimal cosmetic results. The meticulous work of Roland Holland and coworkers(1) in the early 1980's on whole breast specimen showed invasive foci at more then 2 cm distance from the invasive primary cancer in more then 40% of specimen. Although multiple tumor foci may occur in up to 60% of mastectomy specimens, equivalent survival outcomes were observed in prospective trials comparing BCT and mastectomy for clinically unifocal lesions, suggesting that the majority of these foci are not, or do not become, biologically relevant or clinically significant with appropriate treatment. As diagnostic tools advance, MF and MC tumors are more commonly diagnosed. Cancers that previously would have been classified as unifocal now can be detected as MF or MC. In addition, locoregional treatment modalities have improved significantly over the past decade. More recent studies reflect these advances in diagnosis and treatment. Studies evaluated staging MRI showed that up to 19% of woman with diagnosed breast cancer harbor a second malignant ipsilateral lesion. These findings should only have consequences when additional lesions are proven cancer. Multiple enhancing lesions on MRI are in itself not an indication for a mastectomy. The Z0011 trial and the AMAROS trial demonstrated a similar phenomenon for axillary treatment; less surgery does not necessarily lead to inferior local control or survival outcomes. Recent studies supplement the growing evidence that treatment of patients with MF

  19. A mutation in the canine BHD gene is associated with hereditary multifocal renal cystadenocarcinoma and nodular dermatofibrosis in the German Shepherd dog

    NARCIS (Netherlands)

    Lingaas, F; Comstock, KE; Kirkness, EF; Sorensen, A; Aarskaug, T; Hitte, C; Nickerson, ML; Moe, L; Schmidt, LS; Thomas, R; Breen, M; Galibert, F; Zbar, B; Ostrander, EA

    2003-01-01

    Hereditary multifocal renal cystadenocarcinoma and nodular dermatofibrosis (RCND) is a naturally occurring canine kidney cancer syndrome that was originally described in German Shepherd dogs. The disease is characterized by bilateral, multifocal tumors in the kidneys, uterine leiomyomas and nodules

  20. Multifocal Inflammatory Leukoencephalopathy Induced by Accidental Consumption of Levamisole: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Ghanbari

    2012-01-01

    Full Text Available Levamisole is an anthelmintic agent and also immunostimulant drug which is used to treat colorectal cancer. The present study aimed to show accidental consumption of levamisole alone induced multifocalinflammatory leukoencephalopathy. A 53-year-old male was admitted to the Neurology Department of Farabi Hospital(Kermanshah, Iran with walking inability and recognition disorder. Following clinical examinations, the patient diagnosed as multifocal inflammatory leukoencephalopathy following levamisole consumption.The patient was treated with intravenous methylprednisolone followed by prednisolone. The magnetic resonance imaging (MRI was done 1 month later and did not show a reduction or remission in the lesions. History of the patient showed that he had accidentally consumed levamisole 8 months ago. It seems that the consumption of levamisole can induce multifocal inflammatory leukoencephalopathy and delayed treatment of the patient with corticosteroid cannot diminish the neurotoxicity of levamisole. In addition, the cytotoxic dose of levamisole induces irreversible multifocal inflammatory leukoencephalopathy.

  1. Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing

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    Arai H

    2014-04-01

    Full Text Available Haruka Arai,1 Tsutomu Sakai,1 Kiichiro Okano,1 Ranko Aoyagi,1 Ayano Imai,2 Hiroshi Takase,2 Manabu Mochizuki,2 Hiroshi Tsuneoka11Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, JapanAbstract: Central retinal artery occlusion (CRAO and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of the left eye showed a swollen optic disc and sheathing of the retinal artery with a dense vitreous haze and a white retinal lesion. Serum anti-toxoplasma antibodies were positive in a latex agglutination assay. Vitrectomy was performed to improve visualization of the retinal lesions and for examination of causative microorganisms. A postoperative fundus examination revealed CRAO with optic disc involvement and multifocal retinitis with perivascular sheathing. Qualitative multiplex polymerase chain reaction detected the Toxoplasma gondii B1 gene in ocular fluid from both the aqueous and vitreous humor. The presumed diagnosis of ocular toxoplasmosis was made and treatment was started with prednisone and acetylspiramycin with subsequent improvement. Two months later, the patient developed active retinochoroiditis in the left eye. After 6 weeks of anti-toxoplasma therapy, the disease involuted. Retinal vascular occlusions and multifocal retinitis with perivascular sheathing are rare in toxoplasmosis. This is the first case report of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. The diagnosis of ocular toxoplasmosis should be considered in patients with retinal artery occlusions and multifocal retinitis with perivascular sheathing associated with inflammation.Keywords: ocular toxoplasmosis, toxoplasma retinochoroiditis

  2. HIV/aids related home based care practices among primary health care workers in Ogun state, Nigeria

    Directory of Open Access Journals (Sweden)

    E Amoran

    2012-05-01

    Full Text Available Abstract Background HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria. Methods This study is an analytical cross-sectional study. A multistage cluster sampling technique was used to obtain a representative sample of the primary health care workers in Ogun state. An interviewer administered structured questionnaire was administered by trained health workers to elicit the required information. Result A total of 350 health care workers were interviewed, 70% of the respondents could adequately describe the components of home based care. Only 38.7% were aware of the National guideline on home based care practices and 17.1% believe that home based care will not significantly improve the prognosis of PLWAs. Few 19.1% had ever been trained or ever involved 16.6% in home based care practices. Only 20 [5.7%] are involved on a weekly basis, 16 [4.6%] monthly and 22 [6.3%] quarterly. Reasons given for non implementation of home based care are inadequate number of healthcare workers 45%, lack of political will 24.4%, lack of implementation by facility managers 14% and inadequate funds 16.6%. Factors that were significantly associated with the practice of home based care were perception of its relevance in improving prognosis [OR = 54.21, C.I = 23.22-129.52] and presence of a support group in the facility [OR = 4.80, C.I = 2.40-9.57]. There was however no statistically significant relationship between adequate knowledge of home based care [OR = 0.78, C.I = 0.39-1.54] and previous training on home based care (OR = 1.43, C.I = 0.66-3.06]. Conclusion The practice of home based care for HIV/AIDS among the study population is low

  3. Multifocal fibrosclerosis: a new case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Kader Karli; Oguz, Oguzhan; Cila, Aysenur; Oto, Aytekin [Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Kiratli, Hayyam [Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Gokoz, Aytac [Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara (Turkey)

    2002-05-01

    A case of multifocal fibrosclerosis is presented with MR images. Bilateral sclerosing orbital pseudotumor invading cavernous sinuses were the presenting disorder. Magnetic resonance imaging showed involvement of paranasal sinuses bilaterally and multiple supratentorial dural masses. Retroperitoneal fibrosis was associated with the condition. Multifocal involvement should be considered in patients with sclerosing orbital pseudotumor and an imaging approach should be performed on the appropriate clinical condition to document possible coexistence of other disorders including retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and Riedel's thyroiditis (orig.)

  4. Multifocal gastrointestinal stromal tumor (GIST) of the stomach in an 11-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin [University of North Carolina Hospitals, Department of Radiology, Chapel Hill, NC (United States); Rubinas, Tara C. [University of North Carolina Hospitals, Department of Pathology, Chapel Hill, NC (United States); Fordham, Lynn A. [University of North Carolina School of Medicine, Department of Radiology, Chapel Hill, NC (United States); Phillips, J.D. [University of North Carolina School of Medicine, Department of Surgery, Division of Pediatric Surgery, Chapel Hill, NC (United States)

    2006-11-15

    A previously healthy 11-year-old girl presented with an 8-month history of anemia and left upper quadrant abdominal pain. US examination demonstrated a 9-cm cystic mass with a fluid-fluid level in the left upper quadrant with unclear organ of origin. Abdominal MR imaging demonstrated a complex cystic mass, likely arising from the stomach. Additional T2 hyperintense submucosal lesions were identified in the gastric wall. Surgical excision confirmed the diagnosis of multifocal gastric gastrointestinal stromal tumor (GIST). MR imaging was helpful in suggesting a gastric origin of the primary mass and in demonstrating multifocal disease within the stomach. (orig.)

  5. Inadvertent implantation of a reversed-optic Tecnis ZM900 multifocal intraocular lens: case report Implante invertido da lente intraocular Tecnis ZM900 multifocal: relato de caso

    Directory of Open Access Journals (Sweden)

    Wilson Takashi Hida

    2012-12-01

    Full Text Available A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.Paciente de 51 anos, sexo feminino, apresentando catarata foi submetida a cirurgia de facoemulsificação com implante de lente intraocular (LIO multifocal Tecnis ZM900 em ambos os olhos (AO. Durante a implantação da LIO no olho esquerdo, a lente foi inadvertidamente implantada invertida e deixada dessa maneira. Seis meses pós-operatório a surpresa refracional não se mostrou significativa e a acuidade visual corrigida era de 20/20 em AO, sem nenhuma queixa de desconforto visual. Em conclusão, no presente caso, o implante de uma LIO Tecnis multifocal invertida resultou em boa acuidade visual final e sem diferenças significativas na aberrometria em comparação ao olho contralateral, tendo sido possível conduzir o caso de maneira conservadora.

  6. Risk stratification for progressive multifocal leukoencephalopathy in patients treated with natalizumab

    DEFF Research Database (Denmark)

    Sørensen, Per Soelberg; Bertolotto, Antonio; Edan, Gilles

    2012-01-01

    virus (JCV). We searched PubMed and used current data from the natalizumab global safety database to assess risk factors and quantify the risk of PML. Natalizumab treatment duration and prior use of immunosuppressive therapies are established risk factors for development of PML in natalizumab...

  7. Modeling probability of additional cases of natalizumab-associated JCV sero-negative progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Carruthers, Robert L; Chitnis, Tanuja; Healy, Brian C

    2014-05-01

    JCV serologic status is used to determine PML risk in natalizumab-treated patients. Given two cases of natalizumab-associated PML in JCV sero-negative patients and two publications that question the false negative rate of the JCV serologic test, clinicians may question whether our understanding of PML risk is adequate. Given that there is no gold standard for diagnosing previous JCV exposure, the test characteristics of the JCV serologic test are unknowable. We propose a model of PML risk in JCV sero-negative natalizumab patients. Using the numbers of JCV sero-positive and -negative patients from a study of PML risk by JCV serologic status (sero-positive: 13,950 and sero-negative: 11,414), we apply a range of sensitivities and specificities in order calculate the number of JCV-exposed but JCV sero-negative patients (false negatives). We then apply a range of rates of developing PML in sero-negative patients to calculate the expected number of PML cases. By using the binomial function, we calculate the probability of a given number of JCV sero-negative PML cases. With this model, one has a means to establish a threshold number of JCV sero-negative natalizumab-associated PML cases at which it is improbable that our understanding of PML risk in JCV sero-negative patients is adequate.

  8. Fatal Progressive Multifocal Leukoencephalopathy in a Kidney Transplant Recipient 19 Years After Successful Renal Allograft Transplantation

    DEFF Research Database (Denmark)

    Carlson, N; Hansen, Jesper Melchior

    2014-01-01

    in circumstances of extreme immunodeficiency. Development of fulminant PML is rare and treatment options are limited. CASE REPORT: We have presented a case of JCV reactivation resulting in PML 19 years after renal allograft transplantation and after recent conversion of immunosuppressive treatment. One year after...

  9. Validity and Reliability of Persian Version of HIV/AIDS Related Stigma Scale for People Living With HIV/AIDS in Iran

    Directory of Open Access Journals (Sweden)

    Davoud Pourmarzi

    2016-04-01

    Full Text Available Objective: To assess the perceived HIV/AIDS related stigma a comprehensive and well developed stigma instrument is necessary. This study aimed to assess validity and reliability of the Persian version of HIV/AIDS related stigma scale which was developed by Kang et al for people living with HIV/AIDS in Iran.Materials and methods: Thescale was forward translatedby two bilingual academic members then both translations were discussed by expert team. Back-translation was done by two other bilingual translators then we carried out discussion with both of them. To evaluate understandability the scale was administered to 10 Persons Living with HIV/AIDS (PLWHA. Final Persian version was administered to 80 PLWHA in Qom, Iran in 2014. Test–retest reliability was assessed in a sample of 20 PLWHA after a week by intra-class correlation coefficient (ICC.Results: Cronbach’s alpha coefficient for overall scale was 0.85. Also Cronbach’s alpha coefficients for the five subscales were as follows: social rejection (9 items, α = 0.84, negative self-worth (4 items, α = 0.70, perceived interpersonal insecurity (2 items, α = 0.57, financial insecurity (3 items, α = 0.70, discretionary disclosure (2 items, α = 0.83. Test–retest reliability was also approved with ICC = 0.78. Correlation between items and their hypothesized subscale is greater than 0.5. Correlation between an item and its own subscale was significantly higher than its correlation with other subscales.Conclusion: This study demonstrate that the Persian version of HIV/AIDS related stigma scale is valid and reliable to assess HIV/AIDS related stigma perceived by people living whit HIV/AIDS in Iran.

  10. Objective visual field determination in forensic ophthalmology with an optimized 4-channel multifocal VEP perimetry system: a case report of a patient with retinitis pigmentosa.

    Science.gov (United States)

    Kaltwasser, C; Horn, F K; Kremers, J; Juenemann, A; Bergua, A

    2011-10-01

    We present the case of a 59-year-old male patient with progressive vision impairment and consecutive visual field narrowing ("tunnel view") for 7 years and a known retinitis pigmentosa for 5 years. The remaining Goldmann perimetric visual field at time reported was less than 5°. A request for blindness-related social benefits was rejected because an ophthalmologic expert assessment suggested malingering. This prompted us to assess an objective determination of the visual field using multifocal VEPs. Objective visual field recordings were performed with a four-channel multifocal VEP-perimeter using 58 stimulus fields (pattern reversal dartboard stimulus configuration). The correlated signal data were processed using an off-line method. At each field, the recording from the channel with the maximal signal-to-noise ratio (SNR) was retained, thus resulting in an SNR optimized virtual recording. Analysis of VEP signals was performed for each single field and concentric rings and compared to an average response measured in five healthy subjects. Substantial VEP responses could be identified in three fields within the innermost ring (eccentricity, 1.7°) for both eyes, although SNR was generally low. More eccentric stimuli did not elicit reliable VEP responses. The mfVEP recording was correlated with perimetric visual field data. The current SNR optimization by using the channel with the largest SNR provides a good method to extract useful data from recordings and may be appropriate for the use in forensic ophthalmology.

  11. Right ventricular lipomatous mass and biventricular multifocal fat in a young woman: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo Rahm; Park, Jae Hyeong; Ahn, Kye Taek; Kim, Song Soo; Jeong, Jin Ok; Choi, Si Wan; Jin, Seon Ah; Lee, Jae Hwan [Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of)

    2015-04-15

    Cardiac lipoma is a rare neoplasm of encapsulated mature adult adipose tissue. It is usually asymptomatic, but it may be related to hemodynamic obstruction depending on its location. We report a typical case of right ventricular lipomatous mass and multifocal fat infiltration of both ventricles, which were detected incidentally in a young woman.

  12. European Federation of Neurological Societies Peripheral Nerve Society guideline on management of multifocal motor neuropathy

    NARCIS (Netherlands)

    I.N. van Schaik; P. Bouche; I. Illa; J.M. Leger; P. van den Bergh; D.R. Cornblath; E.M.A. Evers; R.D.M. Hadden; R.A.C. Hughes; C.L. Koski; E. Nobile-Orazio; J. Pollard; C. Sommer; P.A. van Doorn

    2006-01-01

    Several diagnostic criteria for multifocal motor neuropathy have been proposed in recent years and a beneficial effect of intravenous immunoglobulin (IVIg) and various other immunomodulatory drugs has been suggested in several trials and uncontrolled studies. The objectives were to prepare consensus

  13. Clinical developments in Multifocal Intraocular Lens Surgery: The ease of being specs-free

    NARCIS (Netherlands)

    van der Linden, J.W.

    2016-01-01

    In multifocal IOL implantation the aim is to achieve a high level of spectacle independence for all vision distances. Many types of mIOLs have been invented and implemented. Data on the performance of these different types of mIOLs comes from the medical devices industry at the time of launch, and f

  14. Genome-wide Investigation of multifocal and unifocal prostate cancer-are they Genetically different?

    NARCIS (Netherlands)

    C. Ibeawuchi (Chinyere); H. Schmidt (Hartmut); R. Voss (Reinhard); A. Titze (Anja); M. Abbas (Mahmoud); J. Neumann (Joerg); E. Eltze (Elke); A.M. Hoogland (Marije); G.W. Jenster (Guido); B. Brandt (Burkhard); A. Semjonow (Axel)

    2013-01-01

    textabstractProstate cancer is widely observed to be biologically heterogeneous. Its heterogeneity is manifested histologically as multifocal prostate cancer, which is observed more frequently than unifocal prostate cancer. The clinical and prognostic significance of either focal cancer type is not

  15. Exploring the methods of data analysis in multifocal visual evoked potentials

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; De Santiago, L; Fraser, C

    2016-01-01

    PURPOSE: The multifocal visual evoked potential (mfVEP) provides a topographical assessment of visual function, which has already shown potential for use in patients with glaucoma and multiple sclerosis. However, the variability in mfVEP measurements has limited its broader application. The purpose...

  16. Late hemodynamic failure following percutaneous transluminal angioplasty for long and multifocal femoropopliteal stenoses

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Holstein, P

    1991-01-01

    The outcome of percutaneous transluminal angioplasty (PTA) was evaluated for treatment of 87 limbs with femoropopliteal stenoses, including 55 short stenoses (2.4 +/- 1.6 cm, mean +/- SD), seven single long stenoses (10.4 +/- 2.0 cm), and 25 multifocal stenoses (2.1 +/- 1.6 cm), where two to four...

  17. Velopharyngeal incompetence in a patient with multifocal eosinophilic granuloma (Hand-Schüller-Christian disease).

    Science.gov (United States)

    Cohn, E R; Garver, K L; Metz, H C; McWilliams, B J; Skolnick, M L; Garrett, W S

    1982-08-01

    The diagnosis and management of velopharyngeal insufficiency in a 16-year-old boy with multifocal eosinophilic granuloma (Hand-Schüller-Christian disease) is described. Medical history, speech and velopharyngeal valving information, and the results of clinical management are presented.

  18. Multifocal acquired demyelinating sensory and motor neuropathy: the Lewis-Sumner syndrome.

    Science.gov (United States)

    Saperstein, D S; Amato, A A; Wolfe, G I; Katz, J S; Nations, S P; Jackson, C E; Bryan, W W; Burns, D K; Barohn, R J

    1999-05-01

    We report 11 patients with multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy, defined clinically by a multifocal pattern of motor and sensory loss, with nerve conduction studies showing conduction block and other features of demyelination. The clinical, laboratory, and histological features of these patients were contrasted with those of 16 patients with multifocal motor neuropathy (MMN). Eighty-two percent of MADSAM neuropathy patients had elevated protein concentrations in the cerebrospinal fluid, compared with 9% of the MMN patients (P < 0.001). No MADSAM neuropathy patient had elevated anti-GM1 antibody titers, compared with 56% of MMN patients (P < 0.01). In contrast to the subtle abnormalities described for MMN, MADSAM neuropathy patients had prominent demyelination on sensory nerve biopsies. Response to intravenous immunoglobulin treatment was similar in both groups (P = 1.0). Multifocal motor neuropathy patients typically do not respond to prednisone, but 3 of 6 MADSAM neuropathy patients improved with prednisone. MADSAM neuropathy more closely resembles chronic inflammatory demyelinating polyneuropathy and probably represents an asymmetrical variant. Given their different clinical patterns and responses to treatment, it is important to distinguish between MADSAM neuropathy and MMN.

  19. Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy

    NARCIS (Netherlands)

    Cats, E. A.; van der Pol, W. -L.; Piepers, S.; Franssen, H.; Jacobs, B. C.; van den Berg-Vos, R. M.; Kuks, J. B.; van Doorn, P. A.; van Engelen, B. G.; Verschuuren, J. J.; Wokke, J. H.; Veldink, J. H.; van den Berg, L. H.

    2010-01-01

    Objective: Identification and examination of all patients with multifocal motor neuropathy (MMN) in the Netherlands to document the clinical spectrum and response to IV immunoglobulin (IVIg) and to determine correlates of outcome. Methods: A national cross-sectional descriptive study was performed.

  20. Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy

    NARCIS (Netherlands)

    Cats, E.A.; Pol, W.L. van der; Piepers, S.; Franssen, H.; Jacobs, B.C.; Berg-Vos, R.M. van den; Kuks, J.B.M.; Doorn, P.A. van; Engelen, B.G.M. van; Verschuuren, J.J.; Wokke, J.H.J.; Veldink, J.H.; Berg, L.H. van den

    2010-01-01

    OBJECTIVE: Identification and examination of all patients with multifocal motor neuropathy (MMN) in the Netherlands to document the clinical spectrum and response to IV immunoglobulin (IVIg) and to determine correlates of outcome. METHODS: A national cross-sectional descriptive study was performed.

  1. Contactin-1 and Neurofascin-155/-186 Are Not Targets of Auto-Antibodies in Multifocal Motor Neuropathy.

    Directory of Open Access Journals (Sweden)

    Kathrin Doppler

    Full Text Available Multifocal motor neuropathy is an immune mediated disease presenting with multifocal muscle weakness and conduction block. IgM auto-antibodies against the ganglioside GM1 are detectable in about 50% of the patients. Auto-antibodies against the paranodal proteins contactin-1 and neurofascin-155 and the nodal protein neurofascin-186 have been detected in subgroups of patients with chronic inflammatory demyelinating polyneuropathy. Recently, auto-antibodies against neurofascin-186 and gliomedin were described in more than 60% of patients with multifocal motor neuropathy. In the current study, we aimed to validate this finding, using a combination of different assays for auto-antibody detection. In addition we intended to detect further auto-antibodies against paranodal proteins, specifically contactin-1 and neurofascin-155 in multifocal motor neuropathy patients' sera. We analyzed sera of 33 patients with well-characterized multifocal motor neuropathy for IgM or IgG anti-contactin-1, anti-neurofascin-155 or -186 antibodies using enzyme-linked immunosorbent assay, binding assays with transfected human embryonic kidney 293 cells and murine teased fibers. We did not detect any IgM or IgG auto-antibodies against contactin-1, neurofascin-155 or -186 in any of our multifocal motor neuropathy patients. We conclude that auto-antibodies against contactin-1, neurofascin-155 and -186 do not play a relevant role in the pathogenesis in this cohort with multifocal motor neuropathy.

  2. Wavefront analysis and modulation transfer function of three multifocal intraocular lenses

    Directory of Open Access Journals (Sweden)

    Santhiago Marcony

    2010-01-01

    Full Text Available Purpose: To evaluate wavefront performance and modulation transfer function (MTF in the human eye after the implantation of diffractive or refractive multifocal intraocular lenses (IOLs. Materials and Methods: This was a prospective, interventional, comparative, nonrandomized clinical study. Uncorrected distance and near visual acuity, and wavefront analysis including MTF curves (iTrace aberrometer, Tracey Technologies, Houston, TX, USA were measured in 60 patients after bilateral IOL implantation with 6 months of follow-up. Forty eyes received the diffractive ReSTOR (Alcon, 40 eyes received the refractive ReZoom (Advanced Medical Optics and 40 eyes, the Tecnis ZM900 (Advanced Medical Optics. The comparison of MTF and aberration between the intraocular lenses was performed using analysis of variance (ANOVA, followed by the Dunn test when necessary. Results: The mean uncorrected distance visual acuity was similar in all three groups of multifocal IOLs. The ReSTOR group provided better uncorrected near visual acuity than the ReZoom group ( P < 0.001, but similar to the Tecnis group. Spherical aberration was significantly higher in the ReZoom group ( P = 0.007. Similar MTF curves were found for the aspheric multifocal IOL Tecnis and the spheric multifocal IOL ReSTOR, and both performed better than the multifocal IOL ReZoom in a 5 mm pupil ( P < 0.001 at all spatial frequencies. Conclusions: Diffractive IOLs studied presented similar MTF curves for a 5 mm pupil diameter. Both diffractive IOLs showed similar spherical aberration, which was significantly better with the full-diffractive IOL Tecnis than with the refractive IOL ReZoom.

  3. Short-term visual performance of soft multifocal contact lenses for presbyopia

    Directory of Open Access Journals (Sweden)

    Jennifer Sha

    2016-04-01

    Full Text Available ABSTRACT Purpose: To compare visual acuity (VA, contrast sensitivity, stereopsis, and subjective visual performance of Acuvue® Oasys® for Presbyopia (AOP, Air Optix® Aqua Multifocal (AOMF, and Air Optix® Aqua Single Vision (AOSV lenses in patients with presbyopia. Methods: A single-blinded crossover trial was conducted. Twenty patients with mild presbyopia (add ≤+1.25 D and 22 with moderate/severe presbyopia (add ≥+1.50 D who wore lenses bilaterally for 1 h, with a minimum overnight washout period between the use of each lens. Measurements included high- and low-contrast visual acuity (HCVA and LCVA, respectively at a distance, contrast sensitivity (CS at a distance, HCVA at intermediate (70 cm and near (50 cm & 40 cm distances, stereopsis, and subjective questionnaires regarding vision clarity, ghosting, overall vision satisfaction, and comfort. The test variables were compared among the lens types using repeated-measures ANOVA. Results: Distance variables (HCVA, LCVA, and CS were significantly worse with multifocal lens than with AOSV lens (p≤0.008, except for AOMF lens in the mild presbyopia group in which no significant difference was observed (p>0.05. Multifocal lenses had significantly greater HCVA at 40 cm than AOSV lens (p≤0.026. AOMF lens had greater intermediate HCVA than AOP lens (p0.05. The proportions of patients willing to buy AOSV, AOMF, and AOP lenses were 20%, 40%, and 50%, respectively, in the mild presbyopia group and 14%, 32%, and 23%, respectively, in the moderate/severe presbyopia group; however, these differences were not statistically significant (p≥0.159. Conclusions: Further development of multifocal lenses is required before significant advantages of multifocal lenses over single vision lens are observed in patients with presbyopia.

  4. Impact of Interventions Targeting Unhealthy Alcohol Use in Kenya on HIV Transmission and AIDS-Related Deaths

    OpenAIRE

    Braithwaite, R. Scott; Nucifora, Kimberly A; KESSLER, Jason; Toohey, Christopher; Mentor, Sherry M; Uhler, Lauren M.; Roberts, Mark S.; Bryant, Kendall

    2014-01-01

    Background HIV remains a major cause of preventable morbidity and mortality in Kenya. The effects of behaviors that accompany unhealthy alcohol consumption are a pervasive risk factor for HIV transmission and progression. Our objective was to estimate the portion of HIV infections attributable to unhealthy alcohol use and to evaluate the impact of hypothetical interventions directed at unhealthy alcohol use on HIV infections and deaths. Methods We estimated outcomes over a time horizon of 20 ...

  5. Targeting multiple signaling pathways as a strategy for managing prostate cancer: multifocal signal modulation therapy.

    Science.gov (United States)

    McCarty, Mark F

    2004-12-01

    The aberrant behavior of cancer reflects upregulation of certain oncogenic signaling pathways that promote proliferation, inhibit apoptosis, and enable the cancer to spread and evoke angiogenesis. Theoretically, it should be feasible to decrease the activity of these pathways-or increase the activity of pathways that oppose them-with noncytotoxic agents. Since multiple pathways are dysfunctional in most cancers, and cancers accumulate new oncogenic mutations as they progress, the greatest and most durable therapeutic benefit will likely be achieved with combination regimens that address several targets. Thus, a multifocal signal modulation therapy (MSMT) of cancer is proposed. This concept has already been documented by researchers who have shown that certain combinations of signal modulators-of limited utility when administered individually-can achieve dramatic suppression of tumor growth in rodent xenograft models. The present essay attempts to guide development of MSMTs for prostate cancer. Androgen ablation is a signal-modulating measure already in standard use in the management of delocalized prostate cancer. The additional molecular targets considered here include the type 1 insulin-like growth factor receptor, the epidermal growth factor receptor, mammalian target of rapamycin, NF-kappaB, hypoxia-inducible factor-1alpha, hsp90, cyclooxygenase-2, protein kinase A type I, vascular endothelial growth factor, 5-lipoxygenase, 12-lipoxygenase, angiotensin II receptor type 1, bradykinin receptor type 1, c-Src, interleukin-6, ras, MDM2, bcl-2/bclxL, vitamin D receptor, estrogen receptor-beta, and PPAR-. Various nutrients and phytochemicals suspected to have potential utility in prostate cancer prevention and therapy, but whose key molecular targets are still unknown, might reasonably be incorporated into MSMTs for prostate cancer; these include lycopene, selenium, green tea polyphenols, genistein, and silibinin. MSMTs can be developed systematically by testing

  6. Geographical mapping of a multifocal thyroid tumour using genetic alteration analysis & miRNA profiling

    Directory of Open Access Journals (Sweden)

    Li Jing

    2008-12-01

    Full Text Available Abstract Background Papillary thyroid carcinoma (PTC frequently presents as multiple tumour-foci within a single thyroid gland or pluriform, with synchronous tumours comprising different histological variants, raising questions regarding its clonality. Among the genetic aberrations described in PTC, the BRAF V600E mutation and ret/PTC activation occur most commonly. Several studies have investigated the genetic alteration status of multifocal thyroid tumours, with discordant results. To address the question of clonality this study examined disparate geographical and morphological areas from a single PTC (classic PTC, insular and anaplastic foci, and tumour cells adjacent to vascular invasion and lymphocytic infiltrate for the presence of ret/PTC 1 or BRAF mutations. Moreover, we wanted to investigate the consistency of miRNA signatures within disparate areas of a tumour, and geographical data was further correlated with expression profiles of 330 different miRNAs. Putative miRNA gene targets were predicted for differentially regulated miRNAs and immunohistochemistry was performed on tissue sections in an effort to investigate phenotypic variations in microvascular density (MVD, and cytokeratin and p53 protein expression levels. Results All of the morphological areas proved negative for ret/PTC 1 rearrangement. Two distinct foci with classic morphology harboured the BRAF mutation. All other regions, including the insular and anaplastic areas were negative for the mutation. MiRNA profiles were found to distinguish tumours containing the BRAF mutation from the other tumour types, and to differentiate between the more aggressive insular & anaplastic tumours, and the classic variant. Our data corroborated miRNAs previously discovered in this carcinoma, and additional miRNAs linked to various processes involved in tumour growth and proliferation. Conclusion The initial genetic alteration analysis indicated that pluriform PTC did not necessarily evolve

  7. Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Wu, Zunyou; Lin, Chunqing; Wen, Yi

    2009-01-01

    This study examined HIV/AIDS-related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor-nurse ratio of each hospital or clinic. Lab technicians were over-sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV-related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs. Cette étude a examiné le VIH/SIDA lié à stigmatisation parmi les agences chinoises fournissant des soins en comparant leurs attitudes

  8. Effect of media use on HIV/AIDS-related knowledge and condom use in sub-Saharan Africa: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Minsoo Jung

    Full Text Available It is known that the level of HIV/AIDS-related knowledge and the degree of condom use varies by socioeconomic status (SES. However, there is limited research on the effect of mass media use on HIV/AIDS-related cognitive and behavioral outcomes in low-income countries and how it might influence the association between SES and HIV-related outcomes. We investigated the moderating effect of media use on the relationship between SES and HIV/AIDS-related knowledge and condom use in sub-Saharan Africa in terms of communication inequalities. Cross-sectional data from the Demographic Health Surveys from 13 sub-Saharan countries (2004-10 were pooled. Gender-stratified multivariable poisson regression of 151,209 women and 68,890 men were used to calculate adjusted relative ratios and 95% confidence intervals for the associations between SES, media use, HIV-related outcomes, and condom use. We found significant disparities in mass media use among people from different SES groups as well as among countries. Education and wealth are strongly and positively associated with awareness of HIV/AIDS and knowledge about transmission and prevention of HIV/AIDS and are significantly associated with condom use. These associations are attenuated when the use of various types of mass media is added to the models, with newspapers showing the strongest effect. The findings of this study suggest that media use has the potential to blunt the impact of socioeconomic status though not completely eliminate it. Thus, we need to pay attention to reducing communication inequalities among social groups and countries to moderate the effect of wealth and SES on HIV/AIDS.

  9. Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), and neuromuscular and vascular hamartoma (NMVH): two sides of the same coin?

    Science.gov (United States)

    Setaffy, Lisa; Osuna, María José Martín; Plieschnegger, Wolfgang; del Pino Florez Rial, María; Geboes, Karel; Langner, Cord

    2015-04-01

    Multifocal stenosing enteritis, not related to Crohn's disease or drug intake, has been described under two different terms: "cryptogenic multifocal ulcerous stenosing enteritis" (CMUSE) and "neuromuscular and vascular hamartoma" (NMVH). We present three new cases of this condition and argue that the two terms reflect the same disease entity. Although etiology and pathogenesis of the disease remain largely unclear, obliterative vascular changes may play an important role.

  10. Monitoring HIV and AIDS Related Policy Reforms: A Road Map to Strengthen Policy Monitoring and Implementation in PEPFAR Partner Countries.

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    Jeffrey Lane

    Full Text Available Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President's Emergency Plan for AIDS Relief (PEPFAR. It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. A total of 64 participants representing the U.S. Government, partner country governments, and civil society organizations attended the workshops. On average, participants responded that their policy monitoring skills improved and that they felt they were better prepared to monitor policy reforms three months after the workshop. When followed-up regarding utilization of the Road Map action plan, responses were mixed. Reasons cited for not making progress included an inability to meet or a lack of time, personnel, or governmental support. This lack of progress may point to a need for building policy monitoring systems in high HIV burden countries. Because the success of policy reforms cannot be measured by the mere adoption of written policy documents, monitoring the implementation of policy reforms and evaluating their public health impact is essential. In many high HIV burden countries, policy development and monitoring capacity remains weak. This lack of capacity could hinder efforts to achieve the ambitious AIDS-free generation treatment, care and prevention goals. The Road Map appears to be a useful tool for strengthening these critical capacities.

  11. An adult multifocal medulloblastoma with diffuse acute postoperative cerebellar swelling: immunohistochemical and molecular genetics analysis.

    Science.gov (United States)

    Balik, Vladimir; Trojanec, Radek; Holzerova, Milena; Tuckova, Lucie; Sulla, Igor; Megova, Magdalena; Vaverka, Miroslav; Hrabalek, Lumir; Ehrmann, Jiri

    2015-01-01

    Medulloblastoma (MB), the most common malignant tumor typically affecting children, occurs only exceptionally in adults. Multifocal presentation of this malignancy in adulthood is even much rarer—only four cases with favorable postoperative course have been reported, so far. The study illustrates a very rare rapid postoperative clinical deterioration due to diffuse cerebellar swelling (DCS) in an adult multifocal MB (MMB). To the best of their knowledge, authors for the first time performed genetic analysis of MMB and demonstrated expression patterns of selected markers that put the patient within the sonic hedgehog (SHH) molecular subgroup and at least partially explain her unsatisfactory clinical course. Herein, authors summarized the relevant literature concerning this issue with the aim to determine features that would facilitate diagnosis and therapy of such a scarce clinical entity.

  12. Optimizing distance image quality of an aspheric multifocal intraocular lens using a comprehensive statistical design approach.

    Science.gov (United States)

    Hong, Xin; Zhang, Xiaoxiao

    2008-12-01

    The AcrySof ReSTOR intraocular lens (IOL) is a multifocal lens with state-of-the-art apodized diffractive technology, and is indicated for visual correction of aphakia secondary to removal of cataractous lenses in adult patients with/without presbyopia, who desire near, intermediate, and distance vision with increased spectacle independence. The multifocal design results in some optical contrast reduction, which may be improved by reducing spherical aberration. A novel patent-pending approach was undertaken to investigate the optical performance of aspheric lens designs. Simulated eyes using human normal distributions were corrected with different lens designs in a Monte Carlo simulation that allowed for variability in multiple surgical parameters (e.g. positioning error, biometric variation). Monte Carlo optimized results indicated that a lens spherical aberration of -0.10 microm provided optimal distance image quality.

  13. Inadvertent implantation of a reversed-optic Tecnis ZM900 multifocal intraocular lens: case report

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    Wilson Takashi Hida

    2012-12-01

    Full Text Available A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.

  14. Brucella spondylodiscitis: Multifocal involvement in thoracic and lumbar areas; a rare case

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    Pınar Korkmaz

    2015-09-01

    Full Text Available Brucellosis is a zoonosis that can affect many organs or systems. Musculoskeletal system is the most commonly affected site in brucellosis and the frequency of musculoskeletal system involvement varies between 2% and 53%. Multifocal spinal involvement is rare. Here, it was aimed to present our case with brucellar spondylodiscitis involving the thoracic and lumbar regions simultaneously. MRI is a useful imaging method in the diagnosis of multifocal spinal infection caused by brucellosis. Especially in endemic regions, at least two serological tests should be used in the diagnosis of brucellosis. Brucellosis should be absolutely kept in mind for the differential diagnosis of the lderly patients with complaint of longstanding thoracic and back pain in the regions where brucellosis is endemic. J Microbiol Infect Dis 2015;5(3: 129-132

  15. Is radioiodine administration in patients with papillary thyroid multifocal microcarcinoma unnecessary?

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    Eva Krčálová

    2016-05-01

    Full Text Available Radioiodine (RAI has played a crucial role in differentiated thyroid cancer treatment for more than 60years. However, the use of RAI administration in patients with papillary thyroid microcarcinoma (even multifocal is now being widely discussed and often not recommended. In accordance with European consensus, and contrary to the American Thyroid Association (ATA guidelines, we recently performed RAI thyroid remnant ablation in a patient with differentiated papillary multifocal microcarcinoma. The post-therapeutic whole-body scan and SPECT/CT revealed the real and unexpected extent of disease, with metastases to upper mediastinal lymph nodes. This finding led to the patient’s upstaging from stage I to stage IVa according to the American Joint Committee on Cancer/International Union Against Cancer criteria.

  16. Skull-base Ewing sarcoma with multifocal extracranial metastases

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    Sumit Thakar

    2012-01-01

    Full Text Available Intracranial occurrence of Ewing sarcoma (ES is unusual, with a skull-base location being anecdotal. We report a 29-year-old man who presented with rapidly progressive ophthalmoplegia, and was found to be harboring an infiltrative lesion involving the sphenoid sinus, sella, and clivus. He underwent trans-sphenoidal decompression of the lesion which was histologically suggestive of ES. He developed paraparesis 2 weeks after commencing adjuvant therapy. Imaging revealed two thoracic extradural lesions and florid vertebral and pulmonary metastases. This is the first report in indexed literature of a primary intracranial ES on the skull-base with disseminated extracranial disease.

  17. Multifocal VEP (mfVEP) reveals abnormal neuronal delays in diabetes

    OpenAIRE

    2010-01-01

    This pilot study examined the diagnostic role of multifocal visually evoked potentials (mfVEP) in a small number of patients with diabetes. mfVEP, mfERG, and fundus photographs of both eyes of five patients with diabetes, three with nonproliferative diabetic retinopathy (NPDR) and two without NPDR were examined. Thirteen control subjects were also examined. Eighteen zones were constructed from the 60-element mfVEP stimulus array. mfVEP implicit time (IT) and amplitude (SNR) differences were t...

  18. Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity

    OpenAIRE

    M. P. V. Prabhat; Chintamaneni Raja Lakshmi; Sai Madhavi, N.; Sujana Mulk Bhavana; Gummadapu Sarat; Kodali Ramamohan

    2013-01-01

    Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Usually HPV involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65-year-old female. We also discuss the probable multifactorial etiology and variable clinical presentations of the lesions, including evidence of...

  19. Capecitabine Induced Multifocal Leukoencephalopathy: Do We Have Always to Switch off the Chemotherapy?

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    Anastasia Bougea

    2016-01-01

    Full Text Available Capecitabine is a well tolerated and safe 5-fluorouracil agent for adjuvant, neoadjuvant chemotherapy or metastatic cases. Neurological side effects require discontinuation of chemotherapy. We report this unique case of a 50-year-old female, who presented an isolated episode of dysarthria and ataxia under bevacizumab, capecitabine, and oxaliplatin treatment due to reversible multifocal leukoencephalopathy that did not recur after readministration of chemotherapy.

  20. Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

    Science.gov (United States)

    Schallhorn, Steven C; Venter, Jan A; Teenan, David; Schallhorn, Julie M; Hettinger, Keith A; Hannan, Stephen J; Pelouskova, Martina

    2016-01-01

    Purpose The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC) to correct residual refraction after multifocal intraocular lens (IOL) implantation. Patients and methods In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from −0.02±0.83 D (−3.38 D to +2.25 D) pre-enhancement to 0.00±0.34 D (−1.38 D to +1.25 D) post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (−0.04±0.06 logMAR [logarithm of the minimum angle of resolution]) and after LVC procedure (−0.04±0.07 logMAR; P=0.70). There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision) following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of patients. PMID:27175059

  1. Multifocal fibrosing thyroiditis: report of 55 cases of a poorly recognized entity.

    Science.gov (United States)

    Fellegara, Giovanni; Rosai, Juan

    2015-03-01

    During the course of our consultation activity, we have recognized a peculiar form of thyroiditis in which multiple foci of fibrosis, most of which were associated with reactive atypia of the surrounding follicles, are present. We have referred to this condition, both in our consultation reports and in the third series of A.F.I.P. Fascicle on Tumors of the Thyroid Gland, as "multifocal fibrosing thyroiditis" or (less frequently) "multifocal sclerosing thyroiditis," which are descriptive terms that highlight the benign/inflammatory nature of the process, its multiplicity, and its unknown pathogenesis. The aim of this study is to better define the morphologic features of this process and correlate it with some clinical data. With this purpose, the consultation files of one of the authors (J.R.) were searched for cases coded as multifocal fibrosing thyroiditis or multifocal sclerosing thyroiditis in a 20-year period ranging from January 1989 to December 2009. A total of 55 cases were identified that displayed the above-listed features. There were 51 (93%) female and 4 (7%) male patients (F/M=12.75), with ages ranging between 15 and 71 years (mean age, 47.03 y; median age, 44.5 y). Microscopically, multiple foci of fibrosis were identified in all cases, their number ranging from 2 to 51 per case (mean number, 16), with a mean diameter of 3 mm (range: 0.36 to 15.1 mm). Although heterogenous in shape and size, the individual foci were rather similar to each other in composition, being characterized by a fibrotic poorly cellular center that merged with a cellular peripheral zone. Some of the follicular structures present at the periphery of the scar and-to a lesser extent-those entrapped inside it underwent complex reactive and regenerative (atypical) changes that simulated malignancy. We discuss the differential diagnosis with other benign and malignant thyroid conditions and speculate about its pathogenesis and possible relationship with papillary thyroid microcarcinoma.

  2. Recurrent multifocal cutaneous Kaposiform hemangioendothelioma: A rare vascular tumor of infancy and childhood

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    Bhagyalakshmi Atla

    2016-01-01

    Full Text Available Kaposiform hemangioendothelioma (KHE is a locally aggressive vascular tumor of childhood although cases occurring in adulthood are also described. The features overlap with juvenile capillary hemangioma and Kaposi sarcoma. We report a rare case of recurrent, multifocal (nose and chin cutaneous KHE initially occurring in a 3-year-old female child, uncomplicated by Kasabach–Merritt syndrome. Recurrences occurred over the next 6 years and resulted in complete distortion of the nose, requiring plastic repair.

  3. Usefulness of Implantation of Diffractive Multifocal Intraocular Lens in Eyes with Long Axial Lengths

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    Tomoichiro Ogawa

    2015-01-01

    Full Text Available Purpose. This study retrospectively analyzed the postoperative visual functions of myopic eyes implanted with multifocal intraocular lens (IOL to evaluate the efficacy of multifocal IOL in highly myopic eyes. Methods. We studied 61 patients (96 eyes who were implanted with multifocal IOL ZMA00 or ZMB00 (Abbott Medical Optics. The patients were stratified into two groups by axial length: 26 mm or above (AL≥26 group and below 26 mm (AL<26 group. Postoperative corrected and uncorrected distance (5 m and near (30 cm visual acuity (VA, contrast sensitivity, and depth of focus were compared between two groups. Results. In the AL≥26 group and the AL<26 group, the mean ± standard deviation uncorrected distance logMAR VA at 12-month postoperative follow-up was -0.04±0.11 and -0.01±0.14, respectively; and the corrected distance VA was -0.17±0.08 and -0.14±0.07, with no significant differences between two groups (p=0.558 and 0.101; Mann-Whitney U test. For near VA, the corresponding uncorrected VA was 0.06±0.08 and 0.05±0.09; and distance-corrected VA was 0.01±0.06 and 0.01±0.02, with no significant differences between two groups (p=0.572, and 0.157; Mann-Whitney U test. Conclusion. The present study demonstrates that it is possible to achieve good uncorrected near and distance VA following implantation of multifocal IOL in eyes with long axial lengths.

  4. Usefulness of Implantation of Diffractive Multifocal Intraocular Lens in Eyes with Long Axial Lengths

    Science.gov (United States)

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2015-01-01

    Purpose. This study retrospectively analyzed the postoperative visual functions of myopic eyes implanted with multifocal intraocular lens (IOL) to evaluate the efficacy of multifocal IOL in highly myopic eyes. Methods. We studied 61 patients (96 eyes) who were implanted with multifocal IOL ZMA00 or ZMB00 (Abbott Medical Optics). The patients were stratified into two groups by axial length: 26 mm or above (AL ≥ 26 group) and below 26 mm (AL < 26 group). Postoperative corrected and uncorrected distance (5 m) and near (30 cm) visual acuity (VA), contrast sensitivity, and depth of focus were compared between two groups. Results. In the AL ≥ 26 group and the AL < 26 group, the mean ± standard deviation uncorrected distance logMAR VA at 12-month postoperative follow-up was −0.04 ± 0.11 and −0.01 ± 0.14, respectively; and the corrected distance VA was −0.17 ± 0.08 and −0.14 ± 0.07, with no significant differences between two groups (p = 0.558 and 0.101; Mann-Whitney U test). For near VA, the corresponding uncorrected VA was 0.06 ± 0.08 and 0.05 ± 0.09; and distance-corrected VA was 0.01 ± 0.06 and 0.01 ± 0.02, with no significant differences between two groups (p = 0.572, and 0.157; Mann-Whitney U test). Conclusion. The present study demonstrates that it is possible to achieve good uncorrected near and distance VA following implantation of multifocal IOL in eyes with long axial lengths. PMID:26609428

  5. Multifocal phaeohyphomycosis caused by Exophiala xenobiotica in a kidney transplant recipient.

    Science.gov (United States)

    Palmisano, A; Morio, F; Le Pape, P; Degli Antoni, A M; Ricci, R; Zucchi, A; Vaglio, A; Piotti, G; Antoniotti, R; Cremaschi, E; Buzio, C; Maggiore, U

    2015-04-01

    In recent years, black fungi have been increasingly reported as causing opportunistic infections after solid organ transplantation. Here, we report a case of insidious, relentless, and multifocal Exophiala xenobiotica infection in a kidney transplant recipient that eventually required multiple surgical excisions along with oral and intravenous antifungal combination therapy using liposomal amphotericin B and posaconazole. We compare the present case with all previously reported cases of Exophiala infection after kidney transplantation.

  6. Current Understanding of the Pathogenesis and Management of Chronic Recurrent Multifocal Osteomyelitis

    OpenAIRE

    Ferguson, P. J.; M. Sandu

    2012-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory disorder that primarily affects children. Its hallmark is recurring episodes of sterile osteomyelitis. The clinical presentation is insidious onset of bone pain with or without fever. Laboratory studies typically reveal nonspecific evidence of inflammation. Radiologic imaging and histologic appearance resemble those of infectious osteomyelitis. There is a strong association with inflammatory disorders of the skin and intesti...

  7. Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)

    2015-08-15

    Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor.

  8. Chronic recurrent multifocal osteomyelitis manifested as painful clavicular swelling: a case report

    OpenAIRE

    Bleckwenn, Markus; Sommer, Bernd; Weckbecker, Klaus

    2014-01-01

    Background Chronic recurrent multifocal osteomyelitis is a form of non-bacterial osteomyelitis which occurs primarily in childhood. In some cases painful bone swelling occurs. After a malignancy has been ruled out, antibiotic therapy is often started to treat the osteomyelitis. The course of this benign disease is self-limiting and is not positively affected by the antibiotic therapy. Case presentation A 14-year-old German girl from South Africa came to the surgery with painful swelling in th...

  9. Multifocal meningeal melanocytoma: a new pathological entity or the result of leptomeningeal seeding?

    Science.gov (United States)

    Ali, Youssef; Rahme, Ralph; Moussa, Ronald; Abadjian, Gerard; Menassa-Moussa, Lina; Samaha, Elie

    2009-09-01

    Meningeal melanocytoma is a rare benign CNS tumor derived from the leptomeningeal melanocytes. Although unusual, malignant transformation with leptomeningeal seeding into the brain or spinal cord may occur years after the initial diagnosis. The authors report a unique case of multifocal benign meningeal melanocytoma involving both cerebellopontine angles and the thoracic spinal cord, with associated diffuse leptomeningeal hyperpigmentation. They review the literature relevant to this topic and discuss the radiological and pathological features of this disease as well as its treatment options.

  10. Meningeal Castleman's disease with multifocal involvement: a case report and review of literature.

    Science.gov (United States)

    Coca, Santiago; Salas, Isabel; Martínez, Roberto; Saez, Miguel Angel; Vaquero, Jesús

    2008-05-01

    Castleman's disease is an uncommon lymphoproliferative disorder characterized by lymph node enlargement, hyperplasia of lymphoid follicles surrounded by mature lymphocytes, and capillary proliferation with endothelial hyperplasia. Although intracranial location is very uncommon, it should be considered in the differential diagnosis of meningeal tumors. We describe a new case appearing as two solid extraaxial masses simulating meningiomas. This multifocal meningeal involvement can be considered as an exceptional form of presentation of intracranial Castleman's disease.

  11. Analysis of trends in total deaths and AIDS-related deaths certified at Mosvold Hospital, Ingwavuma, KwaZulu-Natal, from 2003 to 2008

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    C H Vaughan Williams

    2010-04-01

    Full Text Available Objectives. To analyse mortality trends from deaths registered at Mosvold Hospital, Ingwavuma, KwaZulu-Natal, and possible impact of programmes to treat and prevent HIV infection. Design. Longitudinal study of death certifications from 2003 to 2008. Setting. Mosvold Hospital mortuary, Ingwavuma. Subjects. Counterfoils of form 83/BI-1663, Notification/Register of Death/Stillbirths (Republic of South Africa, Department of Home Affairs, completed at Mosvold Hospital from January 2003 to December 2008. Outcome measures. Age at death, cause of death, patterns of deaths grouped by age, gender and cause of death. Results. AIDS-related deaths were the cause of 53% of deaths, particularly affecting the 20 - 59-year and under-5 age groups. Since 2005 there has been a decline in deaths in the 20 - 59 age group and an increase in average age at death. Conclusions. The decrease in mortality from 2005 may be associated with antiretroviral roll-out reducing mortality from AIDS-related illnesses.

  12. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

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    Lobna Ouldamer

    Full Text Available The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality.Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality.We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality.These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

  13. Chlorogenic acid supplementation improves multifocal electroretinography in patients with retinitis pigmentosa.

    Science.gov (United States)

    Shin, Joo Young; Yu, Hyeong Gon

    2014-01-01

    To evaluate the effect of chlorogenic acid supplementation in patients with retinitis pigmentosa, we evaluated objective change in visual function with multifocal electroretinography, along with visual acuity, visual field, standard electroretinography, and contrast sensitivity. Eighteen patients diagnosed with retinitis pigmentosa were enrolled in this prospective, non-comparative, single-arm study. Multifocal electroretinography, best-corrected visual acuity in Early Treatment Diabetic Retinopathy Study letters, total point score on visual field examination with Humphrey Field Analyzer II, electroretinography, and contrast sensitivity were measured and repeated after 3 months supplementation with chlorogenic acid. The amplitude of ring 5 was significantly higher on multifocal electroretinography after 3 months of chlorogenic acid supplementation (7.2 ± 9.5 vs 8.3 ± 10.8 nV/deg(2), mean ± standard deviation, P = 0.022). There were no significant changes in the best-corrected visual acuity, total point score on Humphrey Field Analyzer, 30 Hz flicker amplitude on standard electroretinography, or contrast sensitivity. Chlorogenic acid may have a beneficial effect on the peripheral area at the margins of retinal degeneration, and should be considered as an anti-oxidant for the management of retinitis pigmentosa.

  14. Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

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    Schallhorn SC

    2016-04-01

    Full Text Available Steven C Schallhorn,1–3 Jan A Venter,2 David Teenan,2 Julie M Schallhorn,3 Keith A Hettinger,2 Stephen J Hannan,2 Martina Pelouskova2 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Optical Express, Glasgow, UK; 3Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC to correct residual refraction after multifocal intraocular lens (IOL implantation. Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution] and after LVC procedure (-0.04±0.07 logMAR; P=0.70. There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of

  15. Characterization of a new simian immunodeficiency virus strain in a naturally infected Pan troglodytes troglodytes chimpanzee with AIDS related symptoms

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    Aghokeng Avelin F

    2011-01-01

    Full Text Available Abstract Background Data on the evolution of natural SIV infection in chimpanzees (SIVcpz and on the impact of SIV on local ape populations are only available for Eastern African chimpanzee subspecies (Pan troglodytes schweinfurthii, and no data exist for Central chimpanzees (Pan troglodytes troglodytes, the natural reservoir of the ancestors of HIV-1 in humans. Here, we report a case of naturally-acquired SIVcpz infection in a P.t.troglodytes chimpanzee with clinical and biological data and analysis of viral evolution over the course of infection. Results A male chimpanzee (Cam155, 1.5 years, was seized in southern Cameroon in November 2003 and screened SIV positive during quarantine. Clinical follow-up and biological analyses have been performed for 7 years and showed a significant decline of CD4 counts (1,380 cells/mm3 in 2004 vs 287 in 2009, a severe thrombocytopenia (130,000 cells/mm3 in 2004 vs 5,000 cells/mm3 in 2009, a weight loss of 21.8% from August 2009 to January 2010 (16 to 12.5 kg and frequent periods of infections with diverse pathogens. DNA from PBMC, leftover from clinical follow-up samples collected in 2004 and 2009, was used to amplify overlapping fragments and sequence two full-length SIVcpzPtt-Cam155 genomes. SIVcpzPtt-Cam155 was phylogenetically related to other SIVcpzPtt from Cameroon (SIVcpzPtt-Cam13 and Gabon (SIVcpzPtt-Gab1. Ten molecular clones 5 years apart, spanning the V1V4 gp120 env region (1,100 bp, were obtained. Analyses of the env region showed positive selection (dN-dS >0, intra-host length variation and extensive amino acid diversity between clones, greater in 2009. Over 5 years, N-glycosylation site frequency significantly increased (p Conclusions Here, we describe for the first time the clinical history and viral evolution of a naturally SIV infected P.t.troglodytes chimpanzee. The findings show an increasing viral diversity over time and suggest clinical progression to an AIDS-like disease, showing that

  16. Fatores técnicos intervenientes na realização do exame de eletrorretinograma multifocal (ERGmf Technical factors that influence multifocal electroretinogram (mfERG recording

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    Maria Kiyoko Oyamada

    2007-08-01

    Full Text Available OBJETIVO: Descrever os principais fatores intervenientes observados durante a aquisição e análise do exame de eletrorretinograma multifocal (ERGmf, que afetam o registro gráfico das ondas obtidas e portanto sua análise. MÉTODOS: Análise dos fatores de erro observados durante a aquisição de 100 exames seqüenciais de eletrorretinograma multifocal, realizados com o Reti System da Roland Consult, no período de maio a julho de 2005. Os exames de eletrorretinograma multifocal foram realizados conforme recomendações internacionais, respeitando-se os parâmetros preestabelecidos do equipamento, com 61 elementos, e ângulo visual de 30º. Todos os pacientes foram submetidos à avaliação oftalmológica completa, excluindo-se aqueles com transparência inadequada de meios, córneas planas e os incapazes de visualizar as linhas de fixação. RESULTADOS: Os fatores intervenientes, que poderiam causar erros na interpretação dos resultados obtidos, observados e corrigidos durante a realização dos exames foram: fixação excêntrica, movimentação dos olhos, contração do orbicular, contração da musculatura cervical, não-correção adequada, não-transparência adequada do eletrodo corneano, deslocamento do eletrodo em geral para baixo, descentralização do suporte da lente corretora, distância inadequada paciente-monitor em pacientes com alta ametropia, altura inadequada dos olhos em relação ao centro da tela, ruído na freqüência de 60 HZ (rede elétrica e de campo eletromagnético, impedâncias elevadas. No processamento das ondas, a utilização excessiva de filtros para remoção de ruídos dos registros obtidos, pode interferir na análise dos resultados obtidos. CONCLUSÕES: Cuidados simplesmente observacionais durante a aquisição dos sinais são de importância significativa para a obtenção de registros com boa morfologia e baixo nível de ruído. Permitindo, por meio de sua pronta correção, a análise correta e

  17. The hemolytic component of cancer anemia: effects of osmotic and metabolic stress on the erythrocytes of rats bearing multifocal inoculations of the Walker 256 tumor

    Directory of Open Access Journals (Sweden)

    Vido A.A.

    2000-01-01

    Full Text Available Cancer anemia is classified as an anemia of chronic diseases, although it is sometimes the first symptom of cancer. Cancer anemia includes a hemolytic component, important in the terminal stage when even transfused cells are rapidly destroyed. The presence of a chronic component and the terminal complications of the illness limit studies of the hemolytic component. A multifocal model of tumor growth was used here to simulate the terminal metastatic dissemination stage (several simultaneous inoculations of Walker 256 cells. The hemolytic component of anemia began 3-4 days after inoculation in 100% of the rats and progressed rapidly thereafter: Hb levels dropped from 14.9 ± 0.02 to 8.7 ± 0.06 from days 7 to 11 (~5 times the physiologically normal rate in rats in the absence of bleeding. The development of anemia was correlated (r2 = 0.86 with the development of other systemic effects such as anorexia. There was a significant decrease in the osmotic fragility of circulating erythrocytes: the NaCl concentration causing 50% lysis was reduced from 4.52 ± 0.06 to 4.10 ± 0.01 (P<0.01 on day 7, indicating a reduction in erythrocyte volume. However, with mild metabolic stress (4-h incubation at 37oC, the erythrocytes showed a greater increase in osmotic fragility than the controls, suggesting marked alteration of erythrocyte homeostasis. These effects may be due to primary plasma membrane alterations (transport and/or permeability and/or may be secondary to metabolic changes. This multifocal model is adequate for studying the hemolytic component of cancer anemia since it is rapid, highly reproducible and causes minimal animal suffering.

  18. HIV and/or AIDS-related deaths and modifiable risk factors: A descriptive study of medical admissions at Oshakati Intermediate Hospital in Northern Namibia

    Directory of Open Access Journals (Sweden)

    N.K. Mgori

    2015-02-01

    Full Text Available Background: High rates of HIV infection have decreased life expectancy in many African countries. Regardless of worldwide efforts to escalate treatment, care and prevention strategies, the number of deaths due to AIDS-related disorders is still high. Local healthcare workers suspect that there are modifiable factors in the care of HIV and/or AIDS patients which can be identified and improved.Aim: To describe the HIV and/or AIDS-related causes of adult mortality and identify modifiable factors amongst patients admitted to Oshakati Intermediate Hospital, northern Namibia.Methods: Data was extracted retrospectively and coded using the modified CoDe protocol for AIDS. Modifiable factors relating to the patient, health system or clinical care were identified using a standardised data collection tool.Results: A total of 177 HIV and/or AIDS patients were identified, 94 (53.1% were male and 120 (68% had a CD4 count of less than 200 cells/mL. The common HIV-related causes of death were tuberculosis (25.9%, renal failure (15.8%, Pneumocystis jirovecii pneumonia (11.3%, cryptococcal meningitis (9%, HIV wasting syndrome (7.9% and AIDS-defining malignancy (7.9%. The analysis revealed 281 modifiable factors; patient-related factors were the most common (153 [54.4%], followed by health system factors (97 [34.5%] and healthcare personnel factors (31 [11%].Conclusion: Our findings have highlighted the challenges in overall HIV and/or AIDS inpatient care and surrounding primary care facilities. The identification of specific modifiable factors can be used to reduce mortality by providing training as well as rational monitoring, planning and resource allocation.

  19. Depósito multifocal de grasa en hígado: Reporte de un caso Liver multifocal fat deposition: Case report

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    Federico Pasardi

    2009-03-01

    Full Text Available Describir los hallazgos radiológicos distintivos en ultrasonido (US, tomografía computada (TC y resonancia magnética (RM del depósito multifocal de grasa en hígado y su importancia en el diagnóstico diferencial en pacientes con antecedente neoplásico. Se reporta el caso de una paciente femenina de 66 años de edad, operada de cáncer de mama 2 años atrás, que en controles ecográficos de rutina muestra múltiples imágenes nodulares hiperecogénicas hepáticas de reciente aparición. La paciente fue estudiada con TC, RM e histo-patológicamente, confirmándose la naturaleza grasa de las imágenes nodulares. La esteatosis hepática se trata de una patología bastante frecuente, bien caracterizada por los métodos de imágenes. Presenta patrones de depósito diferentes, siendo necesario en algunos casos para el diagnóstico de certeza la toma de biopsia del tejido afectado, que, en nuestro caso, fue realizada con guía ecográfica.To describe the distinctive imaging findings in ultrasound (US, computed tomography (CT and magnetic resonance imaging (MRI of liver multifocal fat deposition and its importance in the differential diagnosis in patients with neoplasic antecedents. The authors reported a 66 years old female patient, who had surgery for breast cancer two years ago, and presents in routine US multiple liver nodular hiperecogenic images from recent diagnosis. The patient was studied with CT, MRI and histo-pathology confirmed fatty liver disease. Fatty liver disease is a frequent pathology, well characterized with imaging, that presents different patterns, being necessary biopsy for final diagnosis, that in our patient was performed under US guidance.

  20. Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti′s Crystalline Retinopathy

    Institute of Scientific and Technical Information of China (English)

    Libin Jiang; Feng Wen; Lezheng Wu; Hong Yan; Shixing Hu

    2002-01-01

    Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.

  1. Comparison between OPD-Scan results and visual outcomes of monofocal and multifocal intraocular lenses Comparação dos resultados do OPD-Scan e performance visual das lentes intraoculares monofocal e multifocal

    Directory of Open Access Journals (Sweden)

    Wilson Takashi Hida

    2009-08-01

    Full Text Available PURPOSE: To compare the visual outcome, contrast sensitivity and wavefront analysis of patients that underwent cataract surgery and implantation of AcrySof SN60D3 multifocal intraocular lens with those who received the AcrySof SN60AT monofocal IOL. METHODS: This was a prospective clinical trial of forty eyes that received the multifocal IOL and thirty-two eyes that received the monofocal IOL after phacoemulsification. RESULTS: Values for total and spherical aberrations in the multifocal group were statistically lower than in the monofocal group. In the monofocal group, 75% achieved uncorrected intermediate visual acuities between Jaeger 1 and 6. In the multifocal group, 75% of the eyes achieved more than Jaeger 6. At least 87.5% of the multifocal group and 6.3% of the monofocal group achieved monocular uncorrected near acuity of 20/30 (J2, N5 or better. And 90.0% of the eyes in the multifocal group and 37.5% in the monofocal group achieved an uncorrected near acuity of 20/40 (J3, N6 or better. The mean spherical error was 0.11 D in the multifocal group and -0.18 D in the monofocal group (p=0.0379. The SN60D3 group compared to SN60AT group had low contrast sensitivity (log units with statistically significant differences in 6.0 cpd in photopic conditions (p=0.014 and the SN60D3 group compared to SN60AT group had higher contrast sensitivity (log units under mesopic conditions (p=0.044. CONCLUSION: The multifocal IOLs induced less spherical aberration than monofocal IOLs and predictably good uncorrected distance and uncorrected near acuities. However, contrast sensitivity was lower in the multifocal group.OBJETIVO: Comparar a performance visual, sensibilidade ao contraste e de wavefront com OPD-Scan em pacientes submetidos a cirurgia de facoemulsificação com implante de lente intraocular AcrySof SN60D3 multifocal e AcrySof SA60AT monofocal. MÉTODOS: Quarenta olhos com a lente intraocular multifocal e trinta e dois olhos com a lente intraocular

  2. Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, S.E. [Department of Radiology, University Hospital of Bern, Inselspital, 3010, Bern (Switzerland); Heini, P.; Kalbermatten, D. [Department of Orthopedic Surgery, University Hospital of Bern, Inselspital, Bern (Switzerland); Sauvain, M.J. [Department of Pediatric Rheumatology, University Hospital of Bern, Inselspital, Bern (Switzerland); Stauffer, E. [Department of Pathology, University Hospital of Bern, Inselspital, Bern (Switzerland); Geiger, L. [Section Nuclear Medicine, Department of Radiology, University Hospital of Bern, Inselspital, Bern (Switzerland); Johnston, J.O. [Department of Orthopedic Surgery, University of California at San Francisco, San Francisco, California (United States); Roggo, A. [Department of Surgery, University Hospital of Bern, Inselspital, Bern (Switzerland); Steinbach, L.S. [Department of Radiology, University of California at San Francisco, San Francisco, California (United States)

    2003-06-01

    Initial presentation with primary spinal involvement in chronic recurrent multifocal osteomyelitis of childhood (CRMO) is rare. Our objective was to review the imaging appearances of three patients who had CRMO who initially presented with isolated primary spinal involvement.Design and patients The imaging, clinical, laboratory and histology findings of the three patients were retrospectively reviewed. Imaging included seven spinal MR imaging scans, one computed tomography scan, nine bone scans, two tomograms and 16 radiographs. These were reviewed by two musculoskeletal radiologists and a consensus view is reported. All three patients presented with atraumatic spinal pain and had extensive bone spinal pathology. The patients were aged 11, 13 and 12 years. There were two females and one male.Results and conclusions The initial patient had thoracic T6 and T8 vertebra plana. Bone scan showed additional vertebral body involvement. Follow-up was available over a 3 year period. The second patient had partial collapse of T9 and, 2 years later, of C6. Subsequently extensive multifocal disease ensued and follow-up was available over 8 years. The third patient initially had L3 inferior partial collapse and 1 year later T8 involvement with multifocal disease. Follow-up was available over 3 years. The imaging findings of the three patients include partial and complete vertebra plana with a subchondral line adjacent to endplates associated with bone marrow MR signal alterations. Awareness of the imaging appearances may help the radiologist to include this entity in the differential diagnosis in children who present with spinal pathology and no history of trauma. Histopathological examination excludes tumor and infection but with typical imaging findings may not always be necessary. (orig.)

  3. Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

    2013-10-15

    Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

  4. Arbitrary continuous nano-marks generated by multifocal spot arrays for controllable laser printing

    Science.gov (United States)

    Wen, Jing; Feng, Hui; Liu, Shiliang; Zhang, Dawei

    2017-04-01

    Phase-only modulations derived from the Debye approximation of the Richards–Wolf vectorial integral are used to produce a multifocal spot array. An analytical solution, which controls the position of each focal spot, can generate phase modulation images which are loaded into spatial light modulators. The calculated field distributions and the experimental images of the spot array on the back aperture of the objective are both demonstrated and validated. By overlapping the discrete focal points, continuous nano-structures of arbitrary marks can be achieved conveniently and easily. The above-proposed approach offers opportunities for flexible laser printing and creative micro-manipulation in the future.

  5. Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity

    Science.gov (United States)

    Prabhat, M. P. V.; Raja Lakshmi, Chintamaneni; Sai Madhavi, N.; Bhavana, Sujana Mulk; Sarat, Gummadapu; Ramamohan, Kodali

    2013-01-01

    Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Usually HPV involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65-year-old female. We also discuss the probable multifactorial etiology and variable clinical presentations of the lesions, including evidence of HPV 16 expression, as detected by polymerase chain reaction. The present report illustrates the need for careful examination and prompt diagnosis of the disease, as it might be associated with high risk genotypes such as HPV 16 and 18. PMID:24455323

  6. [Wave front aberrations -- practical conclusions in eye with Restor 3+ difractive multifocal lens].

    Science.gov (United States)

    Staicu, Corina; Moraru, Ozana; Moraru, Cristian

    2014-01-01

    Implantation of multifocal intraocular lenses has become a rutine nowadays, but achieving good visual results requires a perfect intraoperative technique and also an adequate preoperative selection of the patients. We analysed the wave front aberrations (spherical aberations, coma and astigmatism) in the eyes implanted with ReStor + 3 IOL, and we realized some clinical correlations of these aberations with the pupil diameter in scotopic and fotopic conditions, kappa angle, IOL centration, residual refraction errors postoperatively. Taking into account the causes of postoperative high order aberration will allow the surgeon to make a good selection of the patiens and to a higher degree of satisfaction of both sides.

  7. Multifocal periostitis as a complication of chronic use of voriconazole in a lung transplant recipient.

    Science.gov (United States)

    Tedja, R; El-Sherief, A; Olbrych, T; Gordon, S

    2013-08-01

    Fungal infections are common in solid organ transplantation. An increasing number of transplant recipients receive antifungal therapy for prolonged duration owing to invasive fungal infections. Herein, we describe a diagnosis of periostitis as a complication of chronic use of voriconazole in a lung transplant recipient. The patient was diagnosed with probable pulmonary aspergillosis and was treated with oral voriconazole for a total of 9 months. Evidence of multifocal periostitis was observed in the axial and appendicular skeleton. Early recognition of this phenomenon is important to prevent unnecessary tests and procedures. Prompt discontinuation of voriconazole should result in improvement of symptoms.

  8. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Haakma, Wieke; Jongbloed, Bas A.; Froeling, Martijn

    2016-01-01

    Objectives To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. Methods We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls...... (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA...... nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p nerves...

  9. Multifocal renal cell carcinoma of different histological subtypes in autosomal dominant polycystic kidney disease.

    Science.gov (United States)

    Na, Ki Yong; Kim, Hyun-Soo; Park, Yong-Koo; Chang, Sung-Goo; Kim, Youn Wha

    2012-08-01

    Renal cell carcinoma (RCC) in autosomal dominant polycystic kidney (ADPKD) is rare. To date, 54 cases of RCC in ADPKD have been reported. Among these, only 2 cases have different histologic types of RCC. Here we describe a 45-year-old man who received radical nephrectomy for multifocal RCC with synchronous papillary and clear cell histology in ADPKD and chronic renal failure under regular hemodialysis. The case reported herein is another example of the rare pathological finding of RCC arising in a patient with ADPKD.

  10. Confirmed case of levamisole-associated multifocal inflammatory leukoencephalopathy in a cocaine user.

    Science.gov (United States)

    Vitt, Jeffrey R; Brown, Ethan G; Chow, Daniel S; Josephson, S Andrew

    2017-04-15

    Levamisole is a common adulterant in cocaine and has previously been associated with a variety of serious complications including multifocal inflammatory leukoencephalopathy (MIL). There have been several reports of MIL in patients taking cocaine and, though suspected, the presence of levamisole was not confirmed. We present a case of a 63-year-old woman presenting with stupor and spastic quadraparesis found to have urine positive for cocaine and levamisole. An MRI brain revealed innumerable FLAIR hyperintensities with restricted diffusion and incomplete ring-enhancement. This is the first case to confirm the presence of levamisole in a patient with MIL associated with cocaine use.

  11. Multifocal, recurrent malignant chondroid syringoma with visceral metastases: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ann Meredith Garcia

    2016-03-01

    Full Text Available We present the unusual case of malignant chondroid syringoma (MCS in a 64-year-old male with recurrent nodular skin lesions and visceral metastases. The patient underwent repeated excisions, with eventual development of widespread nodules and multiple pulmonary and hepatic nodules. Systemic chemotherapy was planned. MCS is a very rare skin adnexal tumor of the sweat glands with only around 50 cases reported worldwide. To the authors’ knowledge, this is the first reported case of MCS with a multifocal presentation and mucosal involvement.

  12. Autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Kamikura, Isao; Mizutani, Tomohiko; Sakamaki, Shuji; Takasu, Toshiaki; Kawamura, Toshiaki

    1988-01-01

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.).

  13. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, Campus Box 8118, St. Louis, MO (United States); El-Khoury, Georges Y. [University of Iowa, Department of Radiology, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO (United States); Buckwalter, Joseph A. [University of Iowa, Department of Orthopaedics, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); Sundaram, Murali [Cleveland Clinic Foundation, Department of Radiology, Cleveland, OH (United States); DeYoung, Barry [University of Iowa, Department of Pathology, School of Medicine, Iowa City, IA (United States); O' Brien, Michael P. [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

    2007-03-15

    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  14. Visual performance with multifocal soft contact lenses in non-presbyopic myopic eyes during an adaptation period

    Directory of Open Access Journals (Sweden)

    Fedtke C

    2016-04-01

    Full Text Available Cathleen Fedtke,1 Klaus Ehrmann,1,2 Varghese Thomas,1 Ravi C Bakaraju,1,2 1The Brien Holden Vision Institute, Clinical Trial Research Centre, 2School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia Purpose: Multifocal soft contact lenses (MFCLs have been proposed and used for controlling the rate of myopia progression; however, little is known on the performance and adaptation with MFCLs in non-presbyopes. This study aims to evaluate the visual performance of four commercially available MFCLs in non-presbyopic myopic eyes during an adaptation period. Methods: Fifty-two experienced myopic contact lens wearers (67% female; mean age 21.4±2.0 years were enrolled in this trial and 40 completed the trial. Twenty-six participants (Group 1 wore Lotrafilcon B single vision (SV, control, Omafilcon A MFCL center-distance (D and center-near (N and the other 26 participants (Group 2 wore Lotrafilcon B SV, Lotrafilcon B MFCL N, and Balafilcon A MFCL N. Lens order was randomized. Participants wore each allocated lens for a minimum of 8 days over four scheduled visits (dispensing and three follow-up visits with a 1-week washout period between the lens types. At each visit, high-contrast visual acuity (HCVA (in logarithm of the minimum angle of resolution [logMAR] and seven subjective performance variables (via questionnaire were obtained. Power profiles of each lens type, pupil size, and contact lens centration, with lens placed on the eye, were measured. Results: The SV control outperformed the MFCLs in all variables (P<0.05. There were no significant differences in HCVA over time, with the exception of monocular HCVA with Omafilcon A MFCL N, which at the end of the adaptation period had significantly (P<0.05 improved by 0.10 logMAR. No differences were found between visits for any subjective variables. Subjectively, Lotrafilcon B MFCL N performed best and was the only lens that did not decenter significantly

  15. HIV and AIDS related knowledge, sources of information, and reported need for further education among dental students in Sudan- a cross sectional study

    Directory of Open Access Journals (Sweden)

    Åstrøm Anne

    2008-08-01

    Full Text Available Abstract Background Information on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject. Purposes Focusing on a census of dental students attending their 3rd, 4th and 5th study year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socio-economic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS. Methods At the time of the survey (March–May 2007, the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls completed anonymous self-administered questionnaires in supervised class room settings. Results A total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues to 84% (patient management. Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6 and occupational risk groups (OR = 0.6 and to have received information from lectures/health care workers (OR = 0.5. Conclusion Students attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need

  16. Growth regulation of simian and human AIDS-related non-Hodgkin's lymphoma cell lines by TGF-β1 and IL-6

    Directory of Open Access Journals (Sweden)

    Levy Laura S

    2007-02-01

    Full Text Available Abstract Background AIDS-related non-Hodgkin's lymphoma (AIDS-NHL is the second most frequent cancer associated with AIDS, and is a frequent cause of death in HIV-infected individuals. Experimental analysis of AIDS-NHL has been facilitated by the availability of an excellent animal model, i.e., simian Acquired Immunodeficiency Syndrome (SAIDS in the rhesus macaque consequent to infection with simian immunodeficiency virus. A recent study of SAIDS-NHL demonstrated a lymphoma-derived cell line to be sensitive to the growth inhibitory effects of the ubiquitous cytokine, transforming growth factor-beta (TGF-beta. The authors concluded that TGF-beta acts as a negative growth regulator of the lymphoma-derived cell line and, potentially, as an inhibitory factor in the regulatory network of AIDS-related lymphomagenesis. The present study was conducted to assess whether other SAIDS-NHL and AIDS-NHL cell lines are similarly sensitive to the growth inhibitory effects of TGF-beta, and to test the hypothesis that interleukin-6 (IL-6 may represent a counteracting positive influence in their growth regulation. Methods Growth stimulation or inhibition in response to cytokine treatment was quantified using trypan blue exclusion or colorimetric MTT assay. Intracellular flow cytometry was used to analyze the activation of signaling pathways and to examine the expression of anti-apoptotic proteins and distinguishing hallmarks of AIDS-NHL subclass. Apoptosis was quantified by flow cytometric analysis of cell populations with sub-G1 DNA content and by measuring activated caspase-3. Results Results confirmed the sensitivity of LCL8664, an immunoblastic SAIDS-NHL cell line, to TGF-beta1-mediated growth inhibition, and further demonstrated the partial rescue by simultaneous treatment with IL-6. IL-6 was shown to activate STAT3, even in the presence of TGF-beta1, and thereby to activate proliferative and anti-apoptotic pathways. By comparison, human AIDS-NHL cell lines

  17. The brain triuno and the ethical intelligence: fundamental counterfoil of the multifocal intelligence

    Directory of Open Access Journals (Sweden)

    C. Seijo

    2013-10-01

    Full Text Available This study has for aim offer an analysis as for the brain triuno and the ethical intelligence: fundamental Counterfoil of the multifocal intelligence, taking in tells one of the theories that it sustains her like they are the different types of multiple intelligences established by Beauport and Cury (2004. The theoretical sustenance, it is based on the contents of Martin (2005, Belohlavek (2007, Galicians (2002, Beauport and Cury (2004, between others, being realized under a symbolic interpretive approach, across a qualitative methodology, type descriptive and not experimental design, by means of a documentary analysis. In this regard, it is found that the ethical intelligence is a mental mechanism that constructs the structural preconceptos and the rules of game with which an individual approaches the reality, that is to say, it is the capacity of the general formation, predicting the behavior for the achievement of aims organizacionales. As for the final considerations they focused in obtaining the most wide knowledge inside the organizations, allowing to reflect before the weaknesses that they present thinking about the brain triuno applying the multifocal intelligence, fundamental counterfoil of the ethical intelligence and of what way the rationing visualizes the strengths, nevertheless of the weaknesses that they present. 

  18. Visual outcomes and optical quality after implantation of a diffractive multifocal toric intraocular lens

    Science.gov (United States)

    Chen, Xiangfei; Zhao, Ming; Shi, Yuhua; Yang, Liping; Lu, Yan; Huang, Zhenping

    2016-01-01

    Background: This study evaluated the visual function after implantation of a multifocal toric intraocular lenses (IOLs). Materials and Methods: This study involved 10 eyes from eight cataract patients with corneal astigmatism of 1.0 diopter (D) or higher who had received phacoemulsification with implantation of an AcrySof IQ ReSTOR Toric IOL. Six-month evaluations included visual acuity, spherical equivalent (SE), defocus curve, residual astigmatism, IOL rotation, contrast sensitivity (CS), wavefront aberrations, modulation transfer function (MTF), and patient satisfaction assessments. Results: At 6 months postoperatively, uncorrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.09 ± 0.04, corrected distance visual acuity was 0.02 ± 0.11, and uncorrected near visual acuity was 0.12 ± 0.07. The mean SE was −0.095 ± 0.394 D (±0.50 D in 90%). Refractive astigmatism at the 6-month follow-up visit was significantly reduced to 0.35 ± 0.32 D from 1.50 ± 0.41 D presurgery (P 0.05). There was an increase in MTF results between preoperative and postoperative evaluations at all spatial frequencies. Conclusions: The diffractive multifocal toric IOL is able to provide a predictable astigmatic correction with apparently outstanding levels of optical quality after implantation. PMID:27221680

  19. Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses

    Directory of Open Access Journals (Sweden)

    Ugur Unsal

    2016-01-01

    Full Text Available Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50 and p=0.509, resp.. The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049, p=0.005, and p=0.001, resp. and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001. The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities, whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading.

  20. Multifocal intraductal papillary mucinous neoplasm of the pancreas-A case report

    Institute of Scientific and Technical Information of China (English)

    Kun-Chun Chiang; Jun Te Hsu; Huang-Yang Chen; Shyh Chuan Jwo; Tsann-Long Hwang; Yi-Yin Jan; Chun-Nan Yeh

    2009-01-01

    Cystic neoplasms of the pancreas are relatively rare, comprising 10 percent of pancreatic cysts and only 1 percent of pancreatic cancers. Cystic neoplasms include mucinous cystic neoplasms, serous cystadenomas,papillary cystic tumors, cystic islet cell tumors and intraductal papillary mucinous neoplasms of the pancreas (IPMNs). IPMN was first described in 1982.It has been most commonly described in 60 to 70 years old males, and represents a relatively "new" but increasingly recognized disease. The improvement and widespread use of modern imaging equipments and heightened awareness of physicians contribute to the increasing incidence of IPMN. The majority of IPMNs are located in the pancreatic head (75%) while the rest involves the body/tail regions. Multifocal IPMNs have been hypothesized, but the true presence of multifocality is unknown. Here we present a 72-yearold male diagnosed with IPMN (carcinoma in situ) in the pancreatic head and a branch duct type IPMN (duct atypia) in the pancreatic body and tail. The patient underwent a Whipple intervention and a distal pancreatectomy. A three-year disease-free survival has been observed so far.

  1. The dynamics of the production of AIDS-related stigma among pregnant women living with HIV/AIDS in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Monteiro, Simone; Villela, Wilza; Fraga, Livia; Soares, Priscilla; Pinho, Adriana

    2016-12-15

    The study analyses the relationship between AIDS-related stigma and the processes of discrimination prior to diagnosis among pregnant women living with HIV/AIDS. The fieldwork involved interviews about the life trajectories of 29 pregnant women living with HIV/AIDS, recruited at two AIDS services in Rio de Janeiro, Brazil. The analysis revealed that before HIV diagnosis, social and gender inequalities experienced by these women reduced their access to material and symbolic goods that could have enhanced educational and career prospects and their ability and autonomy to exercise sexual and reproductive rights. Being diagnosed with HIV triggered fear of moral judgment and of breakdown in social and family support networks. Given these fears, pregnant women living with HIV/AIDS opt for concealment of the diagnosis. It is necessary for health services, NGOs and government agencies to work together to face the factors that fuel stigma, such as socioeconomic and gender inequalities, taboos and prejudices related to sexuality, and also develop actions to enable women to redefine the meaning of the disease.

  2. The dynamics of the production of AIDS-related stigma among pregnant women living with HIV/AIDS in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Simone Monteiro

    Full Text Available The study analyses the relationship between AIDS-related stigma and the processes of discrimination prior to diagnosis among pregnant women living with HIV/AIDS. The fieldwork involved interviews about the life trajectories of 29 pregnant women living with HIV/AIDS, recruited at two AIDS services in Rio de Janeiro, Brazil. The analysis revealed that before HIV diagnosis, social and gender inequalities experienced by these women reduced their access to material and symbolic goods that could have enhanced educational and career prospects and their ability and autonomy to exercise sexual and reproductive rights. Being diagnosed with HIV triggered fear of moral judgment and of breakdown in social and family support networks. Given these fears, pregnant women living with HIV/AIDS opt for concealment of the diagnosis. It is necessary for health services, NGOs and government agencies to work together to face the factors that fuel stigma, such as socioeconomic and gender inequalities, taboos and prejudices related to sexuality, and also develop actions to enable women to redefine the meaning of the disease.

  3. 建筑工人艾滋病相关行为及HIV感染状况调查%AIDS- related Behaviors and HIV Infection Status Among Construction Workers

    Institute of Scientific and Technical Information of China (English)

    何波; 农丽萍; 张建明; 黄祖斌; 钟海东

    2012-01-01

    Objective To explore AIDS - related behaviors and HIV infection status among construction workers in Pingxiang city for effective interventions on high risk behavior. Methods A cluster sampling method was adopted and 405 workers from 9 construction sites in Pingxiang city were selected from January to March 2011. Sexual behaviors including marriage sex, commercial sex and non - marriage/commercial casually sex were analyzed as well as HIV/AIDS related knowledge awareness, drug using and HIV, Syphilis and HCV test results in laboratory. Result A total of 405 construction workers were selected and investigated, with the HIV infection rate of 0. 49% , syphilis infection rate of 3. 95% , and HCV infection rate of 0. 99%. The awareness rate of AIDS -related knowledge (who could answer more than 6 items) was 72. 28% among the workers. The percentage of having sex with regular partners within the past year was 93.24% , and the rate of using condom each time was only 8. 69%. The rate of having non - marriage/commercial casual sex was 5. 68% in the past year. And 13. 39% of investiged male construction workers had had commercial sex in the past year with the rate of 62. 22% using condom each time. Also the rate was 0. 74% of drug using. Single factor analysis shows that the rate of commercial sex behavior is related to both education level and the AIDS - related knowledge awareness among the male construction workers ( P < 0. 05 ). Conclusion There was synergistic effect of multiple high risks related to HIV among construction workers in Pingxiang. Those construction workers were becoming the high risk and bridge group of AIDS infection and transmission. Effective interventions on high risk behavior should be carried out for HIV/AIDS prevention and control.%目的 了解凭祥市建筑工人艾滋病(AIDS)相关行为与艾滋病病毒( HIV)感染状况,以便采取有针对性的高危行为干预措施.方法 于2011 - 01/03,采用整群抽样方法抽取凭祥市9

  4. 艾滋病相关性腹泻中医综合疗法探析%Explore in the Comprehensive Therapy of TCM to AIDS Related Diarrhea

    Institute of Scientific and Technical Information of China (English)

    张亚萍; 邓鑫; 李永亮

    2011-01-01

    腹泻是艾滋病患者一种非常普遍的临床症状,严重影响患者的生活质量.艾滋病患者腹泻的病机主要在脾,以脾虚失运为主.在防治上,运用健脾益气的中药和艾灸综合疗法对于改善艾滋病患者腹泻症状,提高患者生活质量,维持机体免疫功能,减缓疾病的发展等都有积极的意义.%Diarrhea which is a common clinical symptom of patients with AIDS influences the quality of patients ' life significandy. The pathogenesis of AIDS related diarrhea lies mainly in the spleen with losing transport because of splenic asthenia as the most common syndrome type. To prevent or treat it with comprehensive therapy of strengthening spleen and replenishing Qi and moxibustion can help to alleviate the symptoms, improve the quality of life, maintain the immune function of the body and slow down the steps of the development of the disease.

  5. Most multifocal papillary thyroid carcinomas acquire genetic and morphotype diversity through subclonal evolution following the intra-glandular spread of the initial neoplastic clone.

    Science.gov (United States)

    Jovanovic, L; Delahunt, B; McIver, B; Eberhardt, N L; Grebe, S K G

    2008-06-01

    Papillary thyroid carcinoma (PTC) is frequently multifocal (mPTC), with synchronous tumour foci often showing varied morphology. The genetic mechanisms underlying the development of multiple and histologically diverse tumour foci remain uncertain. Different tumour foci might develop either through intrathyroidal dissemination of a single malignant clone, with morphotype differentiation occurring as a result of subclonal progression, or they may stem from independent transformational events involving multiple progenitor clones. To determine the clonal derivation of multiple tumour foci and to map their clonal relationships and genetic progression in mPTC, we evaluated genome-wide allelic imbalances (AI) and BRAF V600E mutation status in 55 synchronous tumour foci from 18 mPTC patients. For apparently monoclonal tumours, we calculated the probabilities of monoclonal derivation and used phylogenetic analysis to model clonal evolution. Genome-wide allelotyping and BRAF mutation analysis showed genetic alterations consistent with monoclonal origin in 83% of cases, mostly with evidence of subclonal evolution. BRAF V600E mutations were early events during clonal evolution of most, but not all cases. MPTC with morphologically diverse tumour foci also arose through monoclonal derivation in 75% of cases, demonstrating that morphotype-determining genetic changes can be acquired during clonal diversification, subsequent to the spread of the original malignant progenitor clone. In 17% of patients, discordant AI or BRAF V600E profiles implied that mPTCs can occasionally develop from distinct transformation events. This study suggests that mPTC originates usually from neoplastic transformation and subsequent intrathyroidal spread of a single malignant progenitor clone. Clonal progression and morphotype differentiation occur through progressive acquisition of genetic alterations subsequent to the initial intra-glandular spread. In monoclonal BRAF V600E-positive mPTCs, BRAF V600E

  6. Secondary Analysis of an Electronic Surveillance System Combined with Multi-focal Interventions for Early Detection of Sepsis.

    Science.gov (United States)

    Westra, Bonnie L; Landman, Sean; Yadav, Pranjul; Steinbach, Michael

    2017-01-18

    To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveillance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application.

  7. Surgical treatment of multifocal giant cell tumor of carpal bones with preservation of wrist function: case report.

    Science.gov (United States)

    Tarng, Yih-Wen; Yang, Shan-Wei; Hsu, Chien-Jen

    2009-02-01

    We report a rare case of multifocal giant cell tumor of bone involving the trapezium, trapezoid, capitate, and scaphoid with soft tissue extension. Following intralesional resection, an autogenous corticocancellous iliac crest bone graft was used to fill the resultant defect and preserve carpal height and radiocarpal motion. Successful union with no recurrence was noted at 1-year follow-up.

  8. Multifocal sparganosis mimicking lymphoma involvement: Multimodal imaging findings of ultrasonography, CT, MRI, and position emission tomography-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Heo, So Young; Park, Ji Yeon; Park, Noh Hyuck; Park, Chan Sub; Kim, Tae Jung [Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Yi, Seong Yoon [Dev. of Hematology-Omcology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of); Jun, Hyun Jung [Dev. of Hematology-Omcology, Dept. of Internal Medicine, Seoul Medical Center, Seoul (Korea, Republic of)

    2016-01-15

    Sparganosis is a rare parasitic disease caused by the migrating plerocercoid larva of Spirometra species tapeworms. The most frequent clinical manifestation is a subcutaneous nodule resembling a neoplasm. In this study, we presented multimodal findings of ultrasonography, computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography and follow-up imagings on multifocal sparganosis, mimicking lymphoma involvement in a patient with lymphoma.

  9. 新型多焦点人工晶状体临床应用的研究进展%Clinical application of new types of multifocal intraocular lens

    Institute of Scientific and Technical Information of China (English)

    张景尚; 万修华

    2015-01-01

    近年来新型多焦点人工晶状体(IOL)如非球面多焦点IOL、Toric多焦点IOL和非球面Toric多焦点IOL等的不断问世及临床应用,更好地改善了白内障患者术后的生活视力、工作视力以及生存质量.对于新型多焦点IOL的适应证应严格掌握,以使患者术后获得最佳效果.%In recent years new types of multifocal intraocular lens have been developed,such as aspheric multifocal intraocular lens,Toric multifocal intraocular lens and aspheric Toric multifocal intraocular lens and so on.The vision in life and work and the quality of life in patients with cataract were significantly improved after phacoemulsification with the new types of multifocal intraocular lens.At the same time there should be a strict indications for the new types of multifocal intraocular lens,so as to make the cataract patients implanted multifocal intraocular lens getting the best visual quality.

  10. MRI characteristics are predictive for CDMS in monofocal, but not in multifocal patients with a clinically isolated syndrome

    Directory of Open Access Journals (Sweden)

    Nielsen Jessica M

    2009-05-01

    Full Text Available Abstract Background To diagnose multiple sclerosis (MS, evidence for dissemination in space and time is required. There is no clear definition on how symptoms and signs of a patient indicate clinical dissemination in space. To provide a uniform approach on this subject, a clinical classification system was described recently differentiating patients with mono- and multifocal clinical presentation. Here we assess the predictive value of clinically defined dissemination in space at first presentation for time to clinically definite MS (CDMS. Methods Four hundred and sixty-eight patients with a first episode suggestive of MS were classified as clinically mono- or multifocal by two neurologists blinded to magnetic resonance imaging (MRI results. These patients were part of the BENEFIT study in which 292 patients were randomized to interferon beta-1b (IFNB-1b and 176 to placebo. By using Kaplan-Meier statistics the risk for CDMS was studied in mono- and multifocal patients of the placebo group, both with and without taking into account MRI measures of potential prognostic relevance. Results Time to CDMS was similar in monofocal and multifocal patients. In monofocal patients, the risk for CDMS over 2 years was significantly higher when ≥ 9 T2 lesions or at least one Gd-enhancing lesion were present at the first event or 3 or 6 months after the first event. In patients with multifocal presentation, these MRI measures had no significant added value in predicting time to CDMS. Conclusion These data indicate that a carefully performed neurological assessment of symptoms and signs, combined with lesions on MRI, is important for defining the risk of conversion to CDMS. Trial Registration The Benefit trial has been registered under NCT00185211 http://www.clinicaltrials.gov

  11. IgM, IgG and IgA rheumatoid factors and circulating immune complexes in patients with AIDS and AIDS-related complex with serological abnormalities.

    Science.gov (United States)

    Procaccia, S; Lazzarin, A; Colucci, A; Gasparini, A; Forcellini, P; Lanzanova, D; Foppa, C U; Novati, R; Zanussi, C

    1987-01-01

    To investigate some humoral aspects which may reflect the involvement of B lymphocytes in the acquired immunodeficiency syndrome (AIDS), we used an enzyme-linked immunoassay (ELISA) to determine the levels of IgM, IgG and IgA rheumatoid factors (RF) in 16 patients suffering from full-blown AIDS and 32 patients with AIDS-related complex (ARC), in the clinical form of lymphoadenopathy syndrome (LAS), compared with 40 healthy, young heterosexual subjects. Both AIDS and ARC patients showed a greater incidence of high IgM RF levels, with mean values significantly higher than controls, but with no differences between the two pathological groups. IgG RF behaviour was similar in the two patient populations and the healthy subjects. IgA RF were significantly raised in AIDS and ARC. Further information on RF was obtained by determination of the immunoglobulin levels of the respective isotypes in the same patients. Mean IgG levels were above normal in AIDS and ARC patients, but the latter group showed a higher incidence of increased values and higher mean levels. The IgA isotype was significantly increased mainly in AIDS patients. The behaviour of IgM was virtually the same in the three groups studied. A difference between AIDS and ARC patients was established by the detection of circulating immune-complexes (IC) by the C1q-binding and CIC-conglutinin assays. IC were significantly high, by both methods, only in the ARC group, but normal or very low in AIDS. These overall findings suggest once again the impairment of B cell function in AIDS, with prevalent hyperactivation in ARC and exhaustion in full-blown AIDS, and apparent preservation, in the latter group, of the antibody responses which are more closely related to the activity of subsets of T helper cells. PMID:3608224

  12. Analysis on the Traditional Chinese Medicine Syndromes of AIDS-related Diarrhea%艾滋病相关性腹泻中医证候学研究

    Institute of Scientific and Technical Information of China (English)

    李永亮; 邓鑫; 梁健; 张亚萍

    2012-01-01

    Acquired Immune Deficiency Syndrome (AIDS) , caused by human immunodeficiency virus (HIV) ,has strong in-fectivity and high mortality. As one of the most common clinical symtoms of AIDS, diarrhea severely influences the quality of pa-tientslives. According to the report, almost 30% -90% of AIDS patients have digestive system symptoms, diarrhea is-especially common. It is a difficult task to research the AiDS-related diarrhea. It will give us some guiding clues to explore the traditional Chinese medicine syndromes of AIDS-related diarrhea.%艾滋病是由人类免疫缺陷病毒(human immunodeficiency virus,HIV)引起的获得性免疫功能缺陷综合征(Acquired immunodeficiency syndrome,AIDS),死亡率极高,传染性极强.腹泻是艾滋病发生发展过程中常见的一种并发症,严重影响患者的生活质量.据报道,艾滋病患者约30% ~ 90%伴有消化系统症状,其中以腹泻最为常见,对于艾滋病相关性腹泻的研究是一项非常艰巨的任务.通过对其中医证候学的研究,对艾滋病相关性腹泻的防治具有一定的积极意义.

  13. Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity

    Directory of Open Access Journals (Sweden)

    M. P. V. Prabhat

    2013-01-01

    Full Text Available Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Usually HPV involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65-year-old female. We also discuss the probable multifactorial etiology and variable clinical presentations of the lesions, including evidence of HPV 16 expression, as detected by polymerase chain reaction. The present report illustrates the need for careful examination and prompt diagnosis of the disease, as it might be associated with high risk genotypes such as HPV 16 and 18.

  14. Multifocal Epithelioid Hemangioendothelioma Derived from the Spine Region: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    G. Kerry

    2012-02-01

    Full Text Available Background: Epithelioid hemangioendothelioma (EHE is a rare vascular tumor with malignant biological behavior. It arises from endothelial cells, usually within soft tissues, and can occur in almost all locations. Case Report: We report a unique case of a 25-year-old man who presented with sudden attacks of severe back pain followed by acute non-traumatic paraplegia. Emergency diagnostics revealed a pathologic fracture of the T7 vertebra with tumor tissue invasion of the spinal canal. Furthermore, multifocal metastases were found. Results: To achieve en bloc resection, interdisciplinary surgical approaches were indicated. Despite multimodal therapy concepts, including radiotherapy and chemotherapy as well as endovascular embolization, the patient died within 8 weeks. Conclusion: Prognosis of EHE is unpredictable and mainly determined by its location. The lesions are potentially aggressive; therefore, en bloc resection should be attempted whenever possible. However, as shown in the literature, only 15% of patients are suitable for total resection.

  15. Nerve sonography in multifocal motor neuropathy and chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    D. S. Druzhinin

    2016-01-01

    Full Text Available The quantitative ultrasound characteristics (USC of the median, ulnar nerve at different levels and the spinal nerves in patients with multifocal motor neuropathy (MMN; n=13; 40,4 ± 12,6 years old and chronic inflammatory demyelinating polyneuropathy (CIDP; n = 7; 47,3 ± 11,2 year old did not reveal statistical difference in cross sectional area (CSA between analyzed groups. Patients with MMN have more pronounced asymmetry of CSA in comparison with CIDP patients which have a symmetrical pattern of diffuse nerve involvement. Quantitative USC has shown to be not informative enough in differentiation of MMN and CIDP. The qualitative analysis (QA according to 3 described types of nerve changes has shown that CIDP is characterized by the prevalence of type 3 pattern (85.8 % while MMN – by type 2 (69.2 %. The sensitivity and specificity of proposed QA patterns in nerve USC need to be analyzed in additional investigations. 

  16. Comparative study of peripheral nerve Mri and ultrasound in multifocal motor neuropathy and amyotrophic lateral sclerosis

    DEFF Research Database (Denmark)

    Jongbloed, Bas A.; Haakma, Wieke; Goedee, H. Stephan

    2017-01-01

    INTRODUCTION: Differentiating multifocal motor neuropathy (MMN) from amyotrophic lateral sclerosis (ALS) is important, as MMN is a difficult, but treatable disorder. METHODS: We studied peripheral nerve imaging techniques in differentiating MMN from ALS by measuring the cross-sectional area (CSA......) of the median and ulnar nerves in the forearms using high resolution ultrasound (HRUS) and MRI. RESULTS: HRUS CSA values of the median nerve in the forearm (P = 0.002) and the ulnar nerve distal to the sulcus (P = 0.009) were significantly enlarged in patients with MMN. There was a positive correlation between...... CSA as measured with HRUS and MRI (Spearman rho 0.60; P nerve imaging is a potentially powerful technique to distinguish MMN from ALS. Muscle Nerve, 2016 Muscle Nerve 54: 1133-1135, 2016....

  17. Multifocal epithelial hyperplasia: a case report of a family of Somalian descent living in Australia.

    Science.gov (United States)

    Hall, Charmaine; McCullough, Michael; Angel, Chris; Manton, David

    2010-01-01

    Multifocal epithelial hyperplasia (MEH) presents as painless, single or multiple nodular or papular lesions with a sessile base, ranging in diameter from 0.1 cm to 1.0 cm, frequently coalescing. Lesion color varies from red to white, depending on the extent of keratinization. The condition appears mainly in children and adolescents and regresses spontaneously. The etiological factors and pathogenesis of MEH are speculative. A 13-year-old boy presented to the Royal Dental Hospital of Melbourne for dental examination revealing several asymptomatic, exophytic, pink, sessile, smooth-surfaced nodules on the lateral borders of the tongue and lingual surface of the lower lip. The subject is of Somalian background and one of 11 siblings aged 2 to 22 years old living with his parents in an overcrowded residence. Examination of other family members revealed the presence of similar lesions in 2 younger sisters. An incisional biopsy confirmed the diagnosis of MEH histopathologically.

  18. Effective treatment with interferon-alpha in chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Andersson, R

    1995-10-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disease of unknown etiology characterized by multiple osteomyelitic changes in the predominantly metaphysial regions of long bones. It was first described by Giedon et al. in 1972. Cultures for all known microorganisms are negative. Pain is the most common symptom, and sometimes soft tissue swelling is present. Patients are usually treated with nonsteroidal antiinflammatory drugs (NSAIDs) or corticosteroids and respond, at least partly, to these treatments. CRMO is most commonly seen in children and is in the majority of cases self-limiting but has a protracted course of several years. Some patients have a more prolonged disease period, as in the patient reported here. Treatment with corticosteroids in children has the risk of causing growth retardation as a potential adverse effect, and alternative treatments are of great interest. In the actual paper, a successful treatment with interferon-alpha 2b in a 34-year-old man with CRMO is presented.

  19. Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Ferguson, Polly J; Sandu, Monica

    2012-04-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory disorder that primarily affects children. Its hallmark is recurring episodes of sterile osteomyelitis. The clinical presentation is insidious onset of bone pain with or without fever. Laboratory studies typically reveal nonspecific evidence of inflammation. Radiologic imaging and histologic appearance resemble those of infectious osteomyelitis. There is a strong association with inflammatory disorders of the skin and intestinal tract in affected individuals and their close relatives, suggesting a shared pathophysiology and supporting a genetic component to disease susceptibility. Two genetic syndromes have CRMO as a prominent phenotype-Majeed syndrome and deficiency of the interleukin-1 receptor antagonist-and suggest that interleukin-1 may be a key cytokine in disease pathogenesis. This review briefly summarizes the main clinical and radiologic aspects of the disease and then focuses on genetics and pathophysiology and provides an update on treatment.

  20. Improvement of the classification accuracy in discriminating diabetic retinopathy by multifocal electroretinogram analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The multifocal electroretinogram (mfERG) is a newly developed electrophysiological technique. In this paper, a classification method is proposed for early diagnosis of the diabetic retinopathy using mfERG data. MfERG records were obtained from eyes of healthy individuals and patients with diabetes at different stages. For each mfERG record, 103 local responses were extracted. Amplitude value of each point on all the mfERG local responses was looked as one potential feature to classify the experimental subjects. Feature subsets were selected from the feature space by comparing the inter-intra distance. Based on the selected feature subset, Fisher's linear classifiers were trained. And the final classification decision of the record was made by voting all the classifiers' outputs. Applying the method to classify all experimental subjects, very low error rates were achieved. Some crucial properties of the diabetic retinopathy classification method are also discussed.

  1. Media richness and social information processing: rationale for multifocal continuing medical education activities.

    Science.gov (United States)

    Gilman, S C; Turner, J W

    2001-01-01

    Academic business communication has studied the results of media selection in organizations. Little of this work has been discussed in the context of continuing medical education (CME); however, it may apply to improving the design of educational activities. This article reviews literature on media richness and social information processing theories. The concept of media richness suggests that media choice results from a match between the objective characteristics of the medium and the content requirements of a message. In this context, media include face-to-face conversation and print and electronic media. Social information processing theory suggests that media selection is also based on participants' social norms for how information is communicated in their environment and the participants' familiarity with specific media types. Appraisal of CME with respect to these theories suggests that the complex relationship of CME content and CME participant environments invites the most effective strategies of multiple media experienced over time in what might be called multifocal continuing medical education.

  2. [Multifocal demyelinating polyneuropathy with persistent conduction block (Lewis-Sumner syndrome)].

    Science.gov (United States)

    Mezaki, T; Kaji, R; Hamano, T; Kimura, J; Kameyama, M

    1990-11-01

    Multifocal demyelinating neuropathy with persistent conduction block (Lewis-Sumner syndrome) is a variant of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which often clinically simulates a motor neuron disease (MND). We report here three patients initially suspected to have MND, who later were diagnosed as a Lewis-Sumner syndrome. One of them showed a remarkable clinical improvement after immunoglobulin therapy. The definitive diagnosis of this syndrome rests upon nerve conduction studies, uncovering multiple sites of persistent conduction block. Technically, it is important to exclude insufficient stimulus which may lead to an erroneous impression of conduction block. Magnetic stimulation, as compared to electric current, elicited larger responses possibly because of deeper current penetration. We found this mode of stimulation useful especially in testing focal demyelination requiring full activation of a diseased nerve at a most proximal segment.

  3. Rare lung manifestation of multifocal micronodular pneumocyte hyperplasia in a teenage girl with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Seung Mi; Yoon, Hye Kyung; Lee, Seung Koo [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-08-15

    Multifocal micronodular pneumocyte hyperplasia (MMPH) is a relatively rare pulmonary disorder that can be associated with tuberous sclerosis complex (TSC). It has been rarely reported in children or adolescents. MMPH is a hamartomatous process of the lung with multiple small nodules, composed of type II pneumocytes. Plain radiography and chest CT in MMPH may demonstrate numerous small nodules measuring 1-10 mm in diameters, distributed randomly throughout both lungs. If MMPH is an initial presentation of TSC, and unless we are familiar with this lung manifestation of TSC, radiologic findings can mimic miliary tuberculosis or metastatic disease. We report a teenage girl with TSC and histologically confirmed MMPH which mimicked miliary tuberculosis at the initial presentation.

  4. Office immunotherapy in chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy.

    Science.gov (United States)

    Dyck, Peter J; Taylor, Bruce V; Davies, Jenny L; Mauermann, Michelle L; Litchy, William J; Klein, Christopher J; Dyck, P James B

    2015-10-01

    Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-based immunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons).

  5. The surgery and early postoperative radicular pain in cases with multifocal lumbar disc herniation

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    Ulutaş, Murat; Çınar, Kadir; Seçer, Mehmet

    2017-01-01

    Abstract Persistence of postoperative radicular pain after surgery for multifocal disc herniation (MFDH) is a clinical problem. This study aims to evaluate the effects of a combined treatment approach compared with unilateral stabilization on early postoperative radicular pain in patients with MFDH. Age, sex, level of operation, clinical findings, and radicular pain visual analogue scale (VAS) scores before surgery in the early postoperative period and at 3 months after surgery were retrospectively reviewed for 20 cases of multifocal lumbar disc herniation. The combined approach (translaminar and far lateral) was used for 13 cases. Seven cases underwent transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular stabilization following total facetectomy. The mean age of the sample was 49.4 ± 10.1 years and the female-to-male ratio was 8:12. The mean VAS scores for radicular pain in cases treated with the combined approach were 8.2, 4.07, and 2.3 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean score for radicular pain improved by 50.4% in the early postoperative period and by 72% in the late postoperative period. The mean VAS scores for radicular pain in cases who underwent TLIF and unilateral stabilization after facetectomy were 8.4, 2.1, and 1.4 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean VAS score for radicular pain improved by 75% in the early postoperative period and by 83.3% in the late postoperative period. The combined approach is an effective alternative in cases with MFDH. TLIF and unilateral segmental stabilization provide substantial decompression and eliminate mechanical compression by conserving the height of the intervertebral foramen in the event that sufficient decompression is unable to obtain. We suggest that elimination of chemical mediators, particularly those causing pain in the dorsal ganglion, contributes to

  6. Visual outcomes after implantation of a novel refractive toric multifocal intraocular lens

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    Talita Shimoda

    2014-04-01

    Full Text Available Purpose: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC was -2.19 (SD: ± 0.53. After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001. Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.

  7. A missense mutation in pstpip2 is associated with the murine autoinflammatory disorder chronic multifocal osteomyelitis.

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    Ferguson, Polly J; Bing, Xinyu; Vasef, Mohammed A; Ochoa, Luis A; Mahgoub, Amar; Waldschmidt, Thomas J; Tygrett, Lorraine T; Schlueter, Annette J; El-Shanti, Hatem

    2006-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder that primarily affects bone but is often accompanied by inflammation of the skin and/or gastrointestinal tract. The etiology is unknown but evidence suggests a genetic component to disease susceptibility. Although most cases of CRMO are sporadic, there is an autosomal recessive syndromic form of the disease, called Majeed syndrome, which is due to homozygous mutations in LPIN2. In addition, there is a phenotypically similar mouse, called cmo (chronic multifocal osteomyelitis) in which the disease is inherited as an autosomal recessive disorder. The cmo locus has been mapped to murine chromosome 18. In this report, we describe phenotypic abnormalities in the cmo mouse that include bone, cartilage and skin inflammation. Utilizing a backcross breeding strategy, we refined the cmo locus to a 1.3 Mb region on murine chromosome 18. Within the refined region was the gene pstpip2, which shares significant sequence homology to the PSTPIP1. Mutations in PSTPIP1 have been shown to cause the autoinflammatory disorder PAPA syndrome (pyogenic arthritis, pyoderma gangrenosum and acne). Mutation analysis, utilizing direct sequencing, revealed a single base pair change c.293T --> C in the pstpip2 gene resulting in a highly conserved leucine at amino acid 98 being replaced by a proline (L98P). No other mutations were found in the coding sequence of the remaining genes in the refined interval, although a 50 kb gap remains unexplored. These data suggest that mutations in pstpip2 may be the genetic explanation for the autoinflammatory phenotype seen in the cmo mouse.

  8. Sensory loss in multifocal motor neuropathy: a clinical and electrophysiological study.

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    Lambrecq, Virginie; Krim, Elsa; Rouanet-Larrivière, Marie; Lagueny, Alain

    2009-02-01

    Some patients fulfilling the criteria for the diagnosis of multifocal motor neuropathy with conduction block (MMN-CB) at the onset of disease may subsequently develop a sensory loss associated with electrophysiological sensory abnormalities. The latter could represent an overlap between MMN-CB and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy. The objective was to specify the features of MMN-CB with sensory loss (MMN-CB-Se). Five patients in a series of 11 consecutive patients who fulfilled the criteria of the American Association of Neuromuscular and Electrodiagnostic Medicine for MMN-CB at the first examination and were treated periodically with intravenous immunoglobulin (IVIg) developed sensory loss in the course of the disease. In these five patients we compared the clinical, laboratory, and electrophysiological features found after the development of sensory loss with those at the first examination. The mean time to appearance of objective sensory signs was 7.2 years. In three of the five patients the sensory loss was preceded by intermittent paresthesias in the same nerve territories as the motor involvement. The most frequent electrophysiological abnormality was amplitude reduction of sensory nerve action potentials. There were no bilateral or symmetrical clinical and electrophysiological sensory abnormalities. Anti-GM1 IgM antibodies were positive in four patients. MMN-CB-Se could be an overlap between MMN-CB and MADSAM. It shares the distribution of the sensory disorders encountered in MADSAM, but it is closer to MMN-CB on clinical and therapeutic levels. Study of more patients would be useful to classify this subgroup more accurately.

  9. Diagnostic value of combined magnetic resonance imaging examination of brachial plexus and electrophysiological studies in multifocal motor neuropathy

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    Basta Ivana

    2014-01-01

    Full Text Available Background/Aim. Multifocal motor neuropathy (MMN is an immune-mediated disorder characterized by slowly progressive asymetrical weakness of limbs without sensory loss. The objective of this study was to investigate the involvement of brachial plexus using combined cervical magnetic stimulation and magnetic resonance imaging (MRI of plexus brachialis in patients with MMN. We payed special attention to the nerve roots forming nerves inervating weak muscles, but without detectable conduction block (CB using conventional nerve conduction studies. Methods. Nine patients with proven MMN were included in the study. In all of them MRI of the cervical spine and brachial plexus was performed using a Siemens Avanto 1.5 T unit, applying T1 and turbo spinecho T1 sequence, axial turbo spin-echo T2 sequence and a coronal fat-saturated turbo spin-echo T2 sequence. Results. In all the patients severe asymmetric distal weakness of muscles inervated by radial, ulnar, median and peroneal nerves was observed and the most striking presentation was bilateral wrist and finger drop. Three of them had additional proximal weakness of muscles inervated by axillar and femoral nerves. The majority of the patients had slightly increased cerebrospinal fluid (CSF protein content. Six of the patients had positive serum polyclonal IgM anti-GM1 antibodies. Electromyoneurography (EMG showed neurogenic changes, the most severe in distal muscles inervated by radial nerves. All the patients had persistent partial CBs outside the usual sites of nerve compression in radial, ulnar, median and peroneal nerves. In three of the patients cervical magnetic stimulation suggested proximal CBs between cervical root emergence and Erb’s point (prolonged motor root conduction time. In all the patients T2-weighted MRI revealed increased signal intensity in at least one cervical root, truncus or fasciculus of brachial plexus. Conclusion. We found clinical correlation between muscle weakness

  10. Multifocal VEP and OCT findings in patients with primary open angle glaucoma: A cross-sectional study

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    Moschos Marilita M

    2012-08-01

    Full Text Available Abstract Bakground To evaluate objectively the anatomical and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG by the joint use of optical coherence tomography (OCT and multifocal visual evoked potentials (mfVEP. Methods 29 eyes with open angle glaucoma and visual field defects, as well as 20 eyes of 10 age-matched control normal subjects were tested. All participants underwent a complete ophthalmological examination. Moreover, Humphrey visual field test, OCT examination and recording of mfVEP were performed. Amplitude and implicit time of mfVEP, as well as RNFL thickness were measured. Differences in density components of mfVEP and in RNFL thickness among POAG eyes and control eyes were examined using Student’s t-test. Results In glaucomatous eyes the mean Retinal Response Density (RRD was lower than normal in ring 1, 2 and 3 of mfVEP (p 2, 6.9 ± 4.8 nV/deg2 and 2.6 ± 1.6 nV/deg2 in rings 1, 2 and 3 respectively. In contrast the mean implicit time was similar to control eyes. In addition, the mean RNFL thickness in POAG eyes was estimated at 76.8 ± 26.6 μm in the superior area, 52.1 ± 16.3 μm in the temporal area, 75.9 ± 32.5 μm in the inferior area and 58.6 ± 19.4 μm in the nasal area. There was a statistically significant difference in RNFL thickness in all peripapillary areas (p  Conclusions Our study shows that, although Standard Automatic Perimetry is the gold standard to evaluate glaucomatous neuropathy, the joint use of mfVEP and OCT could be useful in better monitoring glaucoma progression.

  11. Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens

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    Leonardo Akaishi

    2010-08-01

    Full Text Available OBJETIVO: Avaliar a acuidade visual a distancia, intermediária e perto após o implante de uma lente intraocular (LIO asférica multifocal difrativa AcrySof® ReSTOR® SN6AD1. MÉTODOS: Estudo prospectivo de 50 pacientes com catarata submetidos à facoemulsificação e implante de LIO AcrySof® ReSTOR®. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e acuidade visual intermediária corrigida para longe (AVIC. Um questionário de satisfação e fenômenos visuais foi administrado ao final do estudo. RESULTADO: Após três meses de cirurgia, a média das acuidades (logMAR era: AVSC, 0,05 ± 0,07; AVCC, 0,00 ± 0,01; AVPC, 0,00 ± 0,0, e AVIC, 0,15 ± 0,05. A AVCC e AVPC era de 20/25 ou melhor em todos os pacientes, sendo a AVIC J3 ou melhor em 83% dos pacientes. Pacientes relataram excelente desempenho visual nas questões relacionadas a atividades para distância, intermediário, e perto com pouca ou nenhuma dificuldade. Nenhum paciente relatou halos ou 'glare' severos, sendo os mesmos caracterizados entre nenhum a moderado. CONCLUSÃO: A LIO asférica AcrySof® ReSTOR® SN6AD1 mostrou excelentes resultados na visão para longe, perto e intermediário, além de apresentar uma baixa incidência de fenômenos visuais.PURPOSE: To evaluate distance, intermediate, and near vision after aspheric multifocal diffractive AcrySof® ReSTOR® SN6AD1 intraocular lens (IOL implantation. METHODS: Prospective study of 50 patients with cataract that had phacoemulsification and AcrySof® ReSTOR® IOL implantation. Uncorrected distance vision acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered at the end of the study. RESULTS: Three months

  12. 商业人身保险涉及的艾滋病相关问题探讨%Analysis of issues of HIV/AIDS related commercial life insurance

    Institute of Scientific and Technical Information of China (English)

    李佳; 陈清峰

    2011-01-01

    Objective To analyze the issues of HIV/AIDS related commercial life insurance and explore the ways to tackle them in perspectives of conflicting views.Methods Literature concerning these issues were reviewed.Resuits Three conflicting views were present in regards to HIV/AIDS related commercial life insurance: 1)Whether differential treatments concerning HIV/AIDS related commercial life insurance constituted discrimination and stigma; 2)Whether provision of HIV/AIDS related insurance would impact on risk management and control of insurance companies; 3) Whether HIV/AIDS related life insurance is part of social responsibilities undertaken by insurance companies.Conclusion Three issues have led to the conflicting views in regards to HIV/AIDS related commercial life insurance: 1)Perceptions on features of commercial insurance could influence understanding of HIV/AIDS discrimination and stigma in commercial life insurance; 2)Insurance companies are faced with pricing and "non-moral"judgment of HIV/AIDS related risk; 3) There is different understanding of relation between HIV/AIDS related life insurance and social responsibilities of insurance companies.Hence, it is suggested that HIV/AIDS related risk,and scientific definition of differential treatments and HIV/AIDS discrimination in commercial life insurance be objectively assessed, regulations on exclusion clauses of commercial life insurance concerning HIV/AIDS be enhanced,and participation by insurance companies in the fight against HIV/AIDS be promoted.%目的 从艾滋病相关商业人身保险服务现状及针对这些现状的不同观点人手,理清艾滋病相关商业人身保险服务所面临的问题,探讨解决商业人身保险涉及的艾滋病相关问题.方法 采取文献研究方法.结果 对艾滋病相关商业人身保险服务主要有三个对立观点:商业人身保险服务中,艾滋病相关的区别对待是否构成歧视;将艾滋病纳入商业人身保险责任范围,是否对

  13. Re-validation of the Van Rie HIV/AIDS-related stigma scale for use with people living with HIV in the United States.

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    Kipp, Aaron M; Audet, Carolyn M; Earnshaw, Valerie A; Owens, Jared; McGowan, Catherine C; Wallston, Kenneth A

    2015-01-01

    There is little consensus about which of the many validated human immunodeficiency virus (HIV) stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40%) eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale), Managing HIV Concealment (new subscale), and Perceived Community Stigma (original subscale). These subscales were moderately inter-related (r = 0.51 to 0.58) with acceptable to excellent reliability (Cronbach's alpha = 0.69 to 0.90). The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76), had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual's transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding), highlight

  14. Re-validation of the Van Rie HIV/AIDS-related stigma scale for use with people living with HIV in the United States.

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    Aaron M Kipp

    Full Text Available There is little consensus about which of the many validated human immunodeficiency virus (HIV stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40% eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale, Managing HIV Concealment (new subscale, and Perceived Community Stigma (original subscale. These subscales were moderately inter-related (r = 0.51 to 0.58 with acceptable to excellent reliability (Cronbach's alpha = 0.69 to 0.90. The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76, had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual's transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding

  15. Use of interleukin-2 for management of natalizumab-associated progressive multifocal leukoencephalopathy: case report and review of literature.

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    Dubey, Divyanshu; Zhang, Yinan; Graves, Donna; DeSena, Allen D; Frohman, Elliot; Greenberg, Benjamin

    2016-05-01

    A 51-year-old woman with relapsing-remitting multiple sclerosis (RRMS) and 3-year history of natalizumab use developed expressive aphasia. A brain magnetic resonance image (MRI) showed left frontotemporal and right parietal lesion with mild contrast enhancement and cerebrospinal fluid (CSF) was positive for John Cunningham virus (JCV) by polymerase chain reaction (PCR). The patient received five cycles of plasmapheresis followed by intravenous immunoglobulin. Despite this intervention, her speech deteriorated and she developed right hemiparesis. Upon referral to our institution, CSF quantitative JCV PCR was notable for 834 copies/ml. The patient was given an initial dose of 50,000 units of interleukin-2 (IL-2) subcutaneously (SQ) followed by 1 million units IL-2 SQ daily. Due to concern for immune reconstitution inflammatory syndrome (IRIS), the patient also received intravenous methylprednisone weekly. The regimen was tolerated well by the patient with no severe adverse effects. Clinically, the patient showed some improvement, and became more responsive and regained right lower extremity antigravity strength. After 12 weeks of IL-2 therapy, JCV quantitative PCR was notable for 31 copies/ml and the patient was more responsive. Due to persistence of JCV, IL-2 therapy was changed to mefloquine. At follow up after 6 months, the patient showed no clinical deterioration.

  16. Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinical Surveillance and Malignant Progression, Multifocality and Implications of a Field-Defect

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    Helen Elaine Remotti

    2012-03-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs are a heterogeneous group of mucin producing cystic tumors that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. Predicting the risk of malignant transformation of an IPMN lesion can be challenging. The Sendai criteria, based in large part on radiographic imaging features, help guide surgical intervention based on the stratification of cysts into high and low risk lesions for malignancy. Invasive carcinoma may develop in the index IPMN lesion or in a separate site within the pancreas, supporting the concept of a field defect in IPMN tumorigenesis. This stresses the importance of evaluation of the entire pancreas upon diagnosis of IPMN and continued surveillance of the residual pancreas following resection. Herein, the authors summarize the data presented at the 2012 ASCO Gastrointestinal Cancers Symposium regarding prevalence and site of invasive carcinoma detected in patients undergoing surveillance for IPMN (Abstract #152.

  17. Multifocal Head and Neck Neurofibromas with Osseous Abnormalities and Muscular Hypoplasia in a Child with Neurofibromatosis: Type I.

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    Rath, Rachna; Kaur, Sheetal; Baig, Shadab Ali; Pati, Punyashlok; Sahoo, Sonalisa

    2016-01-01

    Neurofibromatosis type 1 (NF1) is a clinically and genetically distinct disease involving both neuroectodermal and mesenchymal derivatives. Orofacial manifestations in NF1 have been documented before but occurrence of multifocal intraosseous (IO) and extraosseous (EO) neurofibromas is rare. The present case highlights the importance of imaging findings in the diagnosis and management of multifocal jaw, infratemporal, and parotid neurofibromas with muscular hypoplasia in an eight-year-old girl with NF1. Apart from orthopantomograms (OPG), three-dimensional computed tomography (3D CT) and cross-sectional reformations were valuable in delineating the extent of the lytic lesion and identifying additional bony deformities of the mandible. Magnetic resonance imaging (MRI) helped to identify the solid nature of the lesion and true extent of the soft tissue mass.

  18. Multifocal Head and Neck Neurofibromas with Osseous Abnormalities and Muscular Hypoplasia in a Child with Neurofibromatosis: Type I

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    Rachna Rath

    2016-01-01

    Full Text Available Neurofibromatosis type 1 (NF1 is a clinically and genetically distinct disease involving both neuroectodermal and mesenchymal derivatives. Orofacial manifestations in NF1 have been documented before but occurrence of multifocal intraosseous (IO and extraosseous (EO neurofibromas is rare. The present case highlights the importance of imaging findings in the diagnosis and management of multifocal jaw, infratemporal, and parotid neurofibromas with muscular hypoplasia in an eight-year-old girl with NF1. Apart from orthopantomograms (OPG, three-dimensional computed tomography (3D CT and cross-sectional reformations were valuable in delineating the extent of the lytic lesion and identifying additional bony deformities of the mandible. Magnetic resonance imaging (MRI helped to identify the solid nature of the lesion and true extent of the soft tissue mass.

  19. Advancing multifocal nonlinear microscopy: development and application of a novel multibeam Yb:KGd(WO4)2 oscillator.

    Science.gov (United States)

    Sheetz, Kraig E; Hoover, Erich E; Carriles, Ramón; Kleinfeld, David; Squier, Jeff A

    2008-10-27

    We present a novel Yb:KGd(WO(4))(2) oscillator design that generates six beams of temporally delayed, 253 fs, 11 nJ pulses. This allows multifocal nonlinear microscopy to be performed without the need for complicated optical multiplexers. We demonstrate our design with twelve simultaneously acquired two-photon, second-harmonic and/or third-harmonic images generated from six laterally separated foci.

  20. Treatment of chronic immune-mediated neuropathies: chronic inflammatory demyelinating polyradiculoneuropathy, multifocal motor neuropathy, and the Lewis-Sumner syndrome.

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    Sederholm, Benson H

    2010-09-01

    Current treatment approaches for the management of chronic immune-mediated peripheral neuropathies are reviewed, including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), and the Lewis-Sumner syndrome (LSS). A summary of existing evidence for commonly used treatment modalities, such as corticosteroids, intravenous immune globulin (IVIG), and plasma exchange is provided. Evidence for the use of additional immunosuppressant and immunomodulatory agents is also reviewed.

  1. Resection And Reconstructive-plastic Surgery In Treatment Of Extended And Multifocal Cicatrical Tracheal Stenosis

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    Otabek Eshonkhodjaev

    2015-12-01

    Full Text Available Background. Main issues of treatment of patients with cicatricial stenosis of trachea (CST are to increase its efficacy and safety, as well as to determine indications and contraindications for circular resection and reconstructive interventions on the trachea in patients with extended lesions of trachea, with stenoses involving subvocal cords part of larynx and well as multifocal narrowing of the trachea which could improve treatment results and quality of life of patients, to gain recovery and reduce disability and mortality.Material and methods. One hundred two patients aged from 11 to 62 years with CST were surgically treated. Stenotic site length in patients varied from 0,3 to 7 cm. Most frequently (64,2%, CST length of more than 2 cm was observed. In critical and decompensated stenosis with diameter of CST up to 5 mm with the threat of asphyxiation by the first stage we used endoscopic laser-and electric destruction of constriction followed by restricted zone bouging. If long-term rehabilitation was necessary and in case of absence of the conditions to the implementation of circular tracheal resection, we used tracheal stents. Circular resection of the trachea was performed in 24 patients. In case of contraindications, 28 patients underwent reconstructive plastic surgery with dissection the stenosis, excision of scar tissue and formation of trachea lumen in T-tube. After removing T-tube plasty of anterior tracheal wall and of soft tissues of the neck defects was performed using local tissues and grafts with microsurgical techniques.Results. Long-term results of treatment evaluated and studied in a period of 6 months to 5 years in 89 (87.3% patients. 13 patients continues to one of the stages of complex treatment. Еhe patients are under dynamic endoscopic control. Good results were achieved in the treatment of 71 patients (79.8%, satisfactory - in 12 (13.4%, unsatisfactory results in 6 (6.7% patients.Conclusions. 1. Patients with CST

  2. Patients' satisfaction and spectacle independence after cataract surgery with multifocal intraocular lens implantation in a tertiary care hospital.

    Science.gov (United States)

    Baig, Rashid; A Chaudhry, Tanveer; Kukreja, Saajan; Shakil, Sidra; Ahmad, Khabir

    2016-06-01

    This single group cohort study, undertaken at Aga Khan University Hospital, Karachi, from Jan 2012 to September 2013, assessed patients' satisfaction, spectacle independence and visual disturbance after implantation of multifocal IOLs. A total of 39 patients who underwent bilateral cataract surgery with multifocal IOL implantation were included for telephonic interviews. The mean age of participants was 55.5 ± 8.1 years. The mean follow up time was 9.60 ± 3.19 months. The overall satisfaction rate after surgery was found to be 84.6% and there was no statistically significant association of satisfaction with gender, age or education. In all 84.6%, 94.9% and 84.6% people had spectacle independence for far, intermediate and near, respectively. More than half of participants (59%) had some degree of visual disturbance. In this study, multifocal IOL implantation provided high levels of satisfaction and spectacle independence despite notable risk of halo or glare symptoms at night. Therefore, careful patient selection and preoperative counselling regarding possible risks and benefits is recommended.

  3. Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases.

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    Wang, Wei; Seeruttun, Sharvesh Raj; Fang, Cheng; Zhou, Zhiwei

    2014-08-01

    A 64-year-old man was admitted to the Sun Yat-Sen University Cancer Center with chief complaints of recurrent abdominal pain and diarrhea for about 3 years and with a history of surgical repair for intestinal perforation owing to stress ulcer. Positron emission tomography (PET)/computed tomography (CT) demonstrated a primary tumor on the pancreatic tail with multifocal liver metastases. Pathological and immunohistochemistry staining revealed the lesion to be a pancreatic neuroendocrine tumor (pNET). According to the latest World Health Organization (WHO, 2013) classification, the tumor was classified as stage IV functional G1 pNET. After referral to the multidisciplinary treatment board (MDT), the patient was started on periodic dose of omeprazole, somatostatin analogues and Interferon α (IFNα) and had scanning follow-ups. Based upon the imaging results, CT-guided radioactive iodine-125 ((125)I) seeds implantation therapy, radiofrequency ablation therapy (RFA) or microwave ablation technique were chosen for the treatment of the primary tumor. Transarterial chemoembolization (TACE), RFA and microwave ablation techniques were decided upon for liver metastases. The patient showed beneficial response to the treatment with clinically manageable low-grade side effects and attained partial remission (RECIST criteria) with a good quality of life.

  4. Multifocal Breast Cancer in Young Women with Prolonged Contact between Their Breasts and Their Cellular Phones

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    John G. West

    2013-01-01

    Full Text Available Breast cancer occurring in women under the age of 40 is uncommon in the absence of family history or genetic predisposition, and prompts the exploration of other possible exposures or environmental risks. We report a case series of four young women—ages from 21 to 39—with multifocal invasive breast cancer that raises the concern of a possible association with nonionizing radiation of electromagnetic field exposures from cellular phones. All patients regularly carried their smartphones directly against their breasts in their brassieres for up to 10 hours a day, for several years, and developed tumors in areas of their breasts immediately underlying the phones. All patients had no family history of breast cancer, tested negative for BRCA1 and BRCA2, and had no other known breast cancer risks. Their breast imaging is reviewed, showing clustering of multiple tumor foci in the breast directly under the area of phone contact. Pathology of all four cases shows striking similarity; all tumors are hormone-positive, low-intermediate grade, having an extensive intraductal component, and all tumors have near identical morphology. These cases raise awareness to the lack of safety data of prolonged direct contact with cellular phones.

  5. New concentrator multifocal Fresnel lens for improved uniformity: design and characterization

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    Vázquez-Moliní, Daniel; Fernández-Balbuena, Antonio Álvarez; Bernabeu, Eusebio; Muñoz de Luna Clemente, Javier; Domingo-Marique, Alfonso; García-Botella, Ángel

    2009-08-01

    The emergence of high efficiency photovoltaic cells is leading the industry into using solar concentrators in order to reduce costs by decreasing the number of cells used. In this paper Optics department of Universidad Complutense de Madrid has designed a multifocal Fresnel lens of PMMA and has studied the main parameters that have influence on its final function. This has been done by taking into account its manufacturing tolerances. The lens is square shaped with sides measuring 270 mm and it is composed of three different zones based on three different criteria: The central zone has been designed by using paraxial formulation, the intermediate one has been designed based on Fresnel classical formula while the marginal zone's purpose is to deflect the light by total internal reflection on prism faces. All three zones have different focal areas and different optical axis so the energy distribution will be more uniform whilst avoiding cell damage caused by hot spots. The design stage is feedback through simulations using a ray tracer software. In order to characterize the lens operation a measure of optical concentration was first taken on different lens areas using an integrating sphere. Finally, the lens performance in terms of concentration and in terms of uniformity at the focal spot was studied by processing the images taken with a CCD camera on a screen placed at the focal plane of the lens.

  6. Visual evoked potential (VEP) and multifocal electroretinogram (mfERG) in ocular syphilitic posterior segment inflammation.

    Science.gov (United States)

    Alexander, Philip; Wen, Yaqin; Baxter, Julia M; Tint, Naing L; Browning, Andrew C; Amoaku, Winfried M

    2012-10-01

    The aim of this study is to correlate multifocal electroretinogram (mfERG) and visual evoked potential (VEP) changes with visual acuity and clinical features in patients with posterior segment inflammation secondary to syphilis. A retrospective interventional case series of 4 patients with visual loss secondary to syphilitic uveitis is reported. The mfERG (P1) showed diminished amplitudes and prolonged latency in 7 affected eyes. Visual acuity rapidly improved 2 weeks after initiation of therapy. OCT demonstrated anatomical recovery at 1 month. In three patients, visual acuity was restored to 6/6 at 6-9 months but mfERG responses remained significantly reduced and delayed for 12-15 months before recovery to normal levels. One patient developed a retinal detachment, but achieved 6/9 vision at 30 months. VEP changes, interpreted in combination with mfERG responses, showed evidence of optic nerve involvement in 6 eyes. Ocular findings, including posterior placoid chorioretinitis, are important diagnostic features of secondary and tertiary syphilis. Visual acuity and clinical recovery occur early with appropriate diagnosis and treatment, and precede full electrophysiological recovery of the outer retina-RPE complex. Ophthalmologists have the opportunity to play a key role in undetected or missed diagnoses of syphilis, and with appropriate treatment the visual prognosis is excellent.

  7. Chronic Multifocal Inflammation of the Alveolar Bone Mimicking Malignancy: A Case Report

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    Shahidi Sh.

    2012-03-01

    Full Text Available ronic inflammation of the alveolar bone is a great clinical and radiologic mimic, which merits recognition by the clinician and pathologist. The patient can thus be reassured of the proper early treatment and a favorable prognosis. Occasionally, it is difficult to differentiate inflammatory lesions from malign-ant tumors. The aim of this report is to present a case with an inflammatory lesion mimicking malignant condition.We report a 19-year-old male complaining of rapid onset gingival swelling of the right side of both jaws and looseness of the right upper molar teeth in 20 days. Based on the acute onset of the gingival hyperplasia, severe looseness of the affected teeth especially in the maxilla, and the patient's age, multifocal rapid growing malignant condition was not ruled out. The lesion was misdiagnosed as a malignant condition by clinical and radiographic examination. The whole body bone scan showed no significant increased uptake in the right oral cavity compatible with no active bony pathology. The surgical pathology findings of the lesion showed severe chronic inflammation with surface epithelial hyperplasia.The initial diagnosis of the lesion was malignant condition but it was ruled out by bone scan and histological appearance.

  8. [Acute posterior multifocal placoid pigment epitheliopathy. A rare cause of ischaemic stroke].

    Science.gov (United States)

    del Saz-Saucedo, Pablo; Alfaya-Muñoz, Laura Blanca; Recio-Bermejo, Marta; Lara-Medina, Francisco Javier; García-Chiclano, Amalia; Ortega-León, Teresa; Rueda-Medina, Ignacio; Domínguez-Fernández, María José; Madrid-Muñiz, Carmen; Franco-Huerta, María

    2013-06-01

    Introduccion. La epiteliopatia pigmentaria placoide multifocal posterior aguda (EPPMPA) es una enfermedad inflamatoria rara, generalmente de etiologia indeterminada, de la coriocapilar, el epitelio pigmentario y la retina externa. Afecta predominantemente a pacientes jovenes y en algunos casos puede involucrar al sistema nervioso central en forma de ictus o de meningoencefalitis. Presentamos el caso clinico de una mujer joven con EPPMPA complicada con ictus e hipertension intracraneal. Caso clinico. Mujer de 16 anos que comienza con cefalea intensa sugestiva de hipertension intracraneal, asi como con un deficit agudo hemisferico izquierdo. La resonancia magnetica craneal ponia de manifiesto lesiones embolicas o vasculiticas en diferentes territorios. No se evidenciaron datos de meningoencefalitis en el estudio del liquido cefalorraquideo, pero si de hipertension intracraneal asociada. La presencia de lesiones muy especificas en el polo ocular posterior permitio el diagnostico de EPPMPA complicada con ictus isquemico, probablemente por mecanismo vasculitico. Un amplio estudio etiologico fue negativo para identificar un factor desencadenante claro del proceso. Se inicio tratamiento corticoideo con buena evolucion clinica y radiologica. Conclusiones. La EPPMPA es una entidad rara que generalmente entrana buen pronostico; sin embargo, en algunos casos puede complicarse con afectacion del sistema nervioso central, y el ictus isquemico secundario a vasculitis es la complicacion mas grave. Ante un paciente joven con ictus que presente sintomatologia visual y lesiones coriorretinianas, debe considerarse la EPPMPA en su diagnostico etiologico.

  9. Perspectives of Cosmesis following Breast Conservation for Multifocal and Multicentric Breast Cancers

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    Mona P. Tan

    2015-01-01

    Full Text Available Background. Contemporary data suggest that breast conservation treatment (BCT for multifocal and multicentric breast cancer (MFMCBC may be appropriate with noninferior local control rates. However, there is a paucity of data to evaluate patient’s satisfaction with cosmetic outcomes after BCT for MFMCBC. This study was performed to bridge this information gap. Methods. All patients treated at the authors’ healthcare facility were included in the study. Patients with MFMCBC who were assessed to be eligible for BCT underwent tumour resection using standard surgical techniques with direct parenchymal closure through a single incision. After at least three years of follow-up, they were invited to participate in a survey regarding their cosmetic outcomes. Results. Of a total of 160 patients, 40 had MFMCBC, of whom 34 (85% underwent successful BCT. Five-year cancer-specific survival and disease-free survival were 95.7%. Twenty of the 34 patients responded to the survey. No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients’ self-assessment and clinician-directed evaluation of aesthetic results. Conclusion. BCT for MFMCBC is feasible with acceptable survival and cosmetic outcomes. However, there appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research.

  10. Multifocal fibrosing thyroiditis and its association with papillary thyroid carcinoma using BRAF pyrosequencing.

    Science.gov (United States)

    Frank, Renee; Baloch, Zubair W; Gentile, Caren; Watt, Christopher D; LiVolsi, Virginia A

    2014-09-01

    Multifocal fibrosing thyroiditis (MFT) is characterized by numerous foci of fibrosis in a stellate configuration with fibroelastotic and fibroblastic centers entrapping epithelial structures. MFT has been proposed as a risk factor for papillary thyroid carcinoma (PTC) development. We attempted to identify whether MFT showed such molecular changes and could possibly be related to PTC. We identified seven cases of PTC with MFT in our institutional pathology database and personal consult service of one of the authors (VAL) for the years 1999 to 2012. Areas of PTC, MFT, and normal tissue were selected for BRAF analysis. Macro-dissection, DNA extraction and PCR amplification, and pyrosequencing were performed to detect BRAF mutations in codon 600. All of the MFT lesions and normal thyroid tissue were negative for BRAF mutations. Of the seven PTCs analyzed, five (71 %) were negative for BRAF mutations, while two cases were positive. In our study, none of the MFT lesions harbored BRAF mutations, whereas 29 % (two of seven) PTCs in the same gland were positive. Hence, in this small study, we found no evidence that the MFT lesion is a direct precursor to PTC. It is likely an incidental bystander in the process and a reflection of the background thyroiditis.

  11. Aspherical Lens Design Using Genetic Algorithm for Reducing Aberrations in Multifocal Artificial Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Chih-Ta Yen

    2015-09-01

    Full Text Available A complex intraocular lens (IOL design involving numerous uncertain variables is proposed. We integrated a genetic algorithm (GA with the commercial optical design software of (CODE V to design a multifocal IOL for the human eye. We mainly used an aspherical lens in the initial state to the crystalline type; therefore, we used the internal human eye model in the software. The proposed optimized algorithm employs a GA method for optimally simulating the focusing function of the human eye; in this method, the thickness and curvature of the anterior lens and the posterior part of the IOL were varied. A comparison of the proposed GA-designed IOLs and those designed using a CODE V built-in optimal algorithm for 550 degrees myopia and 175 degrees astigmatism conditions of the human eye for pupil size 6 mm showed that the proposed IOL design improved the spot size of root mean square (RMS, tangential coma (TCO and modulation transfer function (MTF at a spatial frequency of 30 with a pupil size of 6 mm by approximately 17%, 43% and 35%, respectively. However, the worst performance of spherical aberration (SA was lower than 46%, because the optical design involves a tradeoff between all aberrations. Compared with the traditional CODE V built-in optimal scheme, the proposed IOL design can efficiently improve the critical parameters, namely TCO, RMS, and MTF.

  12. Acute Posterior Multifocal Placoid Pigment Epitheliopathy as the Initial Manifestation of Sarcoidosis

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    Adil Darugar

    2011-01-01

    Full Text Available Purpose: To report an undiagnosed case of systemic sarcoidosis manifesting with bilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE. Case Report: A 26-year-old Caucasian man was referred for management of unilateral visual loss together with a paracentral scotoma developing 2 weeks after a flu-like syndrome. Clinical signs and ancillary diagnostic investigations suggested APMPPE. Laboratory tests demonstrated elevated serum angiotensin converting enzyme and lysozyme levels. Chest CT-scan disclosed moderate hilar lymph node calcifications but QuantiFERON-TB gold test was negative and bronchoalveolar lavage and biopsies were unremarkable. Accessory salivary gland biopsy disclosed epithelioid and gigantocellular granuloma formation without caseum, confirming a diagnosis of sarcoidosis. The fellow eye was involved a few days later and the patient complained of dyspnea. Echocardiography disclosed severe granulomatous myocardial infiltration and high dose corticosteroids and intravenous cyclophosphamide were initiated. Systemic treatment controlled both cardiac and ocular lesions, and was tapered accordingly. Conclusion: The constellation of "white dot syndromes" and systemic symptoms necessitates a general work-up to exclude granulomatous disorders such as sarcoidosis or tuberculosis. Delayed diagnosis of cardiac sarcoidosis may have life-threatening consequences and the ophthalmologist may be the first physician to diagnose the condition.

  13. Sustained multifocal attentional enhancement of stimulus processing in early visual areas predicts tracking performance.

    Science.gov (United States)

    Störmer, Viola S; Winther, Gesche N; Li, Shu-Chen; Andersen, Søren K

    2013-03-20

    Keeping track of multiple moving objects is an essential ability of visual perception. However, the mechanisms underlying this ability are not well understood. We instructed human observers to track five or seven independent randomly moving target objects amid identical nontargets and recorded steady-state visual evoked potentials (SSVEPs) elicited by these stimuli. Visual processing of moving targets, as assessed by SSVEP amplitudes, was continuously facilitated relative to the processing of identical but irrelevant nontargets. The cortical sources of this enhancement were located to areas including early visual cortex V1-V3 and motion-sensitive area MT, suggesting that the sustained multifocal attentional enhancement during multiple object tracking already operates at hierarchically early stages of visual processing. Consistent with this interpretation, the magnitude of attentional facilitation during tracking in a single trial predicted the speed of target identification at the end of the trial. Together, these findings demonstrate that attention can flexibly and dynamically facilitate the processing of multiple independent object locations in early visual areas and thereby allow for tracking of these objects.

  14. Multifocal array with controllable orbital angular momentum modes by tight focusing

    Science.gov (United States)

    Deng, Duo; Li, Yan; Han, Yanhua; Ye, Jingfu; Guo, Zhongyi; Qu, Shiliang

    2017-01-01

    Multifocal spots arrays with controllable three-dimensional (3D) position, orbital angular momentum (OAM) and the number of focal planes along longitudinal direction have been proposed and investigated by using a special designed phase-only multi-zone plate at the back aperture of a high numerical aperture (NA) objective. By using Debye diffraction integral, the focusing field could be rewritten as a fast Fourier transform (FFT), which is the theory and principle for generating the controllable OAM-modes focusing spots. According to this theory, a hybrid multi-zone plate at the back aperture of a high NA objective is designed for the illuminations of the radially polarized Bessel-Gaussian beam. Each focusing spot in the focal plane is generated by independent parts, so the multiplexing OAM-modes could be realized by focusing two or more spots at the same position with different orthogonal eigenstates. It is a practical and flexible OAM multi-focus technique with dynamically controllable 3D position, number of focal planes, corresponding topological charges and focal lengths to meet different requirements, such as 3D optical data storage, air-core fiber coupler and parallel optical manipulation.

  15. Chronic recurrent multifocal osteomyelitis: typical patterns of bone involvement in whole-body bone scintigraphy.

    Science.gov (United States)

    Acikgoz, Gunsel; Averill, Lauren W

    2014-08-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease of unknown etiology. It affects children and adolescents predominantly and occurs mostly in the female population. It is characterized by the insidious onset of pain and swelling, with a fluctuating clinical course of relapses and remissions. Typically, several bones are affected, either synchronously or metachronously, and bilateral involvement is common. CRMO most commonly affects the metaphysis of long bones, especially the tibia, femur, and clavicle. The spine, pelvis, ribs, sternum, and mandible may also be affected. Although lesions are mostly multiple, patients may present with a single symptomatic focus. Radiographic findings may be negative early in the course of the disease. Bone scintigraphy is useful in determining the presence of abnormality and the extent of disease. The imaging and clinical features of CRMO overlap with those of infectious osteomyelitis, bone malignancy, and inflammatory arthritis. Nonetheless, CRMO can be confidently diagnosed with the recognition of typical imaging patterns in the appropriate clinical setting. This article reviews imaging findings with special emphasis on bone scintigraphy and specific disease sites.

  16. Multifocal Breast Cancer in Young Women with Prolonged Contact between Their Breasts and Their Cellular Phones.

    Science.gov (United States)

    West, John G; Kapoor, Nimmi S; Liao, Shu-Yuan; Chen, June W; Bailey, Lisa; Nagourney, Robert A

    2013-01-01

    Breast cancer occurring in women under the age of 40 is uncommon in the absence of family history or genetic predisposition, and prompts the exploration of other possible exposures or environmental risks. We report a case series of four young women-ages from 21 to 39-with multifocal invasive breast cancer that raises the concern of a possible association with nonionizing radiation of electromagnetic field exposures from cellular phones. All patients regularly carried their smartphones directly against their breasts in their brassieres for up to 10 hours a day, for several years, and developed tumors in areas of their breasts immediately underlying the phones. All patients had no family history of breast cancer, tested negative for BRCA1 and BRCA2, and had no other known breast cancer risks. Their breast imaging is reviewed, showing clustering of multiple tumor foci in the breast directly under the area of phone contact. Pathology of all four cases shows striking similarity; all tumors are hormone-positive, low-intermediate grade, having an extensive intraductal component, and all tumors have near identical morphology. These cases raise awareness to the lack of safety data of prolonged direct contact with cellular phones.

  17. Multifocal hepatoblastoma in a 6-month-old girl with trisomy 18: a case report

    Directory of Open Access Journals (Sweden)

    Kitanovski Lidija

    2009-06-01

    Full Text Available Abstract Introduction Edward's syndrome (trisomy 18 is a rare entity with a reported incidence of 1/3000 to 1/7000 births. Less than 10% of patients survive beyond the first year of life, which may influence the fact that malignant tumors are rarely reported in association with this syndrome. Case presentation The authors report a rare case of a 6-month-old girl with trisomy 18 and multifocal hepatoblastoma. The course of the disease, autopsy results and review of the literature are presented. Conclusion Our case represents the seventh published case of hepatoblastoma in a patient with trisomy 18. All of the seven published cases were women, possibly due to the high preponderance of females among the children with Edward's syndrome and longer survival of females with trisomy 18 compared to males. Since both trisomy 18 and hepatoblastoma are rare conditions, the probability that a child with trisomy 18 will independently develop a hepatoblastoma is very low. Therefore, we believe that the existence of these cases in children with trisomy 18 indicates a significant association. It can be assumed that trisomy 18 potentiates the development of hepatoblastoma. Careful clinical and post-mortem studies are needed to recognize the real frequency of hepatoblastoma in children with trisomy 18, who might die from different causes with unrecognizable hepatoblastoma.

  18. Clonality Assessment in a Case of Multifocal Adamantinoma and a Review of the Literature

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    Paul Borbas

    2012-01-01

    Full Text Available Adamantinoma is a low-grade, malignant biphasic bone tumour predominantly located in the tibia. In up to 50% of all cases this is combined with one or more lesions in the ipsilateral fibula. Whether these lesions represent regional metastases or arise de novo is not yet exactly known. In order to address this question, we extracted DNA from the respective fresh frozen tumour tissues in a case of a young woman with a multifocal adamantinoma of both the tibia and ipsilateral fibula. Afterwards the X inactivation pattern was studied by means of methylation-sensitive polymerase chain reaction and primers that target the polymorphic CGG trinucleotide repeat of FMR1 gene and the polymorphic CAG repeat, on exon 1 of the human androgen receptor gene (AR. The analysis of the AR was homozygous and not informative. Studying the FMR1 gene, we detected a 100% skewing of the X inactivation pattern of both locations and found that the same allele was methylated. Even if the fibula lesion arose de novo there would have been a 50 : 50 chance that the same allele was methylated. As this methylation pattern was found we cannot provide a valid explanation for the origin of the fibula lesion. Analysis of X inactivation patterns in future cases of polyfocal adamantinoma might provide further evidence for one of the two theories.

  19. Heterogeneous echogenicity of the thyroid parenchyma does not influence the detection of multi-focality in papillary thyroid carcinoma on preoperative ultrasound staging.

    Science.gov (United States)

    Herh, Sun Jin; Kim, Eun-Kyung; Sung, Ji Min; Yoon, Jung Hyun; Moon, Hee Jung; Kwak, Jin Young

    2014-05-01

    Heterogeneous echogenicity and micro-nodulations of diffuse thyroid disease on ultrasonography (US) might influence the diagnostic performance of pre-operative US staging, especially the detection of multi-focality. This study was designed to determine whether heterogeneous echogenicity of the thyroid parenchyma influences the diagnostic performance of US in the detection of multi-focality in papillary thyroid carcinoma. Between December 2010 and April 2011, 811 patients underwent pre-operative staging US for papillary thyroid carcinoma and surgery. Twelve radiologists performed the pre-operative US for T and N staging. Underlying parenchymal echogenicity and unilateral and bilateral multi-focality of the thyroid nodules were also evaluated. Patients were divided into two groups on the basis of the underlying echogenicity of the thyroid gland. To evaluate the diagnostic accuracy of US with respect to underlying echogenicity, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated and compared between the two groups. Among the 811 patients included, US revealed underlying heterogeneous echogenicity of the thyroid parenchyma in 204 (25.2%) and underlying homogeneous echogenicity of the thyroid parenchyma in 607 (74.8%). There were no significant differences between the two groups in the diagnostic performance of pre-operative staging US in predicting unilateral multi-focality and bilaterality. Underlying heterogeneous echogenicity in a thyroid gland with Hashimoto's thyroiditis does not significantly influence the detection of multi-focality in papillary thyroid cancer on pre-operative US staging.

  20. Multifocal visual evoked potentials are influenced by variable contrast stimulation in MS

    Science.gov (United States)

    Frohman, Audrey R.; Schnurman, Zane; Conger, Amy; Conger, Darrel; Beh, Shin; Greenberg, Benjamin; Sutter, Erich; Calabresi, Peter A.; Balcer, Laura J.; Frohman, Teresa C.

    2012-01-01

    Objective: To test the hypothesis that patients with multiple sclerosis (MS) with intereye asymmetry on low contrast letter acuity, and thickness of the retinal nerve fiber layer (RNFL), would exhibit corresponding changes in cortical timing and amplitude responses on pattern reversal multifocal visual evoked potentials (mfVEP), contingent upon variable stimulus contrast. Methods: In a cross-sectional study, we investigated a cohort of 11 normal subjects and 40 patients with MS, 21 of whom had a history of acute optic neuritis (MS-AON) with an intereye asymmetry with respect to RNFL thickness, and on low contrast letter acuity performance. Pattern reversal mfVEP was performed at high (100%), low (33.3%), and very low (14.2%) Michelson-contrast levels. Results: Compared to baseline measures at 100% contrast, the mean amplitude of the mfVEP was reduced in MS-AON eyes, upon pattern-reversal stimulation at the 2 lower contrast levels (p < 0.0001). With respect to changes in timing responses, the intereye asymmetry was increased in the MS-AON patients upon lower contrast pattern-reversal stimulation (p < 0.0001 for 33.3% compared to 100%, and p < 0.001 for 14.2% compared to 100%). The fellow eye in 12 (57%; p < 0.001) of the patients with an abnormal eye, and a history of AON, revealed abnormal amplitude and timing responses upon low contrast stimulation (signifying unmasking of occult damage). Conclusions: Our findings support the hypothesis that mfVEP metric abnormalities are contingent upon contrast magnitude during pattern reversal stimulation. Further, this paradigm was capable of unmasking occult abnormalities in a significant number of apparently unaffected eyes. PMID:22815550

  1. Clonality analysis of multifocal papillary thyroid carcinoma by using genetic profiles.

    Science.gov (United States)

    Lu, Zheming; Sheng, Jindong; Zhang, Yujie; Deng, Jianhua; Li, Yong; Lu, Aiping; Zhang, Juan; Yu, Huan; Zhang, Min; Xiong, Zikai; Yan, Hai; Diplas, Bill H; Lu, Youyong; Liu, Baoguo

    2016-05-01

    Papillary thyroid carcinoma (PTC) is the most common adult thyroid malignancy and often presents with multiple anatomically distinct foci within the thyroid, known as multifocal papillary thyroid carcinoma (MPTC). The widespread application of the next-generation sequencing technologies in cancer genomics research provides novel insights into determining the clonal relationship between multiple tumours within the same thyroid gland. For eight MPTC patients, we performed whole-exome sequencing and targeted region sequencing to identify the non-synonymous point mutations and gene rearrangements of distinct and spatially separated tumour foci. Among these eight MPTCs, completely discordant mutational spectra were observed in the distinct cancerous nodules of patients MPTC1 and 5, suggesting that these nodules originated from independent precursors. In another three cases (MPTC2, 6, and 8), the distinct MPTC foci of these patients had no other shared mutations except BRAF V600E, also indicating likely independent origins. Two patients (MPTC3 and 4) shared almost identical mutational spectra amongst their separate tumour nodules, suggesting a common clonal origin. MPTC patient 7 had seven cancer foci, of which two foci shared 66.7% of mutations, while the remaining cancer foci displayed no common non-synonymous mutations, indicating that MPTC7 has multiple independent origins accompanied by intraglandular disease dissemination. In this study, we found that 75% of MPTC cases arose as independent tumours, which supports the field cancerization hypothesis describing multiple malignant lesions. MPTC may also arise from intrathyroidal metastases from a single malignant clone, as well as multiple independent origins accompanied by intrathyroidal metastasis.

  2. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Gotthardt, M. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Nuclear Medicine; Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Rubner, C. [Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Bauhofer, A. [Philipps Univ., Marburg (DE). Inst. of Theoretical Surgery] (and others)

    2006-07-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76{+-}80.6 Gy versus 125.6{+-}46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2{+-}101.7 Gy versus 125.6{+-}46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  3. Multifocal visual evoked potential in optic neuritis, ischemic optic neuropathy and compressive optic neuropathy

    Directory of Open Access Journals (Sweden)

    Manju Jayaraman

    2014-01-01

    Full Text Available Purpose: To investigate the effect of optic neuritis (ON, ischemic optic neuropathy (ION and compressive optic neuropathy (CON on multifocal visual evoked potential (mfVEP amplitudes and latencies, and to compare the parameters among three optic nerve disorders. Materials and Methods: mfVEP was recorded for 71 eyes of controls and 48 eyes of optic nerve disorders with subgroups of optic neuritis (ON, n = 21 eyes, ischemic optic neuropathy (ION, n = 14 eyes, and compressive optic neuropathy (CON, n = 13 eyes. The size of defect in mfVEP amplitude probability plots and relative latency plots were analyzed. The pattern of the defect in amplitude probability plot was classified according to the visual field profile of optic neuritis treatment trail (ONTT. Results: Median of mfVEP amplitude (log SNR averaged across 60 sectors were reduced in ON (0.17 (0.13-0.33, ION (0.14 (0.12-0.21 and CON (0.21 (0.14-0.30 when compared to controls. The median mfVEP relative latencies compared to controls were significantly prolonged in ON and CON group of 10.53 (2.62-15.50 ms and 5.73 (2.67-14.14 ms respectively compared to ION group (2.06 (-4.09-13.02. The common mfVEP amplitude defects observed in probability plots were diffuse pattern in ON, inferior altitudinal defect in ION and temporal hemianopia in CON eyes. Conclusions: Optic nerve disorders cause reduction in mfVEP amplitudes. The extent of delayed latency noted in ischemic optic neuropathy was significantly lesser compared to subjects with optic neuritis and compressive optic neuropathy. mfVEP amplitudes can be used to objectively assess the topography of the visual field defect.

  4. Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate.

    Science.gov (United States)

    Hospach, Toni; Langendoerfer, Micha; von Kalle, Tekla; Maier, Jan; Dannecker, Guenther E

    2010-09-01

    There are only a few studies that address the frequency and type of spinal involvement in patients with chronic recurrent multifocal osteomyelitis (CRMO) as well as the outcome of these patients treated with pamidronate (PAM). We performed a retrospective study on patients with CRMO and analyzed clinical and pain assessments as well as regional and whole body MRI findings and compared with posttreatment findings. Of 102 children and adolescents with CRMO, 27 (26%) had involvement of the spine. Vertebral deformities were seen in 14 of these 27 patients, scoliosis or kyphosis in 6. After routine whole body MRI, 19 complained of back pain, whereas eight were asymptomatic with spinal lesions detected incidentally. A total of 72 spinal lesions were detected, thoracic vertebrae being the most commonly affected. Seven patients were treated with PAM; all of whom had vertebral deformities and ongoing back pain. Pain resolution was achieved within 3 months of PAM treatment in every case. One patient subsequently developed a pain amplification syndrome. Repeat MRI performed at a mean interval of 13 months revealed partial or complete resolution of vertebral hyperintensities in every patient. Improvement of vertebral height was seen in a total of three vertebrae in two patients. Severe side effects were not observed. In conclusion, we demonstrated that spinal involvement and associated vertebral deformities with or without kyphoscoliosis are not rare in CRMO, and PAM appears to be an effective and safe treatment for this condition. Although controlled studies are urgently needed, the use of PAM for refractory CRMO with extended spinal involvement (vertebral deformities, kyphosis, and scoliosis) should be considered, especially after failing of conventional therapy.

  5. Losing focus: how lens position and viewing angle affect the function of multifocal lenses in fishes.

    Science.gov (United States)

    Gagnon, Yakir Luc; Wilby, David; Temple, Shelby Eric

    2016-09-01

    Light rays of different wavelengths are focused at different distances when they pass through a lens (longitudinal chromatic aberration [LCA]). For animals with color vision this can pose a serious problem, because in order to perceive a sharp image the rays must be focused at the shallow plane of the photoreceptor's outer segments in the retina. A variety of fish and tetrapods have been found to possess multifocal lenses, which correct for LCA by assigning concentric zones to correctly focus specific wavelengths. Each zone receives light from a specific beam entrance position (BEP) (the lateral distance between incoming light and the center of the lens). Any occlusion of incoming light at specific BEPs changes the composition of the wavelengths that are correctly focused on the retina. Here, we calculated the effect of lens position relative to the plane of the iris and light entering the eye at oblique angles on how much of the lens was involved in focusing the image on the retina (measured as the availability of BEPs). We used rotational photography of fish eyes and mathematical modeling to quantify the degree of lens occlusion. We found that, at most lens positions and viewing angles, there was a decrease of BEP availability and in some cases complete absence of some BEPs. Given the implications of these effects on image quality, we postulate that three morphological features (aphakic spaces, curvature of the iris, and intraretinal variability in spectral sensitivity) may, in part, be adaptations to mitigate the loss of spectral image quality in the periphery of the eyes of fishes.

  6. Effect of autologous bone mesenchymal stem cell transplantation on neurological function in rehabilitation period of multifocal cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Rui Zhang

    2016-01-01

    Objective:To study the effect of autologous bone mesenchymal stem cell transplantation on neurological function in rehabilitation period of multifocal cerebral hemorrhage.Methods:A total of 48 patients with multifocal cerebral hemorrhage who were treated in our hospital from April 2012 to December 2014 were selected as the research subjects, the therapy was made according to the illness and the patients’ will, combined treatment group received minimally invasive evacuation of hematoma combined with autologous bone mesenchymal stem cell transplantation therapy, surgical treatment group received regular minimally invasive evacuation of hematoma, and then imaging features, endothelial progenitor cell activation in peripheral blood as well as the content of nerve injury molecules and neurotrophic factors in serum of two groups were compared.Results:According to the result of head CT scan, the degree of brain edema of both groups was reduced 14 days after treatment, and the reducing degree of brain edema of combined treatment group was more significant than that of surgical treatment group; the 7th day, 14th day, 21st day and 28th day after treatment, CD34+CD133+endothelial progenitor cell levels in peripheral blood of combined treatment group were higher than those of surgical treatment group; 7th day and 14th day after treatment, serum S100β and NSE levels of combined treatment group were significantly lower than those of surgical treatment group; 21st day and 28th day after treatment, serum BDNF and NGF levels of combined treatment group were significantly higher than those of surgical treatment group. Conclusions:Autologous bone mesenchymal stem cell transplantation can relieve cerebral edema, increase the content of endothelial progenitor cells and neurotrophic factors and decrease neurological function injury in patients with multifocal cerebral hemorrhage, and it is conducive to the recovery of neurological function in patients with cerebral hemorrhage.

  7. 福建省部分地区暗娼人群艾滋病相关知识行为调查%Survey on AIDS-related Knowledge and Behavior among Commercial Sex Workers in Fujian Province

    Institute of Scientific and Technical Information of China (English)

    吴韶彬; 陈舸; 潘蕴蛟; 林永添; 郑武雄; 林丽; 杨莹

    2012-01-01

    Objectives To investigate AIDS-related knowledge and behaviors among commercial sex workers in Fujian province, and provide the basis for behavioral intervention. Methods An anonymous questionnaire was conducted among commercial sex workers in entertainment places in 15 counties of Fujian province. Results The awareness rate of AIDS-related knowledge is 86. 59%, the condom use rate in their latest commercial sex behavior is 62. 01%, 18. 16% sex workers had STD related symptoms. The main route of receiving AIDS related preventing services was health education. Conclusions Commercial sex workers don't have comprehensive understanding for AIDS-related knowledge; the condom use rate among them is low. Therefore, it's necessary to carry out more suitable intervention methods for commercial sex workers and improve awareness and condom use rate. Meanwhile, the stability and constancy of intervention work should be maintained, in order to expand the coverage of the intervention and detection rate among commercial sex workers.%目的 了解福建省暗娼人群艾滋病防治知识和相关行为状况,为行为干预提供依据.方法 对福建省15个县区的部分娱乐场所暗娼人群进行匿名问卷调查.结果 艾滋病基本知识知晓率为86.59%,最后一次发生商业性行为安全套使用率为62.01%,18.16%曾出现性病相关症状.接受预防艾滋病相关服务以宣传教育为主.结论 暗娼人群对艾滋病相关知识了解不全面,安全套使用率不高.应有针对性地制定适合暗娼人群的干预方法,提高其各知识点的知晓率和安全套使用率;同时应保持干预措施的稳定性和恒定性,进一步扩大暗娼人群的干预覆盖面和检测率.

  8. Hemosuccus Pancreaticus in the Era of Capsule Endoscopy and Double Balloon Enteroscopy Complicated by Multifocal Mycobacterium chelonae/abscessus Infection

    Directory of Open Access Journals (Sweden)

    Shabana F. Pasha

    2007-08-01

    Full Text Available Hemosuccus pancreaticus is a rare etiology of obscure gastrointestinal bleeding characterized by bleeding into the pancreatic duct. The diagnosis may be delayed for months to years, due to the episodic nature of bleeding and failure to consider the diagnosis. Patients often undergo multiple endoscopies and radiologic evaluations prior to diagnosis. Incidental gastrointestinal findings may lead to unnecessary endoscopic and surgical interventions. This report describes a patient with hemosuccus pancreaticus diagnosed in the era of video capsule endoscopy and double balloon enteroscopy, whose management was complicated by multifocal Mycobacteria chelonae/abscessus infection.

  9. Paracoccidioidomicose crônica multifocal tendo como primeira manifestação o envolvimento palpebral: relato de caso Chronical and multifocal paracoccidioidomycosis having the lid involvement as the first sign: case report

    Directory of Open Access Journals (Sweden)

    Tiago Nelson de Oliveira Rassi

    2009-12-01

    Full Text Available O acometimento ocular da paracoccidioidomicose é raro e quando ocorre é geralmente secundário à disseminação hematogênica. Descrição de um caso de paracococcidioidomicose multifocal em homem de 73 anos com história de trauma contuso no olho direito por pedaço de madeira e que teve como primeira manifestação clínica lesão palpebro-conjuntival. Interroga-se possível infecção primária ocular por contiguidade e alerta-se para a manifestação da doença em idade mais avançada.Ocular involvement of paracoccidioidomycosis is rare and when it occurs it is usually secondary to hematogenic dissemination. A case of multifocal paracoccidioidomycosis in a 73 year-old male after history of blunt trauma in the right eye with a stick of wood that presented as the first clinical sign a lid-conjunctival lesion is described. The possible primary ocular infection spreading by contiguity is argued and the disease manifestation in an advanced age is highlighted.

  10. Dysfunctional Epstein-Barr virus (EBV)-specific CD8(+) T lymphocytes and increased EBV load in HIV-1 infected individuals progressing to AIDS-related non-Hodgkin lymphoma

    NARCIS (Netherlands)

    D. van Baarle (Debbie); F. Miedema (Frank); E. Hovenkamp (Egbert); M.F.C. Callan (Margareth); K.C. Wolthers (Katja); S. Kostense; L.C. Tan; H.G.M. Niesters (Bert); A.D.M.E. Osterhaus (Albert); A.J. McMichael (Andrew); M.H.J. van Oers (Marinus)

    2001-01-01

    textabstractAcquired immunodeficiency syndrome-related non-Hodgkin lymphomas (AIDS-NHL) are thought to arise because of loss of Epstein-Barr Virus (EBV)-specific cellular immunity. Here, an investigation was done to determine whether cellular immunity to EBV is lost because of physical loss or dysfu

  11. Dysfunctional Epstein-Barr virus (EBV)-specific CD8(+) T lymphocytes and increased EBV load in HIV-1 infected individuals progressing to AIDS-related non-Hodgkin lymphoma

    NARCIS (Netherlands)

    van Baarle, D; Hovenkamp, E; Callan, M F; Wolthers, K C; Kostense, S; Tan, L C; Niesters, H G; Osterhaus, A D; McMichael, A J; van Oers, M H; Miedema, F

    2001-01-01

    Acquired immunodeficiency syndrome-related non-Hodgkin lymphomas (AIDS-NHL) are thought to arise because of loss of Epstein-Barr Virus (EBV)-specific cellular immunity. Here, an investigation was done to determine whether cellular immunity to EBV is lost because of physical loss or dysfunction of EB

  12. Optical bench performance of a novel trifocal intraocular lens compared with a multifocal intraocular lens

    Science.gov (United States)

    Lee, Shinwook; Choi, Myoung; Xu, Zaiwei; Zhao, Zeyu; Alexander, Elsinore; Liu, Yueai

    2016-01-01

    Purpose The purpose of this study is to compare the optical characteristics of the novel PanOptix presbyopia-correcting trifocal intraocular lens (IOL) and the multifocal ReSTOR +3.0 D IOL, through in vitro bench investigations. Methods The optical characteristics of AcrySof® IQ PanOptix™ (PanOptix) and AcrySof® IQ ReSTOR +3.0 D (ReSTOR +3.0 D) IOLs were evaluated by through-focus Badal images, simulated headlight images, and modulation transfer function (MTF) measurements which determine resolution, photic phenomena, and image quality. Through-focus Badal images of an Early Treatment of Diabetic Retinopathy Study chart were recorded at both photopic and mesopic pupil sizes. Simulated headlight images were taken on an MTF bench with a 50-μm pinhole target and a 5.0 mm pupil at the distance focus of the IOL. MTF curves were measured with a 3.0 mm pupil, and spatial frequencies equivalent to 20/40 and 20/20 visual acuities were recorded to illustrate the through-focus MTF curves. Far-, intermediate-, and near-focus MTF values were obtained. Results Bench Badal image testing and MTF measurements showed that PanOptix has a near focus at a distance of 42 cm and an additional intermediate focus at a distance of about 60 cm. The near focus for ReSTOR +3.0 D is at 45 cm. PanOptix and ReSTOR +3.0 D have comparable photopic distances and near MTF values. Additionally, PanOptix provided a substantial continuous range of vision from distance to intermediate and to near compared with ReSTOR +3.0 D. The halo propensity for PanOptix was slightly higher than that for ReSTOR +3.0 D. Conclusion Laboratory-based in vitro simulations showed that PanOptix trifocal IOL has comparable resolution and image quality performance in distance and near foci compared with ReSTOR +3.0 D IOL. PanOptix showed better resolution and image quality performance at the intermediate focus than ReSTOR +3.0 D IOL. PMID:27330273

  13. Vertebral manifestation of chronic recurrent multifocal osteomyelitis (CRMO); Wirbelsaeulenmanifestationen der chronischen rekurrierenden multifokalen Osteomyelitis (CRMO)

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    Schilling, F. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rheinland-Pfaelzisches Rheumazentrum, Mainz/Bad Kreuznach (Germany); Fedlmeier, M. [Rheuma-Kinderklinik, Garmisch-Partenkirchen (Germany); Eckardt, A. [Mainz Univ. (Germany). Orthopaedische Klinik und Poliklinik; Kessler, S. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie

    2002-10-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a systemic osteo-articular disease that is characterized by a sterile, primarily chronic osteomyelitis with various distribution patterns of the individual lesions. In this article, we describe the 'axial type' with predominant involvement of the spine, which represents 13 of our 41 CMRO cases of different age groups. The important element of its diagnosis is the typical lympho-plasmacellular spondylitis that can be detected and staged by scintigraphy, MRI and conventional radiography. Potentially affected are all vertebrae from the mid-cervical spine to the sacrum. One or several segments can be involved, sometimes as transient inflammatory edema, sometimes as 'migratory spondylitis' or 'saltatory spondylitis', but also as chronic sclerosing type with early radiographically detectable manifestation. Vertebral deformity due to compression and total collapse (vertebra plana) are rare. A complicated course with patulous perivertebral edema can lead to concomitant symptomatic inflammatory changes in adjacent regions and organs. In the course of CRMO, spondylodiscitis only develops as secondary destruction following the spondylitis. This can help to differentiate spondyloarthropathies from CRMO that is initially detected as primary lesion in the spine. While CRMO generally has a good prognosis, its radiological differentiation from rheumatology conditions plays an important role. (orig.) [German] Die chronische rekurrierende multifokale Osteomyelitis (CRMO) ist ein osteo-artikulaeres Systemleiden, das durch sterile, primaer chronische Osteomyelitiden gekennzeichnet ist und mit krankheitsdominanten Lokalisationen verschiedene Befallmustertypen aufweist. In dieser Arbeit wird die Wirbelsaeulenmanifestation ('Vertebraltyp') geschildert, die ein Drittel aller CRMO-Faelle betrifft und im Rahmen unseres CRMO-Kollektivs (n=41) mit 13 Faellen aller Altersstufen vertreten ist. Das

  14. [Commercial sexual exploitation of minor girls. A multifocal, exploratory and prospective study in Cameroon].

    Science.gov (United States)

    Mbassa Menick, D; Dassa, K S; Kenmogne, J B; Abanda Ngon, G

    2009-02-01

    To obtain reliable information on commercial sexual exploitation of minor girls under the age of 21, a multifocal, exploratry and prospective using a questionnaire was undertaken in Cameroon. This investigation was initiated and funded by the Cercle International pour la Promotion de la Création (CIPCRE) and carried out by the Cameroon Society for the Prevention of Child Abuse and Neglect (CASPCAN). The survey was performed during the last quarter of year 2004 in four major cities of Cameroon, i.e. Yaoundé, Douala, Bamenca and Bafoussam. Of the 800 questionnaires that were distributed, 722 were considered as suitable for analysis (90.3%). A total of 291 minor girls were victims of commercial sexual exploitation, i.e., 40% of the population studied. The mean age of the victims was 16.6 years (range, 9-20 years). The main reason given for entering prostitution was poverty. The victims were fairly well educated but the level of instruction was not sufficient to find a job paying an income comparable to prostitution. Many were from large families (mean, 7.1 children). The victims' family was monogamous in 40.2% of cases, polygamous in 24.4%, and monoparental in 35.4%. Eighty percent of the victims already had run away from home at least once due to problems in their families ranging from severe corporal punishment (25.8%) and mistreatment linked to parental alcohol and drug abuse to forced early marriage (27.5%) and intrafamilial sexual abuse. A large proportion of the victims (36.4%) were mothers who could not attend school and could not find work. Many victims were completely neglected by their own parents with 43.4% of parents being aware of the activities of their daughters but only 10.6% being opposed to it. Most (78.5%) had good knowledge of the risk of HIV and used condoms regular. These results confirms the general hypothesis of the authors that commercial exploitation of minor girls is widespread in Cameroon. The authors recommend development of a national

  15. 城市居民艾滋病相关KABP影响因素调查%Survey of HIV/AIDS-related Knowledge, Attitude and Determinants in Urban Residents

    Institute of Scientific and Technical Information of China (English)

    何群; 杨放; 林鹏; 王晔; 刘勇鹰; 付笑冰; 赵葛葛

    2003-01-01

    Objectives: To provide references for HIV/AIDS-related health education strategies through survey on HIV/AIDS-related knowledge, attitude and determinants of HIV/AIDS awareness.Methods: The study subjects were selected by random interception in a downtown street of Guangzhou city on World AIDS Day-December 1,2002. The uniform questionnaires were finished by means of selfadministration.Results: Two hundred questionnaires were distributed and 147 qualified questionnaires were collected.The results showed, the awareness rate of HIV/AIDSrelated knowledge was 63.3%, and awareness rate of transmission routes was 76.2%, whilst non-transmission route was 60.5%; the awareness rate of transmission was 59.2%; the awareness rate of prevention was 47.0 %; the positive attitude to people living with HIV/AIDS was 65.6%. Multiple variable Logistic regression analysis showed the determinants of HIV/AIDS-related knowledge were education level, age,marital status and gender, of which people with high level of education, young age and the group of male and married had better awareness of HIV/AIDS.Conclusion: Current HIV/AIDS-related knowledge of urban residents is relativly low, especially for the non-transmission route, hence further HIV/AIDS-related education should be strengthened, especially focusing on non-transmission route to eliminate discrimination over people living with HIV/AIDS.Further, education efforts also should be put on female population, unmarried population and poorly educated population.%目的 调查城市居民有关艾滋病的知识和对艾滋病的态度及其影响因素,为进一步开展艾滋病知识的宣传教育提供依据.方法 于2002年12月1日,世界艾滋病日,在广州市中心街头随机抽取过路行人进行调查,调查表采用自填方式.结果 在发出的200份问卷中,收回147份有效问卷.对艾滋病有关知识的知晓率为63.3%,知道其传播途径的占76.2%,同时知道不会传播艾滋病的途径的占60.5

  16. Ovarian mucinous cystic tumor with sarcoma-like mural nodules and multifocal anaplastic carcinoma: a case report.

    Science.gov (United States)

    Zheng, Jinfeng; Geng, Ming; Li, Peifeng; Li, Yi; Cao, Yongcheng

    2013-01-01

    A 48-year-old woman presented with left abdominal pain and fullness. Computed tomography scan revealed a multicystic mass with multifocal mural nodules. Histologic examination showed a mucinous cystic tumor with cystadenoma, borderline malignant cystadenoma and cystadenocarcinoma, which were associated with sarcoma-like mural nodules (SLMNs) and multifocal anaplastic carcinoma. Mural nodules showed a positive reaction for CD56 and vimentin, but were negative for cytokeratin 7 and SMA. She underwent postoperative chemotherapy and is currently under follow-up; no recurrence or metastases were found in the first year of follow-up. Ovarian mucinous cystic tumor with SLMNs and foci of anaplastic carcinoma is extremely rare. To our knowledge, this case reports the most complex neoplastic and reactive components. Our findings shed some light on the pathogenesis of this rather rare carcinoma. We think that the formation of SLMNs may be the result of the reactive proliferation of undifferentiated mesenchymal cells, while the anaplastic carcinoma may be derived from mucinous epithelium. Moreover, because of difficulties encountered in their differential diagnosis, we think that the existence of foci of anaplastic carcinoma along with SLMNs necessitates careful histologic and immunohistochemical analysis of mural nodules for the determination of treatment and prognosis.

  17. 类获得性免疫缺陷(阴性HIV)“患者”的流行病学调查%Epidemiological investigation of cases with complained AIDS-related complex (HIV negative)

    Institute of Scientific and Technical Information of China (English)

    刘雅琼; 林辉; 于磊; 王清青; 王太武; 马翔宇; 凌华; 吴国辉; 张路

    2013-01-01

    目的 对社区类获得性免疫缺陷(AIDS)综合征(阴性HIV)“患者”进行病因探索.方法 采用定性系统分析筛检国内外相关综合征报道病例,探索类AIDS综合征“患者”临床特征可能的聚类属性;通过现况调查掌握“患者”人群的一般特征和临床特征.结果 定性系统分析显示,目前在世界范围,与类AIDS综合征(阴性HIV)“患者”相似的疾病有2种,即CD4+T淋巴细胞缺陷综合征(ICL)和非结核分枝杆菌感染(NTM感染);通过174例网络调查和52例现场观察,发现“患者”人群以男性为主,青、中年为主;在国内分布地区广泛;主诉症状涉及呼吸道、消化道、皮肤、肌肉、骨骼和神经系统;根据症状特点,病程有急性期和稳定期之分;群体症状及体征为:淋巴结部位肿胀感、骨痛、肌肉“跳”(痛)、淋巴结节、皮肤结节(皮疹)、舌苔白厚、关节弹响、皮肤干燥;52例“患者”检测发现CD4+T淋巴细胞< 500/μL 17例(32.69%)、CD4/CD8比值异常16例(30.77%)、干扰素-γ抗体阳性17例(36.69%)和PPD阳性39例(++~+++,75.00%);高危险性行为是可疑的暴露因素之一.结论 类AIDS综合征(阴性HIV)“患者”现象不能完全用心理因素予以解释,其呈现的临床特征有明显的一致性和规律性,亟待开展深入研究进行分析.%Objective To investigate the possible causes of AIDS-related complex (HIV negative) in community population. Methods Qualitative systematic analysis was used to screen the cases with AIDS-related complex (HIV negative) that had been reported. The possible clustering types of the clinical features of AIDS-related complex were explored based on a cross-section study that had been conducted to observe the personality and clinical features of the cases with AIDS-related complex. Results The qualitative systematic analysis suggested that the idiopathic CD4+ T lymphocytopenia (ICL) and infection of

  18. STD/AIDS-related knowledge and attitudes of students in four universities in Nanjing%南京四所高校大学生性病、艾滋病知晓率现状调查

    Institute of Scientific and Technical Information of China (English)

    唐雪莲; 曹宁校; 乔学斌

    2015-01-01

    Objective: To investigate awareness of sexually transmitted diseases ﹙STD﹚/ acquired immune deficiency syndrome ﹙AIDS﹚-related knowledge and attitudes towards sexual behavior among college students in Nanjing, so as to provide scientific evidence for the health education of STD/AIDS prevention of in colleges. Methods:By using a stratified random survey, 600 college students in four universities in Nanjing were enrolled to complete an anonymous self-administered questionnaire. Results: The overall awareness rate of STD/AIDS-related knowledge was 21.4% and 55.3%, respectively. The awareness of AIDS-related knowledge was better than that of STD. Difference of STD knowledge awareness rate among college students was statistically significant﹙=52.682, P﹤ 0.01﹚. Difference of AIDS knowledge awareness rate among college students was also statistically significant ﹙=36.357, P ﹤ 0.001﹚. Conclusion: Awareness of STD/AIDS-related knowledge among college students is not optimistic, and STD/AIDS knowledge awareness is affected by many factors.%了解南京地区大学生性病、艾滋病相关知识的知晓情况和性态度、性行为现况,为高校开展预防性病、艾滋病健康教育提供科学依据。在南京地区四所高校中分层随机整群抽取600名大学生,采用匿名自填方式进行问卷调查。高校大学生性病、艾滋病知识总体知晓率分别为21.4%、55.3%,大学生对艾滋病相关知识知晓情况优于性病相关知识知晓情况。不同高校学生的性病知识知晓率差异有统计学意义(P﹤0.01),不同高校学生的艾滋病知识知晓率差异有统计学意义(P﹤0.001)。大学生性病、艾滋病的相关知识知晓情况不容乐观,性病/艾滋病知识水平受到多种因素的影响。

  19. The Effects of Hashimoto Thyroiditis on Lymph Node Metastases in Unifocal and Multifocal Papillary Thyroid Carcinoma: A Retrospective Chinese Cohort Study.

    Science.gov (United States)

    Zhu, Feng; Shen, Yi Bin; Li, Fu Qiang; Fang, Yun; Hu, Liang; Wu, Yi Jun

    2016-02-01

    The purpose of this study was to investigate the risk factors for central and lateral neck lymph node metastases in papillary thyroid carcinoma (PTC) and multifocal papillary thyroid carcinoma (MPTC), particularly when associated with Hashimoto thyroiditis (HT).A retrospective analysis of 763 consecutive patients who underwent total thyroidectomy with bilateral central neck dissection in the First Affiliated Hospital, College of Medicine, Zhejiang University between October 2011 and October 2014 was conducted. All patients had formal histological diagnoses of HT. Multivariable logistic regression analysis was performed to identify risk factors of neck lymph node metastases.Our study identified 277 PTC patients with HT and showed comparatively low rates of central lymph node metastases (CLNM) compared with the PTC patients without HT (37.2% versus 54.7%, P thyroid peroxidase antibody >140 IU/mL was established as the most sensitive and specific level for the prediction of MPTC based on receiver operating characteristic curve analyses. Thyroid peroxidase antibody, age, tumor size, and multifocality exhibited the ability to predict CLNM in PTC with HT patients with an area under the curve of 81.1% based on a multivariate model.Hashimoto thyroiditis was associated with increased prevalences of multifocality and capsular invasion. In contrast, HT was associated with a reduced risk of CLNM in PTC and MPTC patients, which indicated a potential protective effect. We found that the prognostic prediction model was applicable for predicting multifocality and CLNM in PTC patients with HT.

  20. Multifocal diffusion of KPC-3-producing ST512 Klebsiella pneumoniae in Italy

    Directory of Open Access Journals (Sweden)

    Aurora Piazza

    2012-03-01

    Full Text Available Introduction. The dissemination of carbapenemase-producing Klebsiella pneumoniae strains is an increasing problem worldwide. KPC ß-lactamases are Ambler class A enzymes mostly plasmid-encoded; their global spread represents a threat to clinical patients care and public health. Multi locus sequence type (ST258 is currently the most spread K. pneumoniae clone associated with KPC enzymes. Here we report the first identification and multifocal spread of KPC-3 producing K. pneumoniae clinical strains belonging to ST512 in Italy. Materials and Methods. Fifty six carbapenem-resistant K. pneumoniae isolates were collected from 7 Italian hospitals during the period June 2009-May 2011. Isolates were obtained from different wards (spinal unit, medicine, hematology, etc. and biological samples (mostly rectal swabs, urine and blood. Species identification and antimicrobial susceptibilities were obtained by NBC46/NM40 Microscan panels (Siemens. MICs values were interpreted according to EUCAST 2011 breakpoints. Modified Hodge test and combined disk test with phenyl-boronic acid (BOR and EDTA were performed.The presence of blaKPC genes were confirmed by PCR and sequencing. A complete characterization of the produced ß-lactamases (BLs was obtained by IEF followed by PCR experiments using primers specific for the detection of blaCTX-M-, blaTEM- and blaSHV type genes. PFGE and multilocus sequence typing (MLST were both used to investigate clonal isolates relatedness. Results. All 56 isolates resulted positive for the presence of KPC-type carbapenemases by both phenotypical and molecular analysis. Fifteen isolates, chosen as representative, were further investigated. Ten out of 15 isolates harboring the blaKPC-2 gene clustered with the known ST258, while the remaining 5/10 belonged to the newly described ST512 and harbored the blaKPC-3 gene. ST512 isolates, from 3/7 hospitals, were collected from rectal swabs (40%, blood (20%, endotracheal aspirate (20% and

  1. Multifocal septic osteomyelitis mimicking skeletal metastatic disease in a patient with prostate cancer.

    Science.gov (United States)

    Alexiou, Evangelos; Georgoulias, Panagiotis; Valotassiou, Varvara; Georgiou, Evangelia; Fezoulidis, Ioannis; Vlychou, Marianna

    2015-01-01

    enhancement suggestive of septic arthritis. The MR imaging findings combined with the scintigraphic findings were consistent with subacute multifocal septic arthritis involving the axial skeleton, as a pyogenic spondylodiscitis at the T9-T10 level, the left SCJ joint and the left knee joint. Subsequently, aspiration of the SCJ and the left knee joint was performed. A purulent fluid was drained and sent to microbiology. The sample revealed 96.000 cells/μL (95% neutrophils) and methicillin-resistant Staphylococcus aureus (MRSA). The patient received intravenous vancomucin (2gr. twice a day for 14 days) and subsequently the dose was adjusted to maintain the vancomucin serum levels between 17 and 20mcg/mL. The total treatment duration was 12 weeks. Four months later the patient had fully recovered and his blood tests were normal. The patient had not been referred to an oncology department yet, as the onset of the arthritis occurred about two weeks after the diagnosis of prostate cancer. In conclusion, we present a patient with known malignancy, fever, skeletal pain and multiple bone lesions in the (99m)Tc-MDP and the MRI examination, not due to metastatic disease but to septic arthritis.

  2. A previsibilidade biométrica nas lentes intra-oculares multifocais Biometric predictability in multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Augusto Cézar Lacava

    2007-08-01

    Full Text Available OBJETIVO: Apresentar a previsibilidade biométrica, avaliando a refração pós-operatória e acuidade visual (AV, em olhos submetidos a implante de lente intra-ocular multifocal. MÉTODOS: Estudo retrospectivo em 88 olhos de 50 pacientes, submetidos à facoemulsificação com implante de lentes multifocais, de três marcas comerciais ReSTOR, ReZoom e Tecnis. No exame biométrico foram utilizados a biometria óptica ou biometria por interferometria de baixa coerência, associada ao uso de tomógrafo de segmento anterior e à fórmula biométrica Holladay II. Com a refração pós-operatória, acuidade visual e a dioptria da LIO implantada, segundo a fórmula Holladay II, calculamos o valor da lente intra-ocular (LIO a ser implantada caso utilizássemos as fórmulas SRKT e Haigis. Os resultados foram avaliados por métodos estatísticos. RESULTADOS: Todos os olhos obtiveram AV igual ou maior a 20/40 e J3 sem correção. As fórmulas Holladay II, SRKT e Haigis apresentaram performance semelhante em todos os grupos de olhos. CONCLUSÃO: A utilização de novas tecnologias, como a biometria óptica e fórmulas de última geração, favorecem a obtenção do resultado refracional almejado com grande previsibilidade.PURPOSE: To present biometric predictability, evaluating postoperative refraction and visual acuity in eyes submitted to multifocal intraocular lens implantation. METHODS: Retrospective study in 88 eyes of 50 patients, submitted to phacoemulsification with multifocal lens implant of three commercial brands: ReSTOR, ReZoom and Tecnis. For biometric examination were used: optic biometry associated to the use of tomography of anterior segment and Holladay II biometric formula. With postoperative refraction, visual acuity and implanted IOL, according to Holladay II formula, we calculated the value of IOL to be implanted in case we used SRKT and Haigis formulas. The results were evaluated according to statistical methods. RESULTS: All eyes

  3. Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Filipe de Oliveira

    2005-08-01

    Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The

  4. Progressive multiple sclerosis: prospects for disease therapy, repair, and restoration of function.

    Science.gov (United States)

    Ontaneda, Daniel; Thompson, Alan J; Fox, Robert J; Cohen, Jeffrey A

    2016-11-23

    Multiple sclerosis is a major cause of neurological disability, which accrues predominantly during progressive forms of the disease. Although development of multifocal inflammatory lesions is the underlying pathological process in relapsing-remitting multiple sclerosis, the gradual accumulation of disability that characterises progressive multiple sclerosis seems to result more from diffuse immune mechanisms and neurodegeneration. As a result, the 14 anti-inflammatory drugs that have regulatory approval for treatment of relapsing-remitting multiple sclerosis have little or no efficacy in progressive multiple sclerosis without inflammatory lesion activity. Effective therapies for progressive multiple sclerosis that prevent worsening, reverse damage, and restore function are a major unmet need. In this Series paper we summarise the current status of therapy for progressive multiple sclerosis and outline prospects for the future.

  5. 门诊男性性病患者艾滋病知识知晓情况分析%Analysis on Awareness of HIV/AIDS- related Knowledge in Male Outpatients with Sexually Transmitted Diseases

    Institute of Scientific and Technical Information of China (English)

    晏强; 颜艳; 曹群良; 唐华文; 卢懿

    2012-01-01

    Objective To survey the awareness of HIV/AIDS- related knowledge in male outpatients with STDs, and to explore the comprehensive interventions through comparing the differences in the awareness of outpatients with different charac-terstics. Methods Questionnaire surveys were conducted among the outpatients with STDs aged 15 years and over initially consulted in dermatology & venereology department of a comprehensive hospital. The information of sociological characteristics and awareness of HIV/AIDS - related knowledge of the patients were investgated. Results Among 215 male outpatients with STDs, the average score of awareness of HIV/AIDS - related knowledge was 9.19 ± 2.697 (ranged from 0 to 12 points), especially the shortage of awareness about the transmission route of HIV/AIDS. There were statistically significant differences in the scores of awareness about HIV/AIDS- related knowledge among the outpatients with different ages, different educational backgrounds, different individual incomes per month, incipient AIDS or AIDS relapse, and different ages of having sex for the first time (P<0.05) - Conclusions Effective and available health education measures should be developed for STDs patients based on their different characteristics so as to promote the formation of their correct concepts, sexual behavior and health - seeking behavior.%目的 了解门诊男性性病患者艾滋病知识知晓情况,通过比较不同特征患者知晓情况差异,探讨可行的综合干预措施.方法 以首次在该综合医院皮肤性病门诊求诊、年满15周岁的男性性病患者为调查对象,问卷调查患者的社会人口学资料、艾滋病知识知晓情况.结果 215例男性性病患者艾滋病知识知晓平均得分为9.19±2 697(全距0~12分),尤其是对艾滋病传播方式的知晓不足.不同年龄段,不同文化程度、不同个人月均收入水平、病情初发或复发以及不同初次性行为发生年龄间的男性性病患者艾

  6. Multifocal Gastric Ulcers Caused by Diffuse Large B Cell Lymphoma in a Patient With Significant Weight Loss

    Directory of Open Access Journals (Sweden)

    Mark A. Gromski MD

    2016-12-01

    Full Text Available Primary gastrointestinal (GI lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used. Advancements in endoscopic and pathologic technology decrease turnaround time for diagnosis and treatment initiation, thus reducing the need for surgery. Health care providers should maintain a high level of suspicion and consider gastric DLBCL as part of the differential diagnosis, especially in those with warning symptoms such as weight loss and early satiety with abnormal endoscopic findings.

  7. Peripheral Nerve Ultrasonography in Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Correlations with Clinical and Neurophysiological Data.

    Science.gov (United States)

    Merola, Aristide; Rosso, Michela; Romagnolo, Alberto; Peci, Erdita; Cocito, Dario

    2016-01-01

    Objective. This cross-sectional study analyzes the pattern of ultrasound peripheral nerve alterations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) at different stages of functional disability. Material and Methods. 22 CIDP and 10 MMN patients and a group of 70 healthy controls were evaluated with an ultrasound scan of the median, ulnar, peroneal, tibial, and sural nerves. Results were correlated with clinical disability scales and nerve conduction studies. Results. Patients with intermediate functional impairment showed relatively larger cross-sectional areas than subjects with either a milder (p CIDP and in MMN. In addition, MMN was associated with greater side-to-side intranerve variability (p CIDP (p CIDP; p CIDP and MMN showed differential US aspects, with greater side-to-side intranerve variability in MMN and higher cross-sectional areas in CIDP.

  8. Multifocal multi-organ ischaemia and infarction in a preterm baby due to maternal intravenous cocaine use: a case report

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    Reynolds Ben C

    2009-09-01

    Full Text Available Abstract Introduction Although the adverse effects of cocaine use in pregnancy are well recognised, we believe this case highlights the importance of considering the route of administration, and suggests the possibility of multifocal damage relating to intravenous use. Case presentation A Caucasian female baby of 29-weeks' gestation was spontaneously delivered and subsequently developed multi-organ failure considered unrelated to simple prematurity. Intensive care was re-orientated following the development of massive intraventricular haemorrhage. Conclusion This case illustrates the need for regular cranial ultrasound in babies of pregnancies at risk due to intravenous cocaine use and also the necessity of counselling women who misuse cocaine in the antenatal period. As such, this article will be of most interest to paediatric and obstetric staff.

  9. Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes

    Science.gov (United States)

    Chan, Vincent K. C.

    2016-01-01

    Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were −0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction. PMID:27563460

  10. Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes.

    Science.gov (United States)

    Chang, John S M; Chan, Vincent K C; Ng, Jack C M; Law, Antony K P

    2016-01-01

    Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0-5); satisfaction (1-5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were -0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction.

  11. Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kroencke, T.J.; Taupitz, M.; Kivelitz, D.; Scheer, I.; Hamm, B. [Institut fuer Radiologie, Universitaetsklinikum Charite, Humboldt-Universitaet zu Berlin, Schumannstrasse 20-21, D-10117 Berlin (Germany); Daberkow, U. [IV Medizinische Klinik, Universitaetsklinikum Charite, Humboldt-Universitaet zu Berlin, Schumannstrasse 20-21, D-10117 Berlin (Germany); Rudolph, B. [Institut fuer Pathologie, Universitaetsklinikum Charite, Humboldt-Universitaet zu Berlin, Schumannstrasse 20-21, D-10117 Berlin (Germany)

    2000-07-01

    The aim of this study was to describe the MR appearance of multifocal nodular fatty infiltration of the liver (MNFIL) using T1-weighted in-phase (IP) and opposed-phase (OP) gradient-echo as well as T2-weighted turbo-spin-echo sequences with fat suppression (FSTSE) and without (HASTE). Magnetic resonance imaging examinations at 1.5 T using T1-weighted IP and OP-GRE with fast low angle shot (FLASH) technique, and T2-weighted FSTSE, T2-weighted HASTE of 137 patients undergoing evaluation for focal liver lesions were reviewed. Five patients were identified in whom CT indicated metastatic disease; however, no liver malignancy was finally proven. Diagnosis was confirmed by biopsy (n=3), additional wedge resection (n = 1) or follow-up MRI 6-12 months later (n=5). Regarding the identified five patients, the number of focal liver lesions was 2 (n=2) and more than 20 (n=3). The MR imaging characteristics were as follows: OP-image: markedly hypointense (n=5); IP image: isointense (n=2) or slightly hyperintense (n=3); T2-weighted FSTSE-image: isointense (n=5); T2-weighted HASTE image isointense (n=1); slightly hyperintense (n=4). On OP images all lesions were sharply demarcated and of almost spherical configuration (n=5). Further evaluation by histology or follow-up MR imaging did not give evidence of malignancy in any case. Histology revealed fatty infiltration of the liver parenchyma in three patients. Magnetic resonance follow-up showed complete resolution in two patients and no change in three patients. Multifocal nodular fatty infiltration can simulate metastatic disease on both CT and MR imaging. The combination of in-phase (IP) and opposed-phase (OP) gradient-echo imaging can reliably differentiate MNFIL from metastatic disease. (orig.)

  12. Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2014-08-01

    Full Text Available David J Browning,1 Chong Lee2 1Charlotte Eye, Ear, Nose and Throat Associates, 2University of North Carolina – Charlotte, Charlotte, NC, USA Purpose: To determine measurement variability of N1P1 amplitudes and the R1/R2 ratio in normal subjects and hydroxychloroquine users without retinopathy. Design: Retrospective, observational study. Subjects: Normal subjects (n=21 and 44 patients taking hydroxychloroquine (n=44 without retinopathy. Methods: Multifocal electroretinography (mfERG was performed twice in one session in the 21 normal subjects and twice within 1 year in the hydroxychloroquine users, during which time no clinical change in macular status occurred. Main outcome measures: N1P1 amplitudes of rings R1–R5, the R1/R2 ratio, and coefficients of repeatability (COR for these measurements. Results: Values for N1P1 amplitudes in hydroxychloroquine users were reduced compared with normal subjects by the known effect of age, but R1/R2 was not affected by age. The COR for R1–R5 ranged from 43% to 52% for normal subjects and from 43% to 59% for hydroxychloroquine users; for R1/R2 the COR was 29% in normal subjects and 45% in hydroxychloroquine users. Conclusion: mfERG measurements show high test-retest variability, limiting the ability of a single mfERG test to influence a decision to stop hydroxychloroquine; corroborative evidence with a different ancillary test is recommended in a suspicious case. Keywords: multifocal electroretinography, hydroxychloroquine, test-retest variability 

  13. A patient with multifocal tabetic arthropathy: a case report and review of literature

    NARCIS (Netherlands)

    Schotanus, M.; Dorleijn, D.M.; Hosman, A.J.F.; Huits, R.M.; Koopmans, P.P.; Galama, J.M.D.

    2013-01-01

    A 55-year-old man presented with a painless destruction of multiple joints and neurologic deficits. He was admitted with a painless pyogenic arthritis of the right ankle. Four years earlier, he had experienced instability of the right knee after an inexplicable, progressive but painless destruction

  14. Diagnosis of AIDS-Related Intestinal Parasites

    Science.gov (United States)

    1988-01-07

    Peru), Claudio F. Lanata (Instituto de Investigacion Nutricional , Lima, Peru) and Irene Perez-Schael (Instituto de Biomedicina, Caracas, Venezuela) (15...above) and Homero Martinez, M.D., Instituto National de la Nutricion , Mexico City. In this study, 53 children with at least one microscopic stool

  15. AIDS-related mycoses: the way forward

    NARCIS (Netherlands)

    Brown, G.D.; Meintjes, G.; Kolls, J.K.; Gray, C.; Horsnell, W.; Achan, B.; Alber, G.; Aloisi, M.; Armstrong-James, D.; Beale, M.; Bicanic, T.; Black, J.; Bohjanen, P.; Botes, A.; Boulware, D.R.; Brown, G.; Bunjun, R.; Carr, W.; Casadevall, A.; Chang, C.; Chivero, E.; Corcoran, C.; Cross, A.; Dawood, H.; Day, J.; Bernardis, F. De; Jager, V. de; Repentigny, L. de; Denning, D.; Eschke, M.; Finkelman, M.; Govender, N.; Gow, N.; Graham, L.; Gryschek, R.; Hammond-Aryee, K.; Harrison, T.; Heard, N.; Hill, M.; Hoving, J.C.; Janoff, E.; Jarvis, J.; Kayuni, S.; King, K.; Kolls, J.; Kullberg, B.J.; Lalloo, D.G.; Letang, E.; Levitz, S.; Limper, A.; Longley, N.; Machiridza, T.R.; Mahabeer, Y.; Martinsons, N.; Meiring, S.; Meya, D.; Miller, R.; Molloy, S.; Morris, L.; Mukaremera, L.; Musubire, A.K.; Muzoora, C.; Nair, A.; Kimbowa, J. Nakiwala; Netea, M.; Nielsen, K.; O'Hern, J.; Okurut, S.; Parker, A.; Patterson, T.; Pennap, G.; Perfect, J.; Prinsloo, C.; Rhein, J.; Rolfes, M.A.; Samuel, C.; Schutz, C.; Scriven, J.; Sebolai, O.M.; Sojane, K.; Sriruttan, C.; Stead, D.; Steyn, A.; Thawer, N.K.; Thienemann, F.; Hohenberg, M. Von; Vreulink, J.M.; Wessels, J.; Wood, K.; Yang, Y.L.

    2014-01-01

    The contribution of fungal infections to the morbidity and mortality of HIV-infected individuals is largely unrecognized. A recent meeting highlighted several priorities that need to be urgently addressed, including improved epidemiological surveillance, increased availability of existing diagnostic

  16. Diagnosis of AIDS-Related Intestinal Parasites

    Science.gov (United States)

    1990-06-20

    Peruvian Per-Urban Shanty Town (Pueblo joven ) (submitted). Significance: In a field setting, ELISA testing offers a cheap, quick and reliable diagnostic...children living in a Peruvian peri-urban shanty town (Pueblo joven ) (submitted). A&. Taylor ’N, Housion F, Shlim DR, Echeverria P, Bhaibuiaya A and

  17. Dentistry and HIV/AIDS related stigma

    Science.gov (United States)

    Elizondo, Jesus Eduardo; Treviño, Ana Cecilia; Violant, Deborah

    2015-01-01

    OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services. METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment. PMID:26538100

  18. Dentistry and HIV/AIDS related stigma

    Directory of Open Access Journals (Sweden)

    Jesus Eduardo Elizondo

    2015-01-01

    Full Text Available OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services.METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men from Nuevo León, Mexico, took part in the study (2014. They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis.RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%; the ones who have not had those experiences, but feel somewhat concerned (12.7%; and the ones who underwent stigma and discrimination and feel concerned (2.3%.CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment.

  19. 东莞市男男性行为者艾滋病知识行为调查%Investigation on AIDS-related knowledge and behavior of MSM in Dongguan city

    Institute of Scientific and Technical Information of China (English)

    陈柏芬; 钟洁莹; 张巧利; 朱建琼; 伦玉华; 王晓霞; 刘爱红; 方昌勇; 卓彬鼓

    2012-01-01

    Objective To investigate the awareness rate on AIDS-related questions and the high risk behaviors of men v who have sex with men (MSM), and provide evidences for prevention and intervention. Method Questionnaire investigation was conducted at the places where the MSM clustered. Results Median age of the MSM was 29 years old and most of them were unmarried, senior high school educated, from other provinces and living in Dongguan for more than 2 years. The awareness rate on AIDS-related questions was 91.75% .The subjects who underwent homosexual behavior in the last 6 months accounted for 74.75%(3.34% of them had commercial homosexual behavior) ,51.84% of them used condom every time. The subjects who underwent heterosexual behavior in the last 6 months accounted for 39%,37.82% of them used condom every time.27.25% of them had both homosexual and hetero behavior. 7.25% of them had been diagnosed with sexually transmitted diseases in the past year. 10.5% of them were positive by HIV antibody screening. Conclusion Health education of civil society organizations and VCT should be combined,and prevent HIV spread to general population through strengthened AIDS-related knowledge publicity and education and extended condom-using among the MSM.%目的 了解男男性行为者(MSM)艾滋病防治知识掌握情况及高危行为方式,为在该人群中开展艾滋病预防干预工作提供依据.方法 在男男性行为者聚集场所进行问卷调查.结果 调查对象年龄中位数为29岁,以未婚、高中文化程度、省外流动人口及在东莞居住2年以上者为主;艾滋病知识知晓率为91.75%;74.75%的调查者在过去的6个月中有过同性性行为(其中3.34%的人有过同性商业性行为),其中51.84%的人每次都使用安全套;39%的人在过去的6个月与女性有过性行为,其中37.82%的人每次都使用安全套;27.25%的人在过去的6个月与男性、女性都有过性行为;7.25%的人在

  20. 女性吸毒者艾滋病相关知识及高危性行为调查%Investigation on AIDS related knowledge and high risk sex behaviors among female drug abusers

    Institute of Scientific and Technical Information of China (English)

    王玮; 任桂秋; 肇恒伟; 赵子阳

    2012-01-01

    Objective; To understand the awareness situation of AIDS related knowledge and high risk sex behaviors among female drug abusers. Methods: Stratified random cluster sampling method and questionnaire survey were used to investigate 236 female drug abusers in Liaoning province, 1: 1 matched case - control study was carried out, female prison inmates during the same period were selected as control group, then they were surveyed by a questionnaire, Logistic regression analysis was used to analyze the influencing factors of high risk sex behaviors among female drug abusers. Results: The mean correct awareness rate of AIDS related knowledge among female drug abusers was 57. 6% , 69. 9% of the respondents had multiple sexual partners, and 69. 1% of the respondents never used condom; the results of mult-ivariate Logistic regression analysis showed that the scores of intravenous drug abuse and basic knowledge of AIDS were low, the respondents with low positive attitude to condom were easily to have high risk sex behaviors. Conclusion: The female drug abusers had misunderstanding toward AIDS related knowledge and attitudes, it is necessary to carry out interventional strategies targeting to their high risk sex behaviors.%目的:了解女性吸毒者艾滋病相关知识的知晓情况和高危性行为情况.方法:采用分层、随机、整群抽样相结合的方法对辽宁省236例女性吸毒者进行问卷调查,同时采用1:1病例对照研究方法,选择同期调查中女性监所服刑人员作为对照进行问卷调查,应用Logistic回归分析对女性吸毒者高危性行为的影响因素进行分析.结果:女性吸毒者艾滋病相关知识平均答对率为57.6%,69.9%的调查者与多个性伙伴发生性行为,69.1%的调查者从未使用安全套;多因素Logistic回归结果显示,静脉注射吸毒、艾滋病基本知识得分低,以及对安全套正性态度较低者更容易发生高危性行为.结论:女性吸毒者对艾滋病相关

  1. Comparative study on optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis ® ZMB00 and AcrySof ® IQ ReSTOR ® Multifocal IOL SN6AD1

    Directory of Open Access Journals (Sweden)

    Mario Augusto Pereira Dias Chaves

    2016-06-01

    Full Text Available ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D, and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA, with analysis of contrast sensitivity (CS, wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868; postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68; DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000; and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001. In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05. Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04; however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003. The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for

  2. Progress Report

    DEFF Research Database (Denmark)

    Duer, Karsten

    1999-01-01

    Progress report describing the work carried out by the Danish participant in the ALTSET project in the period January 1999 to July 1999.......Progress report describing the work carried out by the Danish participant in the ALTSET project in the period January 1999 to July 1999....

  3. 男男与女女两种同性性行为人群艾滋病知识知晓率比较研究%Comparative study on awareness of AIDS-related knowledge among MSM and WSW

    Institute of Scientific and Technical Information of China (English)

    赵金星; 赵哲; 杜桂英; 于海荣; 蔡新; 张娜; 康殿民

    2014-01-01

    Objective To understand the AIDS-related knowledge and influencing factors among men who have sex with men and women who have sex with women,so as to provide the basis for health education and behavior intervention.Methods The subjects were adopted through snowball sampling,network recruiting and random sampling in target population gathering place.The face to face questionnaire survey was used to collected information.SPSS 17.0 was used for statistical analysis.Results 400 MSM were interviewed,median age was 30 years old,45.0% of MSM were unmarried,70.5% were high school or above educational background,82.4% were homosexual preference.A total of 85 WSW were surveyed,median age was 24 years old,76.5% were unmarried,78.0% were high school or above,the majority of them were commercial servers (32.9%) and housework and unemployment(17.6%).82.4% of the WSW were homosexual preference.The awareness rate of AIDS-related knowledge of two groups (MSM: 50.6% vs WSW: 70.5%) had statistically difference (x2 =12.573,P < 0.05).Age,marriage were influence factors on the awareness rate of AIDS-related knowledge.The awareness rate were different among different age groups (x2 =26.021,P < 0.05) and different marital status (x2 =10.028,P < 0.05).Conclusions The awareness rate of AIDS-related knowledge in WSW and MSM was low,personalized health education and intervention measures should be carried out to decrease incidence rate.%目的 为了解男男性行为人群(men who have sex with men,MSM)和女女性行为人群(women who have sex with women,WSW)艾滋病知识知晓率及影响因素,为在高危人群中开展艾滋病、性病防治知识宣传教育和干预提供科学依据.方法 采用滚雪球、网络招募、目标人群聚集场所随机抽样三种抽样方法招募调查对象,采用面对面问卷调查,应用SPSS 17.0统计分析.结果 共调查MSM400人,年龄中位数30岁,未婚占45.0%,文化程度高中及以上占70.5

  4. Impact of a Manualized Multifocal Perinatal Home-Visiting Program Using Psychologists on Postnatal Depression: The CAPEDP Randomized Controlled Trial

    Science.gov (United States)

    Dugravier, Romain; Tubach, Florence; Saias, Thomas; Guedeney, Nicole; Pasquet, Blandine; Purper-Ouakil, Diane; Tereno, Susana; Welniarz, Bertrand; Matos, Joana

    2013-01-01

    Context Postnatal maternal depression (PND) is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. Objective This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. Methods 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child’s second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS). Results At three months postpartum, mean (SD) EPDS scores were 9.4 (5.4) for the control group and 8.6 (5.4) for the intervention group (p = 0.18). The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34). The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8): difference = 1.66 (95%CI: 0.17; 3.15), p = 0.05, adjusted for baseline EPDS score), women who were planning to raise the child with the child’s father: difference = 1.45 (95%CI: 0.27; 2.62), p = 0.04 (adjusted); women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68) p = 0.05 (adjusted). Conclusion CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction

  5. Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM

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    Lucas Monferrari Monteiro Vianna

    2014-04-01

    Full Text Available Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39. Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe. O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39 teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39.

  6. Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Romain Dugravier

    Full Text Available CONTEXT: Postnatal maternal depression (PND is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. OBJECTIVE: This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. METHODS: 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child's second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS. RESULTS: At three months postpartum, mean (SD EPDS scores were 9.4 (5.4 for the control group and 8.6 (5.4 for the intervention group (p = 0.18. The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34. The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8: difference = 1.66 (95%CI: 0.17; 3.15, p = 0.05, adjusted for baseline EPDS score, women who were planning to raise the child with the child's father: difference = 1.45 (95%CI: 0.27; 2.62, p = 0.04 (adjusted; women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68 p = 0.05 (adjusted. CONCLUSION: CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction of PND

  7. Multifocal Skeletal Tuberculosis Mimicking Langerhans Cell Histiocytosis in a Child: a Case Report With a Long-Term Follow-Up

    Science.gov (United States)

    Haghighatkhah, Hamidreza; Jafroodi, Yousef; Sanei Taheri, Morteza; Pourghorban, Ramin; Sadeghian Dehkordy, Afarin

    2015-01-01

    Introduction: Multifocal skeletal tuberculosis is a rare condition that may masquerade as Langerhans cell histiocytosis, especially in children. Case Presentation: We report a case of multifocal osseous tuberculosis in a 5-year-old female patient admitted to our hospital with a complaint of low back pain but no history of respiratory symptoms or malaise. Radiological findings included vertebra plana and multiple lytic lesions in both the frontal and pelvic bones. An initial diagnosis of Langerhans cell histiocytosis was made based on imaging findings; however, the patient underwent further evaluation for Mycobacterium tuberculosis, and histopathologic findings confirmed the diagnosis of tuberculosis. The patient showed a nearly complete response after receiving a course of anti-tuberculosis drugs. Conclusions: A high index of suspicion is required for the early diagnosis and prompt treatment of patients with osseous tuberculosis. Given the high prevalence of tuberculosis in developing countries, tuberculosis should be considered in the differential diagnosis of multifocal lytic lesions and vertebra plana, especially in children. PMID:26744631

  8. Intraocular Lens Multifocality Combined with the Compensation for Corneal Spherical Aberration:A New Concept ofPresbyopia-CorrectingIntraocular Lens

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    Reiner Friedrich

    2012-10-01

    Full Text Available The outcomes of a prospective consecutive study aimed at evaluating the visual and refractive benefit after cataract surgery with the implantation of the aspheric diffractive multifocal intraocular lens (IOL Tecnis ZMB00 (Abbott Medical Optics are reported. A total of 31 eyes of 19 patients (age range, 40 to 81 years underwent phacoemulsification surgery with implantation of this aspheric multifocal IOL. At 6 months after surgery, postoperative spherical equivalent was within ±1.00 D in 96.8% of eyes, with 94.7% of patients presenting a postoperative binocular far LogMAR uncorrected visual acuity (UCVA of 0.1 or better. Far best-corrected distance VA improved significantly (p < 0.01, with postoperative values of 0.1 or better in 96.8% of eyes. Postoperative near UCVA was 0.10 (equivalent to J1 or better in 93.55% of eyes. Furthermore, the IOL power was found to be very poorly correlated with the postoperative far LogMAR (r = 0.13 and near UCVA (r = 0.13. In conclusion, the aspheric diffractive multifocal IOL Tecnis ZMB00 provides a restoration of the far and near visual function after phacoemulsification surgery for cataract removal or presbyopia correction, which is predictable and independent from the optical power of the implanted IOL.

  9. PROGNOSTIC FACTORS OF POSITIVE RESULTS OF MULTIFOCAL TRUS-GUIDED VESICOURETHRAL ANASTOMOSIS BIOPSY IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

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    P. D. Demeshko

    2014-07-01

    Full Text Available Purpose. To evaluate influence of clinical, biochemical and histological factors to detection rate of local recurrence following radical prostatectomy (RPE using multifocal TRUS-guided vesicourethral anastomosis (VUA biopsy.Material and methods. 59 patients with newly diagnosed biochemical recurrence (BR after RPE were included into prospective study. All of them underwent multifocal TRUS-guided VUA biopsy. Сlinical variables (serum prostate-specifi c antigen [PSA] level and PSA kinetics, time RPE-BR, Gleason grade, stage after RPE and clinical findings were evaluated. Logistic regression and receiver operating characteristic (ROC curve analyses were performed.Results. The detection rate of local prostate recurrence with TRUS-guided VUA biopsy was 45,8 % (95 % CI 33,7–58,3. At multivariate analysis only PSA level at the moment of biopsy (≤ 1,5 ng/ml vs > 1,5 ng/ml and time RPE-BR (≤ 15 months vs > 15 months were significantly associated with positive results of multifocal TRUS-guided VUA biopsy (p < 0,05.Conclusion The detection rate of local prostate recurrence with TRUS-guided VUA biopsy depends on combination of independent predictors (PSA level at the moment of biopsy and time RPE—BR.

  10. Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature.

    Science.gov (United States)

    Tlougan, Brook E; Podjasek, Joshua O; O'Haver, Judith; Cordova, Katherine B; Nguyen, Xuan H; Tee, Ronald; Pinckard-Hansen, Kay C; Hansen, Ronald C

    2009-01-01

    A growing body of literature has identified the association between neutrophilic dermatoses and multifocal, aseptic bone lesions in children, termed chronic recurrent multifocal osteomyelitis (CRMO). Classically, patients present with swelling, pain, and impaired mobility of the affected area, with skin lesions developing concurrently or in the future. Bone biopsy reveals inflammatory changes consistent with infectious osteomyelitis, but cultures and histologic staining invariably fail to identify an infectious source. Patients are refractory to antibiotic therapy, but dramatically respond to systemic steroids and may need to be maintained on low-dose steroids to prevent relapse. Numerous authors have suggested that CRMO and synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome lie along the same clinical spectrum. In fact some believe that CRMO is the pediatric presentation of SAPHO. The two syndromes share numerous characteristics, including osteitis, a unifocal or multifocal presentation, hyperostosis, and pustulosis, which all occur in a generally healthy individual. Our seven patients, five of whom were diagnosed with CRMO, and two of whom were diagnosed with SAPHO syndrome further strengthen the idea that CRMO and SAPHO syndrome do indeed lie along the same clinical spectrum. In addition, we include two rare cases of pediatric Sweet's syndrome with evidence of pathergy.

  11. Initial Stody on Multifocal Visualevoked Potential (Multifocal Vep) of Optic Neuritis%视神经炎多焦视觉诱发电位的初步研究

    Institute of Scientific and Technical Information of China (English)

    隋源; 李雪丽; 勾晓梅; 周丽霞

    2016-01-01

    Objective To investigate the wavelet character in the same ring according to the dieffrent eccentricity dis-tribution in the multifocal visual evoked potential of optic neuritis:Tracking the local damage to the optic nerve after out-break of optic neuritis and the recovery after treatment,so offer the objective way of the early diagnosis,the effects of treatments and the monitor of Prognosis.Methods Carry on the multifocal VEP examination to30 eyes with thirty cases of optic neuritis,and adopt to contrast the sick eyes and the normal eyes in the same patients and the 30 eyes of fifteen normal individuals,mainly analysis the multifocal VEP Second-order kernel response,according to the diffent ring in the same heart, analysing each reaction total wave, carrying on the comparison to each ring.Results Before treatment the sick eyes contrast to the normal eyes in the same Patients, the latencies of P-wavelet were lengthened,and the ampli-tudes of P -wavelet were lowered ( P 0.05),the latencies of p-wavelet still have the obvious difference (P<0.05).Conclusion The multifo-cal VEP can apply the early diagnosis of optic neuritis, and the effects of treatments,and have the obvious advantage in estimating the local damage to the optic Nerve and traeking the recovery of damage of the optic nerve contrasting to visual field or the traditional VEP.%目的:研究视神经炎在多焦视觉诱发电位( mfVEP)检查中按照不同离心度分布的各同心环的波形特征;追踪视神经炎发病后局部视神经损害情况及经治疗后的恢复情况,从而为视神经炎的诊断、疗效判定及预后监测提供客观依据。方法对30例(30只眼)单眼患轴性球后视神经炎患者进行多焦视觉诱发电位(mfVEP)和视野检测,采用同一个体的患眼治疗前后与健侧眼及15例(30只眼)正常对照组的比较方法,主要分析多焦视觉诱发电位( mfVEP)的特征,按不同离心度的同心环进行分析,

  12. Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acute posterior multifocal placoid epitheliopathy

    Directory of Open Access Journals (Sweden)

    Jong Hoon Park

    2013-01-01

    Full Text Available A 55-year-old female presented with bilateral progressive retinal vasculitis. She was on systemic and intravitreal steroids on the basis of uveitis work-up result (negative result including rapid plasma reagin, but her visual acuity continued to deteriorate to light perception only. Ocular examination showed retinal vasculitis, multiple yellow placoid lesions and severe macula edema in both eyes. Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid. Ocular syphilis was diagnosed. And intravenous penicillin G resulted in rapid resolution of vasculitis and macular edema. To avoid delay in the diagnosis of ocular syphilis, high index of suspicion and repeating serological tests (including both treponemal and non-treponemal tests are warranted.

  13. Progressive Business

    DEFF Research Database (Denmark)

    Christiansen, Christian O.

    2016-01-01

    Guest Post to the Society for U.S. Intellectual History Blog. Brief introduction to the book Progressive Business: An Intellectual History of the Role of Business in American Society, Oxford U.P., 2015.......Guest Post to the Society for U.S. Intellectual History Blog. Brief introduction to the book Progressive Business: An Intellectual History of the Role of Business in American Society, Oxford U.P., 2015....

  14. Peripheral Nerve Ultrasonography in Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Correlations with Clinical and Neurophysiological Data

    Directory of Open Access Journals (Sweden)

    Aristide Merola

    2016-01-01

    Full Text Available Objective. This cross-sectional study analyzes the pattern of ultrasound peripheral nerve alterations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP and multifocal motor neuropathy (MMN at different stages of functional disability. Material and Methods. 22 CIDP and 10 MMN patients and a group of 70 healthy controls were evaluated with an ultrasound scan of the median, ulnar, peroneal, tibial, and sural nerves. Results were correlated with clinical disability scales and nerve conduction studies. Results. Patients with intermediate functional impairment showed relatively larger cross-sectional areas than subjects with either a milder (p<0.05 or more severe impairment (p<0.05, both in CIDP and in MMN. In addition, MMN was associated with greater side-to-side intranerve variability (p<0.05, while higher cross-sectional areas were observed in CIDP (p<0.05 and in nerve segments with predominantly demyelinating features (p<0.05. Higher CSA values were observed in nerves with demyelinating features versus axonal damage (p<0.05 for CIDP; p<0.05 for MMN. Discussion and Conclusions. Greater extent of quantitative and qualitative US alterations was observed in patients at intermediate versus higher functional disability and in nerves with demyelinating versus axonal damage. CIDP and MMN showed differential US aspects, with greater side-to-side intranerve variability in MMN and higher cross-sectional areas in CIDP.

  15. The multifocal visual evoked potential and cone-isolating stimuli: implications for L- to M-cone ratios and normalization.

    Science.gov (United States)

    Hood, Donald C; Yu, Alice L; Zhang, Xian; Albrecht, Johannes; Jägle, Herbert; Sharpe, Lindsay T

    2002-01-01

    Multifocal visual evoked potentials (mfVEP) were recorded with a pattern-reversing display that modulated only the long wavelength-sensitive (L) cones or only the middle wavelength-sensitive (M) cones. Outside the central 5.8 degrees (radius), the ratio of the amplitudes of the mfVEP responses to L- and M-cone modulation varied across the six subjects, ranging from 1.1 to 1.7. The responses from the central 1 degrees (radius) showed a substantially lower ratio, ranging from 0.8 to 1.1 (average of 0.9). The variation among individuals outside the central fovea is probably due to differences in the ratio of the L/M cone input to both magno- and parvocellular pathways. The substantially lower ratios for the central responses is consistent with an L/M cone ratio closer to 1.0 in the central 1 degrees and/or an adjustment in the gain of the L- versus M-cone contributions to the central parvocellular pathways. Taking into consideration evidence from other techniques, we believe it is unlikely that most individuals have a L/M cone ratio of 1.0 in the fovea. Instead, it appears that there is a change in gain before the mfVEP is generated in area 17.

  16. Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens

    Directory of Open Access Journals (Sweden)

    John S. M. Chang

    2014-01-01

    Full Text Available Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE with a single-piece bifocal diffractive multifocal intraocular lens (MIOL. Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics. Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA, contrast sensitivity, extent of visual symptoms (0–5, satisfaction (1–5, and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm, and near (30 cm were 0.01±0.12 (standard deviation, 0.27±0.18, and 0.15±0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P>0.05. Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82% and unilateral group (75% (P=1.000. Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence.

  17. Multifocal Langerhans cell histiocytosis of bone: Indications for radiotherapy; Histiocytose langerhansienne osseuse multifocale: place de la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Gaundong Mbethe, G.L.; Dejean, C.; Henriques de Figueiredo, B.; Sargos, P.; Italiano, A.; Kantor, G. [Service de radiotherapie, centre regional de lutte contre le cancer, institut Bergonie, 33 - Bordeaux (France)

    2010-12-15

    Langerhans cell histiocytosis is a non-malignant proliferative disease of unknown etiology that can affect one or more organs. This is a rare disease, 1 to 2/100, 000, affecting mainly children with a male predominance. The osseous lesions are the most frequent (60 to 90%). There is however no consensus treatment for the management of these sites. We report the cases of two patients successfully treated with radiotherapy after primary chemotherapy, at doses of 15 Gy in ten sessions of 1.5 Gy for one patient and 18 Gy in ten fractions of 1.8 Gy for the other. Single or multifocal bone Langerhans cell histiocytosis without visceral involvement is a benign, self-limiting affection in most cases. Some bone lesions could be treated by radiotherapy alone. But the high variability of doses currently given in the literature does not allow determining the lowest effective dose limiting the risk of secondary neoplasia or impaired growth in children, in whom lower doses of 6 to 8 Gy are recommended. The decision of radiotherapy must be weighed against the risk of the disease. Caution should be the rule in this non-malignant tumour pathology. (authors)

  18. Antibodies to Glycoproteins Shared by Human Peripheral Nerve and Campylobacter jejuni in Patients with Multifocal Motor Neuropathy

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    Ljubica Suturkova

    2013-01-01

    Full Text Available We have tested serum samples from 24 patients with multifocal motor neuropathy (MMN for reactivity to ganglioside GM1 and to Gal(β1–3GalNAc-bearing glycoproteins isolated from human peripheral nerve and from Campylobacter jejuni (Cj serotype O:19. IgM anti-GM1 antibodies were detected by ELISA in 11 patients (45.8% with MMN and in only one subject (4% from the control group. Western blots showed positive reactivity of sera from 6 patients (25% with MMN to several Gal(β1–3GalNAc-bearing glycoproteins from human peripheral nerve and from Cj O:19 isolates. Sera from three patients (12.5% with MMN showed positively reactive bands with similar electrophoretic mobility in all isolates (60–62 kDa, 48–51 kDa, 42 kDa, and 38 kDa. All six patients showed positive reactivity to 48–52 kDa protein isolated from human peripheral nerve. Increased titer of IgG antibodies to 60–62 kDa protein isolated from Cj O:19 associated with Guillain-Barré syndrome was detected in three patients, and their serum showed also IgG positive reactivity to peripheral nerve antigen with the same electrophoretic mobility. One of these patients had a previous history of Cj infection which suggests the possibility that Cj may be also involved in the pathogenesis of MMN.

  19. Modulation of the pupil function of microscope objective lens for multifocal multi-photon microscopy using a spatial light modulator

    Science.gov (United States)

    Matsumoto, Naoya; Okazaki, Shigetoshi; Takamoto, Hisayoshi; Inoue, Takashi; Terakawa, Susumu

    2014-02-01

    We propose a method for high precision modulation of the pupil function of a microscope objective lens to improve the performance of multifocal multi-photon microscopy (MMM). To modulate the pupil function, we adopt a spatial light modulator (SLM) and place it at the conjugate position of the objective lens. The SLM can generate an arbitrary number of spots to excite the multiple fluorescence spots (MFS) at the desired positions and intensities by applying an appropriate computer-generated hologram (CGH). This flexibility allows us to control the MFS according to the photobleaching level of a fluorescent protein and phototoxicity of a specimen. However, when a large number of excitation spots are generated, the intensity distribution of the MFS is significantly different from the one originally designed due to misalignment of the optical setup and characteristics of the SLM. As a result, the image of a specimen obtained using laser scanning for the MFS has block noise segments because the SLM could not generate a uniform MFS. To improve the intensity distribution of the MFS, we adaptively redesigned the CGH based on the observed MFS. We experimentally demonstrate an improvement in the uniformity of a 10 × 10 MFS grid using a dye solution. The simplicity of the proposed method will allow it to be applied for calibration of MMM before observing living tissue. After the MMM calibration, we performed laser scanning with two-photon excitation to observe a real specimen without detecting block noise segments.

  20. Visual and optical performance of diffractive multifocal intraocular lenses with different haptic designs: 6 month follow-up

    Directory of Open Access Journals (Sweden)

    Wang M

    2014-05-01

    Full Text Available Mengmeng Wang,1,* Christine Carole C Corpuz,1 Megumi Fujiwara,1 Minoru Tomita1,2,*1Shinagawa LASIK Center, Tokyo, Japan; 2Department of Ophthalmology, Wenzhou Medical College, Wenzhou, People’s Republic of China*These authors contributed equally to this workPurpose: To evaluate and compare the visual acuity outcomes and optical performances of eyes implanted with two diffractive multifocal intraocular lens (IOL models with either a plate haptic design or a modified-C design.Methods: This retrospective study comprised cataract patients who were implanted with either a plate haptic multifocal IOL model (AcrivaUD Reviol BB MFM 611 [VSY Biotechnology, Amsterdam, the Netherlands], group 1 or a modified-C haptic multifocal IOL model ( AcrivaUD Reviol BB MF 613 [VSY Biotechnology, Amsterdam, the Netherlands], group 2 between June 2012 and May 2013. The 6 month postoperative visual acuity, refraction, defocus curve, contrast sensitivity, and wave-front aberration were evaluated and compared between these eyes, using different IOL models.Results: One hundred fifty-eight eyes of 107 patients were included in this study. Significant improvement in visual acuities and refraction was found in both groups after cataract surgery (P<0.01. The visual acuity and contrast sensitivity were statistically better in group 1 than in group 2 (P<0.01. No statistically significant difference in the corneal higher-order aberrations was found between the two groups (P>0.05. However, the ocular higher-order aberrations in group 2 were significantly greater than in group 1 (P<0.05.Conclusion: At 6 months postoperatively, both AcrivaUD Reviol BB MFM 611 IOL and AcrivaUD Reviol BB MF 613 IOL achieved excellent visual and refractive outcomes. The multifocal IOL model with plate haptic design resulted in better optical performances than that with the modified-C haptic design.Keywords: AcrivaUD, VSY, plate haptic, modified-C haptic, multifocal

  1. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids.

  2. Prevalence of AIDS-related high risk behaviors among men who have sex with men with STI%不同性传播感染MSM艾滋病高危行为对比分析

    Institute of Scientific and Technical Information of China (English)

    于增照; 李洋; 史同新; 李秀芳; 张北川; 王燕飞

    2013-01-01

    目的 探讨男男性行为者(MSM)中近1年内曾患性传播感染(STI)者与未患STI者的艾滋病(AIDS)高危行为状况.方法 采用滚雪球法进行横断面调查;应用SPSS 13.0软件对9个城市2 134名MSM进行匿名问卷分析,比较患STI者与未患STI者AIDS高危行为差异.结果 患STI者中累计同性肛交性伴数、近6个月同性肛交性伴数中位数分别为20、3个,均高于未患STI者的7、2个;近1年内,患STI者中有28.8% (95/330)曾参加群交,24.7%(81/328)向同性买性,44.1%(146/331)性交时出血,均高于未患STI者的17.0%(289/1 697)、11.4%(189/1 657)、24.4%(417/1 706)(P=0.000);患STI者中有67.3%(181/269)近1次同性肛交时使用安全套,低于未患STI者的76.9%(964/1 253)(x2=11.065,P=0.001);患STI者艾滋病病毒(HIV)感染率为4.03%(14/347),明显高于未患STI者的1.96% (35/1 787) (x2=5.582,P=0.018).结论 MSM中患STI者具有更多的AIDS高危行为,需加强对其进行健康干预.%Objective To investigate the prevalence of AIDS-related high risk behaviors among men who have sex with men(MSM) ever infected by sexually transmitted disease(STI) within previous one year.Methods Snowball sampiing and an anonymous questionnaire survey were adopted for a cross-sectional study to compare the differences in high risk behaviors related to AIDS between MSM with STI and without STI experience in nine cities.SPSS 13.0 statistical software was used in data analysis.Results Among the 2 134 MSM,compared to the MSM without STI experience,the MSM with STI had a significant higher number of total sexual partners of anal sex with same sex and the number of anal sex in the previous six months,with the medians of 20.0 and 3.0,respectively.In the previous year,28.8 % (95/330)of MSM with STI participated in group sex,24.7% (81/328)had commercial homosex,44.1% (146/331)reported bleeding while having sexual intercourse,with significant differences compared to those of MSM

  3. Investigation on AIDS-related KAP in female sex workers and clients (drug users)%吸毒者中暗娼与嫖客艾滋病相关KAP调查分析

    Institute of Scientific and Technical Information of China (English)

    周翔; 郑武; 刘旺民

    2011-01-01

    Objective To investigate the AIDS related KAP in female sex workers and clients, in particular, drug users, so as to provide basis for health education and behavioral intervention. Methods Basic information and KAP of sex workers and clients from drug rehabilitation centers were investigated, self-designed questionnaire was performed and cluster sampling method was applied. Results In terms of relevant knowledge of AIDS ,80.49% female sex workers thought that the use of condom could prevent AIDS;31.71% of female sex workers thought that the danger of AIDS was far away from them, and 28. 57% of clients had the similar idea( P < 0.05 ). The understanding rate of the AIDS transmission path in the female sex workers and clients was rather low,except that mother-infant breast-feeding path of HIV transmission,the difference was of statistical significance. The ratio of female sex workers resisting sexual freedom was significantly higher than that of the clients ( P < 0.05 ) ; The ratio of sex workers using condom was significantly higher than that of the clients ( P < 0.05). Conclusions Priority should be put on male high-risk group while carrying out the condom-use education and intervention for HIV prevention. Psychological, sexual moral publicity and AIDS-related knowledge education should be reinforced and the intervention of high-risk sexual behavior should be emphasized, in particular, among the drug-using group, including female sex workers and clients.%目的 了解吸毒者中暗娼与嫖客KAP现状,为该类人群的健康教育、行为干预提供依据.方法 应用自行设计的调查问卷,采取整群抽样的方法,对某戒毒所吸毒人员中暗娼与嫖客基本情况、KAP等进行调查分析.结果 艾滋病相关知识的掌握,80.49%的暗娼认为使用安全套可以预防艾滋病;31.71%的暗娼和28.57%的嫖客认为艾滋病离我们很远;暗娼和嫖客对传播途径的知晓率比较,除HIV阳性

  4. Controlling myopia progression in children and adolescents

    Directory of Open Access Journals (Sweden)

    Smith MJ

    2015-08-01

    Full Text Available Molly J Smith, Jeffrey J WallineThe Ohio State University College of Optometry, Columbus, OH, USAAbstract: Myopia is a common disorder, affecting approximately one-third of the US population and over 90% of the population in some East Asian countries. High amounts of myopia are associated with an increased risk of sight-threatening problems, such as retinal detachment, choroidal degeneration, cataracts, and glaucoma. Slowing the progression of myopia could potentially benefit millions of children in the USA. To date, few strategies used for myopia control have proven to be effective. Treatment options such as undercorrection of myopia, gas permeable contact lenses, and bifocal or multifocal spectacles have all been proven to be ineffective for myopia control, although one recent randomized clinical trial using executive top bifocal spectacles on children with progressive myopia has shown to decrease the progression to nearly half of the control subjects. The most effective methods are the use of orthokeratology contact lenses, soft bifocal contact lenses, and topical pharmaceutical agents such as atropine or pirenzepine. Although none of these modalities are US Food and Drug Administration-approved to slow myopia progression, they have been shown to slow the progression by approximately 50% with few risks. Both orthokeratology and soft bifocal contact lenses have shown to slow myopia progression by slightly less than 50% in most studies. Parents and eye care practitioners should work together to determine which modality may be best suited for a particular child. Topical pharmaceutical agents such as anti-muscarinic eye drops typically lead to light sensitivity and poor near vision. The most effective myopia control is provided by atropine, but is rarely prescribed due to the side effects. Pirenzepine provides myopia control with little light sensitivity and few near-vision problems, but it is not yet commercially available as an eye drop or

  5. HIV/AIDS相关性慢性腹泻患者感染空肠弯曲菌的临床分析%Infections of Campylobacter Jejuni among Patients with HIV/AIDS-related Chronic Diarrhea

    Institute of Scientific and Technical Information of China (English)

    华文浩; 王慧珠; 赵辉; 李敏; 张燕; 田敬华; 王玉光

    2011-01-01

    Objective To investigate the Campylobacter jejuni infection status of HIV/AIDS patients with chronic diarrhea in Beijing, Henan, and Xinjiang.Methods Micro - aerobic cultivation of stool specimens were carried out in 253 cases of HIV/AIDS patients with chronic diarrhea in Beijing, Henan, and Xinjiang.The colonies were identified according to morphology, Gram staining, and results frombiochemical reactions.Results Two strains of Campylobacter jejuni were identified from the 253 cases of HIV/AIDS - related chronic diarrhea ( infection rate: 0.8% ).Conclusion It is important that monitoring for Campylobacter jejuni be carried out in high risk patients for prevention and control of the infection of the bacteria.%目的 了解北京、河南、新疆三地HIV/AIDS相关性慢性腹泻患者空肠弯曲菌的感染状况.方法 对北京、河南、新疆三地253例HIV/AIDS慢性腹泻患者的粪便标本进行微需氧培养,根据菌落的形态、菌体的革兰染色及生化反应进行鉴定.结果 从253例HIV/AIDS相关性慢性腹泻患者的粪便中共检出2株空肠弯曲菌,感染率为0.8%.结论 加强空肠弯曲菌的监测是预防和控制空肠弯曲菌病的重要手段.

  6. 中国西南地区暗娼艾滋病相关行为分析%HIV/AIDS-related Risk Behaviour in Female Sex Workers, Southwest China

    Institute of Scientific and Technical Information of China (English)

    吴庆; 何朝阳; 朵林; 和丽梅; 陈莹; 王耶盈

    2011-01-01

    Objective:To assess HIV/AIDS-related knowledge and risk behaviour in temale sex workers (FSWs) living in 5outhwest China [Methods] A cross-sectional epidemiological study was conducted in 5 cities of Yunnan province. In each city standardized questionnair%目的:了解暗娼艾滋病相关知识和危险行为水平。方法:采用等容量分层整群抽样方法,选择云南省5个县(市、区)各级场所的暗娼进行问卷调查。结果:调查暗娼1065人。艾滋病相关知识得分均分为(5.14±1.9),得分及格率(得分〉=4.8/8)为77.8%,各地的差异无统计学意义(χ2=3.27,P〉0.05)。最近一次商业性行为的安全套使用率为84.8%,不使用的主要原因是嫖客不愿使用为20.2%;5个调查地点暗娼人群吸毒率为1.3%。24.1%的调查对象在过去一年内出现过性病相关症状和体征,18.3%选择到私

  7. 建筑工地农民工艾滋病知识、态度及行为调查%HIV/AIDS related knowledge, attitude and behavior among peasant workers in construction sites

    Institute of Scientific and Technical Information of China (English)

    刘洁; 张阳; 何钦成

    2013-01-01

    目的 了解建筑工地农民工艾滋病相关知识、态度及行为状况,为农民工艾滋病预防及健康教育工作提供背景资料和依据.方法 整群抽取辽宁省沈阳市和辽阳市4个建筑工地432名男性建筑农民工进行横断面现场调查.结果 农民工对非传播途径问题回答的正确率较差;年龄较小、文化程度低、在当地居住时间短的农民工艾滋病知识知晓率较低,差异有统计学意义(x2=17.891、14.958、8.155,P<0.05或P<0.01).农民工获得HIV/AIDS相关知识通过电视380人(87.9%)、报纸及杂志206人(47.6%)、广播97人(22.4%)、宣传画69人(15.9%)、朋友32人(7.3%)、小折页19人(4.5%)、讲座或光盘13人(3.1%)、小画册14人(3.3%)、其他15人(3.4%).320人(74.1%)认为不安全性行为会给人们带来艾滋病,309人(71.5%)认为应该帮助AIDS患者,301人(69.7%)不同意和感染艾滋病的工作伙伴来往.农民工共用刮胡刀159人(36.8%)、卖血24人(5.6%)、婚外性行为23人(5.3%)、商业性行为16人(3.7%)、性行为使用安全套99人(22.9%).结论 建筑工地农民工缺乏艾滋病防治知识,存在高危行为,应对农民工进行正面、集中的艾滋病宣传教育.%Objective To explore human immunodeficiency virus/acquired immunodeificiency syndrome (HIV/AIDS)-related knowledge,attitude and behavior among peasant workers in construction sites and to provide scientific basis for making prevention and control measures.Methods An anonymous questionnaire survey on knowledge,attitude and behavior about HIV/AIDS was carried out among peasant workers.Results A total of 432 peasant workers with an average age of 30.6 years were surveyed.The awareness of non-transmission route of HIV was poor.The peasant workers of younger,lower education level,and shorter living time in the local area has poorer cognition of HIV/AIDS-related knowledge (P < 0.05).The ratios of mastering AIDS related knowledge

  8. Multifocal and pattern-reversal visual evoked potentials vs. automated perimetry frequency-doubling technology matrix in optic neuritis

    Directory of Open Access Journals (Sweden)

    Marcella Nebbioso

    2013-01-01

    Full Text Available Background: To compare the usefulness of the traditional pattern-reversal Visual Evoked Potentials (VEP with multifocal VEP (mfVEP and Frequency-Doubling Technology (FDT perimetry in the evaluation of the ocular abnormalities induced by acute or subacute optic neuritis (ON. Materials and Methods: The test results of 24 ON patients were compared with those obtained in 40 normal control subjects. MfVEP recordings were obtained by using an Optoelectronic Stimulator that extracts topographic VEP using a pseudorandom m-sequence stimulus. Receiver operator characteristic (ROC curves were calculated to determine the sensitivity and specificity of abnormal values. Results: The frequency of the abnormal ocular findings differed in the ON patients according to the used technique. Reduced visual sensitivity was demonstrated in 12 eyes (54.5% using FDT perimetry; 17 eyes (77.2% showed decreased amplitude and/or an increase in the implicit time of the P1 wave in mfVEP and 20 eyes (90.9% showed an abnormal decrease in the amplitude and/or an increase in the latency of the P100 peak at VEP examination. The areas under the ROC curves ranged from 0.743 to 0.935, with VEP having the largest areas. The VEP and mfVEP amplitudes and latencies yielded the greatest sensitivity and specificity. Conclusions: The mfVEP and the FDT perimetry can be used for the evaluation and monitoring of visual impairment in patients with ON. The most sensitive and practical diagnostic tool in patients with ON is, however, the traditional VEP. The mfVEP can be utilized in those cases with doubtful or negative VEP results.

  9. Recording of both VEP and multifocal ERG for evaluation of unexplained visual loss electrophysiology in unexplained visual loss.

    Science.gov (United States)

    Renner, Agnes B; Kellner, Ulrich; Tillack, Hilmar; Kraus, Hannelore; Foerster, Michael H

    2005-11-01

    The purpose of this retrospective study was to determine the relevance of both visual-evoked potentials (VEP) and multifocal electroretinography (mfERG) to evaluate unexplained visual loss. Seventy-two consecutive patients (1996-2002) with visual disturbances of unknown origin underwent both VEP and mfERG (ISCEV standard). The mean age was 42.4 years (11.8-74.5) and median visual acuity 0.5 (no light perception - 1.0). Symptoms reported included visual acuity loss (n=69), visual field defects (n=11), disturbances of colour vision, light or dark adaptation (n=10). VEP and mfERG were normal in 43% (n=31). Both VEP and mfERG were pathological in 24% (n=17). In a further 18% (n=13) only the mfERG was pathological and in 15% (n=11) only the VEP was pathological. Macular dysfunction as detected with mfERG was present in 73% of 41 patients with at least one pathological test. Neuroimaging (MRI, CCT) and/or neurological examination was performed in 27/72 patients (38%), to account for unexplained visual loss, prior to the electrophysiological tests; these were normal in all patients. Electrophysiological tests revealed disturbances of the post-retinal visual pathway in only 3/27 patients. In 12/27 patients, mfERG revealed a macular disorder; in a further 12/27 patients VEP and mfERG were normal. The combined evaluation of VEP and mfERG is useful both to establish the area of dysfunction and the normality of the visual system. Electrophysiological testing prior to neuroimaging is recommended for patients where clear clinical signs of cerebral disorders are not evident. This reduces the frequency of unnecessary neuroimaging and associated radiation exposure.

  10. Neurovirulence of H5N1 infection in ferrets is mediated by multifocal replication in distinct permissive neuronal cell regions.

    Directory of Open Access Journals (Sweden)

    Jennifer R Plourde

    Full Text Available Highly pathogenic avian influenza A (HPAI, subtype H5N1, remains an emergent threat to the human population. While respiratory disease is a hallmark of influenza infection, H5N1 has a high incidence of neurological sequelae in many animal species and sporadically in humans. We elucidate the temporal/spatial infection of H5N1 in the brain of ferrets following a low dose, intranasal infection of two HPAI strains of varying neurovirulence and lethality. A/Vietnam/1203/2004 (VN1203 induced mortality in 100% of infected ferrets while A/Hong Kong/483/1997 (HK483 induced lethality in only 20% of ferrets, with death occurring significantly later following infection. Neurological signs were prominent in VN1203 infection, but not HK483, with seizures observed three days post challenge and torticollis or paresis at later time points. VN1203 and HK483 replication kinetics were similar in primary differentiated ferret nasal turbinate cells, and similar viral titers were measured in the nasal turbinates of infected ferrets. Pulmonary viral titers were not different between strains and pathological findings in the lungs were similar in severity. VN1203 replicated to high titers in the olfactory bulb, cerebral cortex, and brain stem; whereas HK483 was not recovered in these tissues. VN1203 was identified adjacent to and within the olfactory nerve tract, and multifocal infection was observed throughout the frontal cortex and cerebrum. VN1203 was also detected throughout the cerebellum, specifically in Purkinje cells and regions that coordinate voluntary movements. These findings suggest the increased lethality of VN1203 in ferrets is due to increased replication in brain regions important in higher order function and explains the neurological signs observed during H5N1 neurovirulence.

  11. Retinotopic maps, spatial tuning, and locations of human visual areas in surface coordinates characterized with multifocal and blocked FMRI designs.

    Directory of Open Access Journals (Sweden)

    Linda Henriksson

    Full Text Available The localization of visual areas in the human cortex is typically based on mapping the retinotopic organization with functional magnetic resonance imaging (fMRI. The most common approach is to encode the response phase for a slowly moving visual stimulus and to present the result on an individual's reconstructed cortical surface. The main aims of this study were to develop complementary general linear model (GLM-based retinotopic mapping methods and to characterize the inter-individual variability of the visual area positions on the cortical surface. We studied 15 subjects with two methods: a 24-region multifocal checkerboard stimulus and a blocked presentation of object stimuli at different visual field locations. The retinotopic maps were based on weighted averaging of the GLM parameter estimates for the stimulus regions. In addition to localizing visual areas, both methods could be used to localize multiple retinotopic regions-of-interest. The two methods yielded consistent retinotopic maps in the visual areas V1, V2, V3, hV4, and V3AB. In the higher-level areas IPS0, VO1, LO1, LO2, TO1, and TO2, retinotopy could only be mapped with the blocked stimulus presentation. The gradual widening of spatial tuning and an increase in the responses to stimuli in the ipsilateral visual field along the hierarchy of visual areas likely reflected the increase in the average receptive field size. Finally, after registration to Freesurfer's surface-based atlas of the human cerebral cortex, we calculated the mean and variability of the visual area positions in the spherical surface-based coordinate system and generated probability maps of the visual areas on the average cortical surface. The inter-individual variability in the area locations decreased when the midpoints were calculated along the spherical cortical surface compared with volumetric coordinates. These results can facilitate both analysis of individual functional anatomy and comparisons of visual

  12. Frequency-doubling technology perimetry and multifocal visual evoked potential in glaucoma, suspected glaucoma, and control patients

    Directory of Open Access Journals (Sweden)

    Kanadani FN

    2014-07-01

    Full Text Available Fabio N Kanadani,1 Paulo AA Mello,1 Syril K Dorairaj,2 Tereza CM Kanadani31Federal University of Sao Paulo, Sao Paulo, Brazil; 2Mayo Clinic, Department of Ophthalmology, Jacksonville, Florida, USA; 3Sao Jose University Hospital, Belo Horizonte, BrazilIntroduction: The gold standard in functional glaucoma evaluation is standard automated perimetry (SAP. However, SAP depends on the reliability of the patients’ responses and other external factors; therefore, other technologies have been developed for earlier detection of visual field changes in glaucoma patients. The frequency-doubling perimetry (FDT is believed to detect glaucoma earlier than SAP. The multifocal visual evoked potential (mfVEP is an objective test for functional evaluation.Objective: To evaluate the sensitivity and specificity of FDT and mfVEP tests in normal, suspect, and glaucomatous eyes and compare the monocular and interocuar mf VEP.Methods: Ninety-five eyes from 95 individuals (23 controls, 33 glaucoma suspects, 39 glaucomatous were enrolled. All participants underwent a full ophthalmic examination, followed by SAP, FDT, and mfVEP tests. Results: The area under the curve for mean deviation and pattern standard deviation were 0.756 and 0.761, respectively, for FDT, 0.564 and 0.512 for signal and alpha for interocular mfVEP, and 0.568 and 0.538 for signal and alpha for monocular mfVEP. This difference between monocular and interocular mfVEP was not significant. Conclusion: The FDT matrix was superior to mfVEP in glaucoma detection. The difference between monocular and interocular mfVEP in the diagnosis of glaucoma was not significant. Keywords: standard automated perimetry, electrophysiology, glaucomatous eyes

  13. Medium-Term Visual Outcomes of Apodized Diffractive Multifocal Intraocular Lens with +3.00 D Addition Power

    Directory of Open Access Journals (Sweden)

    Xiaohong Guo

    2014-01-01

    Full Text Available Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL or SN60WF IOL. Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evaluated. Results. Each group comprised 20 patients. Uncorrected intermediate visual acuities and uncorrected near visual acuity were better in SN6AD1 group than in SN60WF group (P=0.005, P=0.011, and P<0.001. In SN6AD1 group, the uncorrected intermediate and near visual acuities 1 year and 2 years postoperatively were reduced than postoperative 3-month outcomes, respectively. SN6AD1 group reported superior overall spectacle independence and inferior satisfaction. SN6AD1 group had a longer reading newspaper duration than SN60WF group (P=0.036. When using mobile phone, SN6AD1 group had a more comfortable distance than SN60WF group (P<0.001 and higher speed of reading fixed text message (P<0.001. Conclusion. SN6AD1 MIOL provided a satisfactory full range of visual acuities and questionnaire performance 2 years postoperatively. One-year and 2-year uncorrected near and intermediate visual acuities of SN6AD1 MIOL were lower than those 3 months postoperatively.

  14. Clinical Evaluation of Functional Vision of +1.5 Diopters near Addition, Aspheric, Rotational Asymmetric Multifocal Intraocular Lens

    Science.gov (United States)

    Khoramnia, Rahmin; Attia, Mary Safwat; Koss, Michael Janusz; Linz, Katharina; Auffarth, Gerd Uwe

    2016-01-01

    Purpose To evaluate postoperative outcomes and visual performance in intermediate distance after implantation of a +1.5 diopters (D) addition, aspheric, rotational asymmetric multifocal intraocular lens (MIOL). Methods Patients underwent bilateral cataract surgery with implantation of an aspheric, asymmetric MIOL with +1.5 D near addition. A complete ophthalmological examination was performed preoperatively and 3 months postoperatively. The main outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA) and distance corrected keratometry, and manifest refraction. The Salzburg Reading Desk was used to analyze unilateral and bilateral functional vision with uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at near and intermediate distances. Results The study comprised 60 eyes of 30 patients (mean age, 68.30 ± 9.26 years; range, 34 to 80 years). There was significant improvement in UDVA and CDVA. Mean UIVA was 0.01 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and mean DCIVA was -0.02 ± 0.11 logMAR. In Salzburg Reading Desk analysis for UIVA, the mean subjective intermediate distance was 67.58 ± 8.59 cm with mean UIVA of -0.02 ± 0.09 logMAR and mean word count of 96.38 ± 28.32 words/min. Conclusions The new aspheric, asymmetric, +1.5 D near addition MIOL offers good results for distance visual function in combination with good performance for intermediate distances and functional results for near distance. PMID:27729759

  15. Incidence, clinical presentation, and outcome of progressive multifocal leukoencephalopathy in HIV-infected patients during the highly active antiretroviral therapy era: a nationwide cohort study

    DEFF Research Database (Denmark)

    Engsig, Frederik Neess; Hansen, Ann-Brit Eg; Omland, Lars Haukali;

    2009-01-01

    at presentation and follow-up. RESULTS: Among 4,649 patients, we identified 47 patients with PML. The incidence rates were 3.3, 1.8, and 1.3 cases per 1000 person-years at risk in 1995-1996, 1997-1999, and 2000-2006, respectively. The risk of PML was significantly associated with low CD4(+) cell count, and 47......-1996) and during the early HAART (1997-1999) and late HAART (2000-2006) periods. METHODS: Patients from a nationwide population-based cohort of adult HIV-1-infected individuals were included. We calculated incidence rates of PML and median survival times after diagnosis. We also described neurological symptoms...... interval [CI], 0.0-0.7) in 1995-1996 and 1.8 years (95% CI, 0.6-3.0) in both 1997-1999 and 2000-2006. CD4(+) cell count >50 cells/microL at diagnosis of PML was significantly associated with reduced mortality. Conclusions: The incidence of PML in HIV-infected patients decreased after the introduction...

  16. AIDS related knowledge and risk behaviors investigation among the female commercial sex works in a county of Guangxi%广西某县CSW艾滋病相关知识及危险行为调查

    Institute of Scientific and Technical Information of China (English)

    黄广兰; 翟庆秀

    2012-01-01

    目的 了解暗娼(CSW)基本情况、艾滋病相关行为及梅毒、艾滋病病毒(HIV)感染情况,为今后艾滋病防控工作提供科学依据.方法 采取横断面调查分层抽样的方法,对广西某县城区的高、中、低宾馆及桑拿房、按摩足浴保健中心等娱乐场所中301名CSW进行面对面访谈,填写匿名调查问卷.结果 调查发现CSW年龄较小、文化程度低、性生活频率高、艾滋病知识知晓率低,多数人出现过性病症状,患病后只有62.50%选择到正规医院治疗,艾滋病病毒感染率为0.66%,梅毒感染率为4.36%.结论 该县CSW人群中存在艾滋病传播的潜在危险因素,应采取进一步的预防干预措施.%Objective To understand the basic information of female commercial sex works and AIDS related behaviors and syphilis and HIV infection status, in order to provide scientific basis for future AIDS prevention and control. Method During July to September in 2011, taking a cross - sectional survey design, adopting stratified sampling method to select 301 female commercial sex works which worked in guesthouses, sauna, massage foot health centers and other places, carrying out face to face interview and fill in anonymous questionnaire. Results The survey found that the FSWs were younger, low education level, without job skills, high frequency sexual life, low awareness of AIDS. Most of the people had venereal symptoms, only 62. 50% them went to the normal hospitals. The HIV infection rate was 0. 66% , syphilis was 4. 36%. Conclusions There were HIV potential risk factors among the females commercial sex works, we should take further preventive interventions

  17. A case of osseous scintigraphy showing focuses of multifocal tuberculosis; Un cas de scintigraphie osseuse montrant des foyers de tuberculose multifocale

    Energy Technology Data Exchange (ETDEWEB)

    Faurous-Vanaud, R. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Faurous, P. [CRLC, Montpellier (France); Kalfa, G.; Collet, H. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Couty, H.; Artus, J.C. [CRLC, Montpellier (France)

    1997-12-31

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur`s upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  18. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens

    Science.gov (United States)

    Chang, Daniel H

    2016-01-01

    Purpose The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. Methods In this retrospective–prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50–81 years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft), intermediate (70–80 cm), and near (35–40 cm) under photopic (85 cd/m2) and mesopic (3 cd/m2) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. Results At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Conclusion Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction. PMID:27536061

  19. CORRELATIONS OF LOW MOLECULAR WEIGHT PHENOTYPE OF APOPROTEIN(A AND SERUM LEVEL OF LIPOPROTEIN(A WITH MULTIFOCAL ATHEROSCLEROSIS IN PATIENTS WITH CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    O. I. Afanasieva

    2010-01-01

    Full Text Available Background. Atherosclerosis is a systemic disease. That is why the damage is not restricted by one vascular area in 18-50% of patients. High serum level of lipoprotein(a [Lp(a] is an independent risk factor for coronary, carotid and peripheral atherosclerosis. However the correlation of apoprotein(a [apo(a] polymorphism with the multifocal atherosclerosis in coronary heart disease (CHD is not sufficiently studied.Aim. To study the correlation of apo(a phenotype with the multifocal atherosclerosis in CHD patients.Material and Methods. 220 patients aged 32- 76 y.o. with the proven coronary and carotid atherosclerosis were split into two groups depending on the presence (n=22 or absence (n=198 of peripheral atherosclerosis. Evaluation of lipid profile, Lp(a and determination of apo(a isoforms by SDS electrophoresis in polyacrylamide gel and immunoblotting was performed in all patients.Results. Both groups of patients were comparable by age, sex, classical cardiovascular risk factors, including frequency of hyperlipidemia and diabetes mellitus, lipid profile. The Lp(a serum level ≥30 mg/dL and low molecular weight (LMW apo(a phenotype were found more often in patients with multifocal than coronary and carotid atherosclerosis: 55 and 45% (р=0.372; 73 and 44% (p<0.05, respectively. According to multiple regression analysis (including sex, age, smoking status, and Lp(a serum level only smoking status (β=0.203, p=0.0003 and a size of apo(a isoforms (β=0.191, p=0.0133 correlated with the peripheral atherosclerosis in patients with CHD. LMW apo(a phenotype was the most significant predictor of peripheral atherosclerosis (β=0.281, p=0.0089 regardless of the Lp(a serum level in patients under 55 y.o. High Lp(a serum level combined with LMW apo(a phenotype associated with more significant coronary, carotid and peripheral atherosclerosis.Conclusion. LMW apo(a phenotype relates to the presence of multifocal atherosclerosis in CHD patients regardless of

  20. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens

    Directory of Open Access Journals (Sweden)

    Chang DH

    2016-08-01

    Full Text Available Daniel H Chang Empire Eye and Laser Center, Bakersfield, CA, USA Purpose: The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. Methods: In this retrospective–prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50–81 years who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00 were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft, intermediate (70–80 cm, and near (35–40 cm under photopic (85 cd/m2 and mesopic (3 cd/m2 lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. Results: At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Conclusion: Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction. Keywords: Tecnis multifocal one-piece IOL, photopic visual acuity, mesopic visual acuity, intermediate visual

  1. Image of the Month: Multifocal 68Ga Prostate-Specific Membrane Antigen Ligand Uptake in the Skeleton in a Man With Both Prostate Cancer and Multiple Myeloma.

    Science.gov (United States)

    Rauscher, Isabel; Maurer, Tobias; Steiger, Katja; Schwaiger, Markus; Eiber, Matthias

    2017-03-31

    Ga prostate-specific membrane antigen (PSMA) HBED-CC PET/CT in a 65-year-old man with first diagnosis of prostate cancer (PC) and a history of multiple myeloma showing multifocal PSMA ligand uptake in the skeleton with corresponding osteolytic lesions in CT. Although osteolytic bone metastases are very rare in PC, PSMA expression in PET raised the suspicion of PC bone metastases. Bone marrow biopsy excluded PC metastases with immunohistochemistry showing endothelial expression of PSMA in small vessels within the myeloma.

  2. Analysis of needs for AIDS related health services among MSM in Shanghai%上海地区MSM人群艾滋病相关的需求分析

    Institute of Scientific and Technical Information of China (English)

    孙乔; 许磊; 张枭; 蔡晓峰; 毛军; 康来仪; Steele S; Myers T.

    2012-01-01

    Objective To learn the demographic characteristics and needs for AIDS-related health services among MSM in Shanghai, analyze the factors that influence their participation in HIV tests, and provide suggestions for the improvement of the interventions to the high-risk behaviors related with AIDS among MSM. Methods A cross-sectional survey was carried out to collect information about demographic characteristics, living conditions, social networks and sexual behaviors, history of HIV tests and HIV infections among selected MSM in Shanghai. A total of 314 eligible MSM with different ages and income levels were face-to-face surveyed with questionnaires in 2010. Results Among the MSM investigated, 68. 5/%(215/314) were from other provinces. Only-male sex partners, mainly-male sex partners, male and female sex partners each half and mainly-female sex partners accounted for 64. 0 %'(201/ 314), 21. 7%(68/314),7. 0%(22/314) and 7. 3% (23/314) .respectively. 73. 9%(232/314)of the subjects had history of HIV tests and 63. 4% (199/314) were tested in the past 2 years. The main reason for not taking HIV tests was that the subjects did not believe in the possibility of getting infected. Their suggestions included being given more health education, more care, more understanding and less discrimination, and providing more free and quality condoms. Conclusion The MSM in Shanghai have greater needs for AIDS related health interventions. Strengthened publicity and education for eliminating discrimination against AIDS, provision of more care and understanding for the MSM population and promotion of free and quality condoms to meet their health and psychological needs will play an important role in pursuing effective prevention and control of AIDS transmission.%目的 了解上海地区男男性行为人群(Men who have sex with men,MSM)的社会学特征及艾滋病相关的健康需求,分析该人群主动参与艾滋病病毒(Human immunodeficiency virus,HIV)抗体检测的情况,

  3. Gender characteristics and HIV/AIDS related knowledge awareness and behaviors of transgender women%跨性别女性的特征及艾滋病相关知识行为调查

    Institute of Scientific and Technical Information of China (English)

    陈吴康; 张晓菲; 吕翠霞; 董蕾; 杜以慧; 傅继华

    2016-01-01

    Objective To understand the gender characteristics,HIV/AIDS related knowledge awareness and behaviors of transgender women.Methods A questionnaire survey was conducted among the transgender women recruited through snowball sampling in Jinan in 2014,and descriptive epidemiologic analysis was conducted on the survey results.Results A total of 55 transgender women were surveyed,all of them were male physically and female psychologically.Serious gender conflict occurred in 27 subjects (49.1%),and very serious gender conflict occurred in 8 subjects (14.5%).Thirty subjects dressed up as a man in social life,accounting for 54.5%;25 subjects dressed up as a women in social life,accounting for 45.5%.The average awareness rate of HIV/AIDS related knowledge was 57.9%(22/38).The awareness of knowledge about AIDS associated behaviors,such as multi sex partner and anal sex,was poor.For the lovers or sexual partners,58.2% of the subjects (32/55) would choose males and 50.9% of the subjects (28/55) had chosen males,and for the sex partner at latest sex,63.6%(35/55) of the subjects had chosen males.Up to 56.3% of the subjects had sex with casual sexual partners (net friends and partners of one-night stand) at latest sex behavior.Among the subjects surveyed,18(32.7%) never used condoms;29(52.7%) used condoms occasionally;4(7.3%) used condoms frequently and 4(7.3%) used condoms at each sex.Conclusions AIDS associated high risk behaviors were common among the transgender women,such as unprotected anal sex,multiple sexual partners,frequent sex and poor condom use.It is necessary to conduct the study of the HIV infection prevention in transgender women.%目的 了解跨性别女性(male-to-female,MTF)的性别特征、对艾滋病知识的知晓情况及其艾滋病相关行为状况.方法 2014年在济南市采用滚雪球法招募MTF进行间卷调查,采用描述性流行病学的方法分析该人群的艾滋病知识知晓情况及

  4. 泻痢康胶囊治疗艾滋病相关慢性腹泻的临床研究%Clinical study on Xielikang Capsule in treatment of AIDS-related chronic diarrhea

    Institute of Scientific and Technical Information of China (English)

    徐卓; 杨小平; 倪量; 张明利; 郭长河; 王东旭; 王玉光; 徐立然

    2011-01-01

    Objective To investigate the clinical therapeutic effect of Xielikang Capsule for AIDSrelated chronic diarrhea. Methods A randomized, double-blind, double dummy and controlled clinical method was applied to the study. 158 AIDS-related chronic diarrhea patients were randomly divided into Xielikang Capsule group( n = 106)and loperamide capsule group( n = 52). Patients in Xielikang Capsule group were administrated with Xielikang Capsule 2.5 gram/time, 3 times/day and loperamide placebo 2 capsules/time, 3 times/day, while patients in loperamide group were administrated with loperamide 2mg/time, 3 times/day and Xielikang placebo 5 capsules/time, 3 times/day for 14 consecutive days. The effects were assessed on day 1, day 3, day 7 and day 14. The main indicators used to evaluate the effects included score of Diarrhea Questionnaire, total daily stool volume and stool frequency. The safety of the drugs was evaluated according to the adverse reactions, liver and renal function, ECG, routine blood, urine, stool test,Fecal occult blood, HIV-RNA and other laboratory indicators. Results After 14 days' treatment, the difference of Diarrhea Questionnaire score between the two groups was significant( P < 0.05 ). The same result was observed on the change of the total stool volume on day 7 . There were significant differences in the frequency of diarrhea between the two groups after 7 days and 14 days'treatment(P < 0.05). There were no significant differences in the incidence of adverse reactions between the two groups. Condusion The Xielikang Capsule was safe and effective on the treatment of AIDS related chronic diarrhea of, and it had better efficacy than Loperamide hydrochloride capsule.%目的 观察泻痢康胶囊治疗艾滋病相关慢性腹泻的临床疗效及安全性.方法 采用随机、双盲双模拟、对照的临床研究方法,分别将158例艾滋病相关慢性腹泻患者按照2:1比例随机分为2组.治疗组106例,口服泻痢康胶囊(2.5克/次,3

  5. Interest of PET/CT with {sup 18}F-F.D.G. in the management of a multifocal tuberculosis with multi-resistant bacillus; Interet de la TEP-TDM au {sup 18}F-FDG dans la prise en charge d'une tuberculose multifocale a bacilles multiresistants

    Energy Technology Data Exchange (ETDEWEB)

    Ben Sellem, D.; Hubele, F.; Hassler, S.; Goetz, C.; Constantinesco, A. [hopital Hautepierre, Service de medecine nucleaire, 67 - Strasbourg (France)

    2010-07-01

    Purpose: Assess the interest of PET / CT with {sup 18}F-F.D.G. in the management of multifocal tuberculosis with resistant bacilli. Conclusion: Through this case, PET-CT with {sup 18}F-F.D.G. seems to be well suited in evaluating the therapeutic efficiency of bacilli resistant multifocal tuberculosis. (N.C.)

  6. Multifocal but Non-Disseminated Phaeohyphomycosis in a Healthy Man via a Unique Mechanism: Ejection from MVA into a Vegetable Field in Afghanistan Resulting in Multiple Contaminated Skin Wounds.

    Science.gov (United States)

    Malakzai, M Omer; Sahak, Janat Gul; Campbell, Ryan; Abobakar, Mirwais; Hoogestraat, Daniel R; SenGupta, Dhruba J; Bryan, Andrew; Gardner, Jerad M

    2017-03-28

    A 20 year-old male presented with multiple subcutaneous nodules on the head, neck, chest and oral cavity. FNA and biopsy showed pigmented fungal hyphae diagnostic of multifocal phaeohyphomycosis, found to be Exophiala spinifera by molecular diagnostics. The presentation initially raised concern for disseminated disease and occult immunosuppression. However, the patient appeared to be immunocompetent and otherwise healthy. Upon further inquiry, the patient was in a motor vehicle accident four years before presentation; he was ejected into a vegetable field resulting in multiple open wounds. Multifocal phaeohyphomycosis usually indicates disseminated systemic disease from immunosuppression and carries a grave prognosis.

  7. Progressive Neurologic Dysfunction in a Psoriasis Patient Treated With Dimethyl Fumarate

    Science.gov (United States)

    Bartsch, Thorsten; Rempe, Torge; Wrede, Arne; Leypoldt, Frank; Brück, Wolfgang; Adams, Ortwin; Rohr, Axel; Jansen, Olav; Wüthrich, Christian; Deuschl, Günther; Koralnik, Igor J.

    2016-01-01

    Progressive multifocal leukoencephalopathy (PML) has recently been described in psoriasis or multiple sclerosis patients treated with fumaric acid esters (fumarates), who had developed severe and long-standing lymphocytopenia (<500/mm3). We report a psoriasis patient who presented with progressive neurologic dysfunction and seizures after 2.5 years of fumarate therapy. Despite absolute lymphocyte counts remaining between 500–1000/mm3, his CD4+ and CD8+ T-cell counts were markedly low. MRI showed right hemispheric and brainstem lesions and JC virus DNA was undetectable in his cerebrospinal fluid. Brain biopsy revealed typical features of PML as well as JC virus-infected neurons. Clinicians should consider PML in the differential diagnosis of fumarate-treated patients presenting with brain lesions or seizures even in the absence of severe lymphocytopenia. PMID:26150206

  8. Improved visualization of breast cancer features in multifocal carcinoma using phase-contrast and dark-field mammography: an ex vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Grandl, Susanne; Sztrokay-Gaul, Aniko; Auweter, Sigrid D.; Hellerhoff, Karin [Ludwig-Maximilians-University Hospital Munich, Institute of Clinical Radiology, Munich (Germany); Scherer, Kai; Birnbacher, Lorenz; Willer, Konstantin; Chabior, Michael; Herzen, Julia; Pfeiffer, Franz [Technische Universitaet Muenchen, Department of Physics and Institute of Medical Engineering, Garching (Germany); Mayr, Doris [Ludwig-Maximilians-Universitaet Muenchen, Institute of Pathology, Munich (Germany); Bamberg, Fabian [University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2015-12-15

    Conventional X-ray attenuation-based contrast is inherently low for the soft-tissue components of the female breast. To overcome this limitation, we investigate the diagnostic merits arising from dark-field mammography by means of certain tumour structures enclosed within freshly dissected mastectomy samples. We performed grating-based absorption, absolute phase and dark-field mammography of three freshly dissected mastectomy samples containing bi- and multifocal carcinoma using a compact, laboratory Talbot-Lau interferometer. Preoperative in vivo imaging (digital mammography, ultrasound, MRI), postoperative histopathological analysis and ex vivo digital mammograms of all samples were acquired for the diagnostic verification of our results. In the diagnosis of multifocal tumour growth, dark-field mammography seems superior to standard breast imaging modalities, providing a better resolution of small, calcified tumour nodules, demarcation of tumour boundaries with desmoplastic stromal response and spiculated soft-tissue strands extending from an invasive ductal breast cancer. On the basis of selected cases, we demonstrate that dark-field mammography is capable of outperforming conventional mammographic imaging of tumour features in both calcified and non-calcified tumours. Presuming dose optimization, our results encourage further studies on larger patient cohorts to identify those patients that will benefit the most from this promising additional imaging modality. (orig.)

  9. 13-year-old tuberous sclerosis patient with renal cell carcinoma associated with multiple renal angiomyolipomas developing multifocal micronodular pneumocyte hyperplasia

    Directory of Open Access Journals (Sweden)

    Behnes Carl Ludwig

    2013-02-01

    Full Text Available Abstract Background The autosomal dominant tumor syndrome tuberous sclerosis complex is caused by the mutated TSC1 gene, hamartin, and the TSC2 gene, tuberin. Patients with this complex develop typical cutaneus symptoms such as peau chagrin or angiofibromas of the skin as well as other lesions such as astrocytomas in the brain and lymphangioleiomyomatosis in the lung. Only a few tuberous sclerosis patients have been described who showed a multifocal micronodular pneumocyte hyperplasia of the lung. Another benign tumor which often occurs together with tuberous sclerosis is the angiomyolipoma of the kidney. Furthermore, an increased incidence of renal cell carcinoma in connection with tuberous sclerosis has also been proven. Case presentation We report a 13-year-old white girl with epilepsy and hypopigmented skin lesions. Radiological studies demonstrated the typical cortical tubers leading to the diagnosis of tuberous sclerosis. In the following examinations a large number of angiomyolipomas were found in both kidneys. One lesion showed an increasing size and tumor like aspects in magnetic resonance imaging. The pathological examination of the following tumorectomy demonstrated an unclassified renal cell carcinoma. Four months postoperatively, a follow-up computer tomography revealed multiple bilateral pulmonary nodules. To exclude lung metastases of the renal cell carcinoma, multiple open-lung biopsies were performed. Conclusion Here we report a diagnostically challenging case of a 13-year-old patient with tuberous sclerosis and angiomyolipomas of the kidney who developed an unclassified renal cell carcinoma as well as multifocal micronodular pneumocyte hyperplasia.

  10. Analysis of the results of multifocal electroretinogram and optical coherence tomography in diagnosis and monitoring of patients with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Ait Ahmed Кh.

    2014-06-01

    Full Text Available Purpose: to study the correlation between the results of the macular area responses by multifocal-electroretinog-raphy (mf-ERG and the retina thickness obtained by the spectralis optical coherence tomography (ОСТ in patients with age-related macular degeneration (AMD. Material and methods. 28 patients (32 eyes where enrolled in the main group. The control group was up to 10 patients without any AMD's pathological sign in retina. All patients were examined by the optical coherence tomography (ОСТ and multifocal electroretinography (mf-ERG. Results. The data showed a high level of negative correlation between the retinal thickness and electrical amplitudes of the fovea. With the group of "dry" AMD the rise of the macular thickness (drusen not over 290 urn showed a moderate reduction of the amplitude on mf-ERG The group with "wet" AMD showed that a higher rise of the retinal thickness (edema, fibrosis of the macular zone negatively influences the bio-electrical activity of this area and this fact was confirmed by a considerable decline of the amplitude on the mf-ERG. Conclusion. The AMD's pathological changes that have been observed by ОСТ are objectively confirmed by mf-ERG. The mf-ERG in supplement of ОСТ can be used as an important element in the complex studies and objectively monitoring of patients with AMD.

  11. [On the mechanisms and diagnosis of conduction disturbances due to demyelination with special reference to multifocal demyelinating neuropathy (Lewis-Sumner)].

    Science.gov (United States)

    Kaji, R; Kimura, J

    1991-12-01

    Multifocal demyelinating neuropathy with persistent conduction block can mimic motor neuron disease, but is potentially reversible. Its diagnosis rests upon electrophysiological demonstration of focal conduction block at multiple sites. Conduction block is the most important mechanism causing clinical symptoms in peripheral nerve demyelination. On the other hand, conduction slowing is not always associated with clinical symptoms. In 2 out of 9 patients with multifocal demyelinating motor neuropathy, MRI showed focal swelling of the nerve at the site of conduction block. Both of them had elevated titers of anti-GM1 antibodies. In one, we biopsied a portion of the medial pectoral nerve, which was adjacent to the focal swelling, at surgical exploration. Pathological findings included very thin myelin associated with large diameter fibers and small onion bulb formation, suggesting that remyelinative process is abortive in this disease leading to persistent conduction block. Anti-GM1 antibodies bound to the denuded axoplasmic membrane may interfere with the process by masking the cell surface markers. The reason why the sensory fibers are spared is unclear, but it may be possible that GM1 in sensory axons have less affinity to the antibody than that in motor fibers.

  12. Study on Internet use and AIDS related knowledge and behaviors among MSM%MSM艾滋病相关知识行为及互联网的使用情况调查

    Institute of Scientific and Technical Information of China (English)

    戴丽萍; 姜宜海; 龚诚华; 黄丽娟

    2012-01-01

    目的 了解男男性行为人群(MSM)使用互联网的情况、MSM人口学和性行为特征、艾滋病知识知晓情况,以及HIV、梅毒感染情况,为MSM艾滋病干预提供依据.方法 对2011年参加艾滋病自愿咨询检测的MSM进行整群抽样调查,用自行设计的调查问卷,对MSM人口学特征、互联网的使用情况以及艾滋病知识知晓情况进行分析.结果 调查735名MSM,77.28%通过互联网认识第一个男性伴,80.95%的人以互联网做为寻找男性性伴最常去的场所,每周上网浏览同性交友信息1~3小时以上占73.06%,近6个月53.47%有2个以上性伴,46.87%每次性交都用安全套;HIV感染率6.39%,梅毒感染率3.40%,艾滋病知晓率为94.56%,文化程度越高,艾滋病知晓率越高,艾滋病感染率越低.结论 多性伴和无保护肛交等高危行为使MSM艾滋病感染情况严重,大多数MSM喜欢使用互联网结交同性朋友,为提高艾滋病知识知晓率,减少高危行为,应充分利用互联网等信息资源控制艾滋病.%Objective To understand the status of Internet use, AIDS related sexual behavior and knowledge, prevalence of HIV and syphilis infection, and provide evidence for AIDS intervention among MSM. Methods In 2011, a cluster sampling survey was carried out among MSM when they took AIDS voluntary counseling and testing (VCT) by using self-designed questionnaire. The MSM demographic characteristics, Internet use and the knowledge about HIV/AIDS were analyzed. Results 735 MSM were enrolled, 77.28% of them acquainted their first male partner through the Internet, 80. 95% of them used the Internet as a search site for male sexual partner. 73. 06% of them spent 1-3 hours or more per week for Internet gay friend sites. 53.47% of them had two or more sexual partners in nearly six months, 46. 87% of them used condom during sexual intercourse. HIV infection rate was 6. 39% , and syphilis infection rate was 3. 40% , AIDS knowledge rate

  13. Study on AIDS related knowledge and homosexual cognition attitude and behavior among medical college students%医学生艾滋病知识及对同性恋认知态度与行为调查

    Institute of Scientific and Technical Information of China (English)

    陈舸; 郑武雄; 林丽

    2012-01-01

    目的 了解福建省高校医学生艾滋病相关知识及对同性恋的认知、态度和同性性行为情况,为在高校中开展艾滋病预防工作和大学生中同性恋研究提供依据.方法 采用整群抽样方法,对某医学院校492名在校大学生进行匿名问卷调查.结果 对艾滋病传播途径的知晓率较高,均超过85%;而对蚊虫叮咬不会传播的知晓率只有64.0%.对同性恋的认知与态度,37.6%的学生认为是正常的生活方式,42.1%认为社会应该接纳同性恋现象,63.4%认为有必要在学校增加有关同性恋方面的健康教育.8.3%的学生承认有过性行为,0.6%的学生承认尝试过同性性行为.结论 高校医学生对同性恋的认知还存在较多误区,有必要进行同性恋相关健康教育,应结合学生的特点有针对性地开展高校预防艾滋病宣传教育工作.%Objective To investigate AIDS related knowledge and homosexual cognition, attitude and behavior a-mong medical college students in Fujian Province, so as to provide a hasis for further researches regarding homosexuality and AIDS prevention. Methods 492 students selected by cluster sampling from a medical college were surveyed with anonymous uniform questionnaires. Results The awareness rate of AIDS transmission route were over 85%. However, only 64% of the students gave the correct answer to the guestion of mosquito bite could not spread HIV. In cognition and attitude towards homosexuality, 37. 6% took it as a normal lifestyle, and 42. 1% thought that the society should have basic understanding and tolerance of homosexual lifestyle, 63. 4% identified that it was necessary to provide health education towards homosexuality in schools; 8. 3% admitted having had sex experience, and 0. 6% admitted having tried homosexual intercourses. Conclusion Many students' cognition towards homosexuality was not correct. It is necessary to strengthen health education on homosexuality, and efficient work

  14. HIV阴性MSM人群艾滋病相关行为特征及其干预效果%A Research on HIV/AIDS Related Behavior Characteristics and Their Intervention Effect among HIV Negative MSM

    Institute of Scientific and Technical Information of China (English)

    蔡高峰; 马瞧勤; 潘晓红; 周欣; 姚丹

    2012-01-01

    Objective To explore the HIV/AIDS related behavior characteristics and their intervention effect among HIV negative MSM. Methods Sexual behaviors including: homosexual anal intercourse and heterosexual behavior, and the condom use were analyzed using the base line data of the program of the MSM intervention cohoit study in 201 1. Results During the last 3 months, 87, 32% of 339 MSM had homosexual anal intercourse, in which 52.03% had more than 1 male sex partner; 72. 57% had anal intercourse with regular male sex partners, in which 40. 65% insisted on using condoms; 49. 26% had casual homosexual anal intercourse, in which the persistence rate of using condoms was 50. 90% ; 76. 70% received face to face health education, whose condom use rate ( 80. 16% ) and HIV testing rate (69.62% ) were both higher than the rates ( 60. 53% and 28%, respectively) of those without intervention ( P < 0. 05 and P< 0.01, respectively ). Conclusion With a high rate of homosexual anal intercourse, multiple sex partners and low condom use, MSM are at high risk of infecting and diffusing HIV/AIDS and STDs, which requires improving the interventions urgently.%目的 分析HIV抗体阴性MSM人群艾滋病相关行为特征,探讨干预效果.方法 利用浙江省2011年MSM干预队列基线调查资料,分析MSM人群性行为及安全套使用等情况.结果 在最近3个月,339名MSM中有87.32%的人发生同性非商业性肛交,其中52.03%的人有2个或2个以上同性非商业性伴;72.57%的人与同性固定性伴发生肛交,其中40.65%的人坚持使用安全套;49.26%的人发生同性临时性伴肛交,其中50.90%的人坚持使用安全套;76.70%的人接受面对面宣传干预,其最近1次同性临时性伴肛交安全套使用率80.16%高于未接受干预者60.53%(P <0.05),HIV检测率69.62%高于未干预者28.00%(P <0.01).结论 MSM人群同性肛交发生率高,多性伴现象普遍,安全套使用率低,处于艾滋病感染和传播的高风险状态,干预措施亟需进一步完善.

  15. Desarrollo de neoplasias e infecciones definitorias de sida después de iniciar la terapia antirretroviral de alta eficacia Development of AIDS-related malignancies and infections after starting HAART

    Directory of Open Access Journals (Sweden)

    Eduardo Warley

    2010-02-01

    Full Text Available Con el objetivo de evaluar la incidencia de neoplasias e infecciones definitorias de Sida (NIDS y los posibles factores asociados a su desarrollo luego de iniciada la terapia antirretroviral de alta eficacia (HAART analizamos las historias clínicas de los pacientes que iniciaron tratamiento entre julio 2003 y octubre 2007. Todos recibieron profilaxis con trimetoprima-sulfametoxazol y azitromicina según la recomendación actual. Evaluamos el desarrollo de NIDS en los 6 meses posteriores al inicio de la terapia y su asociación con variables clínicas y epidemiológicas. Analizamos 235 historias clínicas: 118 mujeres (50.2% y 117 hombres (49.8%. Observamos 11 casos de NIDS: 3 formas pulmonares y 3 ganglionares de tuberculosis, 3 meningitis por Criptococcus neoformans, 1 chagoma cerebral y 1 linfoma no Hodgkin. Presentar recuento de células CD4 menor a 100 o 150 células/ml se asoció con riesgo de desarrollar NIDS. La media de células CD4 fue 73 en los pacientes que desarrollaron NIDS y 143 en los que no la desarrollaron. No hubo asociación con las otras variables analizadas. En pacientes con CD4 menor a 150 células/ml observamos un caso de chagoma cerebral entre 4 con serología reactiva para Chagas, y ninguno de toxoplasmosis cerebral entre 46 con serología reactiva para toxoplasmosis. Concluimos que la tasa de incidencia de NIDS fue del 4.7%, siendo tuberculosis en primer lugar y criptococosis en segundo las enfermedades más frecuentemente observadas. Presentar bajo recuento de células CD4 se asoció de manera significativa al desarrollo de NIDS. Debería reevaluarse el rol de la quimioprofilaxis.In order to evaluate the incidence rate and possible risk factors associated with AIDS-related malignancies and infections (ARMI we performed data analysis of clinical charts of HIV patients in two hospital cohorts, that started high activity antiretroviral therapy (HAART between July 2003 and October 2007. Trimethoprim-sulfamethoxazole and

  16. 我国育龄妇女艾滋病相关知识和态度调查%Investigation of HIV/AIDS related knowledge and attitudes among child-bearing women in China

    Institute of Scientific and Technical Information of China (English)

    田晓波; 吴久玲; 李伯华; 覃民; 齐嘉楠

    2013-01-01

    Objective To investigate HIV /AIDS related knowledge and attitudes among child-bearing women in China.Methods A stratified,three-staged,population proportion to size sampling method was employed in 30 counties in October,2010.A totol of 7364 women aged 15 -49 were investigated by face-to-face interview.Results Only 41.1% of the women gave correct answer to all 10 questions related with HIV transmission ways,and there was low correct respond (44.7%)to 6 Non-HIV transmission ways,such as kissing and mosquito biting.66.4% of the women knew the interven-tions of HIV transmission.Almost 1 /4 believed condom could be took off after penis become flaccid,and 30% believed air leak checking condom was needed before using or oily lubricant could be used.33.6% didn’t support HIV positive person have reproductive rights,25.2% answered HIV positive person should be isolated.Conclusion Women have a misunder-standing on the Non-HIV transmission ways and condom use,discrimination to HIV positive person still can be seen every-where.%目的了解我国育龄妇女对艾滋病相关知识和态度。方法2010年10月,在我国30个县采用分层、三阶段与规模成正比的容量比例抽样方法获得调查对象,对7364名15~49岁的育龄妇女进行面对面的问卷调查。结果仅有41.1%的调查对象全面了解与艾滋病病毒(HIV)传播相关的10个问题,对接吻和蚊虫叮咬等6种非传播途径的回答正确率较低(44.7%)。66.4%的妇女了解艾滋病预防措施。近1/4的调查对象认为安全套可以在阴茎疲软后再取下,超过30%的调查对象认为使用安全套前应吹气检查是否漏气或可以使用油质润滑剂。不支持 HIV 感染者享有生育权利者约占1/3(33.6%),认为应该将 HIV 感染者隔离起来者约占1/4(25.2%)。结论育龄妇女对于 HIV 非传播途径以及安全套的使用上还存在错误的认识,对于 HIV 感染者的歧视仍然比较常见。

  17. 艾滋病相关腹部淋巴瘤的临床及 CT 表现特征%The clinical and CT imaging features of AIDS-related abdominal lymphoma

    Institute of Scientific and Technical Information of China (English)

    叶雯; 施裕新; 刘峰君; 徐燕

    2015-01-01

    目的:总结分析艾滋病相关腹部淋巴瘤的 CT 表现特征,对比非艾滋病与艾滋病相关淋巴瘤(ARL)的临床及影像学表现异同。方法:回顾性分析28例经手术病理证实的艾滋病相关淋巴瘤患者的临床及 CT 表现。结果:28例艾滋病相关淋巴瘤中霍奇金病1例,非霍奇金淋巴瘤27例,受累脏器包括肝脏10例、脾脏9例、胰腺6例、肾脏5例、胃肠道8例、结内病变23例。病变器官解剖结构留存,病灶多数密度均匀,呈轻中度均匀强化,小部分病变中央出现坏死,呈环形轻中度强化。淋巴结以腹主动脉周围、腹腔干周围、肠系膜、肠系膜根部最为好发。ARL 病灶侵袭性高,累及范围广,对放化疗反应性较差。结论:ARL 的 CT 表现具有一定特征性,结合临床表现,有利于提高诊断符合率。%Objective:The purpose of this study was to clarify and summarize the clinical and CT features of abdomi-nal AIDS-related lymphoma (ARL)and to compare the imaging manifestations between ARL with the lymphoma without AIDS.Methods:The clinical and CT findings of 28 patients with abdominal ARL confirmed by pathology were retrospective-ly analyzed,had the CT scan before surgery.Results:One case was Hodgkin's disease and the other 27 cases were non-Hodgkin lymphoma (NHL).The involved organs included 10 cases of liver involvement,9 cases of spleen,6 cases of pan-creas,5 cases of kidney,8 cases of gastrointestinal tract,23 cases of lymphadenopathy.The CT findings showed that the in-volved organs still remained their anatomic structures.A majority of the lesions presented as solid homogeneous density masses with low to middle degree dynamic enhancement.A minority showed uneven central necrosis with circle peripheral low to middle degree enhancement.Lymph node involvements were commonly seen in the para-aortic,celiac and mesentery regions.Abdominal ARLs were highly malignant with broader involvements

  18. 男男性行为者艾滋病防治知识知晓及与人口学特征的关系%Relationship Between Awareness of AIDS- related Knowledge and the Demographic Features in MSM

    Institute of Scientific and Technical Information of China (English)

    王毅; 徐杰; 李志军; 张光贵; 李六林; 樊静

    2011-01-01

    questionnaires were used to survey the awareness of AIDS - related knowledge among the MAM. Results Totally 400 volunteers were surveyed, and the total awareness rate of AIDS prevention and treatment was 92.1 %. In particular, at least 75% of them learned about that the AIDS can not be transmitted by mosquito bites, and the awareness rates of the rest items were all more than 90%. Several factors had a demographic influence on the statistical difference of the awareness of AIDS prevention, such as different educational degrees (H = 24.257, P = 0.000), different jobs (x2 = 332.096,P = 0.000), different ages (H= 16.222,P = 0.001), heterosexual married state (x2=39.950, P = 0.000), sexual orientation (x2= 52.294,P = 0.000), different incomes (H= 8.927,P = 0.030), census registration and ethnic groups (x2=8.056.x2= 5.332,P = 0.046,P = 0.021). According to the comparison between the awareness of AIDS prevention and the demographic features, we found the following conclusions: MSM with junior college degree or above knew more knowledge about AIDS prevention than MSM with primary education or junior middle school education (Z= - 2.804, Z= -4.144,P = 0.005,P = 0.000); students had more the knowledge than wonders and the ones who worked for business service and other groups; cadres were superior to other groups (x2=5.906,x2 = 169.126.x2=79.938,P = 0.005,P = 0.000, P = 0.000); the ones under 20 years old had more the knowledge than the twenties and the thirties (Z= - 3.870, Z = -2.3u4,P = 0.000,P = 0.021); the unmarried had a higher rate than the married (Z= -3.870, P = 0.000); the homosexual knew more the knowledge than the heterosexual, the bisexual and the ones who had unsure sexual orientation (x2 =10.354,x2=47.373,x2 =5.008,P = 0.001,P = 0.000, P = 0.025); the ones who had less than 1,000 monthly income knew more the knowledge than those who had no income, and the ones who had 1,000 monthly income were inferior to those who had more than 3,000 (Z= -2.353, Z= -2.126, Z= -2.550, P = 0

  19. Multidisciplinary therapy for multi-focal esophageal cancer%综合治疗食管多原发癌22例

    Institute of Scientific and Technical Information of China (English)

    马少华; 杨合利; 梁震; 熊宏超; 秦斌; 陈克能

    2011-01-01

    目的探讨食管多原发癌的治疗策略及疗效。方法回顾性分析2000年3月至201 1年3月间北京大学临床肿瘤医院胸外科收治的22例食管多原发癌患者的临床病理资料,并与同期、同一手术组收治的471例单发食管癌患者的预后进行比较。结果22例食管多原发癌手术采用剖胸食管切除者18例,经裂孔食管切除者4例;接受术前化疗者8例,术后化疗者15例,其中手术前、后均予化疗者6例。471例单发食管癌患者手术采用剖胸食管切除者423例,经裂孔食管切除者60例;接受术前化疗者148例,术后化疗者267例,其中手术前后均予化疗者101例。22例多原发癌患者3年生存率为41.9%,中位生存期为29.2个月;471例单发食管癌患者的3年生存率为54.7%,中位生存期46.8个月;两组比较差异无统计学意义(P=0.051)。结论食管多原发癌治疗效果较差;广泛的食管切除在此类患者中有重要的意义,同时辅以积极的全身综合治疗。%Objective To explore the management strategies and outcome of treatment for multi-focal esophageal carcinoma. Methods Twenty two patients with multi-focal esophageal carcinoma who underwent esophagectomy by a single surgeon team from March 2000 to March 2011 at the Beijing Cancer Hospital were reviewed retrospectively. The clinical and pathological characters were analyzed, and the outcome was compared with that of 471 patients with single esophageal carcinoma who received esophagectomy by the same surgeon team during the same period. Results Eighteen out of 22 patients with multi-focal esophageal cancer underwent esophagectomy via transthoracic approach while 4 patients via transhiatal. Eight patients received neoadjuvant chemotherapy and 15 patients received adjuvant chemotherapy. Four hundred and seventy-one out of 471 patients with single esophageal cancer underwent esophagectomy via transthoracic approach while 60 patients via

  20. Multifocal atrial tachycardia

    Science.gov (United States)

    ... obstructive pulmonary disease (COPD) Congestive heart failure Lung cancer Lung failure Pulmonary embolism You may be at higher risk for ... obstructive pulmonary disease Diabetes Heart failure - overview Lung cancer - small ... embolus Pulse - bounding Stable angina Review Date 5/ ...

  1. Multifocal Motor Neuropathy

    Science.gov (United States)

    ... men much more than women. Symptoms also include muscle wasting, cramping, and involuntary contractions or twitching of the leg ... men much more than women. Symptoms also include muscle wasting, cramping, and involuntary contractions or twitching of the leg ...

  2. Survey on the MSM's Marital Status and AIDS-related Behavior Characteristics%男男性行为者婚姻状况及其艾滋病相关行为特征调查

    Institute of Scientific and Technical Information of China (English)

    王毅; 李六林; 张光贵; 樊静; 赵西和; 李可

    2012-01-01

    Objective To survey the MSM's marital status and AIDS-related behavior characteristics. Methods The anonymous questionnaire survey was achieved by recruiting MSM by snowball sampling and asking them related information at a fixed place. Results Totally, 400 MSM were recruited into the survey, among which 77.0% were unmarried, 18.3% were married, 0.3% were cohabitated, and 4. 5% were divorced or widowed. The distribution of the marital status among different age groups had statistical significance (x2 = 200.588, P<0.01). With the increase of the age, the proportions of the married, divorced or widowed were elevated. The proportion of the married was higher than that of the unmarried in the groups of junior high school and below education level, of restaurant/commercial/ workers/farmers, of monthly income ≥ 1,001 RMB, of bisexual and other sexual orientations (x2/H= 71.835, 22.398, 17.190, 56.533,P<0.01). Compared with the unmarried, the married got to know fewer friends from the local MSM. Their HIV awareness was poorer, and a smaller proportion accepted HIV testing in the recent year. Fewer married MSM obtained knowledge and information from the Internet, while more got it from friends (x2/H= 19.139, 12.047, 4.771, 50.060,10.101, P<0.01 or P<0.05). The proportions of those whose first sexual behavior objects was women, who, in recent six months, looked for sexual partners mainly in bathrooms or parks, who had female sexual behaviors,multiple sexual partners, occasional sexual partners, regular heterosexual partners, unprotected initiative anal sex or unprotected female sexual behaviors, were higher in the married than in the unmarried (x2/H=60.335, 94.536, 79.299, 12.799, 9.508, 42.132, 6.462, 4.170, P<0.01 or P<0.05), while the married had a smaller proportion of MSM who had regular homosexual partners (x2 = 24.756,P<0.01). There was no statistical difference in the proportion of anal sex with men in recent six months between the married

  3. The relationship between personality characteristics and AIDS related factors of MSM%男男性行为人群人格特征与艾滋病相关因素的关系

    Institute of Scientific and Technical Information of China (English)

    王毅; 李六林; 张光贵; 樊静; 赵西和; 杨红; 姚卫; 周力

    2015-01-01

    Objective To understand the personality characteristics and the relationship with HIV-related factors of MSM (Men who have sex with men,MSM).Methods Using the Snowball Sampling method to recruit the people and determine eight people as the seed.To survey the on-site behavior like demographic characteristics,sexual behavior,personality traits and have serological test in a fixed location.Useing EPQ-RSC to measure the personality.Analyzing the data with t test,x2 test,H test and Logistic regression analysis.Results 402 people were included in the queue.The scores of the tables were P(3.28± 1.83),E(8.49±2.57),N(5.02±3.29),L(6.29 ± ±2.82).They were higher than the national norm (P<0.01).In temperament,the Sanguine is 33.6% (135/402),Choleric is 28.1% (113/402),Phlegm is 13.9% (56/402),Melancholic is 24.4% (98/402).The multivariate analysis showed that,compared with the Sanguine,the Choleric had independent statistically with the level of education and having received the examination or treatment of sexually transmitted diseases in a year (P< 0.05).The Phlegm had independent statistically with marital status,having received peer education in a year,first MSM age,the number of male anal sex in recent six mouths and the health of sexual partners in recent six mouths(P<0.05).The melancholic had independent statistically with marital status,having received the examination or treatment of sexually transmitted diseases in a year and the number of male anal sex nearly a week(P<0.05).Conclusion The temperamental type of MSM has its own characteristics,and has the relationship with AIDS-related factors.The Sanguine has more risks.%目的 了解男男性行为人群(MSM)人格特征及与艾滋病相关因素的关系.方法 采用滚雪球抽样法进行人员招募,从不同亚群特征确定种子8人,在固定场所进行招募对象的人口学特征、性行为、人格特征等现场行为学调查和血清学检验.人格测定使用艾

  4. Incisões relaxantes limbares ou incisões no meridiano mais curvo associadas a facoemulsificação com implante de lente intra-ocular multifocal: relato de três casos Limbal relaxing incision or the more curved meridian incision associated to phacoemulsification with multifocal intraocular lens implant: three case reports

    Directory of Open Access Journals (Sweden)

    Wilson Takashi Hida

    2008-04-01

    Full Text Available O implante de lentes intra-oculares (LIOs multifocais é um grande avanço na reabilitação de pacientes permitindo boa acuidade visual sem correção óptica para longe e perto. Contudo pacientes com alguns graus de astigmatismo corneano tem indicação limitada. Este artigo relata três pacientes que foram submetidas a facoemulsificação com implante de lentes intra-oculares multifocais (AcrySof® Restor®, Alcon Labs após incisão relaxante limbar (IRL no olho dominante e incisão no eixo mais curvo da topografia no olho contralateral. Não foi encontrado nenhuma análise relacionada a dominância ocular e relaxante limbar na literatura. Acredita-se que essa associação pode ampliar as indicações de implante das lentes intra-oculares multifocais em pacientes com astigmatismo corneano significativo, devendo-se confirmar esta possibilidade por meio de futuros estudos.The use of multifocal intraocular lenses (IOLs is a great advance in the treatment of patients with cataract allowing near and distance uncorrected visual acuity recovery. However patients with some degrees of corneal astigmatism have some limitations. We present 3 cases that were indicated for phacoemulsitfication and multifocal intraocular lens implant (AcrySof® Restor®, Alcon Labs after limbal relaxing incision (LRI in the dominant eye and axis topographic incision in the fellow eye. There was no similar case report in the literature. It is believed that this association can extend the indications for multifocal intraocular lens implants in patients with significant corneal astigmatism and this possibility should be confirmed by future studies.

  5. Chronic multifocal neuropathy with persistent conduction block (Lewis-Sumner syndrome). A clinico-morphologic study of two further cases with review of the literature.

    Science.gov (United States)

    Gibbels, E; Behse, F; Kentenich, M; Haupt, W F

    1993-01-01

    We present data of 2 patients suffering from chronic motor-sensory multifocal neuropathy with persistent conduction block. The first case concerns a 9-year follow-up of a female, aged 24 years at onset with persistent multiple conduction blocks and a tendency towards generalization of clinical deficits. Eight years after onset sural nerve biopsy revealed extreme interfascicular variations of de/remyelination, onion bulb formation, fiber loss, edema, and proliferation of basal lamina of endoneurial capillaries. Serum antibodies against GM1 gangliosides were not detected. The second case, a 29-year-old Yemenitic male with a 5-year history, exhibited conduction blocks in motor and sensory fibers, and a normal sural nerve biopsy. Our results are discussed with respect to those of some 30 cases individually reported in the literature.

  6. Fixation stability and implication for multifocal electroretinography in patients with neovascular age-related macular degeneration after anti-VEGF treatment

    DEFF Research Database (Denmark)

    Pedersen, Karen Bjerg; Sjølie, Anne Katrin; Vestergaard, Anders Højslet;

    2016-01-01

    was at baseline, 3 and 6 months negatively correlated to visual acuity (VA) (rbaseline = −0.65, r3 months = −0.60, and r6 months = −0.66 respectively, p ... reduced due to poor fixation as a large number of patients may use a fixation area of more than 5 deg2. Fixation monitoring during recording as well as interpretation of results should be performed with care, especially in patients with poor visual acuity.......Purpose: To quantify fixation stability in patients with neovascular age-related macular degeneration (nAMD) at baseline, 3 and 6 months after anti-vascular endothelial growth factor (anti-VEGF) treatment and furthermore asses the implications of an unsteady fixation for multifocal...

  7. Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

    Institute of Scientific and Technical Information of China (English)

    David; P.Piero; Vicente; J.Camps; María; L.Ramón; Verónica; Mateo; Rafael; J.Pérez-Cambrodí

    2015-01-01

    AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position(ELP).METHODS: Retrospective study including a total of 25 eyes of 13 patients(age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL(Oculentis Gmb H, Germany). In all cases, an adjusted IOL power(P IOLadj) was calculated based on Gaussian optics using a variable keratometric index value(n kadj) for the estimation of the corneal power(P kadj) and on a new value for ELP(ELP adj) obtained by multiple regression analysis.This P IOLadj was compared with the IOL power implanted(P IOLReal) and the value proposed by three conventional formulas(Haigis, Hoffer Q and Holladay Ⅰ).RESULTS: P IOLReal was not significantly different than P IOLadj and Holladay IOL power(P >0.05). In the Bland and Altman analysis, P IOLadj showed lower mean difference(-0.07 D) and limits of agreement(of 1.47 and-1.61 D)when compared to P IOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELP adj was significantly lower than ELP calculated with other conventional formulas(P <0.01) and was found to be dependent on axial length, anterior chamber depth and P kadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing thekeratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

  8. Status of articles published by the Chinese Journal of AIDS&STD in HIV/AIDS related domestic literature%《中国艾滋病性病》刊载文献在国内发表的艾滋病相关文献中的位置

    Institute of Scientific and Technical Information of China (English)

    郑京婵; 张蕊; 刘霞

    2012-01-01

    目的 了解《中国艾滋病性病》刊载文献在国内发表艾滋病相关文献中的位置.方法 在CNKI中国知网数据库中,以“艾滋病”为关键词检索文献,下载题录信息后整理分析.结果 2006-2010年国内分别有461、464、462、469、457本杂志发表与“艾滋病”相关的文献,《中国艾滋病性病》的发表篇数(所占比例在6.2%~8.1%之间波动)、被引篇数、被引频次、下载篇数、下载频次始终居于第一位,被引率和下载率处于发表艾滋病相关文献篇数前6名杂志的中上水平.结论 《中国艾滋病性病》杂志在传播性病艾滋病科研成果方面起了重要作用,还存在增加载文数量的发展空间.%Objective To evaluate the status of the articles published by the Chinese Journal of AIDS &. STD in HIV/AIDS related domestic literatures. Method Literatures were searched in China CNKI database by using HIV/AIDS as a key word, and related information was downloaded and analyzed. Results There were totally 461, 464,462,469 and 457 domestic journals which published HIV/AIDS related articles in respective years from 2006 to 2010. The articles published by the Chinese Journal of AIDS &. STD accounted for 6. 2%- 8. 1% of all the related domestic articles, ranking the first in terms of number and frequency of citation and downloading. As for the rate of citation and downloading the journal stays at a high or middle level and is listed among the 6 top HIV/ AIDS related journals. Conclusion The Chinese Journal of AIDS & STD plays a vital role in publicizing STD/AIDS related scientific achievements in this country, but there is much room for its further increasing number of articles.

  9. EDITORIAL: Catalysing progress Catalysing progress

    Science.gov (United States)

    Demming, Anna

    2010-01-01

    Examples of the merits of blue-sky research in the history of science are legion. The invention of the laser, celebrating its 50th anniversary this year, is an excellent example. When it was invented it was considered to be 'a solution waiting for a problem', and yet the level to which it has now infiltrated our day-to-day technological landscape speaks volumes. At the same time it is also true to say that the direction of research is also at times rightly influenced by the needs and concerns of the general public. Over recent years, growing concerns about the environment have had a noticeable effect on research in nanotechnology, motivating work on a range of topics from green nanomaterial synthesis [1] to high-efficiency solar cells [2] and hydrogen storage [3]. The impact of the world's energy consumption on the welfare of the planet is now an enduring and well founded concern. In the face of an instinctive reluctance to curtail habits of comfort and convenience and the appendages of culture and consumerism, research into renewable and more efficient energy sources seem an encouraging approach to alleviating an impending energy crisis. Fuel cells present one alternative to traditional combustion cells that have huge benefits in terms of the efficiency of energy conversion and the limited harmful emissions. In last week's issue of Nanotechnology, Chuan-Jian Zhong and colleagues at the State University of New York at Binghamton in the USA presented an overview of research on nanostructured catalysts in fuel cells [4]. The topical review includes insights into the interactions between nanoparticles and between nanoparticles and their substrate as well as control over the composition and nanostructure of catalysts. The review also serves to highlight how the flourishing of nanotechnology research has heralded great progress in the exploitation of catalysts with nanostructures ingeniously controlled to maximize surface area and optimize energetics for synthesis

  10. Virus isolation and molecular characterization of canine distemper virus by RT-PCR from a mature dog with multifocal encephalomyelit Isolamento e caracterização molecular do vírus da cinomose canina por RT-PCR a partir de um cão adulto com encefalomielite multifocal

    Directory of Open Access Journals (Sweden)

    Alexandre Mendes Amude

    2007-06-01

    Full Text Available A case of multifocal distemper encephalomyelitis in a mature dog is described. In the presented case the ante mortem clinical diagnosis of canine distemper virus (CDV infection could not be ideally performed due to the absence of typical signs of distemper, such as myoclonus and systemic signs accompanying the nervous signs. The definitive diagnosis of distemper encephalomyelitis was only carried out at post mortem through virus isolation in cell culture from fresh central nervous system (CNS fragments and CDV nucleoprotein gene detection in the CNS by RT-PCR.Descreve-se um caso de encefalomielite multifocal pela cinomose em um cão adulto. No caso apresentado o diagnóstico clínico da infecção pelo vírus da cinomose canina (CDV não pode ser adequadamente realizado devido à ausência de sinais típicos da enfermidade, tais como mioclonia e sinais sistêmicos. O diagnóstico definitivo somente foi possível post mortem pelo isolamento do CDV em cultivo celular a partir dos fragmentos frescos do sistema nervoso central (SNC e pela detecção do gene da nucleoproteína do CDV em fragmentos do SNC por meio da RT-PCR.

  11. The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes.

    Science.gov (United States)

    Trojano, M; Paolicelli, D

    2001-11-01

    In the absence of pathognomonic clinical features or a definitive laboratory test, multiple sclerosis (MS) remains ultimately a diagnosis of exclusion. Accurate diagnosis is increasingly important with available disease modifying therapy. Unfortunately the rate of misdiagnosis remains around 5%-10%, indicating that 1 in 20 patients thought to have MS has, instead, a condition resembling MS. In this review we describe conditions that may be confused with MS because they can present as lesions disseminated in time, space, or both. Conditions often confused with MS may be inflammatory (systemic lupus erythematosus, Sjögren's syndrome, vasculitis, sarcoidosis, Behçet's disease), infectious (Lyme disease, syphilis, progressive multifocal leukoencephalopathy, HTLV-1 infection, herpes zoster), genetic (lysosomal disorders, adrenoleukodystrophy, mitochondrial disorders, CADASIL), metabolic (vitamin B12 deficiency), neoplastic (CNS lymphoma) and spinal (degenerative and vascular malformations) diseases. The key to the accurate diagnosis of MS is vigilance for atypical features, suggesting the possibility of an alternative diagnosis.

  12. Progressive subretinal fibrosis in patients with rheumatoid arthritis and renal dysfunction.

    Science.gov (United States)

    Matsuo, T; Matsuo, N

    1998-01-01

    We present two patients (56-year-old and 71-year-old women) who developed subretinal fibrosis in parallel with exacerbation of rheumatoid arthritis and deteriorated renal function. The first patient developed subretinal fibrosis in the right eye, coupled with multifocal choroiditis and serous retinal detachment in both eyes, in the course of rapidly progressive glomerulonephritis complicated with rheumatoid arthritis. Antineutrophil cytoplasmic antibody was positive in a perinuclear pattern (pANCA) and the increased dose of prednisolone to 40 mg/day resulted in subsidence of the subretinal inflammation. The second patient developed subretinal fibrosis in the left eye with mottled retinal pigment epithelium of both eyes, in the course of rheumatoid arthritis and stable chronic renal failure. Although the manifestations of subretinal fibrosis and concurrent renal dysfunction were different between these two patients, subretinal fibrosis might be noted as a complication of rheumatoid arthritis and renal dysfunction.

  13. Learning numerical progressions.

    Science.gov (United States)

    Vitz, P C; Hazan, D N

    1974-01-01

    Learning of simple numerical progressions and compound progressions formed by combining two or three simple progressions is investigated. In two experiments, time to solution was greater for compound vs simple progressions; greater the higher the progression's solution level; and greater if the progression consisted of large vs small numbers. A set of strategies is proposed to account for progression learning based on the assumption S computes differences between integers, differences between differences, etc., in a hierarchical fashion. Two measures of progression difficulty, each a summary of the strategies, are proposed; C1 is a count of the number of differences needed to solve a progression; C2 is the same count with higher level differences given more weight. The measures accurately predict in both experiments the mean time to solve 16 different progressions with C2 being somewhat superior. The measures also predict the learning difficulty of 10 other progressions reported by Bjork (1968).

  14. Geothermal progress monitor. Progress report No. 1

    Energy Technology Data Exchange (ETDEWEB)

    1979-12-01

    Progress is reported on the following: electrical uses, direct-heat uses, drilling activities, leases, geothermal loan guarantee program, general activities, and legal, institutional, and regulatory activites. (MHR)

  15. Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

    Directory of Open Access Journals (Sweden)

    Rodrigo M. Navarro

    2015-01-01

    Full Text Available Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV for symptomatic posterior vitreous detachment (PVD on visual acuity (VA and quality after multifocal intraocular lenses (IOLs. Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA, intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25 was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P=0.017. All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P=0.023, near activities (P=0.043, distance activities (P=0.041, mental health (P=0.011, role difficulties (P=0.042, and driving (P=0.016. Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised.

  16. 娱乐场所女性服务人员艾滋歧视及其对艾滋病防治服务依从性的影响%AIDS-Related Discrimination and its Effects on Prevention Service Adherence among Female Entertainment Workers

    Institute of Scientific and Technical Information of China (English)

    石国政; 殷方兰; 吴杰; 郭丽华; RobertS.Remis; 钟平

    2011-01-01

    [ Objective ] To investigate AIDS-related discrimination among female entertainment workers (FEWs) and its effect on prevention service adherence. [ Methods ] A total of 126 FEWs were randomly selected from Juyuan New Area as the study subjects, interviewed with an unified questionnaire for socio-demographic, behavioral, cognition and AIDS-related discrimination status, and tested for HIV, HSV-2, syphilis, gonorrhea and Chlamydia trachomatis with blood and urine samples. [ Results ] Among the 126 FEWs investigated, 31.75% came from large KTVs, 62.70% from small hair salons, 2.38% from small foot care stores, and 3.17% from small bathrooms. None was HIV-positive and 22.22% was infected with sexually transmitted diseases (STD). The mean score of AIDS-related discrimination was 4.19 ± 1.61. AIDS-related discrimination had a statistical relationship with the level of AIDS knowledge (x2=5.184, P=0.023). Only 23.81% had HIV tests ever, and "don't know where to go to get a test" and "chance of having AIDS is low" were the main reasons for not to get a test. Those having STD-related symptoms in the past one month accounted for 61.90%, and 70.51% saw a doctor. Those who went for routine STD check-ups in the past one year taken 50.00%, and the mean of STD checkups were 1.79 ± 0.99. In their last sexual encounter, 96.83% used condoms when having sex with clients, but 45.74% did so when with regular sexual partners. The proportion of having a miscarriage ever was 11.11%, and 65.87% for an abortion ever. The times of miscarriage and abortion varied from 1 to 7, with the median of 1. Those using contraceptives accounted for 97.62%, among which 66.67% chose condoms. X2 test showed AIDS-related discrimination had a statistical relationship with HIV test (x2=5.936,P=0.015) and sexually transmitted infection rate (x2=4.829, P=0.028). [ Conclusion ] AIDS-related discrimination is common among FEWs. HIV prevention service adherence is far from being satisfactory, and AIDS-related

  17. 艾滋病合并非霍奇金淋巴瘤五例临床分析并文献复习%A clinical analysis of AIDS-related non-Hodgkin lymphoma in 5 patients and review of literature

    Institute of Scientific and Technical Information of China (English)

    阮桂仁; 王焕玲; 葛瑛; 侍效春; 郭伏平; 钟定荣; 周道斌; 李太生

    2012-01-01

    目的 通过分析5例艾滋病相关非霍奇金淋巴瘤(ARL)患者的临床资料并复习相关文献,提高对该病的认识.方法 回顾性分析北京协和医院2009年4月至2011年4月因非霍奇金淋巴瘤住院的艾滋病患者的临床资料,复习相关文献.结果 共收治5例ARL患者,均为男性,年龄32~65岁.2例在淋巴瘤诊治中首次发现HIV感染,3例在抗逆转录病毒治疗(HAART)7~8个月后发现ARL.发病时CD4+ T细胞计数(69~232)×106/L.2例以咽痛、咽部溃疡起病,1例以颈部包块起病,1例以腹盆腔占位起病,1例以发热、右下肢肿痛起病.4例为B细胞淋巴瘤,其中1例为Burkitt淋巴瘤,3例为弥漫大B细胞性淋巴瘤,1例为T细胞淋巴瘤.4例进行化疗,1例完全缓解,1例复发,1例无缓解,1例死亡;1例进行单纯放疗,出现病变进展.化疗的主要副作用为骨髓抑制及消化道反应.结论 HIV感染者若出现不明原因的淋巴结肿大、顽固性咽痛、咽部溃疡、不明原因发热等,应考虑可能为淋巴瘤,尽可能行病理活检明确.积极的HAART联合规范性化疗可能改善预后.%Objective To analyze the clinical characteristics of AIDS-related non-Hodgkin lymphoma(ARL)and review relative literature for the diagnosis and treatment of ARL.Method The clinical data of ARL patients admitted to Peking Union Medical College Hospital from April 2009 to April 2011 were retrospectively analyzed.Results Five male ARL patients aged 32 to 65 years old were included in this retrospective study.Among them,two patients were found to be HIV-positive for the first time,three were on regular highly active anti-retroviral therapy(HAART)for 7-8 months before the emergence of lymphoma-related symptoms.CD4+ T cell count was(69-232)× 106/L at presentation.Two patients firstly presented with sore throat and throat ulcer,one with cervical nodules,one with pelvic mass,one with fever and edema in right thigh.Through pathological analysis

  18. Middle-Preserving Pancreatectomy for Multifocal Metastatic Renal Cell Carcinoma Located in the Head, Body and Tail of the Pancreas. A Case Report

    Directory of Open Access Journals (Sweden)

    Hiroki Ohzato

    2010-11-01

    Full Text Available Context Postoperative endocrine and exocrine insufficiencies following traditional pancreatectomies might cause a deterioration of the quality of life and surgical outcome. Parenchyma-sparing pancreatectomies have been utilized in benign lesions and low-grade malignancies. Case report A 67-year-old female with a past history of right nephrectomy for renal cell carcinoma 20 years earlier was referred to our institute with obstructive jaundice and multiple nodules in the pancreas. Computed tomography demonstrated five well-demarcated, strongly enhanced nodules with diameters of 5.5 cm in the head, 2.0 and 1.8 cm in the body, and 1.2 and 1.0 cm in the tail. Fluorine-18 fluorodeoxyglucose positron emission tomography did not demonstrate any extrapancreatic uptake. A middle-preserving pancreatectomy was performed after ultrasonography had confirmed arterial perfusion in the middle segment. A histological study demonstrated metastatic clear cell renal carcinoma. To date, the patient has remained without recurrence for two and a half years since surgery. A minimal administration of insulin has been necessary; however, C-peptide is detectable and nutritional status is comparatively good. Conclusion A middle-preserving pancreatectomy is a useful procedure in a parenchymasparing pancreatectomy for resecting multifocal lesions in the head, body and tail of the pancreas.

  19. 大鼠多焦点视网膜电图的记录方法%Recording method of multifocal electroretinography in rat

    Institute of Scientific and Technical Information of China (English)

    张作明; 顾永昊; 李莉; 龙潭

    2002-01-01

    The multi-focal electroretinography (mERG)is a new technique to evaluate objectively the visual function and characterized by observing the function change in focal retina quantitatively. The recording condition is very rigorous and the relative position between the eye and stimuli field must be kept to obtain accurate results. In experiments, the albino Sprague-Dawley rats were kept on a special platform, which can be moved in three dimensions, and the distance between the tested eye and CRT were controlled by a self made apparatus. A silver chloride loop electrode was contacted with corneal limbus as recording electrode. The waveforms of dark-adapted mERG in albino rats were stable, clear and repeatable in focal retina. The amplitudes of a and b waves in upper field were greater than those in lower field while the latencies were shorter. There was no large-amplitude area just like the human macular. This procedure paves the way for evaluating objectively functional change in focal retina in laboratory animals.

  20. Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

    Energy Technology Data Exchange (ETDEWEB)

    Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de [University of Magdeburg, Department of Urology (Germany); Pech, Maciej [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Porsch, Markus; Janitzky, Andreas [University of Magdeburg, Department of Urology (Germany); Fischbach, Frank [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Buhtz, Peter; Vogler, Klaus [University of Magdeburg, Institute of Pathology (Germany); Huehne, Sarah [University of Magdeburg, Department of Urology (Germany); Borucki, Katrin [University of Magdeburg, Institute of Clinical Chemistry (Germany); Strang, Christof [University of Magdeburg, Department of Anaesthesiology (Germany); Mahnkopf, Dirk [Institute of Medical Technology and Research (Germany); Ricke, Jens [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Liehr, Uwe-Bernd [University of Magdeburg, Department of Urology (Germany)

    2012-08-15

    Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE's effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

  1. Survey of HIV/AIDS-related knowledge, attitudes and practices among clients in rural areas of Gu7angxi%广西农村地区低档场所嫖客艾滋病相关知信行调查

    Institute of Scientific and Technical Information of China (English)

    崔岩; 周月姣; 杨莉

    2013-01-01

    目的 了解广西农村低档场所嫖客的艾滋病相关知识知晓率情况和高危行为的特征及影响因素.方法 通过观察法、个人深入访谈、问卷调查等方法对103名嫖客的一般情况、艾滋病知识的知晓率、安全套使用等情况进行了调查.结果 调查发现,低档场所的嫖客对艾滋病相关知识的知晓率较低,平均答对题数仅为3.24题(共8题);嫖客人群以50岁以上的中老年人为主,占70.87%;嫖客文化程度较低,初中以下文化程度者超过90%;最近一个月商业性行为中坚持使用安全套的比例为3.88%;HIV感染率为1.94%,梅毒感染率为9.71%.结论 农村地区低档场所的嫖客艾滋病相关知识的知晓率较低,HIV感染率较高,安全套使用率较低,自愿进行HIV检测的比例和性病诊疗获得率都较低.可根据其自身特点开展具有针对性的宣传教育和外展服务,扩大自愿咨询检测和规范化性病诊疗的覆盖面和可及性.%Objective To survey the HIV/AIDS-related knowledge awareness,high risk behavior among clients in low cost sites of rural areas in Guangxi.Methods The HIV/AIDS-related knowledge awareness,high risk behavior among clients in low cost sites of rural areas in Guangxi were surveyed both by personal in-depth interviews and questionnaire.Results The awareness of HIV/AIDS-related knowledge of clients whose average number of correct answers was only 3.24 questions (8questions in total).The clients were mainly in the age group of over 50 years old,accounted for 70.87% and 90% of them were below junior middle school education level.The frequency of condom use during commercial sex behaviors with the CSW in the last month was 3.88%,HIV infection rate was 1.94%,and the syphilis infection rate was 9.71%.Conclusion The awareness rate of HIV/AIDS-related knowledge of clients in low-cost sites was low.The HIV infection rate among them was high; the rate of condom use was low

  2. Disability Progression After Switching from Natalizumab to Fingolimod or Interferon Beta/Glatiramer Acetate Therapies

    Science.gov (United States)

    Fox, Robert J.; Tyry, Tuula; Salter, Amber R.; Campagnolo, Denise

    2016-01-01

    Background: Physicians must weigh the benefits against the risk of progressive multifocal leukoencephalopathy (PML) in patients treated with natalizumab, especially beyond 2 years. However, disability progression associated with switching therapies versus continuing natalizumab therapy after 2 years has not been fully evaluated. Methods: In this retrospective analysis using the NARCOMS Registry, disability progression (Patient-Determined Disease Steps [PDDS] scale) and physical health-related quality of life (HRQOL) worsening (12-item Short Form Health Status Survey Physical Component Score [SF-12 PCS]) were compared between participants switching to fingolimod (n = 50) or interferon beta (IFNβ)/glatiramer acetate (GA) (n = 71) therapy and those continuing natalizumab (n = 406) after 2 years or more of treatment (median follow-up: natalizumab, 4 years; fingolimod, 4.5 years; IFNβ/GA, 5 years). Results: Participants continuing to take natalizumab had less disability progression (mean PDDS change: natalizumab, 0.3; fingolimod, 0.6; IFNβ/GA, 0.7; P = .0036), were less likely to report disability progression (proportion with PDDS increase: natalizumab, 31%; fingolimod, 46%; IFNβ/GA, 42%; P = .0296), and had less worsening in physical HRQOL (mean SF-12 PCS change: natalizumab, −1.4; fingolimod, −2.8; IFNβ/GA, −4.6; P = .0476) than those switching treatment. Conclusions: Although all medication groups exhibited some level of worsening, switching from natalizumab treatment after 2 years was associated with increased disability progression and worsening physical HRQOL. The risk of disability progression from disease activity and the risk of PML should be considered when making natalizumab treatment decisions. PMID:27803638

  3. Study on Current Situation of HIV/AIDS-related KAP and Its Influencing Factors Among Floating Population in Changping District in 2010%2010年昌平区流动人口艾滋病KAP现状及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    张崛; 刘红新; 李芬; 侯钊; 马树波

    2011-01-01

    - related knowledge in the floating population was 84.8%. There were statistically significant differences in the awareness rate of HIV/AIDS- related knowledge among the population of different gender and occupations. Binary Logistic regression showed that gender, age, household registration, educational background, and whether having free HIV testing or not, were the main factors which significantly influenced the awareness rate of HIV/AIDS - related knowledge. The floating population acquired AIDS - related knowledge through various ways, which were television, free media publicity materials, radio, etc. But the most desired ways of obtaining HIV/AIDS - related knowledge in the floating population from high to Iow were television, free media publicity materials, books, etc. 3.6% of the floating population had been tested for HIV antibodies. Only 22. 1% demonstrated that they could treat the HIV/AIDS with correct attitude. 4.7% had comercial sex behavior, and only 18. 1 % used a condom each time they had sex. 7.3% of the floating population had sex with temporary sexual partrer, and only 18. 1% used a condom each time they had sex. 0. 5% of men had homosexual behavior, and only 16.7% used a condom each time they had sex. Conclusions HIV/AIDS- related knowledge of the floating population in Chengping District is insufficient, and their HIV/AIDS risk attitudes and behaviors are higher. It is suggested to further strengthen health education and behavior intervention among the floating population.

  4. Neural dynamics of object-based multifocal visual spatial attention and priming: object cueing, useful-field-of-view, and crowding.

    Science.gov (United States)

    Foley, Nicholas C; Grossberg, Stephen; Mingolla, Ennio

    2012-08-01

    How are spatial and object attention coordinated to achieve rapid object learning and recognition during eye movement search? How do prefrontal priming and parietal spatial mechanisms interact to determine the reaction time costs of intra-object attention shifts, inter-object attention shifts, and shifts between visible objects and covertly cued locations? What factors underlie individual differences in the timing and frequency of such attentional shifts? How do transient and sustained spatial attentional mechanisms work and interact? How can volition, mediated via the basal ganglia, influence the span of spatial attention? A neural model is developed of how spatial attention in the where cortical stream coordinates view-invariant object category learning in the what cortical stream under free viewing conditions. The model simulates psychological data about the dynamics of covert attention priming and switching requiring multifocal attention without eye movements. The model predicts how "attentional shrouds" are formed when surface representations in cortical area V4 resonate with spatial attention in posterior parietal cortex (PPC) and prefrontal cortex (PFC), while shrouds compete among themselves for dominance. Winning shrouds support invariant object category learning, and active surface-shroud resonances support conscious surface perception and recognition. Attentive competition between multiple objects and cues simulates reaction-time data from the two-object cueing paradigm. The relative strength of sustained surface-driven and fast-transient motion-driven spatial attention controls individual differences in reaction time for invalid cues. Competition between surface-driven attentional shrouds controls individual differences in detection rate of peripheral targets in useful-field-of-view tasks. The model proposes how the strength of competition can be mediated, though learning or momentary changes in volition, by the basal ganglia. A new explanation of

  5. Lymphoscintigraphy and SPECT/CT in multicentric and multifocal breast cancer: does each tumour have a separate drainage pattern? Results of a Dutch multicentre study (MULTISENT)

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, O.R. [Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam (Netherlands); Antoni van Leeuwenhoekhospital, Amsterdam (Netherlands); Vermeeren, L.; Valdes Olmos, R.A. [Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam (Netherlands); Ploeg, I.M.C. van der; Rutgers, E.J.T.; Oldenburg, H.S.A. [Antoni van Leeuwenhoek Hospital, Department of Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Loo, C.E. [Antoni van Leeuwenhoek Hospital, Department of Radiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Pereira-Bouda, L.M.; Smit, F. [Rijnland Hospital, Department of Nuclear Medicine, Leiderdorp (Netherlands); Neijenhuis, P. [Rijnland Hospital, Department of Surgery, Leiderdorp (Netherlands); Vrouenraets, B.C. [Sint Lucas Andreas Hospital, Department of Surgery, Amsterdam (Netherlands); Sivro-Prndelj, F. [Sint Lucas Andreas Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Jap-a-Joe, S.M.; Borgstein, P.J. [Onze Lieve Vrouwe Gasthuis, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2012-07-15

    multifocal breast cancer. (orig.)

  6. The multifocal electroretinogram (mfERG) and cone isolating stimuli: variation in L- and M-cone driven signals across the retina.

    Science.gov (United States)

    Albrecht, Johannes; Jägle, Herbert; Hood, Donald C; Sharpe, Lindsay T

    2002-01-01

    Multifocal electroretinograms (mfERG) were recorded from 38 normal trichromats with a pattern-reversing display that modulated only their long-wavelength sensitive (L) or only their middle-wavelength sensitive (M) cones at equal cone contrasts and average quantal catches. The display consisted of scaled, 103 hexagonal elements, subtending 84 degrees x 75 degrees of visual angle. Typically, the amplitude of the L-cone driven signal was greater than that for the M-cone driven one at all retinal eccentricities, but large differences were found among observers. These values correlated with L- to M-cone ratios obtained psychophysically in the same observers using 2 degrees (dia.) heterochromatic flicker photometry. Interestingly, the L- to M-cone driven amplitude ratios differed between the central and peripheral retina. For the central fovea (5 degrees dia.), the mean ratio was 1.4 +/- 0.6 (for the N1P1 component), whereas for the annular ring centered at 40 degrees in the periphery, it was 2.3 +/- 2.0. The mean P1 latency of the summed M-cone driven mfERG (28.0 +/- 2.6 ms) was significantly advanced relative to the L-cone driven signal (29.0 +/- 1.9 ms), but the mean N1 latencies were similar (15.6 +/- 1.7 ms and 16.2 +/- 1.3 ms, respectively). The P1 latency difference between the L- and M-cone driven waveforms was not found in the central 5 degrees (dia.) of the retina. However, it increased with retinal eccentricity. The regional differences in the amplitudes and latencies of the L- and M-cone driven mfERG signals can be related to variations in the L- to M-cone ratios and/or the receptor to bipolar gain factors that depend on eccentricity.

  7. Visual Outcomes, Quality of Vision, and Quality of Life of Diffractive Multifocal Intraocular Lens Implantation after Myopic Laser In Situ Keratomileusis: A Prospective, Observational Case Series

    Science.gov (United States)

    2017-01-01

    Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients. Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life. Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were 0.13 ± 0.15 (standard deviation), 0.22 ± 0.15, and 0.16 ± 0.15, respectively. Corresponding mean values for binocular uncorrected VA were 0.00 ± 0.10, 0.08 ± 0.13, and 0.13 ± 0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (all P > 0.05). Mean score for halos, night glare, starbursts, and satisfaction were 1.46 ± 1.62, 1.85 ± 1.69, 0.78 ± 1.31, and 3.50 ± 1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was 90.31 ± 8.50 out of 100. Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance.

  8. Analysis of HIV/AIDS related risk behaviors and their impact factors among out-of-school adolescents in outflow areas%流出地校外青少年艾滋病相关危险行为及其影响因素

    Institute of Scientific and Technical Information of China (English)

    孙霄; 朱广荣; 季成叶; 王真真

    2012-01-01

    目的:了解流出地15~24岁未婚校外青少年艾滋病相关危险行为发生情况及影响因素,为对此人群开展相关健康教育提供参考.方法:采用整群抽样方法,抽取某县某所劳务培训和输出机构所有15~24岁未婚校外青少年进行问卷调查.以理性行为理论为基础设计结构式问卷,匿名,在调查员的指导下填写后当场装入信封回收.共收回问卷1800份,有效问卷1 712份.利用Epidata 3.0建立数据库用SPSS 13.0软件进行统计分析.结果:(1)流出地校外青少年艾滋病危险行为发生率较高,婚前性行为的发生率为18.0%,其中过去3个月中性行为从未使用过安全套的占27.3%,有多性伴者占30.8%,有过商业性行为者占31.0%,有过使用毒品经历占9.7%;艾滋病知识知晓率仅为25.1%;同伴环境较差;(2)性行为中使用安全套与艾滋病知识得分、性关系中能谈论安全套相关;发生多性伴行为与年龄、朋友中有多性伴者、对多性伴的态度、主观规范相关;发生商业性行为与艾滋病知识得分、家庭住址、朋友中有发生商业性行为、主观规范、商业性行为意向相关;静脉吸毒与年龄、艾滋病知识得分、朋友吸毒、主观规范、吸毒意向相关;(3)理性行为理论框架中主观规范和行为意向对校外青少年艾滋病危险行为的发生影响较大.结论:流出地校外青少年感染艾滋病的危险性主要表现为缺乏相关知识和应对不良的伙伴压力的能力,应帮助他们树立良好的行为规范,外出打工前期是对校外青少年进行相关健康教育的“关键期”.%Objective:To analyze HIV/AIDS related risk behaviors among unmarried outside school adolescents and ihe impact factors in outflow areas, in order to provide basis for related health education. Methods: Using cluster sampling method, we investigated a vocational training center for all 15 to 24 years-old unmarried

  9. Alveolar damage in AIDS-related Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Prentø, P; Junge, Jette

    1997-01-01

    OBJECTIVE: Pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of AIDS. Despite this, many basic aspects in the pathogenesis of HIV-associated P carinii pneumonia are unknown. We therefore undertook a light and electron microscopic study of transbronchial...... biopsy specimens to compare pathologic features of P carinii pneumonia and other HIV-related lung diseases. DESIGN AND PATIENTS: Thirty-seven consecutive HIV-infected patients undergoing a diagnostic bronchoscopy. RESULTS: P carinii pneumonia was characterized by an increase in inflammation, edema...... with P carinii pneumonia, whereas none without P carinii pneumonia had this finding (p pneumonia. The changes may form...

  10. Creating social spaces to tackle AIDS-related stigma

    DEFF Research Database (Denmark)

    Campbell, C.; Skovdal, Morten; Gibbs, A.

    2011-01-01

    reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v...

  11. AIDS-related Pneumocystis jirovecii genotypes in French Guiana.

    Science.gov (United States)

    Le Gal, Solène; Blanchet, Denis; Damiani, Céline; Guéguen, Paul; Virmaux, Michèle; Abboud, Philippe; Guillot, Geneviève; Kérangart, Stéphane; Merle, Cédric; Calderon, Enrique; Totet, Anne; Carme, Bernard; Nevez, Gilles

    2015-01-01

    The study described Pneumocystis jirovecii (P. jirovecii) multilocus typing in seven AIDS patients living in French Guiana (Cayenne Hospital) and seven immunosuppressed patients living in Brest, metropolitan France (Brest Hospital). Archival P. jirovecii specimens were examined at the dihydropteroate synthase (DHPS) locus using a PCR-RFLP technique, the internal transcribed spacer (ITS) 1 and ITS 2 and the mitochondrial large subunit rRNA (mtLSUrRNA) gene using PCR and sequencing. Analysis of typing results were combined with an analysis of the literature on P. jirovecii mtLSUrRNA types and ITS haplotypes. A wild DHPS type was identified in six Guianese patients and in seven patients from metropolitan France whereas a DHPS mutant was infected in the remaining Guianese patient. Typing of the two other loci pointed out a high diversity of ITS haplotypes and an average diversity of mtLSUrRNA types in French Guiana with a partial commonality of these haplotypes and types described in metropolitan France and around the world. Combining DHPS, ITS and mtLSU types, 12 different multilocus genotypes (MLGs) were identified, 4 MLGs in Guianese patients and 8 MLGs in Brest patients. MLG analysis allows to discriminate patients in 2 groups according to their geographical origin. Indeed, none of the MLGs identified in the Guianese patients were found in the Brest patients and none of the MLGs identified in the Brest patients were found in the Guianese patients. These results show that in French Guiana (i) PCP involving DHPS mutants occur, (ii) there is a diversity of ITS and mtLSUrRNA types and (iii) although partial type commonality in this territory and metropolitan France can be observed, MLG analysis suggests that P. jirovecii organisms from French Guiana may present specific characteristics.

  12. Alveolar damage in AIDS-related Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Prentø, P; Junge, Jette

    1997-01-01

    OBJECTIVE: Pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of AIDS. Despite this, many basic aspects in the pathogenesis of HIV-associated P carinii pneumonia are unknown. We therefore undertook a light and electron microscopic study of transbronchial...... biopsy specimens to compare pathologic features of P carinii pneumonia and other HIV-related lung diseases. DESIGN AND PATIENTS: Thirty-seven consecutive HIV-infected patients undergoing a diagnostic bronchoscopy. RESULTS: P carinii pneumonia was characterized by an increase in inflammation, edema...

  13. AIDS-related primary Kaposi sarcoma of the nasopharynx.

    Science.gov (United States)

    Çelenk, Fatih; Yilmaz, Metin; Asal, Korhan; Ekinci, Özgür; Tokgöz, Nil

    2011-06-01

    Primary nasopharyngeal Kaposi sarcoma is extremely rare, as only 1 case has been previously reported in the literature. We report a new case, which occurred in a 37-year-old man with a known history of acquired immune deficiency syndrome (AIDS). The patient presented with complaints of recurrent epistaxis and postnasal hemorrhage. Endoscopic examination detected a bluish, smooth, firm, nonpulsatile mass in the nasopharyngeal wall. Histopathologic findings on biopsy were consistent with Kaposi sarcoma. The tumor was successfully treated with radiotherapy. Kaposi sarcoma should be considered in the differential diagnosis of any AIDS patient who presents with recurrent unilateral nasal bleeding.

  14. AIDS-related Knowledge, Condom Usage Among Medical Postgraduates

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To investigate the knowledge about safety/unsafty of sexual acts relating to HIV transmission, levels of embarrassment related to condom and condom usage among medical postgraduates. Methods From August to December, 1998, a self-administered anonymous questionnaire was given to 271 new medical postgraduates from two medical colleges of Beijing and Hebei Province. Results There was a hazy understanding of the protective function of condom from AIDS among medical postgraduates. Only 14.4% medical postgraduates persisted in using condom, and 27.94% had never or almost never used it. The levels of embarrassment about condom were high. The median score was 3.55+0.98. Whether to use condom was related with the attitudes to condom, but not to AIDS. Conclusion There was some misunderstanding about condom and inconsistent condom usage in medical postgraduates. So it is essential to strengthen the sexual health education among them.

  15. HGF/c-MET Pathway in AIDS-Related Lymphoma

    Science.gov (United States)

    2016-09-01

    Russell DL. The metalloproteinase ADAMTS1: a comprehensive review of its role in tumorigenic and metastatic pathways . Int J Cancer . 2013; 133...protein kinase and p38 pathways acting on hypoxia-inducible factor 1alpha. Cancer Res. 2000; 60:4873–4880. 45. Dai L, Trillo-Tinoco J, Bai L, Kang B...Louisiana Cancer Research Center, New Orleans, LA Key Points • The HGF/c-MET pathway has a complex network to control KSHV1 PEL cell survival. • The c-MET

  16. Natalizumab in progressive MS

    DEFF Research Database (Denmark)

    Romme Christensen, Jeppe; Ratzer, Rikke; Börnsen, Lars;

    2014-01-01

    OBJECTIVE: Natalizumab inhibits the migration of systemic immune cells to the CNS and may be beneficial in progressive multiple sclerosis (MS). The objective of the study was to examine the effects of natalizumab in progressive MS. METHODS: In an open-label phase 2A study, 24 patients with progre......OBJECTIVE: Natalizumab inhibits the migration of systemic immune cells to the CNS and may be beneficial in progressive multiple sclerosis (MS). The objective of the study was to examine the effects of natalizumab in progressive MS. METHODS: In an open-label phase 2A study, 24 patients...

  17. 男男性行为HIV感染者艾滋病相关羞辱和歧视的调查分析%HIV/AIDS related-stigma and discrimination among HIV positive men who have sex with men

    Institute of Scientific and Technical Information of China (English)

    李现红; 刘立珍; 何国平; 王红红; 黄树源

    2013-01-01

    目的 了解HIV阳性的男男性行为者(MSM)的基本特征,以及艾滋病相关羞辱和歧视的现状及影响因素.方法 2009年7~11月匿名调查成都市内HIV阳性的MSM107例.结果 艾滋病相关羞辱和歧视总得分为(127.36±17.68)分,处于中等水平.影响因素有疾病告知、安全套使用频率、文化程度、是否进行抗病毒治疗、自我感觉身体状况.结论 医护人员在提供卫生服务时应持中立态度,鼓励其告知亲近人员,建立支持性环境,可在一定程度上降低羞辱和歧视水平.%Objective To investigate the characteristics of men who have sex with men(MSM) and the level and influencing factors of HIV/AIDS related-stigma and discrimination among them. Methods Totally 107 HIV positive MSM in Chengdu were investigated by an anonymous questionnaire. Results The mean score of HIV/AIDS related-stigma and discrimination scale was 127.36?7.68, which was in moderate level. The influencing factors were disclosure of HIV status,frequency of condom use,educational background,anti-retrovirus treatment and self-reported health status. Conclusion Doctors and nurses who are working with HIV positive MSM should hold a non-judgmental attitude when providing health care,and encourage them to tell their significant others in order to build a supportive environment around the patient,which may reduce the stigma level to extent.

  18. Effects analyzing of reinforcing the Primordial Qi in the process of prevention and treatment to patients with AIDS-related diarrhea%试析培补元气在艾滋病相关性腹泻防治中的作用

    Institute of Scientific and Technical Information of China (English)

    张亚萍; 梁健; 邓鑫; 李永亮

    2011-01-01

    艾滋病相关性腹泻的发生主要责之于脾虚湿盛,与肺脾肾等脏腑功能失调密切相关.元气是人体生命活动的原动力,具有推动和调节人体脏腑生理活动之功;同时,元气也是正气的重要组成部分,对维持人体的免疫功能有着重要的作用.脾胃水谷精气对元气有滋养之功,两者相互为用,密切相关.从培补元气人手防治艾滋病相关性腹泻,是中医学“治病求本”思想的体现.培补元气,不仅对推动和激发艾滋病患者脏腑功能活动、改善机体虚弱的状态、提高其免疫功能有重要作用,而且对减轻患者腹泻的症状、减少腹泻发生的次数、提高患者的生活质量都有积极的影响.%The main cause of the onset of AIDS-related diarrhea is damp abundance due to spleen asthenia syndrome and the function situation of lung, spleen, and kidney has a lot to do with it. Primordial Qi is the primitive active power of human actions and can promote and regulate the physiological activities of human being. Meanwhile, Primordial Qi which is the major components of vital Qi has a lot to do with the maintenance of immune function of human being. The nutrients grown and transformed in the spleen and stomach moisten the vital Qi. These two has a close relationship and react to each other. To prevent and treat AIDS-related diarrhea by cultivating and promote Primordial Qi embodies the thoughts of TCM which goes treating a disease by removing its cause. Reinforcing the Primordial Qi can not only stimulate the functional activities of Zang-Fu, better the general condition of body and improve the immune function of the patients with AIDS, but also has positive effects in eliminating the symptoms of diarrhea, decreasing the frequency of the occurrence of diarrhea and improving the quality of life.

  19. Physicians’ Progress Notes

    DEFF Research Database (Denmark)

    Bansler, Jørgen; Havn, Erling C.; Mønsted, Troels;

    2013-01-01

    in patient care, they have not dealt specifically with the role, structure, and content of the progress notes. As a consequence, CSCW research has not yet taken fully into account the fact that progress notes are coordinative artifacts of a rather special kind, an open-ended chain of prose texts, written...

  20. Progression i musikundervisningen

    DEFF Research Database (Denmark)

    Dahlbæk, Annelise

    Hvad er progression? ; Musikalitetsbegrebet ; Fælles mål for musik ; Modeller som redskab ; Stemmen : sang ; Sammenspil ; Dans og bevægelse ; Lytning......Hvad er progression? ; Musikalitetsbegrebet ; Fælles mål for musik ; Modeller som redskab ; Stemmen : sang ; Sammenspil ; Dans og bevægelse ; Lytning...