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  1. Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    ... most prominent symptoms are clumsiness; progressive weakness; and visual, speech, and sometimes personality changes. The progression of deficits leads to life-threatening disability and (frequently) death. A diagnosis of PML can ...

  2. Progressive multifocal leukoencephalopathy: rheumatological aspects

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    Boris Sergeevich Belov

    2015-01-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a severe progressive viral disease that affects the central nervous system in patients with immunodeficiency. It may develop as a complication in patients with systemic inflammatory rheumatic diseases (primarily in those with systemic lupus erythematosus, including that during active antirheumatic therapy. The paper presents data on the etiology, epidemiology, and pathogenesis of the disease, characterizes its clinical presentation, highlights main approaches to its diagnosis, and gives current diagnostic criteria. A questionnaire used to monitor neurological status is shown. The paper emphasizes the importance of this monitoring, for early diagnosis and timely cessation of PML treatment with a drug, a potential trigger, are factors that influence prognosis to the utmost degree.

  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

    Directory of Open Access Journals (Sweden)

    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. Progressive multifocal leukoencephalopathy in an immunocompetent patient.

    Science.gov (United States)

    van der Kolk, Nicolien M; Arts, Peer; van Uden, Ingeborg W M; Hoischen, Alexander; van de Veerdonk, Frank L; Netea, Mihai G; de Jong, Brigit A

    2016-03-01

    Progressive multifocal leukoencephalopathy (PML), a demyelinating disease of the brain, is typically diagnosed in immunocompromised persons. Here, we describe the diagnostic challenge of PML in an apparently immunocompetent patient. Thorough analyses, including cytokine release assays and whole exome sequencing, revealed a deficit in the antiviral interferon gamma production capacity of this patient and compound heterozygous mutations in BCL-2-associated athanogene 3. Interestingly, both factors are associated with reduced expression of John Cunningham virus T-antigen, a protein that plays a key role in viral replication in infected cells. After validation in other patients, our findings may contribute to novel insights into the etiology and possibly treatment of PML. PMID:27042682

  6. CT and MRI in progressive multifocal leukoencephalopathy

    International Nuclear Information System (INIS)

    Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients (1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia) were analysed retrospectively and correlated with clinical symptoms. A total of 21 CT and 16 MRI studies were evaluated. CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: 6 lesions with a diameter of 1 cm and below were not detected on CT scans, in 5 patients the extent of lesions was underestimated. Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 65 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: 1. Initial precentral demyelinisation with contralateral hemiparesis (n=8); 2. lesions in temporo-occipital locations with visual disturbances (n=2); 3. predominantly bilateral lesions of cerebellar white matter with ataxia (n=4). (orig.)

  7. Integrative agnosia following progressive multifocal leukoencephalopathy.

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    Butter, C M; Trobe, J D

    1994-03-01

    A 43 year-old man with presumed progressive multifocal leukoencephalopathy developed difficulty recognizing objects and faces in the presence of adequate visual acuity and visual fields. His copying and matching of line drawings was intact, suggesting that his agnosia was associative. However, he had difficulty perceiving overlapping forms and drawings of single objects as integrated wholes. Unlike control subjects, he made fewer errors identifying silhouettes compared to line drawings with internal details. These alterations, together with his feature-by-feature descriptions of objects and copying, suggest that his agnosia was due to a disturbance in integrating local form features, as described by Riddoch and Humphreys (1987). This interpretation is supported by the findings that his tactile recognition and semantic and structural knowledge of the objects he could not identify visually were intact. Furthermore, his deficient performance in categorical matching of photographs to objects was dependent upon the perceptual complexity of the photographs. Similar deficits in early form processing described by other investigators are discussed. PMID:8004984

  8. 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.

  9. Is There a (Host Genetic Predisposition to Progressive Multifocal Leukoencephalopathy?

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    Eli eHatchwell

    2015-05-01

    Full Text Available Progressive Multifocal Leukoencephalopathy (PML has been described in association with a variety of predisposing risk factors, including HIV/AIDS, lymphoproliferative disorders and, most recently, treatment with a range of biologics, most notably natalizumab in Multiple Sclerosis (MS. However, while these underlying disorders appear to be (usually necessary, they are not sufficient to predict the development of PML, since only a fraction of such individuals will succumb, raising the question of whether host genetic factors must also play a role. Evidence is mounting that this is, indeed, the case but more work needs to be done to fully delineate these underlying genetic factors.

  10. 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.

  11. [Neuropathology of Natalizumab-Associated Progressive Multifocal Leukoencephalopathy].

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    Kanda, Takashi

    2015-07-01

    The pathological findings of natalizumab-associated progressive multifocal leukoencephalopathy (PML) are reviewed. In addition to the classical pathology of PML including the presence of enlarged abnormal astrocytes, intranuclear inclusions mainly found within large swollen oligodendrocytes and abundant myelin-laden macrophages/microglia, massive perivascular and parenchymal mononuclear cell infiltration was observed. The latter pathologic picture is that of immune reconstitution inflammatory syndrome (IRIS), and most of these infiltrating cells are CD8-positive T cells. Because IRIS inevitably occurs after the cessation of natalizumab therapy due to the development of PML and subsequent plasma exchange, most of the published pathologic pictures of natalizumab-associated PML patients were a mixture of PML and PML-IRIS. PML-IRIS is also characterized by fewer oligodendroglial viral inclusions and fewer cells that are immunoreactive against anti-JCV antibodies. These findings suggest the effective removal of JCV after the return of normal immune-surveillance in the central nervous system, but clinicians should be aware that JCV elimination is not complete under the IRIS condition, and the immunosuppressive therapy against IRIS should be carefully performed. Mononuclear cell infiltration in natalizumab-associated PML-IRIS patients was much more prominent than that in HIV-associated PML-IRIS patients, reflecting the retained, even enhanced, systemic immunities in patients treated by natalizumab. PMID:26160817

  12. Progressive multifocal leuko-encephalopathy studied by magnetization transfer imaging

    International Nuclear Information System (INIS)

    Purpose: magnetization transfer imaging (MT) has bees used to study the degree of demyelination in progressive multifocal leuko-encephalopathy (PML). Material and method: two groups were studied: a group of 10 HIV + patients with clinical, MR features, biological and/or biopsy proven PLM, and a group of 11 normal volunteers with matched age. MT ratio (MTR) were obtained from the center of the PLM lesions and 11 areas of normal appearing white matter (NAWM) in the control group. Results: the mean MTR of NAWM in the control group was 46.6% (SD = 2,3). PLM lesions demonstrated a strong and significant (p = 0) decreased of the MTR with mean MTR value of 22.4% (SD = 2,3). Conclusion: MT characterized the demyelinating process in PLM, and can be to used to improve diagnosis. Furthermore, MT allowed a quantification of the degree of the demyelination which can be helpful in other demyelinating process of CNS such multiple sclerosis. (authors)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Possible pitfalls in the diagnostic of progressive multifocal leukoencephalopathy.

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    Zivanovic, Milanka; Savšek, Lina; Poljak, Mario; Popovic, Mara

    2016-01-01

    The most accurate diagnosis of clinically suspected progressive multifocal leukoencephalopathy (PML) is made by neuronavigated needle brain biopsy and microscopic examination of the specimen confirming typical morphological features of the disease and, additionally, using immunohistochemistry (IHC) for detection of early viral proteins of the etiologic agent - polyoma virus JC (JCV). Due to the small biopsy volume, this approach can sometimes fail to confirm the clinical diagnosis of PML, as demonstrated by the presented clinical case. To check the reliability of using only IHC, we additionally tested 6 archival cases from our institute using IHC, in-situ hybridization (ISH) and real-time polymerase chain reaction (PCR). In the presented case, both biopsy and autopsy material were tested, in three archival cases only biopsy material and in the remaining cases post-mortem brain tissue was available. IHC (Anti-SV40 T antigen, mAb Pab416) was negative in 3 samples, in another 3 fewer than 10 cells per one ×20 microscopic field were positive. In our study, ISH proved to be a more sensitive method for JCV detection than IHC, being positive in all cases. Out of 7 tested specimens, realtime PCR failed to confirm the presence of JCV in 1 specimen, which was the oldest brain autopsy of an AIDS patient. Our study demonstrated that, especially when confronted with borderline clinical suspicion of PML and when only a small biopsy specimen is available, a combination of at least two different methods for JCV detection should be considered, preferably IHC with one of the available molecular methods. PMID:26754416

  15. Multifocal Motor Neuropathy

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    ... Enhancing Diversity Find People About NINDS NINDS Multifocal Motor Neuropathy Information Page Table of Contents (click to ... being done? Clinical Trials Organizations What is Multifocal Motor Neuropathy? Multifocal motor neuropathy is a progressive muscle ...

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

    NARCIS (Netherlands)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S; Macchiarulo, C; Straus, S M; Hidalgo-Simon, A; De Bruin, M L

    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 safe

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    DEFF Research Database (Denmark)

    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....

  20. 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.

  1. 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.

  2. Efficacy of Recombinant Human Interleukin 7 in a Patient With Severe Lymphopenia-Related Progressive Multifocal Leukoencephalopathy

    OpenAIRE

    Gasnault, Jacques; de Goër de Herve, Marie-Ghislaine; Michot, Jean-Marie; Hendel-Chavez, Houria; Seta, Vannina; Mazet, Anne-Aurélie; Croughs, Thérèse; Stankoff, Bruno; Bourhis, Jean-Henri; Lambotte, Olivier; Delfraissy, Jean-François; Taoufik, Yassine

    2014-01-01

    In this study, we report the case of a patient with profound lymphopenia after allogenic bone marrow transplantation who developed severe progressive multifocal leukoencephalopathy. Single-agent recombinant human interleukin-7 therapy was associated with restoration of anti-John Cunningham polyomavirus (JCV) T-cell responses, JCV clearance from cerebrospinal fluid, and a dramatic clinical improvement.

  3. Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

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    Ellison AC

    2014-05-01

    Full Text Available Ashton C Ellison, A John Campbell, M Clare Robertson, Gordon F SandersonDunedin School of Medicine, Department of Medicine, Dunedin, New ZealandBackground: Multifocal glasses (bifocals, trifocals, and progressives increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1 map the prismatic displacement of a progressive lens, and 2 test whether this displacement impaired reaction time and accuracy.Methods: The reaction times of healthy ≥75-year-olds (31 participants were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter.Results: Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis] and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007. There was no difference in accuracy between the two types of glasses.Conclusion: Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.Keywords: fall prevention, false projection, stored visual spatial information

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

    OpenAIRE

    Mónica Rodríguez; Fernando Antonio Silva-Sánchez; César Luna-Rivero; Ricardo Vega-Barrientos; Claudia Alvarado-de la Barrera; Gustavo Reyes-Terán

    2014-01-01

    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-asso...

  5. Immune reconstitution inflammatory syndrome in a patient with progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Shahani, Lokesh; Shah, Minal; Tavakoli-Tabasi, Shahriar

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) is a severe opportunistic infection of the central nervous system. A 52-year-old man with HIV infection, recently started on antiretroviral therapy, presented with symptoms of mental cloudiness, blurry vision and ataxia. MRI of the brain showed nodular perivascular space enhancement with surrounding vasogenic oedema and midline shift. A lumbar puncture revealed non-inflammatory cerebrospinal fluid and was positive for JC virus. As the patient developed worsening symptoms in the setting of initiation of antiretroviral therapy with immune recovery, a diagnosis of JC virus-associated immune reconstitution inflammatory syndrome (IRIS) was made. With recent literature on the use of CCR5 antagonist maraviroc in PML, our patient was started on maraviroc and noted to have improvement in PML IRIS. This is the first case of an HIV-positive patient successfully treated for PML IRIS with maraviroc, as verified by our literature review; also, our case has clinical implications in improving outcome in PML IRIS. PMID:26063110

  6. Predictors and characteristics of seizures in survivors of progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Miskin, Dhanashri P; Herman, Susan T; Ngo, Long H; Koralnik, Igor J

    2016-08-01

    This study aims to determine the risk factors for epileptogenesis and characteristics of seizures in patients with progressive multifocal leukoencephalopathy (PML) who survive more than 1 year from onset of neurological symptoms (PML survivors). We reviewed clinical data including seizure history and MR imaging studies from PML survivors evaluated at our institution between 1997 and 2014. PML progressors who passed away within 1 year and patients with a history of seizures prior to PML diagnosis were excluded from the analysis. Of 64 PML survivors, 28 (44 %) developed seizures. The median time from the onset of PML symptoms to the first seizure was 5.4 months (range 0-159) and 64 % of patients with seizures had them within the first year. The presence of juxtacortical PML lesions was associated with a relative risk of seizures of 3.5 (p < 0.02; 95 % confidence interval (CI) 1.3-9.4) in multivariate analyses. Of all seizure types, 86 % were focal and 60 % most likely originated from the frontal lobes. Among seizure patients, 89 % required treatment, including one (54 %), two (25 %), or three (10.5 %) antiepileptic drugs. Seizures are a frequent complication in PML and can develop throughout the entire course of the disease. However, late onset seizures did not signify PML relapse. Seizures may require treatment with multiple antiepileptic medications and are a significant co-morbidity in PML. PMID:26676826

  7. Immune reconstitution is not a prognostic factor in progressive multifocal leukoencephalopathy☆,☆☆

    Science.gov (United States)

    Harrison, Daniel M.; Newsome, Scott D.; Skolasky, Richard L.; McArthur, Justin C.; Nath, Avindra

    2016-01-01

    Progressive multifocal leukoencephalopathy (PML) is typically associated with minimal inflammation; however, patients may develop an inflammatory response due to immune reconstitution (IRIS). The authors aimed to determine if characteristics and outcomes of PML are altered in those with IRIS. A retrospective records review was performed on 87 patients diagnosed with PML at Johns Hopkins, 27 of which had a syndrome consistent with IRIS. Gadolinium enhancement on MRI occurred in 44.4% of cases of PML-IRIS versus 5.1% in PML (p<0.05), and thus had low diagnostic sensitivity and specificity. In HIV+ cases, CD4 counts were lower in those who later developed IRIS (mean 34.8 vs. 71.7, p<0.05) and was predictive of the development of IRIS (p<0.05). Improved prognosis was seen with higher cerebrospinal fluid (CSF) white blood cell counts and protein levels, but not for gadolinium enhancement and there were no differences in survival for PML versus PML-IRIS. PMID:21840066

  8. 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.

  9. 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

  10. 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.

  11. A Rare Case of Immune Reconstitution Inflammatory Syndrome (IRIS) Development in an Immunocompromised Patient with Progressive Multifocal Leukoencephalopathy and Multicentric Castleman’s Disease

    OpenAIRE

    Mohankumar Kurukumbi; Sheldon Steiner; Shariff Dunlap; Sherita Chapman; Noha Solieman; Annapurni Jayam-Trouth

    2013-01-01

    Immune reconstitution inflammatory syndrome (IRIS) development in HIV with preexistent progressive multifocal leukoencephalopathy (PML) has been extensively studied. PML-IRIS typically manifests clinically as new or worsening neurologic symptoms in conjunction with enlarging CNS lesions and occurs in approximately 10–20 percent of HIV-infected patients with PML who begin HAART. Likewise, Multicentric Castleman’s Disease (MCD), a rare malignant lymphoproliferative disorder, has a strong and we...

  12. Progressive Multifocal Leucoencephalopathy Isolated to Posterior Fossa in a Patient with AIDS: DWI and 1H-MRS Features

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Sa; Yu, In Kyu; Lee, Byung Hee [Eulji University Hospital, College of Medicine, Daejeon (Korea, Republic of)

    2010-11-15

    We report a case of progressive multifocal leukoencephalopathy (PML) isolated to the posterior fossa in a 55-year-old male with acquired immune deficiency syndrome (AIDS). Initial MR images revealed a few foci of patchy increased signal intensity (SI) on a T2-weighted image and a diffusion weighted image (DWI) at the pons, right middle cerebellar peduncle, and right cerebellar hemisphere, with no enhancement. After anti-retroviral therapy, follow-up MR images revealed the more prominent extent of previously-seen lesions and newly discovered newly developed focal increased SI on T2-weighted images located left of the inferior cerebellar hemisphere. Proton MR spectroscopy (1H-MRS) showed a slightly increased choline peak (3.2 ppm) and lactate peak (1.35 ppm), as well as a decreased N-acetylaspartate (NAA) peak (2.0 ppm), which suggests active demyelinating disease. DWI and 1H-MRS may support the diagnosis of PML in patients with AIDS

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Research progress of HIV/AIDS related lymphoma%HIV/AIDS 相关淋巴瘤研究进展

    Institute of Scientific and Technical Information of China (English)

    王迪; 冯艳玲

    2015-01-01

    HIV /AIDS related lymphoma (ARL)are a group of heterogeneity of neoplasms,and they have poor prognosis.The factors of pathogenesis elucidated in recent years include immune injury caused by HIV,EB virus infection and genetic changes.There are four pathological types of ARL,including diffuse large B cell lymphoma,Burkitt lymphoma,plasmablastic lymphoma and primary effusion lymphoma.Morphological characteristics,immunophenotype markers and clinical data should be combined to make diagnosis and differen-tial diagnosis,which will facilitate timely treatment and improve prognosis.%人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)相关淋巴瘤(ARL)是一组异质性肿瘤,预后较差。近年来阐明的发病机制包括 HIV 引起的免疫损伤、EB 病毒的感染及基因的改变。ARL 的病理类型主要有4种,即弥漫大 B 细胞淋巴瘤、Burkitt 淋巴瘤、原发渗出性淋巴瘤和浆母细胞淋巴瘤。形态学特征、免疫标记和遗传学特点的联合应用有助于诊断和鉴别诊断,从而有利于及时治疗和改善预后。

  15. Broadly neutralizing human monoclonal JC polyomavirus VP1-specific antibodies as candidate therapeutics for progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Jelcic, Ivan; Combaluzier, Benoit; Jelcic, Ilijas; Faigle, Wolfgang; Senn, Luzia; Reinhart, Brenda J; Ströh, Luisa; Nitsch, Roger M; Stehle, Thilo; Sospedra, Mireia; Grimm, Jan; Martin, Roland

    2015-09-23

    In immunocompromised individuals, JC polyomavirus (JCPyV) may mutate and gain access to the central nervous system resulting in progressive multifocal leukoencephalopathy (PML), an often fatal opportunistic infection for which no treatments are currently available. Despite recent progress, the contribution of JCPyV-specific humoral immunity to controlling asymptomatic infection throughout life and to eliminating JCPyV from the brain is poorly understood. We examined antibody responses against JCPyV major capsid protein VP1 (viral protein 1) variants in the serum and cerebrospinal fluid (CSF) of healthy donors (HDs), JCPyV-positive multiple sclerosis patients treated with the anti-VLA-4 monoclonal antibody natalizumab (NAT), and patients with NAT-associated PML. Before and during PML, CSF antibody responses against JCPyV VP1 variants show "recognition holes"; however, upon immune reconstitution, CSF antibody titers rise, then recognize PML-associated JCPyV VP1 variants, and may be involved in elimination of the virus. We therefore reasoned that the memory B cell repertoire of individuals who recovered from PML could be a source for the molecular cloning of broadly neutralizing antibodies for passive immunization. We generated a series of memory B cell-derived JCPyV VP1-specific human monoclonal antibodies from HDs and a patient with NAT-associated PML-immune reconstitution inflammatory syndrome (IRIS). These antibodies exhibited diverse binding affinity, cross-reactivity with the closely related BK polyomavirus, recognition of PML-causing VP1 variants, and JCPyV neutralization. Almost all antibodies with exquisite specificity for JCPyV, neutralizing activity, recognition of all tested JCPyV PML variants, and high affinity were derived from one patient who had recovered from PML. These antibodies are promising drug candidates for the development of a treatment of PML. PMID:26400911

  16. 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.

  17. 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. PMID:24929753

  18. Multifocal motor neuropathy

    OpenAIRE

    Thy P Nguyen; Vinay Chaudhry

    2011-01-01

    Multifocal motor neuropathy (MMN) is a unique disorder characterized by slowly progressive, asymmetric, distal and upper limb predominant weakness without significant sensory abnormalities. Electrophysiology is crucial to the diagnosis, revealing the hallmark partial conduction block. MMN is considered immune mediated due to the association with anti-GM1 antibodies and the response to immunomodulatory treatment. It is paramount to recognize MMN from other motor neuronopathies or peripheral ne...

  19. 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

    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...... conversion of immunosuppressive therapy owing to biopsy-proven acute humoral rejection, our patient presented with symptoms of deteriorating neurologic status. Cerebral computed tomography showed abnormal signals in the frontal lobe suspect for PML. Diagnosis was confirmed by qualitative polymerase chain...... progressive neurologic decline and death rapidly ensued. CONCLUSION: Development of PML in transplant recipients remains rare. Despite advances in our understanding of JCV infection and PML, treatment options remain limited and prognosis is often poor....

  20. Progressive Multifocal Leukoencephalopathy in HIV-Infected Children: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Peninnah Oberdorfer

    2009-01-01

    Full Text Available We report a case of a perinatally HIV-infected patient aged 9 years, who presented with right-sided hemiplegia. His initial CD4 T-cell was of 0.21% (4 cells/μL and plasma HIV RNA virus of 185 976 copies/mL (log 5.27. Plasma and CSF samples were subsequently positive for JCV. Twelve days after the initiation of highly active antiretroviral therapy (HAART, the MRI showed progressive white matter lesions with asymmetrical deep and subcortical white matter lesions over the left frontotemporoparietal region and the right frontal lobe. Immune Reconstitution Inflammatory Syndrome (IRIS was suspected, and the patient was treated with methylprednisolone. His clinical symptoms worsened and despite therapy the patient deteriorated.

  1. Adaptive mutations in the JC virus protein capsid are associated with progressive multifocal leukoencephalopathy (PML.

    Directory of Open Access Journals (Sweden)

    Shamil R Sunyaev

    2009-02-01

    Full Text Available PML is a progressive and mostly fatal demyelinating disease caused by JC virus infection and destruction of infected oligodendrocytes in multiple brain foci of susceptible individuals. While JC virus is highly prevalent in the human population, PML is a rare disease that exclusively afflicts only a small percentage of immunocompromised individuals including those affected by HIV (AIDS or immunosuppressive drugs. Viral- and/or host-specific factors, and not simply immune status, must be at play to account for the very large discrepancy between viral prevalence and low disease incidence. Here, we show that several amino acids on the surface of the JC virus capsid protein VP1 display accelerated evolution in viral sequences isolated from PML patients but not in sequences isolated from healthy subjects. We provide strong evidence that at least some of these mutations are involved in binding of sialic acid, a known receptor for the JC virus. Using statistical methods of molecular evolution, we performed a comprehensive analysis of JC virus VP1 sequences isolated from 55 PML patients and 253 sequences isolated from the urine of healthy individuals and found that a subset of amino acids found exclusively among PML VP1 sequences is acquired via adaptive evolution. By modeling of the 3-D structure of the JC virus capsid, we showed that these residues are located within the sialic acid binding site, a JC virus receptor for cell infection. Finally, we go on to demonstrate the involvement of some of these sites in receptor binding by demonstrating a profound reduction in hemagglutination properties of viral-like particles made of the VP1 protein carrying these mutations. Collectively, these results suggest that a more virulent PML causing phenotype of JC virus is acquired via adaptive evolution that changes viral specificity for its cellular receptor(s.

  2. Progressive multifocal leuko-encephalopathy studied by magnetization transfer imaging; Leucoencephalopathie multifocale progressive. Etude de la demyelinisation par transfert de magnetisation

    Energy Technology Data Exchange (ETDEWEB)

    Armand, J.P.; Dousset, V.; Mieze, S.; Caille, J.M. [Hopital Pellegrin, 33 - Bordeaux (France); Franconi, J.M. [Siemens SA, 92 - Saint-Denis (France). Service Instrumentation Scientifique; Lacoste, D. [Gecsa, Groupe d`Epidemiologie Clinique du Sida en Aquitaine, CHU, 33 - Bordeaux (France); Letenneur, L. [Bordeaux-2 Univ., 33 (France)

    1997-09-01

    Purpose: magnetization transfer imaging (MT) has bees used to study the degree of demyelination in progressive multifocal leuko-encephalopathy (PML). Material and method: two groups were studied: a group of 10 HIV + patients with clinical, MR features, biological and/or biopsy proven PLM, and a group of 11 normal volunteers with matched age. MT ratio (MTR) were obtained from the center of the PLM lesions and 11 areas of normal appearing white matter (NAWM) in the control group. Results: the mean MTR of NAWM in the control group was 46.6% (SD = 2,3). PLM lesions demonstrated a strong and significant (p = 0) decreased of the MTR with mean MTR value of 22.4% (SD = 2,3). Conclusion: MT characterized the demyelinating process in PLM, and can be to used to improve diagnosis. Furthermore, MT allowed a quantification of the degree of the demyelination which can be helpful in other demyelinating process of CNS such multiple sclerosis. (authors). 11 refs.

  3. Solitary Extramedullary Plasmacytoma of the Maxillary Sinus, Progressing to Smoldering Multiple Myeloma with Multifocal Skeletal Involvement, which Resolved Completely Following Chemotherapy Alone.

    Science.gov (United States)

    Jeyaraj, Priya; Venkatesan, Manu; Nijhawan, V S

    2016-07-01

    Plasmacytoma is an uncommon malignant tumor originating either from plasma cells located in the bone marrow also known as the solitary bone plasmacytoma, or from plasma cells located outside the bone, for e.g. in mucosal surfaces, referred to as the extramedullary plasmacytoma also called the solitary extramedullary plasmacytoma. Both, solitary as well as extramedullary bone plasmacytomas may, particularly in later stages, be accompanied by other osteolytic bone lesions (multifocal bone involvement) and features such as anemia, hypercalcemia, or renal impairment attributable to and indicative of progression to multiple myeloma. These three distinct disorders together comprise the plasma cell neoplasms and essentially represent a continuum of related disease processes. Extramedullary and solitary bone plasmacytomas of the head and neck region are extremely uncommon, and amongst them plasmacytoma of the maxilla is extremely rare. Such a case is being reported here for its rarity. Also, it was associated with multifocal skeletal involvement, making a correct categorization difficult as well as imperative in order to institute the correct treatment. Radiotherapy is considered to be the treatment of choice of plasmacytoma, with adjuvant chemotherapy for multi focal involvement. Surgery is usually limited to biopsy and excision of any residual disease following radiotherapy. The case presented responded extremely well to chemotherapy alone, with a complete resolution of the maxillary tumor, obviating the need for radiotherapy. PMID:27408443

  4. 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.

  5. Primary multifocal osseous Hodgkin's lymphoma

    OpenAIRE

    Kohler Janice; Urand Jill; Garrett Simon JW; Langley Clare R; Clarke Nick MP

    2008-01-01

    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 h...

  6. 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. PMID:27594961

  7. Progressive multifocal leukoencephalopathy associated with brentuximab vedotin therapy: A report of 5 cases from the Southern Network on Adverse Reactions (SONAR) project

    Science.gov (United States)

    Carson, Kenneth R.; Newsome, Scott D.; Kim, Ellen J.; Wagner-Johnston, Nina D.; von Geldern, Gloria; Moskowitz, Craig H.; Moskowitz, Alison J.; Rook, Alain H.; Jalan, Pankaj; Loren, Alison W.; Landsburg, Daniel; Coyne, Thomas; Tsai, Donald; Raisch, Dennis W.; Norris, LeAnn B.; Bookstaver, P Brandon; Sartor, Oliver; Bennett, Charles L.

    2015-01-01

    Purpose Brentuxiumab vedotin (BV) is an anti-CD30 monoclonal antibody-drug conjugate approved in 2011 for treating anaplastic large cell and Hodgkin lymphomas. The product label indicates that three BV-treated patients developed progressive multifocal leukoencephalopathy (PML), a frequently fatal JC-virus induced central nervous system infection. Prior immunosuppressive therapy and compromised immune systems were postulated risk factors. We report 5 patients who developed BV-associated PML, including two immunocompetent patients. Patients Case information was obtained from clinicians (four patients) or a Food and Drug Administration database (one patient). Results All five patients had lymphoid malignancies. Two patients with cutaneous T-cell lymphomas had not previously received chemotherapy. PML developed after a median of three BV doses (range, 2 to 6) and within a median of 7 weeks following BV initiation (range, 3 to 34 weeks). Presenting findings included aphasia, dysarthria, confusion, hemiparesis, and gait dysfunction; JC virus in cerebrospinal fluid (two patients), or CNS biopsy (three patients); and brain MRI scans with white matter abnormalities (five patients). Four patients died a median of 8 weeks (range, 6 to 16 weeks) after PML diagnosis. The sole survivor developed immune reconstitution inflammatory syndrome. Conclusion PML can develop after a few BV doses and within weeks of BV initiation. Clinicians should be aware of this syndrome, particularly when neurologic changes develop following BV initiation. The decision to administer BV to patients with indolent cutaneous lymphomas should be based on consideration of risk-benefit profiles and of alternative options. PMID:24771533

  8. Identical rearranged forms of JC polyomavirus transcriptional control region in plasma and cerebrospinal fluid of acquired immunodeficiency syndrome patients with progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Fedele, Cesare Giovanni; Ciardi, Maria Rosa; Delia, Salvatore; Contreras, Gerardo; Perez, José Luis; De Oña, Maria; Vidal, Elisa; Tenorio, Antonio

    2003-10-01

    Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system (CNS) caused by the human polyomavirus JC (JCV). JCV has a hypervariable noncoding transcriptional control region (TCR) that spans the origin of replication of the JCV genome through to the first ATG start codon for late gene transcription. The archetype form of TCR is frequently found in the urine and kidneys of healthy and immunocompromised subjects. However the rearranged forms, whose prototype is Mad-1, possibly generated by deletion and duplication of segments of the archetype sequence, are found in the brain and cerebrospinal fluid (CSF) of PML patients. In this study the authors compared JCV TCR detected in paired CSF, plasma, and urine samples of 11 acquired immunodeficiency syndrome (AIDS) patients affected by PML to try to determine where the rearranged JCV TCRs are selected. In one patient, it was also possible to amplify and sequence the TCR in the brain and lymphocytes. Moreover, in 5/11 patients, the CSF, plasma, and urine samples corresponding to 2 months after PML development were available; and in another patient, it was possible to sequence the TCR in plasma and lymphocytes sampled 8 months before the onset of PML. The presence of the same TCR sequences in all the CSF and plasma samples taken from individual patients could strengthen the hypothesis that the blood is a compartment where JCV may replicate and undergo rearrangement of the TCR. This further supports the hypothesis that JCV reaches the brain by a hematogenous route and indicates that the JCV TCR sequences detected in plasma could be used as an early marker of JCV pathogenicity before the clinical appearance of PML in immunocompromised patients. PMID:13129769

  9. 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...

  10. Radiological characteristics of AIDS- related lymphoma

    International Nuclear Information System (INIS)

    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)

  11. Primary multifocal leptomeningeal gliomatosis

    International Nuclear Information System (INIS)

    A 23-year-old female university student was presented with recent onset of non-specific headache and dizziness. She had no neurological deficit on neurological examination and magnetic resonance imaging of the brain revealed diffuse enhancement in the basal cisterns and cerebral sulci. She was treated as tuberculous meningitis but she did not improve and developed respiratory arrest. Autopsy showed primary multifocal leptomeningeal gliomatosis

  12. Primary multifocal leptomeningeal gliomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Yik Kong Tsui, Edmund; Tai Loo, Ka; Keung Mok, Chun; Keung Yuen, Ming; Keung Cheung, Yu E-mail: hykcheung@hotmail.com

    2001-01-01

    A 23-year-old female university student was presented with recent onset of non-specific headache and dizziness. She had no neurological deficit on neurological examination and magnetic resonance imaging of the brain revealed diffuse enhancement in the basal cisterns and cerebral sulci. She was treated as tuberculous meningitis but she did not improve and developed respiratory arrest. Autopsy showed primary multifocal leptomeningeal gliomatosis.

  13. Multifocal recurrent periostitis

    International Nuclear Information System (INIS)

    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. (orig.)

  14. 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.

  15. Report of AIDS-related lymphoma in South Korea

    International Nuclear Information System (INIS)

    The prevalence of acquired immunodeficiency syndrome (AIDS)-related lymphoma (ARL) is increasing in South Korea. The aim of this study is to identify the clinical features of ARL in South Korea. From 1998 through 2006, we retrospectively analysed a total of 23 cases of ARL from seven institutions. The patients consisted of 20 males and 3 females at a median age of 40 (range, 20-72) on diagnosis of AIDS. ARL developed at their median age of 41 (range, 24-72). The histological diagnosis was aggressive B cell lymphoma in the majority, but rare T cell and NK/T cell lymphoma were also included. Ten of 23 (43.5%) was receiving highly active anti-retroviral therapy (HAART) before the diagnosis of ARL. Fifteen of twenty-three patients were given combination chemotherapy with/without radiation, four were given radiation alone, and four did not receive any treatment against medical advice. Of 20 patients followed-up, nine were alive in remission, two alive in disease, one died of treatment related complication, four died of progressive lymphoma, four died of AIDS related causes. The response to treatment included complete response (CR) in eight (44.4%), partial response (PR) in four (22.2%) and progressive disease (PD) in three (16.7%). The response to HARRT was evaluable in 13 patients based on CD4+ cell count and human immnodeficiency virus (HIV) viral load, among which nine (69.2%) responded. Estimated median survival time was 43.9 months. Although the population of patients is small, this is the first clinical data analyses of Korean ARL patients. As a substantial portion of the patients remains alive disease free, the impact of HAART on the clinical course of ARL needs further follow-up and evaluation. (author)

  16. Progressive multifocal leukoencephalopathy with bilateral middle cerebellar peduncle lesions confirmed by repeated CSF-JC virus tests and coexistence of JC virus granule cell neuronopathy. Report of a case.

    Science.gov (United States)

    Ito, Daisuke; Yasui, Keizo; Hasegawa, Yasuhiro; Nakamichi, Kazuo; Katsuno, Masahisa; Takahashi, Akira

    2016-07-28

    A 65 year-old woman with small lymphocytic leukemia presented with subacute cerebellar ataxia. Six months after rituximab chemotherapy, a cranial MRI revealed lesions in the bilateral middle cerebellar peduncles. Both cerebrospinal fluid (CSF) JC virus (JCV)-DNA PCR test on three occasions and brain biopsy were negative. CSF tests were repeated. The fourth test performed 6 months after the onset showed positive JCV-DNA, and a definite diagnosis of progressive multifocal leukoencephalopathy (PML) was made. Neuroimaging of cerebellar atrophy was considered to be coexistence of granule cell neuronopathy. Medication with mirtazapine and mefloquine was temporarily effective for several months. Little are known solitary bilateral MRI lesions of the middle cerebellar peduncle in PML. JCV-PCR test of CSF may be negative at an earlier stage of PML. Repeated CSF tests should be essential to confirming the diagnosis in such cases. PMID:27356732

  17. AIDS-related lymphomas in Nigeria

    Directory of Open Access Journals (Sweden)

    R.A. Bolarinwa

    2009-10-01

    weeks of admission into the hospital. The prevalence of AIDS-related lymphomas is 2.3% compared to 4.4% found in the general population. However, it is interesting that no single case of AIDS-associated BL was seen, despite the fact that Burkitt's lymphoma is endemic in this part of the world. All the patients presented at a very advanced stage of the disease with significantly shortened survival.

  18. Multifocal interferometric synthetic aperture microscopy.

    Science.gov (United States)

    Xu, Yang; Chng, Xiong Kai Benjamin; Adie, Steven G; Boppart, Stephen A; Carney, P Scott

    2014-06-30

    There is an inherent trade-off between transverse resolution and depth of field (DOF) in optical coherence tomography (OCT) which becomes a limiting factor for certain applications. Multifocal OCT and interferometric synthetic aperture microscopy (ISAM) each provide a distinct solution to the trade-off through modification to the experiment or via post-processing, respectively. In this paper, we have solved the inverse problem of multifocal OCT and present a general algorithm for combining multiple ISAM datasets. Multifocal ISAM (MISAM) uses a regularized combination of the resampled datasets to bring advantages of both multifocal OCT and ISAM to achieve optimal transverse resolution, extended effective DOF and improved signal-to-noise ratio. We present theory, simulation and experimental results. PMID:24977909

  19. Multifocal interferometric synthetic aperture microscopy

    OpenAIRE

    Xu, Yang; Chng, Xiong Kai Benjamin; Adie, Steven G.; Boppart, Stephen A.; Scott Carney, P.

    2014-01-01

    There is an inherent trade-off between transverse resolution and depth of field (DOF) in optical coherence tomography (OCT) which becomes a limiting factor for certain applications. Multifocal OCT and interferometric synthetic aperture microscopy (ISAM) each provide a distinct solution to the trade-off through modification to the experiment or via post-processing, respectively. In this paper, we have solved the inverse problem of multifocal OCT and present a general algorithm for combining mu...

  20. Tratamiento conjunto con mirtazapina y terapia antiretroviral para la leucoencefalopatía multifocal progresiva asociada a infección por VIH-1: presentación de un caso clínico y revisión de la literatura Mirtazapine and antiretroviral therapy in the treatment of progressive multifocal leukoencephalopathy associated with HIV-1 infection: report of a case and review of literature

    Directory of Open Access Journals (Sweden)

    Martín Lasso

    2012-04-01

    Full Text Available Se presenta el caso cl��nico de un paciente de sexo masculino, de 43 años portador de VIH que desarrolló un grave daño neurológico subagudo debido a una leucoencefalopatía multifocal progresiva diagnosticada mediante reacción de polimerasa en cadena de virus JC. El paciente fue tratado con terapia anti-retroviral de penetración eficiente al SNC y con mirtazapina, un antidepresivo inhibidor de los receptores de serotonina. Su evolución durante un año de seguimiento ha sido favorable tanto del punto de vista clínico como de imágenes.We report a 43 years old HIV-1 infected male who developed a severe subacute neurological damage because of a progressive multifocal leukoencephalopathy confirmed by PCR for JC virus. The patient was treated with antiretroviral therapy in adequate doses for CNS penetration and mirtazapine, an antidepressant inhibitor of serotonin receptors. His evolution during one year follow up has been favorable in both, clinically and images.

  1. Multifocal Tubercular Osteomyelitis: A Case with Atypical Manifestations

    Directory of Open Access Journals (Sweden)

    Mukesh Thawani

    2011-01-01

    Full Text Available Skeletal tuberculosis (TB accounts for about 1–2% of all TB cases and 10% of extrapulmonary TB cases. We present a 19-year-old male with multifocal tubercular osteomyelitis, who presented with progressively worsening back pain, weight loss, fatigue, anorexia, decreased mobility, low-grade fever, and night sweats—but without pulmonary involvement.

  2. 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...

  3. AIDS related thoracic lymphoma: evaluation by computed tomography

    International Nuclear Information System (INIS)

    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)

  4. Radiological and histological findings characteristic of AIDS related Burkitt lymphoma

    Directory of Open Access Journals (Sweden)

    Yixian Luo

    2015-06-01

    Conclusion: AIDS-related Burkitt lymphoma is radiologically shown as lymphadenopathy and multi-organ involvement. Diffuse tumor cells with moderate sizes exist in intra- and extra-nodal tissues, characterized by stars-in-the-sky sign. Immunohistochemically, both CD10 and CD20 are positive, and the positive rate of Ki67 is almost up to 100%.

  5. 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.

  6. Drug-induced progressive multifocal leukoencephalopathy

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... to such comparisons. Lumping uncharacterized PML reports together without taking these differences into account may result in biased comparisons and flawed conclusions about differential safety....

  7. Multifocal skeletal tuberculosis: A case report

    OpenAIRE

    Zhang, Liang; Wang, Jingcheng; Feng, Xinmin; Tao, Yuping; Yang, Jiandong; ZHANG, SHENFEI; Cai, Jun

    2016-01-01

    Tuberculosis (TB) of the musculoskeletal system is a rare clinical condition. Multifocal bone involvement is extremely rare and difficult to recognize. Thus, due to the diverse and atypical clinical manifestations of multifocal skeletal TB, the disease is easy to misdiagnose. In the present study, a rare case of atypical disseminated multifocal skeletal TB was reported, which exhibited uncommon findings in radiological images that were more suggestive of a hematological malignancy or metastat...

  8. 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.)

  9. Primary multifocal osseous lymphoma in a child

    International Nuclear Information System (INIS)

    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.)

  10. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?

    International Nuclear Information System (INIS)

    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)

  11. 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.

  12. Chronic recurrent multifocal osteomyelitis (CRMO)

    International Nuclear Information System (INIS)

    Chronic recurrent multifocal osteomyelitis (CRMO) is an unusual clinical entity. More than 200 cases are described in the literature and it is presented here with special reference to its radiological aspects. It is an acquired disease of the skeleton which occurs predominantly during childhood and adolescence. About ten per cent of cases begin in early or, rarely, in later adult life. This variant is described here for the first time and is discussed as 'adult CRMO'. The underlying pathology is a bland, predominantly lympho-plasma cellular osteomyelitis which is self-limiting and leads to bone sclerosis (Garre). It probably involves an abnormal immune process which follows an infection but remains clinically latent and remains aseptic and sterile. In a quarter of cases there is an association with pustulosis palmo-plantaris and its relationship with psoriatic arthropathy is discussed. The clinical, histopathological and imaging features (radiological and particularly MRT) and the bone changes are described. (orig./AJ)

  13. Multifocal skeletal tuberculosis: A case report

    Science.gov (United States)

    ZHANG, LIANG; WANG, JINGCHENG; FENG, XINMIN; TAO, YUPING; YANG, JIANDONG; ZHANG, SHENFEI; CAI, JUN

    2016-01-01

    Tuberculosis (TB) of the musculoskeletal system is a rare clinical condition. Multifocal bone involvement is extremely rare and difficult to recognize. Thus, due to the diverse and atypical clinical manifestations of multifocal skeletal TB, the disease is easy to misdiagnose. In the present study, a rare case of atypical disseminated multifocal skeletal TB was reported, which exhibited uncommon findings in radiological images that were more suggestive of a hematological malignancy or metastatic disease. In conclusion, the diagnosis of this condition by conventional diagnostic methods is challenging. The importance of CT-guided needle biopsy and open biopsy in the diagnosis of skeletal TB was emphasized. PMID:27073438

  14. Recurrent multifocal chronic osteitis in children

    International Nuclear Information System (INIS)

    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)

  15. AIDS-related apprehensions among nursing students of Delhi.

    Science.gov (United States)

    Kumar, A; Lal, P; Ingle, G K; Gulati, N

    1999-12-01

    Students from a nursing school of Delhi were surveyed anonymously using a self-administered questionnaire to explore various AIDS-related apprehensions and their possible reasons. The observations revealed that, majority of the students and their families/friends feared that these students were at risk of contracting HIV infection while providing routine patient care. A large number of students also opined that they would feel uncomfortable while talking, hugging, shaking hands, and sharing a room with an HIV positive person. The main reasons for their apprehensions were unsatisfactory anti-AIDS campaigning by the government, non-availability of sufficient protective measures in the health care settings, inadequate professional education related to prevention of HIV infection, and increase in HIV transmission following false sense of security due to excessive condom promotion. Findings of the study imply imparting factual knowledge addressing the concerns and removing misconceptions which influence attitudes and willingness of the nursing students to provide care to the HIV positives/AIDS patients, facts regarding efficacy of various preventive measures, and provision of counselling services in the event of exposure. PMID:10937297

  16. VISUAL OUTCOME IN MULTIFOCAL INTRA OCULAR LENS

    Directory of Open Access Journals (Sweden)

    Karunakar

    2015-10-01

    Full Text Available AIM : To study Visual outcome in multifocal intraocular lens. METHODS: This is a prospective randomized study conducted at Sarojini D e vi E ye H ospital from September 2012 to September 2014 consisting of total 50 patients with senile cataract requiring cataract surgery .These patients were divided randomly into 2 groups 25 patients in each group. In the first group 25 eyes of 25 patients underwent phacoemulsification with monofocal iol implantation and in the 2nd group 25 eyes of 25 patients underwent phacoemulsification with multifocal implantation. Age of the pa tients ranged from 50 to 70 years. RESULTS: Graph 1 shows 11(44% patients had a UCDVA >6/9 at 1 week post - op in monofocal group. 10(40% had UCDVA > 6/9 in multifocal group. Graph 2 shows 23(92% patients had a BCDVA >6/9 at 1 week post - op in monofocal gr oup. 24(96% had BCDVA >6/9 in multifocal group. Graph 3 shows 20(80% patients had a UCDVA >6/9 at 6 weeks post - op in monofocal group. 21(84% had UCDVA > 6/9 in multifocal group. Graph 4 shows 25(100% patients had a BCDVA >6/9 at 6 weeks post - op in mono focal group and in multifocal group. Graph 5 shows (20% patients had a UCNVA >N6 - N10 at 1 week post - op in monofocal group. 25(100% had UCNVA > N6 – N10 in multifocal group. Graph 6 shows in monofocal group 25(100% contrast sensitivity >20%, multifocal gro up had only 10(40% patients >20% contrast sensitivity. CONCLUSION: In our study there is no significant difference in uncorrected distant visual acuity after 1 and 6 weeks post operatively in both the groups. However there was significant difference in th e uncorrected near visual acuity. There was no difference in the corrected near visual acuity in both the groups.

  17. Multifocal skeletal tuberculosis in children.

    Science.gov (United States)

    Rahman, M A; Mutanabbi, M; Rahman, M H; Arefin, K E; Helal, M A

    2009-01-01

    Multifocal bone involvement is though rare but is reported from some countries where tuberculosis is endemic. Here we report a case of three years old boy was admitted in Bangabandhu Sheikh Mujib Medical University, Dhaka with the complaints of difficulty in walking ,low grade fever for six months, swelling over the back, elbow joint, knee joint and upper part of forearm and legs for two months. Family history of tuberculosis was positive. Mantoux test was 18 mm, ESR 85 mm in first hour, chest X-ray reveals right hilar lymphadenopathy, X-ray dorsolumber spine shows wedge shaped deformity in T11, L4 and with paravertebral collection from L2-L4. X-ray of legs, knee joint and forearms show multiple lytic lesions in shaft with periosteal reaction and cortical thickening. Ultrasonograph of whole abdomen shows psoas abscess. Culture of bone marrow aspirate reveals Mycobacterium tuberculosis. Patient was given an anti tubercular regimen with Rifampicin, Isoniazid, Pyrazinamide and Streptomycin for initial two months which to be followed by Rifampicin and Isoniazid for another 10 months. PMID:19182762

  18. Multifocal osteolysis following limb-sparing procedures: imaging findings and a review of the literature

    International Nuclear Information System (INIS)

    Limb-sparing procedures utilizing endoprostheses improve both the quality of life and functional level of patients treated for primary bone sarcomas. Herein, we present the imaging findings of an uncommon cause of prosthetic failure, i. e., foreign body reaction, manifested by progressive multifocal osteolysis along the prosthetic femoral shaft. (orig.). With 3 figs

  19. The political context of AIDS-related stigma and knowledge in a South African township community.

    Science.gov (United States)

    Forsyth, Brian; Vandormael, Alain; Kershaw, Trace; Grobbelaar, Janis

    2008-07-01

    The purpose of this study was to examine the presentation of AIDS-related stigma and knowledge within the political context of the South African government's response to the AIDS epidemic. It was during the 2000 - 2004 period that key government officials publicly challenged the orthodox views of HIV/AIDS, with the South African president, Thabo Mbeki, actively positing the primary role of poverty and other socio-economic stressors in the progression of the AIDS epidemic. This discursive position had real-time effects for AIDS policy-making and ultimately delayed the implementation of a national antiretroviral (ARV) rollout programme. Consequently this position was criticised by commentators in the media and elsewhere for contributing to an already widespread climate of AIDS stigmatization and misinformation. To shed more light on these claims we conducted a survey in 2005 in Atteridgeville, a South African township, and compared results with those of a similar survey conducted shortly after ARV medications became available in 2004. Results indicated a reduction in AIDS stigma levels across the 1-year period, and that those participants who endorsed contentious political views (such as those expressed by key government officials) were more likely to have a higher level of AIDS-related stigma than those who disagreed. Nevertheless, this study cautions against drawing a causal relationship between the South African government's position and IDS-stigmatizing attitudes, and suggests that further political and social factors be accounted for in an attempt to gain a fuller understanding of this seemingly complex relationship. PMID:18709210

  20. A theoretical design of gradient index multifocal contact lens for correcting presbyopia and an attempt to elicit its performance using ray tracing

    Science.gov (United States)

    Bakaraju, Ravi C.; Ehrmann, Klaus; Papas, Eric B.; Ho, Arthur

    2009-02-01

    We propose a novel theoretical design of gradient index (GRIN) multifocal contact lens (MFCL) to compensate presbyopia and make predictions regarding its performance on a schematic model eye and to compare its performance with conventional aspheric progressive MFCL.

  1. 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.

  2. 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...

  3. 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…

  4. Chronic recurrent multifocal osteomyelitis with MR correlation: a case report

    International Nuclear Information System (INIS)

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disorder of unknown etiology. The main characteristics on plain X-rays are a lytic destruction in the metaphyseal region of the long bones followed by progressive sclerosis. CRMO of the tibial and fibular bones is described in a 14-year-old girl, who suffered from pain and soft tissue swelling in both ankles. Initial plain X-rays and laboratory findings were normal. After relapsing clinically, progressive sclerosis of both fibular bones occurred. The diagnostics of CRMO was suggested based on CT and MRI findings. CRMO was confirmed after curettage and bone biopsy. Histopathological findings were consistent with active chronic osteomyelitis. (orig./DG)

  5. Chronic recurrent multifocal osteomyelitis with MR correlation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Machiels, F. (Dept. of Radiology, Middelheim Hospital, Antwerp (Belgium)); Seynaeve, P. (Dept. of Radiology, Middelheim Hospital, Antwerp (Belgium)); Lagey, C. (Dept. of Orthopaedic Surgery, Children' s Hospital, Antwerp (Belgium)); Mortelmans, L.L. (Dept. of Radiology, Middelheim Hospital, Antwerp (Belgium))

    1992-11-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disorder of unknown etiology. The main characteristics on plain X-rays are a lytic destruction in the metaphyseal region of the long bones followed by progressive sclerosis. CRMO of the tibial and fibular bones is described in a 14-year-old girl, who suffered from pain and soft tissue swelling in both ankles. Initial plain X-rays and laboratory findings were normal. After relapsing clinically, progressive sclerosis of both fibular bones occurred. The diagnostics of CRMO was suggested based on CT and MRI findings. CRMO was confirmed after curettage and bone biopsy. Histopathological findings were consistent with active chronic osteomyelitis. (orig./DG)

  6. Multifocal chronic osteomyelitis of unknown etiology

    International Nuclear Information System (INIS)

    Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

  7. MULTIFOCAL LEUCOENCEPHALOPATHY PRESENTING AS ANTIDEPRESSANT INDUCED MANIA

    OpenAIRE

    Damodaran, Saji S.; Sinha, Vinod Kumar; Das, Arunava; Akhtar, Sayeed

    1994-01-01

    A male patient presented with tricyclic induced hypomania after treatment for chronic depression. On follow up the patient deteriorated towards dementia with multifocal leucoencephalopathy. The possible role of brain lesions in the causation of affective syndromes and the neurobiological hypothesis of bipolar syndromes are discussed. The authors propose that chronic depression should be thoroughly investigated for a probable Axis III diagnosis.

  8. 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. PMID:26923156

  9. Immune reconstitution syndrome presenting as probable AIDS-related lymphoma: a case report

    Directory of Open Access Journals (Sweden)

    Christensen Charlotte B

    2011-09-01

    Full Text Available Abstract We report an unusual case of HIV-related immune reconstitution inflammatory syndrome, presenting as suspected AIDS-related lymphoma. Symptoms, initial investigations including fine-needle biopsy and 18F-FDG PET/CT scan were highly compatible with high grade AIDS-related lymphoma, however subsequently IRIS was diagnosed. We discuss pitfalls in the interpretation of diagnostic results in ARL versus IRIS.

  10. Immune reconstitution syndrome presenting as probable AIDS-related lymphoma: a case report

    DEFF Research Database (Denmark)

    Mortensen, Bo K; Nielsen, Susanne D; Christensen, Charlotte; Helweg-Larsen, Jannik

    2011-01-01

    ABSTRACT: We report an unusual case of HIV-related immune reconstitution inflammatory syndrome, presenting as suspected AIDS-related lymphoma. Symptoms, initial investigations including fine-needle biopsy and 18F-FDG PET/CT scan were highly compatible with high grade AIDS-related lymphoma, however...... subsequently IRIS was diagnosed. We discuss pitfalls in the interpretation of diagnostic results in ARL versus IRIS....

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

    OpenAIRE

    Vidal, Jose E; Augusto C. Penalva de Oliveira; Dauar, Rafi F.; Boulware, David R.

    2013-01-01

    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) earl...

  12. Jejunitis and brown bowel syndrome with multifocal carcinogenesis of the small bowel.

    Science.gov (United States)

    Raithel, Martin; Rau, Tilman T; Hagel, Alexander F; Albrecht, Heinz; de Rossi, Thomas; Kirchner, Thomas; Hahn, Eckhart G

    2015-09-28

    This is the first report describing a case where prolonged, severe malabsorption from brown bowel syndrome progressed to multifocally spread small bowel adenocarcinoma. This case involves a female patient who was initially diagnosed with chronic jejunitis associated with primary diffuse lymphangiectasia at the age of 26 years. The course of the disease was clinically, endoscopically, and histologically followed for 21 years until her death at the age 47 due to multifocal, metastasizing adenocarcinoma of the small bowel. Multiple lipofuscin deposits (so-called brown bowel syndrome) and severe jejunitis were observed microscopically, and sections of the small bowel showed dense lymphoplasmacytic infiltration of the lamina propria as well as blocked lymphatic vessels. After several decades, multifocal nests of adenocarcinoma cells and extensive, flat, neoplastic mucosal proliferations were found only in the small bowel, along with a loss of the mismatch repair protein MLH1 as a long-term consequence of chronic jejunitis with malabsorption. No evidence was found for hereditary nonpolyposis colon carcinoma syndrome. This article demonstrates for the first time multifocal carcinogenesis in the small bowel in a malabsorption syndrome in an enteritis-dysplasia-carcinoma sequence. PMID:26420973

  13. Basic characterization of normal multifocal electroretinogram

    International Nuclear Information System (INIS)

    A scientific literature review was made on the novel multifocal electroretinogram technique, the involved cell mechanisms and some of the factors modifying its results together with the form of presentation. The basic characteristics of this electrophysiological record obtained from several regions of the retina of normal subjects is important in order to create at a small scale a comparative database to evaluate pathological eye tracing. All this will greatly help in early less invasive electrodiagnosis of localized retinal lesions. (Author)

  14. 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.

  15. Two-photon excitation improves multifocal structured illumination microscopy in thick scattering tissue

    OpenAIRE

    Ingaramo, Maria; York, Andrew G.; Wawrzusin, Peter; Milberg, Oleg; Hong, Amy; Weigert, Roberto; Shroff, Hari; Patterson, George H.

    2014-01-01

    Superresolution microscopy has made much progress in improving resolution and imaging speed over the past several years, but the ability to image below the diffraction limit in thick scattering specimens has not kept pace. In many interesting samples, such as Caenorhabditis elegans, Drosophila melanogaster, mouse, or human tissues, resolution is limited primarily by scattering rather than diffraction. In this paper, we show that the combination of multiphoton excitation with multifocal struct...

  16. 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.

  17. Physeal involvement in chronic recurrent multifocal osteomyelitis

    International Nuclear Information System (INIS)

    Chronic recurrent multifocal osteomyelitis is a recently recognized disease characterized by remissions and exacerbations of multiple bone lesions which radiographically and pathologically have the appearance of hematogenous osteomyelitis. No consistent etiology can be identified, and antimicrobial agents seem to have no beneficial effect. A review of the appearances on imaging modalities and the clinical and pathologic manifestations is undertaken in seven cases of CRMO. No therapeutic regimen resulted in consistent clinical or radiographic improvement. We suggest the sequelae of this process are not as benign as previously reported. (orig.)

  18. Physeal involvement in chronic recurrent multifocal osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Manson, D. (McMaster Univ., Hamilton, Ontario (Canada). Dept. of Radiology); Wilmot, D.M. (Hospital for Sick Children, Toronto, Ontario (Canada). Dept. of Radiology); King, S. (Hospital for Sick Children, Toronto, ON (Canada). Dept. of Infectious Diseases); Laxer, R.M. (Hospital for Sick Children, Toronto, ON (Canada). Div. of Immunology)

    1989-11-01

    Chronic recurrent multifocal osteomyelitis is a recently recognized disease characterized by remissions and exacerbations of multiple bone lesions which radiographically and pathologically have the appearance of hematogenous osteomyelitis. No consistent etiology can be identified, and antimicrobial agents seem to have no beneficial effect. A review of the appearances on imaging modalities and the clinical and pathologic manifestations is undertaken in seven cases of CRMO. No therapeutic regimen resulted in consistent clinical or radiographic improvement. We suggest the sequelae of this process are not as benign as previously reported. (orig.).

  19. Immune reconstitution inflammatory syndrome in AIDS-related non-hodgkin′s lymphoma

    Directory of Open Access Journals (Sweden)

    Phatak Uday

    2009-12-01

    Full Text Available Immune Reconstitution syndrome following antiretroviral therapy is common in HIV/AIDS patients due to boosting of immunity. A case is reported here wherein AIDS-related Non-Hodgkin′s lymphoma patient received CHOP regimen and antiretroviral therapy. Patient developed tubercular lymphadenopathy paradoxically as a manifestation of IRIS.

  20. Multifocal thoracic chordoma mimicking a paraganglioma

    Directory of Open Access Journals (Sweden)

    Giovanni Conzo

    2013-01-01

    Full Text Available Chordoma of thoracic vertebras is a very rare locally invasive neoplasm with low grade malignancy arising from embryonic notochordal remnants. Radical surgery remains the cornerstone of the treatment. We describe a case of multifocal T1-T2 chordoma, without bone and disc involvement, incidentally misdiagnosed as a paraganglioma, occurring in a 47-year-old male asymptomatic patient. Neoplasm was radically removed by an endocrine surgeon through a right extended cervicotomy. A preoperative reliable diagnosis of chordoma, as in the reported case, is often difficult. Radical surgery can provide a favorable outcome but, given the high rates of local recurrence of this neoplasm, a strict and careful follow-up is recommended. Although very rare, chordoma should be suggested in the differential diagnosis of the paravertebral cervical masses of unknown origin. Spine surgeon consultation and a FNB should be routinely included in the multidisciplinary preoperative work-up of these neoplasms.

  1. Multifocal thoracic chordoma mimicking a paraganglioma.

    Science.gov (United States)

    Conzo, Giovanni; Gambardella, Claudio; Pasquali, Daniela; Ciancia, Giuseppe; Avenia, Nicola; Pietra, Cristina Della; Napolitano, Salvatore; Palazzo, Antonietta; Mauriello, Claudio; Parmeggiani, Domenico; Pettinato, Guido; Napolitano, Vincenzo; Santini, Luigi

    2013-01-01

    Chordoma of thoracic vertebras is a very rare locally invasive neoplasm with low grade malignancy arising from embryonic notochordal remnants. Radical surgery remains the cornerstone of the treatment. We describe a case of multifocal T1-T2 chordoma, without bone and disc involvement, incidentally misdiagnosed as a paraganglioma, occurring in a 47-year-old male asymptomatic patient. Neoplasm was radically removed by an endocrine surgeon through a right extended cervicotomy. A preoperative reliable diagnosis of chordoma, as in the reported case, is often difficult. Radical surgery can provide a favorable outcome but, given the high rates of local recurrence of this neoplasm, a strict and careful follow-up is recommended. Although very rare, chordoma should be suggested in the differential diagnosis of the paravertebral cervical masses of unknown origin. Spine surgeon consultation and a FNB should be routinely included in the multidisciplinary preoperative work-up of these neoplasms. PMID:24125991

  2. Multifocal tuberculosis of long bones in an immunocompetent child.

    Science.gov (United States)

    Baghdadi, Taghi; Shirazi, Mehdi Ramezan; Daneshjoo, Khadijeh

    2016-05-01

    Although tuberculosis (TB) is prevalent in many parts of the world, multifocal TB involvement of bones is rare. It is believed that less than 5% of skeletal TB is multifocal. We report a case of multifocal TB of long bones in an immunocompetent child. We describe the radiological and diagnostic features of TB osteomyelitis and outline its therapy and prognosis. To the best of the authors' knowledge, such a case with multiple long bone involvement without articular sequel and visceral involvement/constitutional symptoms has not been reported previously in the literature. PMID:26600081

  3. 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.

  4. AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989–2003

    International Nuclear Information System (INIS)

    Primary central nervous system lymphoma (PCNSL) is a frequent complication in acquired immunodeficiency syndrome (AIDS). The objective of this survey was to investigate incidence, clinical features, radiological findings, histologic diagnosis, treatment and outcome for all patients with histologically verified AIDS-related PCNSL diagnosed in Norway in 1989–2003. We identified the patients by chart review of all cases recorded as PCNSL in The Norwegian Cancer Registry (by law recording all cases of cancer in Norway) and all cases recorded as AIDS-related PCNSL in the autopsy registry at a hospital having 67% autopsy rate and treating 59% of AIDS patients in Norway, from 1989 to 2003. Histologic material and radiological images were reviewed. We used person-time techniques to calculate incidence rates of PCNSL among AIDS patients based on recordings on AIDS at the Norwegian Surveillance System for Communicable Diseases (by law recording all cases of AIDS in Norway). Twenty-nine patients had histologically confirmed, newly diagnosed AIDS-related PCNSL in Norway from 1989–2003. Only 2 patients had this diagnosis established while alive. AIDS patients had 5.5% lifetime risk of PCNSL. Their absolute incidence rate of PCNSL per 100 person-years was 1.7 (95%CI: 1.1–2.4) and decreased during the consecutive 5-year periods from 3.6, to 2.5, and to 0.4 (p < 0.001). Median survival from initial symptom of PCNSL was 2.3 months, but one patient was still alive 4 years after completed radiotherapy. This is the first national survey to confirm decreasing incidence of AIDS-related PCNSL. Despite dismal survival in most patients, the possibility of long term survival should prompt more aggressive diagnostics in suspected PCNSL

  5. 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.

  6. Predicting AIDS-related events using CD4 percentage or CD4 absolute counts

    Directory of Open Access Journals (Sweden)

    Donabedian Haig

    2006-08-01

    Full Text Available Abstract Background The extent of immunosuppression and the probability of developing an AIDS-related complication in HIV-infected people is usually measured by the absolute number of CD4 positive T-cells. The percentage of CD4 positive cells is a more easily measured and less variable number. We analyzed sequential CD4 and CD8 numbers, percentages and ratios in 218 of our HIV infected patients to determine the most reliable predictor of an AIDS-related event. Results The CD4 percentage was an unsurpassed predictor of the occurrence of AIDS-related events when all subsets of patients are considered. The CD4 absolute count was the next most reliable, followed by the ratio of CD4/CD8 percentages. The value of CD4 percentage over the CD4 absolute count was seen even after the introduction of highly effective HIV therapy. Conclusion The CD4 percentage is unsurpassed as a parameter for predicting the onset of HIV-related diseases. The extra time and expense of measuring the CD4 absolute count may be unnecessary.

  7. [Progressive multifocal leukoencephalopathy and AIDS. Response to cytarabine].

    Science.gov (United States)

    Hervas Laguna, M J; Nieto Rodríguez, J A; Geijo Martínez, M P; Ruiz Ribo, M D; Borregón, S

    1994-05-01

    PML affects 4% of patients with AIDS and there is no effective treatment. Five cases of PML-AIDS have been described, showing clinical and radiological improvement after treatment with C-ara. We describe the case of a 33-year-old woman, addict to heroin, her clinical record including VIH infection, pneumonia by P. carinii, milliary tuberculosis, infection by virus B and C and treatment with AZT and tuberculostatics since January, 1992. In May, she began to develop a cerebellar syndrome. Images obtained with nuclear magnetic resonance were typical of PML. Subsequently, treatment with C-ara (2 mg/kg/day IV during 5 days each 4-6 weeks) was begun. From the third month of treatment on, the patient showed a clinical improvement and as of the sixth month, the affected areas of white substance were reduced in size. In addition, CD4 improved. Although in this patient a positive effect was observed after treatment with C-area, it should be verified in a controlled clinical trial. PMID:8061141

  8. Multifocal ERG Guiding Therapy in a Case of Hydroxychloroquine Premaculopathy

    Directory of Open Access Journals (Sweden)

    José Antonio Sáez-Moreno

    2015-01-01

    Full Text Available We report the case of a 28-year-old female treated for systemic lupus erythematosus with hydroxychloroquine (200 mg/day for 11 years. She was visually asymptomatic, with normal fundus appearance, normal colour vision testing findings, 20/20 visual acuity in both eyes, and only mild central bilateral defects on 10-2 perimetry. Multifocal electroretinography (mfERG showed low density values for ring 1 in both eyes. Because the patient had not previously responded to alternative treatments and in consultation with her physician, the hydroxychloroquine dose was reduced to 200 mg four days/week. Four serial mfERGs performed at 4, 18, 25, and 34 months after dose reduction showed a progressive improvement in the definition and density of the responses until they were normalized at the third mfERG (25 months after hydroxychloroquine dose reduction. The fourth and final mfERG at 34 months confirmed the recovery in both eyes. Perimetry defects were mostly normalized. These results demonstrate the importance of mfERG for the safe management of patients under long-term hydroxychloroquine treatment.

  9. Multifocal ERG Guiding Therapy in a Case of Hydroxychloroquine Premaculopathy.

    Science.gov (United States)

    Sáez-Moreno, José Antonio; Domínguez-Hidalgo, Concepción; Rodríguez-Ferrer, José Manuel

    2015-01-01

    We report the case of a 28-year-old female treated for systemic lupus erythematosus with hydroxychloroquine (200 mg/day) for 11 years. She was visually asymptomatic, with normal fundus appearance, normal colour vision testing findings, 20/20 visual acuity in both eyes, and only mild central bilateral defects on 10-2 perimetry. Multifocal electroretinography (mfERG) showed low density values for ring 1 in both eyes. Because the patient had not previously responded to alternative treatments and in consultation with her physician, the hydroxychloroquine dose was reduced to 200 mg four days/week. Four serial mfERGs performed at 4, 18, 25, and 34 months after dose reduction showed a progressive improvement in the definition and density of the responses until they were normalized at the third mfERG (25 months after hydroxychloroquine dose reduction). The fourth and final mfERG at 34 months confirmed the recovery in both eyes. Perimetry defects were mostly normalized. These results demonstrate the importance of mfERG for the safe management of patients under long-term hydroxychloroquine treatment. PMID:26557401

  10. 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 

  11. Simultaneous Development of Renal Cell Carcinoma and Multifocal Urothelial Carcinoma

    OpenAIRE

    Cheng-Keng Chuang; Heng-Chang Chuang; Kwai-Fong Ng

    2008-01-01

    Simultaneous occurrence of multifocal urothelial carcinoma (UC) and ipsilateral renalcell carcinoma (RCC) is rare. We report a 67-year-old woman with multifocal, infiltratingurothelial carcinoma and unilateral renal cell carcinoma. She was referred to our departmentbecause of painless gross hematuria. Cystoscopy, computed tomography and retrogradepyelography studies revealed bladder, bilateral renal and ureter UC. She was treated withtransurethral resection of the bladder tumor followed by bi...

  12. Patient acceptability of the Tecnis® multifocal intraocular lens

    OpenAIRE

    Sood, Priyanka; Woodward, Maria A.

    2011-01-01

    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....

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

    OpenAIRE

    Basta Ivana; Nikolić Ana; Apostolski Slobodan; Lavrnić Slobodan; Stošić-Opinćal Tatjana; Banjalić Sandra; Knežević-Apostolski Slađana; Ilić Tihomir V.; Marjanović Ivan; Milićev Milena; Lavrnić Dragana

    2014-01-01

    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,...

  14. Productive human immunodeficiency virus infection levels correlate with AIDS-related manifestations in the patient

    International Nuclear Information System (INIS)

    Mononuclear cells were obtained from 71 human immunodeficiency virus type 1 (HIV-1) seropositive subjects presenting and first visit either as asymptomatic or with minor symptoms and with CD4 lymphocytes greater than 550 per mm3 (group A, 35 patients) or as patients with AIDS, AIDS-related illnesses, or CD4 lymphocytes less than 400 per mm3 (group B, 36 patients). After 1-5 years of follow-up, 13 patients of group A had essentially retained their initial status (asymptomatics); the 22 others had suffered clinical or immunological deterioration (progressors). Frozen cells were thawed and submitted to lethal gamma-irradiation in vitro (4500 rads; 1 rad = 0.01 Gy) before they were cultured with normal phytohemagglutinin-stimulated lymphocytes to determine radiation-resistant HIV expression ex vivo (R-HEV). HIV antigenemia correlated with R-HEV values in 142 samples (r = 0.92, P less than 0.001) but was a less sensitive predictor of disease than R-HEV. R-HEV was detected in all specimens from patients with major AIDS-related illnesses or HIV-associated CD4 lymphopenia. In 77% of the progressors from group A, R-HEV detection preceded the onset of AIDS-associated disease or CD4 lymphopenia by 1 year (average). Conversely, R-HEV was low or was not detected in 36 sequential specimens from the 13 patients who remained asymptomatic over the following 2-5 years. Thus, persistently low HIV expression in vivo predicted a nondiseased state, whereas higher HIV expression levels seemed necessary for disease to occur. These data indicate that R-HEV is related to productive HIV infection in vivo, the latter acting as a determinant of AIDS-related illnesses. In view of this, measurement of HIV expression levels in the patient should be useful in antiviral efficacy trials

  15. Multifocal electroretinography: a functional laser injury metric

    Science.gov (United States)

    DiCarlo, Cheryl D.; Zwick, Harry; Rentmeister-Bryant, Heike; Sankovich, James M.; Brown, Araceli; Grado, Andres; Dicks, Ronald J.; Akers, Andre; Stuck, Bruce E.

    2003-06-01

    Currently there are no universally accepted functional diagnostics and treatments for laser eye injury. The multifocal electroretinogram (MERG) determines the function of several areas of the retina simultaneously. The objective of this research is to determine if the MERG is sensitive enough to provide a functional assessment of retinal laser lesions that correlates to established contrast sensitivity/visual acuity tests currently in use. The Visual-Evoked Response Imaging System (VERIS) ClinicTM, a MERG system with continuous visualization of the fundus, was used to record from normal rhesus monkeys. The MERG mapping of the rhesus monkeys was localized to the macula and centered on the foveal region. The recordings yielded three waveforms for each of the 103-recorded responses. A difference was seen in all of the waveform mean amplitudes with the human normal values being one and one-half times as large for the first, twice as large for the second and four times as large for the third waveform. This may be due to a much lower number of subjects for recording (5 Rhesus versus 48 human recordings) or the monkey retina may, in fact, produce lower amplitude retinal responses. This on-going project is expanding research to include the functional assessment of laser retinal injury through the use of the MERG with the intent of correlating the function to currently used behavioral metrics of the visual system.

  16. HIV-positive patients’ and their families’ comprehension of HIV- and AIDS-related information

    Directory of Open Access Journals (Sweden)

    Gedina E. de Wet

    2013-04-01

    Full Text Available Despite acknowledgement of the importance of sharing HIV- and AIDS-related information with people living with HIV, it is still unclear as to what their actual comprehension is of this information. This research was part of a larger project, Tswaragano, conducted in the North-West Province, South Africa, which explored and described the competence, ability and strengths of the family of the HIV-positive patient during home support. This research focused on Potchefstroom in the North-West Province. This article focuses on research with the objective being to explore and describe the comprehension of HIV-positive patients and their families with regard to HIV- and AIDS-related information, and to formulate recommendations to improve their comprehension of this information. A quantitative, explorative and descriptive survey design was followed. Data were collected by means of questionnaires completed by HIV-positive patients (n= 79 and their family members (n= 34. Descriptive statistical analysis by means of frequency analysis was conducted. Ethical considerations and mechanisms to enhance validity and reliability are discussed. The results indicated that both HIV-positive respondents and their families face social and financial challenges due to unemployment and low income. A strength found in this research is that the majority of respondents are linked to a church, which can be a valuable platform to share information on HIV and AIDS. With regards to sharing, sources and comprehension of HIV- and AIDS-related information, it is apparent that respondents perceived that pre- and post-counselling provided an opportunity for information sharing, but that they need health care workers to spend more time with them, to be non-judgemental and to make more use of visual aids. It furthermore seems that the majority of HIV-positive respondents in this study did comprehend the need for and negotiate for safer sexual practices. It was concluded that although

  17. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

    Science.gov (United States)

    Parker, Richard; Aggleton, Peter

    2003-07-01

    Internationally, there has been a recent resurgence of interest in HIV and AIDS-related stigma and discrimination, triggered at least in part by growing recognition that negative social responses to the epidemic remain pervasive even in seriously affected communities. Yet, rarely are existing notions of stigma and discrimination interrogated for their conceptual adequacy and their usefulness in leading to the design of effective programmes and interventions. Taking as its starting point, the classic formulation of stigma as a 'significantly discrediting' attribute, but moving beyond this to conceptualize stigma and stigmatization as intimately linked to the reproduction of social difference, this paper offers a new framework by which to understand HIV and AIDS-related stigma and its effects. It so doing, it highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. It highlights the limitations of individualistic modes of stigma alleviation and calls instead for new programmatic approaches in which the resistance of stigmatized individuals and communities is utilized as a resource for social change. PMID:12753813

  18. HIV/AIDS-related stigmatizing and discriminatory attitudes and recent HIV testing among Beijing men who have sex with men

    OpenAIRE

    Li, Xuefeng; Lu, Hongyan; Ma, Xiaoyan; Sun, Yanming; He, Xiong; Li, Chunmei; Raymond, H.F.; McFarland, Willi; Sun, Jiangping; Pan, Stephen W.; Shao, Yiming; Sten H Vermund; Xiao, Yan; Ruan, Yuhua; Jia, Yujiang

    2012-01-01

    The study was to assess the correlates for recent HIV testing and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Beijing, China. A cross-sectional study probed demographics, sexual and drug use behaviors, HIV testing, and prevention services. Of 500 participants, 39.3% recently received a test for HIV. Recent testing was independently associated with expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes, more...

  19. Care Centre visits to married people living with HIV ? An indicator for measuring AIDS -related stigma & discrimination

    OpenAIRE

    Green, David Andrew; Devi, Shyamala; Paulraj, Louis S

    2007-01-01

    Abstract We tested whether observation of the presence and relationship of attendants (i.e. those that accompany upon admission) and visitors to a sample of 230 (128 male, 102 female) married HIV-positive people in an HIV care centre provides an indicator of caregiving AIDS-related stigma and discrimination. Sensitivity to gender, location (urban vs. rural), age (35) and source of infection (spouse vs. non-spouse) ? factors considered to modulate AIDS-related stigma and discriminat...

  20. Morphological and genetic heterogeneity in multifocal lung adenocarcinoma: The case of a never-smoker woman.

    Science.gov (United States)

    Bonanno, Laura; Calabrese, Fiorella; Nardo, Giorgia; Calistri, Daniele; Tebaldi, Michela; Tedaldi, Gianluca; Polo, Valentina; Vuljan, Stefania; Favaretto, Adolfo; Conte, PierFranco; Amadori, Alberto; Rea, Federico; Indraccolo, Stefano

    2016-06-01

    Discrimination of multifocal primary lung cancers from lung metastases is crucial to allow for an appropriate clinical management. We report here a case of multifocal lung adenocarcinomas with different morphological and molecular patterns. Radical surgery of one lung nodule was performed at the time of diagnosis, and subsequently on two other lung nodules. At the time of distant relapse, biopsy was repeated for molecular characterization. The patient was treated with EGFR tyrosine kinase inhibitor according to the detection of EGFR exon 21 mutation in metastatic sample and in one of the three lung tumors, characterized by lower mutated allele frequency. The progression free survival was three months according to radiological criteria and the treatment was provided for six months, until clinical progression. Following the assessment of EGFR mutations by pyrosequencing, tumor samples were analyzed by a 30-gene next generation sequencing (NGS) panel, allowing to study intra- and inter-tumor heterogeneity and to confirm the three lung tumors as independent. Different molecular profiles of synchronous tumors and identical EGFR, PIK3CA and TP53 mutations in one of three primary lung tumors and the metachronous metastasis were identified. In conclusion, morphological and molecular characterization of multiple lung nodules by NGS may help to define synchronous and metachronous adenocarcinomas, thus affecting surgical indication and systemic treatment. Intratumor heterogeneity may be associated with differential sensitivity to targeted treatment. PMID:27133750

  1. Comparative visual performance with monofocal and multifocal intraocular lenses

    Directory of Open Access Journals (Sweden)

    Gundersen KG

    2013-10-01

    Full Text Available Kjell Gunnar Gundersen,1,* Richard Potvin2,*1Privatsykehuset Haugesund, Haugesund, Norway; 2Science in Vision, Burleson, TX, USA *These authors contributed equally to this workBackground: To compare near, intermediate, and distance vision, and quality of vision using appropriate subjective questionnaires, when monofocal or apodized diffractive multifocal intraocular lenses (IOLs are binocularly implanted.Methods: Patients with different binocular IOLs implanted were recruited after surgery and had their visual acuity tested, and quality of vision evaluated, at a single diagnostic visit between 3 and 8 months after second-eye surgery. Lenses tested included an aspheric monofocal and two apodized diffractive multifocal IOLs with slightly different design parameters. A total of 94 patients were evaluated.Results: Subjects with the ReSTOR® +2.5 D IOL had better near and intermediate vision than those subjects with a monofocal IOL. Intermediate vision was similar to, and near vision slightly lower than, that of subjects with a ReSTOR® +3.0 D IOL implanted. The preferred reading distance was slightly farther out for the +2.5 D relative to the +3.0 D lens, and farthest for the monofocal. Visual acuity at the preferred reading distance was equal with the two multifocal IOLs and significantly worse with the monofocal IOL. Quality of vision measures were highest with the monofocal IOL and similar between the two multifocal IOLs.Conclusion: The data indicate that the ReSTOR +2.5 D IOL provided good intermediate and functional near vision for patients who did not want to accept a higher potential for visual disturbances associated with the ReSTOR +3.0 D IOL, but wanted more near vision than a monofocal IOL generally provides. Quality of vision was not significantly different between the multifocal IOLs, but patient self-selection for each lens type may have been a factor.Keywords: multifocal IOL, near vision, cataract, presbyopia

  2. 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.

  3. Multifocal osteosarcoma as second tumor after childhood retinoblastoma

    International Nuclear Information System (INIS)

    We present a case of multifocal osteosarcoma (MFOS) arising 11.5 years after successful treatment of bilateral retinoblastoma. The clinical, imaging and pathological findings at onset, after therapy, and during follow-up are described. Fluorescent in situ hybridization did not reveal a deletion of the RB-1 retinoblastoma gene, although the presence of an inactivating mutation invisible to this method cannot be ruled out. The MFOS may have been a second multifocal tumor associated with the original retinoblastoma or a post-irradiation sarcoma with extensive metastases. (orig.)

  4. Case Report: Multifocal biphasic squamoid alveolar renal cell carcinoma

    Science.gov (United States)

    Lopez, Jose Ignacio

    2016-01-01

    A multifocal biphasic squamoid alveolar renal cell carcinoma in a 68-year-old man is reported. Four different peripheral tumor nodules were identified on gross examination. A fifth central tumor corresponded to a conventional clear cell renal cell carcinoma. Biphasic squamoid alveolar renal cell carcinoma is a rare tumor that has been very recently characterized as a distinct histotype within the spectrum of papillary renal cell carcinoma. Immunostaining with cyclin D1 seems to be specific of this tumor subtype. This is the first reported case with multifocal presentation. PMID:27158455

  5. Hiperplasia multifocal del epitelio: reporte de nueve casos

    OpenAIRE

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

    2005-01-01

    La hiperplasia multifocal del epitelio (HME) conocida también como hiperplasia epitelial focal, enfermedad de Heck ó hiperplasia multifocal del epitelio por papiloma virus, se caracteriza por la aparición de lesiones múltiples en la mucosa de la cavidad bucal en población pediátrica y se asocia a la presencia del virus papiloma humano. El objetivo de este estudio fue conocer las características clínico-patológicas de los casos diagnosticados de esta enfermedad en el Servi...

  6. Melanoma conjuntival multifocal recidivado originado de nevus pigmentado preexistente

    OpenAIRE

    2014-01-01

    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 ...

  7. A controlled trial of intravenous immunoglobulin in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Hahn, Angelika F; Beydoun, Said R; Lawson, Victoria;

    2013-01-01

    Intravenous immunoglobulin (IVIG) has become the standard treatment for multifocal motor neuropathy (MMN) based on limited data. To critically assess the efficacy, safety, and tolerability of 10% liquid IVIG (IVIG), 44 adults with MMN were randomized 1 : 1 to either double-blind treatment of IVIG...

  8. AIDS-Related Stigma and Mental Disorders among People Living with HIV: A Cross-Sectional Study in Cambodia

    OpenAIRE

    Siyan Yi; Pheak Chhoun; Samedy Suong; Kouland Thin; Carinne Brody; Sovannary Tuot

    2015-01-01

    Background AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia. Methods A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health que...

  9. 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.

  10. 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.

  11. 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.

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

    International Nuclear Information System (INIS)

    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.)

  13. 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.)

  14. Discrete synchronous multifocal osteoid osteoma of the humerus

    International Nuclear Information System (INIS)

    A 24-year-old patient is described who had a 4-year history of pain in the right upper arm, with distinct night pain, that responded to salicylates. From the findings on conventional radiography, bone scintigraphy and MRI a multifocal osteoid osteoma was suspected, with one focus in the cancellous region of the greater tuberosity and a second cortical focus at the proximal humeral diaphysis. The resection ''en bloc'' of both tumors and histological examination confirmed the diagnosis. The patient was painfree after the curative resection of the two osteoid osteomas. Osteoid osteoma is a frequently found benign bone tumor, accounting for approximately 11% of cases. In rare cases a multicentric occurrence has been described. A possible occurrence of more than one osteoid osteoma in a single bone, not verified histologically, has been reported only three times in the literature. In patients with scintigraphic and radiographic findings of two foci, discrete synchronous multifocal osteoid osteomas should be suspected. (orig.). With 6 figs

  15. Successful treatment of multi-focal XDR tuberculous osteomyelitis.

    Science.gov (United States)

    Alshukairi, Abeer N; Alrajhi, Abdulrahman A; Alamri, Abdulfattah W; Alothman, Adel F

    2016-01-01

    We herein describe the nosocomial transmission of a pre-XDR or MDR case of pulmonary tuberculosis in a HIV-negative health care worker in an area endemic for MDR and XDR tuberculosis. Following inadequate therapy and non-compliance, he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after two years of treatment with various anti-tuberculous drugs in addition to interferon gamma. PMID:26631433

  16. 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

  17. 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

  18. Multifocal multiphoton microscopy based on multianode photomultiplier tubes

    OpenAIRE

    Kim, Ki Hean; Buehler, Christof; Bahlmann, Karsten; Ragan, Timothy; Lee, Wei-Chung A.; Nedivi, Elly; Heffer, Erica L.; Fantini, Sergio; So, Peter T. C.

    2007-01-01

    Multifocal multiphoton microscopy (MMM) enhances imaging speed by parallelization. It is not well understood why the imaging depth of MMM is significantly shorter than conventional single-focus multiphoton microscopy (SMM). In this report, we show that the need for spatially resolved detectors in MMM results in a system that is more sensitive to the scattering of emission photons with reduced imaging depth. For imaging depths down to twice the scattering mean free path length of emission phot...

  19. Patient acceptability of the Tecnis® multifocal intraocular lens

    OpenAIRE

    Woodward, Maria

    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...

  20. Multifocal Scedosporium apiospermum spondylitis in a cystic fibrosis patient.

    Science.gov (United States)

    Guignard, S; Hubert, D; Dupont, B; Anract, P; Alioua, D; Guerini, H; Paugam, A; Dougados, M

    2008-01-01

    We report the first case of multifocal Scedosporium apiospermum spondylitis in a cystic fibrosis patient. The infection, which occurred during voriconazole prophylaxis, disseminated contiguously from the base of the left lung and pleura and spread to vertebrae via the epidural space. S. apiospermum osteoarticular infections are rare, and are difficult to diagnose and cure because of their resistance to anti-fungal drugs. PMID:17567545

  1. 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....... Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak....

  2. 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.

  3. 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.

  4. Primary multifocal gliosarcoma of the spinal cord

    Directory of Open Access Journals (Sweden)

    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.

  5. 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

  6. Primary effect of chemotherapy on the transcription profile of AIDS-related Kaposi's sarcoma

    Directory of Open Access Journals (Sweden)

    van Noesel Carel JM

    2002-09-01

    Full Text Available Abstract Background Drugs & used in anticancer chemotherapy have severe effects upon the cellular transcription and replication machinery. From in vitro studies it has become clear that these drugs can affect specific genes, as well as have an effect upon the total transcriptome. Methods Total mRNA from two skin lesions from a single AIDS-KS patient was analyzed with the SAGE (Serial Analysis of Gene Expression technique to assess changes in the transcriptome induced by chemotherapy. SAGE libraries were constructed from material obtained 24 (KS-24 and 48 (KS-48 hrs after combination therapy with bleomycin, doxorubicin and vincristine. KS-24 and KS-48 were compared to SAGE libraries of untreated AIDS-KS, and to libraries generated from normal skin and from isolated CD4+ T-cells, using the programs USAGE and HTM. SAGE libraries were also compared with the SAGEmap database. Results In order to assess the primary response of AIDS-related Kaposi's sarcoma (AIDS-KS to chemotherapy in vivo, we analyzed the transcriptome of AIDS-KS skin lesions from a HIV-1 seropositive patient at two time points after therapy. The mRNA profile was found to have changed dramatically within 24 hours after drug treatment. There was an almost complete absence of transcripts highly expressed in AIDS-KS, probably due to a transcription block. Analysis of KS-24 suggested that mRNA pool used in its construction originated from poly(A binding protein (PABP mRNP complexes, which are probably located in nuclear structures known as interchromatin granule clusters (IGCs. IGCs are known to fuse after transcription inhibition, probably affecting poly(A+RNA distribution. Forty-eight hours after chemotherapy, mRNA isolated from the lesion was largely derived from infiltrating lymphocytes, confirming the transcriptional block in the AIDS-KS tissue. Conclusions These in vivo findings indicate that the effect of anti-cancer drugs is likely to be more global than up- or downregulation of

  7. Gene expression profile of AIDS-related Kaposi's sarcoma

    International Nuclear Information System (INIS)

    Kaposi's Sarcoma (KS) is a proliferation of aberrant vascular structures lined by spindle cells, and is caused by a gammaherpes virus (HHV8/KSHV). Its course is aggravated by co-infection with HIV-1, where the timing of infection with HIV-1 and HHV8 is important for the clinical outcome. In order to better understand the pathogenesis of KS, we have analysed tissue from two AIDS-KS lesions, and from normal skin by serial analysis of gene expression (SAGE). Semi-quantitative RT-PCR was then used to validate the results. The expression profile of AIDS-related KS (AIDS-KS) reflects an active process in the skin. Transcripts of HHV8 were found to be very low, and HIV-1 mRNA was not detected by SAGE, although it could be found using RT-PCR. Comparing the expression profile of AIDS-KS tissue with publicly available SAGE libraries suggested that AIDS-KS mRNA levels are most similar to those in an artificially mixed library of endothelial cells and leukocytes, in line with the description of KS lesions as containing spindle cells with endothelial characteristics, and an inflammatory infiltrate. At least 64 transcripts were found to be significantly elevated, and 28 were statistically downregulated in AIDS-KS compared to normal skin. Five of the upregulated mRNAs, including Tie 1 and sialoadhesin/CD169, were confirmed by semi-quantitative PCR to be elevated in additional AIDS-KS biopsies. Antibodies to sialoadhesin/CD169, a known marker of activated macrophages, were shown to specifically label tumour macrophages. The expression profile of AIDS-KS showed 64 genes to be significantly upregulated, and 28 genes downregulated, compared with normal skin. One of the genes with increased expression was sialoadhesin (CD169). Antibodies to sialoadhesin/CD169 specifically labelled tumour-associated macrophages, suggesting that macrophages present in AIDS-KS lesions belong to a subset of human CD169+ macrophages

  8. 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

    Objectives: Analyzing changes in causes of death over time is essential for understanding the emerging trends in HIV population mortality, yet data on cause of death are often missing. This poses analytic limitations, as does the changing approach in data collection by longitudinal studies, which...... 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 Co...

  9. Forms and determinants of migration and HIV/AIDS-related stigma on the Mexican-Guatemalan border.

    Science.gov (United States)

    Infante, Cesar; Aggleton, Peter; Pridmore, Pat

    2009-12-01

    In this study we examined the origins and consequences of HIV/AIDS-related stigma on the Mexican-Guatemalan border. To explore these issues, an inductive/deductive approach was taken. Data were collected using qualitative methods including nonparticipant observation, in-depth interviews, and informal conversation. Informants included Central American immigrants, locals, and contextual key informants. Findings reveal that gender, social class, and race/ ethnicity function as key determinants of HIV/AIDS-related stigma, but serve also as the basis around which migration-related stigma is constructed within this particular context. These issues need to be taken into account in addressing the vulnerability of mobile populations, as well as the stigma attached to migration and HIV/AIDS. To be effective, responses should be based in the social and contextual realities faced by migrants and mobile populations, and be part of a more general process of empowerment that improves their legal, social, economic, and health status. PMID:19949216

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

    OpenAIRE

    Marcelo Corti; VILLAFAÑE, María F.; Norberto Trione; Ricardo Schtirbu; Marina Narbaitz

    2005-01-01

    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...

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

    OpenAIRE

    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 hospita...

  12. Autograft HIV-DNA Load Predicts HIV-1 Peripheral Reservoir After Stem Cell Transplantation for AIDS-Related Lymphoma Patients

    OpenAIRE

    Zanussi, Stefania; Bortolin, Maria Teresa; Pratesi, Chiara; Tedeschi, Rosamaria; Basaglia, Giancarlo; Abbruzzese, Luciano; Mazzucato, Mario; Spina, Michele; Vaccher, Emanuela; Tirelli, Umberto; Rupolo, Maurizio; Michieli, Mariagrazia; Di Mascio, Michele; De Paoli, Paolo

    2015-01-01

    Autologous stem cell transplantation (ASCT) is a widely used procedure for AIDS-related lymphomas, and it represents an opportunity to evaluate strategies curing HIV-1 infection. The association of autograft HIV-DNA load with peripheral blood HIV-1 reservoir before ASCT and its contribution in predicting HIV-1 reservoir size and stability during combination antiretroviral therapy (cART) after transplantation are unknown. Aiming to obtain information suggesting new functional cure strategies b...

  13. A latent trait approach to measuring HIV/AIDS related stigma in healthcare professionals: application of mokken scaling technique

    OpenAIRE

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

    2016-01-01

    The attitudes of healthcare professionals towards HIV positive patients and high risk groups are central to the quality of care and therefore to the management of HIV/AIDS related stigma in health settings. Extant HIV/AIDS stigma scales that measure stigmatising attitudes towards people living with HIV/AIDS have been developed using scaling techniques such as principal component analysis. This approach has resulted in instruments that are often long. Mokken scale analysis is a nonparametric h...

  14. Detection of polyomavirus simian virus 40 tumor antigen DNA in AIDS-related systemic non-Hodgkin lymphoma

    Science.gov (United States)

    Vilchez, Regis A.; Lednicky, John A.; Halvorson, Steven J.; White, Zoe S.; Kozinetz, Claudia A.; Butel, Janet S.

    2002-01-01

    Systemic non-Hodgkin lymphoma (S-NHL) is a common malignancy during HIV infection, and it is hypothesized that infectious agents may be involved in the etiology. Epstein-Barr virus DNA is found in pathogenesis. We analyzed AIDS-related S-NHL samples, NHL samples from HIV-negative patients, peripheral blood leukocytes from HIV-infected and -uninfected patients without NHL, and lymph nodes without tumors from HIV-infected patients. Specimens were examined by polymerase chain reaction analysis with use of primers specific for an N-terminal region of the oncoprotein large tumor antigen ( T-ag ) gene conserved among all three polyomaviruses (simian virus 40 [SV40], JC virus, and BK virus). Polyomavirus T-ag DNA sequences, proven to be SV40-specific, were detected more frequently in AIDS-related S-NHL samples (6 of 26) than in peripheral blood leukocytes from HIV-infected patients (6 of 26 vs. 0 of 69; p =.0001), NHL samples from HIV-negative patients (6 of 26 vs. 0 of 10; p =.09), or lymph nodes (6 of 26 vs. 0 of 7; p =.16). Sequences of C-terminal T-ag DNA from SV40 were amplified from two AIDS-related S-NHL samples. Epstein-Barr virus DNA sequences were detected in 38% (10 of 26) AIDS-related S-NHL samples, 50% (5 of 10) HIV-negative S-NHL samples, and 57% (4 of 7) lymph nodes. None of the S-NHL samples were positive for both Epstein-Barr virus DNA and SV40 DNA. Further studies of the possible role of SV40 in the pathogenesis of S-NHL are warranted.

  15. Visual impairment due to bilateral multifocal choroidal metastasis of parotid adenocarcinoma: a case report.

    Directory of Open Access Journals (Sweden)

    Gerard eWalls

    2014-06-01

    Full Text Available BackgroundOrbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.Case PresentationThe case of a 45 year old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET-CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient's presentation, histopathology and management, with support from the literature regarding applied and related therapies. SummaryIn this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient's death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.

  16. Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in Sub-Saharan Africa.

    Science.gov (United States)

    Campbell, C; Skovdal, M; Gibbs, A

    2011-08-01

    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) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS. PMID:20668927

  17. Focal and multifocal diabetic neuropathies Neuropatia diabética focal e multifocal

    OpenAIRE

    Gérard Said

    2007-01-01

    Diabetic neuropathy is the most common neuropathy in industrialized countries, with a remarkable range of clinical manifestations. The vast majority of the patients with clinical diabetic neuropathy have a distal symmetrical form that progress following a fiber-length dependent pattern, with predominant sensory and autonomic manifestations. This pattern of neuropathy is associated with a progressive distal axonopathy. Patients are exposed to trophic changes in the feet, pains and autonomic di...

  18. A case of osseous scintigraphy showing focuses of multifocal tuberculosis

    International Nuclear Information System (INIS)

    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

  19. 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

  20. Peripheral myopization using a dominant design multifocal contact lens

    Science.gov (United States)

    Lopes-Ferreira, Daniela; Ribeiro, Cláudia; Maia, Raquel; García-Porta, Nery; Queirós, António; Villa-Collar, César; González-Méijome, José Manuel

    2011-01-01

    Purpose The purpose of this study was to characterize the central and peripheral refraction across the horizontal meridian of the visual field without and with a multifocal dominant design soft contact lens of different add powers (+1.00 D to +4.00 D) in emmetropic eyes. Methods Twenty right eyes from 20 emmetropic patients (mean spherical equivalent central refraction –0.06 ± 0.54 D) with a mean age of 21.6 ± 2.3 years were fitted with Proclear Multifocal dominant design (Coopervision, Pleasanton, CA, USA). Lenses had add powers from +1.00 to +4.00 D in 1.00 D steps. The central and peripheral refraction was measured along the horizontal meridian up to 35° of eccentricity in the nasal and temporal retinal area in 5° steps using a open-field autorefractometer. Results Only the +3.00 and +4.00 D add powers generated a significant change in the peripheral refractive pattern compared to central refraction and compared with the no-lens wearing situation. The average myopic increase with these lenses was –3.00 D and –5.00 (p < 0.001) at the margins of inspected nasal and temporal visual field, respectively. Conclusions Multifocal dominant design soft contact lenses are able to change the peripheral refractive profile in emmetropic eyes increasing relative peripheral myopia. Lenses with +3.00 D add power seem to be the best option to create such effect due to significant peripheral myopization.

  1. Multifocal renal angiomyolipoma presenting as massive intraabdominal hemorrhage

    Directory of Open Access Journals (Sweden)

    Kushwaha Rashmi

    2010-04-01

    Full Text Available Angiomyolipomata of the kidney are unusual lesions composed of abnormal thick walled blood vessels, smooth muscle and adipose elements. These are asymptomatic and occasionally present with flank pain, a palpable mass or gross hematuria. They may be associated with tuberous sclerosis. The risk of bleeding is increased with size, and lesions greater than 4 cm have more than 50% chance of significant bleeding. An unusual case of multifocal renal angiomyolipoma associated with tuberous sclerosis and presenting as massive intra abdominal hemorrhage is reported.

  2. Designing multifocal corneal models to correct presbyopia by laser ablation

    Science.gov (United States)

    Alarcón, Aixa; Anera, Rosario G.; Del Barco, Luis Jiménez; Jiménez, José R.

    2012-01-01

    Two multifocal corneal models and an aspheric model designed to correct presbyopia by corneal photoablation were evaluated. The design of each model was optimized to achieve the best visual quality possible for both near and distance vision. In addition, we evaluated the effect of myosis and pupil decentration on visual quality. The corrected model with the central zone for near vision provides better results since it requires less ablated corneal surface area, permits higher addition values, presents stabler visual quality with pupil-size variations and lower high-order aberrations.

  3. Multifocal ERG Guiding Therapy in a Case of Hydroxychloroquine Premaculopathy

    OpenAIRE

    José Antonio Sáez-Moreno; Concepción Domínguez-Hidalgo; José Manuel Rodríguez-Ferrer

    2015-01-01

    We report the case of a 28-year-old female treated for systemic lupus erythematosus with hydroxychloroquine (200 mg/day) for 11 years. She was visually asymptomatic, with normal fundus appearance, normal colour vision testing findings, 20/20 visual acuity in both eyes, and only mild central bilateral defects on 10-2 perimetry. Multifocal electroretinography (mfERG) showed low density values for ring 1 in both eyes. Because the patient had not previously responded to alternative treatments and...

  4. Subcutaneous versus intravenous immunoglobulin in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Harbo, T; Andersen, Henning; Hess, A; Hansen, K; Sindrup, S H; Jakobsen, Johannes K.

    2009-01-01

    Background and purpose: For treatment of multifocal motor neuropathy (MMN), we hypothesized that (i) infusion of equivalent dosages of subcutaneous immunoglobulin (SCIG) is as effective as intravenous immunoglobulin (IVIG) and that (ii) subcutaneous infusion at home is associated with a better...... at the injection sites for a few weeks. All other adverse effects during SCIG were mild and transient. No differences between treatments of health-related quality of life occurred. Conclusion: In MMN, short-term subcutaneous infusion of immunoglobulin is feasible, safe and as effective as intravenous...

  5. 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.

  6. 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.

  7. Neurological complications of acute multifocal placoid pigment epitheliopathy.

    Science.gov (United States)

    Brownlee, W J; Anderson, N E; Sims, J; Pereira, J A

    2016-09-01

    Acute multifocal placoid pigment epitheliopathy (AMPPE) is an autoimmune chorioretinal disease that can be complicated by neurological involvement. There is limited information on this potentially treatable condition in the neurological literature. The objective of this patient series is to describe the neurological complications of AMPPE. We retrospectively identified patients with neurological complications of AMPPE seen at Auckland Hospital between 2008 and 2013 and summarised cases in the literature between 1976 and 2013. We identified five patients with neurological complications of AMPPE at Auckland Hospital and 47 reported patients. These patients demonstrated a spectrum of neurological involvement including isolated headache, stroke or transient ischaemic attack, seizures, venous sinus thrombosis, optic neuritis, sensorineural hearing loss and peripheral vestibular disorder. We propose criteria to define AMPPE with neurological complications. A cerebrospinal fluid (CSF) lymphocytosis in a patient with isolated headache may predict the development of cerebrovascular complications of AMPPE. Patients with cerebrovascular complications of AMPPE have a poor prognosis with high rates of death and neurological disability among survivors. Predictors of poor outcome in those who develop neurological complications of AMPPE are a relapsing course, generalised seizures and multifocal infarction on MRI. All patients with neurological complications of AMPPE, including headache alone, should be investigated with an MRI brain and CSF examination. Patients with focal neurological symptoms should receive intravenous (IV) methylprednisolone followed by a tapering course of oral steroids for at least 3months. Patients with AMPPE and an isolated headache with a CSF pleocytosis should be treated with oral steroids. PMID:27183958

  8. Tuberculosis-related choriocapillaritis (multifocal-serpiginous choroiditis): follow-up and precise monitoring of therapy by indocyanine green angiography.

    Science.gov (United States)

    De Luigi, Giulia; Mantovani, Alessandro; Papadia, Marina; Herbort, Carl P

    2012-02-01

    To report the case of a patient initially diagnosed with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), characterized by relentless evolution despite high-dose steroid therapy. An interferon-gamma release assay (IGRA) indicated a diagnosis of suspected tuberculous choriocapillaritis and the disease responded only to massive inflammation suppressive therapy and antibiotic therapy. Case report. Review of clinical features and investigational procedures. Smoldering relentless evolution and subsequent arrest of progression could be precisely monitored by indocyanine green angiography (ICGA). The patient did not recover after standard anti-tubercolosis (TB) therapy combined with corticosteroid. A fourth antibiotic had to be added in order to stop the progression of the retinal disease. In each case of choriocapillaritis such as APMPPE an infectious cause including TB has to be excluded making IGRA tests unavoidable. As the main structure involved is the choriocapillaris the most precise follow-up or monitoring is obtained with ICGA. PMID:22249644

  9. 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.

  10. 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

    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%). In a...... logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short...

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

    OpenAIRE

    E Amoran; O Ogunsola; O Salako; O Alausa

    2012-01-01

    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...

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

    Science.gov (United States)

    Chinsembu, Kazhila C

    2016-01-01

    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. PMID:27069489

  13. 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.

  14. 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. PMID:20974090

  15. Advantages and disadvantages of multifocal contact lens correction of presbyopia in patients with myopic refraction

    Directory of Open Access Journals (Sweden)

    A. G. Shchuko

    2013-01-01

    Full Text Available Purpose: To evaluate the results of multifocal contact correction of presbyopia in subjects with myopic refraction.Methods: The study included 28 patients with myopia (range 43 to 54 years in conditions of routine contact correction of vision. The examination was repeated a month later after wearing of multifocal contact lenses. The following parameters were assessed: far visual acuity, near and intermediate visual acuity (monocular and binocular, spatial contrast sensitivity, stereo vision (Lang test I&II, area of binocular interaction (binarymeter, visual quality (test VF-14.Results: The indices if visual acuity in patients with multifocal contact lenses were high at all test distances. The significant increase of near vision was noted: visual acuity with monofocal contact correction was 0.39±0.11, with multifocal — 0.62±0.15 (p<0.05. However the decrease of spatial contrast sensitivity was noted: with monofocal contact lenses 21.96±4.6 dB (total in 4 frequencies, with multifocal — 19.48±1.1 dB, p<0.05. The level of stereo perception in users of multifocal contact lenses remains high, but the decrease of fusion capacity in convergence was noted. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (- 0.5 D or difference between eyes 0.3‑0.5 D. The office employees were maximally satisfied with multifocal contact lenses.Conclusion: Multifocal contact correction of presbyopia allows achieving high functional results at different distances. Patients with myopia, previously used contact lens correction, easy pass to multifocal correction options. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (- 0.5 D.

  16. Advantages and disadvantages of multifocal contact lens correction of presbyopia in patients with myopic refraction

    Directory of Open Access Journals (Sweden)

    A. G. Shchuko

    2014-07-01

    Full Text Available Purpose: To evaluate the results of multifocal contact correction of presbyopia in subjects with myopic refraction.Methods: The study included 28 patients with myopia (range 43 to 54 years in conditions of routine contact correction of vision. The examination was repeated a month later after wearing of multifocal contact lenses. The following parameters were assessed: far visual acuity, near and intermediate visual acuity (monocular and binocular, spatial contrast sensitivity, stereo vision (Lang test I&II, area of binocular interaction (binarymeter, visual quality (test VF-14.Results: The indices if visual acuity in patients with multifocal contact lenses were high at all test distances. The significant increase of near vision was noted: visual acuity with monofocal contact correction was 0.39±0.11, with multifocal — 0.62±0.15 (p<0.05. However the decrease of spatial contrast sensitivity was noted: with monofocal contact lenses 21.96±4.6 dB (total in 4 frequencies, with multifocal — 19.48±1.1 dB, p<0.05. The level of stereo perception in users of multifocal contact lenses remains high, but the decrease of fusion capacity in convergence was noted. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (- 0.5 D or difference between eyes 0.3‑0.5 D. The office employees were maximally satisfied with multifocal contact lenses.Conclusion: Multifocal contact correction of presbyopia allows achieving high functional results at different distances. Patients with myopia, previously used contact lens correction, easy pass to multifocal correction options. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (- 0.5 D.

  17. Prolonged multifocal electroretinographic implicit times in the ocular ischemic syndrome

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine; Sander, Birgit;

    2010-01-01

    Purpose. To examine retinal function in chronic ocular ischemia using multifocal electroretinography (mfERG). Methods. Thirteen patients with unilateral ocular ischemic syndrome (OIS) underwent assessment of ophthalmic systolic blood pressure by ocular pneumoplethysmography, carotid artery patency.......4 +/- 1.7 mm Hg, respectively. Summed mfERG implicit times (N1, P1, N2) were prolonged in eyes with OIS, by 7.6%, 6.2%, and 7.5%, respectively, compared with fellow eyes (P ... the central retina was limited by high variance. Second-order kernel (first slice) summed implicit times (N1, P1, N2) were also prolonged in OIS, by 6.6%, 7.3%, and 6.8%, respectively (P

  18. 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

    2014-01-01

    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. PMID:24898470

  19. [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. PMID:27221306

  20. 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.

    2014-06-01

    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.

  1. AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia.

    Directory of Open Access Journals (Sweden)

    Siyan Yi

    Full Text Available AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV. We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12 was used to measure mental disorders. Multivariate logistic regression analysis was conducted.The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4. After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4 remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4-2.6, higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2-2.3, and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1-2.2.AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

  2. Comparative analysis of the visual performance and aberrometric outcomes with a new hybrid and two silicone hydrogel multifocal contact lenses: a pilot study

    OpenAIRE

    Piñero Llorens, David Pablo; Carracedo, Gonzalo; Ruiz Fortes, Pedro; Pérez Cambrodí, Rafael J.

    2015-01-01

    Background: The aim was to evaluate the visual performance achieved with a new multifocal hybrid contact lens and to compare it with that obtained with two other currently available multifocal soft contact lenses. Methods: This pilot prospective comparative study comprised a total of 16 presbyopic eyes of eight patients ranging in age from 43 to 58 years. All patients were fitted with three different models of multifocal contact lens: Duette multifocal (SynergEyes), Air Optix AQUA multifocal ...

  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. [Multiple myeloma with significant multifocal osteolysis in a dog without a detectible gammopathy].

    Science.gov (United States)

    Souchon, F; Koch, A; Sohns, A

    2013-01-01

    Description of a variant of multiple myeloma in a dog lacking the gammopathy normally associated with this type of neoplasm. A Border Collie mongrel was presented with symptoms of progressive hind-leg weakness, lethargy and tiredness, which had started to appear 6 weeks previously. Radiographic examination showed small osteolytic areas in the spinal column, but also diffuse small areas of increased opacity as well as evidence of decreased bone density in the pelvis and of both femoral necks. Moderate regenerative anaemia, hypogammopathy and hypercalcaemia were diagnosed. Computed tomography scans displayed multifocal osteolysis and bone destruction in the skull, spinal column, scapulae, proximal humeri, pelvis and femoral necks. H&E staining of the biopsies showed bone destruction and monomorphic plasmacyotid cell populations, causing infiltrative bone marrow lesions and osteolysis. In many areas neoplastic plasma cell infiltration of the bone marrow was 70% and in some areas reached 100%. The diagnosis was non-secretory multiple myeloma without apparent secretion of paraproteins into the blood. PMID:24326882

  5. 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

    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%). In a...... logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short......-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...

  6. Case of relapsed AIDS-related plasmablastic lymphoma treated with autologous stem cell transplantation and highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Hiroki Goto

    2011-03-01

    Full Text Available Plasmablastic lymphoma is a rare and aggressive malignancy strongly associated with HIV infection. The refractory/relapsed disease rate is high, and the survival rate is characteristically poor. There are no satisfactory salvage regimens for relapsed cases. We successfully performed autologous stem cell transplantation using a regimen consisting of MCNU (ranimustine, etoposide, cytarabine, and melphalan in a Japanese patient with relapsed AIDS-related plasmablastic lymphoma of the oral cavity. Highly active antiretroviral therapy continued during the therapy. Therapy-related toxicity was tolerable, and a total of 40 Gy of irradiation was administered after autologous stem cell transplantation. The patient has remained in complete remission for 16 months since transplantation.

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

    Directory of Open Access Journals (Sweden)

    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

  8. 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.

  9. 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.)

  10. 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.

  11. Advantages and disadvantages of multifocal contact lens correction of presbyopia in patients with myopic refraction

    OpenAIRE

    A.G. Shchuko; N. N. Seliverstova; E. A. Rogozhnikova; O. I. Rozanova

    2014-01-01

    Purpose: To evaluate the results of multifocal contact correction of presbyopia in subjects with myopic refraction.Methods: The study included 28 patients with myopia (range 43 to 54 years) in conditions of routine contact correction of vision. The examination was repeated a month later after wearing of multifocal contact lenses. The following parameters were assessed: far visual acuity, near and intermediate visual acuity (monocular and binocular), spatial contrast sensitivity, stereo vision...

  12. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

    OpenAIRE

    Kassi Komenan; Ecra J. Elidjé; Ildevert, Gbery P.; Yao, Kouassi I.; Kouame Kanga; Kouassi A. Kouamé; Sangaré Abdoulaye; Hamdam, Kourouma S.; Yoboué P. Yao; Kanga Jean-Marie

    2013-01-01

    Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune...

  13. 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.

  14. AIDS-related myopathy.

    Science.gov (United States)

    Sheikh, Rafiq A.; Yasmeen, Shagufta; Munn, Robert; Ruebner, Boris H.; Ellis, William G.

    1999-09-01

    Infection with the human immunodeficiency virus (HIV) is often associated with the acquired immunodeficiency syndrome (AIDS), and wasting is one of the defining clinical features of AIDS. Muscular weakness due to myopathy may develop at any stage of HIV infection. We report two illustrative cases of HIV-associated myopathies. One was due to inflammatory myosits most likely directly related to the HIV infection, and the other was most likely the result of mitochondrial damage due to zidovudine, a nucleoside analogue commonly used in treating HIV infection. Biopsies from both patients showed alterations of myofiber structures, of varying severity, culminating in necrosis, lipid droplets, and lymphoplasmocytic inflammatory response. The zidovudine-treated patient also showed distinctive mitochondrial changes, predominantly enlargement, variation in shape and size, and disorganization of the cristae. These two types of HIV-associated inflammatory myopathies are reviewed, along with other HIV-associated myopathies, including HIV wasting syndrome, nemaline rod myopathy, pyomyositis, rhabdomyolysis, cardiomyopathy, and other miscellaneous myopathies associated with HIV infection. PMID:11810429

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Chronic recurrent multifocal osteomyelitis: an evolving clinical and radiological spectrum

    International Nuclear Information System (INIS)

    Based on radiographic and microscopic findings, three patients were prospectively diagnosed as having chronic recurrent multifocal osteomyelitis (CRMO). They form the basis of this report because of either the unusualness of the clinical presentation, hitherto undescribed associated diseases or the unusual age of presentation and sites of lesions. One patient developed pyoderma gangrenosum at the site of one of the skeletal lesions and then went on the develop ulcerative proctitis. A second patient presented with a soft tissue mass, which on MRI mimicked a sarcoma. The final patient presented with lesions in the wrist and phalanges of the toes at the unusual age of 38. None of the patients was treated with steroids or antibiotics for the skeletal lesions. Steroids were administered to one patient for treatment of pyoderma gangrenosum. The pattern and distribution of skeletal lesions in CRMO are well recognized in the pediatric age group. The unusual clinical and/or radiological features discussed herein suggests that this is a disease that continues to evolve with a broader spectrum of features than recognized. (orig./MG)

  17. Vertebral manifestation of chronic recurrent multifocal osteomyelitis (CRMO)

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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

  19. Multifocal Electroretinography after High Dose Chloroquine Therapy for Malaria

    Directory of Open Access Journals (Sweden)

    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.

  20. Chronic recurrent multifocal osteomyelitis: an evolving clinical and radiological spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M. [Dept. of Radiology, St. Louis Univ. Medical Center, MO (United States); McDonald, D. [Dept. of Orthopedic Surgery, St. Louis Univ. Medical Center, MO (United States); Engel, E. [Dept. of Orthopedic Surgery, St. Louis Univ. Medical Center, MO (United States); Rotman, M. [Dept. of Orthopedic Surgery, St. Louis Univ. Medical Center, MO (United States); Siegfried, E.C. [Dept. of Internal Medicine, Dermatology Div., St. Louis Univ. Medical Center, MO (United States)

    1996-05-01

    Based on radiographic and microscopic findings, three patients were prospectively diagnosed as having chronic recurrent multifocal osteomyelitis (CRMO). They form the basis of this report because of either the unusualness of the clinical presentation, hitherto undescribed associated diseases or the unusual age of presentation and sites of lesions. One patient developed pyoderma gangrenosum at the site of one of the skeletal lesions and then went on the develop ulcerative proctitis. A second patient presented with a soft tissue mass, which on MRI mimicked a sarcoma. The final patient presented with lesions in the wrist and phalanges of the toes at the unusual age of 38. None of the patients was treated with steroids or antibiotics for the skeletal lesions. Steroids were administered to one patient for treatment of pyoderma gangrenosum. The pattern and distribution of skeletal lesions in CRMO are well recognized in the pediatric age group. The unusual clinical and/or radiological features discussed herein suggests that this is a disease that continues to evolve with a broader spectrum of features than recognized. (orig./MG)

  1. Multifocal Langerhans cell histiocytosis of bone: Indications for radiotherapy

    International Nuclear Information System (INIS)

    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)

  2. Case report: Multifocal chronic paracoccidioidomycosis in an adult

    Directory of Open Access Journals (Sweden)

    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.

  3. Toxoplasma gondii infection in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of congenital and AIDS-related toxoplasmosis.

    Directory of Open Access Journals (Sweden)

    Gulnara Minbaeva

    Full Text Available BACKGROUND: HIV-prevalence, as well as incidence of zoonotic parasitic diseases like cystic echinococcosis, has increased in the Kyrgyz Republic due to fundamental socio-economic changes after the breakdown of the Soviet Union. The possible impact on morbidity and mortality caused by Toxoplasma gondii infection in congenital toxoplasmosis or as an opportunistic infection in the emerging AIDS pandemic has not been reported from Kyrgyzstan. METHODOLOGY/PRINCIPAL FINDINGS: We screened 1,061 rural and 899 urban people to determine the seroprevalence of T. gondii infection in 2 representative but epidemiologically distinct populations in Kyrgyzstan. The rural population was from a typical agricultural district where sheep husbandry is a major occupation. The urban population was selected in collaboration with several diagnostic laboratories in Bishkek, the largest city in Kyrgyzstan. We designed a questionnaire that was used on all rural subjects so a risk-factor analysis could be undertaken. The samples from the urban population were anonymous and only data with regard to age and gender was available. Estimates of putative cases of congenital and AIDS-related toxoplasmosis in the whole country were made from the results of the serology. Specific antibodies (IgG against Triton X-100 extracted antigens of T. gondii tachyzoites from in vitro cultures were determined by ELISA. Overall seroprevalence of infection with T. gondii in people living in rural vs. urban areas was 6.2% (95%CI: 4.8-7.8 (adjusted seroprevalence based on census figures 5.1%, 95% CI 3.9-6.5, and 19.0% (95%CI: 16.5-21.7 (adjusted 16.4%, 95% CI 14.1-19.3, respectively, without significant gender-specific differences. The seroprevalence increased with age. Independently low social status increased the risk of Toxoplasma seropositivity while increasing numbers of sheep owned decreased the risk of seropositivity. Water supply, consumption of unpasteurized milk products or undercooked

  4. Comparison of efficacy of two techniques for testicular sperm retrieval in nonobstructive azoospermia: multifocal testicular sperm extraction versus multifocal testicular sperm aspiration.

    Science.gov (United States)

    Hauser, Ron; Yogev, Leah; Paz, Gedalia; Yavetz, Haim; Azem, Fuad; Lessing, Joseph B; Botchan, Amnon

    2006-01-01

    To compare the efficacy of 2 sperm-retrieval procedures, testicular sperm extraction (TESE) and testicular sperm aspiration (TESA), during the same procedure using the same subjects as their own controls. The presence of mature testicular sperm cells and motility were evaluated in 87 men with nonobstructive azoospermia (NOA) by means of multifocal TESE and multifocal TESA, which were performed during the same procedure using the same subjects as their own controls. Sperm cells were recovered by TESE in 54 cases, but by TESA in only 36 cases. There were significantly more cases (n = 20) in which sperm cells were recovered by TESE only, compared with 2 cases in whom cells were recovered by TESA only (McNemar's test, P < .001). The mean number of locations in each testis in which sperm cells were detected was significantly higher in the TESE group. In significantly more cases (n = 27), motility was observed in TESE material only, compared with 3 cases in which motility was present in material extracted by TESA only (McNemar's test, P < .001). Mean number of locations in each testis with motile sperm cells was significantly higher in the TESE group. The TESE procedure yielded significantly more sperm cells, as was also reflected by the difference in number of straws with cryopreserved sperm. This comparative prospective clinical study revealed that multifocal TESE is more efficient than multifocal TESA for sperm detection and recovery in men with NOA and should be the procedure of choice for sperm retrieval for them. PMID:16400074

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Discussion on treatment of AIDS related diarrhea from spleen%艾滋病相关性腹泻从脾论治的探讨

    Institute of Scientific and Technical Information of China (English)

    王翠芳; 李峰; 王玉光

    2012-01-01

    目的:探讨艾滋病相关性腹泻从脾论治的理论依据.方法:通过研究古代文献中泄泻与脾的关系的论述,结合现代免疫学及分子生物学对脾的功能研究以及艾滋病相关性腹泻临床治疗方面的报道,分析脾在艾滋病相关性腹泻发生过程中所起的作用以及艾滋病相关性腹泻从脾论治的可行性.结果:脾在艾滋病相关性腹泻的发生、发展过程中起举足轻重的作用.结论:对艾滋病相关性腹泻进行临床治疗,必须重视脾的作用.%Objective: To explore the treatment theoretical basis of AIDS related diarrhea from spleen. Methods: According to the research of ancient literature on relationship between spleen and diarrhea, combination with immunology, molecular biology and clinical treatment of AIDS related diarrhea, to explore the important role of spleen in AIDS related diarrhea and the feasibility of AIDS related diarrhea treated from spleen. Results: Spleen has a important role in the processes, development of AIDS related diarrhea. Conclusion: To treat AIDS related diarrhea, and the role of spleen must be emphasized.

  7. A systematic review of HIV/AIDS-related stigma and discrimination in India: current understanding and future needs.

    Science.gov (United States)

    Bharat, Shalini

    2011-01-01

    HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement, conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as, transgender people. Context-specific (health care, community) interventions are needed to address various forms of stigma - enacted, perceived, internalised and layered - including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall, the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction. PMID:23237728

  8. AIDS-related knowledge, attitudes and behaviour among South African street youth: reflections on power, sexuality and the autonomous self.

    Science.gov (United States)

    Swart-Kruger, J; Richter, L M

    1997-09-01

    Street children in South Africa are, in the main, between the ages of 11 and 17 years. Rape, prostitution, sexual bartering and exchange, casual sex and romantic sexual relationships all occur in the experiences of young people who live and work on inner-city streets. In this study, the AIDS-related knowledge, attitudes and behaviour of 141 street youth, living in seven large cities in South Africa, were elicited in focus group discussions. At the time of the study, 79 boys (56%) were living in shelters run by nongovernmental and welfare organisations, while 62 boys (44%) were sleeping "rough". The results, both qualitative and quantitative, indicated that the AIDS knowledge of South African street children was comparable to levels reported for groups of "hard-to-reach" youth in other parts of the world. Fear of HIV infection did not appear in a list of day-to-day priorities constructed by the children, a list dominated by survival concerns with food, money and clothes. However, more than half of the boys conceded that they engaged in sex for money, goods or protection, several boys indicated that they had been raped, and most reported being sexually active with "girlfriends", who themselves frequently engaged in transactional sex. The findings are interpreted in terms of the relationships between power dynamics surrounding race and age, and how they affect self-initiated controls over sexuality and sexual protection. PMID:9255928

  9. HIV/AIDS-related knowledge and behaviors among rural married migrant women in Shandong Province, China: a comparison study.

    Science.gov (United States)

    Song, Yapei; Kang, Dianmin; Wang, Guoyong; Wei, Chongyi; Tao, Xiaorun; Huang, Tao; Qian, Yuesheng; Zhu, Tiwen; Yang, Shan; Yu, Shaoqi; Wang, Hong; Ma, Wei

    2015-02-01

    Migrant women in China are disproportionately affected by HIV/AIDS. This study described HIV/AIDS-related knowledge and behaviors among married migrant women in Shandong province in comparison to non-migrant local women and identified factors associated with HIV testing history and extramarital sex among married migrant women. A probability-based sample of 1,076 migrant and 1,195 local women were included in the analyses. Compared to local women, married migrant women had lower levels of HIV/AIDS knowledge and were more likely to have had premarital sex, extramarital sex, history of sexually transmitted diseases, and drug use. Less than a quarter of migrant women used condoms consistently in extramarital sex. Only 31.0 % of married migrant women had ever tested for HIV, and the rate of premarital HIV testing was very low. Multivariable analysis showed that married migrant women with a history of extramarital sex were more likely to be from Yunnan province, be living in Yantai city, be in their first marriage, have lower family income, have poor relationship with spouses, use drug, have a history of sexually transmitted diseases, and have lower social support. Our findings provide further evidence that married migrant women are at higher risk for HIV infection and that targeted interventions need to be developed for this population. PMID:25323941

  10. Hemophagocytic Syndrome Associated with Immune Reconstitution Inflammatory Syndrome in a Patient with AIDS Related Burkitt’s Leukemia/Lymphoma

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    Metin Kanıtez

    2014-01-01

    Full Text Available Highly active antiretroviral therapy (HAART has markedly decreased human immunodeficiency virus- (HIV- related mortality and the incidence of opportunistic infections. The dramatic reduction in HIV-1 RNA and increase in CD4 lymphocyte count mean a recovery in immune function. This restoration in immune function may be associated with paradoxical deterioration in subclinical opportunistic infections in some patients, a condition called immune reconstitution inflammatory syndrome (IRIS. IRIS, a “paradoxical” inflammatory response to either previously treated or subclinical infections or noninfectious diseases, can manifest during the restoration phase of immunity hemophagocytic syndrome (HS which is a very rare complication in patients with acquired immune deficiency syndrome (AIDS. We describe a case of hemophagocytic syndrome associated with IRIS in a patient with AIDS related Burkitt’s leukemia/lymphoma (BL. IRIS was probably the cause of hemophagocytosis for our patient. Zoster infection may facilitate to IRIS. With the increasing number of people with HIV infection and the accompanying use of HAART, much more clinical manifestations of IRIS will be experienced especially in patients given high dose chemotherapy, just like in our case.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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. Sensitivity of imaging for multifocal-multicentric breast carcinoma

    Directory of Open Access Journals (Sweden)

    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

  15. Tuberous sclerosis diagnosed by incidental computed tomography findings of multifocal micronodular pneumocyte hyperplasia: a case report

    Directory of Open Access Journals (Sweden)

    Ishii Makoto

    2012-10-01

    Full Text Available Abstract Introduction The majority of multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis complex is diagnosed with the classical clinical triad of seizures, mental retardation, and skin lesions. We report a rare case of tuberous sclerosis complex with no classical clinical findings, which was diagnosed through incidental computed tomography findings of multiple nodular lesions of multifocal micronodular pneumocyte hyperplasia. Case presentation A chest computed tomography scan of a 51-year-old Japanese woman showed multiple nodular ground-glass opacities that were not seen on chest X-ray. Video-assisted thoracoscopic surgery was performed. A histological examination demonstrated type II pneumocyte hyperplasia with thickened fibrotic alveolar septa, which was consistent with multifocal micronodular pneumocyte hyperplasia. Brain magnetic resonance imaging displayed multiple cortical tubers, and abdominal computed tomography showed bilateral renal angiomyolipoma. Our patient was finally diagnosed as having tuberous sclerosis complex with multifocal micronodular pneumocyte hyperplasia, although she had no episodes of epilepsy, no skin lesions, and no family history. Conclusions Multifocal micronodular pneumocyte hyperplasia with latent tuberous sclerosis complex should be considered in the differential diagnosis of multiple ground-glass opacities.

  16. With and With"out": The Bereavement Experiences of Gay Men Who Have Lost a Partner to Non-AIDS-Related Causes

    Science.gov (United States)

    Hornjatkevyc, Nina L.; Alderson, Kevin G.

    2011-01-01

    This study gives voice to the experiences of gay men who have lost a partner to non-AIDS-related causes, a subject that has received little attention in the psychological literature. Interviews were conducted with 8 gay men. An analysis informed by hermeneutic phenomenology generated themes and contextualized meanings regarding the participants'…

  17. 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...

  18. 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...

  19. 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.

  20. Hypervascular multifocal hepatoblastoma: dynamic gadolinium-enhanced MRI findings indistinguishable from infantile hemangioendothelioma

    International Nuclear Information System (INIS)

    In this case report we describe a neonate with multifocal hypervascular hepatoblastoma indistinguishable from infantile hemangioendothelioma on dynamic gadolinium-enhanced MRI. Review of the literature revealed a description of a hypervascular form of solitary hepatoblastoma visualized using sonography and CT. Our case is unique in that it illustrates centripetal fill-in of multifocal hepatoblastoma on dynamic gadolinium-enhanced MRI. MRI has several advantages over CT in the characterization and follow-up of neonatal liver tumors. These advantages include the lack of ionizing radiation, as well as an ability to visualize vascular structures that is less dependent upon the timing of contrast material administration. This case further highlights the difficulty in discriminating between infantile hemangioendothelioma and hepatoblastoma in radiology, particularly in a multifocal hypervascular variant of hepatoblastoma. (orig.)

  1. Multifocal two-photon excitation fluorescence sampling imaging combining lifetime and spectrum resolutions

    Science.gov (United States)

    Liu, Lixin; Lin, Ziyang; Qu, Junle; Chen, Danni; Xu, Gaixia; Guo, Baoping; Niu, Hanben

    2006-09-01

    Multifocal multiphoton microscopy (MMM) is a more efficient and powerful method for three-dimensional (3-D) fluorescence imaging with reduced acquisition time compared with conventional confocal and two-photon excitation fluorescence microscopy. We present a novel multifocal two-photon excitation fluorescence sampling imaging technique that is based on a specially designed streak camera and combines fluorescence lifetime and spectrum resolutions. A proof-of-principle experiment is performed on a standard fluorescent dye solution (Rhodamine 6G in ethanol), Time- and spectrum-resolved sampled fluorescence image of Rhodamine 6G is obtained in a snapshot. The reconstructed two-dimensional (2-D) fluorescence image of a prepared plant slide is also obtained by moving the sample laterally. The capability of this system capable of performing simultaneous 2-D measurements of temporal and spectral information has many potential applications, e.g., multi-well imaging and spectrally resolved multifocal multiphoton fluorescence lifetime imaging etc.

  2. Generation of a controllable multifocal array from a modulated azimuthally polarized beam.

    Science.gov (United States)

    Mu, Tingkui; Chen, Zeyu; Pacheco, Shaun; Wu, Rengmao; Zhang, Chunmin; Liang, Rongguang

    2016-01-15

    In this Letter, the focal spot areas of an azimuthally polarized beam modulated with a vortex-0-2π-phase plate or a π-phase-step plate are numerically found to be smaller than a radially polarized beam for three pupil functions with uniform, Gaussian, and Bessel-Gauss profiles. Several types of multizone phase plates are theoretically designed and numerically simulated for generating tight multifocal arrays from the azimuthally polarized beams for what we believe is the first time. The positions and polarization states of the multifocal arrays can be controlled simply by varying the pattern of the multizone plates. The produced multifocal array with controllable position and polarization is beneficial to parallel optical recording and parallel optical imaging. PMID:26766689

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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]....... factors. We found a small but significant influence on disease-free survival (HR=1.16 [1.03-1.31]) and a strong correlation between multifocality and known prognostic factors. This was in accordance with an earlier study done on a smaller population and in a different period of time [Pedersen L...

  5. Ten years observation and treatment of multifocal pilocytic astrocytoma.

    Science.gov (United States)

    Andrychowski, Jarosław; Taraszewska, Anna; Czernicki, Zbigniew; Jurkiewicz, Jerzy; Netczuk, Tomasz; Dabrowski, Piotr

    2009-01-01

    Pilocytic astrocytoma (PA) usually occurs in younger patients. It is a benign, generally well-delineated, WHO grade I tumour with favorable prognosis, which makes it different from diffuse astrocytomas, classified as higher grades of malignancy. A case study of PA was presented in a young female patient, observed and treated at the Neurosurgical Department for the period of 10 years, during which time she had frequent surgical procedures due to recurrence and dissemination of the tumour. The initial symptom of the disease was epileptic seizure at the age of 16. Neuroradiological study revealed cerebral tumour in the right temporal lobe, then the first temporal lobe surgery followed by re-operation and radiotherapy was performed. The patient developed hydrocephalus, treated with the ventriculo-peritoneal shunt. After 5 years local recurrence of the tumour appeared in the right temporal region. The patient was operated and the tumour was totally removed. Initially, the histopathological diagnosis of ganglioglioma was suggested for primary tumour, finally the diagnosis of pilocytic astrocytoma for both recurrent and primary tumour was established. During the next years of observation increasing neurological symptoms in lower limbs developed. Subsequently, the patient reported pain syndrome in lumbosacral and perineal area. Consecutive MRI studies revealed a spinal canal tumours localized at the thoracic level and next at sacral level. The spinal tumour was surgically treated in both locations; the last operation was done 10 years after surgery of the primary temporal lobe tumour. Histopathological examinations of the excised foci from spinal canal revealed neoplasm consistent with WHO grade I pilocytic astrocytoma. The presented case indicates that despite the spread of the neoplastic process, a histopathologically benign tumour (WHO I grade) allows for long-term survival and observation period. Unfortunately, multifocal tumour involving midline structures causes

  6. Primary effect of chemotherapy on the transcription profile of AIDS-related Kaposi's sarcoma

    International Nuclear Information System (INIS)

    Drugs & used in anticancer chemotherapy have severe effects upon the cellular transcription and replication machinery. From in vitro studies it has become clear that these drugs can affect specific genes, as well as have an effect upon the total transcriptome. Total mRNA from two skin lesions from a single AIDS-KS patient was analyzed with the SAGE (Serial Analysis of Gene Expression) technique to assess changes in the transcriptome induced by chemotherapy. SAGE libraries were constructed from material obtained 24 (KS-24) and 48 (KS-48) hrs after combination therapy with bleomycin, doxorubicin and vincristine. KS-24 and KS-48 were compared to SAGE libraries of untreated AIDS-KS, and to libraries generated from normal skin and from isolated CD4+ T-cells, using the programs USAGE and HTM. SAGE libraries were also compared with the SAGEmap database. In order to assess the primary response of AIDS-related Kaposi's sarcoma (AIDS-KS) to chemotherapy in vivo, we analyzed the transcriptome of AIDS-KS skin lesions from a HIV-1 seropositive patient at two time points after therapy. The mRNA profile was found to have changed dramatically within 24 hours after drug treatment. There was an almost complete absence of transcripts highly expressed in AIDS-KS, probably due to a transcription block. Analysis of KS-24 suggested that mRNA pool used in its construction originated from poly(A) binding protein (PABP) mRNP complexes, which are probably located in nuclear structures known as interchromatin granule clusters (IGCs). IGCs are known to fuse after transcription inhibition, probably affecting poly(A)+RNA distribution. Forty-eight hours after chemotherapy, mRNA isolated from the lesion was largely derived from infiltrating lymphocytes, confirming the transcriptional block in the AIDS-KS tissue. These in vivo findings indicate that the effect of anti-cancer drugs is likely to be more global than up- or downregulation of specific genes, at least in this single patient with

  7. 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

  8. Palliation of AIDS-related primary lymphoma of the brain: observations from a multi-institutional database

    International Nuclear Information System (INIS)

    Purpose: To catalogue the presenting symptoms of patients with AIDS who are presumed to have primary central nervous system lymphoma (PCNSL). To document the palliative efficacy of cranial irradiation (RT) relative to the endpoints of complete and overall response for the respective symptoms. Methods: An analysis of 163 patients with AIDS-related PCNSL who were evaluated at nine urban hospitals was performed. These patients were treated for PCNSL after the establishment of a tissue diagnosis or on a presumptive basis after failing empiric treatment for toxoplasmosis. All patients were treated between 1983 and 1995 with radiotherapy (median dose-fractionation scheme = 3 Gy x 10) and steroids (>90% dexamethasone). Because multiple fractionation schemes were used, prescriptions were converted to biologically effective doses according to the formula, Gy10 = Total Dose x (1 + fractional dose/α-β); using an α-β value of 10. Results: The overall palliative response rate for the entire group was 53%. In univariate analysis, trends were present associating complete response rates with higher performance status (KPS ≥ 70 vs. KPS ≤ 60 = 17% vs. 5%), female gender (women vs. men = 29% vs. 8%), and the delivery of higher biologically effective doses (BED) of RT (Gy10 > 39 vs. ≤ 39 = 20% vs. 5%). In multivariate analysis of factors predicting complete response, both higher KPS and higher BED retained independent significance. A separate univariate analysis identified high performance status (KPS ≥ 70 vs. KPS ≤ 60 = 71% vs. 47%), and young age (≤ 35 vs. > 35 = 61% vs. 40%) as factors significantly correlating with the endpoint of the overall response. In multivariate analysis, high performance status and the delivery of higher biologically effective doses of irradiation correlated significantly with higher overall response rates. Conclusion: Most AIDS patients who develop symptoms from primary lymphoma of the brain can achieve some palliation from a management

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

    OpenAIRE

    Yoganathan, Kathir

    2012-01-01

    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 jirove...

  10. Progressive multifocal leukoencephalopathy with gastrointestinal disease in a pediatric kidney transplant recipient.

    Science.gov (United States)

    Burke, M T; Trnka, P; Walsh, M; Poole, L; McTaggart, S J; Burke, J R

    2013-08-01

    PML is a demyelinating disease of the central nervous system caused by infection with JCV. Several cases of PML in bone marrow and solid organ transplant recipients have been reported in recent years. JCV has been isolated from the gastrointestinal mucosa of immunocompromised patients, but there are no published reports of PML associated with symptomatic gastrointestinal involvement in kidney transplant recipients. We report a case of a nine-yr-old girl with a kidney transplant who developed a severe gastrointestinal illness causing pseudo-obstruction in association with PML. JCV was suspected as the causative agent in this patient by the detection of high JCV titer through PCR analysis of the cerebrospinal fluid and blood and positive staining for simian virus 40 in the colon. JCV intestinal infection should be considered in kidney transplant recipients presenting with intestinal pseudo-obstruction. PMID:23902604

  11. Visual symptoms after lung transplantation : a case of progressive multifocal leukoencephalopathy

    NARCIS (Netherlands)

    Ouwens, J P; Haaxma-Reiche, H; Verschuuren, E A; Timens, W; Steenhuis, L H; de Boer, W J; van der Bij, W

    2000-01-01

    After solid organ transplantation, signs and symptoms of the central nervous system may present a diagnostic challenge. A 43-year-old patient developed a decrease in vision 15 months after bilateral lung transplantation. The initial diagnosis was a left posterior cataract, but left eye cataract extr

  12. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    International Nuclear Information System (INIS)

    A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

  13. Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO)

    OpenAIRE

    Hedrich, Christian M.; Hofmann, Sigrun R.; Pablik, Jessica; Morbach, Henner; Girschick, Hermann J.

    2016-01-01

    Sterile bone inflammation is the hallmark of autoinflammatory bone disorders, including chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO). Autoinflammatory osteopathies are the result of a dysregulated innate immune system, resulting in immune cell infiltration of the bone and subsequent osteoclast differentiation and activation. Interestingly, autoinflammatory bone disorders are associated with inflammation of the skin and/or...

  14. Multifocal sclerotic BCG spondylitis in a 13-year-old girl

    International Nuclear Information System (INIS)

    A case is reported of multifocal BCG osteomyelitis in a 13-year-old girl. The lesions in the skull, ribs and in several vertebrae were mainly sclerotic and healed with antituberculotic therapy. The case is unusual because of the late onset, sclerotic changes, and involvement of the spine. (orig.)

  15. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Piddo, C. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); Black, G.B. [Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); F.R.C.S. Section of Orthopedics, Children' s Hospital and the University of Manitoba, Winnipeg, Manitoba (Canada)

    2000-02-01

    A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

  16. 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.

  17. Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with internal limiting membrane peeling

    Directory of Open Access Journals (Sweden)

    Ji Won Lim

    2010-07-01

    Full Text Available Ji Won Lim, Joon Hee Cho, Ha Kyoung KimDepartment of Ophthalmology, Hallym University Sacred Heart Hospital, Chuncheon, Republic of KoreaAbstract: The aim of the current study was to evaluate macular function before and after surgery for idiopathic epiretinal membranes with internal limiting membrane (ILM peeling by means of multifocal electroretinography (ERG. Eighteen eyes of 18 patients who underwent vitrectomy with ILM removal were included. Best corrected visual acuity, optical coherence tomography (OCT, and multifocal electroretinography were assessed prior to surgery, and 3 and 12 months after surgery. All surgical samples were obtained and confirmed inclusion of an ILM by electron microscopy. Visual acuity and the central foveal thickness by OCT improved significantly 3 months postoperatively, with gradual recovery by 12 months. Preoperatively, only the P1 amplitude in rings 1 and 2 were decreased compared with the normal fellow eyes (P < 0.01. Three and 12 months after surgery, the P1 amplitude in rings 1 and 2 were decreased compared with the preoperative P1 amplitudes, but without significance. The photoreceptor status by OCT was related to the N1 amplitude before and after surgery. Although visual acuity and macular edema were improved after surgery, macular function, as indicated by multifocal ERG, had limited recovery at 12 months.Keywords: epiretinal membrane, macular function, multifocal electroretinography

  18. The spatial resolution of the porcine multifocal electroretinogram for detection of laser-induced retinal lesions

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Scherfig, Erik;

    2008-01-01

    This study aimed to investigate the spatial resolution of a porcine multifocal electroretinogram (mfERG) protocol by testing its ability to detect laser-induced retinal lesions. Furthermore, we wanted to describe time-dependent changes in implicit time and amplitude of the different mfERG peaks...

  19. 78 FR 33098 - Prospective Grant of Co-Exclusive Licenses: Multi-Focal Structured Illumination Microscopy...

    Science.gov (United States)

    2013-06-03

    ... HUMAN SERVICES National Institutes of Health Prospective Grant of Co-Exclusive Licenses: Multi-Focal... microscopes. The prospective co-exclusive licenses will be royalty-bearing and comply with the terms and conditions of 35 U.S.C. 209 and 37 CFR 404.7. The prospective co-exclusive license may be granted...

  20. 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...

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

    International Nuclear Information System (INIS)

    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.

  2. Multifocal non-Hodgkin lymphoma in an infant with cardiac involvement: whole-body MR imaging

    International Nuclear Information System (INIS)

    Non-Hodgkin lymphoma (NHL) is rare in infancy, and we present a case of aggressive NHL of T-cell lineage in an infant with multifocal bone, cardiac, mediastinal nodal, paranasal sinus, calvarial, and soft-tissue deposits on presentation that were detected on whole-body MRI. (orig.)

  3. Belief in AIDS-Related Conspiracy Theories and Mistrust in the Government: Relationship With HIV Testing Among At-Risk Older Adults

    OpenAIRE

    Ford, Chandra L.; WALLACE, STEVEN P.; Newman, Peter A.; Lee, Sung-Jae; Cunningham, William

    2013-01-01

    Purpose: One in 4 persons living with HIV/AIDS is an older adult (age 50 or older); unfortunately, older adults are disproportionately diagnosed in late stages of HIV disease. Psychological barriers, including belief in AIDS-related conspiracy theories (e.g., HIV was created to eliminate certain groups) and mistrust in the government, may influence whether adults undergo HIV testing. We examined relationships between these factors and recent HIV testing among at-risk, older adults. Design and...

  4. The Influence of Personality Disorder Indication, Social Support, and Grief on Alcohol and Cocaine Use among HIV-Positive Adults Coping with AIDS-Related Bereavement

    OpenAIRE

    Hansen, Nathan B.; Cavanaugh, Courtenay E.; Vaughan, Ellen L.; Connell, Christian M.; Tate, David C.; Sikkema, Kathleen J.

    2007-01-01

    Substance use is prevalent among HIV-positive adults and linked to a number of adverse health consequences; however little is known about risk and protective factors that influence substance use among HIV-positive adults coping with AIDS-related bereavement. Using structural equation modeling (SEM), male gender, diagnostic indications of antisocial and borderline personality disorders (PD), and grief severity were tested as risk factors, and social support as a protective factor, for alcohol ...

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

    OpenAIRE

    Åstrøm Anne; Nasir Elwalid; David Jamil; Ali Rouf

    2008-01-01

    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-ec...

  6. 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.

  7. 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

  8. 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 ...

  9. Multifocal Retinopathy in Dachshunds with CLN2 Neuronal Ceroid Lipofuscinosis

    OpenAIRE

    Whiting, Rebecca E. H.; Pearce, Jacqueline W.; Castaner, Leilani J.; Jensen, Cheryl A.; Katz, Rebecca J.; Gilliam, Douglas H.; Katz, Martin L.

    2015-01-01

    The CLN2 form of neuronal ceroid lipofuscinosis is an autosomal recessively inherited lysosomal storage disease that is characterized by progressive vision loss culminating in blindness, cognitive and motor decline, neurodegeneration, and premature death. CLN2 disease results from mutations in the gene that encodes the soluble lysosomal enzyme tripeptidyl peptidase-1. A null mutation in the TPP1 gene encoding this enzyme causes a CLN2-like disease in Dachshunds. Dachshunds that are homozygous...

  10. 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

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

    Directory of Open Access Journals (Sweden)

    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

  12. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

    Science.gov (United States)

    Komenan, Kassi; Elidjé, Ecra J.; Ildevert, Gbery P.; Yao, Kouassi I.; Kanga, Kouame; Kouamé, Kouassi A.; Abdoulaye, Sangaré; Hamdam, Kourouma S.; Yao, Yoboué P.; Jean-Marie, Kanga

    2013-01-01

    Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders. PMID:24454398

  13. Acceptance of different multifocal contact lenses depending on the binocular findings.

    Science.gov (United States)

    Cagnolati, W

    1993-04-01

    In a clinical study the subjective acceptance as well as the quality of different visual functions was examined during the wearing of three multifocal lenses (Ciba Spectrum Bifocal, Allergan Echelon, and Essilor Variations). Ten subjects wore each of the 3 contact lens types for a period of 12 to 21 days after the binocular finding (bicentral or disparate vision within the Panum's area); further functions such as contrast or scotopic vision were qualified and/or quantified in a basic examination. All subjects (N = 5) with the binocular finding orthophoria/motorcompensated heterophoria preferred the Ciba Spectrum Bifocal. Furthermore, all visual functions of the 10 test persons were clearly reduced with all 3 multifocal contact lenses. A correlation between the "preferred contact lens and the detailed subjective acceptance" and/or the "subjective acceptance and the functional measurements" could not be proven as statistically significant. PMID:8502460

  14. Optical implementation of multifocal programmable lens with single and multiple axes

    International Nuclear Information System (INIS)

    In this work we analyse the generation of a diffractive optical element (DOE) consisting of a multifocal Fresnel lens by means of an LCoS (liquid cristal on silicon) spatial light modulator (SLM). The multifocal lens is composed of a set of lenses of different focal length that share a common optical axis (coaxial combination) or have different axes in parallel (multi-axis combination). For both configurations, we present several ways to combine the phase distributions for three lenses with different focal lengths (f1, f2, f3), into a single-phase distribution addressed to the SLM. Numerical simulations were carried out along with the experimental analysis to corroborate the results.

  15. Optical implementation of multifocal programmable lens with single and multiple axes

    Energy Technology Data Exchange (ETDEWEB)

    Romero, Lenny A; Millan, Maria S; Perez-Cabre, Elisabet, E-mail: lenny.alexandra.romero@upc.edu [Optics and Optometry Dep. Technical University of Catalonia Violinista Vellsola 37, 08222 Terrassa (Spain)

    2011-01-01

    In this work we analyse the generation of a diffractive optical element (DOE) consisting of a multifocal Fresnel lens by means of an LCoS (liquid cristal on silicon) spatial light modulator (SLM). The multifocal lens is composed of a set of lenses of different focal length that share a common optical axis (coaxial combination) or have different axes in parallel (multi-axis combination). For both configurations, we present several ways to combine the phase distributions for three lenses with different focal lengths (f1, f2, f3), into a single-phase distribution addressed to the SLM. Numerical simulations were carried out along with the experimental analysis to corroborate the results.

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

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. Skull-base Ewing sarcoma with multifocal extracranial metastases

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    2015-01-01

    ABSTRACT 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, an...

  1. Chronic recurrent multifocal osteomyelitis: case series of four patients treated with biphosphonates.

    OpenAIRE

    Ferraria, N; Marques, JG; Ramos, F.; Lopes, G.; Fonseca, JG; Neves, MC

    2014-01-01

    Aim: To report and describe a series of four cases of chronic recurrent multifocal osteomyelitis (CRMO) and to discuss therapeutic options, particularly bisphosphonate therapy. Methods: Retrospective review of four CRMO cases in two Pediatric Units in Lisbon, between 2005 and 2010. Results: Median age of first CRMO symptoms was 11.3 years (range 9-13). The more affected sites were the metaphysis of the long bones, pelvis and coxofemoral joints. Median number of initial bony lesions for each p...

  2. Non-descanned multifocal multiphoton microscopy with a multianode photomultiplier tube

    OpenAIRE

    Jae Won Cha; Yew, Elijah Y. S.; Daekeun Kim; Jaichandar Subramanian; Elly Nedivi; So, Peter T. C.

    2015-01-01

    Multifocal multiphoton microscopy (MMM) improves imaging speed over a point scanning approach by parallelizing the excitation process. Early versions of MMM relied on imaging detectors to record emission signals from multiple foci simultaneously. For many turbid biological specimens, the scattering of emission photons results in blurred images and degrades the signal-to-noise ratio (SNR). We have recently demonstrated that a multianode photomultiplier tube (MAPMT) placed in a descanned config...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Escott S; Tarabishy AB; Davidorf FH

    2013-01-01

    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 o...

  5. Comparison of Different Presbyopia Treatments: Refractive Lens Exchange with Multifocal Intraocular Lens Implantation Versus LASIK Monovision

    OpenAIRE

    Barišić, Ante; Gabrić, Nikica; Dekaris, Iva; Romac, Ivana; Bohač, Maja; Jurić, Branka

    2010-01-01

    There are several methods for presbyopia treatment. Refractive lens exchange (RLE) followed by multifocal intraocular lens (MFIOL) implantation enables high rate of spectacle independance but have some visual disturbances. Laser in Situ Keratomileusis (LASIK) monovision gives patient ability to have good distant vision with dominant eye and good near vision with nondominant eye. In this prospective randomized study we wanted to compare clinical outcomes in patients who underwent either of the...

  6. Multifocal electroretinogram for functional evaluation of retinal injury following ischemia-reperfusion in pigs

    DEFF Research Database (Denmark)

    Morén, Håkan; Gesslein, Bodil; Andreasson, Sten;

    2010-01-01

    Multifocal electroretinogram (mfERG) has the power to discriminate between localized functional losses and overall retinal changes when evaluating retinal injury. So far, full-field ERG has been the gold standard for examining retinal ischemia and the effects of different neuroprotectants in...... experimental conditions. The aim of the present study was to establish mfERG, with simultaneous fundus monitoring, for analyzing the localized functional response in the retina after ischemia-reperfusion in the porcine eye....

  7. Breast-conserving surgery is contraindicated for recurrent giant multifocal phyllodes tumours of breast

    OpenAIRE

    Weledji, Elroy P; Enow-Orock, George; Ngowe, Marcelin N.; Aminde, Leopold

    2014-01-01

    Background The controversy between breast conserving surgery and simple mastectomy for phyllodes tumours of the breast remains because of the unpredictable nature of the disease. Although some benign tumours may show an unusually aggressive behaviour, modified radical surgery for phyllodes tumours offers no survival advantage, and recently more conservative surgical approaches have been deployed. Case presentation A 30-year-old woman with a giant multifocal tumour of the breast underwent brea...

  8. 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.

  9. Nontropical pyomyositis as a cause of subacute, multifocal myalgia in the acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    We report a case of nontropical pyomyositis in a patient with acquired immunodeficiency syndrome and disseminated Mycobacterium avium infection, in which severe myalgia was the presenting symptom over several weeks. Multifocal muscle lesions were identified by gallium scanning and magnetic resonance imaging techniques. The epidemiology, possible pathogenesis, clinical features, diagnostic imaging, and therapy are reviewed. Early suspicion of nontropical pyomyositis in severely immunocompromised patients with cryptic myalgia is recommended

  10. The Impact of Multifocal Intraocular Lens in Retinal Imaging with Optical Coherence Tomography

    OpenAIRE

    Dias-Santos, A; Costa, L; Lemos, V; Anjos, R.; Vicente, A.(IFPA, Dep. AGO, Université de Liège, Bat B5, Sart-Tilman, B-4000, Liège 1, Belgium); Ferreira, J; Cunha, JP

    2015-01-01

    Multifocal intraocular lenses (MF IOLs) have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points. However, several optical limitations have been attributed to this particular design. The purpose of this study is to access the effect of MF IOLs design on the accuracy of retinal optical coherence tomography (OCT). Cross-sectional study conducted at the Refractive Surgery Department of Central Lisbon Hospital Center. Twent...

  11. Multifocal Electroretinogram Findings after Intravitreal Bevacizumab Injection in Choroidal Neovascularization of Age-Related Macular Degeneration

    OpenAIRE

    Park, Joo Youn; Kim, Seung Hoon; Park, Tae Kwann; Ohn, Young-Hoon

    2011-01-01

    Purpose To evaluate the changes in multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) after intravitreal bevacizumab injection in the treatment of age-related macular degeneration (AMD). Methods Twenty-one eyes with choroidal neovascularization secondary to AMD were studied before and after intravitreal bevacizumab injection for best corrected visual acuity (BCVA), OCT, and mfERG. Results The BCVA improved, while central macular thickness and total macular volume in O...

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

    Science.gov (United States)

    Bougea, Anastasia; Voskou, Panagiota; Kilidireas, Constantinos; Andreadou, Elisabeth

    2016-01-01

    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. PMID:26966603

  13. An information-theoretic approach to designing the plane spacing for multifocal plane microscopy

    OpenAIRE

    Tahmasbi, Amir; Ram, Sripad; Chao, Jerry; Abraham, Anish V.; Ward, E Sally; Ober, Raimund J.

    2015-01-01

    Multifocal plane microscopy (MUM) is a 3D imaging modality which enables the localization and tracking of single molecules at high spatial and temporal resolution by simultaneously imaging distinct focal planes within the sample. MUM overcomes the depth discrimination problem of conventional microscopy and allows high accuracy localization of a single molecule in 3D along the z-axis. An important question in the design of MUM experiments concerns the appropriate number of focal planes and the...

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

    OpenAIRE

    Otabek Eshonkhodjaev; Shukrat Khudaybergenov; Ortikali Irisov; Nasretdin Tursunov

    2015-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. 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

  3. 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.

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

    International Nuclear Information System (INIS)

    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.)

  5. 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.)

  6. 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.

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    D. S. Druzhinin; Naumova, E. S.; S. S. Nikitin

    2016-01-01

    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 p...

  9. The effect of pentobarbital sodium and propofol anesthesia on multifocal electroretinograms in rhesus macaques

    OpenAIRE

    Kim, Charlene B. Y.; Ver Hoeve, James N.; Nork, T. Michael

    2011-01-01

    We compared the suitability of pentobarbital sodium (PB) and propofol (PF) anesthetics for multifocal electroretinograms (mfERGs) in rhesus macaques. mfERGs were collected from 4 ocularly normal rhesus macaques. All animals were pre-anesthetized with intramuscular ketamine (10-15 mg/kg). Intravenous PB induction/maintenance levels were 15 mg/kg/2-10 mg/kg, and for PF, 2-5 mg/kg/6-24 mg/kg/h. There were 3 testing sessions with PB anesthesia and 5-7 testing sessions with PF anesthesia. All PB s...

  10. Carcinoma superficial multifocal do pênis: ênfase ao teste do azul de toluidina

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    Hélio Begliomini

    2001-06-01

    Full Text Available The author reports a case of penile multifocal superficial carcinoma in a white 66 years old male. The lesions on glans penis and prepuce were asymptomatic. Their appearence were plain reddish ulceration, irregular margins which became evident after circumcision. There was no palpable groin lymph node. The toluidine blue test was useful for guiding biopsies. A partial penectomy was undertaken with free surgical margins of tumor. In a follow-up of two years, penil erectile function is preserve with no tumor recurrence.

  11. Multifocal capillary malformations in an older, asymptomatic child with a novel RASA1 mutation.

    Science.gov (United States)

    Whitaker, S; Leech, S; Taylor, A; Splitt, M; Natarajan, S; Rajan, N

    2016-03-01

    Multifocal capillary malformation (CM) is the cardinal feature of patients with RASA1 mutations. These CMs are 'red flags', signalling the possible association with an arteriovenous malformation (AVM) or an arteriovenous fistula (AVF). We report an 8-year-old boy who presented with > 20 CMs, who was found to have a novel mutation in the RASA1 gene. Radiological screening of children with RASA1 mutations is not standardized, and we elected to carry out baseline magnetic resonance imaging of the brain and spine in our case, which gave normal results. We discuss the recent literature and our approach in the management of such a case. PMID:26132338

  12. Multifocal, bone manifestation of decompression sickness in a professional pilot: A case report

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    Anna Kuśmierska

    2013-04-01

    Full Text Available Decompression sickness is a group of pathological processes occurring in the body, following its exposure to an excessive drop in atmospheric pressure. The paper presents a case of a 62-year-old patient with no substantial disease history, a long-standing professional military pilot who was diagnosed with multifocal, bone manifestation of decompression sickness during the diagnosis of right knee joint injury following a torsion injury. The case was presented to draw attention to the usefulness of occupational history in the process of diagnosing osteoarticular system diseases. Med Pr 2013;64(2:273–279

  13. Intraocular correction of high-degree ametropia using individual multifocal LentisMPlus IOL

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    I.S. Fedorova

    2013-03-01

    Full Text Available ABSTRACT Background. For surgical correction of high-degree ametropia aggravated with astigmatism the following options are available: excimer laser correction; phakic lens implantation; bioptika – a combination of ablating the transparent crystalline lens (ATL with implantation of multifocal toric diopter IOL of standard series and LASIK for the correction of a residual refractive error, ATL using 2 IOLs according to the Technology «Piggy Back»; additional meniscus IOL implantation «Add-On»; ATL with implantation of an individual multifocal toric IOL. Purpose. To show a possibility of intraocular correction of high ametropia aggravated with astigmatism using toric multifocal custom IOLs. Material and methods. We observed two patients: the first female patient, 39 years old with a diagnosis of OU: high myopia, compound myopic astigmatism, initial complicated cataract, moderate amblyopia, peripheral chorioretinal degeneration (PCRD. On admission the distance visual acuity was vis OD=0.01 sph (- 15.5 D cyl (- 2.5 D ax 0°=0.6; vis OS=0.01 sph (- 18.0 D cyl (- 2.5 D ax 0°=0.5. The second patient was a 35-year woman with a diagnosis of OU: high hyperopia, compound hyperopic astigmatism, moderate amblyopia. Distance visual acuity on admission was OD=0.03 sph (+ 8.0 D cyl (+ 1.5 D ax 95°=0.5; OS=0.03 sph (+ 8.0 D cyl (+ 0.75 D ax 75°=0.6. Individual multifocal toric IOLs were implanted in both patents after the removal of the lens phacoemulsification. All standard ophthalmic examinations were used as well as the ultrasound biomicroscopy (UBM. Results. In the follow-up: 6 months after the surgery in the first patient the uncorrected visual acuity (UCVA was far vis OD=0.6, vis OS=0.5, near vis OD=0.4, vis OS=0.5, middle distance vis OD=0.4, vis OS=0.4. The second patient 3 months after surgery had the UCVA far vis OD=0.5, vis OS=0.6, near vis OD=0.4, vis OS=0.5, middle distance vis OD=0.2, vis OS=0.3. The maximum possible distance visual acuity

  14. 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. PMID:23663268

  15. CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS IN THE PRACTICE OF A RHEUMATOLOGIST: FAMILIAL CASES

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    R. U. Shayakhmetova

    2015-10-01

    Full Text Available The paper describes a female patient who had a concurrence of the signs of juvenile idiopathic arthritis (JIA and chronic recurrent multifocal osteomyelitis (CRMO. The latter was also diagnosed in her mother and brother. There is reason to suggest that CHMO and JIA may be a clinical reflection of identical pathology turning out to be the overlap syndromes of a single autoinflammatory disease. When making a differential diagnosis if there are cases of atypical JIA without signs of autoimmune diseases, CRMO is well to bear in mind.

  16. Correspondence between Multifocal Electroretinography and Microperimetry in Benign Concentric Annular Macular Dystroph

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    Serra Arf

    2011-10-01

    Full Text Available A 32-year-old woman with benign concentric annular macular dystrophy (BCAMD was examined with multifocal electroretinography (mfERG and microperimetry. The mfERG demonstrated reduced focal responses in the area corresponding to the scotoma shown by microperimetry. The correspondence between mfERG and microperimetry in a patient with BCAMD shows that inner retinal layers, which include photoreceptors, are affected and these changes lead to visual field defects. (Turk J Oph thal mol 2011; 41: 351-3

  17. Peripheral refraction with dominant design multifocal contact lenses in young myopes

    Science.gov (United States)

    Lopes-Ferreira, Daniela; Ribeiro, Cláudia; Neves, Helena; Faria-Ribeiro, Miguel; Queirós, António; Villa-Collar, César; Jorge, Jorge; González-Méijome, José Manuel

    2013-01-01

    Purpose The purpose of this study was to show the potential of a commercial center-distance multifocal soft contact lens to induce relative peripheral myopic defocus in myopic eyes. Methods Twenty-eight myopic right eyes from 28 patients (mean age: 22.0 ± 2.0 years) were evaluated. The measurements of axial and off-axis refraction were made using a Grand-Seiko WAM-5500 open-field autorefractometer without lens and with multifocal contact lenses (Proclear Multifocal D® Design) of +2.00 D and +3.00 D add power applied randomly. Central mean spherical equivalent refraction was −2.24 ± 1.33 D. Ocular refraction was measured at center and at eccentricities between 35° nasal and 35° temporal (in 5° steps). Results Baseline relative peripheral refractive error (RPRE) as spherical equivalent (M) was −0.69 ± 1.14 D and −0.46 ± 1.38 D at 35° in the nasal and temporal degrees of visual field, respectively. Both add powers increased the relative peripheral myopic defocus up to −0.82 ± 1.23 D (p = 0.002) and −1.42 ± 1.45 D (p < 0.001) at 35° in the nasal field; and −0.87 ± 1.42 D (p = 0.003) and −2.00 ± 1.48 D (p < 0.001) at 35° in the temporal retina with +2.00 D and +3.00 D add lenses, respectively. Differences between +2.00 and +3.00 D add lenses were statistically significant beyond 20° in the nasal visual field and 10° in the temporal visual field. Conclusion It is possible to induce significant changes in the pattern of relative peripheral refraction in the myopic direction with commercially available dominant design multifocal contact lenses. The higher add (+3.00 D) induced an significantly higher effect than the +2.00 D add lens, although an increase of 1 D in add power does not correspond to the same amount of increase in RPRE.

  18. Spontaneous rupture of the kidney affected by multifocal papillary renal cell carcinoma

    OpenAIRE

    Lucio Dell'Atti

    2014-01-01

    Papillary renal cell carcinoma (pRCC) represents the second most common type of malignant renal epithelial tumor (represents the 10% of the kidney’s carcinoma) and can be subclassified in the basophile type I and eosinophile type II. We report a clinical case of spontaneous rupture of the kidney affected by multifocal (42 tumors foci) pRCC in a young man 53 years old, without showing earlier specific cancer signs and symptoms. Prognosis for type I pRCC is better than type II pRCC, but it is a...

  19. Minus Piggyback Lens Overlaying ReSTOR® Multifocal Lens in High Myopia

    OpenAIRE

    Gupta, Isha; Oakey, Zack; Stagg, Brian C; Ambati, Balamurali K.

    2013-01-01

    Background We report the case of a 40-year-old female patient treated with implantation of the Acrysof® IQ ReSTOR® lens (Alcon, Fort Worth, Tex., USA) with overlaying Acrysof EXpand® minus piggyback lens (Alcon). Methods The patient had high myopia and was diagnosed with presbyopia and bilateral posterior subcapsular cataract. She desired to be spectacle-free and opted to undergo bilateral placement of the ReSTOR multifocal lens. The necessary intraocular lens (IOL) power was +3.5 in the righ...

  20. An autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    International Nuclear Information System (INIS)

    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.)

  1. Case Report: Multifocal biphasic squamoid alveolar renal cell carcinoma [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jose Ignacio Lopez

    2016-04-01

    Full Text Available A multifocal biphasic squamoid alveolar renal cell carcinoma in a 68-year-old man is reported. Four different peripheral tumor nodules were identified on gross examination. A fifth central tumor corresponded to a conventional clear cell renal cell carcinoma. Biphasic squamoid alveolar renal cell carcinoma is a rare tumor that has been very recently characterized as a distinct histotype within the spectrum of papillary renal cell carcinoma. Immunostaining with cyclin D1 seems to be specific of this tumor subtype. This is the first reported case with multifocal presentation.

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

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    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

  3. A novel treatment for bone lesions of multifocal epithelioid sarcoma-like hemangioendothelioma.

    Science.gov (United States)

    Davis, Adrian T; Guo, A Mary; Phillips, Nancy J; Greenberg, David D

    2015-07-01

    Epithelioid sarcoma-like hemangioendothelioma (ES-H) is a rare, indolent vascular neoplasm with characteristics similar to epithelioid sarcoma. It typically affects young males who present with skin and subcutaneous lesions in the extremities. Bone lesions, occurring in approximately 20% of patients, are often multifocal, seen in conjunction with soft tissue lesions, and usually found in bones of the lower extremities. This report details the case of a 20-year-old male who presented with a 1-year history of painful skin lesions on his left lower extremity. Staging studies revealed bone lesions in the cuboid and calcaneus. Bone and soft tissue pathology was consistent with ES-H. The soft tissue lesions were treated with wide excision and the bony lesions with radiofrequency ablation (RFA). The patient had no evidence of recurrence at the 2-year follow-up. Treatment of ES-H typically consists of wide excision of all soft tissue lesions and possible adjuvant radiation therapy. Management of bony lesions has included marginal excision, wide excision, amputation, chemotherapy, observation, or a combination of these modalities. ES-H has the potential for distant metastases. There is no consensus regarding the appropriate treatment of multifocal epithelioid sarcoma-like hemangioendothelioma involving bone. A potential treatment strategy of wide excision of soft tissue lesions and RFA of bone lesions is proposed. PMID:25564226

  4. Multifocal fibrosclerosis and IgG4-related disease involving the cardiovascular system

    International Nuclear Information System (INIS)

    The cardiovascular system may be involved as a target organ of multifocal fibrosclerosis, which may manifest as idiopathic retroperitoneal fibrosis, inflammatory aortic aneurysm, inflammatory periarteritis, and inflammatory pericarditis. These pathological conditions can sometimes occur concomitantly. Idiopathic retroperitoneal fibrosis and inflammatory abdominal aortic aneurysm are both characterized by the presence of fibro-inflammatory tissue around the abdominal aorta expanding into the surrounding retroperitoneal structures, and together they may be termed 'chronic periaortitis'. Cardiovascular fibrosclerosis has become non-uncommonly encountered condition since imaging modalities have made its diagnosis more feasible. In addition, recent studies have demonstrated that a certain fraction, but not all, of cardiovascular fibrosclerosis may have a link with immunoglobulin-G4 (IgG4)-related sclerosing disease (IgG4-SD). IgG4-SD is histologically characterized by dense fibrosclerosis and infiltration of lymphocytes and IgG4-positive plasma cells, and these histopathologic findings seem to be essentially similar regardless of the organs involved. In this mini review, we summarize what is known so far about multifocal fibrosclerosis of the cardiovascular system and its association with IgG4-SD, and what remains to be clarified in future investigations. (author)

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

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    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. 

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

    Science.gov (United States)

    Unsal, Ugur; Baser, Gonen

    2016-01-01

    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). PMID:27340560

  7. 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

  8. Chromatic multifocal pupillometer for objective perimetry in patients with macular degeneration (Conference Presentation)

    Science.gov (United States)

    Rotenstreich, Ygal; Ben-Ner, Daniel; Mahajna, Mohamad; Chibel, Ron; Sher, Ifat

    2016-03-01

    Purpose: To objectively assess visual field (VF) defects and retinal cell function in healthy subjects and patients with macular degeneration using a chromatic multifocal pupillometer. Methods: A multifocal chromatic pupillometer (MCP) was used to record pupillary responses (PR) of 17 healthy subjects and 5 Best Vitelliform macular dystrophy patients. Blue and red light stimuli (peak 485nm and 620nm, respectively) were presented at light intensities of 400 and 1000 cd/m2, respectively at 76 different points in a 16.2 degree VF. The PR of patients were compared with their findings on Humphrey's 24-2 perimetry, optical coherence tomography and the PR obtained from healthy subjects. Results: Patients demonstrated reduced percentage of pupillary contraction and slower maximal contraction velocity, more than two standard errors (SE) away from the mean of healthy subjects in response to red light in majority of VF locations. In response to blue light, the percentage of pupillary contraction was lower (by over two SE) compared with normal controls only in central locations. The latency of maximal contraction velocity was shorter in patients compared with healthy subjects in response to both colors. Conclusions: This study demonstrated the advantage of using MCP-based objective VF to assess central scotoma in macular degeneration. Our finding also suggests that chromatic perimetry may differentiate between PR mediated by cones and rods, and can specifically detect defects in macular cones. Different parameters of PR such as latency of maximal contraction velocity may shed light on the pathophysiology of different blinding diseases.

  9. 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.

  10. Multifocal invasive ductal breast cancer with osteoclast-like giant cells: a case report

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    Uleer Christoph

    2011-02-01

    Full Text Available Abstract Introduction To the best of our knowledge, this is the first case report of a multifocal (trifocal invasive carcinoma of the breast containing osteoclast-like giant cells. Case presentation A 64-year-old Caucasian woman presented for routine mammography screening with three radiodense lesions in the lower inner quadrant of the right breast, a primary breast cancer. Microscopic examination showed three foci of invasive ductal carcinoma with multinucleated osteoclast-like giant cells. Osteoclast-like giant cells in breast cancer are a rare phenomenon. They are described in less than two percent of all breast cancers and occur in association with invasive ductal cancer and invasive lobular cancer. In addition, osteoclast-like giant cells have been described in several sarcomas and metaplastic carcinomas of the breast. Conclusion To the best of our knowledge, this is the first report of a multifocal infiltrating ductal carcinoma of the breast containing osteoclast-like giant cells. This could be an indication for a possible early event in carcinogenesis associated with a biological event or secretion that indicates the differentiation and/or migration of stromal cells or macrophages.

  11. Multifocal Bullous Fixed Drug Erruption Due To Phenytoin: A Lesson Learned!

    Science.gov (United States)

    Jain, Ankur; Gupta, Naresh

    2015-12-01

    Antiepileptic drugs (AED) are a common culprit of cutaneous eruptions in clinical practice. Phenytoin, lamotrigine and carbamazepine are the commonest offenders. Maculopapular eruptions are the most frequently reported events. However, multifocal bullous fixed drug eruptions have rarely been described in association with AED use. The risk factors for skin rash including its association with the rate of drug administration are unclear in the literature. We report a case of a young alcoholic man, on long term phenytoin therapy since 3 years, who presented to our emergency department with a breakthrough seizure episode. Patient's routine investigations including serum biochemistry, imaging and toxicology screen were normal. Patient was found to have sub-therapeutic serum phenytoin levels and was prescribed loading with intravenous phenytoin (15mg/kg body weight), which was mistakenly infused at a rapid rate (60mg/minute). Patient developed multifocal bullous lesions over muco-cutaneous regions after 6 hours of drug administration which healed after its discontinuation leaving behind residual hyperpigmentation. Patient was managed conservatively, switched to oral levetiracetam and discharged in a stable condition after one week of hospital stay. Present case highlights a yet uncommon reaction to a commonly used drug and tries to establish the relation between rate of drug infusion and the risk of skin reaction. PMID:26816935

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

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    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

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

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    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

  14. Is Hepatic Resection for Large or Multifocal Intrahepatic Cholangiocarcinoma Justified? Results from a Multi-Institutional Collaboration

    Science.gov (United States)

    Spolverato, Gaya; Kim, Yuhree; Alexandrescu, Sorin; Popescu, Irinel; Marques, Hugo P.; Aldrighetti, Luca; Gamblin, T. Clark; Miura, John; Maithel, Shishir K.; Squires, Malcolm H.; Pulitano, Carlo; Sandroussi, Charbel; Mentha, Gilles; Bauer, Todd W.; Newhook, Timothy; Shen, Feng; Poultsides, George A.; Marsh, J. Wallis; Pawlik, Timothy M.

    2016-01-01

    Background The role of surgical resection for patients with large or multifocal intrahepatic cholangiocarcinoma (ICC) remains unclear. This study evaluated the long-term outcome of patients who underwent hepatic resection for large (≥7 cm) or multifocal (≥2) ICC. Methods Between 1990 and 2013, 557 patients who underwent liver resection for ICC were identified from a multi-institutional database. Clinicopathologic characteristics, operative details, and long-term survival data were evaluated. Results Of the 557 patients, 215 (38.6 %) had a small, solitary ICC (group A) and 342 (61.4 %) had a large or multifocal ICC (group B). The patients in group B underwent an extended hepatectomy more frequently (16.9 vs. 30.4 %; P 0.05). The group A patients had better rates for 5-year overall survival (OS) (30.5 vs. 18.7 %; P < 0.05) and disease-free survival (DFS) (22.6 vs. 8.2 %; P < 0.05) than the group B patients. For the patients in group B, the factors associated with a worse OS included more than three tumor nodules [hazard ratio (HR), 1.56], nodal metastasis (HR, 1.47), and poor differentiation (HR, 1.48). Conclusions Liver resection can be performed safely for patients with large or multifocal ICC. The long-term outcome for these patients can be stratified on the basis of a prognostic score that includes tumor number, nodal metastasis, and poor differentiation. PMID:25354576

  15. 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

  16. Schnitzler's Disease as an Important Differential Diagnosis of Chronic Recurrent Multifocal Osteomyelitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Kathrin Schrödl

    2012-01-01

    Full Text Available Introduction. At first sight, chronic recurrent multifocal osteomyelitis (CRMO and Schnitzler's disease are diagnoses of exclusion and can be similar in their manifestation. Methods. In this paper we present the reevaluation of the 13-year-old diagnosis of chronic recurrent osteomyelitis of a 58-year-old man with chronic ostealgia, night sweat, and pruritic urticarial lesions on the extremities and trunk. For further examination, we performed blood analysis, bone and skin biopsies, CT scans, and magnetic resonance imaging. Results. Laboratory findings showed increased inflammation parameters. Magnetic resonance imaging (MRI revealed a diffuse bone marrow infiltration. A bone and skin biopsy showed a sclerotic bone marrow involvement and a superficial dermal and perivascular infiltrate of neutrophils. Based on these findings, the diagnosis of Schnitzler’s disease was made. Conclusion. Here, we want to present Schnitzler's disease as an important differential diagnosis to CRMO in adults presenting with signs suggestive of CRMO.

  17. 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. 

  18. A Case of Radiation-Induced Multifocal Laryngeal Angiosarcoma Presenting as a Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Jayme R. Dowdall

    2012-01-01

    Full Text Available Head and neck sarcomas are relatively rare tumors, with angiosarcomas representing a small subset. Angiosarcoma is a malignant endothelial neoplasm characterized by atypical, multilayered, or solid endothelial proliferation with vasoformative architecture. The global incidence of irradiation-associated sarcoma is estimated as between 0.03% and 0.08%. Here we reported the case of an elderly woman previously treated with radiation more than 20 years ago for an unknown primary of head and neck. This interesting case presented as a diagnostic challenge, and multiple biopsies were required to eventually establish the diagnosis of laryngeal angiosarcoma. We additionally have confirmation from our prior radiation records that the patient did, in fact, receive a substantial dose of radiation to the site previously. To our knowledge, this case represents the first report of a documented radiation-induced multifocal laryngeal angiosarcoma.

  19. A joint Richardson—Lucy deconvolution algorithm for the reconstruction of multifocal structured illumination microscopy data

    Science.gov (United States)

    Ströhl, Florian; Kaminski, Clemens F.

    2015-03-01

    We demonstrate the reconstruction of images obtained by multifocal structured illumination microscopy, MSIM, using a joint Richardson-Lucy, jRL-MSIM, deconvolution algorithm, which is based on an underlying widefield image-formation model. The method is efficient in the suppression of out-of-focus light and greatly improves image contrast and resolution. Furthermore, it is particularly well suited for the processing of noise corrupted data. The principle is verified on simulated as well as experimental data and a comparison of the jRL-MSIM approach with the standard reconstruction procedure, which is based on image scanning microscopy, ISM, is made. Our algorithm is efficient and freely available in a user friendly software package.

  20. 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.

  1. [Refraction after Implantation of Multifocal and Presbyopia-Correcting Intraocular Lenses].

    Science.gov (United States)

    Kretz, F T A; Linz, K; Mueller, M; Gerl, M; Koss, M J; Gerl, R H; Auffarth, G U

    2015-08-01

    Nowadays, further developments in the field of intraocular lenses offer a higher level of spectacle independence for our patients. As light gets scattered on different focal points a wider range of defocus is created. This greater defocus area makes it more difficult for us to determine the objective or subjective refraction. This contribution is concerned with the difficulties of measuring visual acuity in different intraocular lens designs and different measurement distances. Measuring refraction after implantation of a multifocal intraocular lens is a complex procedure and the experience of the examiner plays a crucial role. Retinoscopy, keratometry and the defocus curve are reliable methods for testing, while the auto refractometer, bichromatic testing and the cross-cylinder have limitations. PMID:25927177

  2. Platelet activating factor receptor blockade enhances recovery after multifocal brain ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kochanek, P.M.; Dutka, A.J.; Kumaroo, K.K.; Hallenbech, J.M.

    1987-12-14

    The authors treated four anesthetized dogs with the platelet activating factor (PAF) receptor antagonist kadsurenone prior to 60 min of multifocal ischemia induced by air embolism, and measured neuronal recovery, blood flow and autologous /sup 111/In-labeled platelet accumulation for 4 h after ischemia. Four anesthetized animals with identical ischemia served as controls. Kadsurenone administered 5 min prior to ischemia and continuously throughout ischemia and recovery significantly enhanced recovery of cortical somatosensory evoked response (CSER) amplitude when compared to controls. They estimated platelet accumulation as /sup 111/In activity (cmp/g tissue) in the injured hemisphere minus that in the non-injured hemisphere. Kadsurenone treated animals did not exhibit significantly altered /sup 111/In labeled platelet accumulation when compared to controls. Beneficial effects of PAF receptor blockade other than those on platelet accumulation may be involved. 20 references, 1 figure.

  3. Platelet activating factor receptor blockade enhances recovery after multifocal brain ischemia

    International Nuclear Information System (INIS)

    The authors treated four anesthetized dogs with the platelet activating factor (PAF) receptor antagonist kadsurenone prior to 60 min of multifocal ischemia induced by air embolism, and measured neuronal recovery, blood flow and autologous 111In-labeled platelet accumulation for 4 h after ischemia. Four anesthetized animals with identical ischemia served as controls. Kadsurenone administered 5 min prior to ischemia and continuously throughout ischemia and recovery significantly enhanced recovery of cortical somatosensory evoked response (CSER) amplitude when compared to controls. They estimated platelet accumulation as 111In activity (cmp/g tissue) in the injured hemisphere minus that in the non-injured hemisphere. Kadsurenone treated animals did not exhibit significantly altered 111In labeled platelet accumulation when compared to controls. Beneficial effects of PAF receptor blockade other than those on platelet accumulation may be involved. 20 references, 1 figure

  4. High Resolution Depth-Resolved Imaging From Multi-Focal Images for Medical Ultrasound

    DEFF Research Database (Denmark)

    Diamantis, Konstantinos; Dalgarno, Paul A.; Greenaway, Alan H.;

    2015-01-01

    in-focus images. The technique is derived from biological microscopy and is validated here with simulated ultrasound data. A linear array probe is used to scan a point scatterer phantom that moves in depth with a controlled step. From the beamformed responses of each scatterer position the image......An ultrasound imaging technique providing subdiffraction limit axial resolution for point sources is proposed. It is based on simultaneously acquired multi-focal images of the same object, and on the image metric of sharpness. The sharpness is extracted by image data and presents higher values for...... sharpness is assessed. Values from all positions plotted together form a curve that peaks at the receive focus, which is set during the beamforming. Selection of three different receive foci for each acquired dataset will result in the generation of three overlapping sharpness curves. A set of three...

  5. Case Study: Chronic Recurrent Multifocal Osteomyelitis in the Femoral Diaphysis of a Young Female

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Quon

    2012-01-01

    Full Text Available Chronic recurrent multifocal osteomyelitis (CRMO is relatively uncommon. Even though the name suggests it is the result of infection, this is not likely the case. Instead it is more likely the result of genetic, autoimmune, or autoinflammatory causes. Although CRMO has a benign course and responds well to anti-inflammatory medications, it can have a very aggressive clinical and imaging presentation overlapping with infectious osteomyelitis and malignancy. Therefore, radiologists and clinicians need to be aware of its clinical and imaging presentation to avoid morbidity associated with more aggressive treatment. We present the case of a ten-year-old female with CRMO as a solitary expansile-mixed lytic and sclerotic lesion in the distal femoral diaphysis. The diaphyseal location and mixed lytic and sclerotic appearance are less common and have an aggressive imaging appearance. We also review the pathophysiology, imaging findings, and therapeutic approach to this uncommon but clinically important condition.

  6. Parallel analysis of individual biological cells using multifocal laser tweezers Raman spectroscopy.

    Science.gov (United States)

    Liu, Rui; Taylor, Douglas S; Matthews, Dennis L; Chan, James W

    2010-11-01

    We report on the development and characterization of a multifocal laser tweezers Raman spectroscopy (M-LTRS) technique for parallel Raman spectral acquisition of individual biological cells. Using a 785-nm diode laser and a time-sharing laser trapping scheme, multiple laser foci are generated to optically trap single polystyrene beads and suspension cells in a linear pattern. Raman signals from the trapped objects are simultaneously projected through the slit of a spectrometer and spatially resolved on a charge-coupled device (CCD) detector with minimal signal crosstalk between neighboring cells. By improving the rate of single-cell analysis, M-LTRS is expected to be a valuable method for studying single-cell dynamics of cell populations and for the development of high-throughput Raman based cytometers. PMID:21073802

  7. 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.

  8. A fibrous membrane suspends the multifocal lens in the eyes of lampreys and African lungfishes.

    Science.gov (United States)

    Gustafsson, Ola S E; Ekström, Peter; Kröger, Ronald H H

    2010-08-01

    The sharpness and thus information content of the retinal image in the eye depends on the optical quality of the lens and its accurate positioning in the eye. Multifocal lenses create well-focused color images and are present in the eyes of all vertebrate groups studied to date (mammals, reptiles including birds, amphibians, and ray-finned fishes) and occur even in lampreys, i.e., the most basal vertebrates with well-developed eyes. Results from photoretinoscopy obtained in this study indicate that the Dipnoi (lungfishes), i.e., the closest piscine relatives to tetrapods, also possess multifocal lenses. Suspension of the lens is complex and sophisticated in teleosts (bony fishes) and tetrapods. We studied lens suspension using light and electron microscopy in one species of lamprey (Lampetra fluviatilis) and two species of African lungfish (Protopterus aethiopicus aethiopicus and Protopterus annectens annectens). A fibrous and highly transparent membrane suspends the lens in both of these phylogenetically widely separated vertebrate groups. The membrane attaches to the lens approximately along the lens equator, from where it extends to the ora retinalis. The material forming the membrane is similar in ultrastructure to microfibrils in the zonule fibers of tetrapods. The membrane, possibly in conjunction with the cornea, iris, and vitreous body, seems suitable for keeping the lens in the correct position for well-focused imaging. Suspension of the lens by a multitude of zonule fibers in tetrapods may have evolved from a suspensory membrane similar to that in extant African lungfishes, a structure that seems to have appeared first in the lamprey-like ancestors of allextant vertebrates. PMID:20623650

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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

  11. Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

    OpenAIRE

    Gupta, Isha; Oakey, Zack; Ahmed, Faisal; Ambati, Balamurali K

    2014-01-01

    Background We report 2 patients who have undergone radial keratotomy (RK) preceding ReSTOR® multifocal intraocular lens (IOL; Alcon, Fort Worth, Tex., USA) implantation in their nondominant eyes and TECNIS® monofocal IOL (Abbott Medical Optics, Abbott Park, Ill., USA) in their dominant eyes. Methods Retrospective review of 2 patients who underwent hybrid monovision with ReSTOR® multifocal and TECHNIS® monofocal IOLs at the time of cataract surgery after a remote history of RK. Results Implant...

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

    Science.gov (United States)

    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. PMID:27134676

  14. Peripheral Nerve Ultrasonography in Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Correlations with Clinical and Neurophysiological Data

    OpenAIRE

    Aristide Merola; Michela Rosso; Alberto Romagnolo; Erdita Peci; Dario Cocito

    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 disabilit...

  15. Case Report: Multifocal biphasic squamoid alveolar renal cell carcinoma [version 1; referees: 2 approved, 1 approved with reservations

    OpenAIRE

    Jose Ignacio Lopez

    2016-01-01

    A multifocal biphasic squamoid alveolar renal cell carcinoma in a 68-year-old man is reported. Four different peripheral tumor nodules were identified on gross examination. A fifth central tumor corresponded to a conventional clear cell renal cell carcinoma. Biphasic squamoid alveolar renal cell carcinoma is a rare tumor that has been very recently characterized as a distinct histotype within the spectrum of papillary renal cell carcinoma. Immunostaining with cyclin D1 seems to be specific of...

  16. Optimization of multifocal transcranial current stimulation for weighted cortical pattern targeting from realistic modeling of electric fields

    OpenAIRE

    Ruffini, Giulio; Fox, Michael D.; Ripolles, Oscar; Miranda, Pedro Cavaleiro; Pascual-Leone, Alvaro

    2014-01-01

    Recently, multifocal transcranial current stimulation (tCS) devices using several relatively small electrodes have been used to achieve more focal stimulation of specific cortical targets. However, it is becoming increasingly recognized that many behavioral manifestations of neurological and psychiatric disease are not solely the result of abnormality in one isolated brain region but represent alterations in brain networks. In this paper we describe a method for optimizing the configuration o...

  17. Comparison of the reliability of multifocal visual evoked cortical potentials generated by pattern reversal and pattern pulse stimulation

    OpenAIRE

    G.S. Souza; H.B. Schakelford; Moura, A.L.A.; Gomes, B.D.; D.F. Ventura; M.E.C. Fitzgerald; L.C.L. Silveira

    2012-01-01

    This study compared the effectiveness of the multifocal visual evoked cortical potentials (mfVEP) elicited by pattern pulse stimulation with that of pattern reversal in producing reliable responses (signal-to-noise ratio >1.359). Participants were 14 healthy subjects. Visual stimulation was obtained using a 60-sector dartboard display consisting of 6 concentric rings presented in either pulse or reversal mode. Each sector, consisting of 16 checks at 99% Michelson contrast and 80 cd/m² mean lu...

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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. PMID:27339580

  20. Role of the neuromuscular ultrasound in the diagnostic of the multifocal motor neuropathy

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    Antonios Kerasnoudis

    2014-12-01

    Full Text Available Multifocal motor neuropathy (MMN is the one of the most common acquired immune-mediated inflammatory disorders of the peripheral nervous system. The diagnosis is based on the distribution pattern of the neurological semiology and the pathological changes of nerve conduction studies (NCS in classical cases. However, in cases with subtle clinical presentation, an extended diagnostic workup may be needed, such as cerebrospinal fluid examination, laboratory tests, and nerve biopsy. NCS remain nowadays fundamental not only for the diagnosis, but also for the follow-up and measurement of response to immune-treatment in MMN. New challenges arose though, on how best to acquire a static and dynamic imaging of the peripheral nerves, aiming to provide a holistic approach to the nerve impairment. According to the literature, neuromuscular ultrasound is able to detect in MMN patients thickened or swollen cervical roots, peripheral nerves or brachial plexus, findings that suggest ongoing inflammation. This review provides a timely update on the nerve ultrasound findings in MMN.

  1. 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.

  2. Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis

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    Elena Tsitsami

    2011-01-01

    Full Text Available We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with methotrexate, and the patient went into remission, which persists one year after prednisolone tapering. The appearance of arthritis in both knees in the absence of bone lesions and the emergence of severe arthritis of the ankle after remission of spinal bone lesions suggest that CRMO and juvenile idiopathic arthritis may coexist and be causally related.

  3. Is breast conservative surgery a reasonable option in multifocal or multicentric tumors?

    Science.gov (United States)

    Houvenaeghel, Gilles; Tallet, Agnès; Jalaguier-Coudray, Aurélie; Cohen, Monique; Bannier, Marie; Jauffret-Fara, Camille; Lambaudie, Eric

    2016-01-01

    The incidence of multifocal (MF) and multicentric (MC) carcinomas varies widely among clinical studies, depending on definitions and methods for pathological sampling. Magnetic resonance imaging is increasingly used because it can help identify additional and conventionally occult tumors with high sensitivity. However, false positive lesions might incorrectly influence treatment decisions. Therefore, preoperative biopsies must be performed to avoid unnecessary surgery. Most studies have shown higher lymph node involvement rates in MF/MC tumors than in unifocal tumors. However, the rate of local recurrences is usually low after breast conservative treatment (BCT) of MC/MF tumors. It has been suggested that BCT is a reasonable option for MC/MF tumors in women aged 50-69 years, with small tumors and absence of extensive ductal carcinoma in situ. A meta-analysis showed an apparent decreased overall survival in MC/MF tumors but data are controversial. Surgery should achieve both acceptable cosmetic results and negative margins, which requires thorough preoperative radiological workup and localization of lesions. Boost radiotherapy techniques must be evaluated since double boosts might result in increased toxicity, namely fibrosis. In conclusion, BCT is feasible in selected patients with MC/MF but the choice of surgery must be discussed in a multidisciplinary team comprising at least radiologists, surgeons and radiotherapists. PMID:27081646

  4. The Multifocal On- and Off-Responses in the Human Diabetic Retina

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    Lung, Jenny C. Y.; Swann, Peter G.; Chan, Henry H. L.

    2016-01-01

    The characteristics of the on- and off-responses in the human diabetic retina by a “long-duration” multifocal electroretinogram (mfERG) paradigm were investigated. Changes in the retinal antagonistic interaction were also evaluated in the early stage of diabetes mellitus (DM). Twenty type II diabetic patients with no or mild non-proliferative diabetic retinopathy (NPDR) and twenty-one age-matched healthy controls were recruited for “long-duration” mfERG measurements. A 61-hexagon mfERG stimulus was displayed under two chromatic conditions (white/black and blue/black) at matched luminance. The amplitudes and implicit times of the on-response components (N1, P1 and N2) and off-response (P2) components were analysed. The blue stimulation generally triggered greater mfERG amplitudes in P1, N2 and P2 (pdiabetic groups. The diabetic group showed significantly greater N2 amplitude than the controls under white stimulation in mid-retinal regions (Rings 2 and 4) (pdiabetic group showed a smaller percentage change in N2 amplitude than the controls in peripheral retinal region (Ring 5) (pdiabetic patients suggested an imbalance of lateral antagonism, and the lesser percentage change of N2 amplitude in the diabetic group may indicate an impairment of the cross-talk at the middle retinal level in early stages of DM. PMID:27187490

  5. Non-descanned multifocal multiphoton microscopy with a multianode photomultiplier tube

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    Jae Won Cha

    2015-08-01

    Full Text Available Multifocal multiphoton microscopy (MMM improves imaging speed over a point scanning approach by parallelizing the excitation process. Early versions of MMM relied on imaging detectors to record emission signals from multiple foci simultaneously. For many turbid biological specimens, the scattering of emission photons results in blurred images and degrades the signal-to-noise ratio (SNR. We have recently demonstrated that a multianode photomultiplier tube (MAPMT placed in a descanned configuration can effectively collect scattered emission photons from each focus into their corresponding anodes significantly improving image SNR for highly scattering specimens. Unfortunately, a descanned MMM has a longer detection path resulting in substantial emission photon loss. Optical design constraints in a descanned geometry further results in significant optical aberrations especially for large field-of-view (FOV, high NA objectives. Here, we introduce a non-descanned MMM based on MAPMT that substantially overcomes most of these drawbacks. We show that we improve signal efficiency up to fourfold with limited image SNR degradation due to scattered emission photons. The excitation foci can also be spaced wider to cover the full FOV of the objective with minimal aberrations. The performance of this system is demonstrated by imaging interneuron morphological structures deep in the brains of living mice.

  6. 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.

  7. Multifocal inflammatory demyelination in a patient with rheumatoid arthritis and treatment complications.

    Science.gov (United States)

    Lu, Jian-Qiang; Ringrose, Jennifer; Gross, Donald; Emery, Derek; Blevins, Gregg; Power, Christopher

    2016-08-15

    Rheumatoid arthritis (RA) and multiple sclerosis (MS) are both autoimmune diseases that share similar pathogenesis, but the development of MS in RA patients without the treatment of anti-tumor necrosis factor-alpha is rarely reported, which might be attributed to the use of other medications with potential immunosuppressive effects in the treatment of RA. Since MS can be clinically silent and autopsy examination of the central nervous system in RA patients is rarely described, the association of MS with RA may be possibly under-recognized. We report an autopsy case revealing multifocal inflammatory demyelination in a RA patient who had a prolonged use of methotrexate and hydroxychloroquine resulting in hydroxychloroquine-induced myopathies and heart failure. The neuropathological features of this case are consistent with MS, although there are some altered inflammatory demyelinating features such as relatively smaller lesions and less infiltration of inflammatory cells, particularly T-cells. Our present case, in combination with literature review, suggests that the RA treatment especially with hydroxychloroquine and methotrexate is likely to alter the characteristics of inflammatory demyelination and disease course. PMID:27423608

  8. 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.

  9. The impact of multifocal intraocular lens in retinal imaging with optical coherence tomography.

    Science.gov (United States)

    Dias-Santos, Arnaldo; Costa, Lívio; Lemos, Vanessa; Anjos, Rita; Vicente, André; Ferreira, Joana; Cunha, João Paulo

    2015-02-01

    Multifocal intraocular lenses (MF IOLs) have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points. However, several optical limitations have been attributed to this particular design. The purpose of this study is to access the effect of MF IOLs design on the accuracy of retinal optical coherence tomography (OCT). Cross-sectional study conducted at the Refractive Surgery Department of Central Lisbon Hospital Center. Twenty-three eyes of 15 patients with a diffractive MF IOL and 27 eyes of 15 patients with an aspheric monofocal IOL were included in this study. All patients underwent OCT macular scans using Heidelberg Spectralis(®). Macular thickness and volume values and image quality (Q factor) were compared between the two groups. There were no statistically significant differences between both groups regarding macular thickness or volume measurements. Retinal OCT image quality was significantly lower in the MF IOL group (p image quality. However, this fact does not seem to compromise the accuracy of spectral domain OCT retinal measurements. PMID:25381578

  10. Determinations of the First Aid-Related Knowledge Levels of the Mothers Having Children at the Age of 0-6 and Who Live in The Mugla Number Two Health Clinic District

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    Nilgun Turasay

    2010-06-01

    Full Text Available AIM: The study was planned to determinate the first-aid-related knowledge levels of the mothers with a child aged 0-6. METHOD: The universe of the study consist of 772 mothers having a child aged 0-6 and living in Mugla II Number Health Clinic district. Study was carried out on 561 mothers who accepted. The questionnaire which applied used consist of 64 questions in sum, 8 of which are to solicit personal information and 54 to solicit first-aid-related knowledge level. RESULTS: In the study, first–aid related knowledge situation of mothers having a child aged 0-6 was found 28.74 9.44 out of 54 points and was ascertained that they known first-aid. Statistically significant difference was found between their age groups, their levels of education, their working situations, their situations about obtaining information, their experiments of cases requiring first-aid and knowledge points (p<0.05. CONLUSION: The first-aid topics best know by the mothers were found to be; burn, sun stroke and frost, and the least know were animal savages and insect bites. [TAF Prev Med Bull 2010; 9(3.000: 217-224

  11. Resultados do implante bilateral de lente intra-ocular multifocal SA-40N no Hospital de Olhos de Minas Gerais Visual outcome with binocular implantation of SA-40N multifocal intraocular lens at "Hospital de Olhos de Minas Gerais"

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    Cristina Moreira Salera

    2005-02-01

    Full Text Available OBJETIVOS: Avaliar os resultados da facoemulsificação com implante bilateral da lente intra-ocular multifocal modelo SA-40N no Hospital de Olhos de Minas Gerais. MÉTODOS: Foram analisados retrospectivamente os prontuários de 58 pacientes (116 olhos submetidos à cirurgia de facoemulsificação com implante binocular de lente intra-ocular multifocal modelo SA-40N. RESULTADOS: O equivalente esférico médio pré-operatório foi +1,55 dioptrias (variando de -4,25 a +6,25 D e no pós-operatório foi -0,59 dioptrias (variando de -2,25 a +1,25 D. No trigésimo dia de pós-operatório 94 olhos (81% apresentavam visão para longe igual a 20/20 com correção. Para a visão de perto binocular 29 (50% pacientes eram capazes de ler J1 sem correção e 25 pacientes (43,1%, J2 sem correção. Comparando-se as acuidades visuais com correção (AVCC antes e após a cirurgia observamos que em 68 olhos (58,6% a AVCC foi mantida, em 33 olhos (28,4% houve ganho de linhas de visão e em 15 olhos (12,9% houve perda de linhas de visão. Quanto às complicações 19 pacientes (32,7% queixavam-se de halos, em três olhos (2,6% ocorreu edema macular cistóide e em cinco olhos (4,3% ocorreu opacificação de cápsula posterior. Em 36 pacientes (62,1% não foi necessária a prescrição de óculos no pós-operatório. CONCLUSÃO: Os resultados deste estudo indicam que a lente intra-ocular multifocal promove redução na dependência do uso dos óculos e grande satisfação do paciente apesar da ocorrência de halos.PURPOSE: To evaluate the outcomes of phacoemulsification with binocular implantation of SA-40N multifocal intraocular lens at the "Hospital de Olhos de Minas Gerais". METHODS: The charts of 58 patients (116 eyes who were submitted to phacoemulsification with binocular implantation of SA-40N multifocal intraocular lens were retrospectively analyzed. RESULTS: The mean preoperative spherical equivalent was +1.55D (ranging from -4.25 to +6.25D and after surgery

  12. Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis

    International Nuclear Information System (INIS)

    Purpose: To report the safety and diagnostic performance of magnetic resonance (MRI)—guided core biopsy of osseous lesions in children with chronic recurrent multifocal osteomyelitis (CRMO) that were visible on MRI but were occult on radiography and computed tomography (CT). Materials and Methods: A retrospective analysis of MRI-guided osseous biopsy performed in seven children (four girls and three boys; mean age 13 years (range 11 to 14) with CRMO was performed. Indication for using MRI guidance was visibility of lesions by MRI only. MRI-guided procedures were performed with 0.2-Tesla (Magnetom Concerto; Siemens, Erlangen, Germany; n = 5) or 1.5-T (Magnetom Espree; Siemens; n = 2) open MRI systems. Core needle biopsy was obtained using an MRI-compatible 4-mm drill system. Conscious sedation or general anesthesia was used. Parameters evaluated were lesion visibility, technical success, procedure time, complications and microbiology, cytology, and histopathology findings. Results: Seven of seven (100%) targeted lesions were successfully visualized and sampled. All obtained specimens were sufficient for histopathological analysis. Length of time of the procedures was 77 min (range 64 to 107). No complications occurred. Histopathology showed no evidence of malignancy, which was confirmed at mean follow-up of 50 months (range 28 to 78). Chronic nonspecific inflammation characteristic for CRMO was present in four of seven (58%) patients, and edema with no inflammatory cells was found in three of seven (42%) patients. There was no evidence of infection in any patient. Conclusion: MRI-guided osseous biopsy is a safe and accurate technique for the diagnosis of pediatric CRMO lesions that are visible on MRI only.

  13. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

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    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.)

  14. Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis (CRMO).

    Science.gov (United States)

    Hofmann, Sigrun Renate; Kubasch, Anne Sophie; Range, Ursula; Laass, Martin Walther; Morbach, Henner; Girschick, Hermann Joseph; Hedrich, Christian Michael

    2016-06-01

    Chronic recurrent multifocal osteomyelitis (CRMO), the most severe form of chronic nonbacterial osteomyelitis, is an autoinflammatory bone disorder. A timely diagnosis and treatment initiation is complicated by the absence of widely accepted diagnostic criteria and an incomplete pathophysiological understanding. The aim of this study was to determine biomarkers for the diagnosis and follow-up of CRMO. Serum of 56 CRMO patients was collected at the time of diagnosis. As controls, sera from treatment-naïve age-matched patients with Crohn's disease (N = 62) or JIA (N = 28) as well as healthy individuals (N = 62) were collected. Multiplex analysis of 25 inflammation markers was performed. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests, canonical discriminant analysis, and mixed model variance analysis. Mostly monocyte-derived serum proteins were detectable and differed significantly between groups: IL-1RA, IL-2R, IL-6, IL-12, eotaxin, MCP-1, MIP-1b, RANTES. Multicomponent discriminant analysis allowed for the definition of algorithms differentiating between CRMO, Crohn's disease, and healthy controls. Persistently high levels of MCP-1, IL-12, sIL-2R correlated with incomplete remission in follow-up samples from CRMO patients. Discrimination algorithms allow differentiation between patients with CRMO or Crohn's disease, and healthy individuals. IL-12, MCP-1, and sIL-2R can act as markers for treatment response. Though confirmation of our findings in larger multiethnical cohorts is warranted, they may prove valuable to differentiate between otherwise healthy individuals or Crohn's disease patients with "bone pain" and CRMO patients. The elevation of mainly monocyte-derived pro-inflammatory serum proteins supports the hypothesis of pro-inflammatory monocyte/macrophages driving inflammation in CRMO. PMID:27000045

  15. Paucity of bone scan abnormalities in a child with multifocal osteomyelitis and disseminated sepsis

    International Nuclear Information System (INIS)

    Full text: We present an unusual case of multifocal osteomyelitis with minimal bone scan abnormalities and markedly discordant findings on Magnetic Resonance Imaging(MRI) and gallium scans. A seven-year-old female presented with left leg, right elbow pain and fever. A bone scan was performed. Mild increased vascularity was demonstrated on the dynamic and blood pool phases of the study in the area of the right elbow. In the delayed images there was a photopenic lesion in the left distal femoral metadiaphysis and also irregular uptake in the metaphyseal regions of the long bones. Low grade soft tissue tracer uptake was seen in the left thigh and right forearm. The patient deteriorated clinically and underwent further investigations with MRI and gallium scans. The MRI showed extensive abnormalities with mulitlocular fluid collection seen throughout most of the muscle groups of both thighs suggesting myositis with an associated cellulitis and osteomyelitis of the left femur. The gallium study was markedly abnormal with increased uptake in the distal 2/3rds of the left femur, proximal 1/2 of the right femur, right proximal forearm (mid forearm extending to mid upper arm), left proximal humerus and right hemithorax especially the lower zones. Staphylococcal aureus was cultured. The patient required intensive care management and slowly responded to antibiotic therapy and surgery to drain abscesses in the thighs. A bone marrow biopsy was normal and immunological tests were performed but a result has yet to be determined. The lack of increased bone uptake in the demonstrated areas of osteomyelitis maybe explained on the basis of an overwhelming infective process inhibiting the patient's healing response. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Detection of Tumor Multifocality Is Important for Prediction of Tumor Recurrence in Papillary Thyroid Microcarcinoma: A Retrospective Study and Meta-Analysis

    Science.gov (United States)

    Pyo, Jung-Soo; Sohn, Jin Hee; Kang, Guhyun

    2016-01-01

    Background: The clinicopathological characteristics and conclusive treatment modality for multifocal papillary thyroid microcarcinoma (mPTMC) have not been fully established. Methods: A retrospective study, systematic review, and meta-analysis were conducted to elucidate the clinicopathological significance of mPTMC. We investigated the multiplicity of 383 classical papillary thyroid microcarcinomas (PTMCs) and the clinicopathological significance of incidental mPTMCs. Correlation between tumor recurrence and multifocality in PTMCs was evaluated through a systematic review and meta-analysis. Results: Tumor multifocality was identified in 103 of 383 PTMCs (26.9%). On linear regression analysis, primary tumor diameter was significantly correlated with tumor number (R2=0.014, p=.021) and supplemental tumor diameter (R2=0.117, p=.023). Of 103 mPTMCs, 61 (59.2%) were non-incidental, with tumor detected on preoperative ultrasonography, and 42 (40.8%) were diagnosed (incidental mPTMCs) on pathological examination. Lymph node metastasis and higher tumor stage were significantly correlated with tumor multifocality. However, there was no difference in nodal metastasis or tumor stage between incidental and non-incidental mPTMCs. On meta-analysis, tumor multifocality was significantly correlated with tumor recurrence in PTMCs (odds ratio, 2.002; 95% confidence interval, 1.475 to 2.719, paggressive tumor behavior. PMID:27271109

  17. Optimization of multifocal transcranial current stimulation for weighted cortical pattern targeting from realistic modeling of electric fields.

    Science.gov (United States)

    Ruffini, Giulio; Fox, Michael D; Ripolles, Oscar; Miranda, Pedro Cavaleiro; Pascual-Leone, Alvaro

    2014-04-01

    Recently, multifocal transcranial current stimulation (tCS) devices using several relatively small electrodes have been used to achieve more focal stimulation of specific cortical targets. However, it is becoming increasingly recognized that many behavioral manifestations of neurological and psychiatric disease are not solely the result of abnormality in one isolated brain region but represent alterations in brain networks. In this paper we describe a method for optimizing the configuration of multifocal tCS for stimulation of brain networks, represented by spatially extended cortical targets. We show how, based on fMRI, PET, EEG or other data specifying a target map on the cortical surface for excitatory, inhibitory or neutral stimulation and a constraint on the maximal number of electrodes, a solution can be produced with the optimal currents and locations of the electrodes. The method described here relies on a fast calculation of multifocal tCS electric fields (including components normal and tangential to the cortical boundaries) using a five layer finite element model of a realistic head. Based on the hypothesis that the effects of current stimulation are to first order due to the interaction of electric fields with populations of elongated cortical neurons, it is argued that the optimization problem for tCS stimulation can be defined in terms of the component of the electric field normal to the cortical surface. Solutions are found using constrained least squares to optimize current intensities, while electrode number and their locations are selected using a genetic algorithm. For direct current tCS (tDCS) applications, we provide some examples of this technique using an available tCS system providing 8 small Ag/AgCl stimulation electrodes. We demonstrate the approach both for localized and spatially extended targets defined using rs-fcMRI and PET data, with clinical applications in stroke and depression. Finally, we extend these ideas to more general

  18. Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO): Role of imaging in diagnosis

    International Nuclear Information System (INIS)

    There is a spectrum of musculoskeletal disorders which can be associated with dermatologic findings, the fundamental component of which is a nonbacterial osteitis. CRMO (Chronic recurrent multifocal osteomyelitis) and SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) describe paediatric and adult conditions, respectively, of inflammatory osteitis that can be associated with palmoplantar pustulosis and acne. Imaging findings are similar and a key component to the diagnosis in both conditions. This report describes two patients with strikingly similar radiologic presentations of clavicular osteitis in whom the diagnosis was made predominantly on the basis of imaging findings. The typical imaging features and radiographic hallmarks of both conditions will also be discussed.

  19. Simultaneous robot-assisted radical cystoprostatectomy and nephroureterectomy in a patient with multifocal invasive urothelial carcinoma and previous contralateral nephroureterectomy.

    Science.gov (United States)

    Özveren, Bora; Türkeri, Levent

    2013-12-01

    We present a case of simultaneous robot-assisted radical cystoprostatectomy and nephroureterectomy with extended lymphadenectomy for multifocal invasive urothelial carcinoma in a patient with recurrent high-grade urothelial cancer and a previous right nephroureterectomy. The total urinary exenteration and extended lymphadenectomy was successfully performed with robot-assisted surgery in this unique case where the patient was rendered anephric at the end of the operation. We discuss the operative steps and the techniques performed to optimize the oncological results of robot-assisted surgery for invasive urothelial carcinoma, while attempting to preserve the renal function until the patient's urinary system was totally exenterated. PMID:27001880

  20. Cocaine Enhances HIV-1–Induced CD4+ T-Cell Apoptosis: Implications in Disease Progression in Cocaine-Abusing HIV-1 Patients

    OpenAIRE

    Pandhare, Jui; Addai, Amma B.; Mantri, Chinmay K.; Hager, Cynthia; Smith, Rita M.; Barnett, Louis; Villalta, Fernando; Kalams, Spyros A.; Dash, Chandravanu

    2014-01-01

    Substance abuse is a major barrier in eradication of the HIV epidemic because it serves as a powerful cofactor for viral transmission, disease progression, and AIDS-related mortality. Cocaine, one of the commonly abused drugs among HIV-1 patients, has been suggested to accelerate HIV disease progression. However, the underlying mechanism remains largely unknown. Therefore, we tested whether cocaine augments HIV-1–associated CD4+ T-cell decline, a predictor of HIV disease progression. We exami...

  1. Correlation between viral load, plasma levels of CD4 - CD8 T lymphocytes and AIDS-related oral diseases: a multicentre study on 30 HIV+ children in the HAART era.

    Science.gov (United States)

    Nesti, M; Carli, E; Giaquinto, C; Rampon, O; Nastasio, S; Giuca, M R

    2012-01-01

    This experimental retrospective multicenter study carried out on 30 seropositive children treated with Highly Active Antiretroviral Therapy (HAART), between the ages of 18 months and 14 years, in the clinical categories Centers for Disease Control (CDC) classification 1993 A (mildly symptomatic), B (moderately symptomatic) and C (severely symptomatic) aims to: 1) clinically and immunologically demonstrate the therapeutic benefits of HAART; 2) monitor the frequency of AIDS-related oral diseases in seropositive children with HAART therapy; 3) monitor the plasma levels of total CD4, CD4 percent, CD8 percent, CD4-CD8 lymphocytes and viral load from 1997 to 30 April, 2011. The statistic methods used are the analysis of covariance and the Bonferroni Test. More than 100 AIDS-related oral diseases were found in the study samples, the most frequent being: oral candidiasis, oropharyngeal candidiasis, HSV-1 herpetic esophagyitis, herpetic gingivolstomatitis (RHOG), recurrent aphthous stomatitis (RAS), parotid swelling, oral hairy leukoplakia (OHL), Herpes simplex 1 (HSV-1), linear gingival erythema (LGE), necrotizing gingivitis (NUG), facial lipodistrophy, facial-cervical lymphadenopathy (FCL), xerostomia, dysgeusia, hyposmia, oral mucosa hyperpigmentation (OMP). The Bonferroni test showed a significant difference between the mean plasma values (mpVTL) of total CD4, CD4 percentage, CD4-CD8 T lymphocytes and Viral Load (VL) of the various oral diseases found in the study samples. The therapeutic benefits of HAART are: immune reconstitution; reduction of the HIV/AIDS-related stomatology diseases; prevention and cure of the AIDS correlated neoplasias; reduction in maternal-fetal transmission of the HIV virus. The negative effects of HAART in relation to odontostomatolgy are: increase in oral lesions from HPV; xerostomia; dysgeusia/ageusia, hyposmia, perioral paresthesia; hyperpigmentation of oral mucosa; facial lipodystrophy, recurrent aphthous stomatitis (RAS). No case of

  2. 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.

  3. A thirteen year old female with primary T-cell rich B-cell lymphoma of bone masquerading as chronic recurrent multifocal osteomyelitis

    Directory of Open Access Journals (Sweden)

    Saadiya Haque

    2009-09-01

    Full Text Available Primary lymphoma of the bone (PLB accounts for 2% of all non-Hodgkin’s lymphomas, and until recently it had not been well characterized in literature. Most cases present in adulthood (average age 50, with localized painful lesions in the long bones, cranium, or axial skeleton. We describe a case of multifocal PLB in an adolescent female. In this case, the initial presentation, with migratory large joint polyarthralgias and bone pain, mimicked chronic recurrent multifocal osteomyelitis (CRMO. Had a biopsy not been performed the diagnosis would have been missed.

  4. [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

  5. Dysphasia and Phantosmia as First Presentation of Multifocal Cerebral Anaplastic Astrocytomas: Case Report and Review of the Literatures

    Science.gov (United States)

    Kong, Xiangyi; Wang, Yu; Liu, Shuai; Lu, Zhaohui; Wu, Huanwen; Mao, Xinxin; Cheng, Xin; Gao, Jun; Guan, Jian; Yang, Yi; Li, Yongning; Xing, Bing; Ma, Wenbin; Wang, Renzhi

    2015-01-01

    Abstract Multifocal cerebral gliomas (MCGs) represent approximately 10% of gliomas and are frequently mistaken as metastases of an unknown primary cancer site. Most MCGs are glioblastomas with <4 lesions supratentorially, and are lack of typical symptoms and special detections. Through a rare MCG case, we aim to present this rarity and emphasize the need to correctly diagnose multiple intracranial lesions using a variety of diagnostic modalities to ensure that the patient receives proper treatment. We present a case of multifocal cerebral anaplastic astrocytomas with a total of 8 lesions located in the left frontal lobe and invading the lateral ventricle, presenting with dysphasia and phantosmia. The disease course, including diagnosis and treatment, is presented and analyzed in detail. The pertinent literature is reviewed regarding this uncommon entity. After an initial impression of brain metastasis from lung cancer because of the magnetic resonance imaging (MRI) resemblance and history of chronic bronchitis, we were able to use positron emission tomography (PET) and excisional biopsy to get the final diagnosis. After 10 months, the patient's overall condition deteriorated and succumbed to his disease. MCGs are easy to be misdiagnosed as metastatic diseases. In addition to MRI, PET adds more biochemical and molecular information and is helpful in the differentiation. Although uncommon, if multiple lesions are present in various locations in the hemispheres, MCG should be kept in mind. PMID:25997068

  6. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lee Bonsan B

    2009-03-01

    Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

  7. 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

  8. 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

  9. 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

  10. Linfoma no Hodgkin óseo primario multifocal en preadolescente: A propósito de un caso Primary multifocal non-Hodgkin's Lymphoma of the bone in the preadolescent: A case report

    Directory of Open Access Journals (Sweden)

    A. Restrepo Rincón

    2012-01-01

    Full Text Available Los linfomas óseos primarios son tumores poco frecuentes en la edad pediátrica. Su presentación clínica es inespecífica, requiriéndose un alto nivel de sospecha clínica y el apoyo con diferentes pruebas complementarias para poder establecer el diagnóstico adecuado y así brindar un manejo integral. Se expone el caso de una paciente de 9 años, a quien a las 6,5 semanas de inicio de síntomas se diagnosticó un linfoma no Hodgkin Linfoblástico de células B óseo primario multifocal. Recibió tratamiento combinado según protocolo BFM (Berlín-Frankfurt-Munster, presentando una respuesta clínica satisfactoria y encontrándose en resmisión completa (RC a los 24 meses de seguimiento. Primary lymphoma of bone is rare in children and its non-specific clinical presentation requires a high clinical suspicion and paraclinical support to establish the diagnosis and provide a comprehensive approach. We report the case of 9 years-old patient who was diagnosed of multifocal primary B cell non-Hodgkin lymphoma of bone 6.5 weeks from symptoms onset. She received combined treatment based on BFM (Berlin-Frankfurt-Munster protocol with a good medical response. She remains in complete remission (CR after 24 months of follow-up.

  11. 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. PMID:27313890

  12. A joint Richardson—Lucy deconvolution algorithm for the reconstruction of multifocal structured illumination microscopy data

    International Nuclear Information System (INIS)

    We demonstrate the reconstruction of images obtained by multifocal structured illumination microscopy, MSIM, using a joint Richardson–Lucy, jRL-MSIM, deconvolution algorithm, which is based on an underlying widefield image-formation model. The method is efficient in the suppression of out-of-focus light and greatly improves image contrast and resolution. Furthermore, it is particularly well suited for the processing of noise corrupted data. The principle is verified on simulated as well as experimental data and a comparison of the jRL-MSIM approach with the standard reconstruction procedure, which is based on image scanning microscopy, ISM, is made. Our algorithm is efficient and freely available in a user friendly software package. (paper)

  13. Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound

    International Nuclear Information System (INIS)

    AIM: The aim of this study was to evaluate the contribution of bilateral whole-breast ultrasound (BBUS) to the diagnosis and management of women with newly diagnosed breast cancer. METHODS: Over a period of 6 months, 102 women presenting with breast cancer underwent BBUS. Data were collected on clinical findings, radiology, histology and surgical outcome. These women were compared with a control group of 124 women presenting over a similar 6-month period 1 year previously, who had undergone targeted breast ultrasound. RESULTS: Multicentric/multifocal tumours were demonstrated in 35 (34%) of the 102 participants and in 18 (15%) of the 124 controls, a statistically significant difference (Fisher's exact test, p=0.001). Multiple tumours were diagnosed preoperatively in 18% of the study population compared with 8% of the controls, and BBUS identified invasive multifocal/multicentric tumours in significantly more women in the study population (11 versus 1 control) (Fisher's exact test, p=0.019). Contralateral cancer was diagnosed in 4 women in the study population and none in the control population (Fisher's exact test, p=0.040). Surgical review showed that the surgical management changed significantly in 8% (95% confidence interval 4 to 14%) of cases in the study population following BBUS. The increase in the number of women undergoing benign biopsies in the study population (10 versus 5 controls) was not statistically significant (Fisher's exact test, p=0.11). CONCLUSION: BBUS increased the preoperative diagnosis of multiple tumours in women presenting with primary breast cancer, resulting in a management change in 8% of cases

  14. 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 

  15. 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. PMID:27563460

  16. Increasing the diagnosis of multifocal primary breast cancer by the use of bilateral whole-breast ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Wilkinson, L.S. [South West London Breast Screening Service (United Kingdom)]. E-mail: louise.wilkinson@stgeorges.nhs.uk; Given-Wilson, R. [South West London Breast Screening Service (United Kingdom); Hall, T. [South West London Breast Screening Service (United Kingdom); Potts, H. [Centre for Health Informatics and Multiprofessional Education, University College, London (United Kingdom); Sharma, A.K. [Department of Breast Surgery, St George' s Hospital (United Kingdom); Smith, E. [South West London Breast Screening Service (United Kingdom)

    2005-05-01

    AIM: The aim of this study was to evaluate the contribution of bilateral whole-breast ultrasound (BBUS) to the diagnosis and management of women with newly diagnosed breast cancer. METHODS: Over a period of 6 months, 102 women presenting with breast cancer underwent BBUS. Data were collected on clinical findings, radiology, histology and surgical outcome. These women were compared with a control group of 124 women presenting over a similar 6-month period 1 year previously, who had undergone targeted breast ultrasound. RESULTS: Multicentric/multifocal tumours were demonstrated in 35 (34%) of the 102 participants and in 18 (15%) of the 124 controls, a statistically significant difference (Fisher's exact test, p=0.001). Multiple tumours were diagnosed preoperatively in 18% of the study population compared with 8% of the controls, and BBUS identified invasive multifocal/multicentric tumours in significantly more women in the study population (11 versus 1 control) (Fisher's exact test, p=0.019). Contralateral cancer was diagnosed in 4 women in the study population and none in the control population (Fisher's exact test, p=0.040). Surgical review showed that the surgical management changed significantly in 8% (95% confidence interval 4 to 14%) of cases in the study population following BBUS. The increase in the number of women undergoing benign biopsies in the study population (10 versus 5 controls) was not statistically significant (Fisher's exact test, p=0.11). CONCLUSION: BBUS increased the preoperative diagnosis of multiple tumours in women presenting with primary breast cancer, resulting in a management change in 8% of cases.

  17. 江苏省男性HIV感染者/AIDS患者AIDS相关支原体感染情况分析%Analysis for infection of AIDS-related mycoplasma in male HIV carrier and AIDS patients

    Institute of Scientific and Technical Information of China (English)

    周良佳; 吴建茹; 朱一; 徐金水; 傅更锋; 王蓓

    2013-01-01

    目的 了解HIV感染者或AIDS患者AIDS相关支原体生殖支原体(Mycoplasma genitalium,Mg)、发酵支原体(Mycoplasma fermentans,Mf)、穿通支原体(Mycoplasma penetrans,Mpe)和梨支原体(Mycoplasma pirum,Mpi)的感染状况并分析其与疾病发展的关系,为进一步研究AIDS相关支原体在HIV感染者/AIDS患者免疫功能变化中的作用提供依据.方法 对江苏省312名男性HIV感染者/AIDS患者采用流行病学横断面调查的方法,在调查对象知情同意的基础上开展问卷调查,同时采集首段尿、静脉血标本.用PCR法检测支原体,流式细胞仪检测外周血CD4+T淋巴细胞,ELISA双抗体夹心法检测细胞因子水平.结果 江苏省男性HIV感染者/AIDS患者中,除无Mpe感染外,存在其他3种AIDS相关支原体Mg、Mf、Mpi的感染,检出率分别为26.9%、13.8%和21.8%.Mf的感染率在不同CD4+T细胞水平者间的差异有统计学意义(x2=11.775,P=0.003).对男性HIV感染者/AIDS合并AIDS相关支原体感染者血清细胞因子水平进行分析,合并支原体感染组的IL-4水平(4.437pg/mL)高于单纯HIV感染组(1.922 pg/mL),IL-6水平(0.431 pg/mL)低于单纯HIV感染组(0.532 pg/mL),差异均有统计学意义(P<0.001).多因素logistic回归分析结果显示,苏南地区较苏北地区AIDS相关支原体感染危险性高(OR=2.388,95%CI:1.212 ~4.706),而苏中较苏南地区AIDS相关支原体感染危险性低(OR=0.447,95% CI:0.253 ~0.790);HIV感染者/AIDS患者积极进行抗逆转录病毒治疗者发生AIDS相关支原体感染的危险性较小(OR=0.545,95%CI:0.311~0.955).结论 江苏省男性HIV感染者/AIDS患者存在较高AIDS相关支原体的感染;支原体感染与机体免疫状况具有一定的相关性,但其关联机制还需要进一步深入探讨.%Objective To investigate the prevalence of infection with AIDS-related mycoplasma, including Mycoplasma genitalium ( Mg) , Mycoplasma fermentans ( Mf) , Mycoplasma

  18. 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

    OpenAIRE

    Navarro, Rodrigo M.; Machado, Leonardo M.; Ossires Maia; Lihteh Wu; Farah, Michel E.; Octaviano Magalhaes; J Fernando Arevalo; Mauricio Maia

    2015-01-01

    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, biomicro...

  19. 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

  20. Treatment Option Overview (AIDS Related-Lymphoma)

    Science.gov (United States)

    ... throughout the body, including to the brain or bone marrow . It is often diagnosed in an advanced stage. Primary CNS lymphoma Primary CNS lymphoma starts in the central nervous system (brain and spinal cord). It is linked to the Epstein-Barr ...

  1. General Information about AIDS-Related Lymphoma

    Science.gov (United States)

    ... throughout the body, including to the brain or bone marrow . It is often diagnosed in an advanced stage. Primary CNS lymphoma Primary CNS lymphoma starts in the central nervous system (brain and spinal cord). It is linked to the Epstein-Barr ...

  2. Treatment Options for AIDS-Related Lymphoma

    Science.gov (United States)

    ... throughout the body, including to the brain or bone marrow . It is often diagnosed in an advanced stage. Primary CNS lymphoma Primary CNS lymphoma starts in the central nervous system (brain and spinal cord). It is linked to the Epstein-Barr ...

  3. Stages of AIDS-Related Lymphoma

    Science.gov (United States)

    ... throughout the body, including to the brain or bone marrow . It is often diagnosed in an advanced stage. Primary CNS lymphoma Primary CNS lymphoma starts in the central nervous system (brain and spinal cord). It is linked to the Epstein-Barr ...

  4. AIDS-related mycoses: the way forward

    OpenAIRE

    Brown, Gordon D.; Meintjes, Graeme; Kolls, Jay K.; Gray, Clive; Horsnell, William

    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 diagnostics and drugs, more training in the field of medical mycology, and better funding for research and provision of treatment, particularly in developing countries.

  5. 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.

  6. [Magnetic resonance in AIDS-related encephalopathy].

    Science.gov (United States)

    Gualdi, G F; Di Biasi, C; D'Agostino, A; Trasimeni, G; Melone, A

    1995-12-01

    Fifty-eight patients with AIDS disease were studied with MR imaging in the aim of detecting the grade of brain involvement. The examinations were performed with a 1.5 Tesla magnet. Thirty-seven showed white matter lesion (63.5%), twenty-five patients showed cerebral atrophy (43%), in eight patients the MR appearance was consistent with toxoplasmosis infection (13.5%), two patients showed a linfoma (3.4%) and two patients micrococcosis (3.4%). Seventeen out of the thirty-seven patients with white matter disease showed focal well circumscribed lesion (46%), while twenty showed diffuse involvement. Between the twenty-five patients with cerebral atrophy, twelve showed a prevalence of the cortical involvement and eight a subcortical atrophy. In five patients a concomitant, cortical and subcortical atrophy was found. Between the eight patients with neurotoxolesion and two of them a widespread encephalitis picture. The MR appearance of the two limphomas was that of periventricular, space occupying, masses. In two patients with micrococcis a nodular aspect of leptomeningeal lesions was found. PMID:8681504

  7. 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

  8. 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

  9. 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....

  10. Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO)

    OpenAIRE

    Reslan Walid; Kaura Deepak; Wei Xingchang; Miettunen Paivi MH; Aguirre Alberto; Kellner James D

    2009-01-01

    Abstract Background Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory, non-infectious osteopathy that affects predominantly patients ≤ 18 years of age. There is no uniformly effective treatment. Our objective is to describe clinical, magnetic resonance imaging (MRI), and bone resorption response to intravenous pamidronate in pediatric CRMO. Methods We report our prospectively documented experience with all CRMO patients treated with pamidronate between 2003 and 2008 at a te...

  11. Posterior capsular opacification: Incidence and factors influencing and rate of Nd:YAG capsulotomy in diabetic and uveitic patients and after multifocal intraocular lens implantation.

    OpenAIRE

    Elgohary, M A

    2005-01-01

    This thesis examined the incidence and factors affecting the rate of posterior capsular opacification (PCX)), the most common complication of cataract surgery, in diabetic and uvcitic patients and in patients with multifocal intraocular lenses (IOLs). These patients arc particularly sensitive to PCO development because of the risks associated with Nd:YAG capsulotomy in the former two groups and the potential effect on visual function in the latter group. PCO rate was estimated both retrospect...

  12. Nuclear myocardial perfusion imaging using thallium-201 with a novel multifocal collimator SPECT/CT: IQ-SPECT versus conventional protocols in normal subjects

    OpenAIRE

    Matsuo, Shinro; Nakajima, Kenichi; Onoguchi, Masahisa; Wakabayashi, Hiroshi; Okuda, Koichi; Kinuya, Seigo

    2015-01-01

    Objective A novel multifocal collimator, IQ-SPECT (Siemens) consists of SMARTZOOM, cardio-centric and 3D iterative SPECT reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 (201Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging. Methods Forty patients (eight women, mean age of 75 years) who underwent myocardial p...

  13. The persistence of multifocal colonisation by a single ABC genotype of Candida albicans may predict the transition from commensalism to infection

    OpenAIRE

    Guilherme Maranhão Chaves; Fernanda Pahim Santos; Arnaldo Lopes Colombo

    2012-01-01

    Candida albicans is a common member of the human microbiota and may cause invasive disease in susceptible populations. Several risk factors have been proposed for candidaemia acquisition. Previous Candida multifocal colonisation among hospitalised patients may be crucial for the successful establishment of candidaemia. Nevertheless, it is still not clear whether the persistence or replacement of a single clone of C. albicans in multiple anatomical sites of the organism may represent an additi...

  14. Multifocal Ectopic Purkinje-Related Premature Contractions: A New SCN5A-Related Cardiac Channelopathy. : MEPPC: a new SCN5A-related cardiac channelopathy

    OpenAIRE

    Amarouch, Mohamed Yassine; Barc, Julien; Bar, Isabelle; Baron, Estelle; Barthez, Olivier; Bertaux, Geraldine; Béziau, Delphine M.; Charpentier, Flavien; Charron, Philippe; Coudière, Yves; Dina, Christian; Faivre, Laurence; Fressart, Véronique; Kyndt, Florence; Laurent, Gabriel

    2012-01-01

    OBJECTIVES: The aim of this study was to describe a new familial cardiac phenotype and to elucidate the electrophysiological mechanism responsible for the disease. BACKGROUND: Mutations in several genes encoding ion channels, especially SCN5A, have emerged as the basis for a variety of inherited cardiac arrhythmias. METHODS: Three unrelated families comprising 21 individuals affected by multifocal ectopic Purkinje-related premature contractions (MEPPC) characterized by narrow junctional and r...

  15. 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

  16. PROGNOSTIC FACTORS OF POSITIVE RESULTS OF MULTIFOCAL TRUS-GUIDED VESICOURETHRAL ANASTOMOSIS BIOPSY IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    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.

  17. Histopathological aspects of walker 256 tumor using the multifocal technique of inoculation

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Garcez Novaes

    2013-03-01

    Full Text Available Cancer has been considered one of the most serious calamities all over the world producing tremendous economic and social losses. Considering the increasing incidence of these health disturbances, the variable efficacy and frequent adverse events commonly notified with the existing chemotherapy protocols and the new events currently in progress in the world it´s urgent to develop new strategies to prevent and treat cancer. It is well known that Walker 256 tumor is the most common experimental tumor model to study cancer but public health personnel still has little information about it. The aim of this study is not only to review the important aspects of this experimental tumor but also to increase the knowledge and comprehension about it among health professionals.

  18. 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.

  19. Survey of HIV/AIDS-related behavior features among MSM in Jiujiang city%九江市MSM艾滋病相关行为学特征调查

    Institute of Scientific and Technical Information of China (English)

    黄文军; 杨曦; 孔飞勇; 石友纲

    2012-01-01

    Objective To explore the HIV/AIDS - related behavior features among MSM in Jiujiang . Method A cross - sectional questionnaire survey was conducted for 260 MSM in Jiujiang. Results In the past 6 months, among the interviewed MSM, 93. 46% of them had male sexual partners, and only 21. 40% of them used condom persistently. Besides, 17. 69% of them had sex with female , but only 8. 70% of them used condom with their female sexual partners persistently. Conclusions Multiple sex partners and unsafe sexual behaviors are frequent among the interviewed MSM.%目的 了解九江市男男性行为者(MSM)艾滋病相关行为学特征.方法 采取横断面研究设计,对九江市260名MSM开展相关问卷调查.结果 过去6个月,调查对象中93.46%的有同性性伴,其中坚持使用安全套的仅21.40%.17.69%曾与异性发生过性行为,与异性发生性行为坚持使用安全套的仅8.70%.结论 调查对象多性伴和无保护性性行为较普遍.

  20. 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

  1. 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.

  2. Antibodies to Glycoproteins Shared by Human Peripheral Nerve and Campylobacter jejuni in Patients with Multifocal Motor Neuropathy

    Directory of Open Access Journals (Sweden)

    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.

  3. Multifocal PEComa (PEComatosis of the female genital tract and pelvis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2012-03-01

    Full Text Available Abstract Perivascular epithelioid cells (PECs are constantly present in a group of tumors called PEComas, including angiomyolipoma (AML, clear-cell "sugar" tumor (CCST of the lung and extrapulmonary sites, lymphangioleiomyomatosis, clear-cell myomelanocytic tumor of the falciform ligament/ligamentum teres and rare clear-cell tumors of other anatomic sites. PECs have distinctive morphologic, immunohistochemical, ultrastructural and genetic characteristics, including an epithelioid appearance with a clear to granular cytoplasm, a round to oval, centrally located nucleus, and an inconspicuous nucleolus. PECs also express melanocytic and myogenic markers like HMB45 and smooth muscle actin. PEComa is rare in human, and multifocal PEComas (PEComatosis is extremely rare. Up to now there have been only less than 5 cases described in the literature. Here we report a 46-year old Chinese woman who had PEComatosis arising from the genital tract and pelvis. To our knowledge, this is the first case of PEComatosis ever reported in China. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1293097548652023.

  4. 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.

  5. 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)

  6. [Multifocal serous chorioretinopathy secondary to the use of MEK inhibitors: Illustration and example of management through two case reports].

    Science.gov (United States)

    Coutu, A; Farguette, F; Jeannin, G; Chiambaretta, F

    2016-01-01

    New targeted treatments are being used for patients affected by certain types of cancers with specific gene dysregulation. These new treatments transform the prognosis for the patients but the exact way in which they work is often incompletely known. This can prove to be problematic with regard to potential side effects. Ophthalmologic side effects are particularly difficult to detect in animal models. MEK inhibitors are among these new targeted treatments for which the indications are broad. One of the reported side effects of MEK inhibitors is the appearance of atypical multifocal serous chorioretinopathies which, when present, occur rapidly after starting the treatment and disappear soon after stopping it. We report two documented cases of serous chorioretinopathies secondary to the use of selumetinib, an MEK inhibitor. Both patients were followed for several months after initiating the treatment, using angiography, OCT, and filtered photographs. Only a very few cases have been reported, and the detailed description of two clear-cut cases and their management, as well as a review of the current literature, seems a good way to approach the management of this complication. PMID:26747016

  7. 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

  8. Visual performance of subjects wearing multifocal contact lenses%多焦角膜接触镜矫正老视视觉质量评估

    Institute of Scientific and Technical Information of China (English)

    毛欣杰; 王武; 陈岩; 郑斌

    2011-01-01

    目的 探讨配戴多焦角膜接触镜矫正老视视远和视近视觉质量的效果.方法 18例老视患者分别配戴框架眼镜和多焦角膜接触镜后,测量亮环境下不同对比度(100%、25%和5%)视远和视近的LogMar对数视力,并在亮环境下测量对比敏感度,比较两种矫正方法对视觉质量的改善情况.结果 亮环境下,对比度为100%时,框架眼镜配戴后的视远视力和多焦角膜接触镜配戴后的视力无明显差异(P >0.05);而对比度为25%和10%时,多焦角膜接触镜配戴后视远视力均显著低于框架眼镜配戴后视力(P<0.01).多焦角膜接触镜配戴后视近视力均明显低于框架眼镜配戴后视力(P<0.05).在低频(1.5周/度)情况下,框架眼镜和多焦角膜接触镜配戴后对比敏感度值无明显差异(P >0.05);而在其他空间频率(3、6、12、18周/度)下,框架眼镜配戴后的对比敏感度值均明显高于多焦角膜接触镜配戴后的对比敏感度值(P<0.05).结论 多焦角膜接触镜在高对比度和亮环境下有很好的视远和视近视觉质量,而在低对比度下视觉质量有所下降.%Objective To investigate visual quality with the multifocal contact lens wearing and spectacle wearing.Methods 100%,25% and 5% contrast LogMar visual acuity (VA) was measured at light environment in 18 cases of presbyopia wearing spectacle and multifocus contact lens.Contrast sensitivity function (CSF) was measured in light environment with the multifocal contact lens wearing and spectacle wearing.Results There was no significant different in distance VA between two wearing methods in 100% contrast LogMar visual acuity under light environment (P>0.05).And in 25% and 10% contrast, LogMar visual acuity with multifocal contact lens wearing was lower than that with spectacle wearing (P<0.01).For near distance 100%, 25% and 5% contrast LogMar visual acuity with multifocal contact lens wearing was lower than that with

  9. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-01-01

    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. PMID:27511757

  10. 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

  11. 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

  12. 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

  13. 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.

  14. Investigation of cognitive status of hospital cleaning workers about the AIDS related knowledge%医院保洁人员对艾滋病相关知识的认知状况调查

    Institute of Scientific and Technical Information of China (English)

    王丽芹; 陈东方; 夏亮; 孟萌; 陈瑜; 杨晓红

    2015-01-01

    OBJECTIVE To explore the currently cognitive status on AIDS related knowledge among hospital clean‐ing workers so as to put forward reasonable proposals and measures .METHODS Totally 165 cleaning workers were investigated with self‐designed questionnaire by random cluster sampling in Jul .2014 in the hospital .RESULTS In 165 cleaning workers ,147 of them knew about AIDS and the awareness rate was 89 .9% .The correct rate about the fact that the seeming healthy people may be AIDS infected was 43 .6% ;the completely correct rate on three major transmission route of AIDS were 78(47 .3% ) ,the average knowledge rate was 62 .6% .A total of 148 clean‐ing workers knew that skin puncture by medical machines can increase the chance of acquiring AIDS and the awareness rate was 89 .7% .The investigation objects suffered fear and worry at different levels towards AIDS in‐fected people ,115 (69 .7% )people believed that AIDS patients should be given the same medical service ,only 79 (47 .9% )were still willing to work with friends who suffered AIDS ;all 165 subjects were willing to be trained on the AIDS related knowledge and the training approaches they mainly chose were to watch image data such as video and propaganda film ,and centralized instruction .CONCLUSION The cognitive status of hospital cleaning workers on AIDS related knowledge was not optimistic;managers should strengthen the training and education on AIDS knowledge ,establish the hospital cleaning workers occupational protection rules and regulations ,and enhance the self‐protection ability of the cleaning workers .%目的:了解医院保洁人员对艾滋病相关知识的认知现状,为提出合理化建议和措施提供依据。方法自行设计调查表,采用整群抽样的方法,2014年7月对医院165名保洁人员进行调查。结果165名医院保洁人员中,147人知晓艾滋病,知晓率为89.1%;认为每个人均有可能感染艾滋病者有72人,知晓率为43.6

  15. MR imaging with pathologic correlation of central nervous system manifestations of AIDS

    International Nuclear Information System (INIS)

    This paper presents the MR findings with the pathologic correlation of various examples of the opportunistic infection and other related conditions of head and neck involvement in patients with AIDS. Included in this exhibit are cryptococcal meningitis, tuberculous meningitis, tuberculoma, demyelinating white matter disease, aspergillosis, cervical osteomyelitis, transverse myelitis, primary central nervous system lymphoma, metastatic lymphoma, progressive multifocal leukoencephalopathy, parotid cysts, AIDS-related otomastoiditis, and severe nasopharyngeal lymphadenopathy. The basis pathology and MR findings of each entity are described

  16. Quantifying local heterogeneity of in vivo transport dynamics using stochastic scanning multiphoton multifocal microscopy and segmented spatiotemporal image correlation spectroscopy

    Science.gov (United States)

    Kim, Hee Y.; Jureller, Justin E.; Kuznetsov, Andrey; Philipson, Louis H.; Scherer, Norbert F.

    2008-02-01

    Elucidating the mechanisms of insulin granule trafficking in pancreatic β-cells is a critical step in understanding Type II Diabetes and abnormal insulin secretion. In this paper, rapid-sampling stochastic scanning multiphoton multifocal microscopy (SS-MMM) was developed to capture fast insulin granule dynamics in vivo. Stochastic scanning of (a diffractive optic generated) 10×10 hexagonal array of foci with a galvanometer yields a uniformly sampled image with fewer spatio-temporal artifacts than obtained by conventional or multibeam raster scanning. In addition, segmented spatio-temporal image correlation spectroscopy (Segmented STICS) was developed to extract dynamics of insulin granules from the image sequences. Measurements we conducted on MIN6 cells, which exhibit an order of magnitude lower granule number density, allow comparison of particle tracking with Segmented-STICS. Segmentation of the images into 8×8 pixel segments (similar to a size of one granule) allows some amount of spatial averaging, which can reduce the computation time required to calculate the correlation function, yet retains information about the local spatial heterogeneity of transport. This allows the correlation analysis to quantify the dynamics within each of the segments producing a "map" of the localized properties of the cell. The results obtained from Segmented STICS are compared with dynamics determined from particle tracking analysis of the same images. The resulting range of diffusion coefficients of insulin granules are comparable to previously published values indicating that SS-MMM and segmented- STICS will be useful to address the imaging challenges presented by β-cells, particularly the extremely large number density of granules.

  17. Comparison of the reliability of multifocal visual evoked cortical potentials generated by pattern reversal and pattern pulse stimulation

    Directory of Open Access Journals (Sweden)

    G.S. Souza

    2012-10-01

    Full Text Available This study compared the effectiveness of the multifocal visual evoked cortical potentials (mfVEP elicited by pattern pulse stimulation with that of pattern reversal in producing reliable responses (signal-to-noise ratio >1.359. Participants were 14 healthy subjects. Visual stimulation was obtained using a 60-sector dartboard display consisting of 6 concentric rings presented in either pulse or reversal mode. Each sector, consisting of 16 checks at 99% Michelson contrast and 80 cd/m² mean luminance, was controlled by a binary m-sequence in the time domain. The signal-to-noise ratio was generally larger in the pattern reversal than in the pattern pulse mode. The number of reliable responses was similar in the central sectors for the two stimulation modes. At the periphery, pattern reversal showed a larger number of reliable responses. Pattern pulse stimuli performed similarly to pattern reversal stimuli to generate reliable waveforms in R1 and R2. The advantage of using both protocols to study mfVEP responses is their complementarity: in some patients, reliable waveforms in specific sectors may be obtained with only one of the two methods. The joint analysis of pattern reversal and pattern pulse stimuli increased the rate of reliability for central sectors by 7.14% in R1, 5.35% in R2, 4.76% in R3, 3.57% in R4, 2.97% in R5, and 1.78% in R6. From R1 to R4 the reliability to generate mfVEPs was above 70% when using both protocols. Thus, for a very high reliability and thorough examination of visual performance, it is recommended to use both stimulation protocols.

  18. Comparison of the reliability of multifocal visual evoked cortical potentials generated by pattern reversal and pattern pulse stimulation.

    Science.gov (United States)

    Souza, G S; Schakelford, H B; Moura, A L A; Gomes, B D; Ventura, D F; Fitzgerald, M E C; Silveira, L C L

    2012-10-01

    This study compared the effectiveness of the multifocal visual evoked cortical potentials (mfVEP) elicited by pattern pulse stimulation with that of pattern reversal in producing reliable responses (signal-to-noise ratio >1.359). Participants were 14 healthy subjects. Visual stimulation was obtained using a 60-sector dartboard display consisting of 6 concentric rings presented in either pulse or reversal mode. Each sector, consisting of 16 checks at 99% Michelson contrast and 80 cd/m² mean luminance, was controlled by a binary m-sequence in the time domain. The signal-to-noise ratio was generally larger in the pattern reversal than in the pattern pulse mode. The number of reliable responses was similar in the central sectors for the two stimulation modes. At the periphery, pattern reversal showed a larger number of reliable responses. Pattern pulse stimuli performed similarly to pattern reversal stimuli to generate reliable waveforms in R1 and R2. The advantage of using both protocols to study mfVEP responses is their complementarity: in some patients, reliable waveforms in specific sectors may be obtained with only one of the two methods. The joint analysis of pattern reversal and pattern pulse stimuli increased the rate of reliability for central sectors by 7.14% in R1, 5.35% in R2, 4.76% in R3, 3.57% in R4, 2.97% in R5, and 1.78% in R6. From R1 to R4 the reliability to generate mfVEPs was above 70% when using both protocols. Thus, for a very high reliability and thorough examination of visual performance, it is recommended to use both stimulation protocols. PMID:22782556

  19. 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.

  20. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99mTc-pertechnetate thyroid uptake under suppression (TcTUs) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTUs, which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTUs of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTUs>3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.)

  1. 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

    OpenAIRE

    Alexandre Mendes Amude; Glei dos Anjos Carvalho; Amauri Alcindo Alfieri; Alice Fernandes Alfieri

    2007-01-01

    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 (CN...

  2. 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

  3. A study of monofocal intraocular lens (AcrySof ®) in mini-monovision (MMV) and premium multifocal implantation of ReSTOR®

    OpenAIRE

    Chen, Ming

    2009-01-01

    Ming Chen1, Mindy Chen21John A Burns School of Medicine, University of Hawaii, USA; 2University of California, Irvine, USAAbstract: We compared the AcrySof® monofocal intraocular lens (IOL) in mini-monovision (MMV) (n = 20) with the ReSTOR® multifocal IOL (n = 20) for glasses independence after cataract surgery. The ReSTOR IOL showed a significantly higher proportion of postoperative independence from glasses. The MMV formula monofocal AcrySof recipients with the same pre-op s...

  4. 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

    2016-01-01

    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

  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. Vitrectomia transconjuntival 25 gauge via pars plana para opacidade vítrea persistente em pacientes com implante de lentes multifocais Transconjunctival sutureless 25-gauge vitrectomy for visually significant vitreous floaters in patients with multifocal intraocular lens

    OpenAIRE

    Leonardo Akaishi; Fábio Canamary; Patrick Frensel de Moraes Tzelikis

    2010-01-01

    OBJETIVO: O objetivo do presente estudo é relatar o resultado visual obtido após realização de vitrectomia via pars plana 25 gauge (VVPP-25-gauge) em pacientes com opacidades vítreas persistentes e debilitantes previamente submetidos à cirurgia de facectomia com implante de lente intraocular (LIO) multifocal. MÉTODOS: Estudo prospectivo de 14 olhos com implante de LIO multifocal e presença de opacidade vítrea submetidos à VVPP-25-gauge. Foram avaliados acuidade visual sem correção (AVSC), acu...

  7. 东莞市不同人群艾滋病知识水平及影响因素研究%Survey on HIV/AIDS-related knowledge and influencing factors in different people in Dongguan City

    Institute of Scientific and Technical Information of China (English)

    陈柏芬; 朱建琼; 张巧利; 王晓霞; 刘爱红; 伦玉华; 方晓君; 卓彬鼓

    2013-01-01

    Objective To investigate the HIV/AIDS-related knowledge, behavior, and influence factors in different people in Dongguan City to provide scientific basis for target interventions. Methods Worker, student and villager were selected to investigate the demographic information and AIDS-related knowledge in Dongguan City by clustering and convenient sampling methods. Results A total of 2 880 people including 1 385 males and 1 495 females were surveyed. The means of age of workers, students, and villager were 27. 51 ± 6. 70 years old, 16. 16 ± 0. 97 years old, and 35. 46 ± 10. 54 years old, respectively. For the educational level, 35.42% were junior middle school, 42. 19% were senior middle school. The overall HIV/AIDS awareness rate was 91. 77% (2 643/2 880). The awareness rates on HIV/ AIDS among workers, students, and villagers were 94.92% (915/964), 91.88% (883/961), and 88. 48% (845/955), respectively. Logistic regression analysis showed that the individuals living in the coastal area( OR =0. 50) , aged in the 30 -39 years old(OR =0. 61) , married(OR =0.39), with college education( OR =0. 21) had higher HIV/AIDS knowledge, and those living in the area of hill or rivers and lakes ( OR = 1. 95 , 2. 33) , students / villagers ( OR = 1. 65 , 2. 43 ) , aged 40 years old and above ( OR = 1. 31) had lower HIV/AIDS knowledge. Conclusion HIV/AIDS knowledge awareness rate seemed to be high and the effect is evident in the health education of HIV/AIDS knowledge. Propaganda and education should be strengthened to those people living in the area of rivers and lakes or hill, young age, with low ed- ucation level, unmarried cohabitant, and the aged people to improve their HIV/AIDS knowledge awareness.%目的 了解东莞市不同人群艾滋病相关知识及其影响因素,为制定有针对性的干预措施提供科学依据.方法 采用整群分层抽样和方便抽样相结合的方法,对东莞市工厂工人、学生、村民3类人群进行调查.调查内容包括人

  8. 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,

  9. 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

  10. Investigation of HIV/AIDS related knowledge and attitude among 6487 high school students%6487名中学生艾滋病相关知识、态度调查

    Institute of Scientific and Technical Information of China (English)

    何忠虎; 季成叶

    2009-01-01

    Objective To investigate HIV/AIDS related knowledge and attitude among high school students in China, and to preliminarily evaluate the effects of the special HIV/AIDS prevention education programme. Methods A total of 6487 high school students from 24 high schools of Beijing,Zhengzhou and Tangshan were investigated by using questionnaire, among which,6487 students completed the questionnaire (96. 08% ). X~2 test,t test and one way ANOVA were used to test the group differences and logistic regression was employed for futher analysis. P<0.05 was considered as statistically significance. Results The mean knowledge and attitude scores of the students were separately 14. 42 out of 20 and 6. 47 out of 10. Students from Tangshan had the significantly (P<0.001) highest knowledge and attitude level (average score of knowledge = 15.11, average score of attitude=7.21) followed by Beijing( average score of knowledge = 14. 62, average score of attitude = 6.15) and Zhengzhou ( average score of knowledge = 13.56, average score of attitude=6.07). The signifieant differences were observed in all except the varying attitude between Zhengzhou and Beijing ( Knowledge comparison : t_(Tangshan vs Beijing)= 0.49, P<0.001, t_(Tangshan vs Zhengzhou)= 1.56, P<0. 001, t_(Zhengzhou vs Beijing) = 1.07, P<0.001 ; Attitude Comparison : t_(Tangshan vs Beijing)= 1.06, P<0.001, t_(Tangshan vs Zhengzhou)=1.14, P<0.001, t_(Zhengzhou vs Beijing)= 0.08, P=0.282). Boys had higher knowledge scores (average score of knowledge=14.61) than those of girls (average score of knowledge=14.23 ,t=4.22, P<0.001) but no significant difference was found (average knowledge score of boys =6.47, average knowledge score of girls=6.48, t=0.16, P=0.869 ). Higher knowledge level ( OR=1.21, P<0.001 ) and being a rural student (OR=1.31, P<0.001 ) were significantly associated with higher attitude level, while higher grade (OR=0.85, P=0.003) and better academic performance (OR=0.94, P=0.003) were negative predictors of

  11. Validation of a short-scan-time imaging protocol for thallium-201 myocardial SPECT with a multifocal collimator

    International Nuclear Information System (INIS)

    IQ-SPECT (Siemens AG, Munich, Germany) is a highly sensitive single-photon-emission computed tomography (SPECT) myocardial perfusion imaging (MPI) system that uses a multifocal collimator. We searched for a suitable protocol for short-time imaging by IQ-SPECT in thallium-201 (Tl-201) MPI by evaluating phantom images and also by comparing human IQ-SPECT images with conventional SPECT images as reference standards. We assessed the image quality using the normalized mean square error (NMSE) and drew up count profiles in Tl-201 SPECT images acquired with IQ-SPECT in a phantom study. We also performed Tl-201 stress myocardial SPECT/CT in 21 patients and compared delayed images acquired by using IQ-SPECT with 36 or 17 views per head with images obtained by using conventional SPECT. The NMSE of SPECT images from IQ-SPECT with 36 views was approximately one-fifth of that with 17 views. The myocardial count profile of images with 17 views was lower than those of images with 36 or 104 views in some regions. Defect scores were significantly lower, and image quality scores higher, in images from conventional SPECT than in those from IQ-SPECT with 17 views. Defect scores and image quality scores were equivalent in images from conventional SPECT and those from IQ-SPECT with 36 views. Agreement with the results of conventional SPECT in terms of coronary artery territory-based defect judgment was the best in IQ-SPECT with 36 views with computed tomography-derived attenuation correction (CTAC): the kappa values for IQ-SPECT with 36 views were 0.76 (without CTAC) and 0.83 (with CTAC), and those for IQ-SPECT with 17 views were 0.62 (without CTAC) and 0.59 (with CTAC). The difference in quantitative tracer uptake between conventional SPECT images and IQ-SPECT images was significantly greater for IQ-SPECT images with 17 views than for those with 36 views. Scanning with 36 views per head with CTAC may be appropriate for Tl-201 MPI using IQ-SPECT, because it provides images equivalent to

  12. 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.)

  13. Improved visualization of breast cancer features in multifocal carcinoma using phase-contrast and dark-field mammography: an ex vivo study

    International Nuclear Information System (INIS)

    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.)

  14. Femtosecond laser-assisted in situ keratomileusis multifocal ablation profile using a mini-monovision approach for presbyopic patients with hyperopia

    Science.gov (United States)

    Vastardis, Iraklis; Pajic-Eggspühler, Brigitte; Müller, Jörg; Cvejic, Zeljka; Pajic, Bojan

    2016-01-01

    Purpose To report the visual outcomes of the femtosecond laser-assisted multifocal aspheric corneal ablation profile using a mini-monovision approach and to evaluate if corneal multifocality was effective, and to report the relative benefits of this approach. Patients and methods Bilateral femtosecond laser-assisted in situ keratomileusis using a multifocal aspheric corneal ablation profile was performed on 19 hyperopic patients (38 eyes). They were divided into two groups based on eye dominance: dominant eye (DE) group targeting emmetropia and the nondominant eye (NDE) group targeting −0.5 D slight myopia. The uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and retreatment rates were reported from baseline to 6 months. Results The UNVA, UIVA, and UDVA improved significantly in both groups (Kruskal–Wallis test, DE and NDE: P<0.00001, P<0.000005, and P=0.00001, respectively). Corrected distance visual acuity (CDVA) baseline was better in both groups in comparison to UDVA at 6 months (Wilcoxon test, DE: P<0.001, 95% confidence interval (CI) of the median 0.0–0.0 LogMAR and 0.1000–0.1218 LogMAR and NDE: P=0.010, 95% CI of the median 0.0–0.0 LogMAR and 0.00–0.10 LogMAR). There was a significant loss of lines between CDVA baseline and UDVA at 6 months in both groups (DE group: 68% of eyes lost one line or more; NDE group: 58% of eyes lost one line or more). The corrected near visual acuity baseline compared to UNVA at 6 months was not statistically important (Wilcoxon test, DE: P=0.8125, 95% CI of the median 0.0–0.0 LogMAR and 0.0–0.0 LogMAR and NDE: P=0.82, 95% CI of the median 0.0–0.0 LogMAR and 0.0–0.0 LogMAR). The comparison among the UDVA, UIVA, and UNVA between the two groups at baseline and during all follow-ups was not statistically important. Two cases from the DE group were retreated (6%). Conclusion Use of this multifocal aspheric corneal ablation profile in

  15. HIV prevalence and AIDS-related risk factors among foreign female sex workers in Dehong, Yunnan Province%云南省德宏州外籍暗娼艾滋病感染及其影响因素

    Institute of Scientific and Technical Information of China (English)

    项丽芬; 方可芬; 梅红英; 尹留香; 杨建华; 杨炳丽; 段松; 何纳; 唐仁海; 许娟; 高洁; 杨跃诚; 叶润华; 刘志远; 李蕊; 杨忠桔

    2013-01-01

    Objective To investigate HIV prevalence and AIDS-related risk factors among foreign female sex workers in Dehong Prefecture, Yunnan Province. Methods A door to door survey to all the entertainments in three border counties of Dehong Prefecture was conducted to identify foreign female sex workers. A face-to-face anonymous questionnaire was administrated to collect the information of social demography, AIDS prevention related services and high risk behaviors, etc. A blood sample of 5mL was collected for HIV antibody testing. Results A total of 238 subjects were approached. Among them HIV prevalence was 4. 2%; 34. 5% did not use condoms consistently when having sex with clients. Multi factors non-conditional logistic regression analysis showed that the HIV infection risk among the 23-26 years old group was 10. 8 times as high as among the 22 or less years old group and was 7. 8 times among those having not used condoms in the last sex behavior with client as high as among those using condoms; the risk factors of having unprotected sex included no awareness of the AIDS knowledge (OR = 4. 4,95% CI:1. 9-10. 2), age > 26 (OR = 2. 4,95%CI:1. 0-5. 7) and working locally≥6 months there (OR = 2. 8,95%CI: 1. 6 -5. 1). Conclusion The HIV prevalence among foreign female sex workers in Dehong Prefecture is relatively high, and the consistent condom use in sex behaviors is low. It is urgent to enforce AIDS prevention programs targeting at foreign female sex workers in Dehong Prefecture.%目的 了解云南省德宏州外籍暗娼艾滋病病毒(HIV)感染及相关因素状况.方法 运用普查方法,对德宏州3个边境县(市)全部暗娼活动场所的外籍暗娼进行调查.匿名问卷调查收集社会人口学、艾滋病防治服务及高危行为等信息,并抽取5毫升静脉血进行HIV抗体血清学检测.结果 共有238名外籍暗娼接受调查,HIV感染率为4.2%.34.5%最近1个月与客人发生性行为时未坚持使用安全套.多因素非条

  16. 女性人群艾滋病相关行为及影响因素分析%An analysis on AIDS related behaviors and influencing factors among female population

    Institute of Scientific and Technical Information of China (English)

    蒋幼芳; 任娟; 蔡玉群; 郭志宏; 郭文娟; 杨华

    2011-01-01

    目的 了解女性人群艾滋病相关行为情况及影响因素.方法 用分层整群抽样方法抽取16~49岁1006名女性,进行一对一匿名自填式问卷调查和HIV/梅毒螺旋体血清学调查.结果女性人群艾滋病知识平均知晓率67.94%,安全套每次使用和经常使用率为44.34%,过去1年中54人(5.37%)有2个及以上性伴侣,女性文化程度、丈夫文化程度、户籍和艾滋病知识得分对安全套使用情况的影响差异有统计学意义(P ﹤0.05或0.01);丈夫月收入、女性年龄对性伴数的影响差异有统计学意义(P ﹤0.05或0.01).血清学检测均未发现HIV感染,梅毒螺旋体感染率为1.59%.结论 女性人群艾滋病知识知晓率较低,具有艾滋病相关危险因素,应尽早采取有效的健康教育和行为干预措施.%Objective To investigate AIDS related behaviors and influencing factors in female population.Methods A stratified multi -stage cluster sampling method was used.A total of 1006 female people were cnrolled, and one to one anonymous self- administered questionnaire was adopted.Blood sample was collected for HIV/Syphilis serological determination.Results AIDS awareness of female population was 67.94% on average.The rate of using condoms in each and frequently was 44.34%.Meanwhile, 54( 5.37% ) female have two or more sexual partners during the past year.There was a significant difference among the cducation levels of themselves and their husbands, domicile and AIDS awareness for using of condoms ( P< 0.05 orP< 0.01 ).There was a significant difference among income of husbands and age of female ( P< 0.05 orP< 0.01 ).There was no HIV positive and 1.59% syphilis positive rate was found in serological testing.Conclusion AIDS awareness of female population is low, and there are some risk factors for these person.Effective health cducation and intervention measures should be taken as early as possible.

  17. 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.

  18. 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

  19. 149例艾滋病自愿咨询检测求询者知信行情况分析%Analysis of AIDS related knowledge-belief-practice among visitors to VCT clinics

    Institute of Scientific and Technical Information of China (English)

    李明颖; 毕颖; 汤超; 郭秀花

    2011-01-01

    目的 了解去北京市西城(南)区艾滋病自愿咨询检测(VCT)门诊求询者,对艾滋病知、信、行的情况,为更好地开展VCT服务提供依据.方法 对2009年10月1日至2010年3月31日,自愿接受调查的VCT求询者进行现场调查,运用SPSS 13.0软件进行统计描述.结果 共调查149名求询者,获取艾滋病知识的主要途径是网络,艾滋病知识知晓率为95.30%.在有非婚异性性行为史的求询者中,有36.45%的人从不使用安全套,有男男同性性行为史的求询者中,有21.05%的人从不使用安全套.有71.14%的人来咨询门诊前存在焦虑、抑郁、恐惧等不良心理状态.结论 人们对艾滋病知、信、行的态度并不统一,在加强艾滋病防控知识宣传的同时,还应积极倡导正确的防艾生活方式,倡导正确对待艾滋病感染者或病人的态度.在规范宣传内容的同时,还应进一步提高VCT门诊的心理咨询服务技能.%Objective To understand AIDS related knowledge, belief and practice among visitors to VCTS clinics in Xicheng district, and to provide basis for improving local VCT services.Methods From October 1 of 2009 to March 31 of 2010, visitors to VCT clinics were surveyed, and software SPSS13.0 was used for statistical description.Results The main way of acquiring AIDS knowledge among the VCT visitors was the web;95.30% of them were aware of AIDS knowledge.Of the visitors who had extramarital heterosexual behavior , 36.45% never used condoms; of the MSM visitors 21.05% never used condoms.Before receiving VCT service,71.14% of the visitors were affected with mental disorders, such as anxiety, depression and fear.Conclusion The subjects under survey take different attitude, belief and practice toward AIDS.When AIDS prevention and control knowledge is propagated, reasonable anti-AIDS lifestyle and correct attitude toward HIV infectors or AIDS patients should be actively advocated too.Since VCT visitors may have various mental

  20. 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

  1. Multifocal atrial tachycardia

    Science.gov (United States)

    ... 64. Read More Cardiomyopathy Chronic obstructive pulmonary disease Diabetes Heart failure - overview Lung cancer - small cell Pneumonia - adults (community acquired) Pulmonary embolus Pulse - bounding Stable angina ...

  2. Multifocal nodular steatosis

    OpenAIRE

    Fassaert, TA; Ranschaert, ER; Jong, MDF de; Dubelaar, I

    2013-01-01

    Background: A 62-year-old male with no medical history underwent an ultrasonography of the abdomen because of changed bowel habits and abdominal pain. CT-scan of the abdomen was performed, which initially suggested liver metastases. However, no primary tumor could be identified. Further work-up comprised optical colonoscopy which showed diverticulosis but no evidence of malignancy. Tumor markers were within normal limits. US-guided biopsy revealed normal liver parenchyma but the representativ...

  3. Progress report

    International Nuclear Information System (INIS)

    Progress Report, covering the period up to the end of 1979 year, was sent to the IAEA according to the research agreement No. 1971 /CF. This work covered the following fields: preparation and dummy irradiation experiments with a new experimental capsule of ''CHOUCA-M'' type; measurement of temperature fields and design of specimen holders; measurement of neutron energy spectrum in the irradiation place in our experimental reactor of VVR-S type (Nuclear Research Institute) using a set of activation detectors; unification and calibration of the measurement of neutron fluence with the use of Fe, Cu, Mn-Mg and Co-Al monitors; development and improvement of the measuring apparatus and technique for the dynamic testing of pre-cracked specimens with determination of dynamic parameters of fracture mechanics; preparation and manufacture of testing specimens from the Japanese steels - forging, plate and weld metal; preparation of the irradiation capsule for assembling

  4. 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

  5. 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

  6. Comparison of whole-body STIR-MRI and {sup 99m}Tc-methylene-diphosphonate scintigraphy in children with suspected multifocal bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Mentzel, Hans-J.; Sauner, D.; Fleischmann, C.; Vogt, S.; Kaiser, W.A. [University of Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Kentouche, K.; Zintl, F. [University of Jena, Department of Pediatrics, Jena (Germany); Gottschild, D. [University of Jena, Department of Nuclear Medicine, Jena (Germany)

    2004-12-01

    The study was performed to compare whole-body short time inversion recovery (STIR) MR imaging and {sup 99m}Tc-methylene diphosphonate planar scintigraphy in the examination of children with suspected multifocal skeletal malignant lesions. Sixteen patients with known or suspected malignant skeletal disease underwent both whole-body STIR MR imaging and bone scintigraphy. The lesions were described and numbered according to scintigraphic evaluation criteria. Thus, 16 regions were analyzed in each patient for the comparison between the two modalities. Histology was proven in the primary malignant regions. Follow-up MRIs were registered. Scintigraphy and MRI follow-up were evaluated as gold standard. A total of 139 different lesions was observed by both modalities. Baseline whole-body MRI revealed 119 bone lesions in 256 possible sites (46.5%); scintigraphy revealed only 58 lesions (22.6%). Congruence was observed in only four patients (25%). According to the location of the lesion, correlation was observed in 39/139 lesions (28%). In all, 57.5% of the lesions were detected only by MRI and 14.5% of the lesions were detected only by scintigraphy. Whole-body MRI was more sensitive (P<0.001). Of all lesions numbered which could be separated in the initial MRI, whole-body MRI detected 178 lesions in the patients. The results suggest that whole-body MRI using a STIR sequence is an effective radiation free method for examination of children with suspected multifocal bone lesions. MRI showed more lesions than conventional {sup 99m}Tc-methylene diphosphonate scintigraphy. Therefore, whole-body MRI may be feasible as a screening modality for metastatic and skip lesions in osteosarcoma, PNET, Ewing sarcoma and Langerhans cell histiocytosis in children. (orig.)

  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. Interest of external radiotherapy after mastectomy for multifocal breast tumor, classified pT1-pT2 without ganglions injury; Interet de la radiotherapie externe apres mastectomie pour tumeur du sein multifocale classee pT1-pT2 sans atteinte ganglionnaire

    Energy Technology Data Exchange (ETDEWEB)

    Ligey Bartolomeu, A.; Gentil, J.; El Adssi, H.; Crehange, G.; Truc, G.; Blanchard, N.; Maingon, P.; Peignaux, K. [Centre Georges-Francois Leclerc, 21 - Dijon (France); Gentil, J.; El Adssi, H.; Peiffert, D. [Centre Alexis Vautrin, 54 - Nancy (France)

    2009-10-15

    Purpose: it dose not exist a lot data in literature on the prognosis value of the multi-focality in the breast cancer. The principal objective of this study was to analyze the results in term of locoregional recurrence in a cohort of patients having or not received an external radiotherapy after a mastectomy for a multifocal breast cancer inferior or equal to 5 cm without ganglions damage. Conclusion: this study shows that external radiotherapy after mastectomy does not seem to have an impact on the local control nor on the survival of patients suffering of a multifocal breast cancer superior to 5 cm without ganglion damage. (N.C.)

  9. 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.

  10. 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

  11. 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

  12. Mutations in BRAT1 cause autosomal recessive progressive encephalopathy: Report of a Spanish patient

    Science.gov (United States)

    Fernández-Jáen, Alberto; Álvarez, Sara; So, Eui Young; Ouchi, Toru; de la Peña, Mar Jiménez; Duat, Anna; Fernández-Mayoralas, Daniel Martín; Fernández-Perrone, Ana Laura; Albert, Jacobo; Calleja-Pérez, Beatriz

    2016-01-01

    We describe a 4-year-old male child born to non-consanguineous Spanish parents with progressive encephalopathy (PE), microcephaly, and hypertonia. Whole exome sequencing revealed compound heterozygous BRAT1 mutations [c.1564G > A (p.Glu522Lys) and c.638dup (p.Val214Glyfs*189)]. Homozygous and compound heterozygous BRAT1 mutations have been described in patients with lethal neonatal rigidity and multifocal seizure syndrome (MIM# 614498). The seven previously described patients suffered from uncontrolled seizures, and all of those patients died in their first months of life. BRAT1 acts as a regulator of cellular proliferation and migration and is required for mitochondrial function. The loss of these functions may explain the cerebral atrophy observed in this case of PE. This case highlights the extraordinary potential of next generation technologies for the diagnosis of rare genetic diseases, including PE. Making a prompt diagnosis of PE is important for genetic counseling and disease management. PMID:26947546

  13. Progression of Liver Disease

    Science.gov (United States)

    ... Browse Related Terms Progression of Liver Disease , Family History of Liver Disease , Liver Wellness , Liver Failure , Liver Biopsy Home > Your Liver > Liver Disease Information > The Progression ...

  14. 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.

    Science.gov (United States)

    Navarro, Rodrigo M; Machado, Leonardo M; Maia, Ossires; Wu, Lihteh; Farah, Michel E; Magalhaes, Octaviano; Arevalo, J Fernando; Maia, Mauricio

    2015-01-01

    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. PMID:26504590

  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. IgG4-associated multifocal systemic fibrosis detected by cancer screening with 18F-FDG positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Serial fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) studies were performed with an interval of one year in a 62-year-old man with IgG4-associated multifocal systemic fibrosis (IMSF). He first underwent 18F-FDG PET/CT cancer screening, which revealed multiple 18F-FDG-avid uptakes in the pancreas, prostate, and lymph nodes in the upper mediastinum, pulmonary hila, porta hepatis, and the left iliac and inguinal regions. He was not symptomatic at this initial examination. The follow-up 18F-FDG PET/CT study showed disappearance of 18F-FDG-avid uptake foci in the pancreas despite no treatment having been administered, but demonstrated new lesions in the abdominal para-aortic region and more intense FDG uptake in the porta hepatis lesion. Serial 18F-FDG PET/CT studies might be useful in monitoring patients with IMSF, as well as evaluating the state of systemic involvement. Findings of 18F-FDG PET/CT may provide information useful for determining the optimal initiation of IMSF treatment. (author)

  18. Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

    International Nuclear Information System (INIS)

    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.

  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. The persistence of multifocal colonisation by a single ABC genotype of Candida albicans may predict the transition from commensalism to infection

    Directory of Open Access Journals (Sweden)

    Guilherme Maranhão Chaves

    2012-03-01

    Full Text Available Candida albicans is a common member of the human microbiota and may cause invasive disease in susceptible populations. Several risk factors have been proposed for candidaemia acquisition. Previous Candida multifocal colonisation among hospitalised patients may be crucial for the successful establishment of candidaemia. Nevertheless, it is still not clear whether the persistence or replacement of a single clone of C. albicans in multiple anatomical sites of the organism may represent an additional risk for candidaemia acquisition. Therefore, we prospectively evaluated the dynamics of the colonising strains of C. albicans for two groups of seven critically ill patients: group I included patients colonised by C. albicans in multiple sites who did not develop candidaemia and group II included patients who were colonised and who developed candidaemia. ABC and microsatellite genotyping of 51 strains of C. albicans revealed that patients who did not develop candidaemia were multiply colonised by at least two ABC genotypes of C. albicans, whereas candidaemic patients had highly related microsatellites and the same ABC genotype in colonising and bloodstream isolates that were probably present in different body sites before the onset of candidaemia.

  1. 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.

  2. A New Technique of Graphic Representation of Myocardial Reserve and Responsiveness of Peripheral Arteries when Choosing the Surgical Approach in Patients with Multifocal Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Ivanov L.N.

    2013-06-01

    Full Text Available The aim of the investigation was to develop a new technique to estimate myocardial and peripheral reserves; and on the basis of the obtained responsiveness indices of coronary and peripheral arteries — to improve the diagnostics and optimize the choice of surgical treatment modality of patients with multifocal atherosclerosis. Materials and Methods. 296 patients with concomitant lesions of coronary arteries and lower extremity vessels were examined. In 15 patients, according to the findings of synchronously performed stress-echocardiography and ultrasound Doppler of lower extremities, we compared the severity of coronary and peripheral syndromes using the developed technique of graphic representation of ejection fraction and ankle brachial index (initial, load-peak, recovery time 3 min, 6 min later on phase plane. Results. The study of the distribution dynamics of the indices of ejection fraction and ankle brachial index — the basic indices of intracardiac regional circulatory dynamics — enabled to distinguish 4 zones: А1 zone — low coronary and satisfactory peripheral reserves, А2 zone — low coronary and peripheral reserves, А3 zone — low peripheral and satisfactory coronary reserves, B zone — satisfactory coronary and peripheral reserves. A surgical approach will depend on the zone the indices of the measured parameters are referred to. Conclusion. The suggested technique for the assessment of functional coronary and peripheral reserves by means of graphic representation of the findings on phase plane enables to specify the indications to surgical management and prognosticate ischemic complications.

  3. 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.

  4. A survey of current status of STD/AIDS related knowledge and health care-seeking behaviors among female sex workers in Zhaoqing City%肇庆市暗娼人群STD/AIDS相关知识及求医行为调查

    Institute of Scientific and Technical Information of China (English)

    马福生; 崔建祥; 陈发颖; 孙建莉; 吴晓红; 温小飞

    2011-01-01

    目的 了解肇庆市暗娼对STD/AIDS相关知识的掌握程度及求医行为,为在暗娼人群中开展有针对性的STD/AIDS防治策略提供科学依据.方法 采用面对面问卷调查的方式,对肇庆市娱乐场所346名暗娼人员STD/AIDS相关知识及求医行为进行调查.结果 肇庆市暗娼人群对STD/AIDS基本知识及安全套使用知识总体知晓率分别为74.3%、75.0%,全部答对率分别为36.1%、26.3%;正确就医比例为87.3%;获取STD/AIDS知识来源主要通过书报杂志(55.0%)、电视或广播(54.3%)等大众传播媒介.结论 暗娼人群STD/AIDS相关知识有待提高,暗娼人员的STD/AIDS防治知识宣传教育工作仍需要进一步加强.%Aim To investigate the STD/AIDS related knowledge and health care-seeking behavior among female sex workers in Zhaoqing and provide scientific basis for copnrol of STD/AIDS among female sex workers. Methods Face to face questionnaire survey was conducted to survey STD/AIDS related knowledge and health care-seeking behaviors among 346 female sex workers in public entertainment places n Zhaoqing. Results The general awareness rates of the basic STD/AIDS knowledge and condom usage were 74.3% and 75.0% ,respectively, but the complete correct rates was only 36.1% and 26.3%,respectively. The correct rate of seeking medical was 87.3%.The female sex workers attained the STD/AIDS related knowledge mainly through the mass communication media such as newspapers or journals (55.0%),TV or radio (54.3%). Conclusion The female sex workers' knowledge of STD/AIDS need to be further improved and the practice od propaganda and health education be carried out among female sex workers for controllingSTD/AIDS.

  5. 2009-2011年北京市西城区暗娼艾滋病知识行为调查分析%Investigation and analysis on AIDS-related knowledge and behaviors among female sex workers in Xicheng district of Beijing from 2009-2011

    Institute of Scientific and Technical Information of China (English)

    李敏; 李民; 于建平; 闵婕; 张向军; 韩强

    2012-01-01

    目的 了解2009-2011年北京市西城区暗娼(FSW)人群艾滋病知识认知水平、行为特征和人类免疫缺陷病毒(HIV)、梅毒感染率,为开展有针对性的行为干预和宣教工作提供依据.方法 使用问卷每年对200人进行艾滋病防治相关知识与行为调查;采集静脉血标本,检测HIV、梅毒螺旋体抗体.结果 2009-2011年,FSW的艾滋病知识知晓率分别为77.5%、81.0%和99.0%,差异有统计学意义(X2=43.78,P<0.01).最近1次商业性行为时安全套使用率分别为56.5%、46.0%和93.0% (P <0.01).梅毒检出率分别为1.5%、1.0%和1.0%,HIV抗体阳性检出率分别为0.5%、0、0.结论 2009-2011年,北京市西城区FSW人群艾滋病知识知晓率逐年上升.2011年最近1次商业性行为时安全套使用率较2009和2010年明显上升,但安全套坚持使用率仍较低,应继续加强安全套推广工作,继续做好对该人群艾滋病性病的宣传教育及干预工作.%[Objective]To understand the status of AIDS-related knowledge and behavior characteristics, as well as the infection rate of HIV and syphilis among female sex workers ( FSWs) in Xicheng district of Beijing from 2009-2011, provide the basis for implementing behavioral intervention and health education. [ Methods]An investigation about AIDS-related knowledge and behaviors was conducted in 200 FSWs with questionnaires every year. The venous blood samples were collected for HIV and syphilis detection. [Results]During 2009-2011, the awareness rate of AIDS-related knowledge among FSWs was respectively 77. 5% , 81. 0% and 99.0% , and the difference was significant ( x2=43. 78 ,P <0. 01). The condom use rate in the recent commercial sexual activity was respectively 56. 5% , 46. 0% and 93. 0% (P < 0. 01). The detection rate of syphilis was respectively 1.5%, 1.0% and 1.0%. The detection rate of HIV antibody was respectively 0. 5% , 0 and 0. [ Conclusion]From 2009 to 2011, the awareness rate of AIDS-related

  6. Progress against Prostate Cancer

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Prostate Cancer Progress Against Prostate Cancer Past Issues / Winter 2010 Table of Contents ... Read More "Prostate Cancer" Articles Progress Against Prostate Cancer / Prostate Cancer Research Trial Helps John Spencer Treat His ...

  7. Multifocal Head and Neck Paraganglioma Evaluated with Different PET Tracers: Comparison Between Fluorine-18-Fluorodeoxyglucose Between Fluorine-18-Fluorodeoxyglucose and Gallium-68-Somatostatin Receptor PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Castaldi, Paola; Rufini, Vittoria [Catholic Univ. of the Sacred Heart, Rome (Italy); Treglia, G. [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2013-09-15

    We report the case of a 46-year-old woman with a succinate dehydrogenase subtype D (SDHD) gene mutation and multifocal head and neck paraganglioma evaluated with fluorine-18-fluorodeoxyglucose and gallium-68-somatostatin receptor positron emission tomography/computed tomography (PET/CT). Gallium-68-somatostatin receptor PET/CT correctly assessed the extent of the disease in this patient, detecting additional lesions compared with fluorine-18-fluorodeoxyglucose PET/CT and influencing the patient management. A 46-year-old woman was referred to our centre for surveillance of a gastrointestinal stromal tumour (GIST). The patient underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT), which demonstrated a focal area of increased radiopharmaceutical uptake corresponding to a lesion located between the right carotid vessels (yellow arrow; Fig. 1a). This F-18-FDG-PET/CT finding was suspicious for a paraganglioma of the neck. The patient underwent further examinations, including biochemical and genetic tests and a somatostatin receptor PET/CT using somatostatin analogues labelled with gallium-68 (Ga-68-DOTANOC-PET/CT). Laboratory data were suspicious for a non-functioning neuroendocrine tumour. Increased serum chromogranin A value and normal values of plasmatic and urinary catecholamines and their metabolites were found. The patient had no symptoms of a functioning tumour. Genetic tests demonstrated the presence of a succinate dehydrogenase subtype D (SDHD) gene mutation, which is associated with head and neck paragangliomas. Surprisingly, Ga-68-DOTANOC-PET/CT (Fig. 1b) showed multiple bilateral areas of increased radiopharmaceutical uptake in the head and neck region, corresponding to bilateral neuroendocrine lesions and suggesting the presence of bilateral paragangliomas (yellow arrows) with small cervical lymph nodal metastases with short axis less than 1 cm of diameter (red arrows). Physiological radiopharmaceutical

  8. Operative and scientific set-up to treat diffused and multi-focal metastases in the explanted liver. Preliminary indications from the first case

    International Nuclear Information System (INIS)

    A new method has been developed for the therapy of human liver affected with multi-focal and diffused metastases. The therapeutic concept is based on the neutron irradiation of the explanted organ which, soon after such a treatment, is re-implanted according to the self-transplant procedure. Metastases are generally numerous and not completely detectable by the current diagnostic methodologies: so it is necessary to irradiate the whole organ in a thermal neutron field to treat all metastases and to minimize the recurrence probability. The irradiation position into the thermal column of the Triga Mark II reactor of University of Pavia was designed by means of neutron transport code MCNP. The neutron flux components in air at the irradiation position are shown. During the irradiation, to have a neutron flux inside the liver as flat as possible (in the longitudinal axis of the irradiation channel), we rotate the liver of an angle of 180 deg around the vertical axis. The irradiation of the liver is performed putting the organ inside a two teflon bags and than in another rigid teflon container equipped with two thermocouples to monitor the liver temperature. The first clinical trial consist in the treatment of a male 48 years old made on December 19th 2001. The self-graft procedure and the neutron therapy were performed at S. Matteo Polyclinic and inside the thermal column of Triga Mark II reactor of the University of Pavia respectively. The patient's liver contained more than 20 metastases following the removal of a colon-adenocarcinoma few months before. Six months after treatment all radiological and clinical checks indicated a positive and hopeful trend of the patient's condition

  9. 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.)

  10. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake

    International Nuclear Information System (INIS)

    The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTUs). The TcTUs value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70±9 years, and the mean thyroid volume was 54±26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTUs: 150 Gy for a TcTUs of 1.5%-2.49%, 200 Gy for a TcTUs of 2.5%-3.49%, 250 Gy for a TcTUs of 3.5%-4.49% and 300 Gy for a TcTUs of ≥4.5%. Normalisation of TcTUs and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTUs in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54±26 before treatment to 34±20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTUs can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

  11. Multifocal Head and Neck Paraganglioma Evaluated with Different PET Tracers: Comparison Between Fluorine-18-Fluorodeoxyglucose Between Fluorine-18-Fluorodeoxyglucose and Gallium-68-Somatostatin Receptor PET/CT

    International Nuclear Information System (INIS)

    We report the case of a 46-year-old woman with a succinate dehydrogenase subtype D (SDHD) gene mutation and multifocal head and neck paraganglioma evaluated with fluorine-18-fluorodeoxyglucose and gallium-68-somatostatin receptor positron emission tomography/computed tomography (PET/CT). Gallium-68-somatostatin receptor PET/CT correctly assessed the extent of the disease in this patient, detecting additional lesions compared with fluorine-18-fluorodeoxyglucose PET/CT and influencing the patient management. A 46-year-old woman was referred to our centre for surveillance of a gastrointestinal stromal tumour (GIST). The patient underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT), which demonstrated a focal area of increased radiopharmaceutical uptake corresponding to a lesion located between the right carotid vessels (yellow arrow; Fig. 1a). This F-18-FDG-PET/CT finding was suspicious for a paraganglioma of the neck. The patient underwent further examinations, including biochemical and genetic tests and a somatostatin receptor PET/CT using somatostatin analogues labelled with gallium-68 (Ga-68-DOTANOC-PET/CT). Laboratory data were suspicious for a non-functioning neuroendocrine tumour. Increased serum chromogranin A value and normal values of plasmatic and urinary catecholamines and their metabolites were found. The patient had no symptoms of a functioning tumour. Genetic tests demonstrated the presence of a succinate dehydrogenase subtype D (SDHD) gene mutation, which is associated with head and neck paragangliomas. Surprisingly, Ga-68-DOTANOC-PET/CT (Fig. 1b) showed multiple bilateral areas of increased radiopharmaceutical uptake in the head and neck region, corresponding to bilateral neuroendocrine lesions and suggesting the presence of bilateral paragangliomas (yellow arrows) with small cervical lymph nodal metastases with short axis less than 1 cm of diameter (red arrows). Physiological radiopharmaceutical

  12. Early antiretroviral therapy reduces AIDS progression/death in individuals with acute opportunistic infections: a multicenter randomized strategy trial.

    Directory of Open Access Journals (Sweden)

    Andrew Zolopa

    Full Text Available BACKGROUND: Optimal timing of ART initiation for individuals presenting with AIDS-related OIs has not been defined. METHODS AND FINDINGS: A5164 was a randomized strategy trial of "early ART"--given within 14 days of starting acute OI treatment versus "deferred ART"--given after acute OI treatment is completed. Randomization was stratified by presenting OI and entry CD4 count. The primary week 48 endpoint was 3-level ordered categorical variable: 1. Death/AIDS progression; 2. No progression with incomplete viral suppression (ie HIV viral load (VL >or=50 copies/ml; 3. No progression with optimal viral suppression (ie HIV VL <50 copies/ml. Secondary endpoints included: AIDS progression/death; plasma HIV RNA and CD4 responses and safety parameters including IRIS. 282 subjects were evaluable; 141 per arm. Entry OIs included Pneumocytis jirovecii pneumonia 63%, cryptococcal meningitis 12%, and bacterial infections 12%. The early and deferred arms started ART a median of 12 and 45 days after start of OI treatment, respectively. THE DIFFERENCE IN THE PRIMARY ENDPOINT DID NOT REACH STATISTICAL SIGNIFICANCE: AIDS progression/death was seen in 20 (14% vs. 34 (24%; whereas no progression but with incomplete viral suppression was seen in 54 (38% vs. 44 (31%; and no progression with optimal viral suppression in 67 (48% vs 63 (45% in the early vs. deferred arm, respectively (p = 0.22. However, the early ART arm had fewer AIDS progression/deaths (OR = 0.51; 95% CI = 0.27-0.94 and a longer time to AIDS progression/death (stratified HR = 0.53; 95% CI = 0.30-0.92. The early ART had shorter time to achieving a CD4 count above 50 cells/mL (p<0.001 and no increase in adverse events. CONCLUSIONS: Early ART resulted in less AIDS progression/death with no increase in adverse events or loss of virologic response compared to deferred ART. These results support the early initiation of ART in patients presenting with acute AIDS-related OIs, absent major contraindications

  13. 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

  14. Alveolar damage in AIDS-related Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Prentø, P; Junge, Jette;

    1997-01-01

    P carinii pneumonia, whereas none without P carinii pneumonia had this finding (p < 0.05). Erosion of the type II pneumocyte was not observed. CONCLUSION: Inflammation, interstitial fibrosis, and alveolar epithelial erosion are characteristic features of P carinii pneumonia. The changes may form the......, exudate, fibrosts, type II pneumocyte proliferation, and cellular infiltration of the alveolar wall when compared with other lung diseases (all p < 0.05). Electron microscopy showed apposition of the trophozoite to the type I pneumocyte. Erosion of type I pneumocytes was observed in 13 of 15 patients with...

  15. 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.

  16. AIDS-related reasons for gay men's adoption of celibacy.

    Science.gov (United States)

    Siegel, K; Raveis, V H

    1993-01-01

    Since it was first recognized that human immunodeficiency virus (HIV) infection could be sexually transmitted, celibacy has been advocated by some as the only unequivocally effective adaptation for avoiding the risk of infection. Others, however, have countered that few will be willing to be celibate and, further, that such behavior may have adverse psychosocial consequences. As part of a qualitative study of gay men's sexual decision-making in the context of the AIDS/HIV epidemic, we identified a subsample of respondents who had adopted celibacy for varying periods of time as an adaptation to the threat of AIDS/HIV infection. A content analysis of these men's interviews revealed 5 principal themes relating their reasons for choosing celibacy. PMID:8297710

  17. 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...

  18. Progressive fractal coding

    OpenAIRE

    Kopilovic, Ivan; Saupe, Dietmar; Hamzaoui, Raouf

    2001-01-01

    Progressive coding is an important feature of compression schemes. Wavelet coders are well suited for this purpose because the wavelet coefficients can be naturally ordered according to decreasing importance. Progressive fractal coding is feasible, but it was proposed only for hybrid fractal-wavelet schemes. We introduce a progressive fractal image coder in the spatial domain. A Lagrange optimization based on rate-distortion performance estimates determines an optimal ordering of the code bit...

  19. 医学生与非医学生艾滋病知信行和知识获取的差异分析%Analysis of differences in AIDS-related knowledge,attitude,behavior and knowledge acquisition between medical students and non-medical students

    Institute of Scientific and Technical Information of China (English)

    奚蒙蒙; 谷利斌

    2014-01-01

    目的:了解医学生与非医学生在艾滋病(A ID S )知识、态度、行为和知识获取方面的基本情况及差异,为高校制订合理的健康教育策略提供相关依据。方法运用AIDS知识、态度、行为、知识获取调查问卷对440名在校大学生进行调查,其中医学生与非医学生各220名,运用SPSS19.0分析调查结果。结果医学生和非医学生在AIDS知识问卷和态度问卷方面的平均得分比较,差异有统计学意义( P<0.05)。医学生发生婚前性行为的概率为3.96%,非医学生为7.62%。医学生与非医学生获得AIDS知识的主要途径均为报纸、杂志,电视、电影,最愿意获得AIDS知识的途径为电视、电影。结论高校应联合家庭,运用大学生喜闻乐见的方式对其进行AIDS教育,重点加强非医学生在非传播途径知识、对AIDS患者/感染者的态度、预防知识等方面的教育。%Objective To understand the basic information and differences in the AIDS-related knowledge ,attitude ,behavior and knowledge acquisition between the medical students and the non-medical students to provide the related basis for formulating the ra-tional health education strategy in the colleges and universities .Methods The questionnaires of the AIDS-related knowledge ,atti-tude ,behavior and knowledge acquisition were used to perform the survey on 440 college students including 220 medical students and 220 non-medical students .The SPSS19 .0 software was adopted to analyze the survey results .Results The statistical differ-ences existed between the the medical students and the non-medical students in the average scores of the AIDS-related knowledge and attitude questionnaires(P<0 .05) .The propability of premarital sexual behavior was 3 .96% in the medical stedents and 7 .62%in the non-medical students .The main routes for obtaining the AIDS knowledge in the medical students and the non-medical students were

  20. Analysis on Awareness of STDs/AIDS- related Knowledge in Out - for - job Young Adults in Dai Ethnic Minority Community%傣族社区外出或准备外出打工青、壮年人群性病/艾滋病认知情况分析

    Institute of Scientific and Technical Information of China (English)

    高莉; 杨云娟; 彭霞; 郑克勤; 李洪

    2011-01-01

    目的 了解傣族外出或准备外出打工青、壮年人群对性病/艾滋病相关知识的认知情况,为在该人群中开展宣传教育干预工作奠定基础.方法 采用整群随机抽样的方法,对381名年龄在16岁及以上、曾经外出打工过或者有外出打工打算的傣族村民进行调查.结果 该人群对传播途径和日常接触的非传播途径的知晓率均达到并超过80%,明显高于国家的要求.但是,对蚊虫叮咬能否传播艾滋病这一问题的正确回答率却低至56.17%.结论 应进一步加强对傣族外出或准备外出打工青、壮年人群对性病/艾滋病相关知识培训和提高.%Objective To investigate the awareness of STDs/ AIDS- related knowledge among young adults who went or will go out for work in Dai ethnic minority community, and to provide a basis for implementing intervention in this population. Methods A questionnaire survey was conducted among 381 out - for - job young persons aged 16 years and above selected by stratified cluster random sampling from Dai ethnic minority community. Results The awareness rates about the STDs/AIDS transmission route and non - transmission route in this group were over 80%, which were significantly higher than the national requirements. But we found the correct answer rate about if HIV can be transmitted through misquote or other insect bites was lower to 56.17%. Conclusions It is necessary to further strengthen the training about STDs/AIDS- related knowledge among young adults who went or will go out for work in Dai ethnic minority community.

  1. Cyst infection in hospital-admitted autosomal dominant polycystic kidney disease patients is predominantly multifocal and associated with kidney and liver volume

    International Nuclear Information System (INIS)

    Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication

  2. Spectacle independence and subjective satisfaction of ReSTOR® multifocal intraocular lens after cataract or presbyopia surgery in two European countries

    Directory of Open Access Journals (Sweden)

    Béatrice Cochener

    2010-02-01

    Full Text Available Béatrice Cochener1, Luis Fernández-Vega2, Jose F Alfonso2, Frédérique Maurel3, Juliette Meunier4, Gilles Berdeaux5,61Centre Hospitalier de Brest, Brest, France; 2Instituto Oftalmologico Fernandez Vega, Oviedo, Spain; 3IMS Health, Health Economics Department, Puteaux, France; 4Mapi Values, Lyon, France; 5Alcon France, Health Economics Department, Rueil-Malmaison, France; 6Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To determine the percentage of patients implanted bilaterally with ReSTOR® requiring spectacles at 18 months, the patient satisfaction, and factors that predict spectacles independence.Methods: The medical and surgical data were collected from patient records. The ‘Freedom from Spectacles Value Scale’ (FGVS was used to rank their experiences via telephone interview. A Bayesian network was used to predict postoperative spectacles use.Results: 304 patients (65.6 years were included. Postoperative visual acuity was ≥0.8 in 93.3% of patients for near vision and in 88.6% of patients for distance vision. After surgery, 87.2% of the patients were spectacles free. 88.2% of the patients rated their vision as being better following the surgery and 93.1% thought that surgery resulted in a positive change. FGVS mean scores (5 the most favorable rating were: ‘Practical Advantages’ 3.8, ‘Psychological Advantages’ 3.8, ‘Evaluation of the Result’ 4.5, ‘Feelings’ 4.4, and ‘Global Judgement’ 4.4. Patients who stated that spectacles wear was particularly bothersome and those who thought that their appearance was more favorable without spectacles were 3 times more likely not to wear spectacles postoperatively.Conclusion: ReSTOR® provides patients with good distance and near vision, a high rate of spectacles independence, and a high degree of patient satisfaction.Keywords: cataract surgery, multifocal intraocular lens, patient satisfaction, spectacles independence

  3. Fuentes de variabilidad en el diagnóstico de gastritis atrófica multifocal asociada con la infección por Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Bravo

    2009-11-01

    Full Text Available Introduction: Multiple sampling from different sites of the stomach as well as the number of fragments of gastric mucosa available for histopathologic evaluation are important sources of variation when classifying and grading chronic gastritis. Objective: To estimate the sensitivity of the number of fragments of gastric mucosa necessary to establish the diagnosis of atrophic gastritis with intestinal metaplasia, gastric dysplasia and H. pylori infection. In addition, this study will attempt to assess the intra-observer variability in the classification of these premalignant gastric lesions. Methods: This is a 6 year-cohort study, wherein 1958 gastric endoscopic procedures performed by two gastroenterologists were reviewed. Five gastric biopsy samples were obtained from the antrum, body and lesser curvature during each procedure. One pathologist was in charge of reviewing the five histopathology samples for each subject and providing a definitive diagnosis which was used as the gold standard. Each gastric mucosa sample reviewed led to an individual diagnosis for that sample which was compared with the gold standard. Intra-observer variability was assessed in 127 individuals who correspond to a random sample of 20% of the total endoscopic procedures performed during the 72 month-follow-up. Results: The sensitivity of the diagnosis of intestinal metaplasia (IM and gastric dysplasia increased proportionally with the number of gastric mucosa samples reviewed. The lesser curvature of the stomach had the highest sensitivity for the diagnosis of IM and dysplasia, among all the stomach regions studied. Just one sample of gastric mucosa attained a sensitivity of 95.9% for the detection of H. pylori infection. The intra-observer agreement for the diagnosis of multifocal atrophic gastritis was 86.1% and the kappa value was 0.79 (95% CI 0.76-0.85. Alcohol-fixed biopsy specimens were inadequate to diagnose H. pylori infection and to assess dysplasia

  4. Patient-reported benefit of ReSTOR® multi-focal intraocular lenses after cataract surgery: Results of Principal Component Analysis on clinical trial data

    Directory of Open Access Journals (Sweden)

    Viala Muriel

    2008-01-01

    Full Text Available Abstract Background Restoration of functional distance and near vision independently of additional correction remains a goal for cataract surgery. ReSTOR®, a new multi-focal intraocular lens (IOL addresses this issue with an improvement in both distance and near vision, often without need for glasses. This analysis attempted to discuss the patient-reported benefit of ReSTOR® using a full but organised representation of data. Methods Two non-randomised, open-label clinical trials conducted in Europe and the United-States were conducted to compare the efficacy of ReSTOR® to AcrySof® mono-focal IOLs. A total of 710 patients in need of bilateral cataract extraction were included in the pooled study. The TyPE, a patient questionnaire, was fully completed by 672 of them before and after each eye surgery. The TyPE, composed of 67 items measuring overall visual functioning in both conditions (with and without wearing glasses, evaluates limitations, troubles and satisfaction in distance and near vision. A principal component analysis (PCA of the TyPE questionnaire was performed on pooled data from baseline and post-surgery observations in order to fully represent the change in the TyPE data over time. ReSTOR® and mono-focal groups were used as illustrative variables. The coordinates of the first 2 factors were compared between visits and between IOLs (ReSTOR® vs. mono-focal, using paired t-tests and t-tests, respectively. Results The first factor of the PCA explained 55% of the variance and represented 'visual functioning and patient satisfaction'. The second factor explained 6% of the variance and was interpreted as 'independence from glasses'. An overall difference in factorial coordinates in both factors was seen between baseline and the first eye surgery, and between the first and the second eye surgery. No difference between ReSTOR® and mono-focal IOL groups was observed at baseline. After surgery, ReSTOR® treated-patients had higher

  5. Vitrectomia transconjuntival 25 gauge via pars plana para opacidade vítrea persistente em pacientes com implante de lentes multifocais Transconjunctival sutureless 25-gauge vitrectomy for visually significant vitreous floaters in patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Leonardo Akaishi

    2010-08-01

    Full Text Available OBJETIVO: O objetivo do presente estudo é relatar o resultado visual obtido após realização de vitrectomia via pars plana 25 gauge (VVPP-25-gauge em pacientes com opacidades vítreas persistentes e debilitantes previamente submetidos à cirurgia de facectomia com implante de lente intraocular (LIO multifocal. MÉTODOS: Estudo prospectivo de 14 olhos com implante de LIO multifocal e presença de opacidade vítrea submetidos à VVPP-25-gauge. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e equivalente esférico (EE antes e 3 meses pós-vitrectomia. Um questionário de satisfação e melhora visual foi administrado antes e após a realização da vitrectomia para avaliar a satisfação dos pacientes. RESULTADO: Após três meses da VVPP25-gauge, a média das acuidades (logMAR era: AVSC, 0,10 ± 0,14;AVCC, 0,02 ± 0,08;AVPC, 0,00 ± 0,0; EE, +0,16 ± 0,34. Treze olhos (92,9% apresentavam AVSC de 20/40 ou melhor, e 11 (78,5% de 20/25 ou melhor. Dez (90,9% pacientes demonstraram satisfação com o procedimento cirúrgico, obtendo eliminação de todos os floaters em 13 olhos (92,8%. Apenas um paciente apresentou insatisfação com o resultado visual final devido ao aparecimento de edema macular cistóide pós-vitrectomia. CONCLUSÃO: A remoção das opacidades vítreas, usando a VVPP-25-gauge se mostrou segura, e resultou em alto nível de satisfação dos pacientes, com resolução dos sintomas na sua quase totalidade, e uma melhora subjetiva da qualidade funcional da visão.PURPOSE: The aim of this study was to evaluate the role of 25-gauge transconjuntival sutureless vitrectomy (TSV in patients with persistent vitreous floaters who underwent multifocal intraocular lens (IOL implantation. METHODS: Fourteen eyes of 11 patients with multifocal IOL implant associated with vitreous opacities that underwent 25-gauge vitrectomy were

  6. 云南省2010-2013年男男性行为人群艾滋病相关危险因素变化趋势分析%Change trend of HIV/AIDS related risk factors and influencing factors among men who have sex with men in Yunnan, 2010-2013

    Institute of Scientific and Technical Information of China (English)

    宋丽军; 梅静远; 陆继云; 付丽茹; 李雪华; 牛瑾; 肖民扬; 张祖样; 卢冉

    2015-01-01

    目的 了解云南省MSM人群知晓率、行为等艾滋病相关危险因素的变化趋势及其安全套使用的影响因素,为干预策略制定和效果评价提供依据.方法 2010-2013年在云南省连续开展MSM哨点监测,调查该人群一般人口学特征、艾滋病相关知识、性行为及安全套使用、吸毒行为、干预措施覆盖等情况,进行趋势和影响因素分析.结果 共调查9 073人,艾滋病知识知晓率、与同性发生性行为比例及安全套使用率均呈逐年上升趋势(P<0.01),与异性发生性行为时安全套使用率明显低于同性,吸毒比例和患性病比例呈下降趋势(P<0.01).同居、低知晓率、外省/外籍、居住时间不足一年、文化程度低、未接受过于预、肛交次数多、未曾做过HIV抗体检测等因素为影响MSM坚持使用安全套的危险因素.结论 云南省近4年MSM艾滋病综合干预效果初显,但多项指标仍处于较低水平,仍需重点关注同居、文化程度低、流动性较大、肛交次数多、有异性性行为的MSM干预,扩大干预覆盖面,继续强化落实HIV动员检测、安全套推广使用等核心干预措施.%Objective To understand the change trend of the awareness rate of HIV/AIDS related knowledge,risk behaviors anong men who have sex with men (MSM) in Yunnan and the factors influencing their condom use,and evaluate the effect of comprehensive intervention.Methods The data about the MSM' s demographic information,HIV/AIDS related knowledge awareness,and sex behavior,condom use,drug use and intervention receiving were obtained from AIDS sentinel surveillance among MSM in Yunnan province during 2010-2013 to conduct change trend and influencing factor analysis.Results A total of 9 073 MSM were surveyed.The awareness rate of the HIV/AIDS related knowledge,homosexual behavior and condom use rate increased year by year (P<0.01).The condom use rate was lower in heterosexual behavior,and the drug use rate and

  7. Investigation and analysis on AIDS-related knowledge, attitude, behaviors and the infection state of HIV among different types of male homosexuals%某市不同类型MSM艾滋病知识态度行为和HIV感染情况

    Institute of Scientific and Technical Information of China (English)

    吕金伟; 程周祥; 杨康生; 豆正东; 成国明; 方艳姣; 安洲; 范引光

    2013-01-01

    目的 了解芜湖市不同类型男男性行为者(men who have sex with men,MSM)艾滋病知识、态度、性行为学特征和艾滋病病毒(human immunodeficiency virus,HIV)感染情况,为实施MSM艾滋病高危行为干预提供科学依据.方法 采用分类滚雪球抽样调查的方法,招募MSM进行问卷调查,并采集静脉血样进行HIV、梅毒、丙型肝炎病毒(hepatitis C virus,HCV)的血清学检测.结果 共调查MSM 422名,不同类型MSM年龄、婚姻状况、文化程度等构成比差异均有统计学意义(均有P <0.05),不同类型MSM艾滋病相关知识知晓率差异有统计学意义(x2=67.92,P<0.001),其中其他型MSM知晓率高达95.1%.酒吧型MSM获得艾滋病相关服务人数高于网络型、公园型和其他型.422名MSM最近半年均与同性发生过性行为,酒吧型MSM每次都用安全套的率最高,为32.6%;11.6%的MSM与同性存在商业性行为,发生商业性行为时安全套使用率低.30.6% MSM存在异性性行为,HIV抗体阳性率为4.3%;梅毒抗体阳性率为9.0%,HCV抗体阳性率为0.7%;各类型MSM的HIV抗体阳性率差异有统计学意义(x2 =8.63,P=0.030).结论 不同类型MSM存在艾滋病知识与行为分离的现象;应在不同类型的MSM人群中采取不同的艾滋病相关知识教育形式和高危行为干预措施.%Objective To investigate AIDS-related knowledge,attitude and sexual behaviors among different types of men who have sex with men (MSM) in Wuhu,and to provide basis for AIDS high risk behaviors intervention.Methods Data from MSM by classification snowball sampling,we investigated MSM by using questionnaires.Results 422 MSM were investigated,there was significant difference in age,marriage,education background and so on (all P < 0.05).There was statistically significant difference in the rate of the knowledge of AIDS-related service among different types of MSM (x2 =67.92,P <0.001),that of MSM from other types was 95.1

  8. Analysis of HIV/AIDS Related Discrimination and Its Correlates with Compliableness in Using Anti-virus Drug and Other Factors%艾滋病相关歧视与抗HIV病毒药物服药依从性等因素的关联性分析

    Institute of Scientific and Technical Information of China (English)

    李宏; 王哲; 徐俊杰; 崔为国; 楚振兴; 胡海清

    2013-01-01

    Objective To investigate the status of HIV/AIDS related discrimination and its correlation with compliableness in using anti - virus drug among former blood donors. Methods A survey of 416 HIV infected former blood donors was conducted from 2008 to 2009 in Henan province, China. The participants experienced HIV/AIDS related stigma and discrimination year were assessed, and association between HIV discrimination and compliableness in using anti - virus drug etc. were analyzed. Blood specimens were drawn from each participant to test of CD4+ T cells counts. Results Totally 140(33. 7% ) of participants once experienced HIV/AIDS related discrimination, 24. 8% was afraid or not dare to visit neighbors/relatives, 6. 3% were forced to changed hospital to treat diseases, and 9. 2% of PLWHs who was receiving HAART treated forgot to take ART drugs within the past month. Logistic analysis identified that, HAART treated PLWHs felt significantly lower proportion of discrimination compared with those who was not currently receiving HAART treatment [32. 9% vs 65. 5% , OR(95% CI) =0. 5(0. 3 - 0. 8) ,P < 0. 001 ]. And those HAART treated PLWHs who did not experience HIV/ ADIS related discrimination had significantly lower proportion of missing to take HAART drugs than those HAART treated PLWHs who experienced HIV/ADIS related discrimination(1.3% vs 45.8% , OR =0.2, 95%CI:0.0 -0. 1,P<0.001). CD4+ T counts had no statistical correlation with discrimination. Conclusion HARRT can decrease the feeling of HIV/AIDS related discrimination, but the suffered HIV/AIDS discrimination may increase the risk of poor compliance for taking HAART drugs. More propaganda and education should be given to the general population and health care system etc. To eliminate their discrimination to PLWH, and to improve PLWHs' quality level of life.%目的 了解河南省既往采供血途径HIV感染者感受到的艾滋病相关歧视与服药依从性等因素之间的关联性.方法 对河南省416采供

  9. Multifocal endometriosis. A case report.

    Science.gov (United States)

    Vercellini, P; Vendola, N; Presti, M; Bolis, G

    1993-10-01

    Disseminated endometriosis of the urinary, genital and intestinal systems was treated successfully with conservative surgery. We hypothesize that this unusual presentation may have derived from retrograde menstruation, pooling of endometrial cells in the dependent anterior and posterior cul-de-sacs with subsequent passage across the peritoneal mesothelium, and dissemination by clockwise intraabdominal currents. PMID:8263874

  10. Multifocal osteoblastoma of the hand

    International Nuclear Information System (INIS)

    Osteoblastoma is a benign bone tumor with uncertain radiologic and typical histologic pattern that, in most cases, can be diagnosed without any problems. Usually, it is a solitary bone tumor. The case presented is a 9-year-old child with multiple osteoblastomas occurring in multiple bones of the right hand. The child had pain in his right hand for several weeks. On physical examination, no swelling or other symptoms were elicited. All lesions noted radiologically were treated by curettage, and in all the pattern of osteoblastoma was diagnosed. (orig.)

  11. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C;

    2016-01-01

    10 cohorts. To assess the relative contribution of genetic factors to progression of WML, we compared in 7 cohorts risk models including demographics, vascular risk factors plus single-nucleotide polymorphisms that have been shown to be associated cross-sectionally with WML in the current and...... factors, and baseline WML burden. CONCLUSIONS: Common genetic factors contribute little to the progression of age-related WML in middle-aged and older adults. Future research on determinants of WML progression should focus more on environmental, lifestyle, or host-related biological factors....

  12. Progress report, Physics Division

    International Nuclear Information System (INIS)

    This report reviews events and progress in the following areas: development of the TASCC facility; experimental and theoretical nuclear physics research; radionuclide standardization; condensed matter research; applied mathematics; and computer facility operation

  13. Progress report for '89

    International Nuclear Information System (INIS)

    The 1989 Progress Report presents the most important scientific and technical achievements of the Nuclear Research Institute's research work. Some specialized products prepared at or fabricated by the NRI are mentioned as well. (author). 24 figs., 8 tabs., 101 refs

  14. Anisotropic progressive photon mapping

    Science.gov (United States)

    Liu, XiaoDan; Zheng, ChangWen

    2014-01-01

    Progressive photon mapping solves the memory limitation problem of traditional photon mapping. It gives the correct radiance with a large passes, but it converges slowly. We propose an anisotropic progressive photon mapping method to generate high quality images with a few passes. During the rendering process, different from standard progressive photon mapping, we store the photons on the surfaces. At the end of each pass, an anisotropic method is employed to compute the radiance of each eye ray based on the stored photons. Before move to a new pass, the photons in the scene are cleared. The experiments show that our method generates better results than the standard progressive photon mapping in both numerical and visual qualities.

  15. Progressive Supranuclear Palsy

    Science.gov (United States)

    Progressive supranuclear palsy (PSP) is a rare brain disease. It affects brain cells that control the movement of your eyes. This leads to ... speech, vision and swallowing problems. Doctors sometimes confuse PSP with Parkinson's disease or Alzheimer's disease. PSP has ...

  16. Progress for the Paralyzed

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: NIBIB Robotics Progress for the Paralyzed Past Issues / Spring 2013 ... Paralyzed —The expanding options for paralyzed individuals include: robotic arms spinal cord stimulation improved prosthetic limbs restored ...

  17. Progress report 1985

    International Nuclear Information System (INIS)

    This progress report of the nuclear physics institute includes five basic subjects: theoretical physics, high energy and intermediate energy physics, nuclear physics, combined research physics and instrumentation (microelectronics, imaging, multidetectors, scintillators,...)

  18. Progression of myopia.

    OpenAIRE

    Kennedy, R.H.

    1995-01-01

    BACKGROUND: Myopia is an important public health problem because it is common and is associated with increased risk for chorioretinal degeneration, retinal detachment, and other vision-threatening abnormalities. In animals, ocular elongation and myopia progression can be lessened with atropine treatment. This study provides information about progression of myopia and atropine therapy for myopia in humans. METHODS: A total of 214 residents of Olmsted County, Minnesota (118 girls and 96 boys; m...

  19. Progressive Finland sees progress with nuclear projects

    International Nuclear Information System (INIS)

    The Finnish Hanhikivi-1 reactor project is firmly on track and a licence has been granted for construction of a final disposal facility for spent nuclear fuel - the first final repository in the world to enter the construction phase. Significant progress has been made with plans for Finland to build its sixth nuclear reactor unit at Hanhikivi. Fennovoima's licensing manager Janne Liuko said the company expects to receive the construction licence for the Generation III+ Hanhikivi-1 plant in late 2017. The application was submitted to the Finnish Ministry of Employment and the Economy in June 2015.

  20. Progressive Finland sees progress with nuclear projects

    Energy Technology Data Exchange (ETDEWEB)

    Dalton, David [NucNet, Brussels (Belgium)

    2016-02-15

    The Finnish Hanhikivi-1 reactor project is firmly on track and a licence has been granted for construction of a final disposal facility for spent nuclear fuel - the first final repository in the world to enter the construction phase. Significant progress has been made with plans for Finland to build its sixth nuclear reactor unit at Hanhikivi. Fennovoima's licensing manager Janne Liuko said the company expects to receive the construction licence for the Generation III+ Hanhikivi-1 plant in late 2017. The application was submitted to the Finnish Ministry of Employment and the Economy in June 2015.