Co-existing sarcoidosis and Takayasu arteritis: report of a case

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Hamzaoui Amira

2011-02-01

Full Text Available Abstract Introduction Takayasu arteritis (TA is a chronic vasculitis of unknown origin, affecting mainly the aorta and its main branches. As a result of the inflammation, stenosis, occlusion or dilatation of the involved vessels may occur and cause a wide range of symptoms. It has been described in association with various auto-immune disorders (mainly inflammatory digestive tract diseases. However, only few cases of TA associated with sarcoidosis have been reported, raising the question of an association by chance. Case report We report a case of a 34 year-old woman, with one year history of sarcoidosis, who presented with asymmetric high hypertension revealing inflammatory humeral, axillary and subclavian arteritis related to TA, successfully treated by steroid and immunosuppressive therapy(MethotrexateR. Conclusion TA and sarcoidosis may be related, rising the hypothesis that TA or Takayasu arteritis-like granulomatous vasculitis may be, in fact, a complication of sarcoidosis.

Successful Pregnancy in a Patient with Takayasu’s Arteritis: a Case Report

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Z Ebrahimi

2012-05-01

Full Text Available

Background and objectives

Takayasu’s arteritis, so-called pulseless disease, is a syndrome mostly seen in young women. It is a chronic inflammatory arteritis affecting large vessels. It is associated with abnormal angiography of the upper aorta and its main branches, resulting in vascular impairment in the upper extremities. This report presents a case of successful pregnancy in a patient with Takayasu’s arteritis.

Case

The patient was a 36 years old G2P1 woman. Her first child was delivered by cesarean section. She was suffering from Takayasu’s arteritis and was treated with prednisolone since 7 years ago. She had an unplanned pregnancy after expulsion of IUD. In her past medical history, in addition to Takayasu’s arteritis involving subclavian artery, an iodine 131 ablation for treatment of hyperthyroidism was noticed. She was first sought medical attention at 8th week of pregnancy and as she had normal cardiopulmonary and renal functions, the pregnancy was continued. Subtotal thyroidectomy was performed at 10th week of gestation following a suspicious FNA showing a cold thyroid nodule. She was then treated with thyroxine in addition to prednisolone to control the post-thyroidectomy hypothyroidism. At 37th week, her pregnancy was terminated by cesarean section with epidural analgesia because of reduction of amniotic fluid index and a BPS of 8/10.

Excess mortality in giant cell arteritis

DEFF Research Database (Denmark)

Bisgård, C; Sloth, H; Keiding, Niels

1991-01-01

A 13-year departmental sample of 34 patients with definite (biopsy-verified) giant cell arteritis (GCA) was reviewed. The mortality of this material was compared to sex-, age- and time-specific death rates in the Danish population. The standardized mortality ratio (SMR) was 1.8 (95% confidence...

[Takayasu arteritis and cerebral venous thrombosis: report of a case].

Science.gov (United States)

Rodríguez de Mingo, E; Riofrío Cabeza, S; Villa Albuger, T; Velasco Blanco, M J

2014-01-01

Palpitations, paresthesias and anxiety are very common reasons of consultation in primary care. We report the case of a 40 year-old Caucasian woman who came to the clinic due to these symptoms, and was finally diagnosed with Takayasu arteritis. Later, she had an episode of headache, as the initial manifestation of cerebral venous thrombosis. Takayasu arteritis is a systemic vasculitis affecting medium and large arteries, mainly leacausing stenosis of the aorta and its branches. It most frequently affects Asian women, being much rarer in Europe. The primary care doctor plays a key role in the initial diagnosis and monitoring of patients with rare diseases, such as Takayasu arteritis, and must be a basic support for the patient and family, providing information and advice, and contributing with his work to reduce the vulnerability of this group. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Multidetector CT angiography in Takayasu arteritis

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Khandelwal, Niranjan; Kalra, Naveen [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Kang, Mandeep; Lal, Anupam [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Jain, Sanjay [Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Suri, Sudha [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India)

2011-02-15

Objective: To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA). Materials and methods: A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings. Results: Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10 mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only. Conclusion: MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.

Arteritis de células gigantes (Arteritis temporal Utilidad del Eco-Doppler Color en el diagnóstico

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Hugo Tarigo

2016-09-01

El objetivo de la presente comunicación es reafirmar la utilidad y valor de este método diagnóstico, subutilizado en nuestra práctica clínica, en pacientes con planteo de arteritis de células gigantes.

FDG PET in the diagnosis of giant cell arteritis

International Nuclear Information System (INIS)

Turlakow, A.; Yeung, H.W.D.; Pui, J.; Macapinlac, H.; Liebovitz, E.; Rusch, V.; Goy, A.; Larson, S.M.

2003-01-01

Full text: To evaluate the role of PET in the diagnosis of vasculitis. Methods: We report a case of giant cell arteritis diagnosed by FDG-PET in a 75-year-old woman with a fever of unknown origin. The patient presented with a 3 month history of fatigue, fevers, headaches, visual disturbance and jaw claudication. Diagnosis of temporal arteritis was initially excluded because of a normal ESR. CT scan showed an anterior mediastinal mass, suspicious for malignancy. An FDG-PET scan for pre-operative evaluation was acquired 45 minutes after intravenous injection of 10 mCi F18-FDG, on a dedicated PET scanner. Image reconstruction was performed using an iterative algorithm with segmented attenuation correction. The study identified striking localisation of FDG to the entire aorta, left main coronary artery, and subclavian, carotid and common iliac arteries bilaterally (SUV max range 4-4.5 g/ml), suggestive of large vessel arteritis. Subsequent excisional biopsy of the mediastinal mass confirmed giant cell vasculitis of a large muscular artery in thymic tissue. No malignancy was detected. A repeat ESR was 129 mm/hr. The patient was commenced on oral Prednisone, with prompt improvement of symptoms, ESR and anaemia and complete normalisation of the FDG-PET scan within two weeks. This case suggests a potential role of FDG-PET in the non-invasive diagnosis, classification and follow-up of giant cell arteritis, and possibly other vasculitides, so far notoriously difficult to diagnose, relying usually on a constellation of non-specific symptoms, laboratory investigations or invasive pathologic and angiographic means. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Percutaneous transluminal angioplasty in renal artery stenosis by takayasu's arteritis

International Nuclear Information System (INIS)

Zeon, Seok Kil; Kim, Ok Bae; Kim, Hyun Chul

1984-01-01

Authors want to report that PTA was an out-standing therapeutic method in treatment of renovascular hypertension by renal artery stenosis due to Takayasu's arteritis in an 18-years-old Korean female. Abdominal aortogram and bilateral renal arteriogram showed mild smooth narrowing of the mid abdominal aorta of 4cm length from origin of renal arteries, complete occlusion of left renal artery from it's origin with a few small collateral arteries and severe stenosis of proximal right renal artery. PTA of right renal artery was performed with Gruntzig Balloon dilatation catheter, and the patient's blood pressure was down to 120/80 from 220/130, stable for 8 months follow-up examination. Takayasu's arteritis is one of the most important cause of renovascular hypertension in Orientals. Multiple treatment modalities, such as steroid administration or variable surgical intervention, were attempted and limited response was presented. But PTA is a simple, cost-effective, repeated, and relatively complication-free method in treatment of renovascular hypertension due to Takayasu's arteritis, with an outstanding result, as authors case

Initial isolated Takayasu's arteritis of the right pulmonary artery: MR appearance

International Nuclear Information System (INIS)

Ferretti, G.; Defaye, P.; Thony, F.; Ranchoup, Y.; Coulomb, M.

1996-01-01

Takayasu's arteritis involves the pulmonary artery tree in more than 50 % of the cases. Initial isolated involvement of the pulmonary artery by Takayasu's arteritis, however, is very rare. We report the case of a 34-year-old white woman who presented a clinical and radiographic pattern that mimicked an acute pulmonary embolism with pulmonary infarction. Pulmonary angiography showed stenosis lesions and occlusion of the right pulmonary artery tree. Magnetic resonance imaging demonstrated thickening of the pulmonary artery wall leading to the correct diagnosis. (orig.). With 3 figs

[«Man-in-the-barrel» syndrome: atypical manifestation of giant cell arteritis].

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Calle-Lopez, Y; Fernandez-Ramirez, A F; Franco-Dager, E; Gomez-Lopera, J G; Vanegas-Garcia, A L

2018-06-01

«Man-in-the-barrel» syndrome refers to diplegia of the upper extremities in which mobility of the head and lower limbs is preserved. Brachial plexitis that presents as «man-in-the-barrel» syndrome is an unusual manifestation of giant cell arteritis. We report a case of C5-C6 plexitis as part of the clinical features of a patient with giant cell arteritis. A 70-year-old male with a two-month history of weight loss, headache, facial pain and jaw claudication, associated with a persistent elevation of acute phase reactants and bilateral brachial plexopathy, with no evidence of neck or brain injuries or occult neoplasm and with negative autoimmunity tests. Results of the biopsy study of the temporal artery were compatible with giant cell arteritis, and the positron emission tomography scan revealed extensive vascular involvement of the aorta and its branches. Although the typical clinical manifestations of giant cell arteritis are headache, jaw claudication, loss of sight, constitutional symptoms and polymyalgia rheumatica, its presence must be suspected in patients over the age of 50 who manifest alterations affecting the peripheral nerve, including brachial diplegia with no other demonstrable cause.

The activation pattern of macrophages in giant cell (temporal) arteritis and primary angiitis of the central nervous system.

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Mihm, Bernhard; Bergmann, Markus; Brück, Wolfgang; Probst-Cousin, Stefan

2014-06-01

To determine if the pattern of macrophage activation reflects differences in the pathogenesis and clinical presentation of giant cell arteritis and primary angiitis of the central nervous system, specimens of 10 patients with giant cell arteritis and five with primary angiitis of the central nervous system were immunohistochemically studied and the expression of the macrophage activation markers 27E10, MRP14, MRP8 and 25F9 was determined in the vasculitic infiltrates. Thus, a partly different expression pattern of macrophage activation markers in giant cell arteritis and primary angiitis of the central nervous system was observed. The group comparison revealed that giant cell arteritis cases had significantly higher numbers of acute activated MRP14-positive macrophages, whereas primary angiitis of the central nervous system is characterized by a tendency toward more MRP8-positive intermediate/late activated macrophages. Furthermore, in giant cell arteritis comparably fewer CD8-positive lymphocytes were observed. These observations suggest, that despite their histopathological similarities, giant cell arteritis and primary angiitis of the central nervous system appear to represent either distinct entities within the spectrum of granulomatous vasculitides or different stages of similar disease processes. Their discrete clinical presentation is reflected by different activation patterns of macrophages, which may characterize giant cell arteritis as a more acute process and primary angiitis of the central nervous system as a more advanced inflammatory process. © 2013 Japanese Society of Neuropathology.

F-18 FDG PET/CT Findings of a Patient with Takayasu Arteritis Before and After Therapy

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Sait Sağer

2012-04-01

Full Text Available Vasculitis is defined as inflammation and necrosis with leukocytic infiltration of the blood vessel wall. Takayasu arteritis is a chronic inflammatory arteritis that primarily involves the aorta and its main branches. A 64-year-old female patient with a 2-month history of fever of unknown origin was presented to our clinic for F-18 FDG PET/CT imaging. Baseline PET/CT images demonstrated intense F-18 FDG uptake in the aorta, bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 2 months of immunosuppressive therapy, she was asymptomatic and follow-up FDG PET/CT scan showed almost complete disappearance of large vessels’ F-18 FDG uptake. FDG PET/CT is a sensitive technique for assessing presence of large-vessel vasculitis such as Takayasu arteritis, extent of large-vessel inflammation and disease activity after therapy. (MIRT 2012;21:32-34

Characteristics of cerebrovascular accidents at time of diagnosis in a series of 98 patients with giant cell arteritis.

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Zenone, Thierry; Puget, Marie

2013-12-01

The objective of this study was to determine the characteristics of cerebrovascular accidents at time of diagnosis in patients with giant cell arteritis. Retrospective data were collected from 98 patients at a single hospital with giant cell arteritis (according to the American College of Rheumatology classification criteria) diagnosed between October 1999 and January 2012. Cerebrovascular accident was found at initial presentation in 6 patients (6.1 %, 95 % CIs 2.3-12.9). Most of them had other symptoms of giant cell arteritis when the disease began. Signs reflecting the involvement of vertebro-basilar territory were present in 3 cases. No other case of cerebrovascular accident was described during the follow-up of patient; particularly no case of cerebrovascular accident occurred once corticosteroid therapy for the treatment of giant cell arteritis had been initiated. No differences in the epidemiologic, clinical and laboratory features at the time of diagnosis between patients who had cerebrovascular accidents and the rest of the giant cell arteritis patients were observed. Prognosis was good in our survey. However, there was no case of bilateral vertebral artery occlusion, a condition associated with poor prognosis. The present study confirms that cerebrovascular accidents may be the initial manifestation of giant cell arteritis, an argument in favor of a direct effect of the vasculitis in the development of cerebrovascular accidents rather than a complication of the corticosteroid therapy. The diagnosis of giant cell arteritis should always be considered in an elderly patient with stroke and an unexplained elevation of inflammatory biomarkers.

[18F]-Sodium fluoride uptake in Takayasu arteritis

NARCIS (Netherlands)

Alexanderson-Rosas, E.; Monroy-Gonzalez, A. G.; Juarez-Orozco, Luis Eduardo; Martinez-Aguilar, M. M.; Estrada, E.; Soldevilla, I.; Garcia-Perez, O.; Soto-Lopez, M. E.

2017-01-01

BACKGROUND: While (18)F-fluorodeoxyglucose and (18)F-sodium fluoride with positron emission tomography relate with inflammation and calcification, their role in the assessment of patients with Takayasu arteritis has not yet been studied. METHODS: We present 5 patients with suspected active metabolic

Isolated aortitis versus giant cell arteritis: are they really two sides of the same coin?

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Talarico, Rosaria; Boiardi, Luigi; Pipitone, Nicolo'; d'Ascanio, Anna; Stagnaro, Chiara; Ferrari, Claudia; Elefante, Elena; Salvarani, Carlo; Bombardieri, Stefano

2014-01-01

The aim of the study was to compare epidemiological data, clinical findings and results of investigations in patients with isolated aortitis and those with giant cell arteritis (GCA) to establish whether patients with isolated aortitis differ from those with GCA. We reviewed the medical notes of all patients consecutively seen in two Rheumatology centres in the last two decades with a suspicion of GCA, searching for cases characterised by abnormal [18F] fluorodeoxyglucose (FDG) PET uptake of the aorta. 'Isolated aortitis' was defined as increased FDG uptake in the aorta not explained by atherosclerosis in the absence of FDG uptake in other large vessels. Comparing the epidemiological and clinical data of patients with isolated arteritis with those with GCA, we observed many statistical significant differences. First of all, the male/female ratio was reversed, with a predominant male involvement in isolated arteritis. Moreover, the mean age of patients with isolated arteritis was significantly lower than that of GCA patients (62 vs. 78.4 yrs; psides of the same coin.

[How to manage Takayasu arteritis?].

Science.gov (United States)

Mirault, Tristan; Emmerich, Joseph

2012-10-01

Thorough clinical and imaging assessment of the arterial tree when a diagnosis of Takayasu arteritis is established. Glucocorticoïd as intiation therapy. Immunosuppresive agent should be considered as adjunctive therapy if resistance or dependance to glucocorticoïd therapy. Supportive care, antihypertensive drugs, glucocorticoïd induced osteoporosis preventive therapy, tuberculosis screening should not be forgiven. Monitoring of therapy should be clinical and supported by biological markers and imaging. Reconstructive surgery should be performed in the quiescent phase of disease. Copyright © 2012. Published by Elsevier Masson SAS.

Extracranial–intracranial bypass for Takayasu’s arteritis: A case report

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Richard M. Young, M.D.

2014-12-01

Conclusion: STA–MCA bypass to enhance cerebral blood flow in the setting of stroke symptoms due to Takayasu’s arteritis can serve as a bridge before definitive cardiothoracic treatment of the great vessels.

Equine viral arteritis

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Kosec Marjan

2016-01-01

Full Text Available Equine viral arteritis (EVA is a contagious disease of equids caused by equine artheritis virus (EAV, widespread in most countries in the world, where patients are diagnosed. The infection usually starts asymptomatic. Clinical signs indicate respiratory infection of different intensity and also abortions are present at different stages of gestation. Large prevalence of this disease in the world has become a growing economic problem. The disease is specific to a particular kind of animals, and it affects only equids (horses, donkeys, mules, mule and zebras. In countries where the infection has been confirmed, the percentage of positive animals differ. Likewise, there is difference in percentage among certain animal kinds. The highest percentage of positive animals has been found in totters and the lowest in cold-blooded.

Tertiary lymphoid organs in Takayasu Arteritis

OpenAIRE

Marc eClement; Marc eClement; Adrien eGaly; Patrick eBruneval; Marion eMorvan; Fabien eHyafil; Fabien eHyafil; Khadija eBenali; Nicoletta ePasi; Lydia eDeschamps; Quentin ePellenc; Quentin ePellenc; Thomas ePapo; Antonino eNicoletti; Antonino eNicoletti

2016-01-01

Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from t...

Tertiary Lymphoid Organs in Takayasu Arteritis

OpenAIRE

Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

2016-01-01

Objective The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Methods Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune ce...

Bilateral ocular ischemia-induced blindness as a presenting manifestation of Takayasu arteritis: a case report

OpenAIRE

Pallangyo, Pedro; Epafra, Emmanuel; Nicholaus, Paulina; Lyimo, Frederick; Kazahura, Parvina; Janabi, Mohamed

2017-01-01

Background Takayasu arteritis is a granulomatous panarteritis that predominantly affects the aorta and its major branches. The initial manifestations of this large-vessel vasculitis are usually nonspecific; however, as the disease progresses, typical symptoms of arterial occlusion, aneurysmal formation, and vascular pain become evident. Ischemic ocular complications of Takayasu arteritis which could lead to complete loss of vision are not uncommon and depend on the obliterated portion(s) of c...

Giant Cell Arteritis and Polymyalgia Rheumatica: 2016 Update

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Gideon Nesher

2016-10-01

Full Text Available Giant cell arteritis (GCA and polymyalgia rheumatica (PMR are both more common among people of North European decent than among Mediterranean people. Women are 2–3 times more commonly affected. Giant cell arteritis and PMR are extremely rare before age 50 years. Polymyalgia rheumatica may be “isolated” or associated with GCA. There is increased expression of inflammatory cytokines in temporal arteries of PMR patients, without overt histological evidence of arteritis. One-third of “isolated” PMR patients have vascular uptake in positron emission tomography (PET scans, suggesting clinically unrecognized, “hidden” GCA. Typical manifestations of GCA are headache, tenderness over temporal arteries, jaw claudication, PMR, acute vision loss, and low-grade fever. Bilateral aching of the shoulders with morning stiffness is typical for PMR. In both conditions sedimentation rate and C-reactive protein are elevated, and anemia and thrombocytosis may occur. Color duplex ultrasonography of the temporal arteries may aid in GCA diagnosis. Temporal artery biopsy showing vasculitis, often with giant cells, confirms GCA diagnosis. In cases with negative biopsy one must rely on the clinical presentation and laboratory abnormalities. The diagnosis of PMR is made primarily on clinical grounds. Other conditions that may mimic GCA or PMR must be excluded. Glucocorticoids are the treatment of choice for both conditions. Prompt treatment is crucial in GCA, to prevent irreversible complications of acute vision loss and stroke. Addition of low-dose aspirin may further prevent these complications. The average duration of treatment is 2–3 years, but some patients require a prolonged course of treatment, and some may develop disease-related or treatment-related complications. No steroid-sparing agent has been proven to be widely effective thus far, but some promising therapeutic agents are currently being studied.

Sol Ana Koroner Arter Çıkış Anomalisi Olan Hasta

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Mustafa Duran

2016-09-01

Full Text Available Koroner arter anomalilerinin anjiyografik insidansı %1,3’tür. Anjiyografik serilerde sol ana koroner arterin sağ sinüs Valsalva’dan orijin aldığı anomalilerin görülme sıklığı %0,019 kadar düşüktür. Bu hastalarda yine nadiren (%20 kadarında anjina pektoris, aritmi, senkop, kalp krizi ve ani ölüm gibi semptomlar görülür. Burada, sağ sinüs Valsalva’dan orijin alan sol ana koroner arter anomalisi gibi nadir bir vakayı sunmaktayız.

Arteriography in ponies with Strongylus vulgaris arteritis.

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Slocombe, J O; Rendano, V T; Owen, R R; Pennock, P W; McCraw, B M

1977-04-01

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis.

Follow-up CT Evaluation of the Mural Changes in Active Takayasu Arteritis

International Nuclear Information System (INIS)

Kim, Sang Young; Park, Jae Hyung; Chung, Jin Wook; Kim, Hyo Cheol; Lee, Whal; So, Young Ho; Jae, Hwan Jun

2007-01-01

We wanted to evaluate the mural changes by CT on the follow-up examination of patients with active Takayasu arteritis. The study included 18 patients, (4 males and 14 females), with active Takayasu arteritis. A total of 44 CT examinations were done during the follow-up period (mean: 55.6 months). At the time of the last follow-up CT, the disease, on the basis of the erythrocyte sedimentation rate (ESR), was found to be inactive in five patients and the disease was active and persistent in 13 patients. The thickness and CT attenuation of the aortic wall on the precontrast, arterial and venous phases were measured on the initial and the follow-up CT examinations. The ratio of the mural attenuation over that of the back muscle on the initial CT was compared with the ratio found on the follow-up CT. The initial CT findings included high density and calcifications of the aortic wall in the precontrast images and a thickened wall with enhancements in the arterial and the venous phases. A low-attenuation ring was demonstrated in the venous phase in 15 patients (83%). On the follow-up evaluation, the mean mural thickness decreased significantly from 4.1 mm to 2.4 mm. The mean mural attenuation ratio in the venous phase decreased significantly from 1.9 to 1.3 (p 0.001). The low attenuation ring was identified in seven patients (39%) who had only with active, persistent Takayasu arteritis. The mural changes demonstrated by the follow-up CT evaluations for the patients with active Takayasu arteritis included a decrease of the mural thickness and enhancement, disappearance of the low-attenuation ring on the venous phase, and an increase of the mural attenuation and calcification on the precontrast phase

Cerebral Embolic Activity in a Patient during Acute Crisis of Takayasu's Arteritis

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Nogueira, Ricardo de Carvalho; Bor-Seng-Shu, Edson; Marchiori, Paulo Eurípedes; Teixeira, Manoel Jacobsen

2012-01-01

Takayasu's arteritis is a disease that affects large vessels and may cause neurological symptoms either by stenoses/occlusions or embolisms from vessels with an inflammatory process. Transcranial Doppler (TCD) ultrasound can provide useful information for diagnosis and monitoring during the active phase of the disease. Cerebral embolic signals can be detected by TCD and have been considered a risk factor for vascular events. We report a patient in whom TCD ultrasound was used to monitor cerebral embolic signals during the active phase of the disease. This case report suggests that embolic activity in Takayasu's arteritis may represent disease activity, and its monitoring may be useful for evaluating the response to therapy. PMID:22379479

The association between statin use and polymyalgia rheumatica/arteritis temporalis: Demonstrated by spontaneous reports and self-described case-reports

NARCIS (Netherlands)

De Jong, Hilda J.; Saldi, Siti R.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ron H.; Passier, Anneke; Van Loveren, Henk; Tervaert, Jan Willem Cohen

2011-01-01

Background: Two case reports of polymyalgia rheumatica (PMR) and one case-report of PMR and temporalis arteritis (AT) suggest that the use of statins may have triggered the development of these inflammatory rheumatic diseases. PMR is closely linked to the disease arteritis temporalis which makes it

Role of 3.0 T MR vessel wall imaging for identifying the activity of takayasu arteritis

International Nuclear Information System (INIS)

Liu Xiaosheng; Xu Jianrong; Zhao Huilin; Cheng Fang; Lu Qing; Yao Qiuying

2010-01-01

Objective: To analyze and explore the value of 3 T high resolution magnetic resonance vessel wall imaging for identifying the activity of Takayasu arteritis. Methods: Twenty-six consecutive patients with Takayasu arteritis underwent 3.0 T high resolution MR vessel wall imaging on supraortic vessels (according to the classification of Lupi-Herrea, type I and III were included). Sixteen patients were in active phase and 10 in inactive phase based on the Kerr criteria. The MR vessel wall imaging appearances of Takayasu arteritis were compared between the active phase and inactive phase cases. Results: Wall thickening was demonstrated in all involved arteries. There were statistically significant differences between active phase and inactive phase cases in MR appearances including multi-ring thickening of vessel wall (75/80 and 18/50), arterial inner wail enhancement (50/80 and 19/50), obscurity of perivascular fat (55/80 and 18/50, X 2 =50.39, 7.41, 13.40, P<0.01). There was also a statistically significant difference in the thickness of carotid artery wall between the two groups [ (3.8 ± 0.2) mm vs (2.5 ± 0.8) mm]. Conclusion: 3 T high resolution MR vessel wall imaging is valuable for identifying the activity of Takayasu arteritis. (authors)

Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

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Espen Benjaminsen

2016-01-01

Full Text Available Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein. Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

Profile of tocilizumab and its potential in the treatment of giant cell arteritis

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Mollan SP

2018-01-01

Full Text Available Susan Patricia Mollan,1,2 John Horsburgh,1 Bhaskar Dasgupta3 1Birmingham Neuro-Ophthalmology Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, 2Institute of Metabolism and Systems Research, University of Birmingham, 3Department of Rheumatology, Southend University Hospital, Southend-on-Sea, UK Abstract: Giant cell arteritis (GCA remains a medical emergency due to the threat of permanent sight loss. High-dose glucocorticoids (GCs are effective in inducing remission in the majority of patients, however, relapses are common which lengthen GC therapy. GC toxicity remains a major morbidity in this group of patients, and conventional steroid-sparing therapies have not yet shown enough of a clinical benefit to change the standard of care. As the understanding of the underlying immunopathophysiology of GCA has increased, positive clinical observations have been made with the use of IL-6 receptor inhibitor therapies, such as tocilizumab (TCZ. This has led to prospective randomized control trials that have highlighted the safety and efficacy of TCZ in both new-onset and relapsing GCA. Keywords: giant cell arteritis, temporal arteritis, Horton disease, interleukin-6, tocilizumab, treatment

Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

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Schuetz, C.T.; Anderson, S.E. [Department of Diagnostic Radiology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland); Aeberli, D.; Oertle, S. [Department of Rheumatology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland)

2002-09-01

Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

Stroke as the First Clinical Manifestation of Takayasu's Arteritis.

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Pereira, Vanessa Caldeira; de Freitas, Carlos Clayton Macedo; Luvizutto, Gustavo José; Sobreira, Marcone Lima; Peixoto, Daniel Escobar Bueno; Magalhães, Inaldo do Nascimento; Bazan, Rodrigo; Braga, Gabriel Pereira

2014-09-01

Takayasu's arteritis is a chronic inflammatory disease, and neurological symptoms occur in 50% of cases, most commonly including headache, dizziness, visual disturbances, convulsive crisis, transient ischemic attack, stroke and posterior reversible encephalopathy syndrome. The aim of this study was to report the case of a young Brazilian female with a focal neurological deficit. She presented with asymmetry of brachial and radial pulses, aphasia, dysarthria and right hemiplegia. Stroke was investigated extensively in this young patient. Only nonspecific inflammatory markers such as velocity of hemosedimentation and C-reactive protein were elevated. During hospitalization, clinical treatment was performed with pulse therapy showing improvement in neurological recuperation on subsequent days. In the chronic phase, the patient was submitted to medicated angioplasty of the brachiocephalic trunk with paclitaxel, with significant improvement of the stenosis. At the 6-month follow-up, the neurological exam presented mild dysarthria, faciobrachial predominant disproportionate hemiparesis, an NIHSS score of 4 and a modified Rankin Scale score of 3 (moderate incapacity). In conclusion, Takayasu's arteritis must be recognized as a potential cause of ischemic stroke in young females.

Giant cell arteritis complicated by acute pancreatitis: a case report

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Seneviratne Deepthi

2008-11-01

Full Text Available Abstract Introduction We describe a case of giant cell arteritis in a woman who was treated with high-dose systemic corticosteroids and subsequently developed acute pancreatitis. Case presentation A 78-year-old Caucasian woman presented with four weeks of progressive headache and scalp tenderness. One day before ophthalmology assessment, she had experienced visual obscurations in both eyes. Her visual acuity was 6/9 in both eyes, with a right afferent pupillary defect and right swollen optic nerve. She was diagnosed as having temporal arteritis and was urgently treated with high-dose pulsed intravenous and oral corticosteroids. Her previous diet-controlled diabetes needed insulin and oral hyperglycaemic therapy to control erratic blood sugars. On day 8 of treatment with steroids, she became unwell with epigastric pain and vomiting. She was diagnosed with acute pancreatitis and was treated conservatively. Conclusion Acute pancreatitis, a potentially life-threatening condition, is a rare but important side effect of systemic corticosteroids.

Repeat Operation for Pseudoaneurysm of Left Ventricular Outflow in a Patient with Concomitant Takayasu's Arteritis and Marfan Syndrome.

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Yamashiro, Satoshi; Kuniyoshi, Yukio; Arakaki, Katsuya; Nagano, Takaaki; Kise, Yuya

2011-01-01

We describe concomitant Marfan syndrome and Takayasu's arteritis complicating a pseudoaneurysm of the left ventricular outflow that developed after aortic root reconstruction. A patient was admitted with a high fever four months after initial root reconstruction that included valve sparing (reimplantation) as well as coronary artery reconstruction using a Carrel's button technique. Computed tomography revealed a pseudoaneurysm at the posterior side of the aortic root. We applied a modified Bentall procedure including coronary artery reconstruction using the Piehler technique. Pathological assessment of a specimen of the aorta revealed no central medial necrosis, but significant lymphocytic infiltration and thick fibrous adventitia indicating Takayasu's arteritis. This case was unique in terms of having simultaneous Takayasu's arteritis and cardiovascular manifestations of Marfan syndrome that were surgically treated.

Lyme carditis mimicking giant cell arteritis

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Krati Chauhan

2015-10-01

Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

Vessel Wall Inflammation of Takayasu Arteritis Detected by Contrast-Enhanced Magnetic Resonance Imaging: Association with Disease Distribution and Activity.

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Yoko Kato

Full Text Available The assessment of the distribution and activity of vessel wall inflammation is clinically important in patients with Takayasu arteritis. Magnetic resonance imaging (MRI is a useful tool, but the clinical utility of late gadolinium enhancement (LGE in Takayasu arteritis has yet to be determined. The aim of the present study was to evaluate the utility of LGE in assessing vessel wall inflammation and disease activity in Takayasu arteritis.We enrolled 49 patients with Takayasu arteritis who had undergone 1.5 T MRI. Patients were divided into Active (n = 19 and Inactive disease (n = 30 groups. The distribution of vessel wall inflammation using angiography and LGE was assessed by qualitative analysis. In 79% and 63% of patients in Active and Inactive groups, respectively, greater distribution of vessel wall inflammation was observed with LGE than with conventional angiography. MRI values of pre- and post-contrast signal-to-noise ratios (SNR, SNR increment (post-SNR minus pre-SNR, pre- and post-contrast contrast-to-noise ratios (CNR, and CNR increment (post-CNR minus pre-CNR were evaluated at arterial wall sites with the highest signal intensity using quantitative analysis of post-contrast LGE images. No statistically significant differences in MRI parameters were observed between Active and Inactive groups. Contrast-enhanced MRI was unable to accurately detect active disease.Contrast-enhanced MRI has utility in detecting the distribution of vessel wall inflammation but has less utility in assessing disease activity in Takayasu arteritis.

Repeat Operation for Pseudoaneurysm of Left Ventricular Outflow in a Patient with Concomitant Takayasu’s Arteritis and Marfan Syndrome

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Yamashiro, Satoshi; Kuniyoshi, Yukio; Arakaki, Katsuya; Nagano, Takaaki; Kise, Yuya

2011-01-01

We describe concomitant Marfan syndrome and Takayasu’s arteritis complicating a pseudoaneurysm of the left ventricular outflow that developed after aortic root reconstruction. A patient was admitted with a high fever four months after initial root reconstruction that included valve sparing (reimplantation) as well as coronary artery reconstruction using a Carrel’s button technique. Computed tomography revealed a pseudoaneurysm at the posterior side of the aortic root. We applied a modified Bentall procedure including coronary artery reconstruction using the Piehler technique. Pathological assessment of a specimen of the aorta revealed no central medial necrosis, but significant lymphocytic infiltration and thick fibrous adventitia indicating Takayasu’s arteritis. This case was unique in terms of having simultaneous Takayasu’s arteritis and cardiovascular manifestations of Marfan syndrome that were surgically treated. PMID:23555475

Equine viral arteritis in breeding and sport horses in central Spain

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Cruz-Lopez, Fatima; Newton, Richard; Sanchez-Rodriguez, Ana; Ireland, Joanne; Mughini-Gras, Lapo|info:eu-repo/dai/nl/413306046; Moreno, Miguel A; Fores, Paloma

2017-01-01

Equine viral arteritis (EVA) may have a high economic impact on breeding stud farms due to the occurrence of EVA-associated abortion outbreaks and the ability of the virus to persist in carrier stallions. While the consequences of EVA in premises with sport horses are usually less severe, the first

Late In-Stent Restenosis of the Abdominal Aorta in a Patient with Takayasu's Arteritis and Related Pathology

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Ishibashi-Ueda, Hatsue; Yutani, Chikao; Kuribayashi, Sachio; Takamiya, Makoto; Imakita, Masami; Ando, Motomi

1999-01-01

This report describes an in-stent restenosis of the infrarenal aorta in a patient with Takayasu's arteritis in a nonactive state. A 10-mm-diameter Wallstent had been deployed 42 months previously. The stented restenosed segment was replaced by a surgical graft. Histopathological examination of the excised aortic segment showed a thin layer of fibrocellular neointima and massive organized and calcified thrombus. To our knowledge, this is the first histopathological report of a late in-stent restenosis of the abdominal aorta in Takayasu's arteritis. RID='''' ID='''' Correspondence to: H. Ishibashi-Ueda, M.D

Tocilizumab for giant cell arteritis with corticosteroid-resistant progressive anterior ischemic optic neuropathy.

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Vionnet, Julien; Buss, Guillaume; Mayer, Cédric; Sokolov, Arseny A; Borruat, François-Xavier; Spertini, François

2017-10-01

Giant cell arteritis is an inflammatory disorder of the medium- and large-size arteries. Permanent visual loss related to arteritic anterior ischemic optic neuropathy is among the most serious complications of this disease and initial treatment usually consists of high dose corticosteroids. There is no consensus in the literature concerning the optimal therapeutic approach in giant cell arteritis patients with corticosteroid-resistant arteritic anterior ischemic optic neuropathy. A 73-year-old Caucasian female with biopsy-proven giant cell arteritis developed an acute visual loss of the right eye due to arteritic anterior ischemic optic neuropathy. Despite 5 daily methylprednisolone pulses, systemic symptoms persisted and rapid involvement of the controlateral eye was documented. Therefore, tocilizumab (humanised monoclonal antibody binding the human interleukin-6 receptor) was introduced as a potential salvage therapy with a swift consecutive resolution of the systemic symptoms and stabilization of the ophthalmic lesions. Although a late effect of steroids pulses cannot be formally ruled out in this dramatic situation, tocilizumab likely offered a decisive effect in preventing bilateral blindness and may have contributed to steroid tapering. Tocilizumab may represent a new early effective second-line treatment option in corticosteroid-resistant anterior ischemic optic neuropathy. More data are needed to confirm this observation and to evaluate the safety profile of this treatment. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Immunogenetics and clinical aspects of Takayasu's arteritis patients in a Mexican Mestizo population.

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Vargas-Alarcón, G; Flores-Domínguez, C; Hernández-Pacheco, G; Zuñiga, J; Gamboa, R; Soto, M E; Granados, J; Reyes, P A

2001-01-01

The aim of the present work was to study the association between HLA alleles and Takayasu's arteritis in Mexican Mestizo patients. The study included 26 Mexican Mestizo patients with Takayasu's arteritis and 99 healthy unrelated individuals. HLA-A, -B and -DR alleles were determined by polymerase chain reaction PCR-SSP RESULTS: Increased gene frequencies were demonstrated for HLA-B15(p=0.009,pC=0.020,OR=3.24,EF=11.9%) and HLA-B52 (p=0.008, pC=0.027, OR=5.16, EF=7.7%), and a decreased frequency for the HLA-A24 allele in patients compared to normal controls (p=0.035, pC=NS, PF=11.1%). When HLA typing was correlated to clinicalfeatures in 24 cases, wefound an increasedfrequencies of HLA-DR14 in patients with systemic arterial hypertension (p=0.005, pC=0.004, OR=24.6, EF=38.3%) and HLA-A2 on patients with pulmonary involvement (p=0.034, pC=0.036, OR=3.67, EF=40.4%) when compared to patients without these clinical manifestations. These data confirm HLA-B52 as a relevant susceptibility allele for Takayasu's arteritis and suggest that HLA-B15 could be important as a marker of the disease in Mexican patients. Other class I and/or class II alleles could also be relevant as markers for the clinical features present in these patients.

MYOMA UTERİ TEDAVİSİNDE LAPARASKOPİK UTERİN ARTER KOAGULASYONUN ETKİSİ; VAKA SERİSİ

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Başar, Hatice; Bostancı, Ahmet; Işık, Hatice; Sarı, Nagihan; Seven, Ali

2014-01-01

Amaç: Bu çalışmanın amacı myoma uteri tanısı alan hastalarda laparaskopik bilateral uterin arter koagulasyonunun tedavideki etkisini araştırmaktır.Gereç ve Yöntemler: Haziran 2007-Ekim 2007 tarihleri arasında   29-47 yaş arası   myoma uteri tanısı alan semptomatik 10 hastaya laparaskopik bilateral arter koagulasyonu yapıldı. Postopo- peratif  myom hacimleri Manyetik Rezonans görüntüleme (MRI) ile değerlendirildi ve hastaların semptomlarındaki değişiklikler kaydedildi.Bulgular: Laparaskopik ar...

Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu’s Arteritis and Antiphospholipid Antibody Syndrome

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Demet Menekşe Gerede

2013-01-01

Full Text Available We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu’s arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu’s arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

Association of aortic and main left coronary aneurysms with severe aortic insufficiency in Takayasu’s arteritis

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Marcelo Ferraz de Freitas

2011-04-01

Full Text Available Takayasu’s arteritis is a granulomatous vasculitis of unknown etiology that affects mainly the aorta and its branches. As a result of intimal fibroproliferation, segmental stenosis, occlusion, dilatation, and aneurysmal formation of the involved vessels may develop. It is an uncommon disease and usually affects young Asian female patients during the second and third decades of life. Coronary arteries are exceptionally affected and coronary aneurysm formation is a very rare finding. We describe a case of a previously healthy 26-year-old Caucasian female whose Takayasu’s arteritis presented as a previously undescribed association of aortic and main left coronary aneurysms with severe aortic insufficiency.

Association of aortic and main left coronary aneurysms with severe aortic insufficiency in Takayasu’s arteritis

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Schafranski, Marcelo Derbli; Ferraz de Freitas, Marcelo; Valladão de Carvalho, Marcelo

2011-01-01

Takayasu’s arteritis is a granulomatous vasculitis of unknown etiology that affects mainly the aorta and its branches. As a result of intimal fibroproliferation, segmental stenosis, occlusion, dilatation, and aneurysmal formation of the involved vessels may develop. It is an uncommon disease and usually affects young Asian female patients during the second and third decades of life. Coronary arteries are exceptionally affected and coronary aneurysm formation is a very rare finding. We describe a case of a previously healthy 26-year-old Caucasian female whose Takayasu’s arteritis presented as a previously undescribed association of aortic and main left coronary aneurysms with severe aortic insufficiency. PMID:24765288

A case with late clinical presentation of Takayasu’s arteritis

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Feyzullah Gümüşçü

2014-06-01

Full Text Available Takayasu's arteritis also known as pulseless disease is a kind of granulomatous vasculitis that characterized large size vessels involvement with massive intimal fibrosis. It is usually occurs in female gender in middle ages. Unusual Takayasu's arteritis case with different clinical presentation was reported in current paper. A 42 years old male patient was admitted to cardiovascular surgery clinic with sudden onset cyanosis in first finger of right hand. There was not any finding or complaint in his past medical history. The right brachial, radial and ulnar pulses were not palpable in physical examination and blood pressure could not measured from this extremity. Bilateral upper limb arterial doppler ultrasound revealed minimal flow in right and disrupted biphasic flow pattern in left. Peripheral angiography revealed total occlusion after the osteal segment of right subclavian artery, pre-occlusive stenosis in proximal segment of left subclavian artery and total occlusion in abdominal aorta just prior the iliac bifurcation. There was no serological or biochemical positivity in blood parameters and no additional visualization finding. Antiaggregant, anticoagulant and intravenous peripheral vasodilator therapy was utilized to patient for finger cyanosis. Patient was discharged with full recovery of finger coloration and referred to rheumatology clinic for further investigation. Microembolism may be messenger of wide-spread vascular disorders for example vasculitis. Thus, detailed systemic examinations should be applied in patients who admitted with micro-circulatory system symptoms.

[Chronic periodontitis with Takayasu arteritis: a case report].

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Gao, Wei; Luan, Qing-xian

2015-10-18

This case report concerns a 23-year-old woman with chronic periodontitis who had been previously diagnosed with Takayasu arteritis (TA). Her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were decreased before and 3 months after non-surgical periodontal therapy with no change in her prescribed medications (ESR from 31.00 mm/h to 23.0 mm/h, CRP from 21.40 mg/L to 18.46 mm/h). Through the occasional findings, we raised a hypothetical analysis about the potential relationship between periodontitis and TA with respect to inflammatory factors, bacteria and medication. Further studies of large samples are needed to verify the findings.

Identification of a divergent genotype of equine arteritis virus from South American donkeys.

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Rivas, J; Neira, V; Mena, J; Brito, B; Garcia, A; Gutierrez, C; Sandoval, D; Ortega, R

2017-12-01

A novel equine arteritis virus (EAV) was isolated and sequenced from feral donkeys in Chile. Phylogenetic analysis indicates that the new virus and South African asinine strains diverged at least 100 years from equine EAV strains. The results indicate that asinine strains belonged to a different EAV genotype. © 2017 Blackwell Verlag GmbH.

Lethal subarachnoid bleeding under immunosuppressive therapy due to mycotic arteritis

International Nuclear Information System (INIS)

Weigel, S.; Kloska, S.; Freund, M.; Kehl, H.G.

2003-01-01

A subarachnoid haemorrhage (SAH) occurred 67 days after cardiac transplantation in 10-year-old girl with consecutive immunocompromising therapy. Neither digital subtraction angiography (DSA) nor computed tomographic angiography showed signs of intracranial vascular malformations. One month before the lethal SAH occurred, she had developed arterial hypertension and attacks of severe headache with cerebrospinal fluid (CSF) pleocytosis while CT scans showed an infarct of the left thalamus. Pathologic findings established the rare diagnosis of SAH due to aspergillosis-related mycotic arteritis. Imaging characteristics are presented. (orig.)

Bilateral ocular ischemia-induced blindness as a presenting manifestation of Takayasu arteritis: a case report.

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Pallangyo, Pedro; Epafra, Emmanuel; Nicholaus, Paulina; Lyimo, Frederick; Kazahura, Parvina; Janabi, Mohamed

2017-06-10

Takayasu arteritis is a granulomatous panarteritis that predominantly affects the aorta and its major branches. The initial manifestations of this large-vessel vasculitis are usually nonspecific; however, as the disease progresses, typical symptoms of arterial occlusion, aneurysmal formation, and vascular pain become evident. Ischemic ocular complications of Takayasu arteritis which could lead to complete loss of vision are not uncommon and depend on the obliterated portion(s) of carotid(s), the intensity and rate of progression of ocular vascular insufficiency, and sufficiency of the collateral blood supply to the eye. A 24-year-old woman of African descent with prior normal vision was referred to us with a 3-year history of gradual decline in visual acuity in both eyes and unintentional weight loss (17 kg) within the past 1 year. A physical examination revealed feeble brachial and radial arterial pulses on her left side. She had sinus tachycardia (136 beats/minute) and her blood pressure was 85/59 mmHg on her left and 134/82 mmHg on her right side. Bilateral microaneurysms, dot and blot hemorrhages, and multiple ischemic areas of retina together with neovascularization in her right eye were noted during a funduscopic examination. Computed tomography angiography of her thoracic and abdominal aorta revealed irregular narrowing with variable degrees of stenosis, tapering, and corrugated appearance. Despite its rarity, Takayasu arteritis significantly impairs a patient's quality of life and has a life-threatening potential. Early initiation of appropriate therapy could delay disease progression and reduce the associated complications.

An ultrasound-based comparative study on carotid plaques in HIV-positive patients vs. atherosclerotic and arteritis patients: atherosclerotic or inflammatory lesions?

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Maggi, Paolo; Perilli, Francesco; Lillo, Antonio; Carito, Valentina; Epifani, Giuseppe; Bellacosa, Chiara; Pastore, Giuseppe; Regina, Guido

2007-02-01

We have previously described two cases of HIV-1-positive patients undergoing surgery for stenosis of the internal carotid arteries. Histology revealed an extensive inflammatory infiltration of the vascular wall and no evidence of atheromasic plaque. This unexpected pattern of carotid damage prompted us to perform a more accurate investigation of the characteristics of carotid plaques in a group of HIV-positive patients. The results were compared with those obtained from young patients affected by atherosclerosis of the epi-aortic vessels and patients with arteritis. The patients underwent ultrasonography of the epi-aortic vessels using one of the latest generation power color-Doppler with 7.5 MHz probes. The study population included 61 HIV-positive patients and 47 HIV-negative patients (37 atherosclerotic and 10 with arteritis). Compared with HIV-negative atherosclerotic patients, there were significantly higher proportions of HIV-positive patients with iso-hypoechogenic lesions (81.8 vs. 29%) that were homogeneous both in their parietal and endoluminal portions (96.7 vs. 21.6% and 88.5 vs. 54.0%, respectively), with a smooth or slightly irregular surface (99.0 vs. 56.7%) (P=0.001 for all differences). No statistically significant differences were seen between HIV-positive and arteritis patients. Our study evidenced that the ultrasonographic structure of the epi-aortic lesions in HIV-positive patients substantially differ from those of the plaques in atherosclerotic patients, although they share similar characteristics with patients affected by arteritis. Further investigations are warranted to better define the structure and the mechanism of onset of these lesions.

The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis

International Nuclear Information System (INIS)

Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John; Mason, Justin C.

2004-01-01

Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 18 F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. 18 F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that 18 F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

Arteritis with left carotid artery thrombosis produced by Salmonella enteritides. Study with CT, MR and angiography with digital subtraction. Arteritis con trombosis carotidea izquierda por Salmonella enteritidis. Estudio con TC, RM y angiografia con sustraccion digital

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Iribarren Marin, M.A.; Fernandez Cruz, J.; Serrano Gotarredona, P.; Reyes Dominguez, M.J. (Hospital Universitario Virgen del Rocio, Sevilla (Spain))

1994-01-01

We present a case of suppurative arteritis of left common carotid artery produced by Salmonella enteritides in a 66-year-old man. We show the findings obtained by CT, MR and selective arteriography of the supra-aortic branches. We review this uncommon disorder. (Author)

Takayasu arteritis with middle aortic syndrome and mesenteric ischemia treated by aortic stenting

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Sarah Morrissey, MD, MA, FRCSC

2017-09-01

Full Text Available A 48-year-old woman suffering from Takayasu arteritis presented with middle aortic syndrome consisting of abdominal pain, refractory hypertension with pulmonary edema and pleural effusions, and lower limb ischemia. She failed to improve with high-dose steroid therapy and underwent endovascular stenting of two severe stenoses in the supraceliac and infrarenal aorta. Her symptoms resolved and hypertension improved after the procedure.

Augmented TLR2 expression on monocytes in both human Kawasaki disease and a mouse model of coronary arteritis.

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I-Chun Lin

Full Text Available BACKGROUND: Kawasaki disease (KD of unknown immunopathogenesis is an acute febrile systemic vasculitis and the leading cause of acquired heart diseases in childhood. To search for a better strategy for the prevention and treatment of KD, this study compared and validated human KD immunopathogenesis in a mouse model of Lactobacillus casei cell wall extract (LCWE-induced coronary arteritis. METHODS: Recruited subjects fulfilled the criteria of KD and were admitted for intravenous gamma globulin (IVIG treatment at the Kaohsiung Chang Gung Memorial Hospital from 2001 to 2009. Blood samples from KD patients were collected before and after IVIG treatment, and cardiovascular abnormalities were examined by transthoracic echocardiography. Wild-type male BALB/c mice (4-week-old were intraperitoneally injected with LCWE (1 mg/mL to induce coronary arteritis. The induced immune response in mice was examined on days 1, 3, 7, and 14 post injections, and histopathology studies were performed on days 7 and 14. RESULTS: Both human KD patients and LCWE-treated mice developed coronary arteritis, myocarditis, valvulitis, and pericarditis, as well as elevated plasma levels of interleukin (IL-2, IL-6, IL-10, monocyte chemoattractant protein (MCP-1, and tumor necrosis factor (TNF-α in acute phase. Most of these proinflammatory cytokines declined to normal levels in mice, whereas normal levels were achieved in patients only after IVIG treatment, with a few exceptions. Toll-like receptor (TLR-2, but not TLR4 surface enhancement on circulating CD14+ monocytes, was augmented in KD patients before IVIG treatment and in LCWE-treated mice, which declined in patients after IVIG treatment. CONCLUSION: This result suggests that that not only TLR2 augmentation on CD14+ monocytes might be an inflammatory marker for both human KD patients and LCWE-induced CAL mouse model but also this model is feasible for studying therapeutic strategies of coronary arteritis in human KD by

Augmented TLR2 expression on monocytes in both human Kawasaki disease and a mouse model of coronary arteritis.

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Lin, I-Chun; Kuo, Ho-Chang; Lin, Ying-Jui; Wang, Feng-Shen; Wang, Lin; Huang, Shun-Chen; Chien, Shao-Ju; Huang, Chien-Fu; Wang, Chih-Lu; Yu, Hong-Ren; Chen, Rong-Fu; Yang, Kuender D

2012-01-01

Kawasaki disease (KD) of unknown immunopathogenesis is an acute febrile systemic vasculitis and the leading cause of acquired heart diseases in childhood. To search for a better strategy for the prevention and treatment of KD, this study compared and validated human KD immunopathogenesis in a mouse model of Lactobacillus casei cell wall extract (LCWE)-induced coronary arteritis. Recruited subjects fulfilled the criteria of KD and were admitted for intravenous gamma globulin (IVIG) treatment at the Kaohsiung Chang Gung Memorial Hospital from 2001 to 2009. Blood samples from KD patients were collected before and after IVIG treatment, and cardiovascular abnormalities were examined by transthoracic echocardiography. Wild-type male BALB/c mice (4-week-old) were intraperitoneally injected with LCWE (1 mg/mL) to induce coronary arteritis. The induced immune response in mice was examined on days 1, 3, 7, and 14 post injections, and histopathology studies were performed on days 7 and 14. Both human KD patients and LCWE-treated mice developed coronary arteritis, myocarditis, valvulitis, and pericarditis, as well as elevated plasma levels of interleukin (IL)-2, IL-6, IL-10, monocyte chemoattractant protein (MCP)-1, and tumor necrosis factor (TNF)-α in acute phase. Most of these proinflammatory cytokines declined to normal levels in mice, whereas normal levels were achieved in patients only after IVIG treatment, with a few exceptions. Toll-like receptor (TLR)-2, but not TLR4 surface enhancement on circulating CD14+ monocytes, was augmented in KD patients before IVIG treatment and in LCWE-treated mice, which declined in patients after IVIG treatment. This result suggests that that not only TLR2 augmentation on CD14+ monocytes might be an inflammatory marker for both human KD patients and LCWE-induced CAL mouse model but also this model is feasible for studying therapeutic strategies of coronary arteritis in human KD by modulating TLR2-mediated immune activation on CD14

The Central Bright Spot Sign: A Potential New MR Imaging Sign for the Early Diagnosis of Anterior Ischemic Optic Neuropathy due to Giant Cell Arteritis.

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Remond, P; Attyé, A; Lecler, A; Lamalle, L; Boudiaf, N; Aptel, F; Krainik, A; Chiquet, C

2017-07-01

A rapid identification of the etiology of anterior ischemic optic neuropathy is crucial because it determines therapeutic management. Our aim was to assess MR imaging to study the optic nerve head in patients referred with anterior ischemic optic neuropathy, due to either giant cell arteritis or the nonarteritic form of the disease, compared with healthy subjects. Fifteen patients with giant cell arteritis-related anterior ischemic optic neuropathy and 15 patients with nonarteritic anterior ischemic optic neuropathy from 2 medical centers were prospectively included in our study between August 2015 and May 2016. Fifteen healthy subjects and patients had undergone contrast-enhanced, flow-compensated, 3D T1-weighted MR imaging. The bright spot sign was defined as optic nerve head enhancement with a 3-grade ranking system. Two radiologists and 1 ophthalmologist independently performed blinded evaluations of MR imaging sequences with this scale. Statistical analysis included interobserver agreement. MR imaging scores were significantly higher in patients with giant cell arteritis-related anterior ischemic optic neuropathy than in patients with nonarteritic anterior ischemic optic neuropathy ( P ≤ .05). All patients with giant cell arteritis-related anterior ischemic optic neuropathy (15/15) and 7/15 patients with nonarteritic anterior ischemic optic neuropathy presented with the bright spot sign. No healthy subjects exhibited enhancement of the anterior part of the optic nerve. There was a significant relationship between the side of the bright spot and the side of the anterior ischemic optic neuropathy ( P ≤ .001). Interreader agreement was good for observers (κ = 0.815). Here, we provide evidence of a new MR imaging sign that identifies the acute stage of giant cell arteritis-related anterior ischemic optic neuropathy; patients without this central bright spot sign always had a nonarteritic pathophysiology and therefore did not require emergency corticosteroid

Temporal artery biopsy is not required in all cases of suspected giant cell arteritis.

LENUS (Irish Health Repository)

Quinn, Edel Marie

2012-07-01

Temporal artery biopsy (TAB) is performed during the diagnostic workup for giant cell arteritis (GCA), a vasculitis with the potential to cause irreversible blindness or stroke. However, treatment is often started on clinical grounds, and TAB result frequently does not influence patient management. The aim of this study was to assess the need for TAB in cases of suspected GCA.

MRI in giant cell (temporal) arteritis; Magnetresonanztomografie der Arteriitis temporalis Horton

Energy Technology Data Exchange (ETDEWEB)

Bley, T.A.; Uhl, M.; Frydrychowicz, A.; Langer, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik; Markl, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik - Medizinische Physik

2007-07-15

Giant cell (temporal) arteritis is a diagnostic challenge. Blindness is a dreaded complication, especially if high-dose steroid treatment is delayed. With an optimized MR protocol, noninvasive diagnosis of giant cell arteritis is facilitated. Submillimeter in-plane resolution makes it possible to distinguish healthy segments from inflamed segments. The lumen and arterial wall can be depicted in high detail. Post-contrast high-resolution MRI visualizes the superficial cranial arteries bilaterally and simultaneously, allowing assessment of the cranial involvement pattern. In combination with MR angiography of the aortic arch and supra-aortic arteries, the extracranial involvement pattern can be demonstrated in a single comprehensive MR examination assessing the cranial, cervical and thoracic vasculature. Good diagnostic image quality can be achieved at 1.5 Tesla and at 3 Tesla. However, due to higher signal-to-noise ratios, image quality seems to be superior at 3 Tesla. Over the course of successful long-term treatment, MR signs of mural inflammation decrease significantly and eventually vanish entirely. In contrast to color-coded Duplex sonography, which is a comparatively cost-efficient imaging modality, acquisition of high-resolution MRI is almost independent of the investigator's expertise. Compared to positron emission tomography with 18F-fluoro-2-deoxy-D-glucose, which is a very sensitive whole-body screening tool for detecting extracranial involvement of large vessel vasculitis, MRI allows visualization and assessment of both the superficial cranial arteries in high detail and the extracranial large artery involvement in the same investigation. (orig.)

Equine viral arteritis in breeding and sport horses in central Spain.

Science.gov (United States)

Cruz-Lopez, Fatima; Newton, Richard; Sanchez-Rodriguez, Ana; Ireland, Joanne; Mughini-Gras, Lapo; Moreno, Miguel A; Fores, Paloma

2017-12-01

Equine viral arteritis (EVA) may have a high economic impact on breeding stud farms due to the occurrence of EVA-associated abortion outbreaks and the ability of the virus to persist in carrier stallions. While the consequences of EVA in premises with sport horses are usually less severe, the first confirmed outbreak of EVA in Spain occurred in a riding club in Barcelona, but no data on the seroprevalence of EVA in sport horses have been reported in Spain. Given the importance of both Spanish Purebred (SP) breeding horses and sport horses for Spain's equine industry, the aim of this study was to determine and compare the seroprevalence of EVA in these two horse populations in central Spain. Serum samples from 155 SP breeding horses residing in 16 stud farms and 105 sport horses of different breeds housed in 12 riding clubs, collected between September 2011 and November 2013, were tested using a commercial EVA antibody ELISA test with a 100% sensitivity, and confirmed by seroneutralisation (SN) test. EVA seroprevalence in SP breeding horses was higher 21.1% (95% CI 15.3-26.8%) than that in sport horses (6.7%, 95% CI 1.89-11.45%). However, the primary use (breeding vs. sport) was not significantly associated with seropositivity to Equine Arteritis Virus (EAV), suggesting that different management factors do not affect EVA circulation in these two horse populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Giant-cell arteritis: a descriptive study in southwestern Spain].

Science.gov (United States)

Calvo Romero, J M; Magro Ledesma, D; Ramos Salado, J L; Bureo Dacal, J C; de Dios Arrebola García, J; Bureo Dacal, P; Pérez Miranda, M

2000-02-01

To study the clinical and laboratory features of a series of patients with giant cell arteritis (GCA) or temporal arteritis in south-western Spain (Extremadura). Retrospective study of 25 patients with GCA diagnosed by temporal artery biopsy between 1990 and 1998. Nine patients were males and 16 (64%) females. Sixteen cases (64%) presented polymyalgia rheumatica (PMR). Other clinical findings were: fever/febricula (64%), constitutional syndrome (64%), new headache (96%), visual symptoms (48%), jaw claudication (17%) and abnormal temporal arteries (17%). All patients had an ESR of more than 50 mm/hour and a raised C-reactive protein. Thirteen patients (52%) had anemia (hemoglobin level < 12 g/dl). Eleven cases (44%) presented a platelet count higher than 400,000/mm3. Four patients (16%) had an elevated AST and/or ALT levels and 8 patients (32%) had an elevated GGT and/or alkaline phosphatase levels. In patients with PMR, there was a higher frequency of constitutional syndrome (81 vs 33%, p = 0.02). In females, there was a higher frequency of anemia (75 vs 11%, p < 0.01), platelet count higher than 400,000/mm3 (75 vs 0%, p < 0.01) and elevated AST and/or ALT (25 vs 0%, p < 0.01) and elevated GGT and/or alkaline phosphatase (50 vs 0%, p < 0.01) levels. The clinical and laboratory features of GCA in our series of patients in south-western Spain are similar to that described in other spanish populations, with the exception of a slightly higher frequency of PMR and a lower frequency of jaw claudication and abnormal temporal arteries. In our study, the clinical picture of GCA was more severe in patients with PMR and in females.

The role of {sup 18}F-FDG PET in characterising disease activity in Takayasu arteritis

Energy Technology Data Exchange (ETDEWEB)

Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John [Department of Nuclear Medicine, Hammersmith Hospital, Du Cane Road, W12 0HS, London (United Kingdom); Mason, Justin C. [Department of Rheumatology, Hammersmith Hospital, London (United Kingdom)

2004-05-01

Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 {sup 18}F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. {sup 18}F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that {sup 18}F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

Superior Mezenter Arter Embolisinde Erken Tanı ve Embolektomi

OpenAIRE

AYDIN, İbrahim; YÜCEL, Ahmet; PERGEL, Ahmet; KARAKAYA, Ahmet; OĞULLAR, Sabri; ŞAHİN, Dursun; ÖZER, Ender

2016-01-01

Akut mezenter arter embolisi, acil girişim gerektiren, nekroz geliştiğinde yaygın ince barsak rezeksiyonu ve sonrasında gelişen kısa barsak sendromu nedeniyle yaşam kalitesini düşüren, morbidite ve mortalitesi oldukça yüksek bir hastalıktır. Multidetektör kontrastlı BT, akut mezenterik embolinin erken tanısında oldukça önemlidir. Biz burada, kontrastlı abdominal BT ile erken tanı ve sonrasında bağırsak rezeksiyonu gerekmeden yalnızca embolektomi yaparak tedavi ettiğimiz olguyu sunmayı amaçlad...

Favorable Pregnancy Outcomes in a Patient with Takayasu’s Arteritis: A Case Report

Directory of Open Access Journals (Sweden)

Sima Kadkhodayan

2016-10-01

Full Text Available Background & aim: Takayasu’s arteritis is a rare, chronic vasculitis, affecting women of reproductive age. With disease progression, evidence of vascular involvement and insufficiency becomes clinically apparent due to the narrowing or occlusion of the proximal or distal branches of the aorta. Therefore, pregnancy-related complications, such as superimposed preeclampsia, renal failure, and congestive heart failure, may be encountered in these patients. Case report: In this report, we present the case of a 23-year-old, Iranian, primigravida woman with a prior history of Takayasu’s arteritis, which was diagnosed two years before her pregnancy. The patient’s primary presentations were thrombocytosis (more than one million per milliliter, weight loss, and weakness in the shoulders and arms, appearing two years before her pregnancy. Following spontaneous pregnancy, the patient received regular perinatal care by a medical team, consisting of an obstetrician, a rheumatologist, a radiologist, and a nephrologist. Pregnancy termination was planned due to the preterm premature rupture of membranes (PPROM at 36 weeks of gestation. A normal live male neonate (weight= 3100 g was born with a normal Apgar score (8-8. Conclusion: Based on the findings, a multidisciplinary collaboration between rheumatologists, nephrologists, and obstetricians is required to achieve optimal maternal and neonatal outcomes.

Seroprevalence and factors associated with seropositivity to equine arteritis virus in Spanish Purebred horses in Spain.

Science.gov (United States)

Cruz, F; Fores, P; Mughini-Gras, L; Ireland, J; Moreno, M A; Newton, R

2016-09-01

Equine viral arteritis (EVA), a disease caused by infection with the equine arteritis virus (EAV), is present in many European countries. In Spain, the last confirmed outbreak was reported in 1992 and there is a paucity of seroprevalence studies. The disease has a major impact on the equine breeding industry, which is mainly represented by Spanish Purebred (SP) horses in Spain. To estimate the seroprevalence of EAV in the breeding SP horse population in central Spain and identify potential horse and studfarm level factors associated with seropositivity to EAV. Cross-sectional study. Individual serum samples from 555 SP horses, collected between September 2011 and November 2013 at 35 studfarms, were tested using a commercially available EAV antibody ELISA and seroneutralisation as the World Organisation for Animal Health reference confirmation test for samples with positive and equivocal results. Data on factors putatively associated with seropositivity to EAV were collected via a questionnaire and examined using random effects logistic regression for analysis of clustered data. Equine arteritis virus seroprevalence in the SP breeding population in central Spain standardised for the sex distribution of the reference horse population, was estimated to be 16.8% (95% confidence interval 5.2-28.5%). Increasing numbers of breeding mares on the studfarm and increasing percentage of mares with reproductive problems during the last 12 months were identified as being positively associated with EAV seropositivity. Mares vaccinated against Equine herpesvirus-1 (EHV-1) and/or -4 (EHV-4) were also positively associated with EAV seropositivity. These findings are of importance to ensure appropriate biosecurity measures for studfarms are carried out and may help facilitate the development of an EVA surveillance programme in the SP breeding horse population. © 2015 EVJ Ltd.

Idiopathic CD4 lymphocytopenia with giant cell arteritis and pulmonary mucormycosis

Directory of Open Access Journals (Sweden)

Ryan A. Denu

2014-10-01

Full Text Available Idiopathic CD4 lymphocytopenia (ICL is characterized by a low CD4+ lymphocyte count in the absence of HIV or other underlying etiologies. We report a case of a 57-year old man with ICL and giant cell arteritis (GCA who developed pulmonary mucormycosis, which, to our knowledge, is the first report of these occurring in a patient with ICL. Abnormally low total lymphocyte or CD4+ cell counts occurring in patients with autoimmune disorders should alert clinicians to the possibility of ICL. Immunosuppressive treatment should be used with caution in this context.

Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

Energy Technology Data Exchange (ETDEWEB)

Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

2013-11-01

Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

Serial analysis of clinical and imaging indices reveals prolonged efficacy of TNF-α and IL-6 receptor targeted therapies in refractory Takayasu arteritis.

Science.gov (United States)

Youngstein, Taryn; Peters, James E; Hamdulay, Shahir S; Mewar, Devesh; Price-Forbes, Alec; Lloyd, Mark; Jeffery, Rachel; Kinderlerer, Anne R; Mason, Justin C

2014-01-01

We analysed a large cohort of patients with Takayasu arteritis, seeking robust clinical evidence for prolonged responses to tumour necrosis factor-α (TNF-α) and interleukin-6 receptor (IL-6R) antagonists in severe refractory disease. Case notes from ninety-eight patients with Takayasu arteritis were retrospectively reviewed. Drug treatment, laboratory and serial non-invasive imaging data were analysed, and the Indian Takayasu arteritis activity (ITAS) and damage scores (TADs) calculated. Nine patients were treated with biologic therapies. All had previously received high dose prednisolone and ≥1 conventional immunosuppressant. Five patients had failed cyclophosphamide. The patients prescribed biologics had more extensive arterial injury than the remainder of the cohort and persistent active disease (ITAS range 2-9, CRP 12-206 mg/L, TADs 3--1). Eight patients were prescribed anti-TNF-α therapy, three IL-6R blockade. The mean duration of anti-TNF-α treatment was 42 months (maximum 8 years). One patient developed new arterial stenoses while receiving anti-TNF-α and subsequently achieved disease remission with tocilizumab. Two patients have now demonstrated sustained responses to IL-6R inhibition at 19 and 20 months. Following introduction of biologic therapy, serial non-invasive imaging has revealed no significant progression in arterial injury. A significant fall in CRP (p<0.01), prednisolone dose (p<0.01) and ITAS (p<0.01) was observed, with no increase in TADs. We report for the first time sustained responses to both anti-TNF-α and IL6R antagonists in refractory Takayasu arteritis. As 5/9 patients were cyclophosphamide non-responders, we propose that biologics should now be considered ahead of cyclophosphamide in these young patients.

EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation

DEFF Research Database (Denmark)

Ruperto, Nicolino; Ozen, Seza; Pistorio, Angela

2010-01-01

To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria.......To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria....

DETECTION OF AUTOANTIBODIES AGAINST MYELOID LYSOSOMAL-ENZYMES - A USEFUL ADJUNCT TO CLASSIFICATION OF PATIENTS WITH BIOPSY-PROVEN NECROTIZING ARTERITIS

NARCIS (Netherlands)

Tervaert, J.W.C.; Limburg, Piet; ELEMA, J.D.; HUITEMA, M.G.; The, T.H; Kallenberg, Cees; Horst, G.

PURPOSE: Assessment of the value of determination of antineutrophil cytoplasmic antibodies (ANCA) and its specificities for classification of patients with biopsy-proven necrotizing arteritis. PATIENTS AND METHODS: The serum samples of 28 consecutive patients with biopsy-proven vasculitis involving

Plasma viscosity or erythrocyte sedimentation rate in the diagnosis of giant cell arteritis?

OpenAIRE

Brittain, G. P.; McIlwaine, G. G.; Bell, J. A.; Gibson, J. M.

1991-01-01

Plasma viscosity (PV) has replaced the erythrocyte sedimentation rate (ESR) as a routine laboratory test in many hospitals. The finding of a normal PV but raised ESR in a case of biopsy proved giant cell arteritis (GCA) cast doubt on this substitution in cases of suspected GCA. To assess the equivalence of PV and ESR in the diagnosis of this disease 40 suspected cases were prospectively investigated with both tests. The correlation between the two tests was good (r = 0.742, p less than 0.0001...

Arteritis with left carotid artery thrombosis produced by Salmonella enteritides. Study with CT, MR and angiography with digital subtraction

International Nuclear Information System (INIS)

Iribarren Marin, M.A.; Fernandez Cruz, J.; Serrano Gotarredona, P.; Reyes Dominguez, M.J.

1994-01-01

We present a case of suppurative arteritis of left common carotid artery produced by Salmonella enteritides in a 66-year-old man. We show the findings obtained by CT, MR and selective arteriography of the supra-aortic branches. We review this uncommon disorder. (Author)

Takayasu’s Arteritis and Crohn’s Disease in a Young Hispanic Female

Directory of Open Access Journals (Sweden)

Namrata Singh

2014-01-01

Full Text Available Takayasu’s arteritis (TA and Crohn’s disease (CD are chronic inflammatory granulomatous disorders of undetermined etiology. TA is a large vessel vasculitis with a predilection for the aorta and its branches in young women of Asian descent; whereas CD has characteristic gastrointestinal manifestations more prevalent in young Caucasians. We describe a case of both diseases in a young Hispanic female, review the literature, and impart new insight on possible genetic linkage and the role of interleukin 12 B (IL-12B as the common autoimmune mechanism and potential therapeutic target in this rare disease combination.

What is the impact of giant cell arteritis on patients’ lives? A UK qualitative study

Science.gov (United States)

Liddle, Jennifer; Bartlam, Roisin; Mallen, Christian D; Mackie, Sarah L; Prior, James A; Helliwell, Toby; Richardson, Jane C

2017-01-01

Objectives Clinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients’ lives. Methods UK patients with GCA participated in semi-structured telephone interviews. Inductive thematic analysis was employed. Results 24 participants were recruited (age: 65–92 years, time since diagnosis: 2 months to >6 years). The overarching themes from analysis were: ongoing symptoms of the disease and its treatment; and ‘life-changing’ impacts. The overall impact of GCA on patients’ lives arose from a changing combination of symptoms, side effects, adaptations to everyday life and impacts on sense of normality. Important factors contributing to loss of normality were glucocorticoid-related treatment burdens and fear about possible future loss of vision. Conclusions The impact of GCA in patients’ everyday lives can be substantial, multifaceted and ongoing despite apparent control of disease activity. The findings of this study will help doctors better understand patient priorities, legitimise patients’ experiences of GCA and work with patients to set realistic treatment goals and plan adaptations to their everyday lives. PMID:28838902

A Model of Left Ventricular Dysfunction Complicated by CAWS Arteritis in DBA/2 Mice

Directory of Open Access Journals (Sweden)

Naoto Hirata

2012-01-01

Full Text Available It was reported previously that a Candida albicans water-soluble fraction (CAWS, including a mannoprotein and β-glucan complex, has strong potency in inducing fatal necrotizing arteritis in DBA/2 mice. In this study, histopathological changes and cardiac function were investigated in this system. One mg/day of CAWS was given to DBA/2 mice via peritoneal injection for five days. The CAWS-treated DBA/2 mice were induced aortitis and died at an incidence of 100% within several weeks. Histological findings included stenosis in the left ventricular outflow tract (LVOT and severe inflammatory changes of the aortic valve with fibrinoid necrosis. Cardiomegaly was observed and heart weight increased 1.62 fold (<0.01. Echocardiography revealed a severe reduction in contractility and dilatation of the cavity in the left ventricle (LV: LV fractional shortening (LVFS decreased from 71% to 38% (<0.01, and the LV end-diastolic diameter (LVDd increased from 2.21 mm to 3.26 mm (<0.01. The titer of BNP mRNA increased in the CAWS-treated group. Severe inflammatory changes resulting from CAWS brought about lethal LV dysfunction by aortic valve deformation with LVOT stenosis. This system is proposed as an easy and useful experimental model of heart failure because CAWS arteritis can be induced by CAWS injection alone.

An unusual case of aortic rupture after deployment of a bare stent in the treatment of aortic dissection in a patient with giant-cell arteritis.

Science.gov (United States)

Rynio, Pawel; Kazimierczak, Arkadiusz; Gutowski, Piotr; Cnotliwy, Miloslaw

2017-06-01

Giant-cell arteritis is associated with a higher risk of aortic aneurysm and aortic dissection formation. We present a women with aortic dissection type B treated with a stent graft and bare-metal stent implantation. After the stent deployment we noticed aortic rupture, which was successfully treated with implantation of an additional stent graft. This report highlights the difficulty of endovascular therapy in patients with giant-cell arteritis. We have to bear in mind that chronic inflammation of the aorta leads to a more fragile aortic wall than normal. We recommend the use of a stent graft over a bare-metal stent and gentle use of a balloon catheter.

Feasibility of Angioplasty and Stenting for Abdominal Aortic Lesions Adjacent to Previously Stented Visceral Artery Lesions in Patients with Takayasu Arteritis

International Nuclear Information System (INIS)

Joseph, George; George, Paul V.; Pati, Purendra Kumar; Chandy, Sunil Thomas

2007-01-01

Two young female patients with Takayasu arteritis presented with symptomatic long-segment abdominal aortic stenosis in the vicinity of previously deployed celiac and renal artery stents that projected markedly into the narrowed aortic lumen. Crushing or distortion of the visceral artery stents during aortic angioplasty was avoided by performing simultaneous or alternating balloon dilatations in the aorta and in the visceral artery stents. Consequently, the visceral artery stents remained patent and shortened longitudinally, allowing unhindered deployment of Wallstents in the adjacent aorta and abolition of a pressure gradient across the aortic lesions. Access to side branches covered by the Wallstent was obtained without difficulty, enabling the performance of balloon dilatation in multiple side branches and ostial stent deployment in a renal artery. These techniques could increase the scope of endovascular therapy in the treatment of patients with Takayasu arteritis

Delayed Contrast-Enhanced MRI of the Coronary Artery Wall in Takayasu Arteritis

Science.gov (United States)

Schneeweis, Christopher; Schnackenburg, Bernhard; Stuber, Matthias; Berger, Alexander; Schneider, Udo; Yu, Jing; Gebker, Rolf; Weiss, Robert G.; Fleck, Eckart; Kelle, Sebastian

2012-01-01

Background Takayasu arteritis (TA) is a rare form of chronic inflammatory granulomatous arteritis of the aorta and its major branches. Late gadolinium enhancement (LGE) with magnetic resonance imaging (MRI) has demonstrated its value for the detection of vessel wall alterations in TA. The aim of this study was to assess LGE of the coronary artery wall in patients with TA compared to patients with stable CAD. Methods We enrolled 9 patients (8 female, average age 46±13 years) with proven TA. In the CAD group 9 patients participated (8 male, average age 65±10 years). Studies were performed on a commercial 3T whole-body MR imaging system (Achieva; Philips, Best, The Netherlands) using a 3D inversion prepared navigator gated spoiled gradient-echo sequence, which was repeated 34–45 minutes after low-dose gadolinium administration. Results No coronary vessel wall enhancement was observed prior to contrast in either group. Post contrast, coronary LGE on IR scans was detected in 28 of 50 segments (56%) seen on T2-Prep scans in TA and in 25 of 57 segments (44%) in CAD patients. LGE quantitative assessment of coronary artery vessel wall CNR post contrast revealed no significant differences between the two groups (CNR in TA: 6.0±2.4 and 7.3±2.5 in CAD; p = 0.474). Conclusion Our findings suggest that LGE of the coronary artery wall seems to be common in patients with TA and similarly pronounced as in CAD patients. The observed coronary LGE seems to be rather unspecific, and differentiation between coronary vessel wall fibrosis and inflammation still remains unclear. PMID:23236382

A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility

NARCIS (Netherlands)

David Carmona, F.; Mackie, Sarah L.; Martin, Jose-Ezequiel; Taylor, John C.; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castaneda, Santos; Cid, Maria C.; Hernandez-Rodriguez, Jose; Prieto-Gonzalez, Sergio; Solans, Roser; Ramentol-Sintas, Marc; Francisca Gonzalez-Escribano, M.; Ortiz-Fernandez, Lourdes; Morado, Inmaculada C.; Narvaez, Javier; Miranda-Filloy, Jose A.; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A.; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A.; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H.; Moosig, Frank; Schoenau, Verena; Franke, Andre; Palm, Oyvind; Molberg, Oyvind; Diamantopoulos, Andreas P.; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J.; Hoffman, Gary S.; Khalidi, Nader A.; Koening, Curry L.; Langford, Carol A.; McAlear, Carol A.; Moreland, Larry; Monach, Paul A.; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G.; Warrington, Kenneth J.; Ytterberg, Steven R.; Gregersen, Peter K.; Pease, Colin T.; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P. C.; de Bakker, Paul I. W.; Barrett, Jennifer H.; Salvarani, Carlo; Merkel, Peter A.; Gonzalez-Gay, Miguel A.; Morgan, Ann W.; Martin, Javier

2015-01-01

We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip

A Genome-wide Association Study Identifies Risk Alleles in Plasminogen and P4HA2 Associated with Giant Cell Arteritis

NARCIS (Netherlands)

Carmona, Francisco David; Vaglio, Augusto; Mackie, Sarah L.; Hernández-Rodríguez, José; Monach, Paul A.; Castañeda, Santos; Solans, Roser; Morado, Inmaculada C.; Narváez, Francisco Javier; Ramentol-Sintas, Marc; Pease, Colin T.; Dasgupta, Bhaskar; Watts, Richard; Khalidi, Nader A.; Langford, Carol A.; Ytterberg, Steven R.; Boiardi, Luigi; Beretta, Lorenzo; Govoni, Marcello; Emmi, Giacomo; Bonatti, Francesco; Cimmino, Marco A.; Witte, Torsten; Neumann, Thomas; Holle, Julia; Schönau, Verena; Sailler, Laurent; Papo, Thomas; Haroche, Julien; Mahr, Alfred; Mouthon, Luc; Molberg, Øyvind; Diamantopoulos, Andreas P.; Voskuyl, Alexandre E.; Brouwer, Elisabeth; Daikeler, Thomas; Berger, Christoph T.; Molloy, Eamonn S.; O'Neill, Lorraine; Blockmans, Daniel; Lie, Benedicte A.; McLaren, Paul J; Vyse, Timothy J.; Wijmenga, Cisca; Allanore, Yannick; Koeleman, Bobby P.C.; Callejas-Rubio, José Luis; Caminal-Montero, Luis; Corbera-Bellalta, Marc; de Miguel, Eugenio; López, J. Bernardino Díaz; García-Villanueva, María Jesús; Gómez-Vaquero, Carmen; Guijarro-Rojas, Mercedes; Hidalgo-Conde, Ana; Marí-Alfonso, Begoña; Berriochoa, Agustín Martínez; Zapico, Aleida Martínez; Martínez-Taboada, Víctor Manuel; Miranda-Filloy, José A.; Monfort, Jordi; Ortego-Centeno, Norberto; Pérez-Conesa, Mercedes; Prieto-González, Sergio; Raya, Enrique; Fernández, Raquel Ríos; Sánchez-Martín, Julio; Sopeña, Bernardo; Tío, Laura; Unzurrunzaga, Ainhoa; Gough, Andrew; Isaacs, John D.; Green, Michael; McHugh, Neil J.; Hordon, Lesley; Kamath, Sanjeet; Nisar, Mohammed; Patel, Yusuf; Yee, Cee Seng; Stevens, Robert; Nandi, Pradip; Nandagudi, Anupama; Jarrett, Stephen; Li, Charles; Levy, Sarah; Mollan, Susan; Salih, Abdel; Wordsworth, Oliver; Sanders, Emma; Roads, Esme; Gill, Anne; Carr, Lisa; Routledge, Christine; Culfear, Karen; Nugaliyadde, Asanka; James, Lynne; Spimpolo, Jenny; Kempa, Andy; Mackenzie, Felicity; Fong, Rosanna; Peters, Genessa; Rowbotham, Bridie; Masqood, Zahira; Hollywood, Jane; Gondo, Prisca; Wood, Rose; Martin, Steve; Rashid, Lubna Haroon; Robinson, James I.; Morgan, Mike; Sorensen, Louise; Taylor, John C.; Carette, Simon; Chung, Sharon; Cuthbertson, David; Forbess, Lindsy J.; Gewurz-Singer, Ora; Hoffman, Gary S.; Koening, Curry L.; Maksimowicz-McKinnon, Kathleen M.; McAlear, Carol A.; Moreland, Larry W.; Pagnoux, Christian; Seo, Philip; Specks, Ulrich; Spiera, Robert F.; Sreih, Antoine G.; Warrington, Kenneth J.; Weisman, Michael H; Barrett, Jennifer H.; Cid, María C.; Salvarani, Carlo; Merkel, Peter A.; Morgan, Ann W.; González-Gay, Miguel A.; Martín, Javier

2017-01-01

Giant cell arteritis (GCA) is the most common form of vasculitis in individuals older than 50 years in Western countries. To shed light onto the genetic background influencing susceptibility for GCA, we performed a genome-wide association screening in a well-powered study cohort. After imputation,

Giant Cell Arteritis in a 12-Year-Old Girl Presenting with Nephrotic Syndrome

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Zeinab A. El-Sayed

2014-01-01

Full Text Available Giant cell arteritis (GCA is rare in children. The kidneys are generally spared. We present a case of GCA in a 12-year-old girl with severe headache and tender scalp especially over the right temporal area. The right superficial temporal artery was cord like and nodular and the pulsations were barely felt. Several small tender nodular swellings were felt in the occipital area. She had been previously diagnosed as a case of nephrotic syndrome due to underlying membranoproliferative glomerulonephritis. This report is aimed at drawing attention to this rare form of vasculitis in children aiming at decreasing its morbidities.

Increased angiotensin II type 1 receptor expression in temporal arteries from patients with giant cell arteritis

DEFF Research Database (Denmark)

Dimitrijevic, Ivan; Malmsjö, Malin; Andersson, Christina

2009-01-01

PURPOSE: Currently, giant cell arteritis (GCA) is primarily treated with corticosteroids or immunomodulating agents, but there is interest in identifying other noncorticosteroid alternatives. Similarities exist in the injury pathways between GCA and atherosclerosis. Angiotensin II is a vasoactive......, internal elastic lamina degeneration, and band-shaped infiltrates of inflammatory cells, including lymphocytes, histocytes, and multinucleated giant cells. AT(1) receptor staining was primarily observed in the medial layer of the temporal arteries and was higher in the patients with GCA than in the control...

Angiographic features of 26 children with Takayasu's arteritis

International Nuclear Information System (INIS)

McCulloch, M.; Goddard, E.; Sinclair, P.; Andronikou, S.; Mandelstam, S.; Beningfield, S.J.; Lawrenson, J.; Millar, A.J.W.

2003-01-01

Background: Takayasu's arteritis (TA) is a chronic idiopathic inflammatory disease affecting primarily the aorta, its proximal branches and the pulmonary arteries Objectives: To retrospectively review the angiograms of children with TA so as to describe the patterns of vascular involvement. Patients and methods: Twenty-six children with TA who differed from most other studies in that almost all of them presented with hypertension, reflecting the incidence of abdominal aortic and renal artery involvement. Results: The most consistent finding was stenosis of the aorta. Marginal irregularity/undulation of the aorta was also a useful angiographic diagnostic feature in subtle disease. The incidence of aneurysms was high compared to other studies and both fusiform and saccular aneurysms were encountered. Percutaneous transluminal angioplasty (PTA) was successful in all eight patients in whom it was performed. MRI, CT angiography and US are discussed as less invasive imaging alternatives. TA is a significant cause of renovascular hypertension in children in South Africa where there is a high incidence of tuberculous infection. Knowledge of the angiographic features and pattern of aortic involvement is essential for diagnosis and initiation of early and appropriate treatment, including PTA. (orig.)

EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria

DEFF Research Database (Denmark)

Ozen, Seza; Pistorio, Angela; Iusan, Silvia M

2010-01-01

To validate the previously proposed classification criteria for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA)....

Comportamento da musculatura das arteríolas intra-hepáticas na forma hepatesplênica da esquistossomose mansônica

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Maria do Socorro Almeida Barbosa

1988-03-01

Full Text Available A determinação da relação parede-lume das arteríolas intra-hepáticas, na esquistossomose mansônica (forma hepatesplênica, demonstra a existência de uma hipotrofia da camada muscular daqueles vasos. Esse achado sugere redução do fluxo sangüíneo arterial hepático nessa entidade.

Augmented TLR2 Expression on Monocytes in both Human Kawasaki Disease and a Mouse Model of Coronary Arteritis

OpenAIRE

Lin, I-Chun; Kuo, Ho-Chang; Lin, Ying-Jui; Wang, Feng-Shen; Wang, Lin; Huang, Shun-Chen; Chien, Shao-Ju; Huang, Chien-Fu; Wang, Chih-Lu; Yu, Hong-Ren; Chen, Rong-Fu; Yang, Kuender D.

2012-01-01

BACKGROUND: Kawasaki disease (KD) of unknown immunopathogenesis is an acute febrile systemic vasculitis and the leading cause of acquired heart diseases in childhood. To search for a better strategy for the prevention and treatment of KD, this study compared and validated human KD immunopathogenesis in a mouse model of Lactobacillus casei cell wall extract (LCWE)-induced coronary arteritis. METHODS: Recruited subjects fulfilled the criteria of KD and were admitted for intravenous gamma globul...

Subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent

Energy Technology Data Exchange (ETDEWEB)

Maskovic, J.; Jankovic, S.; Lusic, I.; Cambj-Sapunar, L.; Mimica, Z.; Bacic, A

1999-09-01

A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I Takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results.

Subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent

International Nuclear Information System (INIS)

Maskovic, J.; Jankovic, S.; Lusic, I.; Cambj-Sapunar, L.; Mimica, Z.; Bacic, A.

1999-01-01

A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I Takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results

Giant-cell Arteritis of the Ovarian Arteries: A Rare Manifestation of a Common Disease

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Prisca Theunissen

2018-02-01

Full Text Available We describe a 58-year-old woman presenting with headache and an elevated erythrocyte sedimentation rate (ESR, who was diagnosed with and successfully treated for giant-cell arteritis (GCA. Seven months after the end of treatment, ovarian GCA was incidentally found after ovariectomy for a simple cyst. GCA of extracranial vessels like the ovarian arteries is rare. Nevertheless, we stress that extracranial GCA should be considered in patients older than 50 years with an elevated ESR, even if a temporal artery biopsy is negative or specific symptoms are absent. Moreover, we discuss the importance of imaging techniques when GCA of the extracranial large vessels is suspected.

Simultaneous Presentation of Giant Cell Arteritis and Myelodysplastic Syndrome in an Elderly Japanese Man.

Science.gov (United States)

Senjo, Hajime; Higuchi, Takakazu; Morimoto, Masaya; Koyamada, Ryosuke; Yanaoka, Chisun; Okada, Sadamu

2018-05-18

An 81-year-old Japanese man presented with constitutional symptoms and anemia and was diagnosed with giant cell arteritis (GCA) and myelodysplastic syndrome (MDS) simultaneously. His symptoms and anemia improved promptly with steroids; however, the MDS rapidly progressed to overt leukemia. While MDS patients are at an increased risk of autoimmune diseases, an association with GCA has rarely been reported. This case illustrates the importance of considering GCA as a cause of anemia in elderly patients if MDS is already diagnosed, even in countries where the prevalence of GCA is very low. The simultaneous development of GCA and MDS suggests a common pathogenetic link between these two diseases.

Repeat Operation for Pseudoaneurysm of Left Ventricular Outflow in a Patient with Concomitant Takayasu’s Arteritis and Marfan Syndrome

OpenAIRE

Yamashiro, Satoshi; Kuniyoshi, Yukio; Arakaki, Katsuya; Nagano, Takaaki; Kise, Yuya

2011-01-01

We describe concomitant Marfan syndrome and Takayasu’s arteritis complicating a pseudoaneurysm of the left ventricular outflow that developed after aortic root reconstruction. A patient was admitted with a high fever four months after initial root reconstruction that included valve sparing (reimplantation) as well as coronary artery reconstruction using a Carrel’s button technique. Computed tomography revealed a pseudoaneurysm at the posterior side of the aortic root. We applie...

THE CASE OF THE GIANT-CELL ARTERITIS MANIFESTED AS DORSOLATERAL MEDULLARY INFARCTION

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V. S. Akimov

2014-01-01

Full Text Available The case of a giant-cell arteritis is presented. First clinical signs of the disease were fewer and development of infarction in the basin of the left vertebral artery. Magnetic resonance angiography showed its prolonged diminution. Laboratory results were remarkable for the high rate of erythrocyte sedimentation and the increase of C-reactive protein (CRP concentration. Physical examination revealed acrotism in temporal arteries. Diagnosis was proven by biopsy results which included giant multinucleate cells. Authors discuss problems of diagnosis of the disease, the role of radiological methods (angio-ultrasonography, magnetic resonance and computed tomography aided angiography, positron-emission tomography and the necessity to pay particular attention to the elderly patients with high rate of erythrocyte sedimentation and the increased CRP concentration.

IgG4-related tubulointerstitial nephritis with plasma cell-rich renal arteritis.

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Sharma, Shree G; Vlase, Horia L; D'Agati, Vivette D

2013-04-01

Immunoglobulin G4 (IgG4)-related tubulointerstitial nephritis is a newly recognized clinicopathologic entity that may occur as an isolated renal lesion or as part of a multisystem disorder. It is characterized by plasma cell-rich interstitial nephritis with abundant IgG4-positive plasma cells and IgG-dominant tubulointerstitial immune deposits. We report the first case of IgG4-related tubulointerstitial nephritis with multifocal plasma cell-rich renal arteritis presenting as acute kidney injury in a 72-year-old man. Seven weeks of prednisone therapy led to nearly complete recovery of kidney function. This case enlarges the morphologic spectrum of this disorder and emphasizes the need to distinguish it from other causes of renal vasculitis. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

227. Arteritis de takayasu y síndrome cardiovocal (síndrome de ortner

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A. Ferreiro

2012-04-01

Resultados y conclusiones: Tras la realización de ventana pericárdica se confirma la presencia de pericarditis aguda serofibrinosa no infecciosa. La paciente fue diagnosticada de arteritis de Takayasu (cumpliendo 4 criterios mayores del American College of Rheumatology, con respuesta clínica y angiográfica favorable a corticoterapia y metotrexato. En 2011 se evidencia progresión de la insuficiencia aórtica hasta hacerse grave, realizándose cirugía de sustitución valvular. La variabilidad clínica en la forma de presentación de las vasculitis hace necesario un riguroso análisis, individualizado y sistemático, tanto en su diagnóstico como en su seguimiento.

CD8+ T Cells Contribute to the Development of Coronary Arteritis in the Lactobacillus casei Cell Wall Extract-Induced Murine Model of Kawasaki Disease.

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Noval Rivas, Magali; Lee, Youngho; Wakita, Daiko; Chiba, Norika; Dagvadorj, Jargalsaikhan; Shimada, Kenichi; Chen, Shuang; Fishbein, Michael C; Lehman, Thomas J A; Crother, Timothy R; Arditi, Moshe

2017-02-01

Kawasaki disease (KD) is the leading cause of acquired heart disease among children in developed countries. Coronary lesions in KD in humans are characterized by an increased presence of infiltrating CD3+ T cells; however, the specific contributions of the different T cell subpopulations in coronary arteritis development remain unknown. Therefore, we sought to investigate the function of CD4+ and CD8+ T cells, Treg cells, and natural killer (NK) T cells in the pathogenesis of KD. We addressed the function of T cell subsets in KD development by using a well-established murine model of Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis. We determined which T cell subsets were required for development of KD vasculitis by using several knockout murine strains and depleting monoclonal antibodies. LCWE-injected mice developed coronary lesions characterized by the presence of inflammatory cell infiltrates. Frequently, this chronic inflammation resulted in complete occlusion of the coronary arteries due to luminal myofibroblast proliferation (LMP) as well as the development of coronary arteritis and aortitis. We found that CD8+ T cells, but not CD4+ T cells, NK T cells, or Treg cells, were required for development of KD vasculitis. The LCWE-induced murine model of KD vasculitis mimics many histologic features of the disease in humans, such as the presence of CD8+ T cells and LMP in coronary artery lesions as well as epicardial coronary arteritis. Moreover, CD8+ T cells functionally contribute to the development of KD vasculitis in this murine model. Therapeutic strategies targeting infiltrating CD8+ T cells might be useful in the management of KD in humans. © 2016, American College of Rheumatology.

Polymyalgia rheumatica and giant cell arteritis-three challenges-consequences of the vasculitis process, osteoporosis, and malignancy

DEFF Research Database (Denmark)

Emamifar, Amir; Hess, Søren; Gerke, Oke

2017-01-01

INTRODUCTION: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common inflammatory conditions. The diagnosis of PMR/GCA poses many challenges since there are no specific diagnostic tests. Recent literature emphasizes the ability of 18F-fluorodeoxyglucose positron emission tomography...... of clinical picture of PMR/GCA with PET findings; the validity of 18F-FDG PET/CT scan for diagnosis of PMR/GCA compared with temporal artery biopsy; the prevalence of newly diagnosed malignancies in patients with PMR/GCA, or PMR-like syndrome, with the focus on diagnostic accuracy of 18F-FDG PET/CT scan...

Remission Achieved in Refractory Advanced Takayasu Arteritis Using Rituximab

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D. Ernst

2012-01-01

Full Text Available A 25-year-old patient was referred due to subclavian stenosis, identified on echocardiography. She presented with exertional dizziness and dyspnoea. Questioning revealed bilateral arm claudication. Examination demonstrated an absent right ulnar pulse and asymmetrical brachial blood pressure. Bruits were evident over both common carotid arteries. Doppler ultrasound and MRI angiograms revealed occlusion or stenosis in multiple large arteries. Takayasu arteritis (TA was diagnosed and induction therapy commenced: 1 mg/kg oral prednisolone and 500 mg/m2 intravenous cyclophosphamide (CYC. Attempts to reduce prednisolone below 15 mg/d proved impossible due to recurring disease activity. Adjuvant azathioprine 100 mg/d was subsequently added. Several weeks later, the patient was admitted with a left homonymous hemianopia. The culprit lesion in the right carotid artery was surgically managed and the patient discharged on azathioprine 150 mg/d and prednisolone 30 mg/d. Despite this, deteriorating exertional dyspnoea and angina pectoris were reported. Reimaging confirmed new stenosis in the right pulmonary artery. Surgical treatment proved infeasible. Given evidence of refractory disease activity on maximal standard therapy, we initiated rituximab, based on recently reported B-cell activity in TA.

Tertiary Lymphoid Organs in Takayasu Arteritis.

Science.gov (United States)

Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

2016-01-01

The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from the adventitial layer of one patient were characterized by flow cytometry. Demographic, medical history, laboratory, imaging, treatment, and follow-up data were extracted from medical records. Aorta specimens from Bentall procedures were available from seven patients (5 females, aged 22-57 years) with TA. Surgical treatment was performed at TA diagnosis (n = 4) or at a median of 108 months (84-156) after TA diagnosis. Disease was active at surgery in four patients according to NIH score. B cell aggregates-TLOs containing HEVs were observed in the adventitia of all but one patient. Of note, ectopic follicles containing CD21(+) FDCs were found in all patients (4/4) with increased aortic (18)F-fluoro-deoxyglucose (FDG) uptake before surgery but were absent in all but one patients (2/3) with no FDG uptake. In addition, flow cytometry analysis confirmed the accumulation of memory/germinal center-like B cells in the adventitial layer and showed the presence of antigen-experienced T follicular helper cells. Ectopic lymphoid neogenesis displaying functional features can be found in the aortic wall of a subset of patients with active TA. The function of these local B cell clusters on the pathogenesis of TA remains to be elucidated.

The endocannabinoid system in canine Steroid-Responsive Meningitis-Arteritis and Intraspinal Spirocercosis.

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Jessica Freundt-Revilla

Full Text Available Endocannabinoids (ECs are involved in immunomodulation, neuroprotection and control of inflammation in the central nervous system (CNS. Activation of cannabinoid type 2 receptors (CB2 is known to diminish the release of pro-inflammatory factors and enhance the secretion of anti-inflammatory cytokines. Furthermore, the endocannabinoid 2-arachidonoyl glycerol (2-AG has been proved to induce the migration of eosinophils in a CB2 receptor-dependent manner in peripheral blood and activate neutrophils independent of CB activation in humans. The aim of the current study was to investigate the influence of the endocannabinoid system in two different CNS inflammatory diseases of the dog, i.e. Steroid-Responsive Meningitis-Arteritis (SRMA and Intraspinal Spirocercosis (IS. The two main endocannabinoids, anandamide (AEA and 2-AG, were quantified by mass spectrometry in CSF and serum samples of dogs affected with Steroid- Responsive Meningitis-Arteritis in the acute phase (SRMA A, SRMA under treatment with prednisolone (SRMA Tr, intraspinal Spirocercosis and healthy dogs. Moreover, expression of the CB2 receptor was evaluated in inflammatory lesions of SRMA and IS and compared to healthy controls using immunohistochemistry (IHC. Dogs with SRMA A showed significantly higher concentrations of total AG and AEA in serum in comparison to healthy controls and in CSF compared to SRMA Tr (p<0.05. Furthermore, dogs with IS displayed the highest ECs concentrations in CSF, being significantly higher than in CSF samples of dogs with SRMA A (p<0.05. CSF samples that demonstrated an eosinophilic pleocytosis had the highest levels of ECs, exceeding those with neutrophilic pleocytosis, suggesting that ECs have a major effect on migration of eosinophils in the CSF. Furthermore, CB2 receptor expression was found in glial cells in the spinal cord of healthy dogs, whereas in dogs with SRMA and IS, CB2 was strongly expressed not only in glial cells but also on the cellular

The endocannabinoid system in canine Steroid-Responsive Meningitis-Arteritis and Intraspinal Spirocercosis.

Science.gov (United States)

Freundt-Revilla, Jessica; Heinrich, Franciska; Zoerner, Alexander; Gesell, Felix; Beyerbach, Martin; Shamir, Merav; Oevermann, Anna; Baumgärtner, Wolfgang; Tipold, Andrea

2018-01-01

Endocannabinoids (ECs) are involved in immunomodulation, neuroprotection and control of inflammation in the central nervous system (CNS). Activation of cannabinoid type 2 receptors (CB2) is known to diminish the release of pro-inflammatory factors and enhance the secretion of anti-inflammatory cytokines. Furthermore, the endocannabinoid 2-arachidonoyl glycerol (2-AG) has been proved to induce the migration of eosinophils in a CB2 receptor-dependent manner in peripheral blood and activate neutrophils independent of CB activation in humans. The aim of the current study was to investigate the influence of the endocannabinoid system in two different CNS inflammatory diseases of the dog, i.e. Steroid-Responsive Meningitis-Arteritis (SRMA) and Intraspinal Spirocercosis (IS). The two main endocannabinoids, anandamide (AEA) and 2-AG, were quantified by mass spectrometry in CSF and serum samples of dogs affected with Steroid- Responsive Meningitis-Arteritis in the acute phase (SRMA A), SRMA under treatment with prednisolone (SRMA Tr), intraspinal Spirocercosis and healthy dogs. Moreover, expression of the CB2 receptor was evaluated in inflammatory lesions of SRMA and IS and compared to healthy controls using immunohistochemistry (IHC). Dogs with SRMA A showed significantly higher concentrations of total AG and AEA in serum in comparison to healthy controls and in CSF compared to SRMA Tr (p<0.05). Furthermore, dogs with IS displayed the highest ECs concentrations in CSF, being significantly higher than in CSF samples of dogs with SRMA A (p<0.05). CSF samples that demonstrated an eosinophilic pleocytosis had the highest levels of ECs, exceeding those with neutrophilic pleocytosis, suggesting that ECs have a major effect on migration of eosinophils in the CSF. Furthermore, CB2 receptor expression was found in glial cells in the spinal cord of healthy dogs, whereas in dogs with SRMA and IS, CB2 was strongly expressed not only in glial cells but also on the cellular surface of

Severe Corticosteroid-Induced Ocular Hypertension Requiring Bilateral Trabeculectomies in a Patient with Takayasu’s Arteritis

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Anna Maria Gruener

2016-01-01

Full Text Available We present a rare case of severe corticosteroid-induced ocular hypertension (OHT after prolonged systemic corticosteroid use in a young woman with Takayasu’s arteritis. As she did not sufficiently respond to ocular antihypertensive therapies, bilateral enhanced trabeculectomies were required to normalize her intraocular pressures. The systemic side effects of corticosteroids are well known, yet steroid-induced OHT and glaucoma remain silent causes of ocular morbidity. This case highlights the importance of IOP-monitoring in visually asymptomatic patients on systemic corticosteroids. It further emphasizes the need to raise awareness of the potential ocular side effects of steroids amongst physicians, in particular those looking after patients with autoimmune and inflammatory diseases.

Tertiary lymphoid organs in Takayasu Arteritis

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Marc eClement

2016-04-01

Full Text Available Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20, follicular dendritic cells (FDCs, CD21, and high endothelial venules (HEVs, PNAd was investigated by immunohistochemistry. Immune cells from the adventitial layer of one patient were characterized by flow cytometry. Demographic, medical history, laboratory, imaging, treatment and follow up data were extracted from medical records.Results: Aorta specimens from Bentall procedures were available from 7 patients (five female, aged 22 to 57 years with TA. Surgical treatment was performed at TA diagnosis (n=4 or at a median of 108 months [84-156] after TA diagnosis. Disease was active at surgery in four patients according to NIH score. B cell aggregates-TLOs containing HEVs were observed in the adventitia of all but one patient.. Of note, ectopic follicles containing CD21+ FDCs were found in all patients (4/4 with increased aortic FDG uptake before surgery but were absent in all but one patients (2/3 with no FDG uptake. In addition, flow cytometry analysis confirmed the accumulation of memory/germinal center–like B cells in the adventitial layer and showed the presence of antigen-experienced T follicular helper cells.Conclusion: Ectopic lymphoid neogenesis displaying functional features can be found in the aortic wall of a subset of patients with active TA. The function of these local B cell clusters on the pathogenesis of TA remains to be elucidated.

The use of the color Doppler ultrasonography in the diagnosis and monitoring of an atypical case of giant-cell arteritis

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Nádia Martins

2016-04-01

Full Text Available Giant Cell Arteritis (GCA is a large vessels vasculitis that is typically characterised by headache, scalp tenderness, jaw claudication and visual disturbances. Temporal arteries color Doppler ultrasonography (CDUS is a sensitive and non-invasive image technique used in the diagnosis of this disease. This work highlights the importance of CDUS in the diagnostic workup of GCA and also demonstrates it´s usefullness in the evaluation and documentation of the response to corticosteroids therapy in an atypical case of ACG.

The use of the color Doppler ultrasonography in the diagnosis and monitoring of an atypical case of giant-cell arteritis.

Science.gov (United States)

Martins, N; Polido-Pereira, J; Rodrigues, A M; Soares, F; Batista, P; Pereira da Silva, J A

2016-01-01

Giant Cell Arteritis (GCA) is a large vessels vasculitis that is typically characterised by headache, scalp tenderness, jaw claudication and visual disturbances. Temporal arteries color Doppler ultrasonography (CDUS) is a sensitive and non-invasive image technique used in the diagnosis of this disease. This work highlights the importance of CDUS in the diagnostic workup of GCA and also demonstrates it´s usefullness in the evaluation and documentation of the response to corticosteroids therapy in an atypical case of ACG.

Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion

Energy Technology Data Exchange (ETDEWEB)

Nam, Se Jin; Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2014-10-15

We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings.

Chimeric viruses containing the N-terminal ectodomains of GP5 and M proteins of porcine reproductive and respiratory syndrome do not change the cellular tropism of equine arteritis virus

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Equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV) are members of family Arteriviridae; they share many biological properties but differ significantly in cellular tropism. Using an infectious cDNA clone of EAV, we engineered a panel of six chimeric viruses b...

ELA-DRA polymorphisms are not associated with Equine Arteritis Virus infection in horses from Argentina.

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Kalemkerian, P B; Metz, G E; Peral-Garcia, P; Echeverria, M G; Giovambattista, G; Díaz, S

2012-12-01

Polymorphisms at Major Histocompatibility Complex (MHC) genes have been associated with resistance/susceptibility to infectious diseases in domestic animals. The aim of this investigation was to evaluate whether polymorphisms of the DRA gene the Equine Lymphocyte Antigen is associated with susceptibility to Equine Arteritis Virus (EAV) infection in horses in Argentina. The equine DRA gene was screened for polymorphisms using Pyrosequencing® Technology which allowed the detection of three ELA-DRA exon 2 alleles. Neither allele frequencies nor genotypic differentiation exhibited any statistically significant (P-values=0.788 and 0.745) differences between the EAV-infected and no-infected horses. Fisher's exact test and OR calculations did not show any significant association. As a consequence, no association could be established between the serological condition and ELA-DRA. Copyright © 2012 Elsevier Ltd. All rights reserved.

Risk factors and long-term changes of non-arteritis anterior ischaemic optic neuropathy

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Ying-Xin Cui

2016-01-01

Full Text Available AIM:To investigate the risk factors and long-term changes of non-arteritis anterior ischaemic optic neuropathy(NAION. METHODS:Three hundred and sixty cases of patients with NAION in our hospital from January 2010 to Juny 2015 were used as patients group and another 400 people undergoing health examination were used as control group. The clinical data was collected. Optical coherence tomography(OCTwas performed. RESULTS:There were significant difference on gender, history of diabetes or hypertension, arteriosclerosis history, disc area, cup area, rim area, cup/disc area ratio, horizontal cup-disc ratio, vertical cup-disc ratio, FBG and TG of two groups(PPP>0.05. CONCLUSION:Male, with diabetes, history of hypertension, arteriosclerosis history, disc area, cup area, rim area, cup/disc area ratio, horizontal cup-disc ratio, vertical cup-disc ratio, FBG and TG are independent risk factors of NAION. Long-term damage of RNFL may not aggravate.

Lymphocytic Arteritis in Epstein-Barr Virus Vulvar Ulceration (Lipschütz Disease): A Report of 7 Cases.

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Barrett, Mary M; Sangüeza, Martin; Werner, Betina; Kutzner, Heinz; Carlson, John A

2015-09-01

Epstein-Barr virus (EBV) infection can rarely present as painful genital ulcers, mostly in young female adolescents. Typically diagnosed by clinical findings, EBV vulvar ulceration (EBVVU) is rarely biopsied. Herein, the authors report the histopathology in 8 biopsies from 7 EBVVU patients, all serologically confirmed for acute (4/7) or reactivated-chronic (3/7) EBV infection. The 7 women all presented with 1 or more painful, punched-out vulvar ulcers. Only patients with acute EBV infection showed other clinical findings: fever and/or atypical lymphocytosis affected 75% (3/4); lymphadenopathy in 50%; and malaise/fatigue, dysuria and/or hepatomegaly in 25%. All reactivated-chronic EBVVU had a solitary ulcer, and 2 had history of a similar episode of vulvar ulceration (aphthosis). Histopathologically, lymphocytic arteritis was identified in 88% (7/8); a submucosal scar was found in the eighth specimen. Other histopathologies included venulitis (62%), endarteritis obliterans (38%), thrombosis (25%), neutrophilic sebaceous adenitis (25%), and mucosal lymphoid hyperplasia (12%). Dense angiocentric CD3 CD4 T-cell lymphocyte-predominant infiltrates were found, regionally or diffusely. In 2 specimens, neutrophils compromised half of the infiltrate. Minor components of CD8, CD20, and CD30 lymphocytes, CD123 plasmacytoid monocytes, CD68 macrophages, and plasma cells were present. Small-vessel endothelium and smooth muscle adjacent to the ulcers faintly expressed cytoplasmic EBV latent membrane protein-1 (LMP1). In situ hybridization for early EBV mRNA (EBER) identified rare solitary or scattered clustered positive lymphocytes in 38%. Polymerase chain reaction for EBV DNA was positive in one EBER positive biopsy. EBV infection has been documented in muscular vessel vasculitis. Based on the aforementioned, EBVVU appears to be the consequence of localized lymphocytic arteritis.

Giant cell arteritis. Part I. Terminology, classification, clinical manifestations, diagnosis

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Azamat Makhmudovich Satybaldyev

2012-01-01

Full Text Available Giant cell arteritis (GCA is a vasculitis affecting mainly large and medium-sized arteries, which the classification of systemic vasculitides refers to as those mainly involving the large vessels. GCA is typified by the involvement of extracranial aortic branches and intracranial vessels, the aorta and its large vessels are being affected most frequently. The paper considers the terminology, classification, prevalence, major pathogenic mechanisms, and morphology of GCA. A broad spectrum of its clinical subtypes is due to target vessel stenosis caused by intimal hyperplasia. In 40% of cases, GCA is shown to be accompanied by polymyalgia rheumatica that may either precede or manifest simultaneously with GCA, or follow this disease. The menacing complications of GCA may be visual loss or ischemic strokes at various sites depending on the location of the occluded vessel. Along with the gold standard verification of the diagnosis of GCA, namely temporal artery biopsy, the author indicates other (noninvasive methods for detection of vascular lesions: color Doppler ultrasonography of the temporal arteries, fluorescein angiography of the retina, mag-netic resonance angiography, magnetic resonance imaging, and computed tomography to rule out aortic aneurysm. Dynamic 18F positron emission tomography is demonstrated to play a role in the evaluation of therapeutic effectiveness.

Equine arteritis virus is delivered to an acidic compartment of host cells via clathrin-dependent endocytosis

International Nuclear Information System (INIS)

Nitschke, Matthias; Korte, Thomas; Tielesch, Claudia; Ter-Avetisyan, Gohar; Tuennemann, Gisela; Cardoso, M. Cristina; Veit, Michael; Herrmann, Andreas

2008-01-01

Equine arteritis virus (EAV) is an enveloped, positive-stranded RNA virus belonging to the family Arteriviridae. Infection by EAV requires the release of the viral genome by fusion with the respective target membrane of the host cell. We have investigated the entry pathway of EAV into Baby Hamster Kindey cells (BHK). Infection of cells assessed by the plaque reduction assay was strongly inhibited by substances which interfere with clathrin-dependent endocytosis and by lysosomotropic compounds. Furthermore, infection of BHK cells was suppressed when clathrin-dependent endocytosis was inhibited by expression of antisense RNA of the clathrin-heavy chain before infection. These results strongly suggest that EAV is taken up via clathrin-dependent endocytosis and is delivered to acidic endosomal compartments

Serum Bilirubin Concentrations in Patients With Takayasu Arteritis.

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Peng, You-Fan; Deng, Yi-Bin

2017-06-01

- Bilirubin has strong anti-inflammatory and antioxidative stress action. Progression of inflammation involving arteries is a crucial activator in pathogenesis of Takayasu arteritis (TA). - To investigate the relationship between serum bilirubin and TA. - Our study involved 115 consecutive TA patients. Patients with active-phase disease were followed and received prednisone therapy. - Lower concentrations of serum bilirubin were detected in TA patients compared with healthy subjects (0.6 ± 0.31 versus 0.7 ± 0.22 mg/dL, P = .02). Serum bilirubin concentrations in active TA patients were lower than those in inactive patients (0.5 ± 0.20 versus 0.8 ± 0.32 mg/dL, P bilirubin correlated positively with total protein (r = 0.193, P = .04) and negatively with C-reactive protein and erythrocyte sedimentation rate (r = -0.213, P = .03, and r = -0.532, P bilirubin was associated with a 1.10 times increase in the odds for TA compared with the controls (odds ratio = 0.913, 95% CI, 0.856-0.974; P = .006). Serum bilirubin was correlated with erythrocyte sedimentation rate (β = -0.170, P bilirubin in predicting active TA patients was 0.802. Serum bilirubin levels were found to be significantly increased after prednisone treatment (0.5 ± 0.20 versus 0.7 ± 0.15 mg/dL, P = .002). - Lower serum bilirubin levels are associated with TA, and serum bilirubin may be influenced by prednisone therapy in active TA patients. Serum bilirubin levels in TA patients correlate negatively with erythrocyte sedimentation rate.

Giant Cell Arteritis of the Female Genital Tract With Occult Temporal Arteritis and Marginal Zone Lymphoma Harboring Novel 20q Deletion: A Case Report and Literature Review.

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Pradhan, Dinesh; Amin, Rajnikant M; Jones, Miroslawa W; Surti, Urvashi; Parwani, Anil V

2016-02-01

Giant cell arteritis (GCA) is an immunologically mediated vasculitis of large and medium-sized vessels, typically affecting the cranial arteries and usually occurring in the elderly. GCA of the female genital tract is extremely rare with only 31 cases reported in the English literature. An 83-year-old white female with postmenopausal vaginal bleeding revealed an endometrial polyp on pelvic ultrasonography following which polypectomy and subsequently hysterectomy with bilateral salpingo-oophorectomy was done. Microscopy revealed a well-differentiated endometrioid adenocarcinoma. Interestingly, classic GCA involving numerous small to medium-sized arteries of the cervix, myometrium, bilateral fallopian tubes, and ovaries was also identified. Hematologic evaluation revealed marginal zone lymphoma with an exceptionally rare 20q deletion. Bilateral temporal artery biopsy was done subsequently, which exhibited GCA on microscopy. Corticosteroid was started that improved her polymyalgia rheumatica symptoms. The patient is on follow-up for 3 years and is doing well. To our knowledge, this is the first case of GCA of the female genital tract associated with a lymphoma and the second case of marginal zone lymphoma with the novel 20q deletion. © The Author(s) 2015.

Third cranial nerve palsy (ptosis, diplopia accompanied by orbital swelling: case report of unusual clinical presentation of giant cell arteritis associated with polymyalgia rheumatica

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Prassede Bravi

2012-12-01

Full Text Available IntroductionGiant cell arteritis (GCA is the most common systemic vasculitis in older individuals, characterized by granulomatosus inflammation of the wall of large and medium-sized arteries. The wide spectrum of arterial sites involved leads to ischemia of different organs resulting in a wide range of clinical signs and symptoms. Temporal artery is commonly involved (temporal arteritis. Unusual patterns of presentation, such as extraocular motility disorders and orbital swelling, may be early and transient manifestations of GCA and precede the permanent visual loss due to ischemic optic neuropathy.Case reportWe describe a patient with uncommon manifestations of GCA consisting of transient recurrent diplopia, ptosis, orbital swelling together with more typical clinical features of the disease such as musculoskeletal manifestations (polymyalgia rheumatica and facial pain: all signs and symptoms promptly resolved under corticosteroid therapy without relapse.Conclusions A high level of suspicion of GCA in individuals over the age of 50 years is needed to prevent the development of severe complications. Clinicians should be aware of uncommon manifestations of the disease such as head–neck swelling and ophthalmoplegia: management guidelines have stated that prompt administration of adequate dose of corticosteroids as soon as ocular manifestations of GCA are noted may almost totally prevent blindness.

Comportamento da musculatura das arteríolas intra-hepáticas na forma hepatesplênica da esquistossomose mansônica

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Maria do Socorro Almeida Barbosa

1988-03-01

Full Text Available A determinação da relação parede-lume das arteríolas intra-hepáticas, na esquistossomose mansônica (forma hepatesplênica, demonstra a existência de uma hipotrofia da camada muscular daqueles vasos. Esse achado sugere redução do fluxo sangüíneo arterial hepático nessa entidade.The determination of the wall-to-lumen ratio of hepatic arterioles in hepatosplenic schistosomiasis shows atrophy of the muscular layer of those vessels. This finding suggests a reduction of hepatic arterial flow as reported by others.

Retrobulbar blood flow and visual organ function disturbance in the course of giant cell arteritis coexisting with optic disc drusen – a case repor

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Monika Modrzejewska

2013-09-01

Full Text Available The review presented ophthalmologic syndrome connected with visual organ function disorder in giant cell arteritis patient concomitant with optic nerve disc drusen. Diagnostic difficulties were shown in relation to incidence of both similar ophthalmic symptoms as well as interpretation of specialists examinations results (pattern visual evoked potential test, scanning laser polarimetry, and perimetric tests – kinetic and static. Apart from ophthalmic investigations, significant role of radiological examinations was considered, especially color Doppler ultrasonography of retrobulbar circulation – optic artery, central retinal artery, long posterior ciliary arteries. Adequate interpretation of results seems to be crucial to establish scheme and timing of treatment in case of co-occurrence of the abovementioned disorders. In the presented case early implementation of steroid therapy resulted in improvement of blood flow parameters and the regression of ophthalmological complaints. Visual field deficiency in kinetic perimetry, reduced wave amplitude p100 in visual evoked potential test as well as decrease in number of optic nerve fibers in optic nerve disc region in scanning laser polarimetry exam can be diagnostic features in diagnosis of visual impairment in the course of giant cell arteritis and optic nerve disc drusen. Evaluation of blood flow velocity parameters in retrobulbar arteries in color Doppler ultrasonography is the most valuable screening in monitoring ophthalmic dysregulation in presented disorders.

Evaluation of neutralization patterns of the five unique Argentine equine arteritis virus field strains reported Evaluación de los patrones de neutralización de las únicas cinco cepas argentinas descritas de arteritis viral equina

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M. G. Echeverría

2010-02-01

Full Text Available Equine viral arteritis (EVA is a contagious viral disease that frequently causes mild or subclinical infections in adult horses. Only one EAV serotype has been described. However, there are differences in antigenicity, pathogenicity and neutralization characteristics of virus field strains. The interaction of two viral proteins, GP5 and M, is critical for infectivity and amino acid changes in the GP5 sequences have an effect on the neutralizing phenotype, regardless the effects of other viral proteins. The objective of the present study was to evaluate the neutralization phenotypes of the 5 unique Argentine EAV strains reported and to compare them with the neutralization phenotypes of the EAV-UCD reference strain, with special emphasis on the analysis of M and GP5 proteins. The strains had a similar neutralization phenotype pattern when anti-EAV serum, derived from EAV seropositive horses, was used in the analysis. Meanwhile, low titers were observed when equine polyclonal anti-EAV reference sera were used in the assay. Argentine strains have almost the same amino acid substitutions, with the exception of LP01 strain, that mainly involves the first variable region V1, especially in neutralization sites B and C. However, they are fairly different from the EAV-UCD strain. Nevertheless, the nucleotide and amino acid differences observed among the Argentine strains LP02/R, LP02/C, LP02/P and LP-LT-ARG did not show any variations in the neutralization phenotype.La arteritis viral equina (AVE ocasiona infecciones, en su mayoría subclínicas, pero puede causar abortos y enfermedad respiratoria. Si bien se ha descrito un solo serotipo de AVE, existen diferencias en cuanto a la antigenicidad, patogenicidad y patrones de neutralización en las cepas de campo. Los ORF5 y ORF6 del virus codifican las proteínas de envoltura GP5 y M; la interacción entre estas proteínas es crítica para la infectividad. Los cambios en las secuencias de aminoácidos en la

Serological survey for equine viral arteritis in several municipalities in the Orinoquia region of Colombia

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Agustín Góngora O.

2014-09-01

Full Text Available Objective. The goal of this study was to determine the current status of the Equine Arteritis virus (EAV in horse populations in the Orinoquia region of Colombia. Materials and methods. A transversal study was conducted by serological survey of equine (n=100 from 11 municipalities of the Colombian Orinoquia region. Serum samples were tested by virus seroneutralization assay according to the guidelines provided by the World Organization for Animal Health. Results. After testing was carried out no positives samples to EAV were found in the population analyzed. Conclusions. Although the sample size of the population screened in this study does not represent the total equine population size for the region or the country, data obtained has shown the absence of EAV infection in these animals. However, a wider study area including other regions of the country, with a feasible statistical design, would determine if this infection continues to be an exotic disease for Colombia.

Multivariable prediction model for suspected giant cell arteritis: development and validation

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Ing EB

2017-11-01

Full Text Available Edsel B Ing,1 Gabriela Lahaie Luna,2 Andrew Toren,3 Royce Ing,4 John J Chen,5 Nitika Arora,6 Nurhan Torun,7 Otana A Jakpor,8 J Alexander Fraser,9 Felix J Tyndel,10 Arun NE Sundaram,10 Xinyang Liu,11 Cindy TY Lam,1 Vivek Patel,12 Ezekiel Weis,13 David Jordan,14 Steven Gilberg,14 Christian Pagnoux,15 Martin ten Hove21Department of Ophthalmology and Vision Sciences, University of Toronto Medical School, Toronto, 2Department of Ophthalmology, Queen’s University, Kingston, ON, 3Department of Ophthalmology, University of Laval, Quebec, QC, 4Toronto Eyelid, Strabismus and Orbit Surgery Clinic, Toronto, ON, Canada; 5Mayo Clinic, Department of Ophthalmology and Neurology, 6Mayo Clinic, Department of Ophthalmology, Rochester, MN, 7Department of Surgery, Division of Ophthalmology, Harvard Medical School, Boston, MA, 8Harvard Medical School, Boston, MA, USA; 9Department of Clinical Neurological Sciences and Ophthalmology, Western University, London, 10Department of Medicine, University of Toronto Medical School, Toronto, ON, Canada; 11Department of Medicine, Fudan University Shanghai Medical College, Shanghai, People’s Republic of China; 12Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 13Departments of Ophthalmology, Universities of Alberta and Calgary, Edmonton and Calgary, AB, 14Department of Ophthalmology, University of Ottawa, Ottawa, ON, 15Vasculitis Clinic, Mount Sinai Hospital, Toronto, ON, CanadaPurpose: To develop and validate a diagnostic prediction model for patients with suspected giant cell arteritis (GCA.Methods: A retrospective review of records of consecutive adult patients undergoing temporal artery biopsy (TABx for suspected GCA was conducted at seven university centers. The pathologic diagnosis was considered the final diagnosis. The predictor variables were age, gender, new onset headache, clinical temporal artery abnormality, jaw claudication, ischemic vision loss (VL, diplopia

Mannose-binding lectin variant alleles and HLA-DR4 alleles are associated with giant cell arteritis

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Jacobsen, Soren; Baslund, Bo; Madsen, Hans O.

2002-01-01

/GCA, MBL variant alleles were associated with signs of increased inflammatory activity and clinical signs of arteritic manifestations. This was not found for HLA-DR4 alleles. These findings indicate that HLA-DR4 and MBL are contributing to the pathophysiology of GCA at different levels in the disease...... alleles in controls, patients with PMR only, and patients with GCA was 37, 32, and 53% (p = 0.01), respectively. HLA-DRB1*04 was found in 47% of patients with PMR only and in 54% of patients with GCA, which differed significantly from the 35% found in controls (p = 0.01). HLA-DR4 alleles were...... not associated with any clinical phenotypes of PMR/GCA, whereas MBL variant alleles were associated with cranial arteritis, high erythrocyte sedimentation rate, and low B-hemoglobin. CONCLUSION: We found MBL variant alleles and HLA-DR4 alleles to be weak susceptibility markers for GCA. In patients with PMR...

Polimiosite associada à arterite linfocítica do sistema nervoso central Polymyositis associated with lymphocytic arteritis of the central nervous system

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Izaias Pereira da Costa

2010-02-01

Full Text Available Complicações do Sistema Nervoso Central (SNC raramente são descritas em miopatias inflamatórias idiopáticas. Os autores relatam o caso de uma paciente de 48 anos com diagnóstico de polimiosite com autoanticorpo anti-Jo-1 positivo que, após cinco anos de evolução, apresentou extensa lesão desmielinizante do SNC associada à arterite linfocítica.Central Nervous System (CNS complications in idiopathic inflammatory myopathies are seldom reported. The authors describe the case of a 48-year old female with polymyositis and positive anti-Jo-1 autoantibody who, after five years of evolution, developed extensive CNS demyelinating injury associated with lymphocytic arteritis.

Lack of association between STAT4 gene polymorphism and biopsy-proven giant cell arteritis.

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Palomino-Morales, Rogelio; Vazquez-Rodriguez, Tomas R; Morado, Inmaculada C; Castañeda, Santos; Ortego-Centeno, Norberto; Miranda-Filloy, Jose A; Lamas, Jose R; Martin, Javier; Gonzalez-Gay, Miguel A

2009-05-01

To investigate the potential implication of the STAT4 gene polymorphism rs7574865 in the predisposition to or the clinical expression of giant cell arteritis (GCA). A total of 212 patients diagnosed with biopsy-proven GCA were studied. DNA from patients and controls matched by age, sex, and ethnicity was obtained from peripheral blood. Samples were genotyped for STAT4 rs7574865 polymorphism. No statistically significant differences in the allele frequencies for the STAT4 rs7574865 polymorphism were observed between patients and controls. Although we observed an increased frequency of the T/T genotype in GCA patients (6.0%) compared to healthy controls (3.9%), this difference did not achieve statistical significance (OR 1.57, 95% CI 0.72-3.41). No statistically significant differences in allele or genotype frequencies were observed when patients were stratified according to the presence of typical disease features such as polymyalgia rheumatica, severe ischemic manifestations, and visual ischemic complications in the setting of this vasculitis. Our results do not support a major role of the STAT4 rs7574865 gene polymorphism in susceptibility to or clinical manifestations of GCA.

Interleukin-6, vascular endothelial growth factor and transforming growth factor beta 1 in canine steroid responsive meningitis-arteritis

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Maiolini Arianna

2013-02-01

Full Text Available Abstract Background Steroid Responsive Meningitis-Arteritis (SRMA is a common cause of inflammation of the canine central nervous system (CNS. To investigate if transforming growth factor beta 1 (TGF-β1, interleukin-6 (IL-6 and vascular endothelial growth factor (VEGF are involved in the production of excessive immunoglobulin A (IgA, the induction of acute phase proteins and in the development of a systemic necrotizing vasculitis, characteristic of SRMA, these three signalling proteins were evaluated. Results Cerebrospinal fluid (CSF and serum samples of dogs during the acute phase of SRMA (SRMA were tested for IL-6, VEGF and TGF- β1. Results were compared to those of dogs affected with SRMA during treatment (SRMA Th and during relapse (SRMA R, to dogs with other meningoencephalomyelitides (ME, with miscellaneous non-inflammatory diseases of the CNS (CNS-Mix, with idiopathic epilepsy (IE, with systemic inflammatory diseases (Syst. Infl. and with healthy dogs (Healthy. Concentrations of IL-6 and VEGF in CSF were significantly elevated in the SRMA group compared to the other disease categories (p 1 were increased in SRMA group, but statistically significant differences were found only in comparison with Healthy and CNS-Mix groups. No differences were detected in the serum concentrations of TGF-β1 between the different groups. In untreated SRMA patients, a positive correlation (rSpear = 0.3549; P = 0.0337 between concentrations of TGF-β1 and IgA concentration was found in CSF, while concentrations of IL-6 and VEGF in CSF positively correlated with the degree of pleocytosis (rSpear = 0.8323; P Spear = 0.5711; P = 0.0166, respectively. Conclusions Our results suggest that these three signalling proteins are biomarkers of disease activity in SRMA. VEGF might play an important role in the development of a systemic arteritis. TGF-β1 is considered to be involved in the excessive IgA production, while IL-6 in the pleocytosis

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

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Prasad Krishnamurthy Narasimha

2013-01-01

Full Text Available Takayasu′s arteritis (TA is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR, end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.

Takayasu’s Arteritis in Pregnancy: A Rare Case Report from a Tertiary Care Infirmary in India

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Sheeba Marwah

2017-01-01

Full Text Available Background. Takayasu’s arteritis (TA is a rare, chronic, inflammatory, progressive, idiopathic arteriopathy, afflicting young women of reproductive age group, causing narrowing, occlusion, and aneurysms of systemic and pulmonary arteries, especially the aorta and its branches. During pregnancy, such patients warrant special attention. An interdisciplinary collaboration of obstetricians, cardiologists, and neurologists is necessary to improve maternal and fetal prognosis. Here a case is reported where a patient with diagnosis of TA, complicated by neurological sequelae, successfully fought the vagaries of the condition twice to deliver uneventfully. Case. 25-year-old G2P1L1 presented at 34 weeks of gestation, with chronic hypertension, with TA, with epilepsy, and with late-onset severe IUGR. Following a multidisciplinary approach, she delivered an alive born low birth weight baby (following induction. Her postpartum course remained uneventful. Conclusion. Pregnancy with TA poses a stringent challenge to an obstetrician. Despite advancements in cardiovascular management and advent of new-fangled drugs, the optimal management for pregnant patients with this disease still remains elusive.

Pediatric-onset Takayasu's arteritis: clinical features and short-term outcome.

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Misra, Durga Prasanna; Aggarwal, Amita; Lawrence, Able; Agarwal, Vikas; Misra, Ramnath

2015-10-01

The aim of this was to assess clinical features and outcome in pediatric-onset Takayasu's arteritis (TA). Retrospective data analysis of patients diagnosed with TA over last 13 years with onset before 18 years of age was done. Their presenting features, activity (by NIH criteria, ITAS2010, ITAS-A), disease extent (by DEI.Tak) and angiographic findings were retrieved from clinic files. Treatment received and follow-up data on disease activity and damage by TA damage score (TADS) were also analyzed. Wherever repeated angiography data were available, the same was analyzed. Values are expressed as median with interquartile range in brackets. There were 29 patients (19 females) with median age at diagnosis of 14 (13-16) years and delay to diagnosis of 1 (0.4-2) year. Common presenting symptoms were pulse loss (23/29) and hypertension (22/29). Patients had extensive disease at presentation with median DEI.Tak of 12 (9.5-15); 23/29 had elevated acute-phase reactants, and 28/29 were active at presentation [median ITAS2010 13 (8-15.5), ITAS-A 14 (10-17)]. Numano's type V was the commonest angiographic type (22/29). At a median follow-up of 2.4 (1.5-5.1) years, 2/20 were active whereas all had sustained damage despite a majority (17/20) being on immunosuppression. The median TADS was 8 (6.3-9.8) with pulse loss, claudication and hypertension being the commonest damage item. Two needed renal artery stenting to control hypertension. Angiographic assessment at least 2 years apart demonstrated disease progression in 5 of 6 patients despite immunosuppression. Significant damage accrued on follow-up despite immunosuppression and control of disease activity. Hypertension remains the major long-term morbidity.

Evaluation of cardiac involvement using radionuclide myuocardial imaging in patients with Takayasu arteritis

International Nuclear Information System (INIS)

Yang Minfu; Guo Xinhua; He Zuoxiang; Jiang Xiongjing; Dou Kefei

2008-01-01

Objective: The aim of the study was to assess the value of radionuclide myocardial imaging in the evaluation of cardiac involvement in patients with Takayasu arteritis (TA). Methods: The 99 Tc m -methoxyisobutylisonitrile myocardial perlusion imaging (MIBI-MPI) and (or) 18 F-fluorodeoxyglucose (FDG) PET imaging findings in 12 TA patients [3 men and 9 women, mean age (35 ± 15) years] with coronary lesions (CL; n=8) or aortic insufficiency (AI; n=4) were retrospectively reviewed and analysed. Of the 4 AI-TA patients, 1 underwent exercise MIBI-MPI, 1 underwent pharmacologic stress MIBI-MPI and 2 un- derwent resting MIBI-MPI. Of the 8 CL-TA patients, 4 pnderwent MIBI-MPI (2 stress and 2 rest) and 4 un- derwent a dual-isotope simultaneous acquisition (DISA) SPECT protocol after injection of MIBI and FDG. Results: All 4 AI-TA patients showed left ventricular enlargement but no peffusion abnormalities. In 3 CL- TA patients with no documented infarct, MPI or DISA showed stress ischemia (n=2) or mismatched perfusion-metabolism defects (n=1). In the remaining 5 CL-TA patients with documented infarcts, 2 showed large perfusion defects on resting MIBI and 3 showed matched perfusion-metabolism defects on DISA SPECT. Conclusion: Radionuclide imaging is useful in providing a comprehensive functional evaluation for TA patients with cardiac involvement. (authors)

Virulent and avirulent strains of equine arteritis virus induce different quantities of TNF-α and other proinflammatory cytokines in alveolar and blood-derived equine macrophages

International Nuclear Information System (INIS)

Moore, Brian D.; Balasuriya, Udeni B.R.; Watson, Johanna L.; Bosio, Catharine M.; MacKay, Robert J.; MacLachlan, N. James

2003-01-01

Equine arteritis virus (EAV) infects endothelial cells (ECs) and macrophages in horses, and many of the clinical manifestations of equine viral arteritis (EVA) reflect vascular injury. To further evaluate the potential role of EAV-induced, macrophage-derived cytokines in the pathogenesis of EVA, we infected cultured equine alveolar macrophages (AMphi), blood monocyte-derived macrophages (BMphi), and pulmonary artery ECs with either a virulent (KY84) or an avirulent (CA95) strain of EAV. EAV infection of equine AMphi, BMphi, and ECs resulted in their activation with increased transcription of genes encoding proinflammatory mediators, including interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α. Furthermore, the virulent KY84 strain of EAV induced significantly higher levels of mRNA encoding proinflammatory cytokines in infected AMphi and BMphi than did the avirulent CA95 strain. Treatment of equine ECs with the culture supernatants of EAV-infected AMphi and BMphi also resulted in EC activation with cell surface expression of E-selectin, whereas infection of ECs with purified EAV alone caused only minimal expression of E-selectin. The presence of TNF-α in the culture supernatants of EAV-infected equine AMphi, BMphi, and ECs was confirmed by bioassay, and the virulent KY84 strain of EAV induced significantly more TNF-α in all cell types than did the avirulent CA95 strain. Thus, the data indicate that EAV-induced, macrophage-derived cytokines may contribute to the pathogenesis of EVA in horses, and that the magnitude of the cytokine response of equine AMphi, BMphi, and ECs to EAV infection reflects the virulence of the infecting virus strain

Polymyalgia rheumatica and giant cell arteritis: a 5-year epidemiologic and clinical study in Reggio Emilia, Italy.

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Salvarani, C; Macchioni, P L; Tartoni, P L; Rossi, F; Baricchi, R; Castri, C; Chiaravalloti, F; Portioli, I

1987-01-01

Among the population of Reggio Emilia, Italy, 56 patients with polymyalgia rheumatica (PR) and giant cell arteritis (GCA) were identified during the 5-year period 1981-85. The average annual incidence rates of PR and GCA were 12.8 and 8.8 respectively per 100,000 population aged 50 years or older. Forty-nine patients were followed up and the mean duration of follow-up was 32 months. All the patients received steroid therapy. We have evaluated the cumulative probability of requiring continued steroid therapy between patients with PR only, GCA only, and PR associated with GCA using life-table methods with permanent discontinuation of therapy as an end point. The different duration of steroid therapy between these 3 groups did not achieve statistical significance by the method of Lee and Desu. We identified a 5 variable discriminant function that correctly predicted whether the duration of therapy would be longer or shorter than 16 months (median duration of therapy) in 80% of our patients followed up for at least 24 months. The presence of synovitis in PR is also discussed.

IgG,kappa monoclonal gammopathy of unknown significance with AL amyloidosis simulating giant cell arteritis

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Pompilian Valer Mihai

2017-09-01

Full Text Available Monoclonal gammopathies complicated by AL amyloidosis can mimic giant cell arteritis (GCA. We hereby present the case of a 63 year old woman in whom symptoms consistent with GCA were the first manifestations of a monoclonal gammopathy of unknown significance (MGUS associated with amyloidosis. A 63 year old woman was admitted for temporal headache, maseterine claudication, neck and shoulder stiffness. She was recently diagnosed with carpal tunnel syndrome. On physical examination she had prominent temporal arteries, macroglosia and orthostatic hypotension. Muscular strength was normal. She had high ESR and CRP; in this clinical context, GCA was suspected. A gamma spike on serum protein electrophoresis raised the suspicion of monoclonal gammopathy (MG. Immunoelectrophoresis revealed monoclonal bands for IgG and kappa chains. Massive deposits of amyloid and no inflammation were found on temporal artery biopsy. Multiple myeloma and lymphoma were ruled out. A diagnosis of AL amyloidosis complicating MGUS was formulated. She did well on therapy with bortezomib, cyclophosphamide and dexamethasone. Cases published in medical literature reveal amyloidosis mimicking GCA in the setting of established MGUS. As far as we know, this is the first case of MGUS with IgG and kappa chains in which a GCA-like picture induced by amyloidosis was present from the very onset.

Dermal arteritis of the nasal philtrum in a Giant Schnauzer and three Saint Bernard dogs.

Science.gov (United States)

Torres, Sheila M F; Brien, Timothy O; Scott, Danny W

2002-10-01

Arteritis of the nasal philtrum is described in four dogs. Two of the Saint Bernards were related. The lesions were solitary, well-circumscribed, linear ulcers that were neither pruritic nor painful. The age of the dogs at the time the owners first noticed the lesion ranged from 3 to 6 years. The ulcers had been present for 0.5-5 years before diagnosis was pursued. Three of the dogs experienced repeated, mild episodes of arterial bleeding from the ulcers. Two dogs also experienced a severe episode of bleeding that required surgical intervention. Histopathological findings included a V-shaped ulcer, neutrophilic dermal inflammation subjacent to the ulcer and lymphoplasmacytic dermatitis bordering the ulcer. The most remarkable pathological findings were present in the deep dermal arteries and arterioles subjacent to the ulcer. The changes were characterized by subendothelial spindle cell proliferation with marked extracellular matrix deposition that stained blue with Alcian Blue (mucin) and Masson's trichrome (collagen) and resulted in intimal thickening, and stenosis of dermal arteries and arterioles. Immunohistochemical studies suggested that the proliferating spindle cells were of either myofibroblast or smooth muscle origin (actin and vimentin positive). Anti-inflammatory therapy (glucocorticoids; tetracycline and niacinamide; fish oil) may be beneficial for long-term control of this condition, however, long-term maintenance treatment appears to be necessary.

Ultrasonography of occipital arteries to diagnose giant cell arteritis: a case series and literature review.

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Pinnell, Jonathan; Tiivas, Carl; Perkins, Phillip; Blake, Tim; Saravana, Shanmugam; Dubey, Shirish

2018-02-01

We describe four cases of giant cell arteritis (GCA) that presented with occipital headache in the last 6 months. Typical ultrasound features of GCA were found in the occipital arteries which helped to confirm the diagnosis. One patient had already suffered significant visual loss by the time the diagnosis was made, reflecting the similarity in prognosis to the more typical GCA patients. These cases prompted a review of the literature to evaluate the evidence regarding the use of occipital artery ultrasonography in the investigation of GCA. We searched PubMed, Google Scholar and Web of Science and identified 17 papers but only four of these were relevant studies. The studies available show that typical features of GCA can be detected in the occipital arteries using ultrasonography. They also suggest that ultrasonography can detect changes in the occipital arteries when temporal arteries are not involved. However, occipital artery abnormalities were less common than temporal artery abnormalities in GCA. We advocate maintaining a high index of suspicion for GCA in patients presenting with atypical features, such as occipital headache. Ultrasonography has a vital role to play in the diagnosis of these patients. We recommend priority imaging of the affected area to facilitate prompt and accurate diagnosis of GCA, especially when atypical vessels are involved.

Vurdering af bevaringsstatus for arter og naturtyper omfattet af EF-Habitatdirektivet (2001-2007) (Notat til By- og Landskabsstyrelsen)

DEFF Research Database (Denmark)

Søgaard, Bjarne; Ejrnæs, Rasmus; Nygaard, Bettina

2008-01-01

naturtype er angivet om bevaringsstatus er gunstig, moderat ugunstig eller stærkt ugunstig. Rapporten giver det første samlede billede af tilstanden af den internationalt beskyttede natur i Danmark. Afrapporteringen er foretaget til EIONET-database i form af fact sheets for hver art og naturtyper........ Afrapportering for arter kan findes på denne link:     http://cdr.eionet.europa.eu/resultsxml?xml_schema_location=http%3A%2F%2Fbiodiversity.eionet.europa.eu%2Fschemas%2Fdir9243eec%2Fspecies.xsd&years%3Aint%3Aignore_empty=&partofyear=&country=http%3A%2F%2Frod.eionet.eu.int%2Fspatial%2F11&sort......_on=reportingdate&sort_order=reverse Afrapportering for naturtyper kan findes på denne link:   http://cdr.eionet.europa.eu/resultsxml?xml_schema_location=http%3A%2F%2Fbiodiversity.eionet.europa.eu%2Fschemas%2Fdir9243eec%2Fhabitats.xsd&years%3Aint%3Aignore_empty=&partofyear=&country=http%3A%2F%2Frod.eionet.eu.int%2...

Effect of CRP value on 18F-FDG PET vascular positivity in Takayasu arteritis: a systematic review and per-patient based meta-analysis.

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Gomez, Léa; Chaumet-Riffaud, Philippe; Noel, Nicolas; Lambotte, Olivier; Goujard, Cécile; Durand, Emmanuel; Besson, Florent L

2018-04-01

The aim of this study was to quantify the association between the CRP value and 18 F-FDG PET vascular positivity in Takayasu arteritis (TAK) through a structured dedicated systematic review and meta-analysis. From January 2000 to December 2016, the PubMed/MEDLINE database was searched for articles specifically dealing with the assessment of vascular inflammation using 18 F-FDG PET and CRP biomarkers in TAK. Inclusion criteria for the qualitative analysis were (1) 18 F-FDG PET used to assess the disease activity, (2) The use of the ACR criteria for the diagnosis of TAK, (3) No case mixed vasculitis (i.e., no giant cell arteritis), and (4) CRP concentration and clinical disease activity available. For the meta-analysis, PET-positive and PET-negative subgroups with the corresponding CRP concentrations were generated based on per patient data. The standard mean difference, which represents the effect of the CRP concentrations on the 18 F-FDG PET vascular uptake, was computed for all studies, and then the results were pooled together. Among the 33 initial citations, nine complete articles including 210 patients fulfilled the inclusion criteria. Five studies found a significant correlation between the 18 F-FDG PET and CRP concentration, one provided a trend towards association and three did not find any association between the two biomarkers. Six studies found a significant association between 18 F-FDG PET and clinical disease activity, one found a trend towards association and the last two studies did not evaluate this correlation. The meta-analysis (121 patients) provided the following results: Standard Mean Deviation = 0.54 [0.15;0.92]; Chi 2  = 3.35; I 2  = 0%; Test for overall effect: Z = 2.70 (P = 0.007). The CRP concentration only moderately reflects the 18 F-FDG PET vascular positivity in TAK, suggesting dissociated information. Standardized longitudinal prospective studies are necessary to assess the value of 18 F-FDG PET as an independent biomarker for

Arterite de Takayasu e doença de Crohn: uma associação incomum Takayasu's arteritis and Crohn's disease: an unusual association

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Clóvis Konopka

2009-12-01

Full Text Available A arterite de Takayasu e a doença de Crohn são doenças inflamatórias com etiologia desconhecida. Raramente ocorrem de modo concomitante em um mesmo indivíduo, havendo menos de 30 casos relatados na literatura. Este trabalho descreve essa associação em uma paciente de 36 anos de idade portadora de doença de Crohn, que apresentou redução dos pulsos no membro superior esquerdo e pressão arterial de 60/40 mmHg. A angiotomografia evidenciou estenose segmentar de artéria subclávia esquerda e espessamento parietal circunferencial da aorta na transição toracoabdominal entre T10 e L1, estabelecendo o diagnóstico de arterite de Takayasu. Ambas as patologias são mediadas imunologicamente e apresentam granulomas e vasculite granulomatosa, o que contribui para reforçar a hipótese de uma origem imunológica comum no seu desenvolvimento. Acreditamos que este seja o primeiro caso relatado na literatura brasileira da presença concomitante destas duas enfermidades.Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases with unknown etiology. They rarely occur together in the same individual, with less than 30 cases reported in the literature. This case report describes this association in a 36-year-old woman with Crohn’s disease and weak pulses in her left arm with blood pressure of 60/40 mmHg. Angiotomography showed segmental stenosis in the left subclavian artery and circumferential thickening of the aortic wall between T10 and L1, establishing the diagnosis of Takayasu's arteritis. Both are organ-specific and immune-mediated diseases and exhibit granulomas and granulomatous vasculitis, which contribute to reinforce the hypothesis of a common immunologic origin. We believe that this is the first case of concomitant presence of these two diseases reported in the Brazilian literature.

Anti-equine arteritis virus activity of ethanolic extract and compounds from Origanum vulgare

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Daiane Einhardt Blank

2017-05-01

Full Text Available The equine arteritis virus (EAV is responsible by an important respiratory and reproductive disease in equine populations and there is no specific antiviral treatment available. The objective of this study was to investigate the activity of an ethanolic crude extract of Origanum vulgare (EEO and of isolated compound caffeic acid, p-coumaric acid, rosmarinic acid, quercetin, luteolin, carnosol, carnosic acid, kaempferol and apigenin against EAV. The assays were performed using non-cytotoxic concentrations. The antiviral activity was monitored initially by cytopathic effect inhibition (CPE assay in RK13 cells in the presence or absence of EEO. Pre-incubated cells with EEO were also examined to show prophylactic effect. Direct viral inactivation by EEO and isolated compounds was evaluated by incubation at 37°C or 20°C. After the incubation period, the infectivity was immediately determined by virus titrations on cell cultures and expressed as 50% tissue culture infective dose (TCID50/100 µL. There was significant virucidal activity of EEO and of the compounds caffeic acid, p-coumaric acid, quercetin, carnosic acid and kaempferol. When EEO was added after infection, EEO inhibited the virus growth in infected cells, as evidenced by significant reduction of the viral titre. The results provide evidence that the EEO exhibit an inhibitory effect anti-EAV. Among the main compounds evaluated, caffeic acid, p-coumaric acid, carnosic acid, kaempferol and mainly quercetin, contributed to the activity of EEO. EEO may represent a good prototype for the development of a new antiviral agent, presenting promising for combating arteriviruses infections.

Genome-Wide Association Study among Four Horse Breeds Identifies a Common Haplotype Associated with In Vitro CD3+ T Cell Susceptibility/Resistance to Equine Arteritis Virus Infection ▿

Science.gov (United States)

Go, Yun Young; Bailey, Ernest; Cook, Deborah G.; Coleman, Stephen J.; MacLeod, James N.; Chen, Kuey-Chu; Timoney, Peter J.; Balasuriya, Udeni B. R.

2011-01-01

Previously, we have shown that horses could be divided into susceptible and resistant groups based on an in vitro assay using dual-color flow cytometric analysis of CD3+ T cells infected with equine arteritis virus (EAV). Here, we demonstrate that the differences in in vitro susceptibility of equine CD3+ T lymphocytes to EAV infection have a genetic basis. To investigate the possible hereditary basis for this trait, we conducted a genome-wide association study (GWAS) to compare susceptible and resistant phenotypes. Testing of 267 DNA samples from four horse breeds that had a susceptible or a resistant CD3+ T lymphocyte phenotype using both Illumina Equine SNP50 BeadChip and Sequenom's MassARRAY system identified a common, genetically dominant haplotype associated with the susceptible phenotype in a region of equine chromosome 11 (ECA11), positions 49572804 to 49643932. The presence of a common haplotype indicates that the trait occurred in a common ancestor of all four breeds, suggesting that it may be segregated among other modern horse breeds. Biological pathway analysis revealed several cellular genes within this region of ECA11 encoding proteins associated with virus attachment and entry, cytoskeletal organization, and NF-κB pathways that may be associated with the trait responsible for the in vitro susceptibility/resistance of CD3+ T lymphocytes to EAV infection. The data presented in this study demonstrated a strong association of genetic markers with the trait, representing de facto proof that the trait is under genetic control. To our knowledge, this is the first GWAS of an equine infectious disease and the first GWAS of equine viral arteritis. PMID:21994447

Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis.

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Soto, M E; Espinola, N; Flores-Suarez, L F; Reyes, P A

2008-01-01

Takayasu Arteritis (TA) is a rare disease that mainly affects large elastic arteries. It is more frequently seen in Asia, the Mediterranean basin, South Africa and Latin America. We have characterized its clinical manifestations and identified the cardiovascular mortality predictors in a cohort of 110 Mexican Mestizo patients. Retrospective review of 110 charts of TA patients complying with the American College of Rheumatology (ACR) criteria, seen in a single hospital between 1976 and 2003. Demographic, clinical, and radiological characteristics were described. With the use of actuarial table analysis at 2, 5, and 10 years, and Kaplan Meier methods applying t function for probability, plus Cox regression analysis, the following factors were identified as mortality predictors: systemic arterial hypertension, coronary heart disease and aortic valve regurgitation. Informed consent and approval from the institutional Internal Review Board (IRB) were obtained. We observed a slowly progressive widespread obstructive arterial disease with cardiovascular (48%), neuro-ophthalmic (36%), and skin morbidity (13%). Systemic hypertension and heart disease were significant mortality predictors. Twenty-six percent of cases died due to myocardial infarction, chronic renal failure, stroke, or surgical complications. TA in Mexican Mestizos shows a clinical pattern similar to the one recognized in the Far East. Management strategies must be directed at reducing the identified mortality risk factors.

Effect of CRP value on {sup 18}F-FDG PET vascular positivity in Takayasu arteritis. A systematic review and per-patient based meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Gomez, Lea; Chaumet-Riffaud, Philippe [Bicetre University Hospital, Department of Biophysics and Nuclear Medicine, Le Kremlin-Bicetre (France); Noel, Nicolas; Lambotte, Olivier [Bicetre University Hospital, Department of Internal Medicine, Le Kremlin-Bicetre (France); Universite Paris Sud, Le Kremlin Bicetre (France); Universite Paris Sud, INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Le Kremlin Bicetre (France); CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris (France); Goujard, Cecile [Bicetre University Hospital, Department of Internal Medicine, Le Kremlin-Bicetre (France); Universite Paris Sud, Le Kremlin Bicetre (France); CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris (France); INSERM U1018, CESP, Le Kremlin Bicetre (France); Durand, Emmanuel; Besson, Florent L. [Bicetre University Hospital, Department of Biophysics and Nuclear Medicine, Le Kremlin-Bicetre (France); Universite Paris Sud, Le Kremlin Bicetre (France); Universite Paris Sud, Universite Paris Saclay, CNRS, IR4M - UMR8081, Orsay (France)

2018-04-15

The aim of this study was to quantify the association between the CRP value and {sup 18}F-FDG PET vascular positivity in Takayasu arteritis (TAK) through a structured dedicated systematic review and meta-analysis. From January 2000 to December 2016, the PubMed/MEDLINE database was searched for articles specifically dealing with the assessment of vascular inflammation using {sup 18}F-FDG PET and CRP biomarkers in TAK. Inclusion criteria for the qualitative analysis were (1) {sup 18}F-FDG PET used to assess the disease activity, (2) The use of the ACR criteria for the diagnosis of TAK, (3) No case mixed vasculitis (i.e., no giant cell arteritis), and (4) CRP concentration and clinical disease activity available. For the meta-analysis, PET-positive and PET-negative subgroups with the corresponding CRP concentrations were generated based on per patient data. The standard mean difference, which represents the effect of the CRP concentrations on the {sup 18}F-FDG PET vascular uptake, was computed for all studies, and then the results were pooled together. Among the 33 initial citations, nine complete articles including 210 patients fulfilled the inclusion criteria. Five studies found a significant correlation between the {sup 18}F-FDG PET and CRP concentration, one provided a trend towards association and three did not find any association between the two biomarkers. Six studies found a significant association between {sup 18}F-FDG PET and clinical disease activity, one found a trend towards association and the last two studies did not evaluate this correlation. The meta-analysis (121 patients) provided the following results: Standard Mean Deviation = 0.54 [0.15;0.92]; Chi{sup 2} = 3.35; I{sup 2} = 0%; Test for overall effect: Z = 2.70 (P = 0.007). The CRP concentration only moderately reflects the {sup 18}F-FDG PET vascular positivity in TAK, suggesting dissociated information. Standardized longitudinal prospective studies are necessary to assess the value of {sup 18}F

Arterite de Takayasu em Gestante: Relato de Caso / Takayasu Arteritis in Pregnancy: Case Report

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Patrícia Resende Penido

2015-12-01

Full Text Available Introdução: A Arterite de Takayasu (AT consiste em uma vasculopatia de origem indefinida, sendo de caráter crônico, que afeta a aorta e seus ramos principais. Em gestantes é uma condição complexa, em que o tratamento clínico é realizado com restrições. A utilização de corticoides tem sido favorável no controle inflamatório, principalmente naqueles casos em que antes da gravidez se fazia uso de imunossupressores. Casuística: Foi relatado um caso de uma gestante portadora de AT, através da análise de prontuário e de exames complementares, sendo realizado o pré-natal pelas equipes de Obstetrícia e Reumatologia, onde foi realizado tratamento clínico com corticoides, mostrando uma evolução satisfatória, ocorrendo apenas uma hospitalização que foi seguida de uma cesárea na trigésima sexta semana de gravidez, com recém nato saudável de 3.810g. Discussão: A AT pode estar associada a várias etiologias, sendo a gênese pouco conhecida. O diagnóstico na maioria das vezes é demorado, pela dificuldade da suspeita clínica, além de demandar o uso de técnicas de imagem mais sofisticadas. A gestação associada é fenômeno raro, já que as portadoras são orientadas a evitarem a gravidez. O controle clínico permitiu uma gestação sem grandes complicações e serviu como meio para levar a gestação até praticamente o fim do terceiro trimestre. Conclusão: Deve-se ressaltar o papel do acompanhamento clínico, especialmente com esta pan-arterite, mostrando os medicamentos que podem ser utilizados nesse grupo, especialmente quando se usava imunossupressores antes da gravidez. Introduction: Takayasu's arteritis (TA consists of a vascular disease of unknown origin and chronic nature, which affects the aorta and its main branches. In pregnant women it is a complex condition, in which the clinical treatment is performed with restrictions. The use of corticosteroids has been favorable to control inflammation, especially in those

Effect of endovascular treatment on nitric oxide and renal function in Takayasu's arteritis with renovascular hypertension.

Science.gov (United States)

Parildar, Zuhal; Gulter, Ceyda; Parildar, Mustafa; Oran, Ismail; Erdener, Dilek; Memis, Ahmet

2002-01-01

Renal involvement in Takayasu's arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients. In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment. Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the others. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels. Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response. Copyright 2002 S. Karger AG, Basel

No evidence of parvovirus B19, Chlamydia pneumoniae or human herpes virus infection in temporal artery biopsies in patients with giant cell arteritis

DEFF Research Database (Denmark)

Helweg-Larsen, J; Tarp, B; Obel, N

2002-01-01

conditions. DNA was extracted from frozen biopsies and PCR was used to amplify genes from Chlamydia pneumoniae, parvovirus B19 and each of the eight human herpes viruses: herpes simplex viruses HSV-1 and 2, Epstein-Barr virus, cytomegalovirus, varicella zoster virus and human herpes viruses HHV-6, -7 and -8......OBJECTIVES: Recent studies have suggested that infective agents may be involved in the pathogenesis of giant cell arteritis (GCA), in particular Chlamydia pneumoniae and parvovirus B19. We investigated temporal arteries from patients with GCA for these infections as well as human herpes viruses....... RESULTS: In all 30 biopsies, PCR was negative for DNAs of parvovirus B19, each of the eight human herpes viruses and C. pneumoniae. CONCLUSIONS: We found no evidence of DNA from parvovirus B19, human herpes virus or C. pneumoniae in any of the temporal arteries. These agents do not seem to play a unique...

Endovascular Versus Open Surgical Intervention in Patients with Takayasu's Arteritis: A Meta-analysis.

Science.gov (United States)

Jung, Jae Hyun; Lee, Young Ho; Song, Gwan Gyu; Jeong, Han Saem; Kim, Jae-Hoon; Choi, Sung Jae

2018-06-01

Although medical treatment has advanced, surgical treatment is needed to control symptoms of Takayasu's arteritis (TA), such as angina, stroke, hypertension, or claudication. Endovascular or open surgical intervention is performed; however, there are few comparative studies on these methods. This meta-analysis and systematic review aimed to examine the outcome of surgical treatment of TA. A meta-analysis comparing outcomes of endovascular and open surgical intervention was performed using MEDLINE and Embase. This meta-analysis included only observational studies, and the evidence level was low to moderate. Data were pooled and analysed using a fixed or random effects model with the I 2 statistic. The included studies involved a total of 770 patients and 1363 lesions, with 389 patients treated endovascularly and 420 treated by surgical revascularization. Restenosis was more common with endovascular than open surgical intervention (odds ratio [OR] 5.18, 95% confidence interval [CI] 2.78-9.62; p open surgical intervention patients in the coronary artery, supra-aortic branches, and renal artery. In both the active and inactive stages, restenosis was more common in those treated endovascularly than in those treated by open surgery. However, stroke occurred less often with endovascular intervention than with open surgical intervention (OR 0.33, 95% CI 0.12-0.90; p = .003). Mortality and complications other than stroke and mortality did not differ between endovascular and open surgical intervention. This meta-analysis has shown a lower risk of restenosis with open surgical intervention than with endovascular intervention. Stroke was generally more common with open surgical intervention than with endovascular intervention. However, there were differences according to the location of the lesion, and the risk of stroke in open surgery is higher when the supra-aortic branches are involved rather than the renal arteries. Copyright © 2018 European Society for Vascular

Pathologic Markers Determining Prognosis in Patients with Treated or Healing Giant Cell Arteritis.

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Sultan, Harris; Smith, Stacy V; Lee, Andrew G; Chévez-Barrios, Patricia

2018-06-08

To provide quantitative evidence linking the Cluster of Differentiation-68 (CD68)+ macrophage-marker found on temporal artery biopsies (TABs) with disease prognosis. Retrospective, cross-sectional study METHODS: We examined 42 consecutive patients who had undergone unilateral TABs at a single hospital in 2015. Clinical data, laboratory data, and histopathologic features of TABs were recorded. clinical diagnosis of giant cell arteritis (GCA) with TAB performed at the same center. CD68 immunohistochemistry was used to label macrophages in the TABs. multiple logistic regression and bivariate comparisons to measure the association between CD68+ cells per histologic section with placement on immunomodulatory therapy (IMT). Twenty seven patients were females (64%), with a mean age of 72 (standard deviation [S.D.] ±7.7). Eleven patients (26%) were placed on IMT, 17 (40%) had disease recurrence during steroid taper, and 25 (60%) were referred to rheumatology. Of 42 biopsies, 35 underwent staining with CD68 to confirm active inflammation in suspicious, but not diagnostic, specimens. Patients eventually placed on IMT had increased CD68+ cells/slice compared to those not on IMT (median 5.00 [25-75 th quartile 2.00-7.15] vs 1.21 [0.38-2.57], p=0.031, respectively). A receiver operating characteristics (ROC) curve demonstrates that 2.17 CD68+ cells/slice predicts placement on IMT with an odds ratio of 1.54 (95% C.I. 1.02-2.33, p=0.038). Patients refractory to initial steroid tapers and those eventually placed on IMT had increased CD68 cells/section. CD68+ macrophages and their location on the internal elastic lamina may predict disease severity in patients with presumed GCA. Our results suggest that this marker may expedite patient triaging to alternate treatment to the usual steroid therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Flares in Biopsy-Proven Giant Cell Arteritis in Northern Italy

Science.gov (United States)

Restuccia, Giovanna; Boiardi, Luigi; Cavazza, Alberto; Catanoso, Mariagrazia; Macchioni, Pierluigi; Muratore, Francesco; Cimino, Luca; Aldigeri, Raffaella; Crescentini, Filippo; Pipitone, Nicolò; Salvarani, Carlo

2016-01-01

Abstract This study evaluated the frequency, timing, and characteristics of flares in a large cohort of Italian patients with biopsy-proven giant cell arteritis (GCA) and to identify factors at diagnosis able to predict the occurrence of flares. We evaluated 157 patients with biopsy-proven transmural GCA diagnosed and followed at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 4 years of follow-up. Fifty-seven patients (36.5%) experienced ≥1 flares. Fifty-one (46.4%) of the 110 total flares (88 relapses and 22 recurrences) were experienced during the first 2 years after diagnosis. The majority of relapses occurred with doses of prednisone ≤ 10 mg/day (82.9%), whereas only 3.4% of relapses occurred for doses ≥ 25 mg/day. Polymyalgia rheumatica (46.5%) and cranial symptoms (41.9%) were the most frequent manifestations at the time of the first relapse. Cumulative prednisone dose during the first year and total cumulative prednisone dose were significantly higher in flaring patients compared with those without flares (7.8 ± 2.4 vs 6.7 ± 2.4 g, P = 0.02; 15.5 ± 8.9 vs 10.0 ± 9.2 g, P = 0.0001, respectively). The total duration of prednisone treatment was longer in flaring patients (58 ± 44 vs 30 ± 30 months, P = 0.0001). Patients with disease flares had at diagnosis more frequently systemic manifestations (P = 0.02) and fever ≥ 38°C (P = 0.02), significantly lower hemoglobin levels (P = 0.05), more frequent presence at temporal artery biopsy (TAB) specimens of giant cells (P = 0.04) and intraluminal acute thrombosis (P = 0.007), and more moderate/severe arterial inflammation (P = 0.009) compared with those without flares. In the multivariate model fever ≥ 38 °C (hazard ratio 2.14; 95% confidence interval, 1.06–4.32, P = 0.03) and the severity of inflammatory infiltrate

Journey of Patients With Vasculitis From First Symptom to Diagnosis

Science.gov (United States)

2018-01-18

Vasculitis; Systemic Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatous Vasculitis; Temporal Arteritis; Giant Cell Arteritis; Granulomatosis With Polyangiitis; Wegener Granulomatosis; Henoch Schonlein Purpura; IgA Vasculitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis; Urticarial Vasculitis

Increased Circulating Th17 Cells, Serum IL-17A, and IL-23 in Takayasu Arteritis.

Science.gov (United States)

Misra, Durga Prasanna; Chaurasia, Smriti; Misra, Ramnath

2016-01-01

Introduction. Th17, γδT, NK, and NKT cells in peripheral blood and serum IL-17 and IL-23 in Takayasu arteritis (TA) were measured and correlated with disease activity. Methods. Th17 (anti-CD3APC, CD4PECy7, and IL-17PE), NKT, NK (anti-CD3APC, CD56FITC), and γδT (anti-CD3FITC and γδTCRAPC) cells were enumerated by flow cytometry in peripheral blood of 30 patients with TA (ACR1990 criteria) and 20 healthy controls, serum IL-17 and IL-23 measured by ELISA. Relation with disease activity (NIH criteria, ITAS2010) was analyzed (using nonparametric tests, median with interquartile range). Results. Mean age of patients was 33.47 ± 11.78 years (25 females); mean symptom duration was 7.1 ± 5.3 years. 13 were not on immunosuppressants; 12 were active (ITAS2010 ≥ 4). The percentage of Th17 cells was significantly expanded in TA (patients 2.1 (1.5-3.2) versus controls 0.75 (0.32-1.2); p < 0.0001) with no differences in other cell populations. Serum IL-17 and IL-23 (pg/mL) in patients (6.2 (4.6-8.5) and 15 (14.9-26.5), resp.) were significantly higher (p < 0.001) than controls (3.9 (3.9-7.3) and undetectable median value, resp.). Subgroup analysis revealed no correlation of Th17 cells, serum IL-17, and IL-23 with disease activity or medications, nor any significant difference before and after medication. Conclusions. There is significant expansion of Th17 cells and elevated serum IL-17 and IL-23 levels in TA patients compared to healthy controls.

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion

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Cook, R. Frank; Eberth, John; Chelvarajan, R. Lakshman; Artiushin, Sergey; Timoney, Peter J.

2016-01-01

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10–70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s) of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS) using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16) that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A) within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1) having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb) encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001) and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R) was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence) in the male reproductive tract. EqCXCL16Sa and Eq

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion.

Directory of Open Access Journals (Sweden)

Sanjay Sarkar

2016-12-01

Full Text Available Equine arteritis virus (EAV is the causative agent of equine viral arteritis (EVA, a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10-70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16 that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1 having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001 and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence in the male reproductive tract. EqCXCL16Sa and

Effect of the South African asinine-94 strain of equine arteritis virus (EAV) in pregnant donkey mares and duration of maternal immunity in foals.

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Paweska, J T

1997-06-01

Clinical, virological and serological responses were investigated in five pregnant donkey mares after experimental exposure to the South African asinine-94 strain of equine arteritis virus (EAV), and the duration of maternal immunity to EAV was studied in their foals. In four intranasally inoculated mares, fever with maximum rectal temperatures of 39.1-40.7 degrees C was recorded 2-11 d after challenge. All the inoculated mares developed mild depression, and a serous ocular and nasal discharge; in three mares mild conjuctivitis was observed. The virus was recovered from the nasopharynx and from buffy-coat samples of all the mares 3-10 d, and 2-18 d post inoculation (p.i.), respectively. Seroconversion to EAV was detected on days 8-10 p.i. Peak serum-virus-neutralizing antibody titres of log10 1.8-2.4, and IgG ELISA OD values of 0.85-2.15 were recorded 2-3 weeks p.i. The in-contact (p.c.) control mare developed fever on days 15-19 post exposure, and showed mild clinical signs of equine viral arteritis similar to those observed in the inoculated mares. Seroconversion to EAV was detected in the p.c. mare on day 20 post exposure, and virus was isolated from nasal swabs and blood samples collected at the time of the febrile response and 1-3 d afterwards. None of the mares aborted. After they had given normal birth 45-128 d p.i. or after p.c. exposure, no virus could be isolated from their placentas. The concentration of EAV-neutralizing antibody in colostrum was two to eight times higher than in serum samples collected at the time of parturition. All the foals born to infected mares were clinically normal at the time of birth and throughout the subsequent 1-2 months of observation. No EAV was recovered from the buffy-coat fraction of blood samples collected at birth nor from those collected on days 1, 2 and 7 after birth. Also, no virus-serum-neutralizing or IgG ELISA antibody to EAV was detected in sera collected immediately after birth before the foals started nursing

The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis

Science.gov (United States)

Kermani, TA; Cuthbertson, D; Carette, S; Hoffman, GS; Khalidi, NA; Koening, CL; Langford, CA; McKinnon-Maksimowicz, K; McAlear, CA; Monach, PA; Seo, P; Warrington, KJ; Ytterberg, SR; Merkel, PA; Matteson, EL

2016-01-01

Objective To evaluate the performance of the Birmingham Vasculitis Activity Score (BVAS) in the assessment of disease activity in giant cell arteritis (GCA). Methods Patients with GCA enrolled in a prospective, multicenter, longitudinal study with symptoms of active vasculitis during any visit were included. Spearman’s rank correlation was used to explore the association of the BVAS with other measures of disease activity. Results During a mean (SD) follow-up of 2.3 (1.6) years, symptoms of active GCA were present in 236 visits in 136 subjects (100 female, 74%). Median (range) BVAS1 (new/worse symptoms) was 1 (0–10) and median (range) BVAS2 (persistent symptoms) was 0 (0–5). Median (range) physician global assessment (PGA) was 4 (0–9) for disease activity in the past 28 days and 2 (0–9) for activity on the day of the visit. Important ischemic manifestations of active vasculitis not captured by the BVAS included tongue/jaw claudication (27%), upper extremity claudication (15%), lower extremity claudication (5%), carotidynia (7%), ischemic retinopathy (5%). During 25 visits (11%) with active disease, all symptoms of active vasculitis were captured in the “Other” category yet still resulted in a BVAS 1 and BVAS 2 of 0. BVAS1 moderately correlated with PGA for the past 28 days (Spearman’s correlation 0.50) and physician-rated disease activity for the past 28 days (Spearman’s correlation 0.46). Conclusions The BVAS has limited utility in GCA. Patients with active GCA can have a BVAS of 0. Many important ischemic symptoms attributable to active vasculitis are not captured in the composite score. PMID:27036388

Circumscribed cicatricial alopecia due to localized sarcoidal granulomas and single-organ granulomatous arteritis: a case report and systematic review of sarcoidal vasculitis.

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Yazdani Abyaneh, Mohammad-Ali; Raghu, Preethi; Kircher, Kenneth; Kutzner, Heinz; Kortz, Alison; Carlson, John Andrew

2015-10-01

Vasculitis associated with sarcoid granulomas is an uncommon phenomenon. A 72-year-old female presented with an expanding region of circumscribed alopecia and scalp atrophy of 2 months duration. Biopsy showed non-caseating granulomas, dermal thinning, loss of follicles, fibrosis and muscular vessels disrupted by mixed lymphocyte, macrophage and giant-cell infiltrates. Affected vessels had loss and fragmentation of the elastic lamina, fibrous replacement of their walls and luminal stenosis (endarteritis obliterans). Dermal and vascular advential intralymphatic granulomas and lymphangiectases were found by D2-40 expression, suggesting lymphatic obstruction and poor antigen clearance. No evidence of a post-zoster eruption, systemic sarcoidosis or systemic giant-cell arteritis was found. Two years later, prednisone had halted - but not reversed - progression of her alopecia. Review of the literature showed two types of vasculitis associated with sarcoid granulomas: (i) acute, self-limited leukocytoclastic vasculitis and (ii) chronic granulomatous vasculitis (GV). Persistence of non-degradable material or antigen contributes to the pathogenesis of granulomatous inflammation. In this case, lymphatic obstruction probably impeded clearance of nonimmunologic and/or immunologic stimuli permitting and sustaining the development of sarcoid granulomas and sarcoid GV, ultimately causing scarring alopecia and cutaneous atrophy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Tratamento cirúrgico sem circulação extracorpórea de arteriopatia relacionada com arterite de Takayasu envolvendo aorta e vasos da base Surgical treatment without extracorporeal circulation of artery disease related to Takayasu's arteritis involving the aorta and great vessels

OpenAIRE

Rodrigo Milani; Paulo Brofman; Tayse Sandri; Alexandre Varela; José Augusto Souza; Luiz Gustavo Emed; Stefan da Silveira; Marcelo Dantas; Maximiliano Guimarães; Rafael Pontarolli; Francisco Maia

2005-01-01

Relatamos o caso de duas pacientes portadoras de arterite de Takayasu, encaminhadas ao nosso serviço onde as lesões acometiam a aorta torácica descendente e os vasos da base e, em uma delas, lesão obstrutiva crítica do óstio da coronária esquerda. Ambas as pacientes foram operadas sem circulação extracorpórea, com heparinização plena e auxílio de autotransfusão.We report the cases of 2 female patients with Takayasu's arteritis referred to our service with lesions affecting the descending thor...

Geographical and genetic factors do not account for significant differences in the clinical spectrum of giant cell arteritis in southern europe.

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Gonzalez-Gay, Miguel A; Boiardi, Luigi; Garcia-Porrua, Carlos; Macchioni, Pierluigi; Amor-Dorado, Juan C; Salvarani, Carlo

2004-03-01

To investigate whether genetic and geographical differences may influence the clinical spectrum of giant cell arteritis (GCA), we compared the demographic and clinical features of patients with biopsy-proven GCA from Reggio Emilia (Northern Italy) and Lugo (Northwest Spain) during a 15-year period. We performed a retrospective review of the case records of all patients diagnosed with biopsy-proven GCA at Hospital Xeral-Calde (Lugo, Spain) and Hospital Santa Maria Nuova (Reggio Emilia, Italy) between 1 January 1986 and 31 December 2001. Both hospitals are the only referral centers for populations living in central Galicia and central Emilia Romagna, respectively. During the period of study, 194 Lugo residents and 126 Reggio Emilia residents were diagnosed with biopsy proven GCA. Reggio Emilia patients were more likely to be female (74% vs 54%; p = 0.0001). Although Lugo patients complained of headache (86%) more commonly than did those from Reggio Emilia (77%), the difference was only marginally significant (p = 0.05). The proportion of patients with visual manifestations or visual loss was remarkably similar (22% for visual manifestations and 17% for visual loss in Lugo and 29% and 21% for Reggio Emilia residents). The mean erythrocyte sedimentation rate prior to the onset of therapy was also similar. Apart from differences in sex, the clinical spectrum of GCA in these 2 Southern European regions was similar.

Low Dose Naltrexone to Improve Physical Health in Patients With Vasculitis

Science.gov (United States)

2018-06-08

Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Giant Cell Arteritis; Granulomatosis With Polyangiitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis

Experimental exposure of pregnant mares to the asinine-94 strain of equine arteritis virus

Directory of Open Access Journals (Sweden)

J.T. Paweska

1997-07-01

Full Text Available Clinical, virological and serological responses were evaluated in 10 pregnant mares after different challenge exposures to the asinine-94 strain of equine arteritis virus (EAV. The outcome of maternal infection on the progeny was also investigated. Mares were inoculated intranasally (n = 4, intramuscularly (n = 2, intravenously (n = 1, or contact-exposed (n = 3. All inoculated mares developed pyrexia, 5 showed mild clinical signs related to EAV infection and 2 remained asymptomatic. Viraemia was detected in all the inoculated animals and shedding of virus from the respiratory tract occurred in 6. Five mares were re-challenged intranasally 7 and 15 weeks after inoculation. Clinical signs of the disease in these mares were limited to mild conjunctivitis. After re-challenge, virus was recovered from buffy coat cultures of 2 mares 2-6 days after re-infection. EAV was not recovered from colostrum and milk samples during the 1st week post partum. All inoculated mares seroconverted to EAV 8-12 days post inoculation and also seroconverted after re-challenge. No clinical signs of EAV infection were observed in the 3 mares kept in close contact during the post-inoculation and re-challenge periods. Serum neutralising antibody to the virus was detected in 1 in-contact mare only, while a detectable concentration of specific IgG was found by ELISA in the colostrum of 1 of the other in-contact mares. Eight of the mares gave birth to clinically normal foals, although 1 was born prematurely. Shortly after birth, 7 foals developed fever and variable clinical signs; 5 foals became septicaemic and 3 of them died 2-5 days after birth, while the remaining 2 were euthanased at 1 month of age. EAV was not recovered from the placenta, from buffy coat fractions of blood collected from foals immediately after birth and 1-3 days later, or from a range of tissues taken from the 3 foals that died and 2 that were euthanased. Virus was not isolated from tissues collected from

Educational Needs of Patients With Systemic Vasculitis

Science.gov (United States)

2014-07-11

Behcet's Disease; Churg-Strauss Syndrome; Vasculitis, Central Nervous System; Giant Cell Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu's Arteritis

Impact of Vasculitis on Employment and Income

Science.gov (United States)

2016-01-26

Vasculitis; Systemic Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis; Temporal Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa (PAN); Takayasu's Arteritis; Urticarial Vasculitis

Reproductive Health in Men and Women With Vasculitis

Science.gov (United States)

2014-06-25

Giant Cell Arteritis; Takayasu's Arteritis; Polyarteritis Nodosa; Wegener's Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Behcet's Disease; Kawasaki Disease; Henoch-schoenlein Purpura; Vasculitis, Central Nervous System; Drug-induced Necrotizing Vasculitis

VCRC Tissue Repository

Science.gov (United States)

2018-04-23

Aortitis; Cutaneous Vasculitis; Eosinophilic Granulomatosis With Polyangiitis; Giant Cell Arteritis; Granulomatosis With Polyangiitis (Wegener's); Henoch-Schonlein Purpura; IgA Vasculitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis; Churg-Strauss Syndrome

Towards an optimal semiquantitative approach in giant cell arteritis: an {sup 18}F-FDG PET/CT case-control study

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Besson, Florent L.; Bouvard, Gerard [CHU Caen, Department of Nuclear Medicine, Caen (France); Boysson, Hubert de; Bienvenu, Boris [CHU Caen, Department of Internal Medicine, Caen (France); Parienti, Jean-Jacques [CHU Caen, Department of Biostatistics, Caen (France); Agostini, Denis [CHU Caen, Department of Nuclear Medicine, Caen (France); University of Caen Lower-Normandy, EA 4650, Caen (France)

2014-01-15

Giant cell arteritis (GCA) is the most common form of vasculitis in western countries. {sup 18}F-FDG PET has been shown to be a valuable tool for the diagnosis of extracranial GCA, but results of studies are inconsistent due to a lack of standardized {sup 18}F-FDG PET criteria. In this study, we compared different semiquantitative approaches using a controlled design to define the most efficient method. All patients with biopsy-proven GCA who had undergone an {sup 18}F-FDG PET/CT scan in our PET unit were reviewed and matched with a control group based on age and sex. Different semiquantitative arterial (ascending and descending thoracic aorta and aortic arch) to background (liver, lung and venous blood pool) SUV ratios were blindly compared between GCA patients and matched controls. We included 11 patients with biopsy-proven GCA cases and 11 matched controls. There were no differences between the groups with regard to body weight, injected radioactivity, blood glucose level or CRP. The arterial to venous blood pool ratios discriminated the two groups better than other methods when applied to the aortic arch and the descending thoracic aorta (p < 0.015). In particular, the highest aortic to highest blood pool SUV{sub max} ratio, when applied to the aortic arch, provided optimal diagnostic performance (sensitivity 81.8 %, specificity 91 %, AUC 0.87; p < 0.0001) using a cut-off value of 1.53. Among all tested {sup 18}F-FDG PET/CT methods, the aortic to blood pool SUV{sub max} ratio outperformed the liver and lung ratios. We suggest the use of this ratio for the assessment of aortic inflammation in GCA patients. (orig.)

[Large vessel vasculitides].

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Morović-Vergles, Jadranka; Puksić, Silva; Gracanin, Ana Gudelj

2013-01-01

Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in young ages. Although all large arteries can be affected, the aorta, subclavian and carotid arteries are most commonly involved. The most common symptoms included upper extremity claudication, hypertension, pain over the carotid arteries (carotidynia), dizziness and visual disturbances. Early diagnosis and treatment has improved the outcome in patients with TA.

Characterization of the neutralization determinants of equine arteritis virus using recombinant chimeric viruses and site-specific mutagenesis of an infectious cDNA clone

International Nuclear Information System (INIS)

Balasuriya, Udeni B.R.; Dobbe, Jessika C.; Heidner, Hans W.; Smalley, Victoria L.; Navarrette, Andrea; Snijder, Eric J.; MacLachlan, N. James

2004-01-01

We have used an infectious cDNA clone of equine arteritis virus (EAV) and reverse genetics technology to further characterize the neutralization determinants in the GP5 envelope glycoprotein of the virus. We generated a panel of 20 recombinant viruses, including 10 chimeric viruses that each contained the ORF5 (which encodes GP5) of different laboratory, field, and vaccine strains of EAV, a chimeric virus containing the N-terminal ectodomain of GP5 of a European strain of porcine reproductive and respiratory syndrome virus, and 9 mutant viruses with site-specific substitutions in their GP5 proteins. The neutralization phenotype of each recombinant chimeric/mutant strain of EAV was determined with EAV-specific monoclonal antibodies and EAV strain-specific polyclonal equine antisera and compared to that of their parental viruses from which the substituted ORF5 was derived. The data unequivocally confirm that the GP5 ectodomain contains critical determinants of EAV neutralization. Furthermore, individual neutralization sites are conformationally interactive, and the interaction of GP5 with the unglycosylated membrane protein M is likely critical to expression of individual epitopes in neutralizing conformation. Substitution of individual amino acids within the GP5 ectodomain usually resulted in differences in neutralization phenotype of the recombinant viruses, analogous to differences in the neutralization phenotype of field strains of EAV and variants generated during persistent infection of EAV carrier stallions

[18F]FDG-PET in large vessel vasculitis

International Nuclear Information System (INIS)

Hauser, A.S.D.; Walter, M.A.

2007-01-01

[ 18 F]FDG-PET is a non-invasive metabolic imaging modality based on the regional distribution of fluorine-18-fluorodeoxyglucose that is highly effective in assessing the activity and the extent of giant cell arteritis and Takayasu's arteritis. It has shown to identify more affected vascular regions than morphologic imaging with Magnetic Resonance Imaging in both diseases. A visual grading of vascular [ 18 F]FDG-uptake helps to discriminate arteritis from atherosclerosis und therefore provides high specificity. High sensitivity is reached by scanning during the active inflammatory phase. [ 18 F]FDG-PET has the potential to develop into a valuable tool in the diagnostic work-up of giant cell arteritis and Takayasu's arteritis, respectively, and might become a first-line investigation technique. Therefore consensus regarding the most favorable imaging procedure as well as further clinical evidence is needed. The purpose of this review is to summarize current information on the present clinical data and to assist nuclear medicine practitioners in recommending, performing and interpreting the results of [ 18 F]FDG-PET in patients with suspected large vessel vasculitis. (orig.)

"1"8F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis

International Nuclear Information System (INIS)

Incerti, Elena; Fallanca, Federico; Alongi, Pierpaolo; Gianolli, Luigi; Picchio, Maria; Tombetti, Enrico; Sartorelli, Silvia; Sabbadini, Maria Grazia; Manfredi, Angelo A.; Baldissera, Elena M.; Tombolini, Elisabetta; Papa, Maurizio; De Cobelli, Francesco; Mason, Justin C.

2017-01-01

The object of this study was to assess whether "1"8F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu's arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick. We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUV_m_a_x), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated. Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUV_m_a_x values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUV_m_a_x in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria. PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder. Prospective

mTOR pathway is activated in endothelial cells from patients with Takayasu arteritis and is modulated by serum immunoglobulin G.

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Hadjadj, Jérôme; Canaud, Guillaume; Mirault, Tristan; Samson, Maxime; Bruneval, Patrick; Régent, Alexis; Goulvestre, Claire; Witko-Sarsat, Véronique; Costedoat-Chalumeau, Nathalie; Guillevin, Loïc; Mouthon, Luc; Terrier, Benjamin

2018-06-01

Takayasu arteritis (TA) and GCA are large-vessel vasculitides characterized by vascular remodelling involving endothelial cells (ECs) and vascular smooth muscle cells. Mammalian target of rapamycin (mTOR) pathway has been involved in vascular remodelling. We hypothesized that the mTOR pathway was involved in the pathogenesis of large-vessel vasculitis. We used IF analysis on aortic and temporal artery biopsies from patients with TA and GCA to assess the involvement of the mTOR pathway and searched for antibodies targeting ECs in serum by IIF and cellular ELISA. We evaluated in vitro the effect of purified IgG from patients on mTOR pathway activation and cell proliferation. IF analyses on tissues revealed that both mTORC1 and mTORC2 are activated specifically in ECs from TA patients but not in ECs from GCA patients and healthy controls (HCs). Using IIF and ELISA, we observed higher levels of antibodies binding to ECs in TA patients compared with GCA patients and HCs. Using western blot, we demonstrated that purified IgG from TA patients caused mTORC1 activation in ECs, whereas this effect was not observed with purified IgG from GCA patients or HCs. Purified IgG from TA patients induced a significant EC proliferation compared with to GCA and HC IgG, and this effect was decreased after EC exposure with sirolimus, a specific mTOR inhibitor and PI3K inhibitor. Our results suggest that antibodies targeting ECs drive endothelial remodelling in TA through activation of the mTOR pathway, but not in GCA. Inhibition of the mTOR pathway could represent a therapeutic option in TA.

The role of colour doppler ultrasonography of facial and occipital arteries in patients with giant cell arteritis: A prospective study.

Science.gov (United States)

Ješe, Rok; Rotar, Žiga; Tomšič, Matija; Hočevar, Alojzija

2017-10-01

Colour Doppler Sonography (CDS) in giant cell arteritis (GCA) allows the study of involvement of cranial arteries other than the temporal arteries, which are inconvenient to biopsy, such as the facial (FaA), and occipital (OcA) arteries. We aimed to estimate the frequency of the FaA, and OcA involvement in GCA; and to explore the clinical characteristics of these subgroups of patients. From 1 January 2014 to 31 December 2016 we prospectively performed a CDS of the FaA, and OcA in addition to the temporal (TA), and the extracranial supra-aortic arteries in all newly diagnosed patients suspected of having GCA. All the arteries were evaluated in two planes for the highly specific halo sign. During the 36-month observation period we performed a CDS of the cranial and extra-cranial arteries in 93 GCA patients. We observed the halo sign on the FaA, and OcA in 38 (40.9%), and 29 (31.2%) cases, respectively. The FaA, or OcA were affected in 4/22 (18.2%) patients with a negative TA CDS. FaA involvement significantly correlated with jaw claudication and with severe visual manifestations, including permanent visual loss. A fifth of patients with a negative CDS of the TAs had signs of vasculitis on the CDS of the FaA, or OcA. The addition of FaA and OcA CDS to the routine CDS of the TAs could identify 4.3% more patients and thus further improve the sensitivity of the CDS in the suspected GCA. Copyright © 2017 Elsevier B.V. All rights reserved.

Giant-cell arteritis. Concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

International Nuclear Information System (INIS)

Boysson, Hubert de; Dumont, Anael; Boutemy, Jonathan; Maigne, Gwenola; Martin Silva, Nicolas; Sultan, Audrey; Bienvenu, Boris; Aouba, Achille; Liozon, Eric; Ly, Kim Heang; Lambert, Marc; Aide, Nicolas; Manrique, Alain

2017-01-01

The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA). We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index. We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively. CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches. (orig.)

Giant-cell arteritis. Concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

Energy Technology Data Exchange (ETDEWEB)

Boysson, Hubert de; Dumont, Anael; Boutemy, Jonathan; Maigne, Gwenola; Martin Silva, Nicolas; Sultan, Audrey; Bienvenu, Boris; Aouba, Achille [Caen University Hospital, Department of Internal Medicine, Caen (France); Liozon, Eric; Ly, Kim Heang [Limoges University Hospital, Department of Internal Medicine, Limoges (France); Lambert, Marc [Lille University Hospital, Department of Internal Medicine, Lille (France); Aide, Nicolas [Caen University Hospital, Department of Nuclear Medicine, Caen (France); INSERM U1086 ' ' ANTICIPE' ' , Francois Baclesse Cancer Centre, Caen (France); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Caen (France); Normandy University, Caen (France)

2017-12-15

The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA). We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index. We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively. CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches. (orig.)

[{sup 18}F]FDG-PET in large vessel vasculitis; [{sup 18}F]FDG-PET bei Grossgefaess-Vaskulitiden

Energy Technology Data Exchange (ETDEWEB)

Hauser, A.S.D.; Walter, M.A. [Universitaetsspital Basel (Switzerland). Inst. fuer Nuklearmedizin

2007-06-15

[{sup 18}F]FDG-PET is a non-invasive metabolic imaging modality based on the regional distribution of fluorine-18-fluorodeoxyglucose that is highly effective in assessing the activity and the extent of giant cell arteritis and Takayasu's arteritis. It has shown to identify more affected vascular regions than morphologic imaging with Magnetic Resonance Imaging in both diseases. A visual grading of vascular [{sup 18}F]FDG-uptake helps to discriminate arteritis from atherosclerosis und therefore provides high specificity. High sensitivity is reached by scanning during the active inflammatory phase. [{sup 18}F]FDG-PET has the potential to develop into a valuable tool in the diagnostic work-up of giant cell arteritis and Takayasu's arteritis, respectively, and might become a first-line investigation technique. Therefore consensus regarding the most favorable imaging procedure as well as further clinical evidence is needed. The purpose of this review is to summarize current information on the present clinical data and to assist nuclear medicine practitioners in recommending, performing and interpreting the results of [{sup 18}F]FDG-PET in patients with suspected large vessel vasculitis. (orig.)

Storkarsvaskulitis påvist ved PET/CT hos patient med initialt formodet cancer

DEFF Research Database (Denmark)

Andersen, Kim Francis; Skøt, Jens; Bülow, Jens

2012-01-01

Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally diagnosed and classified according to the American College of Rheumatology criteria, which do not include findings on imaging modalities. We present a case in which non-invasive imaging with 18F...

Standard and biological treatment in large vessel vasculitis: guidelines and current approaches.

Science.gov (United States)

Muratore, Francesco; Pipitone, Nicolò; Salvarani, Carlo

2017-04-01

Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.

{sup 18}F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu's arteritis

Energy Technology Data Exchange (ETDEWEB)

Incerti, Elena; Fallanca, Federico; Alongi, Pierpaolo; Gianolli, Luigi; Picchio, Maria [IRCCS San Raffaele Scientific Institute, Unit of Nuclear Medicine, Milan (Italy); Tombetti, Enrico; Sartorelli, Silvia; Sabbadini, Maria Grazia; Manfredi, Angelo A. [Vita-Salute San Raffaele University, Milan (Italy); IRCCS San Raffaele Scientific Institute, Unit of Internal Medicine and Clinical Immunology, Milan (Italy); Baldissera, Elena M. [IRCCS San Raffaele Scientific Institute, Unit of Internal Medicine and Clinical Immunology, Milan (Italy); Tombolini, Elisabetta [Vita-Salute San Raffaele University, Milan (Italy); Papa, Maurizio [IRCCS San Raffaele Scientific Institute, Department of Radiology, Milan (Italy); De Cobelli, Francesco [Vita-Salute San Raffaele University, Milan (Italy); IRCCS San Raffaele Scientific Institute, Department of Radiology, Milan (Italy); Mason, Justin C. [Imperial College London and Imperial College Healthcare NHS Trust, Vascular Science and Rheumatology, London (United Kingdom)

2017-07-15

The object of this study was to assess whether {sup 18}F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu's arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick. We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUV{sub max}), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated. Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUV{sub max} values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUV{sub max} in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria. PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder

18F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis

Directory of Open Access Journals (Sweden)

Anne E.D. Arraes

Full Text Available ABSTRACT Objective: To evaluate 18F-fluorodeoxyglucose (18F-FDG uptake on positron emission tomography–computed tomography (PET–CT and serum levels of different cytokines and matrix metalloproteinases (MMPs in patients with Takayasu arteritis (TA and associations with disease activity. Methods: Serum levels of tumor necrosis factor-α (TNF-α, interleukin (IL-2, IL-6, IL-8, IL-12, IL-18, MMP-3 and MMP-9 were measured in 36 TA patients and 36 controls. Maximum standard uptake value (SUVmax of 18F-FDG in arterial walls was determined by PET–CT scans. TA patients were classified as active disease, inactive disease and possible active disease. Results: Serum IL-6 and MMP-3 levels were higher in TA patients than in controls (p < 0.001. Serum IL-6 was higher in patients with active disease and in patients with possible active disease than in inactive disease (p < 0.0001. Patients with active disease had higher serum TNFα levels than patients with inactive disease (p = 0.049 while patients with possible active disease presented higher IL-18 levels than patients with inactive disease (p = 0.046. Patients with active disease had higher SUVmax values than those with inactive disease (p = 0.042. By receiver operating characteristic (ROC curve SUVmax was predictive of active disease in TA and values ≥1.3 were associated with disease activity (p = 0.039. Serum TNF-α levels were higher in patients with SUVmax ≥ 1.3 than <1.3 (p = 0.045 and controls (p = 0.012. Serum IL-6 levels were higher in patients with SUVmax ≥ 1.3 than in controls (p < 0.001. No differences regarding other biomarkers were found between TA patients and controls. Conclusions: Higher serum IL-6 and TNFα levels as well as higher 18F-FDG uptake in arterial wall are associated with active TA.

[Changes in prescription patterns for peripheral and cerebral vasoactive drugs before and after establishing prescription standards in France].

Science.gov (United States)

Vuittenez, F; Guignard, E; Comte, S

1999-01-23

Assess changes in the number of prescriptions for peripheral and cerebral vasoactive drugs for the treatment of lower limb arteritis and cerebrovascular disease since the promulgation in 1995 of prescription standards for the treatment of lower limb arteritis. Assess compliance to prescription standards with a detailed analysis of patient features, prescriptions written for lower limb arteritis, cerebrovascular disease and concomitant diseases and evaluate changes in treatment costs for lower limb arteritis and cerebrovascular disease as well as cost of the full prescription, including treatments for associated diseases. This study was based on data recorded during the Permanent Study of Medical Prescriptions conducted from March 1994 to February 1995 and from March 1995 to February 1996 by the IMS. Prescription costs were established from the National Description Files of the IMS. Treatment costs were expressed as public price (FF) tax included. Prescriptions meeting the following criteria were selected for each period: prescriptions written by general practitioners for drugs with peripheral and cerebral vasoactivity (excepting calcium antagonists with a cerebral target) belonging to the Anatomic Therapeutic Classes C4A1 of the European Pharmaceutical Marketing Research Association, Bromly 1996; prescriptions for diagnoses 447.6 (arteritis) and 437.9 (cerebrovascular disease) according to the 9th WHO classification. A random sample of 500 prescriptions was selected to calculate costs. Since the advent of the prescription standards in 1995, prescriptions have dropped off by 6.3% for lower limb arteritis and by 14.8% for cerebrovascular disease. There was a 3.7 point decline in the percentage of multiple prescriptions of vasoactive drugs for lower limb arteritis (21.7% prior to March 1995 versus 18% after promulgation of the prescription standards, p > 0.1) and a 1.8 increase in the percentage of multiple prescriptions for cerebrovascular disease (14% prior to March

Gülhane Askeri Tıp Akademisi Ankara Eğitim ve Araştırma Hastanesine başvuran koroner arter hastalığı tanılı bireylerin sağlık davranışlarının belirlenmesi

OpenAIRE

KURU, Nilgün

2010-01-01

Koroner Arter Hastalığı (KAH) gelişmiş ülkelerde olduğu gibi ülkemizde de gerek morbidite gerekse mortalitenin en önemli nedenidir. KAH'ın yaşam süresi ve kalitesi üzerindeki olumsuz etkisi, maddi ve manevi maliyetlerin yüksekliği düşünüldüğünde yaşam biçimlerini değiştirmeye yönelik koruyucu programların önemi daha iyi anlaşılacaktır. Bireylere olumlu sağlık davranışı kazandırma programları düzenlenmeden önce, bireylerin davranışlarını etkileyen etmenlerin ve bir davranışı yap...

A large-scale genetic analysis reveals a strong contribution of the HLA class II region to giant cell arteritis susceptibility.

Science.gov (United States)

Carmona, F David; Mackie, Sarah L; Martín, Jose-Ezequiel; Taylor, John C; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castañeda, Santos; Cid, Maria C; Hernández-Rodríguez, José; Prieto-González, Sergio; Solans, Roser; Ramentol-Sintas, Marc; González-Escribano, M Francisca; Ortiz-Fernández, Lourdes; Morado, Inmaculada C; Narváez, Javier; Miranda-Filloy, José A; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H; Moosig, Frank; Schönau, Verena; Franke, Andre; Palm, Øyvind; Molberg, Øyvind; Diamantopoulos, Andreas P; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J; Hoffman, Gary S; Khalidi, Nader A; Koening, Curry L; Langford, Carol A; McAlear, Carol A; Moreland, Larry; Monach, Paul A; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G; Warrington, Kenneth J; Ytterberg, Steven R; Gregersen, Peter K; Pease, Colin T; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P C; de Bakker, Paul I W; Barrett, Jennifer H; Salvarani, Carlo; Merkel, Peter A; González-Gay, Miguel A; Morgan, Ann W; Martín, Javier

2015-04-02

We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10(-40), OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1(∗)04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10(-43)) and HLA-DQα1 47 (p = 4.02 × 10(-46)), 56, and 76 (both p = 1.84 × 10(-45)) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10(-6), OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10(-6), OR = 1.20), and REL (rs115674477, p = 1.10 × 10(-5), OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Evaluation of a 32-channel versus a 12-channel head coil for high-resolution post-contrast MRI in giant cell arteritis (GCA) at 3 T

Energy Technology Data Exchange (ETDEWEB)

Franke, Philipp, E-mail: philipp.franke@uniklinik-freiburg.de [Institut für Diagnostische Radiologie, Gartenstr. 28, 79098 Freiburg (Germany); Markl, Michael, E-mail: mmarkl@northwestern.edu [Departments of Radiology and Biomedical Engineering, Northwestern University Chicago, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611 (United States); Heinzelmann, Sonja, E-mail: sonja.heinzelmann@uniklinik-freiburg.de [Department of Ophthalmology, University Hospital Freiburg, Killianstr. 5, 79106 Freiburg (Germany); Vaith, Peter, E-mail: peter.vaith@uniklinik-freiburg.de [Department of Rheumatology and Immunology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Bürk, Jonas, E-mail: jonas.buerk@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Langer, Mathias, E-mail: mathias.langer@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Geiger, J., E-mail: julia.geiger@uniklinik-freiburg.de [Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg (Germany); Department of Radiology, University Children‘s Hospital Zurich, Steinwiesstr. 75, 8032 Zurich (Switzerland)

2014-10-15

The aim of this study was to evaluate the diagnostic value of a 32-channel head coil for the characterization of mural inflammation patterns in the superficial cranial arteries in patients with giant cell arteritis (GCA) compared to a standard 12-channel coil at 3 T MRI. 55 patients with suspected GCA underwent high resolution T1-weighted post-contrast MRI at 3 T to detect inflammation related vessel wall enhancement using both coils. To account for different time delays between contrast agent injection and sequence acquisition, the patients were divided into two cohorts: 27 patients were examined with the 32-channel coil first and 28 patients with the 12-channel coil first. Images were evaluated by two blinded readers with regard to image quality, artifact level and arteries’ inflammation according to a standardized ranking scale; furthermore signal-to-noise ratio (SNR) measurements were performed at three locations. Identification of arteries’ inflammation was achieved with both coils with excellent inter-observer agreement (κ = 0.89 for 12-channel and κ = 0.96 for 32-channel coil). Regarding image grading, the inter-observer variability was moderate for the 12-channel (κ = 0.5) and substantial for the 32-channel coil (κ = 0.63). Significantly higher SNR and improved image quality (p < 0.01) were obtained with the 32-channel coil in either coil order. Image quality for depiction of the superficial cranial arteries was superior for the 32-channel coil. For standardized GCA diagnosis, the 12-channel coil was sufficient.

Vasculitis assessment with [18F]F.D.G. positron emission tomography

International Nuclear Information System (INIS)

Liozon, E.; Monteil, J.

2008-01-01

[ 18 F]fluorodeoxyglucose ( 18 F.D.G.) positron emission tomography (PET) is a noninvasive metabolic imaging modality that is well suited to the assessment of activity and extent of large vessel vasculitis, such as giant cell arteritis and Takayasu arteritis. PET could be more effective than magnetic resonance imaging in detecting the earliest stages of vascular wall inflammation. The visual grading of vascular [ 18 F]F.D.G. uptake makes it possible to discriminate arteritis from atherosclerosis, providing therefore high specificity. High sensitivity can be achieved provided scanning is performed during active inflammatory phase, preferably before starting corticosteroid treatment. Large scale prospective studies are needed to determine the exact value of PET imaging in assessing the large vessel vasculitis outcome and response to immunosuppressive treatment

Temporal arteritis

Science.gov (United States)

... of corticosteroids will be cut back very slowly. Biologic medicines may also be used. These medicines appear to reduce the amount of corticosteroids needed to control the disease. Long-term treatment with corticosteroids can ...

Vasculitis assessment with [{sup 18}F]F.D.G. positron emission tomography; Place de la tomographie par emission de positons (TEP) au [{sup 18}F]FDG dans l'exploration des vascularites

Energy Technology Data Exchange (ETDEWEB)

Liozon, E. [CHU Dupuytren, Services de Medecine Interne A, 87 - Limoges (France); Monteil, J. [CHU Dupuytren, Services de Medecine Nucleaire, 87 - Limoges (France)

2008-10-15

[{sup 18}F]fluorodeoxyglucose ({sup 18}F.D.G.) positron emission tomography (PET) is a noninvasive metabolic imaging modality that is well suited to the assessment of activity and extent of large vessel vasculitis, such as giant cell arteritis and Takayasu arteritis. PET could be more effective than magnetic resonance imaging in detecting the earliest stages of vascular wall inflammation. The visual grading of vascular [{sup 18}F]F.D.G. uptake makes it possible to discriminate arteritis from atherosclerosis, providing therefore high specificity. High sensitivity can be achieved provided scanning is performed during active inflammatory phase, preferably before starting corticosteroid treatment. Large scale prospective studies are needed to determine the exact value of PET imaging in assessing the large vessel vasculitis outcome and response to immunosuppressive treatment.

Biomass degrading enzymes from Penicillium – cloning and characterization

DEFF Research Database (Denmark)

Krogh, Kristian Bertel Rømer

2008-01-01

. Størstedelen af den forskning, der er foregået indenfor cellulosenedbrydende enzymer er med enzymer produceret af svampen Trichoderma reesei. Under mit Ph.D.studium har jeg undersøgt biomassenedbrydende enzymer fra forskellige Penicillium arter. Hovedvægten af forskningen har været indenfor...... cellulosenedbrydende enzymer.Penicillium arter er blandt de hyppigst forekommende mikroorganismer i skovjord, hvori der netop nedbrydes store mængder plantemateriale. Ved en sammenligning af produktionen af biomassenedbrydende enzymer fra forskellige Penicillium arter blev der fundet flere interessante enzymsystemer...... reaktionstid ved den enzymatisk hydrolyse hvor de enkelte sukkermolekyler bliver frigivet, hvorfor enzymstabilitet er særdeles væsentlig, når et rentabelt cellulosenedbrydende enzymsystem skal sammensættes. De nødvendige enzymer for en fuldstændig hydrolyse af cellulose blev oprenset, klonet, produceret...

Vandmiljø 2002

DEFF Research Database (Denmark)

Andersen, J. M.; Boutrup, S.; Svendsen, L. M.

rengøringsmidler, og DEHP anvendes som blødgører i plastprodukter. Der registreres stadig en udbredt forekomst af påvirkning af kønsorganerne i de fire undersøgte arter af havsnegle, som skyldes TBT (tributyltin). Først og fremmest i kystnære områder, men i de følsomme arter er der også effekter i åbne farvande...

CRISPR – hot genteknologisk teknik til at skabe nye sygdomsmodeller

DEFF Research Database (Denmark)

Alstrup, Aage Kristian Olsen

2017-01-01

CRISPR er i en ny genteknologisk teknik, som gør det muligt at ændre i genomet på alle arter af forsøgsdyr, hvor den gammelkendte teknik kun fungerede i mus.......CRISPR er i en ny genteknologisk teknik, som gør det muligt at ændre i genomet på alle arter af forsøgsdyr, hvor den gammelkendte teknik kun fungerede i mus....

Phytophthora rotråte i juletrefelt

DEFF Research Database (Denmark)

Talgø, Venche; Thomsen, Iben Margrete

2015-01-01

Phytophthora rotråte forårsaket av ulike arter av Phytophthora er et stort problem i juletreproduksjonen iUSA. I Norge er det også rapportert om flere tilfeller av skade på grunn av Phytophthora både i juletrær og klippegrønt, men så langt ikke i Danmark. I begge landene er flere arter av...... Phytophthora funnet på treaktige vekster i grøntanlegg. Vi har også sett en urovekkende spredning av Phytophthora til løvtrær i bynære skoger, vassdrag og naturområder det siste tiåret, spesielt i Norge. Både i Norge og Danmark har vi undersøkt vann i eller like ved juletreplantinger og funnet flere...... Phytophthora-arter, så dette er en skadegjører juletredyrkere må være på vakt overfor...

Effectiveness of ivermectin against later 4th-stage Strongylus vulgaris in ponies.

Science.gov (United States)

Slocombe, J O; McCraw, B M; Pennock, P W; Vasey, J

1982-09-01

Twelve pony foals were reared worm-free and inoculated with Strongylus vulgaris. Approximately 8 weeks after they were inoculated, 6 foals were given ivermectin IM at a dosage rate of 200 micrograms/kg of body weight and 6 were given a placebo. All foals were necropsied 35 days after treatment. Ivermectin was 98.9% effective in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries and in reducing clinical signs and permitting resolution of lesions associated with verminous arteritis. One pony foal reared on pasture and with evidence of arteritis of the cranial mesenteric and ileocolic arteries on arteriography was treated with ivermectin at a dosage rate of 200 micrograms/kg of body weight. On arteriographs taken subsequently, there was evidence of regression of the lesion, and at necropsy 9 weeks after treatment, there was no arteritis or larvae in those arteries.

Interactions between two congeneric gyrodactylids (Gyrodactylus derjavini and G. salaris) with different microhabitats on their common host rainbow trout, Oncorhynchus mykiss

DEFF Research Database (Denmark)

Garbøl, Line W.; Jørgensen, Thomas Rohde; Buchmann, Kurt

2007-01-01

De to Gyrodactylus arter G. derjavini og G. salaris foretrækker forskellige områder på deres fælles vært. Dette ses både i monkulturer og i blandede kulturer, som dette arbejde belyser eksperimentelt.......De to Gyrodactylus arter G. derjavini og G. salaris foretrækker forskellige områder på deres fælles vært. Dette ses både i monkulturer og i blandede kulturer, som dette arbejde belyser eksperimentelt....

Fattige vandløb på Bolivias Andes-højslette

DEFF Research Database (Denmark)

Jacobsen, D.

2006-01-01

På Bolivias højslette, i 4.000 m højde, er selv uforurenede vandløb så fattige på arter af smådyr og fisk at biologisk bedømmelse af vandløbskvalitet ikke umiddelbart kan anvendes.......På Bolivias højslette, i 4.000 m højde, er selv uforurenede vandløb så fattige på arter af smådyr og fisk at biologisk bedømmelse af vandløbskvalitet ikke umiddelbart kan anvendes....

Giant Cell Arteritis

Science.gov (United States)

... OII) Timed Up & Go (TUG) Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) Young Investigators Resources for Doctoral Students/Post-Doctoral Fellows Evidence-Based Practice for Academic Researchers Responsible Data Management in Research Career Planning Treatments Patient ...

Biopsia de la arteria temporal: revisión de indicaciones y técnica quirúrgica para cirujanos plásticos Temporal artery biopsy: review of indications and surgical technique for plastic surgeons

Directory of Open Access Journals (Sweden)

A. Rodríguez Lorenzo

2007-06-01

Full Text Available La arteritis de células gigantes (ACG es una vasculitis que presenta complicaciones graves si no es diagnosticada y tratada precozmente con corticoides a altas dosis. La biopsia de la arteria temporal (BAT es la técnica diagnóstica estandarizada utilizada para confirmar la enfermedad. Se trata de una técnica sencilla y con poca morbilidad. No obstante, en la actualidad existe una controversia sobre su indicación en pacientes con sospecha clínica de arteritis sin síntomas craneales debido a la baja tasa de positividad de la biopsia. Presentamos en este trabajo una serie de 28 pacientes en los que se realizaron 30 BAT con el objetivo de revisar las indicaciones y describir la técnica quirúrgica utilizada.Giant cell arteritis is a vasculitis that presents serious complications if it is not diagnosed and treated prematurely with corticosteroids to high dose. The temporal artery biopsy is the gold estandar technique of diagnosis used to confirm the disease. It is a simple technique with little morbidity. Nevertheless, currently there is a controversy on its indication in patients with clinical suspicion of arteritis without craneal symptoms because of the downward rate of positiveness of the biopsy. We present in this work a serie of 28 patients in which 30 biopsies were carried out with the objective to review the indications and to describe the surgical technique utilized.

Storkarsvaskulitis påvist ved PET/CT hos patient med initialt formodet cancer

DEFF Research Database (Denmark)

Andersen, Kim Francis; Skøt, Jens; Bülow, Jens

2012-01-01

Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally diagnosed and classified according to the American College of Rheumatology criteria, which do not include findings on imaging modalities. We present a case in which non-invasive imaging with 18F......-fluorodeoxyglucose positron emission tomography/computed tomography gave essential information in the diagnostic work-up of large vessel vasculitis in a female presenting with non-specific symptoms. We discuss the role of nuclear medicine imaging in early diagnosis and follow-up of this inflammatory disease, characterized...

Disease: H01698 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available cell arteritis and large vessel vasculitis. ... JOURNAL ... RMD Open 2:e000137 (2016) DOI:10.1136/rmdopen-2015-000137 ...s of C-reactive protein (CRP) Glucocorticoids Tocilizumab [DR:D02596] See also H01465 Large-vessel vasculi...culitis in individuals over the age of 50 in Western countries. It is characterized...nown as temporal arteritis, is a chronic and polygenic immune-mediated disease of unknown etiology. It is the most common form of vas...tis (LVV). ICD-10: M31.6 MeSH: D013700 OMIM: 187360 PMID:27708947 (marker) ... AUTHOR

Overvåking av jordboende sopp i Røsskleiva NR, Bamble 2016

OpenAIRE

Brandrud, Tor Erik; Dima, Bàlint

2017-01-01

Brandrud, T.E. & Dima, B. 2017. Overvåking av jordboende sopp i Røsskleiva NR, Bamble 2016. – NINA Kortrapport 80. 15 s. Kartlegging (start av overvåking) av habitat-spesifikke, jordboende kalksopper i nordre del av Røsskleiva NR ble gjennomført i 2016, før oppstart av skjøtselstiltak med storfébeiting. Tilsammen 27 habitat-spesifikke arter, inkludert 18 rødlistede arter ble registrert i løpet av to registreringsrunder i 2016. Funnene fordelte seg på 10 kalkbarskogsopper, 5 kalklinde-skogs...

[Results of a regional survey on the treatment of rhizomelic pseudopolyarthritis and temporal arteritis. Apropos of 242 cases treated by various modalities with synthetic antimalarials, corticoids and non-steroidal anti-inflammatory agents].

Science.gov (United States)

David-Chaussé, J; Dehais, J; Leman, A

1983-01-01

The authors report the results of a retrospective therapeutic survey concerning 176 cases of rhizomelic pseudopolyarthritis (RPP) and 66 cases of temporal arteritis (TA). Of 128 cases of RPP treated initially by synthetic anti-malarials (SAM) and non-steroidal anti-inflammatory agents (NSAI), 66 were followed up until cure which was obtained after a mean of 23 months and 3 subsequently received brief steroid therapy. 45 cases of RPP were treated initially with corticosteroids. They were generally associated with SAM which enabled early weaning of the steroids, towards the 8 th month, or at least reducing the dose. Cure was obtained within 24 months. Three patients were treated by NSAI and gold therapy. After cure, 5 cases of recurrence and 1 case of TA were observed. 40 cases of TA were initially treated with SAM and NSAI. Twenty cures were obtained within a mean of 28 months. 4 patients later received brief corticosteroid therapy because of an extension of the signs, including two cases of ocular manifestations with a resolving course. Of 25 cases of TA initially treated with steroids, 20 received SAM in combination, or in relay which enabled either steroids, weaning towards the 14th month or a reduction in the dose of steroids. Cure was obtained in an average of 35 months. One case of impaired visual acuity occurred during corticosteroid treatment. Immunosuppressants were used in one patient. No cases of recurrence were observed. Iatrogenic complications with SAM were rare, generally benign and reversible, in contrast to those associated with corticosteroid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Addison's disease secondary to connective tissue diseases: a report of six cases.

Science.gov (United States)

Zhang, Zhuo-li; Wang, Yu; Zhou, Wei; Hao, Yan-jie

2009-04-01

Addison's disease is an autoimmune process. However, Addison's disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison's disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison's disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison's disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.

INNOVATIVE TREATMENTS FOR TAKAYASU’S ARTERITIS: A FOCUS ON INTERLEUKIN-6 INHIBITORS. THE AUTHORS’ EXPERIENCE WITH TOCILIZUMAB AND A REVIEW OF LITERATURE

Directory of Open Access Journals (Sweden)

T. V. Beketova

2017-01-01

Full Text Available The need for further improvement of treatments for Takayasu’s arteritis (TA, the progress in understanding the mechanisms of the disease, and the introduction of biological agents (BA in rheumatology practice have created preconditions for developing a new TA pharmacotherapy using BA associated with interleukin 6 (IL-6 inhibition. The authors describe their two own cases of tocilizumab (TCZ use for complicated TA. They analyze the results of TCZ treatment by the data of preliminary trials in 115 patients with TA, which have been published in 30 literature sources, as well as the results of Phase III double-blind, randomized placebo-controlled trials (RPCTs of the safety and efficacy of TCZ in 18 patients with refractory TA. In one case with a long history of complicated TA, the control of TA activity and the reduction in the dose of glucocorticoids due to TCZ use contributed to the favorable course of pregnancy and labor. In the other case with the onset of TA and focal pulmonary tuberculosis (TB treated with anti-TB drugs during TCZ monotherapy for 6 months could control TA and achieve TB cure. Preliminary trials showed that TCZ treatment-induced remission or improvement was observed in 85% of patients with TA, including that with a refractory course. RPCTs indicated that the relapse-free survival after 6-month maintenance treatment with TCZ was higher than that in the placebo group (51 and 23%, respectively; but the differences failed to reach statistical significance (p = 0.0596. Due to the fact that a recurrence of TA can occur in patients treated with TCZ, it is appropriate to combine this drug with cytostatic drugs, methotrexate in particular. The use of IL-6 inhibitors should be considered as a potentially effective and relatively safe innovative (off-label treatment for refractory TA in patients with intolerance or contraindications to standard therapy, which requires further larger randomized clinical trials. Since now

Prevalência de anticorpos antivírus da arterite dos eqüinos em cavalos criados no Estado de São Paulo Prevalence of equine arteritis virus specific antibodies in horses of São Paulo State, Brazil

Directory of Open Access Journals (Sweden)

M.C.C.S.H. Lara

2002-06-01

Full Text Available Utilizou-se a prova de soroneutralização em microplacas para detecção de anticorpos antivírus da arterite dos eqüinos em 659 amostras de soro sangüíneo de animais criados no Estado de São Paulo. A prevalência de anticorpos na população estudada foi igual a 18,2%. A raça Mangalarga foi a que apresentou maior taxa de prevalência, 33,3%. Animais na faixa etária de 6 a 24 meses de idade apresentaram a maior taxa de prevalência, 30,4%, e as fêmeas apresentaram prevalência de 22, 9%, mais alta do que nos machos.With the purpose of studying the prevalence of equine viral arteritis in horses raised in São Paulo State, Brazil, by the standard microtiter serum neutralization test, 659 serum samples were investigated. The prevalence of antibodies in the horse population was 18.2%, which was significantly higher in Mangalarga horses (33.3% than in any other breed (Thoroughbred, Arab, Quarter Horse, mixed breeds and others. The distribuition of horses by age showed that horses between 6 to 24 months of age (30.4% had a higher prevalence (30.4% rate than others. The female horses prevalence rate of 22.9% was significantly higher than in male horses.

Plasma thromboxane B2 levels in horses experimentally infected with Strongylus vulgaris.

Science.gov (United States)

Cambridge, H; Reynoldson, J A; Dunsmore, J D

1989-06-01

Plasma thromboxane B2 (TXB2) the stable inactive metabolite of thromboxane A2 (TXA2), was measured daily by specific radioimmunoassay in three groups of animals before and after experimental infection with Strongylus vulgaris. Infection of four 'parasite naive' foals produced a typical acute syndrome with intermittent but statistically insignificant rises in TXB2 levels. Interpretation of results was complicated by the presence of a non-septic peritonitis associated with implantation of the foals with electrodes for recording myoelectrical activity. In two foals of similar age, with some natural exposure to S. vulgaris, there was little or no clinical response to infection and increases in TXB2 were absent. Baseline levels were also much lower, indicating that the peritonitis may have affected the results obtained in the first group of foals. Severe mesenteric arteritis was confirmed at necropsy in all six foals. A third group of yearling horses, all with natural exposure to the parasite, were generally resistant to infection. One animal developed arteritis with clinical signs of diarrhoea and mild colic, and also showed intermittent increases in TXB2. The mean plasma TXB2 level after infection was significantly higher than in the control period, although absolute levels were lower than those recorded in the 'parasite naive' foals. Other animals in this group had low TXB2 levels and minimal arteritis was found at necropsy. These results indicate that although infection appears to have an effect on plasma TXB2, the changes are inconsistent and not reliable indicators of the presence of verminous arteritis. The results also confirm the difficulty in establishing infection and the variability of the response in animals with previous exposure.

Cannabis-associated arterial disease.

Science.gov (United States)

Desbois, Anne Claire; Cacoub, Patrice

2013-10-01

The aim of this study was to describe the different arterial complications reported in cannabis smokers. This study was a literature review. Cannabis use was found to be associated with stroke, myocardial infarction, and lower limb arteritis. Arterial disease involved especially young men. There was a very strong temporal link between arterial complications and cannabis use for stroke and myocardial infarction episodes. Patient outcome was closely correlated with cannabis withdrawal and relapses associated with cannabis rechallenge. Cannabis use was associated with particular characteristics of arterial disease. The increased risk of myocardial infarction onset occurred within 1 hour of smoking marijuana compared with periods of non-use. Strokes occurred mainly in the posterior cerebral circulation. Compared with cohorts of thromboangiitis obliterans patients, those with cannabis-associated limb arteritis were younger, more often male, and had more frequent unilateral involvement of the lower limbs at clinical presentation. Cannabis use is associated with arterial disease such as stroke, myocardial infarction, and limbs arteritis. It appears essential to investigate cannabis use in young patients presenting with such arterial manifestations, as outcome is closely correlated with cannabis withdrawal. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation and management of "sinus headache" in the otolaryngology practice.

Science.gov (United States)

Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

2014-04-01

Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

Pediatric Vasculitis Initiative

Science.gov (United States)

2017-05-01

Wegeners Granulomatosis (Granulomatosis With Polyangiitis); Microscopic Polyangiitis; Churg Strauss Syndrome (Eosinophilic Granulomatosis With Polyangiitis); Polyarteritis Nodosa; Takayasu Arteritis; Primary CNS Vasculitis; Unclassified Vasculitis

NOVANA Arter 2004-2005

DEFF Research Database (Denmark)

Søgaard, B.; Pihl, S.; Wind, P.

Mandag den 19. juni blev pdf filen af hele rapporten udskiftet. Figur 4.5.6.3 på side 129 er udskiftet, så figuren har den korrekte skala for antal individer på op til 140.000......Mandag den 19. juni blev pdf filen af hele rapporten udskiftet. Figur 4.5.6.3 på side 129 er udskiftet, så figuren har den korrekte skala for antal individer på op til 140.000...

Management of outpatients in France with stable coronary artery disease. Findings from the prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY) registry.

Science.gov (United States)

Danchin, Nicolas; Ferrieres, Jean; Guenoun, Maxime; Cattan, Simon; Rushton-Smith, Sophie K; Greenlaw, Nicola; Ferrari, Roberto; Steg, Philippe Gabriel

2014-01-01

Improvements in the treatment of coronary artery disease mean that an increasing number of patients survive acute cardiovascular events and live as outpatients with or without anginal symptoms. To determine the characteristics and management of contemporary outpatients with stable coronary artery disease in Western Europe, and to compare France with the other Western European countries. CLARIFY (prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an international, prospective, observational, longitudinal study. Between November 2009 and July 2010, 32,954 adult outpatients with stable coronary artery disease (defined as a history of documented myocardial infarction [of >3 months], prior coronary revascularization, chest pain with myocardial ischaemia, or coronary stenosis of>50% proven by angiography) were enrolled in 45 countries. The demographics and management of CLARIFY patients enrolled in France were compared with those enrolled in other Western European countries (Austria, Belgium, Denmark, Germany, Greece, Ireland, Italy, Netherlands, Portugal, Spain, Switzerland and the UK). Of the 14,726 patients enrolled in Western Europe (mean age 66.2 [10.2] years; 79.6% male), 2432 (16.5%) were from France. The use of aspirin was lower in France than in other Western European countries (74.5% vs. 86.9%, respectively), whereas use of thienopyridines (48.5% vs. 21.7%), oral anticoagulants (12.3% vs. 9.0%) and lipid-lowering drugs (95.8% vs. 92.5%) was higher. Beta-blockers were used in 73% of both groups. Angina was less prevalent in France (6.3% vs. 15.5%) and French patients showed higher levels of physical activity than their counterparts in Western Europe. The management of patients with stable CAD in France appears favourable, with good adherence to guideline-based therapies, but there remains room for improvement in terms of symptom and risk factor control. Copyright © 2014. Published by Elsevier Masson SAS.

Yellow Fever Vaccine in Patients With Rheumatic Diseases

Science.gov (United States)

2018-04-05

Systemic Lupus; Rheumatoid Arthritis; Spondyloarthritis; Inflammatory Myopathy; Systemic Sclerosis; Mixed Connective Tissue Disease; Takayasu Arteritis; Granulomatosis With Polyangiitis; Sjogren's Syndrome; Juvenile Idiopathic Arthritis; Juvenile Dermatomyositis

Temporal artery biopsies in south-east Scotland: a five year review.

Science.gov (United States)

Gajree, S; Borooah, S; Dhillon, N; Goudie, C; Smith, C; Aspinall, P; Dhillon, B

2017-06-01

Temporal artery biopsy is the gold standard investigation for the diagnosis of giant cell arteritis. The aim of this retrospective study was to investigate the use of temporal artery biopsy in diagnosing giant cell arteritis in south-east Scotland over a five-year period. We aimed to quantify success rates, and predictive factors for a positive biopsy, as well as compare the different specialities performing the biopsies. The data should enable the development of better criteria for referral for investigation of giant cell arteritis. Methods Patients were identified using a database of temporal artery biopsies generated by the pathology department in NHS Lothian (south east Scotland), for all biopsies examined between January 2010 and December 2015. An electronic patient record was used to retrospectively examine the records of patients in the database. Results A total of 715 biopsies were included in the study, of which 250 (35.0%) showed features of giant cell arteritis. The main predictors for a positive biopsy were age at biopsy, specialty performing biopsy, erythrocyte sedimentation rate, jaw claudication/pain, and ophthalmic symptoms. The most important predictor of a positive biopsy was erythrocyte sedimentation rate. The length of biopsy was not found to be a predictor of positive biopsy; however, diameter of biopsy was predictive. Conclusions We have shown that many temporal artery biopsies are negative, and finding ways to reduce the number of patients unnecessarily undergoing biopsy will be essential in reducing workload and streamlining services. This study demonstrates some key predictive factors for patients with positive biopsies. The study also shows that a large proportion of biopsies taking place do not result in the recommended length of specimen, but this does not necessarily reduce the likelihood of a positive biopsy.

Bilateral Non-arteritic Anterior Ischaemic Optic Neuropathy as the Presentation of Systemic Amyloidosis.

Science.gov (United States)

Kanaan, M Z; Lorenzi, A R; Thampy, N; Pandit, R; Dayan, Margaret

2017-12-01

A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asymptomatic left optic disc swelling was found at routine review 2 months later, and a diagnosis of giant cell arteritis (GCA) was sought. Temporal artery duplex ultrasound showed the "halo sign," but a subsequent temporal artery biopsy showed light-chain (AL) amyloidosis with no signs of giant cell arteritis. In this case, bilateral sequential ischaemic optic neuropathy mimicking non-arteritic anterior ischaemic optic neuropathy was the presenting sign of systemic amyloidosis involving the temporal arteries.

Diffuse corpus callosum infarction - Rare vascular entity with differing etiology.

Science.gov (United States)

Mahale, Rohan; Mehta, Anish; Buddaraju, Kiran; John, Aju Abraham; Javali, Mahendra; Srinivasa, Rangasetty

2016-01-15

Infarctions of the corpus callosum are rare vascular events. It is relatively immune to vascular insult because of its rich vascular supply from anterior and posterior circulations of brain. Report of 3 patients with largely diffuse acute corpus callosum infarction. 3 patients with largely diffuse acute corpus callosum infarction were studied and each of these 3 patients had 3 different aetiologies. The 3 different aetiologies of largely diffuse acute corpus callosum infarction were cardioembolism, tuberculous arteritis and takayasu arteritis. Diffuse corpus callosum infarcts are rare events. This case series narrates the three different aetiologies of diffuse acute corpus callosum infarction which is a rare vascular event. Copyright © 2015 Elsevier B.V. All rights reserved.

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

Science.gov (United States)

Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

2014-09-01

Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

Imaging of large vessel vasculitis with 18FDG PET: illusion or reality? A critical review of the literature data

International Nuclear Information System (INIS)

Belhocine, Tarik; Vandevivere, Johan; Blockmans, Daniel; Hustinx, Roland; Mortelmans, Luc

2003-01-01

Fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 FDG PET) plays a major role in the management of oncology patients. Owing to the singular properties of the glucose tracer, many patients suffering from non-malignant diseases such as inflammatory or infectious diseases may also derive clinical benefit from the appropriate use of metabolic imaging. Large vessel vasculitides such as giant cell arteritis and Takayasu arteritis are other examples that may potentially extend the field of 18 FDG PET indications. The purpose of the present article is to assess the feasibility of metabolic imaging in vasculitis on the basis of the current literature data. In particular, the clinical context and the 18 FDG imaging patterns seen in patients with large vessel vasculitis are analysed in order to identify potential indications for metabolic imaging. (orig.)

Imaging of large vessel vasculitis with {sup 18}FDG PET: illusion or reality? A critical review of the literature data

Energy Technology Data Exchange (ETDEWEB)

Belhocine, Tarik; Vandevivere, Johan [Department of Nuclear Medicine, A.Z. Middelheim Hospital, 2020, Antwerp (Belgium); Blockmans, Daniel [Department of Internal Medicine, Gasthuisberg University Hospital, Leuven (Belgium); Hustinx, Roland [Department of Nuclear Medicine, University Hospital of Liege, Liege (Belgium); Mortelmans, Luc [Department of Nuclear Medicine, Gasthuisberg University Hospital, Leuven (Belgium)

2003-09-01

Fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}FDG PET) plays a major role in the management of oncology patients. Owing to the singular properties of the glucose tracer, many patients suffering from non-malignant diseases such as inflammatory or infectious diseases may also derive clinical benefit from the appropriate use of metabolic imaging. Large vessel vasculitides such as giant cell arteritis and Takayasu arteritis are other examples that may potentially extend the field of {sup 18}FDG PET indications. The purpose of the present article is to assess the feasibility of metabolic imaging in vasculitis on the basis of the current literature data. In particular, the clinical context and the {sup 18}FDG imaging patterns seen in patients with large vessel vasculitis are analysed in order to identify potential indications for metabolic imaging. (orig.)

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus.

Directory of Open Access Journals (Sweden)

Hassan Borji

2014-09-01

Full Text Available Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

Regulering af jagt på vandfugle i kystzonen: Forsøg med dato-regulering på Nyord

DEFF Research Database (Denmark)

Bregnballe, T.; Hounisen, J. P.; Bøgebjerg, E.

Et 4-årigt forsøg udført på Nyord Sydeng ved Møn har vist at jagt med 1-3 ugers interval ikke påvirkede antallet af gæs, ænder og vadefugle negativt, bort set fra at enkelte arter (især jagtbare arter) optrådte i lavere antal dagen efter en jagt. Fuglenes adfærdsmæssige reaktion på udøvelse af ja...... samt effekten på fuglenes antal var mindst i et år hvor engene blev oversvømmet tidligt på efteråret. Det konkluderes at dato-regulering af jagt på strandenge kan være et velegnet værktøj hvis der skal findes et alternativ til total jagtfredning...

Arterite de Takayasu: tratamento com anti-TNF em uma casuística brasileira Takayasu arteritis: anti-TNF therapy in a Brazilian setting

Directory of Open Access Journals (Sweden)

Guilherme Nunes

2010-06-01

Full Text Available O objetivo deste estudo é descrever as características clínicas e as respostas às intervenções terapêuticas, incluindo a terapia antifator de necrose tumoral (TNF, em uma série de casos brasileiros de arterite de Takayasu (AT. Foi realizado um estudo observacional, retrospectivo, com base na revisão de prontuários, incluindo todos os pacientes com AT, de acordo com os critérios de classificação do American College of Rheumatology, em acompanhamento no Serviço de Reumatologia do Hospital Universitário da Universidade Federal de Santa Catarina (UFSC, Brasil. Foram incluídos 15 pacientes, sendo 14 (93,3% mulheres, com idade média ao diagnóstico de 29,6 anos. Hipertensão arterial sistêmica (60,0% e ausência de pulsos em membros superiores (53,3% foram os achados clínicos mais comuns ao diagnóstico. As artérias subclávias e carotídeas foram os vasos mais frequentemente acometidos. Doze pacientes (80,0% não obtiveram remissão sustentada em terapia isolada com corticosteroide, tendo sido empregada terapia imunossupressora, sendo metotrexato, azatioprina e ciclofosfamida as drogas utilizadas. Intervenções cirúrgicas foram necessárias em 53,3% dos casos. Três casos (20,0% foram refratários à terapia com corticoides e imunossupressores e foram tratados com agentes anti-TNF, com subsequente remissão da doença. Em conclusão, observou-se que uma parcela importante dos casos de AT é refratária à terapia tradicional e os agentes anti-TNF podem representar uma opção promissora para o controle da doença nesses casos.The aim of this study was to describe clinical features and response to different therapeutic interventions, including anti-tumor necrosis factor (TNF agents, in a case series of Takayasu arteritis (TA from Brazil. A retrospective observational chart-review study was performed including all patients meeting the American College of Rheumatology TA classification criteria followed at the rheumatology

Takayasu's arteritis: a challenging diagnosis.

LENUS (Irish Health Repository)

Fanning, D M

2009-03-01

The practices of medicine and surgery are inherently and irrevocably entwined. This case report highlights the need for an integrated, multi-disciplinary approach to care of the modern patient. Our patient fulfils the traditional Ishikawa\\'s criteria and the modified Ishikawa\\'s criteria for the clinical diagnosis of Takayasu\\'s disease. Her case underpins the need for co-ordinated care and careful periodic review of the symptomatology and signs of the multiple clinic attendees.

Relative Frequencies of Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy in an Arab Population.

Science.gov (United States)

Gruener, Anna M; Chang, Jessica R; Bosley, Thomas M; Al-Sadah, Zakeya M; Kum, Clarissa; McCulley, Timothy J

2017-12-01

To evaluate the relative frequencies of arteritic and nonarteritic anterior ischemic optic neuropathy (AION) in an Arab population and to compare and contrast these findings with known epidemiological data from Caucasian populations. A retrospective review of the medical records of all patients diagnosed with AION at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia, between 1997 and 2012. Of 171 patients with AION, 4 had biopsy-proven giant-cell arteritis (GCA). The relative frequencies of arteritic anterior ischemic optic neuropathy (AAION) and nonarteritic anterior ischemic optic neuropathy (NAION) in this Arab cohort were 2.3% and 97.7%, respectively. The relative frequencies of arteritic anterior ischemic optic neuropathy and nonarteritic anterior ischemic optic neuropathy differ between Arab and North American clinic-based populations, with giant-cell arteritis-related ischemia being much less frequent in Saudi Arabia.

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African Journals Online (AJOL)

Dr Olaleye

SHRSP (n=357). None of the WKY rats had the vascular disease (n=373). Arterial .... was clamped at the level of the celiac trunk and the vasculature was flushed with ..... Malignant hypertension as a presenting symptom of. Takayasu arteritis.

Gallium scintigraphy in the diagnosis and total lymphoid irradiation ...

African Journals Online (AJOL)

Other management. cF. ;: No, origin .... an increased failure rate when the operation is performed ... for the long-term management of this often fatal disease in younger ... Slack JD, Waiter B. Acute congestive heart failure due to the arteritis of.

Fever, sore throat and myalgia

African Journals Online (AJOL)

Occult bacterial abscess. Renal carcinoma. Variants of rheumatoid arthritis. Kikuchi-Fujimoto disease. Endocarditis. Atrial myxoma. Systemic lupus erythematosus. Melioidosis. Brucellosis. Temporal arteritis. Polymyalgia rheumatica. Pyrexia of unknown origin defined as temperature >38.3oC for >3 weeks, with >2 outpatient ...

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African Journals Online (AJOL)

andrew

neck of the radius by dividing into ulnar and radial arter- ies (1). Variations .... B: Proximal third arm bifurcation of the BrA (single red circle), HH is the head of the humerus while .... artery: embryology, case report and clinical significance in.

Vasculitis Pregnancy Registry

Science.gov (United States)

2018-04-30

Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (GPA); Wegener's Granulomatosis; IgA Vasculitis; Henoch-Schoenlein Purpura (HSP); Microscopic Polyangiitis (MPA); Polyarteritis Nodosa (PAN); Takayasu Arteritis (TAK); Urticarial Vasculitis; Systemic Vasculitis

Hõivatute edetabelisse jõudis kolm meest Ugalast / Tea Raidsalu

Index Scriptorium Estoniae

Raidsalu, Tea

2009-01-01

Postimehe nädalalõpulisa "Arter" kõige hõivatumate näitlejate loendis on Ugalast Tanel Ingi, Arvo Raimo ja Arvi Mägi. Andmeid nimekirja koostamiseks andsid teatrite trupijuhid. Ugala näitlejate kaalukamate rollide väljaselgitamist kommenteerib kirjandustoimetaja Helle Leppik

[Clinical thinking and decision making in practice. An elderly patient with vertigo and high sedimentation rate].

Science.gov (United States)

van Laar, J M; verschuuren, J J; de Meijer, P H

1999-10-30

A 77-year-old woman was admitted because of progressive vertigo, nausea and a dysarthric speech disorder. The patient's history of diabetes mellitus, hypertension and hypercholesterolaemia, and the finding of murmurs over peripheral arteries at physical examination led to a presumptive diagnosis of cerebellar ischaemia in the context of generalized atherosclerosis. However, the diagnosis was revised when bilateral cerebellar infarction was demonstrated radiologically, and a biopsy of a temporal artery revealed giant cell arteritis. Despite treatment with prednisone (60 mg daily) the patient's neurological condition deteriorated, and she succumbed several months later to pneumonia. The case illustrates the pitfalls in the diagnostic approach of elderly patients with multiple pathology and it also emphasizes that in an elderly person with high erythrocyte sedimentation rate (> 100 mm in the first hour) temporal arteritis should be ruled out as soon as possible to prevent further neurological damage.

Resistin Enhances Inflammatory Cytokine Production in Coronary Artery Tissues by Activating the NF-κB Signaling

Directory of Open Access Journals (Sweden)

Fang Gao

2016-01-01

Full Text Available Purpose. Kawasaki disease (KD is a systemic vasculitis and is a leading cause of coronary artery lesions (CALs in childhood. Our previous study has shown higher levels of serum Resistin in KD patients with coronary aneurysm. This study aimed at examining the association of Resistin with inflammatory cytokine expression in mouse model of coronary arteritis and determining the potential mechanisms. Methods. C57BL/6 mice were injected with Lactobacillus cell wall extract (LCWE to induce coronary arteritis. The relative levels of Resistin, TNF-α, IL-1β, and MMP-9 expression and inflammatory infiltrates in the coronary arteries were determined longitudinally by quantitative RT-PCR, ELISA, and histology. The effect of TLR4 and NF-κB activation on Resistin-induced TNF-α and IL-1β expression in human coronary artery endothelium cells (HCAECs was examined by quantitative RT-PCR. Results. Higher levels of Resistin, TNF-α, IL-1β, and MMP-9 expression were associated with the degrees of inflammatory infiltrates in the coronary artery walls of the LCWE-injected mice. Resistin enhanced TNF-α and IL-1β expression in HCAECs at 18 or 24 hours after stimulation. Pretreatment with anti-TLR4 attenuated Resistin-enhanced IL-1β, but not TNF-α, expression and pretreatment with parthenolide or QNZ demolished Resistin-enhanced TNF-α expression in HACECs. Pretreatment with parthenolide, but not QNZ, blocked Resistin-enhanced IL-1β expression in HCAECs. Conclusion. Resistin may enhance inflammation by cross-talking with TLR4/NF-κB signaling during the development of coronary arteritis in mice.

Senescence of the adaptive immune system in health and aging-associated autoimmune disease

NARCIS (Netherlands)

van der Geest, Kornelis Stephan Mario

2015-01-01

Aging of the immune system may contribute to the development of aging-associated autoimmune diseases, such as giant cell arteritis, polymyalgia rheumatica and rheumatoid arthritis. The aim of this thesis was to identify aging-dependent changes of the adaptive immune system that promote autoimmunity

Sperm cell granuloma in a gobbler ( Meleagris Gallopavo ) | Ajayi ...

African Journals Online (AJOL)

Microscopically, there was severe diffuse testicular degeneration and necrosis of the germinal epithelial cells, extravasation of spermatozoa into the epididymal interstitium, inciting a granulomatous reaction with arteritis. Based on these findings, sperm cell granuloma was diagnosed. This is probably the first reported case ...

Bacterial endocarditis of the aortic valve with septic coronary embolism and myocardial infarction in a 4-month old baby

NARCIS (Netherlands)

Ueda, M.; Becker, A. E.; Fujimoto, T.; Tamai, H.

1986-01-01

A 4-month old baby, who developed infective endocarditis of the aortic valve following purulent arthritis of the hip joint, is presented. The baby developed signs of myocardial infarction and died suddenly at the age of 6 months. Autopsy revealed a localized healed coronary arteritis, almost

Habitats Directive classification of Danish wetlands

DEFF Research Database (Denmark)

Nygaard, Bettina; Ejrnæs, Rasmus; Baattrup-Pedersen, Annette

EUs Habitatdirektiv blev vedtaget i 1992 med det overordnede formål at sikre den biologiske mangfoldighed i Europa. Direktivet forpligter medlemsstaterne til at sikre gunstig bevaringsstatus for de naturtyper og arter, der er opført på direktivets bilagslister. NOVANAs naturtypeprogram har til fo...

Lorentz Spengler's descriptions of chitons (Mollusca: Polyplacophora)

NARCIS (Netherlands)

Kaas, P.; Knudsen, J.

1992-01-01

The present paper deals with an important Danish paper on the Polyplacophora, published in 1797 by Lorentz Spengler: Udförlig Beskrivelse over det mangeskallede Konkylie-Slaegt, af Linnaeus kaldet Chiton; med endeel nye Arter og Varieteter. -Skrivter af Naturhistorie-Selskabet, 4e Bind, Ie Hefte,

Disease: H01465 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available agement of large vessel vasculitis: giant cell arteritis. ... JOURNAL ... Curr Cardiol Rep 16:498 (2014) DOI:10.1007/s11886-014-0498-z ... ...0 D013625 PMID:24893935 (description) ... AUTHORS ... Chatterjee S, Flamm SD, Tan CD, Rodriguez ER ... TITLE ... Clinical diagnosis and man

Monitoring Vasculitis with 18F-FDG PET

International Nuclear Information System (INIS)

Jan BUCERIUS, Jan

2016-01-01

Whereas in the past the term “vasculitis” was most frequently used in context with systemic vasculitides, such as the large vessel vasculitides (LVV) Takayasa arteritis and giant cell arteritis, characterized by inflammation of blood vessel walls, it nowadays comprises also inflammatory changes of the vessel wall as a substantial part of the atherosclerotic disease process. Implementing non-invasive imaging techniques, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA) as well as positron emission tomography (PET) in the diagnostic algorithm of atherosclerosis and LVV, depicts a promising step towards an earlier detection with a, consecutively, improved therapeutic approach and potentially prognostic benefit in patients suffering from vasculitis. Mainly molecular imaging with 18F-fluorodeoxyglucose (FDG) PET seems to be promising in offering an early and sensitive identification of inflammatory changes in both, atherosclerosis and LVV. This review will therefore provide an overview on the diagnostic performance and clinical relevance of FDG-PET in monitoring vasculitis in atherosclerosis and LVV, with a focus on LVV.

Haematological and biochemical values in horses naturally infected with Strongylus vulgaris.

Science.gov (United States)

Bailey, M; Kent, J; Martin, S C; Lloyd, S; Soulsby, E J

1984-08-18

The concentrations of serum proteins (beta 1, beta 2, gamma, alpha 1, alpha 2 globulins and albumin) and absolute numbers of eosinophils, neutrophils and lymphocytes were examined in 64 naturally infected horses and ponies in which the number of larvae of Strongylus vulgaris in the cranial mesenteric artery and the severity of the lesion of verminous arteritis could be determined. The horses were grouped according to the number of larvae found and the severity of the arteritis. The results demonstrated that, although some significant deviation from a random distribution occurred in certain of the values (chi 2 test), there was considerable individual variation in the values obtained for individual animals within groups and overlap of the range of values between groups. Also the number of larvae present in the artery did not necessarily accurately reflect the severity of the arterial lesion. Thus, the parameters examined could not be used reliably to estimate the intensity of infection with S vulgaris in an individual animal.

Investigation of Hydrophobic Concrete Additive for Seawall Replacement at Pililaau Army Recreation Center, Hawaii

Science.gov (United States)

2017-05-01

Eugene Arter – Engineering Technician, US Army Garrison Hawaii (USAP-PTA/DPW) The Commander of ERDC was COL Bryan S. Green , and the Director was...fully demonstrate and validate the technology. ERDC-CERL TR-17-10 22 References Herzberg, Eric F., Norman T. O’Meara, and Rebecca F. Stroh

Serosurveillance of infectious agents in equines of the Central ...

African Journals Online (AJOL)

The presence of antibodies against Equine Infectious Anemia Virus (EIAV), Equine Herpes Virus 1 and 4 (EHV-1 and EHV-4), West Nile Virus (WNV), Influenza A Virus (IAV), Equine Viral Arteritis Virus (EVAV), Babesia caballi, Theileria equi, Neospora caninum and Chlamydia abortus was determined using commercial ...

Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?

Science.gov (United States)

Gupta, Prabha Nini; Salam Basheer, Abdul; Sukumaran, Gireesh Gomaty; Padmajan, Sabin; Praveen, Satheesan; Velappan, Praveen; Nair, Bigesh Unnikrishnan; Nair, Sandeep Govindan; Kunjuraman, Usha Kumari; Madthipat, Unnikrishnan; R, Jayadevan

2013-01-01

Femoral pseudoaneurysm is a common complication of repeated femoral puncture during cardiac catheterisation. We describe here the development of femoral pseudoaneurysms in a patient with Takayasu's arteritis, which healed in response to conservative treatment, and review the literature on the prevention and treatment of femoral pseudoaneurysm. PMID:27326111

GIANT CELL AORTITIS DIAGNOSED WITH PET/CT - PARANEOPLASTIC SYNDROME?

Science.gov (United States)

Bakula, Marija; Cerovec, Mislav; Mayer, Miroslav; Huić, Dražen; Anić, Branimir

2016-05-01

Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of affection of the external carotid artery branches. Furthermore, the only symptoms can be constitutional. In clinical practice, vasculitides are sometimes considered as paraneoplastic, but no definite association with malignancies has been established and the mechanisms are still debated. The gold standard for diagnosing giant cell arteritis is a positive temporal artery biopsy, but the results can often be false negative. Additionally, more than half of the patients have aorta and its main branches affected. Considering aforementioned, imaging studies are essential in confirming large-vessel vasculitis, amongst which is highly sensitive PET/CT. We present the case of a 70-year-old female patient with constitutional symptoms and elevated sedimentation rate. After extensive diagnostic tests, she was admitted to our Rheumatology unit. Aortitis of the abdominal aorta has been confirmed by PET/CT and after the introduction of glucocorticoids the disease soon went into clinical and laboratory remission. Shortly after aortitis has been diagnosed, lung carcinoma was revealed of which the patient died. At the time of the comprehensive diagnostics, there was no reasonable doubt for underlying malignoma. To the best of our knowledge, there are no recent publications concerning giant cell arteritis and neoplastic processes in the context of up-to-date non-invasive diagnostic methods (i.e. PET/CT). In the light of previous research results, we underline that the sensitivity of PET/CT is not satisfactory when estimating cancer dissemination in non-enlarged lymph nodes and that its value can at times be overestimated.

Taksonomi i et hotspot

DEFF Research Database (Denmark)

Balslev, Henrik

2016-01-01

Op mod halvdelen af alle jordens plantearter findes koncentreret på kun 1,4 % af jordoverfladen. Langt de fleste af disse hotspots for biodiversitet befinder sig i de tropiske egne, hvor vores viden om antallet af arter er mangelfuld. Thailand er placeret i centrum af jordens største hotspot, som...

Vurdering af effekten af en vindmøllepark ved Overgaard på forekomsten af fugle i EF-fuglebeskyttelsesområde nr. 15

DEFF Research Database (Denmark)

Clausen, P.; Larsen, J. K.

forekomsten af en række arter der enten yngler eller raster inden for EF-fuglebeskyttelsesområdet, og er omfattet af EF-fuglebeskyttelsesdirektivets bilag I. Det drejer sig om arterne skarv Phalacrocorax carbo sinensis, blå kærhøg Circus cyaneus, hjejle Pluvialis apricaria, brushane Philomachus pugnax, klyde...

New species in Old World Boehmeria (Urticaceae)

DEFF Research Database (Denmark)

Wilmot-Dear, Christine Melanie; Friis, Ib; Thomas, Zarah

2010-01-01

Fire nye arter af slægten Boehmeria (Urticaceae) er nybeskrevet og navngivet: Boehmeria listeri Friis & Wilmot-Dear og B. manipurensis Friis & Wilmot-Dear, begge fra dem østlige del af Himalaya, B. leptostachya Friis & Wilmot-Dear fra Yunan i Kina, Thailan of den nordlige del af Sumatra, og B. su...

The use ofDoppler velocitnetry ofthe utnbilical artery before 24 ...

African Journals Online (AJOL)

growth retardation with umbilical artery Doppler ultrasonography. BM] 1989; 298: 631-635. 12. Schulman H, Winter D, Farmakides G, er al. Pregnancy surveil- lance with Doppler velocimerry of the uterine and umbilical arter- ies. Am] Obstet Gyneco11989; 160: 192-196. 13. Hanrerry KP, Primrose MH, Neilson JP, Whittle MJ.

Elaphostrongylus spp. from Scandinavian cervidae - a scanning electron microscope study (SEM

Directory of Open Access Journals (Sweden)

Margareta Stéen

1990-08-01

Full Text Available Nematodes of the genus Elaphostrongylus collected from moose (Alces alces L., reindeer (Rangifer tarandus tarandus L., and red deer (Cervus elaphus L., respectively, were studied by means of scanning electron microscopy. Morphological differences in the ribs of the genital bursa were demonstrated. The Elaphostrongylus species from reindeer and red deer differed from each other in four ribs of the genital bursa. These results agree with the morphological characters of E. cervi and E. rangiferi described by Cameron (1931 and Mitskevitch (1960. The genital bursa of Elaphostrongylus sp. from moose, in accordance with the description of E. alces by Steen et al. (1989 showed characteristics differing from those found in Elaphostrongylus spp. from reindeer and red deer respectively. These results support the hypothesis that there are three separate species of Elaphostrongylus present in Scandinavian Cervidae. Svep-elektroniska studier på Elaphostrongylus spp. hos skandinaviska hjortdjur.Abstract in Swedish / Sammandrag: Rundmaskar inom slaktet Elaphostrongylus funna hos alg (Alces alces L., ren (Rangifer tarandus tarandus L. och kronhjort(Cervus elaphus L. studerades med hjalp av svepelelektronmikroskop. De hanliga bursorna med sin a stodjeribbor uppvisade variationer i utseende, langd och placering mellan dessa rundmaskar. De arter av Elaphostrongylus funna hos ren och kronhjort skilde sig åt avseende fyra stodjeribbor på de hanliga bursorna. Dessa resultat stammer val overens med de karaktarer som tidigare ar beskrivna av Cameron(1931 och av Mitskevich (1960. Den hanliga bursan hos arten Elaphostrongylus funnen hos alg, vilken tidigare ar beskriven av Steen et al. (1989, visade upp ett utseende som skilde sig från bursorna hos de Elaphostrongylus-arter funna hos ren och kronhjort. Dessa resultat stoder hypotesen om tre skilda arter av Elaphostrongylus hos skandinaviska hjortdjur.

Teeme tutvust / David Vseviov ; Intervjueerinud Urve Elias, Stina Eilsen, Jüri Aarma...[jt.

Index Scriptorium Estoniae

Vseviov, David, 1949-

2009-01-01

Koostatud varem ajakirjanduses ilmunud intervjuude katkenditest. Katkendid pärinevad järgmistest ajalehtedest ja ajakirjadest : Postimees/Arter (8.09.2007 ; Maaleht (11.12.2008 ; Õpetajate Leht 21. 12. 2001 ; Eesti Päevaleht/Arkaadia (24. 01. 2003) ; Eesti Ekspress (15. 12. 1995) ; Sakala (19. 04. 2006) ; Õhtuleht (29. 11. 2008 ; Annabella (veebruar 2005)

Anden generation løvtrælæhegn

DEFF Research Database (Denmark)

Westergaard, Lars; Norrie, John Emil; Jensen, Jan Svejgaard

Rapporten beskriver valget af plantemateriale i 20 jyske læhegn, der fra starten var etableret som forsøgshegn. En lang række arter og kloner/frøkilder beskrives og vurderes, også i forhold til voksepladsen. Generelt fungerer hegnene tilfredsstillende, og resultaterne bekræfter, at flerrækkede lø...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 207 ... Vol 14, No 1 (2012), Stroke-related Wernicke's Aphasia Mistaken for Psychosis: A Case Report, Abstract. LF Owolabi, MM Yakasai. Vol 5, No 1 (2003), Substance abuse among patients with mental illness, Abstract. LN Ayuba, MD Audu, S Sale. Vol 9, No 1 (2007), Takayasu Arteritis Causing Loss of ...

Tuberkulose forårsaget af Mycobacterium africanum

DEFF Research Database (Denmark)

Bek, Dorte; Kjeldsen, Marianne Kirstine; Hansen, Nikolaj Friis

2010-01-01

Tuberkulose (TB) forårsages af patogene arter fra Mycobacterium tuberculosis komplekset (MTBC) og har en incidens på cirka 7/100.000 i Danmark. På mistanke om TB hos en akut indlagt 40 årig afrikansk mand initieredes anti-TB behandling. Efter 13 timers indlæggelse afgik patienten ved døden. Fra...

Hvilke planter er hjemmehørende i Danmark?

DEFF Research Database (Denmark)

Erik, Buchwald,; Wind, Peter; Bruun, Hans Henrik

2013-01-01

Der har i de senere år været debat om, hvorvidt konkrete plantearter - fx Ær (Acer pseudoplatanus) og Gyvel (Cytisus scoparius) - er hjemmehørende arter i Danmark eller indførte fremmede (Buchwald 2008, 20110: Friis 2010: Møller 2011; Bruun2011). En medvirkende årsag til diskussionerne er, at derr...

Ugens usædvanlige art: Rosenrød vokshat

DEFF Research Database (Denmark)

Ejrnæs, Rasmus

2015-01-01

Vokshattene er en oplagt svampegruppe at kaste sig over, når man er klar til at tage springet fra spisesvampe til naturhistorisk opdagelse. For det første er gruppen overskuelig med omkring 50 kendte danske arter, for det andet rummer vokshattene nogle af de mest kulørte svampe I vores natur, fra...

Forskel i naturværdi mellem områder med og uden Japansk Pileurt, Kæmpe Pileurt og Rynket Rose i Aarhus Kommune

DEFF Research Database (Denmark)

Nielsen, Steffen Larni; Madsen, Bjarke

2015-01-01

Invasive arter blandt andre Japansk Pileurt, Kæmpe Pileurt og Rynket Rose, har Aarhus Kommune et særligt fokus på. Vi undersøgte floristiske forskelle mellem lokaliteter med og uden de nævnte invasive plantearter. Vi fandt, at artsrigdom og naturværdi er lavere, samt en anderledes artssammensætning...

NOVANA. Det nationale program for overvågning af vandmiljøet og naturen

DEFF Research Database (Denmark)

Svendsen, L. M.; Bijl, L. van der; Boutrup, S.

-kilder, landovervågning, grundvand, vandløb, søer, hav og fjor, arter og terrestriske naturtyper samt det landsdækkende luftkvalitetsprogram i byerne. For de en-kelte delprogrammer gives bl.a. en baggrund baseret i nationale behov og internationale overvågningsforpligtigelser, formål og strategi og en mere detaljeret...

Jagttider: Hare, agerhøne og ederfugl har behov for mere beskyttelse

DEFF Research Database (Denmark)

Pedersen, Jens Christian

2009-01-01

De fleste bestande af de jagtbare arter har det rigtigt godt, men tre af de klassiske vildtarter, hare, agerhøne og ederfugl, er i problemer. Det fremgår af en 284-siders udredning som Danmarks Miljøundersøgelser ved Aarhus Universitet (DMU) har udarbejdet som fagligt grundlag for revisionen af...

Chest Pain: The Need to Consider Less Frequent Diagnosis

Directory of Open Access Journals (Sweden)

Pedro Magalhães

2016-01-01

Full Text Available Chest pain is one of the most frequent patient’s complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.

Udbredelse af den invasive polychaete Marenzelleria spp. i danske farvande samt effekten på sedimentmiljøet

DEFF Research Database (Denmark)

Christoffersen, Kenn L; Banta, Gary Thomas

De europæiske arter af børsteormen Marenzelleria består af tre siblingearter (M. viridis, M. neglecta og M. arctia). De stammer oprindeligt fra den Nord Amerikanske østkyst og Arktis og har været i den sydlige Østersø siden de tidlige 1980’ere. De har stor tolerance over for svingende salinitet...... genetisk analyse efter metoden beskrevet i Blank et al. 2007 [1]. De genetiske metoder er baseret på PCR/RFLP og bruges i dette projekt til at bestemme udbredelsen af de tre sibling arter i danske farvande. Den quantitative fauna opgørelse, samt de forskellige sediment parametre, såsom organisk indhold og...... Sjælland mangler stadig, men forventes foretaget før mødet. På mødet præsenteres foreløbig data om Marenzellerias udbredelse og sedimentkarakteristika.. [1] Blank M., Laine A.O., Jürss K. and Bastrop R. 2007. Molecular identification key based on PCR/RFLP for three polychaete sibling species of the genus...

[Streptococcus milleri: An unusual cause of skull extensive osteomyelitis in an immunocompetent patient].

Science.gov (United States)

Duquenne, C; Dernis, E; Zehrouni, A; Bizon, A; Duquenne, M

2017-09-01

Streptococcus milleri (Streptococcus anginosus, intermedius and constellatus) are commensal organisms, which can become pathogenic and cause infection with frequent abscess formation, local or metastatic extension. Osteomyelitis of the skull has been rarely reported in this type of infection. Skull osteomyelitis due to Streptococcus milleri is reported in a 61-year-old immunocompetent man without any medical history, occurring 10 months after a head injury without any wound or complication at initial presentation. A progressive right parieto-occipital headache with worsening and increased acute phase reactants evoked a giant cell arteritis. After few days of corticosteroid therapy (0.5 mg/kg/day), diagnosis of subcutaneous abscess associated to an extensive osteomyelitis of the skull due to Streptococcus milleri was diagnosed. The outcome was favorable after drainage of one liter of pus, irrigation, debridement and antibiotherapy by amoxicillin for 8 weeks. It is necessary to discuss the differential diagnosis of giant cell arteritis particularly when symptoms are unusual. Even a short-term corticosteroid therapy may dramatically exacerbate an undetected infection. Copyright © 2017. Published by Elsevier SAS.

Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis

Directory of Open Access Journals (Sweden)

Irfan Moinuddin

2016-01-01

Full Text Available Acute vascular rejection (AVR is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient’s kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively.

First record of a chiton from the Palaeocene of Denmark (Polyplacophora: Leptochitonidae) and its phylogenetic affinities

DEFF Research Database (Denmark)

Sigwart, Julia D.; Andersen, Søren Bo; Schnetler, K. Ingemann

2007-01-01

Den første rapport om en skallus fra Fakse Kalkbrud, i løs koralkalk fra Mellem Danien. Det er samtidig opstillingen af en ny art, Leptochiton faksensis. En cladistisk analyse udføres med flere end 100 recente og fossile arter af ordenen Lepidopleurida. Palæoøkologisk udsiger denne arts forekomst...

Arterivirus replicase processing : regulatory cascade or Gordian knot?

NARCIS (Netherlands)

Aken, Arnoldus Theodorus van

2008-01-01

Equine arteritis virus (EAV) is the prototypic virus of the family Arteriviridae. The EAV genome is a positive-sense single-stranded RNA molecule in which two open reading frames (ORFs) encode the large replicase polyproteins pp1a and pp1ab. Processing of pp1a and pp1ab is mediated by three viral

The genera Conocybe and Pholiotina (Agaricomycotina, Bolbitiaceae) in temperate Asia

DEFF Research Database (Denmark)

Hausknecht, Anton; Kalamees, Kuulo; Knudsen, Henning Jørgen

2009-01-01

. En række arter repræsenterer nye fund for Asien, for Sibirien eller for Georgien, Tadjikistan, Turkmenistan eller Kazakstan. Et mycogeografisk element repræsenteres af C. enderlei, C. herbarum, C. graminis, C. leporina og C. subxerophytica, som er knyttet til tørre, steppeagtige områder med høj pH...

strong>Forureningens spor udviskes i Furesøen.strong>

DEFF Research Database (Denmark)

Jensen, Kaj Sand; Thorsgaard, Inge; Pedersen, Niels Lagergaard

2007-01-01

Furesøs udvikling er historien om et søklenodie, rigt på planter og dyr, som blev voldsomt forurenet med spildevand mellem 1900 og 1970, og som undervejs mistede mange af sine arter. Nu er tilførslerne af fosfor og kvælstof reduceret, vandet er blevet klarere, og planterne har igen bredt sig. Men...

Uracil and beta-alanine degradation in Saccharomyces Kluyveri - discovery of a novel catabolic pathway

DEFF Research Database (Denmark)

Andersen, Gorm

2006-01-01

’en i gær og de genetiske forudsætninger for uracil og beta-alanine (BAL) katabolisme i S. kluyveri undersøgt. Evnen til at bruge uracil, dihydrouracil (DHU), beta-ureidopropionate (BUP) og BAL som nitrogenkilde blev studeret i 38 gær arter. Disse var udvalgt, så de dækkede “Saccharomyces komplekset...

Eesti lääneliku tarbimiskultuuri hoovuses : kas tingimusteta omaksvõtt? / Margit Keller, Triin Vihalemm

Index Scriptorium Estoniae

Keller, Margit, 1971-

2001-01-01

Pilootanalüüs tugineb tudengiesseedele teemal "Lääneliku tarbijakultuuri sissetung Eestisse, mida tähendab see minu jaoks, mida Eesti ühiskonna jaoks", 2000. a. teisel ning 2001. a. esimesel poolel "Postimehe" nädalalõpulisa "Arter" artiklitele ja 2000. a. lõpul AS EMORi poolt läbiviidud, tarbimishoiakuid käsitlevale küsitlusele

Mortality in patients with giant cell arteritis

DEFF Research Database (Denmark)

Baslund, Bo; Helleberg, Marie; Faurschou, Mikkel

2015-01-01

OBJECTIVE: The aim of this study was to examine whether GCA is associated with increased mortality. METHODS: We conducted a nationwide population-based cohort study including all individuals who between 1993 and 2011 were registered in the Danish National Hospital Register and the Danish Patholog...

Vejbred - en evulutionær succes

DEFF Research Database (Denmark)

Rønsted, Nina; Jensen, Søren Rosendal; Mølgaard, Per

2004-01-01

Vejbred slægten har været imponerende god til at kolonisere nye områder og der findes i dag over 200 arter udbredt over hele verden. Her fortæller vi historien om hvordan planternes kemiske forsvarsstoffer og DNA-profiler kan bruges til at opnå kendskab til arternes indbyrdes slægtskab og til slæ...

Neuroradiologic picture of cerebral vasculitis in rheumatoid arthritis

International Nuclear Information System (INIS)

Paci, R.; Giuffrida, C.M.; Marangolo, M.; Ventura, F.; Di Paola, F.

1983-01-01

The central nervous system is rarely involved in rheumatoid arthritis. In this paper the authors report a case of a 50-year-old woman who had rheumatoid arthritis for about 6 years. A month before admission she presented a symptomatology resembling an expansive intracranial process. Angiography revealed cerebral arteritis and CT showed areas of hypodensity with marked contrast enhancement. (orig.)

Diagnosis performance of the positron computed tomography with {sup 18}F-F.D.G. in the Horton disease: meta-analysis; Performances diagnostiques de la tomographie par emission de positons au 18F-FDG dans la maladie de Horton: meta-analyse

Energy Technology Data Exchange (ETDEWEB)

Besson, F.; Costo, S.; Agostini, D. [CHU de Caen, Departement de medecine nucleaire, 14 (France); Dunet, V.; Prior, J. [CHU Vaudois, departement de medecine nucleaire, Lausanne (Switzerland); Hamon, M. [CHU de Caen, Departement de cardiologie, 14 (France); Parienti, J.J. [CHU de Caen, Departement de biostatiques, 14 (France)

2010-07-01

The PET with {sup 18}F-F.D.G. is a sensitive and specific technique to detect Horton disease. It could be used to invalidate the diagnosis among patients suffering of this disease, especially these ones presenting a negative or non contributive temporal artery biopsy or an atypical symptomatology. Furthermore, it should allow to better evaluate the extension of arteritis injuries. (N.C.)

Ilon Wiklandi Imedemaa muudab tagasi lapseks / Janar Ala

Index Scriptorium Estoniae

Ala, Janar, 1979-

2009-01-01

Haapsalus avati 1. juulil 2009. a. lastepärane teemakeskus Iloni Imedemaa, kus saab tutvuda raamatuillustraatori Ilon Wiklandi kujutatud tegelastega. Avamisel viibis ka proua Evelin Ilves koos tütre Kadri Keiuga. Samal teemal ka "Pildi sisse: Iloni Imedemaa avab tee kunstniku loomingusse" lk. 1. Fotod sündmusest vt. ka: Postimees : Arter 4. juuli 2009, lk. 16, pealk.: Imedemaa Haapsalus

The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

International Nuclear Information System (INIS)

Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U.; Melzer, Ralph A.; Tyndall, Alan; Schindler, Christian

2005-01-01

This study was performed to investigate the value of 18 F-fluorodeoxyglucose positron emission tomography ([ 18 F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [ 18 F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [ 18 F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [ 18 F]FDG-PET results by logistic regression. [ 18 F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP 18 F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

Dynamic CT of tuberculous meningeal reactions

International Nuclear Information System (INIS)

Jinkins, J.R.

1987-01-01

The technique of intravenous dynamic cranial computed tomography has been applied to the patient population at this location in Saudi Arabia with meningeal tuberculosis. The various manifestations and sequelae including meningitis, arteritis, infarct, and true meningeal tuberculomata all have characteristic if not specific appearances. The dynamic study enhances an otherwise static examination and reveals a great deal about the pathophysiology of tuberculosis involving the cerebral meningeal surfaces. (orig.)

Differential diagnoses to MS

DEFF Research Database (Denmark)

Horwitz, Henrik; Friis, Tina; Modvig, Signe

2014-01-01

), giant cell arteritis (n = 4), sarcoidosis (n = 3), thyrotoxicosis (n = 2), and hereditary or toxic neuropathies (n = 2). Nine percent of patients referred to the Clinic of Optic Neuritis had symptoms caused by medical, neurosurgical or ophthalmic disorders, and 0.9 % of our patients had NMO. Though most...... of these conditions are rare, it is of importance to keep them in mind upon encountering patients with symptoms of ON....

Microglial Cells Prevent Hemorrhage in Neonatal Focal Arterial Stroke

OpenAIRE

Fernández-López, David; Faustino, Joel; Klibanov, Alexander L.; Derugin, Nikita; Blanchard, Elodie; Simon, Franziska; Leib, Stephen L.; Vexler, Zinaida S.

2016-01-01

Perinatal stroke leads to significant morbidity and long-term neurological and cognitive deficits. The pathophysiological mechanisms of brain damage depend on brain maturation at the time of stroke. To understand whether microglial cells limit injury after neonatal stroke by preserving neurovascular integrity, we subjected postnatal day 7 (P7) rats depleted of microglial cells, rats with inhibited microglial TGFbr2/ALK5 signaling, and corresponding controls, to transient middle cerebral arter...

FİBRİNOJEN VE KORONER ARTER HASTALIĞI

OpenAIRE

AYTAN, Dr. Feridun KOŞAR Dr. İzzet TANDOĞAN Dr.

2015-01-01

Objective. It has previously been shown that fibrinogen is involved in the pathogenesis of atherosclerosis and coronary artery disease. However, only a few studies have shown the correlation between the fibrinogen level and the extent of coronary artery disease and the presence of total luminal occlusion. The purpose of this study was to verify the existence of a correlation between fibrinogen and the presence of total luminal occlusion and the extent of coronary artery disease in our study p...

Successful pregnancy in a patient with Takayasu's arteritis

International Nuclear Information System (INIS)

Al-Ghamdi, Aisha A.

2003-01-01

This report describes a case of Takayasu's in a 19-year-old Palestinian female. She conceived after diagnosis.Her pregnancy was complicated by uncontrolled hypertension, which was not associated with other markers of disease activity.Despite aggressive medical treatment, cesarean section had to be carried out at 34 weeks of pregnancy because of uncontrolled hypertension.A live fetus was borne, and her blood pressure was subsequently controlled with a single antihypertensive agent. (author)

Percutaneous Management of Occlusive Arterial Disease Associated with Vasculitis: A Single Center Experience

International Nuclear Information System (INIS)

Both, M.; Jahnke, T.; Reinhold-Keller, E.; Reuter, M.; Grimm, J.; Biederer, J.; Brossmann, J.; Gross, W.L.; Heller, M.; Mueller-Huelsbeck, S.

2003-01-01

The purpose of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty for occlusive arterial disease associated with vasculitis. Eleven patients(10 women, 1 man; ages 35-82 years) with the diagnosis of vasculitis of the large vessels underwent interventional treatment during intraarterial angiography. The causes included giant cell arteritis(n = 8) and Takayasu arteritis (n = 3).Thirty-three occlusive lesions (including brachiocephalic and renalarteries, and arteries of upper and lower extremities) were treated with balloon angioplasty and/or stent placement. Follow-up included clinical examination, angiography, and color duplex ultrasound.Technical success was 100% (25/25) for stenoses and 50% (4/8) for occlusive lesions, representing all lesions combined from different anatomic locations. Dissection (n = 3) and arterial rupture with retroperitoneal hematoma (n = 1) was found in three patients. During follow-up (mean 12 months), restenoses(n = 8) and re-restenoses (n = 1)occurred in 8 vascular areas. Three of these lesions were treated with repeated PTA (n = 4). The cumulative primary clinical success rate was 67.6%, cumulative secondary success rate 74.4%, and cumulative tertiary success rate 75.9%. Interventional therapy in systemic vasculitis provides promising results in technical success rates and followup. Angioplasty may result in arterial injury, but the rate of complications is low

Risk factors of atherosclerosis and clinical and morphological comparisons in systemic vasculitides

Directory of Open Access Journals (Sweden)

Leonid Aleksandrovich Strizhakov

2012-01-01

Full Text Available Objective: to study the incidence rates of angina, myocardial infarction (MI, stroke, and the frequency of endovascular interventions in patients with systemic vasculitides, and the incidence rate of atherosclerosis according to autopsy data. Subjects and methods. Three hundred and twenty-one patients with systemic vasculitides: Wegener's granulomatosis (n = 138, Takayasu's arteritis (n = 79, polyarteritis nodosum (n = 55, and Churg-Strauss syndrome (n = 49 were examined; 55 autopsies were analyzed in patients with the above diseases. Results. Fifty-one (15.6% of the 321 patients were diagnosed as having cardiovascular diseases (CVD: angina pectoris (7.1% and MI (3.1% and endovascular interventions (0.9%. The risk of cardiovascular events was found to be associated with traditional risk factors, such as male gender and age. Arterial hypertension, hypercholesterolaemia, and increased serum creatinine were more frequently detected in the CVD group that showed no significant differences from the non-CVD group. According to autopsy results, atherosclerosis was identified in the patients with Wegener's granulomatosis (52%, Takayasu's arteritis (50%, polyarteritis nodosum (52.6%, and Churg-Strauss syndrome (57.1%. Conclusion. CVD and atherosclerosis are common in systemic vasculitides, which requires the traditional risk factors of atherosclerosis to be actively corrected.

Inflammatory aortic arch syndrome: contrast-enhanced, three-dimensional MR - angiography in stenotic lesions

International Nuclear Information System (INIS)

Both, M.; Mueller-Huelsbeck, S.; Biederer, J.; Heller, M.; Reuter, M.

2004-01-01

Purpose: To determine the value of contrast-enhanced, three-dimensional MR angiography for the evaluation of stenotic and occlusive vascular lesions in inflammatory aortic arch syndrome. Materials and Methods: 14 patients with inflammatory aortic arch syndrome (giant cell arteritis: n = 8, Takayasu arteritis: n = 4, ankylosing spondylitis: n = 1 sarcoidosis: n = 1) underwent MR angiography of the aortic arch and the supra-aortic vessels (n = 15,2 patients were examined twice) and of the abdominal aorta (n = 2). MRA was performed using a 3D-FLASH sequence (TR/TE 4.6/1.8 ms, flip angle 30 ) on a 1.5T system. MRA imaging was compared with the findings of DSA, which served as gold standard. Results: In a total of 467 examined vascular territories, DSA revealed 50 stenoses and 35 occlusions. All lesions were detected by MRA. In 23 segments, the degree of stenosis was overestimated by MRA. Sensitivity and specificity of MRA were 100% and 94,3%, positive and negative predictive values were 73.6 and 100%, and the accuracy was 95,1%. Conclusions: Despite a tendency to overestimate stenoses, contrast-enhanced three-dimensional MR angiography is a valid, non-invasive technique in the assessment of inflammatory aortic arch syndrome. (orig.) [de

Research into the transmission of natural gas by gas pipeline

Energy Technology Data Exchange (ETDEWEB)

Gadonneix, P.

1998-12-31

This paper is the press release of the talk given at the `Gaz de France scientific meeting with the press` by P. Gadonneix, chairman of Gaz de France company, on October 7, 1998. The aim of this talk concerns the new French and European supply link for bringing natural gas from the Norwegian North Sea fields. This new supply link is the first direct link between Norway and France and the NorFra gas pipeline which brings natural gas from the North Sea to France is the longest offshore pipeline in the world. The `Artere des Hauts de France` pipeline (the largest diameter gas pipeline ever laid in France) is devoted to the transfer of natural gas from Dunkerque to the Gournay-sur-Aronde underground storage site. This paper describes successively: the French European gas supply hub, the NorFra project, the Artere des Hauts de France pipeline, the network performance research, the safety and quality guaranties, the reduction of overland natural gas transmission costs (improvement of pipe-laying techniques and optimization of line route and welding operations), the specific techniques used for road and river crossing (micro-tunnel digging, river-crossing ditches) and for anchoring (buoyancy compensation). Finally, the environmental impact of the laying operations is briefly described. (J.S.)

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

OpenAIRE

Hassan Borji; Zahra Moosavi; Fatemeh Ahmadi

2014-01-01

Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors? knowledge, a complete...

Hidden Danger of Irrational Abusing Illegal Androgenic-anabolic Steroids in Recreational Athletes Age Under 35 in Bosnia & Herzegovina

OpenAIRE

Solakovic, Sid; Totic, Dragan; Vukas, Haris; Djedovic, Muhamed

2015-01-01

Introduction: Androgenic-anabolic steroids are rarely used by sportsmen who want to improve physical performance in competition sport. Despite that they are well aware of the side effects of anabolic steroids, many young athletes in Bosnia and Herzegovina without competition motivation come in temptation, trying to achieve better muscle proportion and physical performance unknowing consequence of side effects and what is hiding behind. Risk factors such as increasing of lipid levels and arter...

The value of [{sup 18}F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

Energy Technology Data Exchange (ETDEWEB)

Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U. [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Melzer, Ralph A.; Tyndall, Alan [University Hospital Basel, Division of Rheumatology (Switzerland); Schindler, Christian [University Hospital Basel, Institute of Social and Preventive Medicine (Switzerland)

2005-06-01

This study was performed to investigate the value of{sup 18}F-fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [{sup 18}F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [{sup 18}F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [{sup 18}F]FDG-PET results by logistic regression. [{sup 18}F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP <12 mg/l or an ESR <12 mm/h, logistic regression revealed a sensitivity of less than 50%. In patients with high CRP/ESR levels, sensitivity was 95.5%/80.7%. [{sup 18}F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

Extravasal occlusion of large vessels with titanic clips: efficiency, indications, and contraindications.

Science.gov (United States)

Vasilenko, Yu V; Kim, A I; Kotov, S A

2002-11-01

The mechanism of extravasal occlusion of blood vessels with titanic clips "Atrauclip" and "Ligaclip extra" was studied in order to reveal indications and contraindications to their use. Occlusion with the clips of both types was ineffective in vessels with a diameter of >7.0 mm. Arteritis or the presence of an intravascular occlusion facility in the vessel were also the contraindications for clip occlusion. In overcases the procedure of occlusion with titanic clips was efficient and atraumatic.

Isolated periostitis as a manifestation of systemic vasculitis in a child: imaging features

Energy Technology Data Exchange (ETDEWEB)

Cheon, Jung-Eun; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine and the Institute of Radiation Medicine, Department of Radiology, 101 Daehang-ro Jongro-gu, Seoul (Korea, Republic of)

2010-12-15

We report a case of isolated periostitis associated with Takayasu arteritis in a 10-year-old boy presenting with calf pain. Radiographs revealed a localized, thick periosteal reaction with irregular margin in the proximal left fibula. MRI revealed irregular thickening with enhancement of the periosteum in the proximal fibula and heterogeneous enhancement along vascular bundles in the calf. Isolated periostitis is a rare skeletal manifestation of systemic vasculitis that could be misdiagnosed as neoplastic or traumatic periosteal reaction. (orig.)

Pharmacological delayed preconditioning against ischaemia-induced ventricular arrhythmias: effect of an adenosine A1-receptor agonist

OpenAIRE

Tissier, Renaud; Souktani, Rachid; Parent de Curzon, Olivier; Lellouche, Nicolas; Henry, Patrick; Giudicelli, Jean-François; Berdeaux, Alain; Ghaleh, Bijan

2001-01-01

The goal of this study was to investigate the effects of the delayed pharmacological preconditioning produced by an adenosine A1-receptor agonist (A1-DPC) against ventricular arrhythmias induced by ischaemia and reperfusion, compared to those of ischaemia-induced delayed preconditioning (I-DPC).Eighty-nine instrumented conscious rabbits underwent a 2 consecutive days protocol. On day 1, rabbits were randomly divided into four groups: ‘Control' (saline, i.v.), ‘I-DPC' (six 4-min coronary arter...

Determination of regional cerebral blood flow curves and parameters by computed γ camera

International Nuclear Information System (INIS)

Zhu Guohong

1988-01-01

Regional CBF curves and parameters were determined in 236 subjects by Sigma 438/MCS 560 computed γ camera. Each subject was given 99m TcO 4 -370 MBq intravenously. Four CBF curves and three parameters were derived by the computer.The results from 39 normal subjects, 22 patients with cerebral embolism, 53 patients with cerebrovascular sclerosis, 56 patients with diseases of cervical vertebrae, 10 patients with concussion and 5 patients with cerebral arteritis were analyzed

Biomarkers in Vasculitis

Science.gov (United States)

Monach, Paul A.

2014-01-01

Purpose of review Better biomarkers are needed for guiding management of patients with vasculitis. Large cohorts and technological advances had led to an increase in pre-clinical studies of potential biomarkers. Recent findings The most interesting markers described recently include a gene expression signature in CD8+ T cells that predicts tendency to relapse or remain relapse-free in ANCA-associated vasculitis, and a pair of urinary proteins that are elevated in Kawasaki disease but not other febrile illnesses. Both of these studies used “omics” technologies to generate and then test hypotheses. More conventional hypothesis-based studies have indicated that the following circulating proteins have potential to improve upon clinically available tests: pentraxin-3 in giant cell arteritis and Takayasu’s arteritis; von Willebrand factor antigen in childhood central nervous system vasculitis; eotaxin-3 and other markers related to eosinophils or Th2 immune responses in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome); and MMP-3, TIMP-1, and CXCL13 in ANCA-associated vasculitis. Summary New markers testable in blood and urine have the potential to assist with diagnosis, staging, assessment of current disease activity, and prognosis. However, the standards for clinical usefulness, in particular the demonstration of either very high sensitivity or very high specificity, have yet to be met for clinically relevant outcomes. PMID:24257367

Effectiveness of fenbendazole against later 4th-stage Strongylus vulgaris in ponies.

Science.gov (United States)

Slocombe, J O; McCraw, B M; Pennock, P W; Baird, J D

1983-12-01

Twelve pony foals (reared worm-free) were inoculated with Strongylus vulgaris. Approximately 8 weeks later, 4 of the foals were given fenbendazole (10% suspension) at a dosage rate of 10 mg/kg of body weight daily for 5 days and 4 foals were given the suspension at a dosage rate of 50 mg/kg daily for 3 days; the remaining foals were given a placebo. All treatments were administered by stomach tube. Fenbendazole was 99.6 and 97.9% effective in the 2 treatment groups, respectively, in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries. On microscopic examination of the ileocolic artery from fenbendazole-treated foals, a few larval remnants were found beneath the tunica intima in small organized mural thrombi overgrown with endothelium. It would appear that larvae are rapidly destroyed after administration of fenbendazole. A pony foal reared on pasture and with arteriographic evidence of arteritis of the cranial mesenteric and ileocolic arteries was treated with fenbendazole (10% suspension) by stomach tube at a dosage rate of 50 mg/kg of body weight daily for 3 days. By arteriographic examination made 4 weeks later, there was evidence of regression of the lesion, and at necropsy done a week later, there was no arteritis or larvae in the lumen of those arteries.

Antiviral activity of a Bacillus sp: P34 peptide against pathogenic viruses of domestic animals

Directory of Open Access Journals (Sweden)

Débora Scopel e Silva

2014-09-01

Full Text Available P34 is an antimicrobial peptide produced by a Bacillus sp. strain isolated from the intestinal contents of a fish in the Brazilian Amazon basin with reported antibacterial activity. The aim of this work was to evaluate the peptide P34 for its in vitro antiviral properties against canine adenovirus type 2 (CAV-2, canine coronavirus (CCoV, canine distemper virus (CDV, canine parvovirus type 2 (CPV-2, equine arteritis virus (EAV, equine influenza virus (EIV, feline calicivirus (FCV and feline herpesvirus type 1 (FHV-1. The results showed that the peptide P34 exhibited antiviral activity against EAV and FHV-1. The peptide P34 inhibited the replication of EAV by 99.9% and FHV-1 by 94.4%. Virucidal activity was detected only against EAV. When P34 and EAV were incubated for 6 h at 37 °C the viral titer reduced from 10(4.5 TCID50 to 10(2.75 TCID50, showing a percent of inhibition of 98.6%. In conclusion, our results demonstrated that P34 inhibited EAV and FHV-1 replication in infected cell cultures and it showed virucidal activity against EAV. Since there is documented resistance to the current drugs used against herpesviruses and there is no treatment for equine viral arteritis, it is advisable to search for new antiviral compounds to overcome these infections.

Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association.

Science.gov (United States)

Procop, Gary W; Eng, Charis; Clifford, Alison; Villa-Forte, Alexandra; Calabrese, Leonard H; Roselli, Eric; Svensson, Lars; Johnston, Douglas; Pettersson, Gosta; Soltesz, Edward; Lystad, Lisa; Perry, Julian D; Blandford, Alexander; Wilson, Deborah A; Hoffman, Gary S

2017-01-01

It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen. DNA samples extracted from 11 surgically sterile temporal arteries and 31 surgically sterile thoracic aortas were used in an attempt to identify the vessel-associated VZV genome. Two different validated PCR methods were used. Thirty-one thoracic aorta aneurysm specimens included biopsies from 8 patients with GCA, 2 from patients with TAK, 6 from patients with FIA, and 15 from patients without vasculitis, who had non-inflammatory aneurysms. Eleven temporal artery biopsies were collected from 5 patients with GCA and 6 controls. The presence of VZV was not identified in either the specimens from patients with large vessel vasculitis or from the controls. Using surgically sterile snap-frozen specimens, we were unable to confirm recent reports of the presence of VZV in either aortas or temporal arteries from patients with large vessel vasculitis or controls.

Unusual headaches in the elderly.

Science.gov (United States)

Bamford, Cynthia C; Mays, MaryAnn; Tepper, Stewart J

2011-08-01

Prevalence of headache lowers with age, and headaches of elderly adults tend to be different than those of the younger population. Secondary headaches, such as headaches associated with vascular disease, head trauma, and neoplasm, are more common. Also, certain headache types tend to be geriatric disorders, such as primary cough headache, hypnic headache, typical aura without headache, exploding head syndrome, and giant cell arteritis. This review provides an overview of some of the major and unusual geriatric headaches, both primary and secondary.

Verminous arteritis in a 3-month-old thoroughbred foal.

OpenAIRE

DeLay, J; Peregrine, A S; Parsons, D A

2001-01-01

Strongylus vulgaris migration and cranial mesenteric arterial thrombus formation resulted in fatal colic in a 3-month-old Thoroughbred foal. Vascular damage associated with S. vulgaris occurs early in the course of infection and, despite widespread use of broad-spectrum anthelmintics, appropriate management is still essential to minimize exposure of young animals to this parasite.

Verminous arteritis in a 3-month-old thoroughbred foal.

Science.gov (United States)

DeLay, J; Peregrine, A S; Parsons, D A

2001-04-01

Strongylus vulgaris migration and cranial mesenteric arterial thrombus formation resulted in fatal colic in a 3-month-old Thoroughbred foal. Vascular damage associated with S. vulgaris occurs early in the course of infection and, despite widespread use of broad-spectrum anthelmintics, appropriate management is still essential to minimize exposure of young animals to this parasite.

Cerebral Vasculitis

Directory of Open Access Journals (Sweden)

Fariborz Khorvash

2017-02-01

Full Text Available Introduction: Vasculitis is an inflammation systems may be involved of blood vessels due to various origins. Vessels of the peripheral and/or central nervous. Vasculitis of the CNS is rare and occurs in the context of systemic diseases or as primary angiitis of the CNS. Epidemiology: The overall incidence of primary vasculitis is about 40/1,000,000 persons [excluding giant cell (temporal arteritis, GCA]. Its incidence increases with age. The incidence of GCA is much higher (around 200/1,000,000 persons in the age group[50 years. Clinical Presentation: Clinical and pathological presentation in CNS vasculitis represents a wide spectrum. Among others, headache, cranial nerve affections, encephalopathy, seizures, psychosis, myelitis, stroke, intracranial haemorrhage and aseptic meningoencephalitis are described. Primary and secondary vasculitides leading more frequently to CNS manifestations are discussed. Primary and secondary Vasculitides: Including Giant Cell (Temporal Arteritis , Takayasu arteritis, Polyarteritis nodosa, Primary angiitis of the CNS, Wegener’s granulomatosis, and Connective tissue diseases, such as systemic lupus erythematosus (SLE, scleroderma, rheumatoid arthritis, mixed connective disease and Sjögren syndrome, are systemic immune-mediated diseases that lead to multiple organ affections. Cerebral Vasculitis: Imaging and Differential Diagnosis: Vasculitides represent a heterogeneous group of inflammatory diseases that affect blood vessel walls of varying calibers (inflammatory vasculopathy. Since the devastating symptoms of CNS vasculitis are at least partially reversible, early diagnosis and appropriate treatment are important. In order to establish a differential diagnosis clinical features, disease progression, age of onset, blood results, as well as CSF examinations have to be taken into consideration. Neuroimaging techniques, such as MRI and DSA, play a central role in the diagnosis and disease monitoring .The diagnostic

Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association

Directory of Open Access Journals (Sweden)

Gary W. Procop

2017-06-01

Full Text Available Objective: It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]. Recent studies have reported the presence of Varicella Zoster Virus (VZV within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen. Methods and Results: DNA samples extracted from 11 surgically sterile temporal arteries and 31 surgically sterile thoracic aortas were used in an attempt to identify the vessel-associated VZV genome. Two different validated PCR methods were used. Thirty-one thoracic aorta aneurysm specimens included biopsies from 8 patients with GCA, 2 from patients with TAK, 6 from patients with FIA, and 15 from patients without vasculitis, who had non-inflammatory aneurysms. Eleven temporal artery biopsies were collected from 5 patients with GCA and 6 controls. The presence of VZV was not identified in either the specimens from patients with large vessel vasculitis or from the controls. Conclusions: Using surgically sterile snap-frozen specimens, we were unable to confirm recent reports of the presence of VZV in either aortas or temporal arteries from patients with large vessel vasculitis or controls. Keywords: Aorta and temporal artery biopsies, Varicella Zoster Virus, Large Vessel Vasculitis

Ion Channels in Leukocytes

Science.gov (United States)

1991-07-01

muscle k142), heart muscle (80), bo- are released. In recent years much has been learned vine pulmonar arter endothelial cells (251), and rat about the...b3 Zn or cytes from cystic fibrosis patients lack a Cl current that Ni (1 mM)-added to the cytoplasmic side of the mem- can be acti% ated b3 the...that at37’C hu- to be defectiv.- in cystic fibrosis (55, 277), and Chen et al. man T-cell CiL channels are active at rest, implies that (25) have shown

CUTANEOUS VASCULITIDES AND CUTANEOUS MANIFESTATIONS OF SYSTEMIC VASCULITIDES

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Vesna Jurčić

2009-06-01

plexes with complement activation. Typical representatives are Henoch-Schönlein purpura, cryoglobulinemic vasculitis and vasculitis in systemic lupus erythematosus. Necrotizing arteriolitis and arteritis of small arteries are usually found in ANCA positive vasculitides. Medium-sized arteries can be involved in both ANCA positive vasculitides and polyarteritis nodosa. Conclusions This article presents the clinical picture, histopathologic characteristics, pathogenetic mechanisms and treatment of some clinicopathologic entities of vasculitides, such as Henoch-Schönlein purpura, urticarial vasculitis, cryoglobulinemic vasculitis, microscopic polyangiitis, Wegener\\'s granulomatosis, Churg-Strauss syndrome and polyarteritis nodosa.

Ophthalmologic complications of systemic disease.

Science.gov (United States)

Klig, Jean E

2008-02-01

The human eye, as an organ, can offer critical clues to the presence of systemic disease. This article discusses the various ophthalmologic manifestations of systemic disease that can be evident on examination by an emergency department provider, as well as some findings that can be discerned with specialty consultation. The following topics are reviewed with respect to potential ocular signs and complications: syphilis, herpes zoster, Lyme disease, acquired immunodeficiency syndrome, Reiter's syndrome, Kawasaki's disease, temporal arteritis, endocarditis, hypertension, and diabetes mellitus. Indications for emergent ophthalmologic consultation are also emphasized.

MR imaging of the pulmonary vasculature - an update

Energy Technology Data Exchange (ETDEWEB)

Pedersen, Mark R.; Fisher, Mark T. [University of Iowa, Department of Radiology, Carver College of Medicine, Iowa City, Iowa (United States); Beek, Edwin J.R. van [University of Iowa, Department of Radiology, Carver College of Medicine, Iowa City, Iowa (United States); University of Iowa Hospitals and Clinics, JPP 3895, Department of Radiology, Iowa City, Iowa (United States)

2006-06-15

Although the advent of multi-detector row computed tomography (CT) angiography has been at the heart of improving the diagnostic management of pulmonary vascular disease, MR technology has also moved forward. This review outlines the current state of affairs of MR techniques for the assessment of pulmonary vascular diseases such as pulmonary hypertension, pulmonary arteritis and arteriovenous malformations. It highlights the main areas of MR angiography and MR perfusion imaging and discusses novel methods, such as non-contrast enhanced direct thrombus imaging, and will discuss its merits in the context of other diagnostic modalities. (orig.)

Ajakiri "Arters" : esteetika ja eetika / Anu Saluäär

Index Scriptorium Estoniae

Saluäär, Anu, 1948-

2008-01-01

Rootsi Muusikaakadeemia, Kunstiakadeemia ja Rootsi Akadeemia ühisväljaandest "Artes", pikemalt teisest numbrist, mis kajastab Pariisis toimunud kollokviumit "Kirjandus ja filosoofia". - Varem ilmunud: Looming 1989, nr. 11

New Features of Disease after Diagnosis in Six Forms of Systemic Vasculitis

Science.gov (United States)

Grayson, Peter C.; Cuthbertson, David; Carette, Simon; Hoffman, Gary S.; Khalidi, Nader A.; Koening, Curry L.; Langford, Carol A.; Maksimowicz-McKinnon, Kathleen; Monach, Paul A.; Seo, Philip; Specks, Ulrich; Ytterberg, Steven R.; Merkel, Peter A.

2015-01-01

Objective To quantify the occurrence of features of vasculitis that initially present after diagnosis in 6 types of primary vasculitis. Methods Standardized collection of data on 95 disease manifestations in 6 vasculitides, including granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA), polyarteritis nodosa (PAN), giant cell arteritis (GCA), and Takayasu's arteritis (TAK), was performed within a set of multicenter longitudinal, observational cohorts. For each form of vasculitis, the frequency of disease-specific manifestations at diagnosis was compared to the cumulative frequency of each manifestation. The percentage of patients who initially developed “severe” manifestations after diagnosis, defined as organ- or life-threatening in the small and medium vessel vasculitides (GPA, MPA, EGPA, PAN) and as ischemic/vascular in the large vessel vasculitides (GCA, TAK), was reported. Results Out of 838 patients with vasculitis, 490 (59%) experienced ≥ 1 new disease manifestation after diagnosis. On average, patients with vasculitis experienced 1.3 new manifestations after diagnosis (GPA - 1.9, MPA - 1.2, EGPA - 1.5, PAN - 1.2, GCA - 0.7, TAK - 1.0). New severe manifestations occurred after diagnosis in 224 (27%) out of 838 patients (GPA - 26%, MPA - 19%, EGPA - 21%, PAN - 23%, GCA - 24%, and TAK - 44%). Timing of onset of new manifestations was not significantly associated with disease duration. Conclusion A majority of patients with vasculitis develop new disease features after diagnosis, including a substantial number of new, severe manifestations. Ongoing assessment of patients with established vasculitis should remain broad in scope. PMID:23908447

Central Nervous System Vasculitis: Still More Questions than Answers

Science.gov (United States)

Alba, Marco A; Espígol-Frigolé, Georgina; Prieto-González, Sergio; Tavera-Bahillo, Itziar; García-Martínez, Ana; Butjosa, Montserrat; Hernández-Rodríguez, José; Cid, Maria C

2011-01-01

The central nervous system (CNS) may be involved by a variety of inflammatory diseases of blood vessels. These include primary angiitis of the central nervous system (PACNS), a rare disorder specifically targeting the CNS vasculature, and the systemic vasculitides which may affect the CNS among other organs and systems. Both situations are severe and convey a guarded prognosis. PACNS usually presents with headache and cognitive impairment. Focal symptoms are infrequent at disease onset but are common in more advanced stages. The diagnosis of PACNS is difficult because, although magnetic resonance imaging is almost invariably abnormal, findings are non specific. Angiography has limited sensitivity and specificity. Brain and leptomeningeal biopsy may provide a definitive diagnosis when disclosing blood vessel inflammation and are also useful to exclude other conditions presenting with similar findings. However, since lesions are segmental, a normal biopsy does not completely exclude PACNS. Secondary CNS involvement by systemic vasculitis occurs in less than one fifth of patients but may be devastating. A prompt recognition and aggressive treatment is crucial to avoid permanent damage and dysfunction. Glucocorticoids and cyclophosphamide are recommended for patients with PACNS and for patients with secondary CNS involvement by small-medium-sized systemic vasculitis. CNS involvement in large-vessel vasculitis is usually managed with high-dose glucocorticoids (giant-cell arteritis) or glucocorticoids and immunosuppressive agents (Takayasu’s disease). However, in large vessel vasculitis, where CNS symptoms are usually due to involvement of extracranial arteries (Takayasu’s disease) or proximal portions of intracranial arteries (giant-cell arteritis), revascularization procedures may also have an important role. PMID:22379458

Vasculitis cerebral cisticercosa y neuropatía óptica isquémica en una paciente con amaurosis unilateral y recuperación ad integrum

OpenAIRE

Enríquez Coronel,Guillermo; Santos Marcial,Edgar; Cabrera Aldana,Eibar Ernesto

2004-01-01

La cisticercosis es una parasitósis bien conocida que puede causar una gran cantidad de síndromes. La neuropatía isquémica-óptica es una enfermedad de adultos cuyas causas principales son hipertensión arterial y la diabetes y la arteritis de células gigantes. Presentamos el caso de una estudiante de medicina de 22 años que presentó súbitamente pérdida de la visión en el ojo derecho y después completa ceguera. Los estudios demostraron múltiples cisticercos en el hemisferio derecho. Fue tratada...

Inhibition of vitamin D2-induced arteriosclerosis in rats by depletion of complement with cobra venom factor.

Science.gov (United States)

Pang, A S; Minta, J O

1980-01-01

Widespread calcerous deposits developed in the aorta, heart and kidneys of rats fed for 4 days with purina chow and high doses of vitamin D2 (200,000 IU/kg body wt/day). Decomplementation of rats with highly purified cobra venom factor (CoF) prior to vitamin D2 feeding, almost completely prevented calcium deposition in the aorta and arteritis. The mortality rate in the CoF-treated vitamin D2-fed rats was much lower than in untreated rats. These findings suggest that the complement system may be recruited in the pathogenesis of vitamin D2-induced arteriosclerosis.

Effekt av ulike kjemiske- og biologiske preparater på forekomsten av Fusarium og mykotoksiner i havre

OpenAIRE

Shakery, Bita

2013-01-01

Aksfusariose er en vanlig sykdom på korn forårsaket av flere ulike Fusarium-arter. En Fusarium-infeksjon på akset gir tap av avling i tillegg til en reduksjon i kvaliteten på kornet. Reduksjonen i kvalitet skjer i hovedsak gjennom produksjon av en rekke toksiske metabolitter (mykotoksiner) som kan være en helserisiko for både dyr og mennesker. I de senere årene har det vært økt fokus på Fusarium og mykotoksiner i korn både i Norge og i store deler av verden. En årsak til det...

Unusual infectious mononucleosis complicated by vasculitis

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Srimanta Kumar Sahu

2016-01-01

Full Text Available Infectious mononucleosis (IM is a clinical syndrome caused by Epstein-Barr virus (EBV. It manifests as fever, pharyngitis, malaise, adenopathy, and atypical lymphocytosis. Cardiovascular complications are thought to be rare in IM. There are very few case reports of EBV-associated vasculitides, like Kawasaki disease and systemic polyarteritis nodosa, however, involvement of the large caliber arteries like the aorta and its branches have been reported only scarcely. Myocarditis also is rare as an early manifestation of EBV infection. We present here a rare case of IM, presented initially with acute myocarditis and later with large-vessels arteritis.

Hepatorenal bypass using autogenous, free internal iliac artery graft: An attractive alternative to revascularize the right kidney in Takayasu's disease.

Science.gov (United States)

Khattar, Nikhil; Guleria, Sandeep; Sharma, Sanjeev

2012-04-01

Nonspecific aortoarteritis or Takayasu's disease (TD) is a chronic pan endarteritis of unknown origin involving the aorta and its major branches affecting young adults especially women. The disease is more common in eastern Asian countries. Hypertension in these patients generally reflects as renal artery stenosis, which is seen in 28-75% of patients. Surgical revascularization is occasionally needed in patients with failed medical management or endovascular interventions. We report two cases of Takayasu's arteritis in young women where renal revascularization was done using free internal iliac artery hepatorenal bypass graft with excellent control of hypertension in the postoperative period.

Epigenetics and Vasculitis: a Comprehensive Review.

Science.gov (United States)

Renauer, Paul; Coit, Patrick; Sawalha, Amr H

2016-06-01

Vasculitides represent a group of relatively rare systemic inflammatory diseases of the blood vessels. Despite recent progress in understanding the genetic basis and the underlying pathogenic mechanisms in vasculitis, the etiology and pathogenesis of vasculitis remain incompletely understood. Epigenetic dysregulation plays an important role in immune-mediated diseases, and the contribution of epigenetic aberrancies in vasculitis is increasingly being recognized. Histone modifications in the PR3 and MPO gene loci might be mechanistically involved in the pathogenesis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Similarly, other studies revealed important epigenetic contribution to other vasculitides, including Kawasaki disease and IgA vasculitis. More recently, genome-wide epigenomic studies have been performed in several vasculitides. A recent genome-wide DNA methylation study uncovered an important role for epigenetic remodeling of cytoskeleton-related genes in the pathogenesis of Behçet's disease and suggested that reversal of some of these DNA methylation changes associates with disease remission. Genome-wide DNA methylation profiling characterized the inflammatory response in temporal artery tissue from patients with giant cell arteritis and showed increased activation of calcineurin/nuclear factor of activated T cells (NFAT) signaling, prompting the suggestion that a specific calcineurin/NFAT inhibitor that is well tolerated and with the added beneficial anti-platelet activity, such as dipyridamole, might be of therapeutic potential in giant cell arteritis. While epigenetic studies in systemic vasculitis are still in their infancy, currently available data clearly indicate that investigating the epigenetic mechanisms underlying these diseases will help to better understand the pathogenesis of vasculitis and provide novel targets for the development of disease biomarkers and new therapies.

Progranulin antibodies in autoimmune diseases.

Science.gov (United States)

Thurner, Lorenz; Preuss, Klaus-Dieter; Fadle, Natalie; Regitz, Evi; Klemm, Philipp; Zaks, Marina; Kemele, Maria; Hasenfus, Andrea; Csernok, Elena; Gross, Wolfgang L; Pasquali, Jean-Louis; Martin, Thierry; Bohle, Rainer Maria; Pfreundschuh, Michael

2013-05-01

Systemic vasculitides constitute a heterogeneous group of diseases. Autoimmunity mediated by B lymphocytes and their humoral effector mechanisms play a major role in ANCA-associated vasculitis (AAV) as well as in non-ANCA associated primary systemic vasculitides and in the different types of autoimmune connective tissue disorders and rheumatoid arthritis. In order to detect autoantibodies in systemic vasculitides, we screened protein macroarrays of human cDNA expression libraries with sera from patients with ANCA-associated and ANCA-negative primary systemic vasculitides. This approach led to the identification of antibodies against progranulin, a 88 kDA secreted glycoprotein with strong anti-inflammatory activity in the course of disease of giant-cell arteritis/polymyalgia rheumatica (14/65), Takayasu's arteritis (4/13), classical panarteritis nodosa (4/10), Behcet's disease (2/6) and in the course of disease in granulomatosis with polyangiitis (31/75), Churg-Strauss syndrome (7/23) and in microscopic polyangiitis (7/19). In extended screenings the progranulin antibodies were also detected in other autoimmune diseases such as systemic lupus erythematosus (39/91) and rheumatoid arthritis (16/44). Progranulin antibodies were detected only in 1 of 97 healthy controls. Anti-progranulin positive patients with systemic vasculitides, systemic lupus erythematosus or rheumatoid arthritis had significant lower progranulin plasma levels, indicating a neutralizing effect. In light of the anti-inflammatory effects of progranulin, progranulin antibodies might exert pro-inflammatory effects thus contributing to the pathogenesis of the respective autoimmune diseases and might serve as a marker for disease activity. This hypothesis is supported by the fact that a positive progranulin antibody status was associated with active disease in granulomatosis with polyangiitis. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of repeated Strongylus vulgaris inoculations and concurrent ivermectin treatments on mesenteric arterial lesions in pony foals.

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Klei, T R; Turk, M A; McClure, J R; Holmes, R A; Dennis, V A; Chapman, M R

1990-04-01

Eight of 10 pony foals reared under helminth-free conditions were inoculated PO with 50 Strongylus vulgaris infective larvae/week for 4 weeks, at which time 1 foal died of acute verminous arteritis. Inoculation of 7 remaining foals continued at 2-week intervals for 20 weeks. Of the 7 foals, 3 were treated with ivermectin (0.2 mg/kg of body weight) in an oral paste formulation at experiment weeks 8, 16, 24; 4 foals were not treated. Two foals were not inoculated or treated and served as controls. After the first ivermectin treatment, ivermectin-treated foals had fewer days (12 +/- 2.9) with rectal temperatures greater than 38.6 C than did nontreated foals (23.3 +/- 3.8). Mean baseline rectal temperatures were 38 +/- 0.2 C. Adverse clinical reactions to ivermectin treatment were not observed in foals. Foals were euthanatized and necropsied 3 weeks after the last ivermectin treatment (week 24). Ivermectin was effective in reducing S vulgaris arterial larval and intestinal adult parasite numbers by 100% in 3 treated foals. Strongylus vulgaris arterial larvae and/or adults were recovered from all 4 nontreated inoculated foals. One nontreated inoculated foal lacked arterial larvae or active arterial lesions, indicating that protective resistance had developed in this individual. Marked gross and histopathologic lesions typical of chronic S vulgaris infection were observed in the 3 nontreated inoculated foals with arterial larvae. Repeated killing of intra-arterial S vulgaris fourth-stage larvae in ivermectin-treated foals did not exacerbate lesions associated with verminous arteritis or induce unique lesions associated with repeated destruction of arterial larvae.(ABSTRACT TRUNCATED AT 250 WORDS)

New analysis of magnetic tornadoes

Science.gov (United States)

Arter, Wayne

2017-04-01

The recent work[1] showed how the equations of ideal, compressible magnetohydrodynamics (MHD) may be elegantly formulated in terms of Lie derivatives, building on the work of Helmholtz, Walen and Arnold. The ``linear" fields approach reduces ideal MHD to a low order set of non-linear ordinary differential equations capable of further simplification, so has the potential to enrich understanding of this difficult subject, which has application both to laboratory and geophysical/astrophysical plasmas. The just published work [2] extends the linear fields' solution of compressible nonlinear MHD to the case where the magnetic field depends on superlinear powers of position vector, usually but not always, expressed in Cartesian components. Implications of the resulting Lie-Taylor series expansion for physical applicability of the Dolzhansky-Kirchhoff (D-K) ``linear field" equations are found to be positive. It is demonstrated how resistivity may be included in the D-K model. Arguments are put forward that the D-K equations may be regarded as illustrating properties of nonlinear MHD in the same sense that the Lorenz equations inform about the onset of convective turbulence. It is thereby suggested that the Lie-Taylor series approach may lead to valuable insights into MHD turbulence, especially fast timescale transients and the role of plasmoids. This work has been part-funded by the RCUK Energy Programme. 1. Arter, W. 2013 ``Potential vorticity formulation of compressible magnetohydrodynamics. Phys. Rev. Lett. 110, 015004." (doi:10.1103/PhysRevLett.110.015004) 2. Arter, W. 2017 ``Beyond linear fields: the Lie-Taylor expansion", Proc. R. Soc. A473, 20160525; http://dx.doi.org/10.1098/rspa.2016.0525

FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC.

Science.gov (United States)

Slart, Riemer H J A

2018-07-01

Large vessel vasculitis (LVV) is defined as a disease mainly affecting the large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists with polymyalgia rheumatica (PMR) in the same patient, since both belong to the same disease spectrum. FDG-PET/CT is a functional imaging technique which is an established tool in oncology, and has also demonstrated a role in the field of inflammatory diseases. Functional FDG-PET combined with anatomical CT angiography, FDG-PET/CT(A), may be of synergistic value for optimal diagnosis, monitoring of disease activity, and evaluating damage progression in LVV. There are currently no guidelines regarding PET imaging acquisition for LVV and PMR, even though standardization is of the utmost importance in order to facilitate clinical studies and for daily clinical practice. This work constitutes a joint procedural recommendation on FDG-PET/CT(A) imaging in large vessel vasculitis (LVV) and PMR from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine (EANM), the Cardiovascular Council of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), and the PET Interest Group (PIG), and endorsed by the American Society of Nuclear Cardiology (ASNC). The aim of this joint paper is to provide recommendations and statements, based on the available evidence in the literature and consensus of experts in the field, for patient preparation, and FDG-PET/CT(A) acquisition and interpretation for the diagnosis and follow-up of patients with suspected or diagnosed LVV and/or PMR. This position paper aims to set an internationally accepted standard for FDG-PET/CT(A) imaging and reporting of LVV and PMR.

Vasculites dos médios e grandes vasos Medium and large vessel vasculitis

Directory of Open Access Journals (Sweden)

Hebert Roberto Clivati Brandt

2009-02-01

Full Text Available As vasculites são constituídas por um grande grupo de síndromes caracterizadas por inflamação e necrose da parede dos vasos sangüíneos, resultando em estreitamento ou oclusão do lúmen. A distribuição dos vasos envolvidos varia consideravelmente e serve de base para a classificação das síndromes vasculíticas: grandes vasos (arterite de Takayasu, arterite temporal; pequenos e médios vasos (poliarterite nodosa, síndrome de Churg-Strauss, granulomatose de Wegener, vasculites nas doenças reumáticas; e pequenos vasos (vasculite de hipersensibilidade, púrpura de Henoch-Schonlein, poliangeíte microscópica, crioglobulinemia. Este artigo revisa as vasculites dos médios e grandes vasos e opções terapêuticas atuais; além de oferecer orientação sobre abordagem diagnóstica e tratamento dos pacientes com suspeita de vasculite cutânea.Vasculitis comprises a broad group of syndromes characterized by inflammation and necrosis on the walls of blood vessels, resulting in narrowing or occlusion of the lumen. The distribution of involved blood vessel varies considerably and serves as the basis for one classification of vasculitic syndromes: large vessels (Takayasu arteritis, giant cell arteritis; medium and small muscular arteries (polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, vasculitis in rheumatic diseases; and small vessels ("hypersensitivity" vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, cryoglobulinemia. This article reviews medium and large vessel vasculitis and current treatment options; it also presents a comprehensive approach to diagnosing and treating patients with suspected cutaneous vasculitis.

Characterization of vascular lesions in pigs affected by porcine circovirus type 2-systemic disease.

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Resendes, A R; Segalés, J

2015-05-01

Vascular lesions and their association with porcine circovirus type 2 (PCV2) were evaluated in multiple organs from 10 pigs affected with PCV2-systemic disease (PCV2-SD). Animals had vascular lesions in multiple organs, consisting of lymphohistiocytic lymphangitis and/or phlebitis, mild to severe necrotizing arteritis, and thrombosis within splenic arterioles and choroid plexus capillaries. Variable amounts of PCV2 nucleic acid detected by in situ hybridization were present within endothelial cells, tunica media myocytes, and perivascular and/or intralesional inflammatory cell infiltrates. PCV2 nucleic acid was detected within endothelial cells of both lymphatic and blood vessels without lesions in the associated tissues. Necrotizing arteritis was principally present in lymph nodes and kidney and consisted of degeneration, necrosis, and pyknosis of myocytes, often with intracytoplasmic, brightly eosinophilic inclusion bodies that were strongly positive for PCV2 nucleic acid. Segmental or circumferential fibrinoid necrosis was mainly present in vessels of the lymph node, spleen, and choroid plexus and was variably associated with PCV2 nucleic acid. Severe lymphangitis associated with strong intralesional PCV2 labeling was frequently detected within the mesenteric and mediastinal lymph nodes and the lamina propria of the ileum. In most tissues, medium and large lymphatics and/or veins often had disruption of the intima and mild mononuclear inflammatory cell infiltration that was variably associated with PCV2 nucleic acid. The present study indicates that vasculitis is a frequent finding in natural cases of PCV2-SD and that PCV2 may have a direct cytopathic effect on tunica media myocytes of small- and medium-sized arteries as well as endothelium. © The Author(s) 2014.

Controlled tests of ivermectin against migrating Strongylus vulgaris in ponies.

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Slocombe, J O; McCraw, B M

1981-06-01

Twelve pony foals were reared worm-free and inoculated with Strongylus vulgaris. On day 7 after inoculation, 6 ponies were given ivermectin IM at a dose of 200 micrograms/kg of body weight and on day 28 were necropsied. Ivermectin was effective in eliminating early 4th-stage S vulgaris larvae and reducing clinical signs associated with acute arteritis. After administrative ivermectin was effective against early 4th-stage Strongylus vulgaris larvae in ponies when administered at 100, 300, or 800 micrograms/kg of body weight. The purpose of the present study was to report on a more extensive trial, using a single dosage of ivermectin.

Primary angiitis of the central nervous system with diffuse cerebral mass effect and giant cells.

LENUS (Irish Health Repository)

Kinsella, J A

2012-02-01

Primary angiitis of the central nervous system (PACNS), also called primary CNS vasculitis, is an idiopathic inflammatory condition affecting only intracranial and spinal cord vessels, particularly medium-sized and smaller arteries and arterioles. Angiography and histopathology typically do not reveal evidence of systemic vasculitis.(1,2) Histopathology usually reveals granulomatous inflammation affecting arterioles and small arteries of the parenchyma and\\/or leptomeninges, similar to that seen in Takayasu\\'s or giant cell arteritis.(1-3) We report a patient with biopsy-proven PACNS with giant cells and cerebral mass effect on MRI. Magnetic resonance angiography and cerebral angiography appeared normal and there was no evidence of extracranial vasculitis.

Iliac artery pseudoaneurysm after lumbar disc hernia operation

OpenAIRE

Atay, Mehmet; Saydam, Onur; Türkyılmaz, Saygın; Kavala, Ali Aycan; Gülmalıyev, Cabir; Bakuy, Vedat

2016-01-01

Lomber disk hernisioperasyonu genellikle posterior yaklaşımla yapılmakta olup vasküleryaralanmalar operasyonun komplikasyonları arasında sayılabilmektedir. Sunulan 39yaşındaki olguda geçirilmiş lomber disk hernisi sonrası başlayan ve bir aydırdevam eden bacak ağrısı vardı. Yakınmaları operasyon sonrasında çıktığıöğrenilen hastada çekilen bilgisayarlı tomografi sonrasında iliak arter psödoanevrizmasıgörüldü. Olgu cerrahi olarak başarıyla tedavi edildi. 

Hepatorenal bypass using autogenous, free internal iliac artery graft: An attractive alternative to revascularize the right kidney in Takayasu′s disease

Directory of Open Access Journals (Sweden)

Nikhil Khattar

2012-01-01

Full Text Available Nonspecific aortoarteritis or Takayasu′s disease (TD is a chronic pan endarteritis of unknown origin involving the aorta and its major branches affecting young adults especially women. The disease is more common in eastern Asian countries. Hypertension in these patients generally reflects as renal artery stenosis, which is seen in 28-75% of patients. Surgical revascularization is occasionally needed in patients with failed medical management or endovascular interventions. We report two cases of Takayasu′s arteritis in young women where renal revascularization was done using free internal iliac artery hepatorenal bypass graft with excellent control of hypertension in the postoperative period.

Acidente Vascular Encefálico como Primeira Manifestação Clínica da Arterite de Takayasu – Relato de Caso / Brain Stroke as First Clinical Manifestation of Takayasu Arteritis – Case Report

Directory of Open Access Journals (Sweden)

Mariana Pires de Sousa e Silva

2016-06-01

Full Text Available Introdução: A Arterite de Takayasu (AT é uma vasculite crônica de médios e grandes vasos cuja etiologia é desconhecida. A incidência anual de AT, segundo estatísticas americanas, é de cerca de 2,6 casos por milhão de pessoas, acometendo principalmente mulheres jovens na idade reprodutiva. Essa doença possui sintomas característicos, como claudicação de membros, dor torácica, ausência de pulsos braquiais, sopro carotídeo e ausência de pressão arterial nos membros superiores. Síndromes neurológicas, como Acidente Vascular Cerebral (AVC e Ataque Isquêmico Transitório (AIT são apresentadas por aproximadamente 10 a 20% dos pacientes com AT. Relato de Caso: Relatou-se o caso de paciente do sexo feminino, de 42 anos, branca, que apesar de apresentar os sintomas de AT com 15 anos, como dor em região torácica e hipertensão arterial, foi diagnosticada com AT somente após 25 anos. A paciente foi admitida no Pronto Socorro do Hospital Escola de Itajubá com sintomas que sugeriam um AVC, confirmado com Tomografia computadorizada (TC de crânio e, posteriormente, AngioTC cerebral e de artérias carótidas e vertebrais que, juntamente com os sinais clínicos observados, como pulsos radiais não palpáveis bilateralmente e sopro carotídeo diagnosticaram a AT. Discussão: A AT costuma apresentar intervalo entre início de sintomas e diagnóstico entre dois e onze anos e pode estar associada a várias manifestações características. O diagnóstico de AT tardio tendo o AVC como primeira manifestação clínica é raro. Conclusão: A importância de se conhecer a AT está no fato do diagnóstico, bem como tratamento precoce poderem evitar complicações ou retardar o seu aparecimento. Introduction: The Takayasu arteritis (TA is a chronic vasculitis of medium and large vessel, whose etiology is unknown. The annual incidence of TA, according to American statistics, is about 2.6 cases per one million people, mainly affects young women in

The Role of IL-1 signaling in a mouse model of Kawasaki Disease-associated Abdominal Aortic Aneurysm

Science.gov (United States)

Wakita, Daiko; Kurashima, Yosuke; Crother, Timothy R.; Rivas, Magali Noval; Lee, Youngho; Chen, Shuang; Fury, Wen; Bai, Yu; Wagner, Shawn; Li, Debiao; Lehman, Thomas; Fishbein, Michael C.; Hoffmann, Hal; Shah, Prediman K.; Shimada, Kenichi; Arditi, Moshe

2016-01-01

Objective Kawasaki disease (KD) is the most common cause of acquired cardiac disease in US children. In addition to coronary artery abnormalities and aneurysms, it can be associated with systemic arterial aneurysms. We evaluated the development of systemic arterial dilatation and aneurysms, including abdominal aortic aneurysm (AAA) in the Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis mouse model. Methods and Results We discovered that in addition to aortitis, coronary arteritis and myocarditis, the LCWE-induced KD mouse model is also associated with abdominal aorta dilatation and AAA, as well as renal and iliac artery aneurysms. AAA induced in KD mice was exclusively infrarenal, both fusiform and saccular, with intimal proliferation, myofibroblastic proliferation, break in the elastin layer, vascular smooth muscle cell loss, and inflammatory cell accumulation in the media and adventitia. Il1r−/−, Il1a−/−, and Il1a−/− mice were protected from KD associated AAA. Infiltrating CD11c+ macrophages produced active caspase-1 and caspase-1 or NLRP3 deficiency inhibited AAA formation. Treatment with IL-1R antagonist (Anakinra), anti-IL-1α, or anti-IL-1β mAb blocked LCWE-induced AAA formation. Conclusions Similar to clinical KD, the LCWE-induced KD vasculitis mouse model can also be accompanied by AAA formation. Both IL-1α and IL-1β play a key role, and that use of an IL-1R blocking agent that inhibits both pathways may be a promising therapeutic target not only for KD coronary arteritis, but also for the other systemic arterial aneurysms including AAA that maybe seen in severe cases of KD. The LCWE-induced vasculitis model may also represent an alternative model for AAA disease. PMID:26941015

Evaluation of pyrantel pamoate, nitramisole and avermectin B1a against migrating Strongylus vulgaris larvae.

Science.gov (United States)

Slocombe, J O; McCraw, B M

1980-01-01

Trials were conducted in ponies to evaluate the efficacy of pyrantel pamoate (Strongid-T(R)) and two newer anthelmintics not yet commercially available, nitramisole and avermectin B(1)a, against migrating Strongylus vulgaris larvae. Ponies were removed from their mares within 24-48 hr after birth and reared in isolation, worm free. Between six and 14 weeks of age they were infected with 2000 or 2500 infective S. vulgaris larvae. Subsequently, they were monitored daily for clinical signs until the experiment terminated at 28 days postinfection. All ponies showed increased body temperature and reduced appetite within the first week of infection. All anthelmintics were administered on day 7 and in addition pyrantel pamoate was given on day 8 postinfection. The anthelmintics were in liquid formulation. Nitramisole and pyrantel pamoate were given by stomach tube and avermectin B(1)a by subcutaneous injection.Following administration of these compounds toxic reactions were not observed. All anthelmintics caused a reduction in body temperature and increased appetite and effected a clinical cure. In ponies which were not treated with an anthelmintic, temperatures remained elevated and appetites never returned completely to normal. These ponies also showed variable degrees of lethargy, depression, recumbency and colic and the majority died between two and three weeks postinfection. At necropsy, these control ponies showed variable degrees of adhesions involving the abdominal organs, necrosis of the ileum and cecum and severe arteritis and thrombosis of the major abdominal arteries and their branches.Although pyrantel pamoate, used at eight times the therapeutic dose for intestinal nematodes in the horse, effected a clinical cure it did not produce a radical cure. At necropsy, ponies treated with pyrantel pamoate had arteritis and thrombosis of the cranial mesenteric artery and its major branches. Nitramisole and avermectin B(1)a were able to effect both a clinical and

Marine områder 2001 - Miljøtilstand og udvikling

DEFF Research Database (Denmark)

Ærtebjerg, G.; Andersen, J.; Carstensen, J.

højere værdier. Målinger af miljøfremmede stoffer i muslinger og fisk viser, at de danske fjorde og indre farvande er forurenet med så høje koncentrationer af tributyltin (TBT) fra bundmalinger på skibe og polyaromatiske hydrokarboner (PAH) fra olieprodukter, at der må forventes at forekomme økologiske...... effekter heraf. Hormonforstyrrelser (imposex og intersex hos havsnegle) induceret af tributyltin (TBT) er da også udbredt, først og fremmest i kystnære områder, hvor TBT-niveauet forventeligt er højest, men i følsomme arter er der også effekter i de åbne farvande, selv i den åbne Nordsø. Generelt er...

Anatomo-pathological aspects of parasitism by nematodes of the superfamily Metastrongyloidea in wild crab-eating fox (Cerdocyon thous in Midwestern Brazil

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Jair Alves Ferreira Júnior

Full Text Available ABSTRACT: Nematodes of the superfamily Metastrongyloidea affect the respiratory, cardiovascular, and nervous systems of domestic carnivores and are uncommonly detected in wild animals. This report describes the lesions associated with pulmonary parasitism by nematodes of the superfamily Metastrongyloidea in a wild crab-eating fox ( Cerdocyon thous in the Federal District, Brazil. Grossly, there was pulmonary hyperemia, edema, and emphysema. Microscopically, there was granulomatous arteritis associated with intravascular metastrongylid. The anatomical location, characteristic lesion, and histological features of the parasite suggested that the nematode involved in this case is Angiostrongylus vasorum . This worm is frequently reported parasitizing pulmonary arteries of domestic canids but is uncommonly described in wild canids in Midwestern Brazil.

Evidence of association of the NLRP1 gene with giant cell arteritis

OpenAIRE

Serrano, Aurora; Carmona, F. David; Castañeda, Santos; Solans, Roser; Hernández Rodríguez, José; Cid Xutglà, M. Cinta; Prieto González, Sergio; Miranda-Filloy, José A.; Rodríguez-Rodríguez, Luis; Morado, Inmaculada C.; Gómez Vaquero, Carmen; Blanco, Ricardo; Sopeña, Bernardo; Ortego Centeno, Norberto; Unzurrunzaga, Ainhoa

2013-01-01

Recent studies have focused attention on the involvement of NLRP1 to confer susceptibility for extended autoimmune/inflammatory disorders, being considered a common risk factor in autoimmunity. NLRP1 provides a scaffold for the assembly of the inflammasome that activates caspases 1 and 5, required for processing and activation of the proinflammatory cytokines interleukin 1β (IL-1β), IL-18 and IL-33 and promoting inflammation.

Monocyte chemoattractant protein 1 (MCP-1) in temporal arteritis and polymyalgia rheumatica

DEFF Research Database (Denmark)

Ellingsen, T; Elling, P; Olson, A

2000-01-01

was localised to the vessel wall in patients with TA. In TA, PMR, and healthy controls MCP-1 was quantified by enzyme linked immunosorbent assay (ELISA) in plasma. RESULTS: MCP-1 was localised to the majority of mononuclear cells, some smooth muscle cells, and giant cells in the arterial biopsy specimens from...

Udbredelsen af den invasive børsteorm, Marenzelleria viridis, langs danske kyster – tegn på økologiske konsekvenser?

DEFF Research Database (Denmark)

Banta, Gary Thomas; Christoffersen, Kenn

ud af de 6 resterende stationer vi undersøgte. Antallet af M. viridis på disse stationer var dog beskeden (... tæthed af M. viridis og en række sediment og abiotiske parametre, hvilket bekræfter artens store tolerance overfor det omskiftelige brakvands miljø og sediment karakteristika, der kendetegner de danske kyster. Disse abiotiske parametre understøtter dog forekomsten af lige netop M. viridis frem for de...... andre søskendearter, da sidstnævnte fortrækker enten lavere salinitet eller lavere temperatur end typisk for de danske kyster. Der blev observerede nogle svage negative sammenhæng mellem Marenzelleria viridis og de naturligt forekommende arter, såsom Hediste (Nereis) diversicolor, Corophium spp. og...

A Unique Case of Systemic Lupus Erythematosus Pelvic Vasculitis

Directory of Open Access Journals (Sweden)

Pamela Traisak

2016-01-01

Full Text Available The clinical presentation of Systemic Lupus Erythematosus (SLE is diverse and vasculitis can be a potential manifestation. Cutaneous lesions involving small vessels are the most frequent presentation. However, medium and large vessel vasculitis may present with life-threatening visceral manifestations. We present a unique case of pelvic vasculitis mimicking a pelvic mass as an initial presentation of SLE. There are case reports of systemic vasculitis involving the female genital tract with giant cell arteritis (GCA, polyarteritis nodosa (PAN, and granulomatous with polyangiitis and microscopic polyangiitis (GPA/MPA, among others, but only a few cases attributed to SLE. Awareness of this condition and a prompt diagnosis are warranted as this is a severe and potentially life-threatening condition.

Saddle-nose and bilateral cauliflower ear deformities with pyoderma gangrenosum-like ulcers, cavitary pulmonary lesions, digital gangrene and pulselessness in a young female.

Science.gov (United States)

Subhadarshani, Sweta; Gupta, Vishal; Chahal, Anurag; Verma, Kaushal K

2017-06-15

We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Finally, a diagnosis of relapsing polychondritis with several unusual features was made. Overlap with Takayasu's arteritis and granulomatosis with polyangitis, which has been reported rarely in the literature, cannot be excluded. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature.

Science.gov (United States)

Sy, Alice; Khalidi, Nader; Dehghan, Natasha; Barra, Lillian; Carette, Simon; Cuthbertson, David; Hoffman, Gary S; Koening, Curry L; Langford, Carol A; McAlear, Carol; Moreland, Larry; Monach, Paul A; Seo, Philip; Specks, Ulrich; Sreih, Antoine; Ytterberg, Steven R; Van Assche, Gert; Merkel, Peter A; Pagnoux, Christian

2016-02-01

Published small case series suggest that inflammatory bowel disease [IBD; Crohn's disease (CD) or ulcerative colitis (UC)] and vasculitis co-occur more frequently than would be expected by chance. To describe this association by an analysis of a large cohort of carefully studied patients and through a systematic literature review. Patients with both IBD and vasculitis enrolled in the Vasculitis Clinical Research Consortium (VCRC) Longitudinal Studies, followed in Canadian Vasculitis research network (CanVasc) centers and/or in the University of Toronto's IBD clinic were included in this case series. A systematic literature review of patients with IBD and vasculitis involved a PubMed search through February 2014. The main characteristics of patients with Takayasu arteritis (TAK) and IBD were compared to those in patients with TAK without IBD followed in the VCRC. The study identified 32 patients with IBD and vasculitis: 13 with large-vessel vasculitis [LVV; 12 with TAK, 1 with giant cell arteritis (GCA); 8 with CD, 5 with UC]; 8 with ANCA-associated vasculitis [AAV; 6 granulomatosis with polyangiitis (GPA), 2 with eosinophilic granulomatosis with polyangiitis (EGPA)]; 5 with isolated cutaneous vasculitis; and 6 with other vasculitides. Patients with LVV and AAV were mostly female (18/21). The diagnosis of IBD preceded that of vasculitis in 12/13 patients with LVV and 8/8 patients with AAV. The review of the literature identified 306 patients with IBD and vasculitis: 144 with LVV (133 TAK; 87 with IBD preceding LVV), 19 with AAV [14 GPA, 1 EGPA, 4 microscopic polyangiitis (MPA)], 66 with isolated cutaneous vasculitis, and 77 with other vasculitides. Patients with IBD and TAK were younger and had more frequent headaches, constitutional symptoms, or gastrointestinal symptoms compared to those patients in the VCRC who had TAK without IBD. These findings highlight the risk of vasculitis, especially TAK, in patients with IBD (both CD and UC). Copyright © 2015 Elsevier

Evaluation of Pyrantel Pamoate, Nitramisole and Avermectin B1aAgainst Migrating Strongylus vulgaris Larvae‡

Science.gov (United States)

Slocombe, J. O. D.; McCraw, B. M.

1980-01-01

Trials were conducted in ponies to evaluate the efficacy of pyrantel pamoate (Strongid-T®) and two newer anthelmintics not yet commercially available, nitramisole and avermectin B1a, against migrating Strongylus vulgaris larvae. Ponies were removed from their mares within 24-48 hr after birth and reared in isolation, worm free. Between six and 14 weeks of age they were infected with 2000 or 2500 infective S. vulgaris larvae. Subsequently, they were monitored daily for clinical signs until the experiment terminated at 28 days postinfection. All ponies showed increased body temperature and reduced appetite within the first week of infection. All anthelmintics were administered on day 7 and in addition pyrantel pamoate was given on day 8 postinfection. The anthelmintics were in liquid formulation. Nitramisole and pyrantel pamoate were given by stomach tube and avermectin B1a by subcutaneous injection. Following administration of these compounds toxic reactions were not observed. All anthelmintics caused a reduction in body temperature and increased appetite and effected a clinical cure. In ponies which were not treated with an anthelmintic, temperatures remained elevated and appetites never returned completely to normal. These ponies also showed variable degrees of lethargy, depression, recumbency and colic and the majority died between two and three weeks postinfection. At necropsy, these control ponies showed variable degrees of adhesions involving the abdominal organs, necrosis of the ileum and cecum and severe arteritis and thrombosis of the major abdominal arteries and their branches. Although pyrantel pamoate, used at eight times the therapeutic dose for intestinal nematodes in the horse, effected a clinical cure it did not produce a radical cure. At necropsy, ponies treated with pyrantel pamoate had arteritis and thrombosis of the cranial mesenteric artery and its major branches. Nitramisole and avermectin B1a were able to effect both a clinical and radical

Five Vessel Coronary Arter Bypass Graft Surgery in a Case with Familial Hypercholesterolemia

Directory of Open Access Journals (Sweden)

Sureyya Talay

2014-08-01

Full Text Available We report a case of a rare and sypmtomatic familyal hypercholesterolemia case with an end-point of coronary artery bypass surgery at the age of 16. Patient was evaluated at the emergency department with chest pain and discomfort. Physical examination were within normal limits. The electrocardiogram showed a normal sinus rhythm for 108/ min. Arterial blood pressure was 90/60 mmHg. Lungs and heart were clear to auscultation. Patient was under treatment with a prior diagnosis of familial hypercholesterolemia (FH for one year by daily 40 mgs rosuvastatine. A coronary artery angiography was performed for chest pain. Multivessel coronary artery disease was diagnosed with a total occlusion of left anterior descending artery. Transthoracic echocardiography presented a left ventricular (LV ejection fraction 50%, LV diameters 44/26 mm, aneurysm formation at interatrial septum and mild dyskinesia of anterior wall. Thus, a five vessel emergent coronary artery graft bypass surgery was performed at this early age. FH is with a severe elevation in total cholesterol (TC and low density lipoprotein cholesterol (LDL in an autosomal dominant characteristic disorder that approximately occurs in 1 per 500 persons by its heterozygous form. FH is most certainly associated with premature coronary artery disease (CAD with catasthrophic early age results. [Cukurova Med J 2014; 39(4.000: 872-875

[Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

Science.gov (United States)

Grard, C; Desmytterre, J; Vinckier, L; Hatron, P Y; Roux, J P; Warembourg, H; Devulder, B

1990-03-01

The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Linezolid and dexamethasone experience in a serious case of listeria rhombencephalitis.

Science.gov (United States)

Yılmaz, Pakize Ö; Mutlu, Nevzat M; Sertçelik, Ahmet; Baştuğ, Aliye; Doğu, Cihangir; Kışlak, Sümeyye

2016-01-01

Listeria rhombencephalitis is a rare cause of brain stem encephalitis. We report a case with a history of immunosupressive therapy due to Takayasu's arteritis that was treated with corticosteroids and linezolid for Listeria rhombencephalitis. A 63-year-old woman was admitted to the hospital with fever, headache, nausea, and vomiting. The patient's body temperature was 38°C, and she had a stiff neck. Listeria monocytogenes was isolated from the cerebrospinal fluid (CSF), and penicillin G and gentamicin treatment was initiated. Linezolid and dexamethasone were added. Due to hematuria and thrombocytopenia, the linezolid was discontinued. In immunocompromised patients with CNS infections, Listeria rhombencephalitis should be suspected. Linezolid can be used in combination with dexamethasone. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

PET-CT findings in patients with polymyalgia rheumatica without symptoms of cranial ischaemia

DEFF Research Database (Denmark)

Lund-Petersen, Alexander; Voss, Anne; Laustrup, Helle

2017-01-01

Introduction: Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the lderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics...... and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis. Methods: The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed. Symptoms, characteristics and PET-CT findings were registered from the medical records. Results...... of the following three locations: the shoulder, the hip and the spinous processes. Vascular FDG uptake was seen in 7% of the patients. No significant correlations between any symptoms and any PET-CT findings were found. C-reactive protein was significantly lower in patients receiving glucocorticoids...

Prevalência de anticorpos contra os vírus da influenza, da arterite viral e herpesvírus em eqüinos do Estado do Rio Grande do Sul, Brasil Prevalence of antibodies to influenza virus, viral arteritis and herpesvirus in horses of the Rio Grande do Sul state, Brazil

Directory of Open Access Journals (Sweden)

Diego Gustavo Diel

2006-10-01

Full Text Available O presente estudo teve como objetivo determinar a prevalência de anticorpos contra os vírus da influenza (EIV, da arterite viral (EVAV e herpesvírus (EHV em eqüinos no Estado do Rio Grande do Sul (RS, Brasil. Amostras de soro provenientes de eqüinos de 65 municípios do Estado foram submetidas ao teste de inibição da hemaglutinação (HI para a pesquisa de anticorpos contra o EIV, e à técnica de soroneutralização (SN, para a detecção de anticorpos contra os vírus da EVA e da EHV. Das 1.506 amostras testadas, 986 (65,4% apresentaram anticorpos para o EIV (títulos entre 10 e 1280, 33 (2,2% para o EVAV (2-16 e 67 (4,5% foram positivas para o EHV (2-64. Dentre os 65 municípios amostrados, 55 (84,6% apresentaram pelo menos um animal positivo para o EIV, 15 (23% para o EVAV e 12 (18,5% para o EHV. A prevalência de anticorpos para cada vírus não variou muito entre animais de diferentes propósitos (esporte, exposição e reprodução e entre machos e fêmeas, indicando que os diferentes sistemas de criação apresentam condições epidemiológicas semelhantes em relação a essas infecções. Os resultados obtidos sugerem a circulação desses agentes na população eqüina do RS e alertam para a necessidade de estudos adicionais sobre a importância e o impacto econômico-sanitário dessas viroses para a eqüideocultura do Estado.This study was aimed at investigating the prevalence of antibodies against infections virus of influenza virus (EIV, viral viral arteritis (EVAV, and herpesvirus (EHV among horses in Rio Grande do Sul (RS state, Brazil. Serum samples from horses of Serum samples from horses from 65 counties of northern and northwestern of RS, submitted to serological diagnosis for equine infectious anemia (EIA at the University of Passo Fundo (UPF, were tested by inhibition hemaglutination test (HI for EIV and by virus -neutralization test (VN for EVAV and EHV antibodies. From 1506 samples, 986 (65.4% presented antibodies

Eosinophilic Pancreatitis: A Rare Cause of Recurrent Acute Pancreatitis

Directory of Open Access Journals (Sweden)

Jennifer Reppucci

2017-03-01

Full Text Available Eosinophilic pancreatitis is a rare form of recurrent acute pancreatitis that demonstrates distinct histologic features, including diffuse, periductal, acinar, and septal inflammatory infiltrates comprised of a pure or predominant population of eosinophils, eosinophilic phlebitis and arteritis, and localized eosinophilic infiltrates with pseudocyst formation. It is associated with elevated serum immunoglobulin E levels, an elevated eosinophil count with systemic manifestations, and eosinophilic infiltrates in other organs of the gastrointestinal tract. We present a case of eosinophilic pancreatitis in a 44-year-old man who was diagnosed after pancreatic resection for recurrent bouts of acute pancreatitis. While the gross and histologic evaluations matched other reported cases of eosinophilic pancreatitis, our patient had only minimal peripheral eosinophilia, no reported history of symptoms related to elevated eosinophilia or immunoglobulin E, and only mild eosinophilic infiltrates in his gallbladder.

Enteropathic Spondyloarthritis: From Diagnosis to Treatment

Directory of Open Access Journals (Sweden)

Rosario Peluso

2013-01-01

Full Text Available Enteropathic arthritis (EA is a spondyloarthritis (SpA which occurs in patients with inflammatory bowel diseases (IBDs and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

Bakteriaemi forårsaget af zoonotiske Salmonella-typer i Storkøbenhavn 1984-1988

DEFF Research Database (Denmark)

Lester, Anne; Eriksen, N H; Nielsen, H

1990-01-01

The five departments of clinical microbiology in Greater Copenhagen have together carried out a retrospective review of bacteraemia caused by the zoonotic Salmonella serotypes in the period 1984-1988 in the municipalities of Copenhagen and Frederiksberg and in the County of Copenhagen. A gradual...... increase in frequency was observed from 11 cases in 1984 to 58 cases in 1988. The serotype most commonly isolated was Salmonella dublin followed by Salmonella enteritidis and Salmonella typhimurium. S. dublin was found to be more invasive and more virulent than the other serotypes. Predisposing factors...... aortic aneurysm probably on account of Salmonella arteritis. 20% developed recurrence of bacteraemia while in the remaining patients the disease ran an uncomplicated course. It is concluded that the marked increase in the number of cases and the serious course taken by the infection demonstrate...

Host Proteins Determine MRSA Biofilm Structure and Integrity

DEFF Research Database (Denmark)

Dreier, Cindy; Nielsen, Astrid; Jørgensen, Nis Pedersen

Human extracellular matrix (hECM) proteins aids the initial attachment and initiation of an infection, by specific binding to bacterial cell surface proteins. However, the importance of hECM proteins in structure, integrity and antibiotic resilience of a biofilm is unknown. This study aims...... to determine how specific hECM proteins affect S. aureus USA300 JE2 biofilms. Biofilms were grown in the presence of synovial fluid from rheumatoid arteritis patients to mimic in vivo conditions, where bacteria incorporate hECM proteins into the biofilm matrix. Difference in biofilm structure, with and without...... addition of hECM to growth media, was visualized by confocal laser scanning microscopy. Two enzymatic degradation experiments were used to study biofilm matrix composition and importance of hECM proteins: enzymatic removal of specific hECM proteins from growth media, before biofilm formation, and enzymatic...

Takayasu's arteritis: A rare cause of cardiac death in a Caucasian teenage female patient

NARCIS (Netherlands)

S.A.M. Saïd (Salah); J.C. Koetsveld-Baart (J.); J.C. den Hollander (Jan)

1997-01-01

textabstractA Caucasian teenage Dutch schoolgirl with known chronic low visual acuity and albinism, presented with frank acute pulmonary oedema, died after 1 h of cardio-pulmonary resuscitation for bradyarrhythmia and cardiac arrest. Two weeks prior to presentation, during sport training, she

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging

Energy Technology Data Exchange (ETDEWEB)

Mavrogeni, Sophie, E-mail: soma13@otenet.gr; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-15

Highlights: • Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis of IgG4-related disease. • CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. • Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques. • CT can assess periarteritis and coronary artery aneurysms, while 18FDG-PET shows FDG uptake at the area of the lesion. • CMR offers an integrated imaging of CV system, including assessment of disease acuity, extent of fibrosis and can guide further treatment. - Abstract: Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18

Associations between interleukin-1 polymorphisms and susceptibility to vasculitis: a meta-analysis.

Science.gov (United States)

Song, G G; Kim, J-H; Lee, Y H

2016-05-01

The objective of this study was to determine whether interleukin-1 (IL-1) polymorphisms are associated with susceptibility to vasculitis. A meta-analysis was conducted to investigate possible associations between IL-1A, IL-1B, and IL-1 receptor antagonist (IL1RN) polymorphisms and vasculitis. A total of 17 studies involving 1384 vasculitis cases [Behçet's disease (BD), IgA vasculitis, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), Kawasaki disease (KD), giant cell arteritis, and Takayasu's arteritis] and 2710 controls were included in the meta-analysis. This analysis showed an association between BD and the TT + TC genotypes of the IL-1A-889 C/T polymorphism in the entire study population [odds ratio (OR) = 0.623, 95 % CI = 0.395-0.981, p = 0.045), and a trend toward an association in a Turkish population (OR = 0.578, 95 % CI = 0.331-1.010, p = 0.054). A meta-analysis of the IL1RN polymorphism revealed no association with vasculitis in all study subjects (OR for IL1RN*2 = 0.904, 95 % CI = 0.626-1.304, p = 0.588). However, stratification by ethnicity revealed a significant association between the IL1RN*2 allele and vasculitis including AAV, BD, KD in Asians (OR = 2.393, 95 % CI = 1.429-4.006, p = 0.001), but not in Caucasian and Turkish populations (OR = 0.776, 95 % CI = 0.487-1.238, p = 0.288; OR = 0.914, 95 % CI = 0.667-1.252, p = 0.576, respectively). No association was found between vasculitis and the IL-1B-511 C/T polymorphism, or the IL-1B+3953 C/T polymorphism. This meta-analysis suggests that the IL-1A-889 C/T polymorphism is associated with susceptibility to BD, and that the IL1RN*2 allele is associated with susceptibility to vasculitis including AAV, BD, and KD in Asians.

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging

International Nuclear Information System (INIS)

Mavrogeni, Sophie; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-01

Highlights: • Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis of IgG4-related disease. • CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. • Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques. • CT can assess periarteritis and coronary artery aneurysms, while 18FDG-PET shows FDG uptake at the area of the lesion. • CMR offers an integrated imaging of CV system, including assessment of disease acuity, extent of fibrosis and can guide further treatment. - Abstract: Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18

Controlled tests of fenbendazole against migrating Strongylus vulgaris in ponies.

Science.gov (United States)

Slocombe, J O; McCraw, B M

1982-03-01

Sixteen pony foals were reared worm-free and inoculated with Strongylus vulgaris. On day 7 after inoculation, 12 ponies were given a fenbendazole 10% suspension at dose rate of 50 mg/kg of body weight by stomach tube. On day 8 after inoculation, 8 of these ponies were given the 2nd treatment of the anthelmintic and on day 9, 4 of these ponies were given the 3rd treatment. (The other 4 of the 16 ponies were given only tap water, as controls.) The ponies were necropsied at death or on day 28 after inoculation. Fenbendazole was effective in minimizing the appearance of clinical signs associated with acute arteritis and was highly efficacious in eliminating early 4th-stage S vulgaris larvae in ponies treated for 3 consecutive days (ie, days 7, 8, and 9). After administration of the anthelmintic, clinical signs of toxicosis were not observed.

Behçet's disease.

Science.gov (United States)

Saadoun, David; Wechsler, Bertrand

2012-04-12

DEFINITION OF THE DISEASE: Behçet disease (BD) is a chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. BD seems to cluster along the ancient Silk Road, which extends from eastern Asia to the Mediterranean basin. European cases are often described, not exclusively in the migrant population. The clinical spectrum includes oral and genital ulcerations, uveitis, vascular, neurological, articular, renal and gastrointestinal manifestations. The etiopathogenesis of the disease remains unknown, although genetic predisposition, environmental factors and immunological abnormalities have been implicated. Diagnosis is only based on clinical criteria. DIFFERRENTIAL DIAGNOSIS: It depends on the clinical presentation of BD, but sarcoidosis, multiple sclerosis, Crohn's disease, Takayasu's arteritis, polychondritis or antiphospholipid syndrome need to be considered. Treatment is symptomatic using steroids and immunomodulatory therapy. It is efficient depending on the rapidity of initiation, the compliance, and the duration of therapy. The prognosis is severe due to the ocular, neurological and arterial involvement.

Pseudoaneurysms of large arteries associated with AIDS

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Carlos Eli Piccinato

Full Text Available BACKGROUND: Several vascular complications are known to occur in association with the acquired immunodeficiency syndrome (AIDS and recent publications have called attention to the development of pseudoaneurysms of large arteries in patients with AIDS. CASE REPORT: We report on 2 patients with AIDS aged 23 and 31 years with pseudoaneurysms of the abdominal aorta and common iliac arteries. After clinical and radiological evaluation by arteriography and computed tomography, the patients were submitted to aneurysmectomy, with the placement of a patch of dacron in the first case and the interposition of a right aorto-iliac and left femoral prosthesis in the second. The second patient developed new aneurysms of the right subclavian and left popliteal arteries 2 months after surgery. Proximal ligation of the right subclavian artery was performed to treat the first aneurysm and resection and interposition of a reversed saphenous vein was carried out to treat the pseudoaneurysm of the popliteal artery. Histopathological examination of the popliteal artery revealed necrotizing arteritis.

The epidemiology of equine strongylosis in southern Queensland. 3. Seasonal variation in arterial populations of Strongylus vulgaris, and the prevalence of some helminths.

Science.gov (United States)

English, A W

1979-07-01

The anterior mesenteric arteries of 138 horses slaughtered in southern Queensland were examined for the presence of S. vulgaris larvae. Seasonal differences were noted in the size of arterial populations of this parasite, with higher mean monthly numbers of worms per horse occurring in winter. There was an equally high incidence of severe verminous arteritis during the winter months of June, July and August, compared to arteries examined during the warmer months, when there were smaller numbers of larvae. It was concluded that more infective larvae were available on pasture during the warmer months, with subsequently large arterial populations some 3 to 4 months later. The parasite was encountered in 121 arteries (88%). The prevalence of adult helminths in the caeca of the same group of horses was S. vulgaris 88%; S. equinus 70%; S. edentatus 18%; Triodontophorus spp. 23%; A. perfoliata 62%. The overall prevalence of S. vulgaris was 93%, when the results of arterial and caecal observations were combined.

MR angiography in pediatric neurological disorders

International Nuclear Information System (INIS)

Lee, B.C.P.; Park, T.S.; Kaufman, B.A.

1995-01-01

MR angiography using 3D and 2D time-of-flight techniques were used to evaluate pediatric neurological disorders. MRA (arteriography) and MRV (venography) were abnormal in 63 and 45 cases, respectively. Conventional cerebral angiography was performed in 30 cases. These techniques were compared with MRI and conventional angiography. In addition, the value of MR angiography for surgical planning was subjectively evaluated. Our results showed that intracranial vessels were invariably better shown on MR angiography than on MRI. MRA and MRV were most useful in evaluating vascular distortions related to congenital brain malformations and intracranial tumors. MRA was valuable in detecting arterial narrowing but overestimated the degree of stenosis compared with conventional angiography. MRV was the technique of choice for evaluation of dural sinus and cerebral venous thrombosis and compression. MRA played little to no role in preoperative planning of vascular malformations and aneurysms. It did not appear to be accurate in assessing tumor vascularity or lesions in small arteries and arteritis. (orig.)

Metastrongyloid nematode (Otostrongylus circumlitus) infection in a stranded California sea lion (Zalophus californianus)--a new host-parasite association.

Science.gov (United States)

Kelly, Terra R; Greig, Denise; Colegrove, Kathleen M; Lowenstine, Linda J; Dailey, Murray; Gulland, Frances M; Haulena, Martin

2005-07-01

A stranded yearling male California sea lion was admitted to a rehabilitation center June 2003. On presentation, the sea lion was emaciated and had diarrhea and neutrophilia. Two weeks later, the animal became anorexic, blood and mucus were observed around the oral cavity, and corneal opacity was noted in the right eye. Hematology results at that time included leukocytosis consisting of neutrophilia with a left shift, anemia, and thrombocytopenia. Despite supportive care, the sea lion died. On post mortem examination, there were multiple areas of hemorrhage scattered throughout all lung lobes, and pulmonary blood vessels were occluded by fibrin thrombi. Nematodes identified as immature forms of Otostrongylus circumlitus were found in the right ventricle and pulmonary arteries. Histologic findings in the lungs included severe suppurative and necrotizing arteritis with vascular thrombosis, interstitial pneumonia, and large areas of pulmonary hemorrhage. This report of O. circumlitus infection in a California sea lion (Zalophus californianus) might indicate a potentially new host-parasite association.

Aleutian Disease: An Emerging Disease in Free-Ranging Striped Skunks (Mephitis mephitis) From California.

Science.gov (United States)

LaDouceur, E E B; Anderson, M; Ritchie, B W; Ciembor, P; Rimoldi, G; Piazza, M; Pesti, D; Clifford, D L; Giannitti, F

2015-11-01

Aleutian disease virus (ADV, Amdovirus, Parvoviridae) primarily infects farmed mustelids (mink and ferrets) but also other fur-bearing animals and humans. Three Aleutian disease (AD) cases have been described in captive striped skunks; however, little is known about the relevance of AD in free-ranging carnivores. This work describes the pathological findings and temporospatial distribution in 7 cases of AD in free-ranging striped skunks. All cases showed neurologic disease and were found in a 46-month period (2010-2013) within a localized geographical region in California. Lesions included multisystemic plasmacytic and lymphocytic inflammation (ie, interstitial nephritis, myocarditis, hepatitis, meningoencephalitis, pneumonia, and splenitis), glomerulonephritis, arteritis with or without fibrinoid necrosis in several organs (ie, kidney, heart, brain, and spleen), splenomegaly, ascites/hydrothorax, and/or encephalomalacia with cerebral microangiopathy. ADV infection was confirmed in all cases by specific polymerase chain reaction and/or in situ hybridization. The results suggest that AD is an emerging disease in free-ranging striped skunks in California. © The Author(s) 2014.

Aspergillus: a rare primary organism in soft-tissue infections.

Science.gov (United States)

Johnson, M A; Lyle, G; Hanly, M; Yeh, K A

1998-02-01

Nonclostridial necrotizing soft-tissue infections are usually polymicrobial, with greater than 90 per cent involving beta-hemolytic streptococci or coagulase-positive staphylococci. The remaining 10 per cent are usually due to Gram-negative enteric pathogens. We describe the case of a 46-year-old woman with bilateral lower extremity fungal soft tissue infections. She underwent multiple surgical debridements of extensive gangrenous necrosis of the skin and subcutaneous fat associated with severe acute arteritis. Histopathological examination revealed Aspergillus niger as the sole initial pathogen. Despite aggressive surgical debridement, allografts, and intravenous amphotericin B, her condition clinically deteriorated and she ultimately died of overwhelming infection. Treatment for soft-tissue infections include surgical debridement and intravenous antibiotics. More specifically, Aspergillus can be treated with intravenous amphotericin B, 5-fluorocytosine, and rifampin. Despite these treatment modalities, necrotizing fascitis is associated with a 60 per cent mortality rate. Primary fungal pathogens should be included in the differential diagnosis of soft-tissue infections.

Antropocæne monstre og vidundere. Kartofler, samarbejdsformer og globale forbindelser i et dansk ruinlandskab

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Frida Hastrup

2016-07-01

Full Text Available Med afsæt i forarbejdningen af kartofler til avanceret kartoffelstivelse i et område af Jylland, der tidligere lagde grund til udvinding af brunkul, udforsker vi i denne artikel former for liv på en stærkt industrialiseret jord. Gennem en kulturanalyse i jordhøjde i et særligt menneskeskabt landskab viser vi, at jyske kartofler har alt muligt at gøre med vingummi, brunkulsudvinding, hjorte, asiatiske nudler, parmesanost og frembringelsen af nye forbindelser i verden. Ved at rette blikket mod sådanne forbindelser i et landskab gennemgribende formet af ressourceudvinding, diskuterer vi muligheder for forskellige arters sameksistens og retter blikket mod både monstrøse og vidunderlige effekter af industriel virksomhed. Begrebet antropocæn bruger vi til at undersøge det menneskeskabte brunkulslandskab som en mangetydig økologi sammensat af både planlagte og løbske elementer.

Eosinophilic gastroenteritis with Splendore-Hoeppli material in the ferret (Mustela putorius furo).

Science.gov (United States)

Fox, J G; Palley, L S; Rose, R

1992-01-01

Eosinophilic gastroenteritis, focal or diffuse with eosinophilic infiltrations of the stomach or intestine, has been described in human beings, cats, dogs, and horses. In this paper, we describe infiltration of the gastrointestinal tract with eosinophils accompanied by a circulating eosinophilia in six ferrets (Mustela putorius furo). Clinical signs included chronic weight loss, anorexia, and diarrhea. The small intestines from five ferrets had diffuse infiltrates of eosinophils. This resulted in focal or multifocal loss of the muscular tunic in three ferrets. Two of these ferrets also had eosinophilic gastritis. Eosinophilic granulomas with Splendore-Hoeppli material were present in mesenteric lymph nodes in four ferrets. Two ferrets had multiple organ involvement; one had eosinophilic granulomas in the liver, mesentery, and choroid plexus as well as moderate parapancreatic segmental arteritis with infiltration of eosinophils and mural thrombosis. The second ferret had, in addition to moderate diffuse gastric and small intestinal eosinophilic mucosal infiltrations, interstitial eosinophilic pulmonary infiltrates. Examination of all tissues failed to reveal an infectious agent.

Lipids and stable isotopes in marine food webs in West Greenland

DEFF Research Database (Denmark)

Møller, Per

Lipider er essentielle for alle livsformer og er den vigtigste molekyle i energitransporten i de arktiske fødekæder. Inden for det marine miljø har lipidsammensætningen tilpassets, for at maksimere produktiviteten og assimilationseffektiviteten hos primær producenter og konsumenter, med en følgelig...... positiv effekt på biodiversitet og produktivitet. Udover betydning på produktiviteten i disse farvande har befolkninger i Arktis også haft gavn af den favorable lipid sammensætning, da det er påvist at den haver en gavnlig effekt på folkesundheden. Med henblik på anvendelse af lipider og stabile isotoper...... som informationskilde til det det trofiske sammenhæng i det vestgrønlandske marine økosystem (62°N – 72°N) og ernæringskvaliteten af den traditionelle arktiske kost, er der blevet analyseret lipider og stabile isotoper fra 42 arter af særlig betydning, samt kosten fra et udsnit af en lokal befolkning...

Early diagnosis and follow-up of aortitis with [{sup 18}F]FDG PET and MRI

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Meller, J.; Siefker, U.; Sahlmann, C.O.; Lehmann, K.; Conrad, M. [Department of Nuclear Medicine, Georg August University, Robert Koch-Strasse 40, 37075, Goettingen (Germany); Strutz, F.; Scheel, A. [Department of Nephrology and Rheumatology, Georg August University, Goettingen (Germany); Vosshenrich, R. [Department of Radiology, Georg August University, Goettingen (Germany)

2003-05-01

The aim of this prospective study was to compare fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) positron emission tomography (PET) with magnetic resonance imaging (MRI) in patients with early aortitis, at the time of initial diagnosis and during immunosuppressive therapy. The study population consisted of 15 patients (nine females and six males; median age 62 years, range 26-76 years) who presented with fever of unknown origin or an elevated erythrocyte sedimentation rate or elevated C-reactive protein and who showed pathological aortic [{sup 18}F]FDG uptake. Fourteen of these patients had features of early giant cell arteritis (GCA), while one had features of early Takayasu arteritis. During follow-up, seven PET scans were performed in six patients with GCA 4-30 months (median 19 months) after starting immunosuppressive medication. The results of [{sup 18}F]FDG imaging were compared with the results of MRI at initial evaluation and during follow-up and with the clinical findings. At baseline, abnormal [{sup 18}F]FDG uptake was present in 59/104 (56%) of the vascular regions studied in 15 patients. Seven follow-up PET studies were performed in six patients. Of 30 regions with initial pathological uptake in these patients, 24 (80%) showed normalisation of uptake during follow-up. Normalisation of [{sup 18}F]FDG uptake correlated with clinical improvement and with normalisation of the laboratory findings. All except one of the patients with positive aortic [{sup 18}F]FDG uptake were investigated with MRI and MRA. Thirteen of these 14 patients showed inflammation in at least one vascular region. Of 76 vascular regions studied, 41 (53%) showed vasculitis on MRI. Of 76 vascular regions studied with both PET and MRI, 47 were concordantly positive or negative on both modalities, 11 were positive on MRI only and 18 were positive on PET only. MRI was performed during follow-up in six patients: of 17 regions with inflammatory changes, 15 regions remained unchanged and two

The Chernobyl accident: Can lichens be used to characterize a radiocesium contaminated range?

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Eldar Gaare

1987-06-01

� sammenligne artsnivåene og for å studere innsamlings-prosedyrer. Vi fant at det fra sted til sted var en svært stor variasjon, til og med innen samme art. På grunn av dette var vi ikke i stand til å vise statistisk sikre forskjeller mellom artene. Men vi fant at arter fra mer eller mindre snøfrie rabbetopper, Cornicularia divergens, Alectoria ochroleuca, Cetraria nivalis og Cladina mitis viste mindre variasjon og derfor må anbefales som de beste arter for overvåkning og sammenligning av områder.

Effects of reindeer density on vascular plant diversity on North Scandinavian mountains

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Johan Olofsson

2005-04-01

studerade hur renbete påverkar kärlväxtflorans artrikedom och diversitet på dolomitpåverkade lågalpina lokaler i de artrikaste delarna av norra Fennoskandien. Vi inventerade 8 lokaler med olika rentätheter. Två lokaler ligger inom Malla Nationalpark, där renar har varit förbjudna sedan 1981 och starkt begränsade sedan 1950-talet. De sex andra lokalerna ligger i andra artrika områden med samma dolomitdominerade berggrund, men är betade av renar. Rentätheterna vid de studerade lokalerna varierar från helt obefintligt till bland de högsta rentätheter man kan finna i Fennoskandien. Inventeringen utfördes genom att systematiskt undersöka fyra 2 m x 10 m stora ytor i varje lokal i en habitattyp som är speciellt rik i ovanliga kärlväxter (fjällsippehed-lågörtsäng komplex. Varje yta delades upp i 20 småytor (1 m x 1 m, och en total artlista upprättades för var och en av dessa småytor. Den första axeln i DCA (detrended correspondence analyses analysen korrelerade med rentätheten. Det visar att renar påverkar sammansättningen av växtsamhället. Ingen av de vanliga måtten på biodiversitet (artrikedom eller Shannon-Wiener diversitetsindex var korrelerade med rentätheten. Trots detta, var tätheterna av Ca-gynnade växter och arter rödlistade i Finland positivt korrelerade med rentätheten. Trots att renarna inte påverkade totala artrikedommen, kan de vara betydelsefulla för regionala biodiversiteten eftersom de gynnar ovanliga och hotade arter. De vanliga måtten på biodiversitet har begränsat värde för bevarandebiologiska frågeställningar, eftersom de är lika känsliga för ovanliga och vanliga arter.

Increased angiotensin II type 1 receptor expression in temporal arteries from patients with giant cell arteritis

DEFF Research Database (Denmark)

Dimitrijevic, Ivan; Malmsjö, Malin; Andersson, Christina

2009-01-01

-AT(2) antibodies, was performed on formalin-fixed and paraffin-embedded temporal arteries. MAIN OUTCOME MEASURES: AT(1) and AT(2) receptor immunostaining intensity was quantified. RESULTS: Hematoxylin-eosin-stained sections of temporal arteries from patients with GCA showed intimal hyperplasia...

Unlikely culprit: congenital middle aortic syndrome diagnosed in the sixth decade of life.

Science.gov (United States)

Ali, Muhammad Sajawal; Tchernodrinski, Stefan; Mohananey, Divyanshu; Ali, Ahya Sajawal

2016-08-16

A 58-year-old woman was admitted with acute heart failure. She had a long history of resistant hypertension, with an unremarkable work up for secondary causes in the past. Her brachial blood pressure was 210/70 mm Hg, with ankle blood pressure of 100/70 mm Hg. CT angiogram revealed marked narrowing of the descending thoracic aorta between the left subclavian artery and the diaphragm, consistent with middle aortic syndrome (MAS). She was initially managed with diuretics and antihypertensives. Subsequently thoracotomy revealed a severely hypoplastic segment of the descending aorta. The diseased segment was resected and aortic reconstruction performed. Histopathology showed fragmentation of the medial elastic fibres and fibrosis of the medial and intimal layers. These findings along with gross aortic hypoplasia and absence of features of Takayasu's arteritis, suggest that our patient had congenital MAS. The patient has done well since her surgery. We believe this is the first case of congenital MAS reported in the sixth decade of life. 2016 BMJ Publishing Group Ltd.

Behçet's disease

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Saadoun David

2012-04-01

Full Text Available Abstract Definition of the disease Behçet disease (BD is a chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. Epidemiology BD seems to cluster along the ancient Silk Road, which extends from eastern Asia to the Mediterranean basin. European cases are often described, not exclusively in the migrant population. Clinical description The clinical spectrum includes oral and genital ulcerations, uveitis, vascular, neurological, articular, renal and gastrointestinal manifestations. Etiology The etiopathogenesis of the disease remains unknown, although genetic predisposition, environmental factors and immunological abnormalities have been implicated. Diagnostic methods Diagnosis is only based on clinical criteria. Differrential diagnosis It depends on the clinical presentation of BD, but sarcoidosis, multiple sclerosis, Crohn’s disease, Takayasu’s arteritis, polychondritis or antiphospholipid syndrome need to be considered. Management Treatment is symptomatic using steroids and immunomodulatory therapy. It is efficient depending on the rapidity of initiation, the compliance, and the duration of therapy. Prognosis The prognosis is severe due to the ocular, neurological and arterial involvement.

[Central nervous system vasculitis and of the peripheral nerves in the elderly].

Science.gov (United States)

Boddaert, Jacques; Verny, Marc

2002-11-01

Vasculitis of the nervous system are rare in the elderly. When present, they may constitute an urgent diagnosis and a therapeutic emergency. Clinical expression is rich and without specificity. Atypical signs (unusual course of dementia, systemic signs) or atypical laboratory results (inflammatory syndrome) may suggest the diagnosis of vasculitis. However, as multiple comorbidity is the rule in elderly subjects, searching for intercurrent factors (e.g. atrial fibrilation due to infectious disease causing embolic stroke) may be more contributive than searching for proof of a rare disease (vasculitis) with invasive procedures in this population. Giant cell (temporal) arteritis is the only vasculitis specifically related with age; the vital prognosis of vision may be compromised. Corticosterid therapy must be instituted without delay. Periartritis nodosa begins in 30% of cases after 60 years of age. The clinical features are the same as in younger subjects. Other vasculidis are rare in the elderly. In absence of specific studies in this population, therapeutic protocols are the same as in younger subjects but may have to be adjusted.

Environmental Factors and Cardiovascular Diseases

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Omer Faruk Tekbas

2008-10-01

Full Text Available Epidemiological and clinical observations have led to the hypothesis that the risk of developing cardiovascular diseases is influenced not only by genetic, lifestyle and major risk factors, but also by environmental factors. Environmental factors are considered key determinants of cardiovascular diseases. Although lifestyle choices such as smoking, diet, and exercise are viewed as major environmental influences, the contribution of pollutants and environmental chemicals is less clear. Accumulating evidence suggests that exposure to physically and chemical pollutants could elevate the risk of cardiovascular diseases. Many epidemiological studies report that exposure to physically, biologically and socio-cultural environmental factors are associated with an increase in cardiovascular mortality. Relationships between environmental factors and coronary arter disease, arhythmias, and cardiomyopathies have been reported. Exposures to arsenic, lead, cadmium, pollutant gases, solvents, and pesticides have also been linked to increased incidence of cardiovascular disease. In this paper, I review that relationships between exposure to physically, chemical, biologically and socio-cultural environmental factors and cardiovascular diseases. [TAF Prev Med Bull 2008; 7(5.000: 435-444

Top Differential Diagnosis Should Be Microscopic Polyangiitis in ANCA-Positive Patient with Diffuse Pulmonary Hemorrhage and Hemosiderosis

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Nicholas D. Ward

2014-01-01

Full Text Available A rat model of antineutrophil cytoplasmic antibody (ANCA associated vasculitides reveals crescentic glomerulonephritis as seen in human renal biopsies and diffuse lung hemorrhage that is not well documented in human lung biopsies. A 64-year-old male, with shortness of breath and mild elevation of serum creatinine, was found to have a positive serum test for ANCA, but negative antiglomerular basement membrane antibody. A renal biopsy showed pauci-immune type of crescentic glomerulonephritis and focal arteritis. The prior lung wedge biopsy was retrospectively reviewed to show diffuse hemorrhage and hemosiderosis with focal giant cells. In addition, small arteries revealed subtle neutrophil aggregation, and margination along vascular endothelium, but no definitive vasculitis. The pathology of ANCA associated vasculitides results from activated neutrophils by ANCA and subsequent activation of the alternative complement cascade with endothelial injury, neutrophil aggregation and margination. Our findings, after the correlation between lung biopsy and renal biopsy, imply that the top differential diagnosis in the lung biopsy should be microscopic polyangiitis when diffuse pulmonary hemorrhage and hemosiderosis are present in this ANCA-positive patient.

Sequential mesenteric arteriography in pony foals during repeated inoculations of Strongylus vulgaris and treatments with ivermectin.

Science.gov (United States)

Holmes, R A; Klei, T R; McClure, J R; Turk, M A; Watters, J W; Chapman, M R

1990-04-01

Semiselective mesenteric arteriography was performed at regular intervals (inoculation weeks [IW] 0, 11, 18, and 24) in 9 of 10 pony foals raised to be free of parasites. Fifty infective larvae (L3) of Strongylus vulgaris were administered weekly for 4 weeks, then every 2 weeks through the 20th week. Three ponies were given ivermectin (oral paste, 0.2 mg/kg of body weight) treatment at IW 8, 16 and 24. Four ponies were inoculated, but did not receive ivermectin, and a third group of 2 ponies acted as uninoculated controls. Control ponies did not have gross or arteriographic lesions, whereas the inoculated untreated ponies had gross and progressive arteriographic lesions typical of verminous arteritis. Arteriographic lesions in the ivermectin-treated inoculated ponies were not as severe those in the untreated inoculated group, and there was either a partial resolution or a lack of progression of arteriographic lesions in all treated ponies. One untreated inoculated pony did not have progressive arterial lesions as did the 3 others in the group, and may develop resistance to the parasite.

Pediatric renovascular hypertension in Thailand: CT angiographic findings

Energy Technology Data Exchange (ETDEWEB)

Visrutaratna, Pannee; Srisuwan, Tanop; Sirivanichai, Chusak [Chiang Mai University, Department of Radiology, Faculty of Medicine, Chiang Mai (Thailand)

2009-12-15

Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications. To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents. Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings. Nine of the 23 children (39%) had abnormal renal arteries with or without abnormal abdominal aortas. Four of these children had Takayasu arteritis, one had moyamoya disease, and one had median arcuate ligament syndrome. One with chronic pyelonephritis had severe stenosis of the proximal right renal artery. The other two children had renal artery stenosis with a nonspecific cause. One child with a normal abdominal aorta and renal arteries had a right suprarenal mass. On pathological examination a ganglioneuroma was found. CTA can help in diagnosis of renovascular hypertension in children and adolescents. Although CTA is not a screening modality, it is appropriate in some situations. (orig.)

Myelin basic protein determination in cerebro-spinal fluid of children with tuberculous meningitis

International Nuclear Information System (INIS)

Samuel, A.M.; Dhalla, A.S.; Mazarello, T.

1986-01-01

Myelin basic protein (MBP), an indicator of neural tissue damage in cerebro-spinal fluid, was studied in patients with tuberculous meningitis (TBM). MBP levels were elevated in 62% of the cases of TBM, the levels being 13.3+-18.8 ng/mL, compared with control levels of 1.34+-0.55 ng/mL(p<0.001). MBP level was related to certain clinical features of the disease, such as level of consciousness, neurological characteristics associated with signs of raised intracranial tension and the presence of arteritis associated with hydrocephalus. However, its greatest significance was its correlation with the progress of disease. Persistence of high levels of MBP over a period of a few weeks was associated with little or no improvement in the clinical state of the patient or a higher mortality rate. Return to normal levels of MBP indicated a more favourable outcome of disease. Hence MBP estimation gave not only an indicator of the degree of neurological damage but also an important marker to evaluate patients' progress and response to treatment. (author)

Pediatric renovascular hypertension in Thailand: CT angiographic findings

International Nuclear Information System (INIS)

Visrutaratna, Pannee; Srisuwan, Tanop; Sirivanichai, Chusak

2009-01-01

Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications. To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents. Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings. Nine of the 23 children (39%) had abnormal renal arteries with or without abnormal abdominal aortas. Four of these children had Takayasu arteritis, one had moyamoya disease, and one had median arcuate ligament syndrome. One with chronic pyelonephritis had severe stenosis of the proximal right renal artery. The other two children had renal artery stenosis with a nonspecific cause. One child with a normal abdominal aorta and renal arteries had a right suprarenal mass. On pathological examination a ganglioneuroma was found. CTA can help in diagnosis of renovascular hypertension in children and adolescents. Although CTA is not a screening modality, it is appropriate in some situations. (orig.)

Determinants of Vessel Targeting in Vasculitis

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Gary S. Hoffman

2004-01-01

Full Text Available Studies of autoimmune diseases have not yet elucidated why certain organs or vessels become the objects of injury while others are spared. This paper will explore the hypothesis that important differences exist in regions of the aorta that determine vulnerability to diseases, such as atherosclerosis, aortitis, giant cell arteritis and Takayasu's disease. The reader is invited to reassess; (1 whether the aorta is indeed a single homogeneous structure, and (2 whether the initial stage of aortitis (and indeed other diseases considered “autoimmune” may be primarily due to acquired alterations of substrate, that influence unique immune profiles, which by themselves may not be pathogenic. Disease susceptibility and patterns are influenced by many factors that are inborn and acquired. Examples include genetic background, gender, ethnicity, aging, prior and concomitant illnesses, habits, diet, toxin and environmental exposures. Studies of vascular diseases must assess how such variables may affect regional differences in endothelial cells, subendothelial matrix, vascular smooth muscle and the response of each to a variety of stimuli.

Angiographic examinations of the circulatory development of living chick embryos

International Nuclear Information System (INIS)

Stoeter, P.; Buchhoecker, M.; Bruzek, W.; Drews, U.; Schulze, K.; Tuebingen Univ.; Tuebingen Univ.

1980-01-01

In chick embryos of an age of incubation of 5-14 days, the physiological development of the circulation and the morphological differentation of the arterical system were studied by intravital and postmortal angiography. For the examinations of the living embryos, a special radiographic and injection technique had to be developed. The contrast medium was injected into the umbilical veins and transported by the actions of the embryonic heart. Continuous ECG recordings showed no marked interference of the injections with the cardiac activity. According to the angiographic findings, the circulation is relatively fast within the main arteries, but the capillary perfusion is prolonged and lasts up to several minutes. The average circulatory velocity of the blood stream within the carotid artery increases parallel to the arterial enlargement, whereas the circulatory time decreases and the number of heart beats during the period of carotid opacification does not change to a great extent. By this, a steady transport of gas and nutritional material may be achieved in the growing arterial system. (orig.) [de

Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know.

Science.gov (United States)

Thomas, Grace; Kloner, Robert A; Rezkalla, Shereif

2014-01-01

Marijuana is the most widely used illicit drug, with approximately 200 million users worldwide. Once illegal throughout the United States, cannabis is now legal for medicinal purposes in several states and for recreational use in 3 states. The current wave of decriminalization may lead to more widespread use, and it is important that cardiologists be made aware of the potential for marijuana-associated adverse cardiovascular effects that may begin to occur in the population at a greater frequency. In this report, the investigators focus on the known cardiovascular, cerebrovascular, and peripheral effects of marijuana inhalation. Temporal associations between marijuana use and serious adverse events, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis have been described. In conclusion, the potential for increased use of marijuana in the changing legal landscape suggests the need for the community to intensify research regarding the safety of marijuana use and for cardiologists to maintain an awareness of the potential for adverse effects. Copyright © 2014 Elsevier Inc. All rights reserved.

Nye oplysninger om effekter af Bt-majs på sommerfugle. MON810, BT11. Brev fra Greenpeace til Miljøministeren. Modtaget 17-12-2004, deadline 22-12-2004, svar 22-12-2004

DEFF Research Database (Denmark)

Strandberg, Morten Tune; Kjellsson, Gøsta; Damgaard, Christian

2012-01-01

"De nye oplysninger medfører ingen væsentlige ændringer af DMUs tidligere risikovurdering af Bt-11 majsen (C/F/96.05.10, mail pr. 28-08-2003). Dog har vi en tilføjelse vedrørende behov for specifik overvågning (se nedenfor). Vi har ikke tidligere foretaget nogen konkret risikovurdering af MON810...... arters fortsatte forekomst. Derfor har DMU ved tidligere risikovurdering af Bt-majslinier til dyrkning (majslinie 1507 og Bt-11) foreslået at der indføres en 5 m dyrkningsfri bufferzone til naturhabitater hvor larver af truede/sjældne sommerfugle findes. En andet virkemiddel kunne være at omgive randen...... af Bt-majsmarker med et værnebælte af konventionel majs. På grund af den usikkerhed der findes på området vil det indtil der foreligger et bedre vidensgrundlag være relevant med en specifik overvågning af truede eller sjældne sommerfuglearter hvor der er habitater for disse i nærheden af Bt...

Blood Vessels in Allotransplantation.

Science.gov (United States)

Abrahimi, P; Liu, R; Pober, J S

2015-07-01

Human vascularized allografts are perfused through blood vessels composed of cells (endothelium, pericytes, and smooth muscle cells) that remain largely of graft origin and are thus subject to host alloimmune responses. Graft vessels must be healthy to maintain homeostatic functions including control of perfusion, maintenance of permselectivity, prevention of thrombosis, and participation in immune surveillance. Vascular cell injury can cause dysfunction that interferes with these processes. Graft vascular cells can be activated by mediators of innate and adaptive immunity to participate in graft inflammation contributing to both ischemia/reperfusion injury and allograft rejection. Different forms of rejection may affect graft vessels in different ways, ranging from thrombosis and neutrophilic inflammation in hyperacute rejection, to endothelialitis/intimal arteritis and fibrinoid necrosis in acute cell-mediated or antibody-mediated rejection, respectively, and to diffuse luminal stenosis in chronic rejection. While some current therapies targeting the host immune system do affect graft vascular cells, direct targeting of the graft vasculature may create new opportunities for preventing allograft injury and loss. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Edema de disco óptico en glaucoma primario por cierre angular agudo: diagnóstico diferencial con edema de disco en neuropatía óptica isquémica anterior no arterítica y arterítica

Directory of Open Access Journals (Sweden)

Andrea Díaz Barrón

2016-05-01

Discusión: La coexistencia de edema de papila y PIO elevada puede deberse, bien a la congestión del nervio óptico secundaria a un GPCAA, bien a una NOIA concomitante, por lo que es de gran relevancia hacer un correcto diagnóstico diferencial en relación con su evolución clínica y morfológica.

Aortic rupture during aortoplasty in Takayasu arteritis – A rare complication: Case report and review of literature

Directory of Open Access Journals (Sweden)

Vimal Mehta

2014-05-01

Full Text Available Balloon angioplasty of the stenosed aorta is usually a relatively simple, yet potentially a catastrophic procedure. Aortic rupture during aortoplasty, though uncommon, carries a high mortality. We report case of a 39-year-old female with aortoarteritis with multiple arterial stenoses whose infra-renal abdominal aorta ruptured during balloon dilatation of the stent deployed in that segment. The site of aortic rupture was temporarily occluded by low-pressure inflation of the same balloon and then was sealed using a stent-graft introduced by contra-lateral femoral arterial access.

Phage display of the Equine arteritis virus nsp1 ZF domain and examination of its metal interactions

DEFF Research Database (Denmark)

Oleksiewicz, Martin B.; Snijder, E.J.; Normann, Preben

2004-01-01

be inhibited by an anti-nsp 1 serum, or by mutation of residues predicted to be important for zinc coordination. Finally, binding was abolished by low concentrations (0.1%) Tween 20, and rescued by including Zn2+, Ni2+ or Cu2+, but not Mg2+, in the binding buffer, suggesting that formation of secondary...

Radiology of the primary systemic vasculitides; Radiologie der primaeren systemischen Vaskulitiden

Energy Technology Data Exchange (ETDEWEB)

Reuter, M.; Biederer, J.; Both, M.; Heller, M.L. [Universitaetsklinikum Kiel (Germany). Klinik fuer Diagnostische Radiologie; Schnabel, A. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany); Sana Rheumazentrum Baden-Wuerttemberg (Germany). Klinik fuer Internistische Rheumatologie und Klinische Immunologie; Reinhold-Keller, E.; Gross,W. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany)

2003-09-01

Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. Computed tomography detects osseous lesions of the skull. Due to its superb sensitivity MRI is an established screening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institutions angiography is still required for radiological confirmation of CNS vasculitis. Perfusion and diffusion MR-imaging may combine the advantages of ''conventional'' MRI and angiography. By now the method is not fully validated for vasculitides, however. Vascular disease in Takayasu's arteritis and in giant cell arteritis involving predominantly large and medium sized vessels is readily diagnosed by non invasive magnetic resonance angiography. Percutaneous transluminal angioplasty has proven to be an effective and save therapeutic modality for the cure of vascular stenoses and occlusions. Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides. (orig.) [German] Die Bestimmung der Krankheitsausdehnung und die Festlegung der Krankheitsaktivitaet stehen im Vordergrund der bildgebenden Diagnostik von Vaskulitiden. Fuer die eigentliche Diagnosefindung ist die Radiologie von untergeordneter Bedeutung. Die verschiedenen radiologischen Methoden weisen jeweils spezifische Indikationen auf. Die Magnetresonanztomographie (MRT) hat sich als hilfreich fuer die Diagnostik von Granulomen und

Clinical application of EBCT angiography and three-dimensional reconstruction in the diagnosis of aortic disease

Energy Technology Data Exchange (ETDEWEB)

Bin, Lu; Ruping, Dai; Shaoxiong, Zhang; Hua, Bai; Sha, He; Baolian, Jing; Cheng, Cao; Li, Ren [Department of Radiology, Cardiovascular Institute of Fuwei Hospital, Chinese Academy of Medical Sciences, Beijing Union Medical College, Beijing (China)

1998-02-01

Purpose: To work out the routine and three dimensional reconstruction (3D) methods of electron beam computed tomography angiography (EBCTA) and evaluate its clinical application. Materials and methods: In this group, 189 cases with aortic diseases (152 male, 37 female) were studied retrospectively. The EBCT scan methods were enhanced single slice mode (SSM) and continuous volume scan (CVS); The 3D reconstruction methods were shaded surface display (SSD), maximum intensity projection (MIP) and multiple/curved planar reconstruction (MPR/CPR). Results: In 189 cases, including 97 cases with aortic dissection, 26 cases with aortic aneurysm and 8 cases with pseudo aneurysm, others including Marfan`s syndrome in 37 cases, Takayasu`s arteritis in 5 cases and congenital aortic malformations in 14 cases; 68 cases received operation and the EBCT diagnosis coincided well with the operative findings in 97% of cases. Conclusion: EBCT angiographic images have very high temporal resolution and most artifacts are eliminated. The 3D images are in helpful accurate diagnosis and direct surgical operation. In the management of aortic diseases, EBCT angiography and 3D reconstruction may supplant conventional angiography in the near future

Clinical application of EBCT angiography and three-dimensional reconstruction in the diagnosis of aortic disease

International Nuclear Information System (INIS)

Lu Bin; Dai Ruping; Zhang Shaoxiong; Bai Hua; He Sha; Jing Baolian; Cao Cheng; Ren Li

1998-01-01

Purpose: To work out the routine and three dimensional reconstruction (3D) methods of electron beam computed tomography angiography (EBCTA) and evaluate its clinical application. Materials and methods: In this group, 189 cases with aortic diseases (152 male, 37 female) were studied retrospectively. The EBCT scan methods were enhanced single slice mode (SSM) and continuous volume scan (CVS); The 3D reconstruction methods were shaded surface display (SSD), maximum intensity projection (MIP) and multiple/curved planar reconstruction (MPR/CPR). Results: In 189 cases, including 97 cases with aortic dissection, 26 cases with aortic aneurysm and 8 cases with pseudo aneurysm, others including Marfan's syndrome in 37 cases, Takayasu's arteritis in 5 cases and congenital aortic malformations in 14 cases; 68 cases received operation and the EBCT diagnosis coincided well with the operative findings in 97% of cases. Conclusion: EBCT angiographic images have very high temporal resolution and most artifacts are eliminated. The 3D images are in helpful accurate diagnosis and direct surgical operation. In the management of aortic diseases, EBCT angiography and 3D reconstruction may supplant conventional angiography in the near future

Art and rheumatology: the artist and the rheumatologist's perspective.

Science.gov (United States)

Hinojosa-Azaola, Andrea; Alcocer-Varela, Jorge

2014-10-01

The reflection of medicine in the universal arts has motivated several rheumatologists to discover features of rheumatic diseases depicted by the artist's eyes long before they were defined as specific pathologic entities. The result has been the identification of several pieces of art dating from the Middle Ages, the Renaissance, the Baroque and Post-Impressionist periods that depict clear features of several rheumatic diseases such as RA, OA, camptodactyly and temporal arteritis, among others. On the other hand, great artists such as Pierre-Auguste Renoir, Antoni Gaudí, Raoul Dufy, Paul Klee, Frida Kahlo and Niki de Saint Phalle are good examples of how rheumatic diseases such as RA, scleroderma and chronic pain can influence the artist's perspective, the technique used and the content of their work. Art can serve as a powerful resource to understand the natural course of diseases. By learning through the artist's eyes the way illnesses behave and evolve in time, rheumatologists can trace the history of several conditions. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Protection of yearling ponies against Strongylus vulgaris by foalhood vaccination.

Science.gov (United States)

Klei, T R; French, D D; Chapman, M R; McClure, J R; Dennis, V A; Taylor, H W; Hutchinson, G W

1989-06-01

The long-term efficacy of an irradiation attenuated larval (L3) vaccine against Strongylus vulgaris was tested in ponies which were reared on pasture. Prior to foaling, mares were divided into two groups. One group of mares and foals received regular (eight weekly) treatment with ivermectin and the second group remained untreated. Half the foals in each pasture group were vaccinated at eight to ten weeks of age. Foals were weaned at three to four months of age and maintained on separate pastures. At eight to ten months of age, ponies were placed in box stalls and half of each treatment group were challenged with S. vulgaris (5 x 1000 L3). Clinical signs and lesions typical of acute verminous arteritis were found at necropsy in the ivermectin treated non-vaccinated challenged yearlings. Ivermectin treated vaccinated challenged yearlings did not show these clinical signs, had markedly reduced to absent arterial lesions and showed an 89 per cent reduction in arterial larval burdens post mortem. Significant differences in clinical signs, arterial lesions or arterial larval burdens were not seen between vaccinated and non-vaccinated foals reared without benefit of ivermectin treatment.

Acute phase proteins: Biomarkers of infection and inflammation in veterinary medicine.

Science.gov (United States)

Eckersall, P D; Bell, R

2010-07-01

Acute phase proteins (APPs) have been used as biomarkers of inflammation, infection and trauma for decades in human medicine but have been relatively under-utilised in the context of veterinary medicine. However, significant progress has been made in the detection, measurement and application of APPs as biomarkers in both companion and farm animal medicine over recent years. In the dog, C-reactive protein, haptoglobin and serum amyloid A have been identified as significant diagnostic 'markers' of steroid-responsive meningitis-arteritis, while in cats and cattle haptoglobin and alpha(1) acid glycoprotein and haptoglobin and serum amyloid A have proved valuable biomarkers of disease, respectively. In dairy cattle, haptoglobin and a mammary-associated serum amyloid A3 isoform, produced by the inflamed mammary gland during episodes of mastitis, have great potential as biomarkers of this economically important disease. Understanding the use of APP as biomarkers of inflammatory conditions of domestic animals has expanded significantly over recent years, and, with the insights provided by ongoing research, it is likely that these compounds will be increasingly used in the future in the diagnosis and prognosis of both companion and farm animal disease. Copyright 2010 Elsevier Ltd. All rights reserved.

History of primary vasculitis in Latin America.

Science.gov (United States)

Iglesias Gammara, Antonio; Coral, Paola; Quintana, Gerardo; Toro, Carlos E; Flores, Luis Felipe; Matteson, Eric L; Restrepo, José Félix

2010-03-01

A literature review utilizing Fepafem, Bireme, LiLacs, Scielo Colombia, Scielo Internacional, former MedLine, Pubmed, and BVS Colombia as well as manual searches in the libraries of major Latin American universities was performed to study vasculitis in Latin America. Since 1945, a total of 752 articles have been published by Latin American authors. However, only a minority are devoted to primary vasculitides, and even fewer have been published in indexed journals. Approximately 126 are in OLD, Medline, Pubmed, Bireme, and Scielo. Most publications are from Mexico, followed by Brazil and Colombia. Systematic studies of the epidemiology of primary idiopathic vasculitis are available for a few countries, i.e. Brazil, Mexico, Colombia, Chile, and Peru. Takayasu arteritis and ANCA-associated vasculitis are the best studied forms of vasculitis in Latin America. Interest and expertise in vasculitis is growing in Latin America, as reflected in the increased number of published articles from this region of the world in the last decade. Racial and environmental factors are possibly responsible for the differential expression of various types of primary vasculitis observed in Latin America. With time, the unique features, epidemiology, and better treatment strategies for idiopathic vasculitides in Latin America will emerge.

Unique topics and issues in rheumatology and clinical immunology.

Science.gov (United States)

Selmi, Carlo

2014-08-01

Clinicians are facing unexpected issues in everyday practice, and these may become counterintuitive or challenging. Illustrative examples are provided by the hypersensitivity to universally used immunosuppressants such as corticosteroids or antibiotics such as beta-lactam. Secondly, additional issues are represented by the discovery of new pathogenetic mechanisms involved in rheumatoid and psoriatic arthritis or other chronic inflammatory diseases, genomic susceptibility to enigmatic diseases such as giant cell arteritis, or the shared role of specific mediators such as semaphorins. Third, the therapeutic armamentarium has dramatically changed over the past decade following the introduction of biotechnological drugs, and new mechanisms are being proposed to reduce adverse events or increase the drug effectiveness, particularly on cardiovascular comorbidities. Finally, rare diseases continue to represent difficult cases, as for Cogan's syndrome, with limited literature available for clinical recommendations. For these reason, the present issue of Clinical Reviews in Allergy and Immunology is timely and dedicated to these and other unique topics in clinical immunology and allergy. The aim of this issue is thus to help clinicians involved in internal medicine as well as allergists and clinical immunologists while discussing new pathways that will prove important in the near future.

Why a standard contrast-enhanced MRI might be useful in intracranial internal carotid artery stenosis.

Science.gov (United States)

Oeinck, Maximilian; Rozeik, Christoph; Wattchow, Jens; Meckel, Stephan; Schlageter, Manuel; Beeskow, Christel; Reinhard, Matthias

2016-06-01

In patients with ischemic stroke of unknown cause cerebral vasculitis is a rare but relevant differential diagnosis, especially when signs of intracranial artery stenosis are found and laboratory findings show systemic inflammation. In such cases, high-resolution T1w vessel wall magnetic resonance imaging (MRI; 'black blood' technique) at 3 T is preferentially performed, but may not be available in every hospital. We report a case of an 84-year-old man with right hemispheric transient ischemic attack and signs of distal occlusion in the right internal carotid artery (ICA) in duplex sonography. Standard MRI with contrast agent pointed the way to the correct diagnosis since it showed an intramural contrast uptake in the right ICA and both vertebral arteries. Temporal artery biopsy confirmed the suspected diagnosis of a giant cell arteritis and dedicated vessel wall MRI performed later supported the suspected intracranial large artery inflammation. Our case also shows that early diagnosis and immunosuppressive therapy may not always prevent disease progression, as our patient suffered several infarcts in the left middle cerebral artery (MCA) territory with consecutive high-grade hemiparesis of the right side within the following four months. © The Author(s) 2016.

Radiology of ischemic strokes in children

International Nuclear Information System (INIS)

Raybaud, C.A.; Jiddane, M.; Livet, M.O.; Pinsard, N.

1985-01-01

Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: 1) congenital heart disease; 2) neonatal distress; 3) infections, focal or general inducing vasculitis, but many cases are considered as idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid syphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the homorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological type of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of-beads appearance). (orig.)

Radiology of ischemic strokes in children

International Nuclear Information System (INIS)

Raybaud, C.A.; Livet, M.O.; Jiddane, M.; Pinsard, N.

1985-01-01

Arterial ischemic strokes are a relatively frequent diagnostic occurrence in pediatric neuroradiology. They occur mostly in three main etiologic contexts: 1) congenital heart disease; 2) neonatal distress; 3) infections, focal or general inducing vasculitis, but many cases are considered idiopathic. The positive diagnosis is made by CT; in neonates, however, ultrasound appears as a promising tool. The CT features are basically similar at that age and in adults, although the site of the infarct may result from pathologies more particular to children (e.g. basal ganglia infarction due to arteritis of the carotid siphon and its branches). Infarcts may be multiple and also more frequently hemorrhagic at that age, the hemorrhagic phenomena affecting only the gray matter except in young infants in which the subcortical white matter may be affected also. Anatomical sequels include focal atrophy and asymmetry of the brain. Data regarding the etiology can be gathered from angiography which may show the degree of impairment of the arterial bed, its extent, the collateral blood supply and the morphological types of arterial lesion responsible for the cerebral damage. The most particular picture at that age is that of the often diffuse vasculitis, with its various expressions (segmental narrowing of the lumen, dissecting aneurysm, string-of-beads appearance)

Variation of hepatic artery on arteriogram and its clinical significance in interventional therapy for hepatic cancer

International Nuclear Information System (INIS)

Wang Xiaodong; Yang Renjie

2009-01-01

Objective: To investigate the variations of hepatic artery and its extrahepatic arteries on hepatic arteriogram and to provide benefit for transhepatic arterical chemoemblization. Methods: The hepatic arteriograms of 200 cases with unresectable hepatic malignant tumor before interventional therapy were analysed. Two interventional radiologists in common reviewed the incidences of various types according to Michels' classification, the absence of proper hepatic artery, and the variations of extrahepatic arteries originating from hepatic artery. Results: The most common hepatic artery variation was Michels type III(n=17,8.5%), followed by type II(n=10,5.0%) and V(n=9,4.5%). Proper hepatic absence was found in 25 cases and appeared as 5 subtypes. 5 kinds of extrahepatic arteries were found. The most common extrahepatic artery was the right gastric artery (n=156,78.0%), followed by cystic artery (n=126,63.0%), accessory left gastric artery (n=19,9.5%), the hepatic falciform artery (n=5,2.5%), and accessory left inferior phrenic artery (n=4,2.0%). Conclusion: There are some other variations of hepatic artery beside Michels' classification,and there are many variations of extrahepatic arteries originating from hepatic artery, it is important to assure interventional therapy effect for hepatic cancer and prevent complication. (authors)

Infections and vasculitis.

Science.gov (United States)

Thomas, Konstantinos; Vassilopoulos, Dimitrios

2017-01-01

To review recent evidence for infection rates in patients with systemic vasculitides, the role of specific infectious agents in the pathogenesis of vasculitis and recent breakthroughs in the treatment of virus-associated vasculitides. In well designed recent studies, infections were found to be common during the first 6-12 months in patients with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) and giant cell arteritis (GCA) and to contribute significantly to increased mortality during this period. New therapeutic schemes with lower cyclophosphamide doses and shorter corticosteroid courses were associated with decreased infectious rates in elderly patients with AAV whereas a prednisone dose greater than 10 mg/day at the end of the first year were associated with increased infectious-related mortality in patients with GCA. Recently, a potential role for varicella zoster virus in GCA pathogenesis has been proposed but more data are needed in order to establish a causal relationship. Finally, preliminary data show excellent short-term efficacy and safety of the new, interferon-free, oral antiviral agents in the treatment of hepatitis C virus-associated cryoglobulinemic vasculitis. Infections continue to be one of the main causes of mortality in patients with systemic vasculitides, emphasizing the need for safer immunosuppressive therapies and appropriate prophylaxis.

Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis.

Science.gov (United States)

Gong, Eun Jeong; Kim, Do Hoon; Chun, Joo Hyun; Ahn, Ji Yong; Choi, Kwi-Sook; Jung, Kee Wook; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon-Yong; Kim, Jin Ho; Song, In Hye; Kim, Yong-Gil

2016-07-15

Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low.

Evaluation of plasma eosinophil count and mean platelet volume in patients with coronary slow flow

Directory of Open Access Journals (Sweden)

Mehmet Demir

2014-01-01

Full Text Available OBJECTIVE: The pathophysiology of coronary slow flow has not been clearly defined, although multiple abnormalities including arteritis, endothelial dysfunction, and atherothrombosis, have been reported. It is known that eosinophils play an important role in inflammation, endothelial dysfunction, and thrombosis. We aimed to compare the eosinophil counts of coronary slow flow patients versus healthy controls. METHODS: This study included 50 coronary slow flow patients (19 males, mean age 65.6±13.7 years and 30 healthy controls (10 males, mean age 57.86±11.6 years. These participants were evaluated using concurrent routine biochemical tests as well as neutrophil, lymphocyte, and eosinophil counts and mean platelet volume (MPV, which were obtained from the whole blood count. These parameters were compared between groups. RESULTS: The baseline characteristics of the study groups were comparable. The coronary slow flow patients had a higher mean platelet volume and eosinophil count than the control group (8.38±0.86 vs 6.28±1.6 fL and 0.31±0.42 vs 0.09±0.05; p<0.001 and 0.008, respectively. CONCLUSION: Our study demonstrated a relationship between eosinophil count and MPV in patients with coronary slow flow.

Inducing fluorescence of uranyl acetate as a dual-purpose contrast agent for correlative light-electron microscopy with nanometre precision.

Science.gov (United States)

Tuijtel, Maarten W; Mulder, Aat A; Posthuma, Clara C; van der Hoeven, Barbara; Koster, Abraham J; Bárcena, Montserrat; Faas, Frank G A; Sharp, Thomas H

2017-09-05

Correlative light-electron microscopy (CLEM) combines the high spatial resolution of transmission electron microscopy (TEM) with the capability of fluorescence light microscopy (FLM) to locate rare or transient cellular events within a large field of view. CLEM is therefore a powerful technique to study cellular processes. Aligning images derived from both imaging modalities is a prerequisite to correlate the two microscopy data sets, and poor alignment can limit interpretability of the data. Here, we describe how uranyl acetate, a commonly-used contrast agent for TEM, can be induced to fluoresce brightly at cryogenic temperatures (-195 °C) and imaged by cryoFLM using standard filter sets. This dual-purpose contrast agent can be used as a general tool for CLEM, whereby the equivalent staining allows direct correlation between fluorescence and TEM images. We demonstrate the potential of this approach by performing multi-colour CLEM of cells containing equine arteritis virus proteins tagged with either green- or red-fluorescent protein, and achieve high-precision localization of virus-induced intracellular membrane modifications. Using uranyl acetate as a dual-purpose contrast agent, we achieve an image alignment precision of ~30 nm, twice as accurate as when using fiducial beads, which will be essential for combining TEM with the evolving field of super-resolution light microscopy.

Epidemiology and molecular detection of equine herpesviruses in western Algeria in 2011.

Science.gov (United States)

Laabassi, F; Hue, E; Fortier, C; Morilland, E; Legrand, L; Hans, A; Pronost, S

2017-08-01

An episode of acute equine respiratory infection was reported in western Algeria (Tiaret province) between February and March 2011, affecting a large population of horses. Nasal swabs (n=100) were taken from horses aged between 1 and 27 years, presenting with cough and mucopurulent nasal discharge. The prevalence of equine respiratory virus infections was examined using quantitative polymerase chain reaction (qPCR). One, or more, of four equine respiratory viruses were detected in the nasal swabs of 90 of 100 horses (90%) and the detection rate of equine herpesvirus type 1 (EHV-1), equine herpesvirus type 4 (EHV-4), equine herpesvirus type 2 (EHV-2) and equine herpesvirus type 5 (EHV-5) were 2%, 14%, 90% and 75%, respectively. Equine influenza virus and equine arteritis virus were not detected in any samples. Among the 90 infected horses, 70 were co-infected with EHV-2 and EHV-5 and 14 others were co-infected with EHV-4, EHV-2 and EHV-5. The present study shows a positivity rate of 97.3% for EHV-5 in young horses aged equine herpesviruses 1, 2, 4 and 5 are endemic in horse populations from Algeria as detected for the first time by qPCR. Copyright © 2017 Elsevier B.V. All rights reserved.

Phosphodiesterase inhibitors suppress Lactobacillus casei cell-wall-induced NF-κB and MAPK activations and cell proliferation through protein kinase A--or exchange protein activated by cAMP-dependent signal pathway.

Science.gov (United States)

Saito, Takekatsu; Sugimoto, Naotoshi; Ohta, Kunio; Shimizu, Tohru; Ohtani, Kaori; Nakayama, Yuko; Nakamura, Taichi; Hitomi, Yashiaki; Nakamura, Hiroyuki; Koizumi, Shoichi; Yachie, Akihiro

2012-01-01

Specific strains of Lactobacillus have been found to be beneficial in treating some types of diarrhea and vaginosis. However, a high mortality rate results from underlying immunosuppressive conditions in patients with Lactobacillus casei bacteremia. Cyclic AMP (cAMP) is a small second messenger molecule that mediates signal transduction. The onset and progression of inflammatory responses are sensitive to changes in steady-state cAMP levels. L. casei cell wall extract (LCWE) develops arteritis in mice through Toll-like receptor-2 signaling. The purpose of this study was to investigate whether intracellular cAMP affects LCWE-induced pathological signaling. LCWE was shown to induce phosphorylation of the nuclear factor κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways and cell proliferation in mice fibroblast cells. Theophylline and phosphodiesterase inhibitor increased intracellular cAMP and inhibited LCWE-induced cell proliferation as well as phosphorylation of NF-κB and MAPK. Protein kinase A inhibitor H89 prevented cAMP-induced MAPK inhibition, but not cAMP-induced NF-κB inhibition. An exchange protein activated by cAMP (Epac) agonist inhibited NF-κB activation but not MAPK activation. These results indicate that an increase in intracellular cAMP prevents LCWE induction of pathological signaling pathways dependent on PKA and Epac signaling.

Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

Science.gov (United States)

Gabriel, Sherine E; Michaud, Kaleb

2009-01-01

Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

Cerebral vasculitis associated with Schistosoma mansoni infection

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Camuset Guillaume

2012-09-01

Full Text Available Abstract Background Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects. Case presentation A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis. Conclusion This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area.

Recurrent symptomatic ischemic stroke in a 46-year-old African male revealing Angio-Behçet with severe cardiovascular involvement.

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Marie, Ba Djibril; Aminata, Diack; Cherif, Mboup Mouhamed; Daouda, Fall Moussa

2017-03-01

Behçet'sdisease (BD) is a chronic, multisystem vasculitis. It is categorized under variable vessel vasculitis in the new Chapel Hill nomenclature as it involves blood vessels of any type and size. It is characterized by relapsing aphthous ulcers commonly occurring in the oral mucosa and genitalia with ocular involvement. Other organ systems may be involved any time throughout the course of the disease. The exact cause is unknown. However, combination of genetic and environmental factors is likely to play a role. Cardiac involvement may occur in the form of intracardiac thrombus, endocarditis, myocarditis, pericarditis, endomyocardial fibrosis, coronary arteritis, myocardial infarction, and valvular disease. We present a case of Angio-Behçet in a 46-year-old African male with severe cardiovascular involvement including pulmonary artery hypertension (PAH), right ventricular failure and left ventricular diastolic dysfunction diagnosed after 2 episodes of symptomatic ischemic stroke resulting from complete occlusion of the right internal carotid artery (ICA) up to its intracranial portion. Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations. Nevertheless, prompt recognition of the primarily vascular manifestation of BD without mucocutaneous manifestations was responsible for considerable delay that did not afford surgical therapy for the carotid occlusion.

Overvågning af orkidéer 2000

DEFF Research Database (Denmark)

Wind, P.

resultaterne af orkidéovervågningen (Wind 2001). Hertil kommer præsentationen af projektet og dets resultater efter forløbet af de første tre år (Løjtnant 1991a) og en bearbejdning af projektets resultater for årene 1987-1995 (Wind 1997). I nærværende rapport undersøges skov-hullæbe for en eventuel sammenhæng...... mellem skudanlæggelsen udtrykt ved antallet af blomstrende og vegetative skud i et givet år og nedbørsmængder i august og september året før. Det er en udbredt antagelse at der er en sammenhæng mellem skudanlæggelse og mængden af nedbør det foregående år. Undersøgelser af skov-hullæbe populationer i...... truet og sårbar samt de to arter der er omfattet af Habitatdirektivets bilag 2. I 2000 kan det i forhold til 1999 konstateres at der i 15 bestande er optalt et øget antal skud. I 11 bestande er der noteret en nedgang i antallet af skud sammenlignet med optællingerne i 1999. Af disse er der 2 be...

Leprosy and the testis La lepra y el testículo

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Fernando López

2011-09-01

Full Text Available Introduction. Damage of testicles is frequent in lepromatous leprosy worsen by the presence of erythema nodosum leprosum.
Objective. One patient is presented who developed lepromatous leprosy and erythema nodosum leprosum with important testicular compromise.
Material and methods. A 28 year old man patient who had lepromatous leprosy since his 22 was studied. During a polychemotherapy treatment for the lepromatous leprosy, he presented chronic erythema nodosum leprosum that affected both testicles and did not respond to the conventional treatment. A left orchidectomy was practiced to treat the persistent pain.
Results. The extracted testis evidenced the following findings: tubular atrophy, remarkable fibrosis, cumulus of foamy macrophages without rods, focal Leydig cell hyperplasia, linfocitary and granulomatous arteritis and endarteritis of small and medium size vessels. These changes were also observed in the epididymis. Two years after the polychemoterapy and the orchidectomy, the patient revealed azoospermy, normal total testosterone, discretely diminished free testosterone and elevated luteinizing hormone and follicle-stimulating hormone. No loss of libido or sexual activity. We reviewed general concepts about erythema nodosum leprosum and the pathologic changes produced by leprosy in the testis.
Conclusion. Lepromatous leprosy may lead to hypogonadism. This should be considered by the leprosy programs in order to avoid and treat the consequences of the possible hypogonadism.
Introducción. La afección testicular es frecuente en la lepra lepromatosa, daño que se incrementa cuando cursa con eritema nodoso leproso.
Objetivo. Presentar un paciente con lepra lepromatosa y eritema nodoso leproso con severo compromiso testicular.
Materiales y métodos. Estudiamos un hombre de 28 años con lepra lepromatosa desde los 22, que durante el tratamiento con poliquimioterapia para la lepra presentó eritema nodoso

DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY - Registry (DESTINY-R): design and protocols.

Science.gov (United States)

Neugebauer, Hermann; Heuschmann, Peter U; Jüttler, Eric

2012-10-02

Randomized controlled trials (RCT) on the treatment of severe space-occupying infarction of the middle cerebral artery (malignant MCA infarction) showed that early decompressive hemicraniectomy (DHC) is life saving and improves outcome without promoting most severe disablity in patients aged 18-60 years. It is, however, unknown whether the results obtained in the randomized trials are reproducible in a broader population in and apart from an academical setting and whether hemicraniectomy has been implemented in clinical practice as recommended by national and international guidelines. In addition, they were not powered to answer further relevant questions, e.g. concerning the selection of patients eligible for and the timing of hemicraniectomy. Other important issues such as the acceptance of disability following hemicraniectomy, the existence of specific prognostic factors, the value of conservative therapeutic measures, and the overall complication rate related to hemicraniectomy have not been sufficiently studied yet. DESTINY-R is a prospective, multicenter, open, controlled registry including a 12 months follow-up. The only inclusion criteria is unilateral ischemic MCA stroke affecting more than 50% of the MCA-territory. The primary study hypothesis is to confirm the results of the RCT (76% mRS ≤ 4 after 12 months) in the subgroup of patients additionally fulfilling the inclusion cirteria of the RCT in daily routine. Assuming a calculated proportion of 0.76 for successes and a sample size of 300 for this subgroup, the width of the 95% CI, calculated using Wilson's method, will be 0.096 with the lower bound 0.709 and the upper bound 0.805. The results of this study will provide information about the effectiveness of DHC in malignant MCA infarction in a broad population and a real-life situation in addition to and beyond RCT. Further prospectively obtained data will give crucial information on open questions and will be helpful in the plannig of upcomming treatment studies. (ICTRP and DRKS): DRKS00000624.

Whole-body magnetic resonance angiography with blood-pool agents

International Nuclear Information System (INIS)

Kramer, H.; Morana, G.

2007-01-01

Although often asymptomatic, peripheral arterial disease (PAD) is associated with significant morbidity in a large proportion of patients. Atherosclerosis is the underlying pathology in many instances, involving the whole arterial tree. Whole-body magnetic resonance angiography (MRA) permits rapid, non-invasive and accurate evaluation of the entire vascular system and can be used for both diagnostic purposes and monitoring of vascular involvement in diseases such as diabetes, Marfan's syndrome and Takayasu arteritis. MRA has been used successfully in the identification of high-grade stenosis in PAD, abnormalities of the ileocaval veins and carotid plaque imaging. Carotid disease is significantly correlated with severe coronary artery disease and renal artery atherosclerosis. Symptomatic lesions in one vascular bed are often related to additional asymptomatic atherosclerotic lesions in other vascular regions. MRA may be advantageous over computed tomographic angiography because it can be performed with contrast media virtually devoid of serious toxicity and without utilization of ionizing radiation. Display of the entire arterial vasculature can be achieved in < 90 s, with excellent sensitivity and specificity. Recent technological advances, such as parallel imaging and the implementation of dedicated matrix coils, have further increased image quality, and in combination with the blood-pool contrast agents, such as gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany), extended imaging time, higher spatial resolution and larger anatomical coverage can be achieved. (orig.)

Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

Energy Technology Data Exchange (ETDEWEB)

Zerizer, Imene; Tan, Kathryn; Khan, Sameer; Barwick, Tara [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Marzola, Maria Cristina [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy); Rubello, Domenico [Department of Nuclear Medicine, PET/CT Centre, Radiology and Medical Physics, ' Santa Maria della Misericordia' Hospital, Rovigo (Italy)], E-mail: domenico.rubello@libero.it; Al-Nahhas, Adil [Department of Nuclear Medicine, Imperial College Healthcare, Hammersmith Hospital, Du Cane Road, London (United Kingdom)

2010-03-15

Purpose: to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis. Materials and methods: a systematic revision of the papers published in PubMed/Medline until December 2009 was done. Results: FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis. Discussion: FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.

Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

International Nuclear Information System (INIS)

Zerizer, Imene; Tan, Kathryn; Khan, Sameer; Barwick, Tara; Marzola, Maria Cristina; Rubello, Domenico; Al-Nahhas, Adil

2010-01-01

Purpose: to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis. Materials and methods: a systematic revision of the papers published in PubMed/Medline until December 2009 was done. Results: FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis. Discussion: FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.

Transcatheter coil occluder for closure of ventricular septal defect (a report of 4 cases)

International Nuclear Information System (INIS)

Gao Wei; Zhou Aiqing; Yu Zhiqing; Li Fen; Zhong Yumin; Zhang Yuqi; Huang Meirong; Sun Kun

2005-01-01

Objective: To explore the indication, methodology and complication of transcatheter coil closure of ventricular septal defect (VSD) in children. Methods: Transcatheter closure of perimembranous VSD with coils was performed in 4 cases from 2003 to 2005. The Duct-Occlude (pfm) and detachable coil (Cook) were chosen for embolization depending on the results of the left ventricular angiogram. The coil size was generally about 1-4 mm larger than the diameter of VSD. Follow up was carried out with echocardiography, ultrasound and clinical examination. Results: The defect diameters of the four cases were 2.0 mm, 2.7 mm, 2.5 mm and 1.5 mm respectively. The Duct-Occlude were successfully implanted in 3 cases of perimembranous VSD with the same type coil (OD[mm]7-3-6, windings 5-3-4) for each. One detachable coil (Cook) (5 x 5) was implanted in the remaining case. All cases had trivial residual shunt immediately after implantation which disappeared 24 hours later. Follow-up for 2 months to one year showed no coil displacement and secondary bacterial arteritis. No tricuspid and aortic regurgitation, no emboli, no endocarditis, and no arrhythmia were found. Conclusions: Coil closure of some small VSD with membranate part pseudo-ventricular aneurysm has good efficacy with the advantages of simple operation, less metal content and mini-invasion also applicable for infants. (authors)

The Risks and Benefits of Cannabis in the Dermatology Clinic.

Science.gov (United States)

Dhadwal, Gurbir; Kirchhof, Mark G

Cannabis ( Cannabis sativa/indica), also known as marijuana, has been used for medicinal and recreational purposes for millennia. There has been a recent trend to legalize the use of cannabis, as illustrated by the recent legalization votes in numerous states in the United States and legislation in Canada to allow recreational cannabis use. With this increasing consumption of cannabis, dermatologists will see increased pressure to prescribe cannabis and will see the side effects of cannabis use with greater frequency. There are several approved medical indications for cannabis use, including psoriasis, lupus, nail-patella syndrome, and severe pain. In addition, very preliminary studies have suggested cannabis and its derivatives might have use in acne, dermatitis, pruritus, wound healing, and skin cancer. Further well-controlled studies are required to explore these potential uses. Conversely, the side effects of cannabis use are relatively well documented, and dermatologists should be aware of these presentations. Side effects of cannabis use include cannabis allergy manifesting as urticaria and pruritus, cannabis arteritis presenting with necrosis and ulcers, and oral cancers from cannabis smoke. In this review, we summarize some of the studies and reports regarding the medicinal uses of cannabis in the dermatology clinic and some of the side effects that might present more often to dermatologists as the use of cannabis increases.

Behçet's disease‬ and familial Mediterranean fever: Two sides of the same coin or just an association? A cross-sectional study‬.

Science.gov (United States)

Watad, Abdulla; Tiosano, Shmuel; Yahav, Dana; Comaneshter, Doron; Shoenfeld, Yehuda; Cohen, Arnon D; Amital, Howard

2017-04-01

Familial Mediterranean fever (FMF) is a genetic disease, characterized by attacks of fever, arthritis, serositis and pain. Behçet's disease (BD) is an inflammatory disorder with a genetic basis, characterized by oral and genital ulcers, uveitis, pustular erythematous cutaneous lesions, arthritis, central nervous system involvement and possible vascular manifestations such as venous thrombosis, arteritis and aneurysms. To investigate the association and actual differentiation between these two entities in a large-scale population-based study. Data for this study was collected from the databases of "Clalit Health Services", the largest state-mandated health service organization in Israel. All adult members diagnosed with BD were included (n=892) and as well as their age- and sex-matched controls (n=4444), creating a cross-sectional population-based study. Medical records of all subjects were analyzed for documented FMF. A logistic regression model was done to estimate how BD, age, gender, BMI, ethnicity and socioeconomic status contributed as risk factors for FMF. The proportion of FMF in patients with BD increased compared with those reported in controls (5.83% and 0.23%, respectively, P30. Our data imply that understating the differentiation between FMF and BD is not evident and clear in a real-life population of patients with BD. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Whole-body magnetic resonance angiography with blood-pool agents

Energy Technology Data Exchange (ETDEWEB)

Kramer, H. [Inst. for Clinical Radiology, Univ. Hospital Munich, Munich (Germany); Morana, G. [Radiological Dept., Hospital Ca' Foncello, Treviso (Italy)

2007-03-15

Although often asymptomatic, peripheral arterial disease (PAD) is associated with significant morbidity in a large proportion of patients. Atherosclerosis is the underlying pathology in many instances, involving the whole arterial tree. Whole-body magnetic resonance angiography (MRA) permits rapid, non-invasive and accurate evaluation of the entire vascular system and can be used for both diagnostic purposes and monitoring of vascular involvement in diseases such as diabetes, Marfan's syndrome and Takayasu arteritis. MRA has been used successfully in the identification of high-grade stenosis in PAD, abnormalities of the ileocaval veins and carotid plaque imaging. Carotid disease is significantly correlated with severe coronary artery disease and renal artery atherosclerosis. Symptomatic lesions in one vascular bed are often related to additional asymptomatic atherosclerotic lesions in other vascular regions. MRA may be advantageous over computed tomographic angiography because it can be performed with contrast media virtually devoid of serious toxicity and without utilization of ionizing radiation. Display of the entire arterial vasculature can be achieved in < 90 s, with excellent sensitivity and specificity. Recent technological advances, such as parallel imaging and the implementation of dedicated matrix coils, have further increased image quality, and in combination with the blood-pool contrast agents, such as gadofosveset trisodium (Vasovist, Bayer Schering Pharma AG, Berlin, Germany), extended imaging time, higher spatial resolution and larger anatomical coverage can be achieved. (orig.)

Anterior ischaemic optic neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a case report and review of the literature.

Science.gov (United States)

Padovano, Ilaria; Pazzola, Giulia; Pipitone, Nicolò; Cimino, Luca; Salvarani, Carlo

2014-01-01

We report a 62-year-old man with mild fever, headache and acute visual loss in his right eye due to anterior ischaemic optic neuropathy (AION), followed a few days later by pain in the legs and left arm associated with numbness and weakness. Giant cell arteritis complicated by AION was suspected at the beginning and high-dose oral glucocorticoids were started. However, on the basis of the past medical history of nasal polyposis, asthma, and hypereosynophilia as well as of further investigations (biopsy of the nasal mucosa showing granulomatous inflammation with a rich eosinophilic infiltrate, electromyography demonstrating, mononeuritis multiplex and positive p-ANCA), eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, was diagnosed. Because visual acuity in the right eye deteriorated despite glucocorticoid therapy, pulse intravenous cyclophosphamide was started, subsequently replaced by oral azathioprine, while prednisone was slowly tapered. This treatment led to gradual improvement of the neurological symptoms, whereas the right visual impairment remained unchanged. EGPA-related AION is an uncommon lesion that is probably due to vasculitic involvement of posterior ciliary and/or chorioretinal arteries. The prognosis of established AION is poor for the affected eye, even when glucocorticoid treatment is started immediately. However, early recognition of AION and prompt aggressive treatment with high-dose glucocorticoids plus cyclophosphamide can prevent visual loss in the unaffected eye.

CT and MR findings in HIV-negative neurosyphilis

Energy Technology Data Exchange (ETDEWEB)

Peng Fuhua [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: pfh93@21cn.com; Hu Xueqiang [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: huxueqiangqm@yahoo.com.cn; Zhong Xiufeng [State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-Sen University, 54 Xianlie Road, Guangzhou, 510060 Guangdong Province (China)], E-mail: xiufengzhong@yahoo.com.cn; Wei Qiu [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: qw9406@tom.com; Jiang Ying [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: jiangying722@163.com; Bao Jian [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: baoj92@tom.com; Wu Aimin [Department of Neurology, Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630 Guangdong Province (China)], E-mail: wuaim@126.com; Pei Zhong [Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, 89 Zhongshaner Road, Guangzhou, 510080 Guangdong Province (China)], E-mail: peizhong@yahoo.com

2008-04-15

Background and purpose: The purpose of this study was to describe and evaluate neuroimaging findings of patients with neurosyphilis. Methods: The neuroimaging studies of 14 patients with documented neurosyphilis were reviewed. Diagnosis was established in 14 patients with cerebrospinal fluid for a Treponema Pallidum Particle Agglutination (TPPA) test. All patients had reactive TPPA and Unheated Serum Regain test (USR) in their sera. Imaging studies included plain, contrast-enhanced CT of the brain, plain and gadolinium-enhanced MR, and MR angiography. Results: In the 14 HIV-negative patients with neurosyphilis, CT and MR showed the presence of cerebral infarction in six cases, arteritis in four cases, nonspecific white matter lesion in three cases, acute syphilitic meningitis in one case and normal neuroimaging finding in one case. In addition, 4 in 14 patients had general paresis, and MRI showed high signal intensity on T2 -weighted images involving frontotemporal lobes, hippocampus and periventricular area. Treatment with penicillin significantly diminished the size of these high signal intensity on T2-weighted images with general paresis. Conclusion: These results suggest that MR and CT images have some characteristic manifestations in patients of neurosyphilis. Because early diagnosis and treatment of neurosyphilis are crucial to avoid persistent brain damage, the neuroimaging findings are valuable adjunct to clinical diagnosis and to provide useful information to follow-up after therapy.

Endovascular Treatment of Chronic Mesenteric Ischemia: Results in 14 Patients

International Nuclear Information System (INIS)

Chahid, Tamam; Alfidja, Agaicha T.; Biard, Marie; Ravel, Anne; Garcier, Jean Marc; Boyer, L.

2004-01-01

We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1-83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA

Acute aortic dissection: be aware of misdiagnosis

Directory of Open Access Journals (Sweden)

Asteri Theodora

2009-02-01

Full Text Available Abstract Background Acute aortic dissection (AAD is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from AAD often presents with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. The aim of this retrospective study is to address the problem of misdiagnosing AD and the different imaging studies used. Methods From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18–75 years old presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfan's syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT, transthoracic echocardiography (TTE and coronary angiography. Results Initial misdiagnosis occurred in fifteen patients (31% later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and cerebral infarction in another three patients. Conclusion Aortic dissection may present with a variety of clinical manifestations, like syncope, chest pain, anuria, pulse deficits, abdominal pain, back pain, or acute congestive heart failure. Nearly a third of the patients found to be suffering from AD, were initially otherwise diagnosed. Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis.

Ogräs, åkertistlar och taggiga växter

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Lars Klintwall

2012-06-01

Full Text Available Psykiatriska diagnoser är kontroversiella. Vissa, ofta psykiatriker, menar att psykiska tillstånd går att dela upp i distinkta klasser medan andra, ofta psykologer, menar att all sådan uppdelning gör våld på verkligheten. Dessutom har psykiatrin anklagats för att vara moraliserande: vem kan avgöra vad som är sjukt och friskt? Är autism en sjukdom? Utifrån en pragmatisk begreppsanalys är uppdelningen mellan sjukt och friskt nödvändigtvis godtycklig. Precis som när en trädgårdsmästare avgör vad som är ogräs så beror det på situationen och ens syften. Och precis som växterarter ibland är distinkta arter så kan vissa psykiatriska diagnoser vara distinkta klasser, och andra inte. Kanske är autism en avgränsad diagnos, kanske inte. Men ibland är inte artsuppdelning det mest användbara för en trädgårdsmästare, precis som det inte behöver vara det för psykiatrin. Istället kan man formulera nya kategoriseringar helt baserade på pragmatiska hänsyn. Ibland räcker det med taggiga växter och socialt indifferenta barn.

Captopril 99mTc-DTPA Renal Scintigraphy in Diagnosis of Renovascular Hypertension

International Nuclear Information System (INIS)

Yang, In Hyung; Lee, Dong Soo; Kim, Sung Chul

1992-01-01

To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of 99m Tc-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

Oclusão da artéria central da retina em paciente com poliangeíte microscópica

Directory of Open Access Journals (Sweden)

Cláudia Gallicchio Domingues

2015-12-01

Full Text Available RESUMO A poliangeíte microscópica é uma vasculite necrotizante sistêmica que acomete arteríolas, capilares e vênulas, mas também pode atingir pequenas e médias artérias. É considerada uma doença rara, idiopática e autoimune. Diversas anormalidades oculares e sistêmicas estão associadas às oclusões arteriais retinianas. Dentre as doenças vasculares do colágeno, a literatura cita como possíveis causas de obstrução das artérias retinianas o lúpus eritematoso sistêmico, a poliarterite nodosa, a arterite de células gigantes, a granulomatose de Wegener e a granulomatose linfóide de Liebow. Até o presente momento, não se encontrou na literatura relatos da associação de casos de oclusão arterial retinana associados à PAM. Os autores relatam o caso de um paciente com poliangeíte microscópica que apresentou comprometimento renal importante e oclusão da artéria central da retina unilateral. Atenta-se para a inclusão de pesquisa da PAM, através do p-ANCA, na avaliação de possível origem sistêmica em pacientes acometidos por oclusão arterial retiniana.

Hypertension in children and adolescents: epidemiology and pathogenesis.

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Raj, Manu; Krishnakumar, R

2013-03-01

High blood pressure is one among the leading contributors to burden of disease globally. Approximately 54 % of stroke and 47 % of ischemic heart disease events worldwide were attributable to high blood pressure in the year 2001. There is deficiency of data on the long-term outcome of hypertension in children. In spite of this, there is sufficient evidence to suspect that the health risks of hypertension in pediatric patients are substantial. Hypertension in childhood is known to result in hypertension in young adulthood. The epidemiology of hypertension in children is well represented from various studies conducted across continents. Factors like methodological issues in measurement, socio demographic differences, adiposity levels and ethnicity appear to influence the distribution of blood pressure as well as prevalence of hypertension in children. The etio-pathogenesis of essential (primary) hypertension is multi-factorial in origin. Obesity, insulin resistance, activation of sympathetic nervous system, alterations in sodium homeostasis, renin-angiotensin system changes, changes in vascular smooth muscle structure and reactivity, high serum uric acid levels, genetic factors and fetal programming have been reported to contribute to this disorder. The causes of secondary hypertension vary with age. Renal disorders and coarctation of the aorta are the most common causes of hypertension in children up to age 6 y. In older children, renal parenchymal disease remains the most frequent cause of increased blood pressure. Other causes of hypertension in children are relatively rare and include systemic arteritis and certain tumours, endocrine dysfunction, and neurologic disorders.

Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases.

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Ramos-Casals, Manuel; Brito-Zerón, Pilar; Kostov, Belchin; Sisó-Almirall, Antoni; Bosch, Xavier; Buss, David; Trilla, Antoni; Stone, John H; Khamashta, Munther A; Shoenfeld, Yehuda

2015-08-01

Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. We explored the potential of the Google search engine to collect and merge large series (>1000 patients) of SADs reported in the Pubmed library, with the aim of obtaining a high-definition geoepidemiological picture of each disease. We collected data from 394,827 patients with SADs. Analysis showed a predominance of medical vs. administrative databases (74% vs. 26%), public health system vs. health insurance resources (88% vs. 12%) and patient-based vs. population-based designs (82% vs. 18%). The most unbalanced gender ratio was found in primary Sjögren syndrome (pSS), with nearly 10 females affected per 1 male, followed by systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and antiphospholipid syndrome (APS) (ratio of nearly 5:1). Each disease predominantly affects a specific age group: children (Kawasaki disease, primary immunodeficiencies and Schonlein-Henoch disease), young people (SLE Behçet disease and sarcoidosis), middle-aged people (SSc, vasculitis and pSS) and the elderly (amyloidosis, polymyalgia rheumatica, and giant cell arteritis). We found significant differences in the geographical distribution of studies for each disease, and a higher frequency of the three SADs with available data (SLE, inflammatory myopathies and Kawasaki disease) in African-American patients. Using a "big data" approach enabled hitherto unseen connections in SADs to emerge. Copyright © 2015 Elsevier B.V. All rights reserved.

Bilateral acute retinal necrosis after herpetic meningitis

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Katsura T

2012-04-01

Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

Parameters and criteria for repair and strengthening of buildings in the old town core of Dubrovnik based on seismic risk analysis

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M. Vladimir

1995-06-01

Full Text Available Definition of the seismicity conditions, the design seismic parameters and the seismic risk level are important and inevitable phases ol the complex process of repair and strengthening of existing structures in certain towns located in seismically active areas. These should be studied in all necessary details in order to provide corresponding bases and define the necessary preventive measures against expected strong earthquakes. Such an approach becomes even nlore necessary arter the experience regarding the last catastrophic earthquakes that occurred in Former Yugoslavia (Skopje. Banja Luka, Montenegro coast and Kopaonik and inflicted heavy losses of human lives and material properties. The old town core of Dubrovnik is known for the large concentration of buildings of enorrnous cultural-historic importance. Considering the high seismic activity of this area. all these buildings are very likely to experience heavy damage and failure. Tlie history of the town records many catastrophic earthquakes that inflicted heavy material losses and loss of human lives. Here, we can rnention the great Dubrovnik earthquake of 1667 and the last Montenegro earthquake of April 15, 1979 with an epicenter in the Ulcinj-Bar area. The consequences of the latter are well known. The purpose of this paper is to present some results and experience gained from the investigations performed for the area of Dubro~nikil lustrated by several examples of buildings existing in the old town core of Dubrovnik.

Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis

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Alexander Tsoukas

2017-01-01

Full Text Available Objective. To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods. Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis nodosa (PAN and granulomatosis with polyangiitis (GPA. Incident acute myocardial infarctions (AMIs and cerebrovascular accidents (CVAs after the diagnosis of vasculitis were ascertained in the PAN and GPA group via billing and hospitalization data. These were compared to rates of a general population comparator group. The incidences of comorbidities (type 2 diabetes mellitus, dyslipidemia, and hypertension were also collected. Results. Among the 626 patients identified with vasculitis, 19.7% had PAN, 2.9% had Kawasaki disease, 23.8% had GPA, 52.4% had GCA, and 1.3% had Takayasu arteritis. The AMI rate was substantially higher in males aged 18–44 with PAN, with rates up to 268.1 events per 10,000 patient years [95% CI 67.1–1070.2], approximately 30 times that in the age- and sex-matched control group. The CVA rate was also substantially higher, particularly in adults aged 45–65. Patients with vasculitis had elevated incidences of diabetes, dyslipidemia, and hypertension versus the general population. Conclusion. Atherothrombotic rates were elevated in patients identified as having primary systemic vasculitis. While incident rates of cardiovascular comorbidities were also increased, the substantial elevation in AMIs seen in young adults suggests a disease-specific component which requires further investigation.

ECG gated magnetic resonance imaging in cardiovascular disease

International Nuclear Information System (INIS)

Park, Jae Hyung; Im, Chung Kie; Han, Man Chung; Kim, Chu Wan

1985-01-01

Using KAIS 0.15 Tesla resistive magnetic imaging system, ECG gated magnetic resonance (MR) image of various cardiovascular disease was obtained in 10 patients. The findings of MR image of the cardiovascular disease were analysed and the results were as follows: 1. In 6 cases of acquired and congenital cardiac diseases, there were 2 cases of myocardial infarction, 1 case of mitral stenosis and 3 cases of corrected transportation of great vessels. The others were 3 cases of aortic disease and 1 case of pericardial effusion with lymphoma. 2. Myocardial thinning and left ventricular aneurysm were detected in MR images of myocardial infarction. The left atrium was well delineated and enlarged in the case of mitral stenosis. And segmental analysis was possible in the cases of corrected transposition since all cardiac structures were well delineated anatomically. 3. In aortic diseases, the findings of MR image were enlarged lumen, compressed cardiac chambers in ascending aortic aneurysm, intimal flap, enhanced false lumen in dissecting aneurysm and irregular narrowing of aorta with arterial obstruction in Takayasu's arteritis. 4. Pericardial effusion revealed a conspicuous contrast with neighboring mediastinal fat and cardiac wall due to it low signal encircling cardiac wall. 5. ECG gated MR image is an accurate non-invasive imaging modality for the diagnosis of cardiovascular disease and better results of its clinical application are expected in the future with further development in the imaging system and more clinical experiences

Renal autotransplantation--a possibility in the treatment of complex renal vascular diseases and ureteric injuries.

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Hau, Hans Michael; Bartels, Michael; Tautenhahn, Hans-Michael; Morgul, Mehmet Haluk; Fellmer, Peter; Ho-Thi, Phuc; Benckert, Christoph; Uhlmann, Dirk; Moche, Michael; Thelen, Armin; Schmelzle, Moritz; Jonas, Sven

2012-12-31

We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure. Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period. Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu's arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6-13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period. The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.

Sudden visual loss after cardiac resynchronization therapy device implantation.

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De Vitis, Luigi A; Marchese, Alessandro; Giuffrè, Chiara; Carnevali, Adriano; Querques, Lea; Tomasso, Livia; Baldin, Giovanni; Maestranzi, Gisella; Lattanzio, Rosangela; Querques, Giuseppe; Bandello, Francesco

2017-03-10

To report a case of sudden decrease in visual acuity possibly due to a cardiogenic embolism in a patient who underwent cardiac resynchronization therapy (CRT) device implantation. A 62-year-old man with severe left ventricular systolic dysfunction and a left bundle branch block was referred to our department because of a sudden decrease in visual acuity. Nine days earlier, he had undergone cardiac transapical implantation of a CRT device, which was followed, 2 days later, by an inflammatory reaction. The patient underwent several general and ophthalmologic examinations, including multimodal imaging. At presentation, right eye (RE) best-corrected visual acuity (BCVA) was counting fingers and RE pupil was hyporeactive. Fundus examination revealed white-centered hemorrhagic dots suggestive of Roth spots. Fluorescein angiography showed delay in vascular perfusion during early stage, late hyperfluorescence of the macula and optic disk, and peripheral perivascular leakage. The first visual field test showed complete loss of vision RE and a normal left eye. Due to suspected giant cell arteritis, temporal artery biopsy was performed. Thirty minutes after the procedure, an ischemic stroke with right hemisyndrome and aphasia occurred. The RE BCVA worsened to hands motion. Four months later, RE BCVA did not improve, despite improvement in fluorescein angiography inflammatory sign. We report a possible cardiogenic embolism secondary to undiagnosed infective endocarditis causing monocular visual loss after CRT device implantation. It remains unclear how the embolus caused severe functional damage without altering the retinal anatomical structure.

Diagnostic and Therapeutic Problems of Geriatric Headache

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Kaviyan Ghandehari

2007-07-01

Full Text Available There is no difference in clinical characteristics of headache between old individuals and younger’s. However, differential diagnosis of migrainous aura and transient ischemic attacks may be difficult in old people who frequently have vascular risk factors. Old people have less headache than the young’s. Chronic tension headache is the most common primary type of headache in the elderly. Chronic paroxismal hemicrania and headache due to giant cell arterities are specified to the elderly, Secondary headaches; e.g headache due to cervical spondylosis and brain tumors is more common in the old people than young. Old people poorly tolerate headache drugs, i.e. Ergotamine, Triptans and Tricyclics. Trigeminal neuralgia is often seen in the elderly and is resistant to medical therapy in the old people. Headache could be the main manifestation of depression in old people. Headaches secondary to disorders of internal medicine; i.e. hypertension and chronic obstructive pulmonary disease have importance in the elderly. Subarachnoid hemorrhage is considered in every old person with sudden onset explosive headache especially in cases with decreased consciousness and neck stiffness. Old individuals use a collection of different drugs due to suffering various diseases and commonly have drug induced headaches. Neuroimaging should be performed in a geriatric patient with new onset sever headache without medical disorder or consumption of drug induced headache. Some of the old people suffer of multiple types of headache.

Thoracic vasculitis presenting as surgical problems.

LENUS (Irish Health Repository)

Jansen, Michael

2010-01-01

We present four patients with vasculitis manifesting with unusual clinical or pathological features, generating surgical problems. Two cases presented with pulmonary hypertension, with investigations and radiological evidence prompting clinical suspicion of pulmonary thrombo-embolic disease. First case, with an antecedant history of Wegener\\'s granulomatosis (WG), demonstrated following "embolectomy", WG involving the large pulmonary elastic arteries. The second case of inoperable "pulmonary thrombo-embolic disease" was subsequently found at limited post mortem to have giant cell arteritis, which affected widespread small peripheral pulmonary arterial vessels. The other two cases were of aortitis occurring in the background of immune-mediated disease, which had been treated with aggressive immunosuppression regimens. The first of these was a case of Cogan\\'s syndrome complicated by descending aortitis, a rarely reported phenomenon, with co-existent acute endocarditis of the aortic valve leaflets. Most cases of endocarditis in this context occur secondary to and in continuity with ascending aortitis. That this case, and a case of ascending aortitis occurring in the context of relapsing polychondritis occurred in the face of aggressive immunosuppression with an apparent clinical response, underscores the need to not accept a clinical picture at face value. This has implications for clinical management, particularly in the follow-up of surgical prosthetic devices such as grafts which may be used in these cases. All four cases emphasise the continued importance of histology and the post-mortem examination in elucidating previously undetected or unsuspected disease.

Diagnostic criteria of 99mTc-diethylenetriaminepentaacetic acid captopril renal scan for the diagnosis of renovascular hypertension by unilateral renal artery stenosis

International Nuclear Information System (INIS)

Choi, Seung Jin; Hong, Il Ki; Chang, Jae Won; Park, Su Kil; Moon, Dae Hyuk

2004-01-01

We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. The study group consisted of 24 patients (m/f = 16/8, age: 39±18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with 99m Tc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ≤ 38); 92% and 50% (BCfun≥ 1 %); 92% and 75% (CBren≥ 1), and 90% and 60% (CNren≥ 1), respectively. Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis

Development of outcome measures for large-vessel vasculitis for use in clinical trials: opportunities, challenges, and research agenda.

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Direskeneli, Haner; Aydin, Sibel Z; Kermani, Tanaz A; Matteson, Eric L; Boers, Maarten; Herlyn, Karen; Luqmani, Raashid A; Neogi, Tuhina; Seo, Philip; Suppiah, Ravi; Tomasson, Gunnar; Merkel, Peter A

2011-07-01

Giant cell (GCA) and Takayasu's arteritis (TAK) are 2 forms of large-vessel vasculitis (LVV) that involve the aorta and its major branches. GCA has a predilection for the cranial branches, while TAK tends to affect the extracranial branches. Both disorders may also cause nonspecific constitutional symptoms. Although some clinical features are more common in one or the other disorder and the ages of initial presentation differ substantially, there is enough clinical and histopathologic overlap between these disorders that some investigators suggest GCA and TAK may be 2 processes within the spectrum of a single disease. There have been few randomized therapeutic trials completed in GCA, and none in TAK. The lack of therapeutic trials in LVV is only partially explained by the rarity of these diseases. It is likely that the lack of well validated outcome measures for LVV and uncertainties regarding trial design contribute to the paucity of trials for these diseases. An initiative to develop a core set of outcome measures for use in clinical trials of LVV was launched by the international OMERACT Vasculitis Working Group in 2009 and subsequently endorsed by the OMERACT community at the OMERACT 10 meeting. Aims of this initiative include: (1) to review the literature and existing data related to outcome assessments in LVV; (2) to obtain the opinion of experts and patients on disease content; and (3) to formulate a research agenda to facilitate a more data-based approach to outcomes development.

Identification of streptococcal proteins reacting with sera from Behçet's disease and rheumatic disorders.

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Cho, Sung Bin; Lee, Ju Hee; Ahn, Keun Jae; Cho, Suhyun; Park, Yong-Beom; Lee, Soo-Kon; Bang, Dongsik; Lee, Kwang Hoon

2010-01-01

We evaluated the reactivity of sera from Behçet's disease (BD), systemic lupus erythematosus (SLE), dermatomyositis (DM), rheumatoid arthritis (RA), and Takayasu's arteritis (TA) patients against human α-enolase and streptococcal α-enolase, and identified additional streptococcal antigens. Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were performed using sera from patients with BD, SLE, DM, RA, and TA and healthy volunteers (control) against human α-enolase and streptococcal α-enolase. Immunoblot analysis and matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry were used to identify and recombine other streptococcal antigens. Specific positive signals against recombinant human α-enolase were detected by IgM ELISA of serum samples from 50% of BD, 14.3% of SLE, 57.1% of DM, 42.9% of RA, and 57.1% of TA patients. Specific positive signals against streptococcal α-enolase were detected from 42.9% of BD, 14.3% of DM, and 14.3% of TA patients. No SLE and RA sera reacted against streptococcal α-enolase antigen. Streptococcal proteins reacting with sera were identified as hypothetical protein (HP) for SLE and DM patients, acid phosphatase (AP) for RA patients, and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) for TA patients. We observed that RA patients did not present serum reactivity against either HP or GAPDH though BD, SLE, DM, and TA patients did. Also, AP reacted with sera from BD, SLE, DM, RA, and TA patients.

Association of STAT4 rs7574865 polymorphism with autoimmune diseases: a meta-analysis.

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Liang, Ya-Ling; Wu, Hua; Shen, Xi; Li, Pei-Qiang; Yang, Xiao-Qing; Liang, Li; Tian, Wei-Hua; Zhang, Li-Feng; Xie, Xiao-Dong

2012-09-01

The association between the signal transducer and activator of transcription 4 (STAT4) gene rs7574865 single nucleotide polymorphism and different autoimmune diseases remains controversial and ambiguous. We conducted this study to investigate whether combined evidence shows the association between STAT4 rs7574865 polymorphism and autoimmune diseases. Comprehensive Medline search and review of the references were used to get the relevant reports published before September 2011. Meta-analysis was conducted for genotype T/T (recessive effect), T/T + G/T (dominant effect) and T allele in random effects models. 40 studies with 90 comparisons including 32 systemic lupus erythematosus (SLE), 19 rheumatoid arthritis (RA), 3 type 1 diabetes (T1D), 11 Systemeric Sclerosis (SSc), 4 inflammatory bowed diseases (IBD), 3 Primary Sjogren's syndrome (pSS), 4 juvenile idiopathic arthritis (JIA), 2 Primary antiphospholipid syndrome (APS), 1 Autoimmune thyroid diseases, 1 multiple sclerosis, 1 Psoriasis, 1 Wegener's granulomatosis, 1 Type 2 diabetes, and 1 giant cell arteritis disease were available for this meta-analysis. The overall odds ratios for rs7574865 T-allele significantly increased in SLE, RA, T1D, SSc, JIA, and APS (OR = 1.56, 1.25, 1.13, 1.34, 1.25, and 2.15, respectively, P rs7574865 T allele confers susceptibility to SLE, RA, T1D, SSc, JIA, APS, IBD-UC, and pSS patients, supporting the hypothesis of association between STAT4 gene polymorphism and subgroup of autoimmune diseases.

Biodiversity and springtime patterns of egg production and development for parasites of the Chisana Caribou herd, Yukon Territory, Canada

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Bryanne Hoar

2009-12-01

¬søkte artsammensetning, egg/oocysteproduksjon og parasittutvikling i et område sørvest i Yukon, Canada, der Chisana caribou’en holder til. Møkkprøver fra 50 voksne simler, holdt i en midlertidig inngjerding i det naturlige beiteområdet ved Bondary Lake, ble samlet og analysert i løpet av fem prøveperioder. Parasitter fra minst seks slekter ble funnet: materialet omfattet egg av Trichostrongylidae-arter (mest sannsynlig Ostertagia gruehneri og Teledorsagia boreoarcti¬cus, Marshallagia-art, Anaplocephalidae-bendelmark og Skrjabinema-art, oocyster av Eimeria-arter, og ryggpiggete førstestadiums Protostrongylidae-larver, bl.a. av Parelaphostrongylus andersoni. I ferske møkkprøver var prosentvis tilstedeværelse av Trichostrongylidae-egg nesten 100 % gjennom prøveperioden, men median intensitet (parasittmengde økte statistisk signifikant fra 8 til 34 egg per gram under kalvingens mest intense periode og avtok til 12 egg per gram to uker etter kalving. Møkk fra forsøkssimlene ble den 4. mai plassert i tre felt utenfor området der simlene ble holdt inngjerdet, og undersøkt hver tiende dag for å følge parasittutviklingen under naturlige betingelser. Det totale antall av egg + larver Trichostrongylidae i feltene forandret seg ikke; larvemengden økte samtidig som eggmengden avtok. Tilstedeværelsen av andre parasitter i feltene forble også konstant over tid. Vår studie er den første til å dokumentere parasittdiversiteten i Chisanavillreinen og å undersøke utviklingen og overlevelsen av egg og larver gjennom vår og tidlig sommer.

Role of Antioxidants in Horse Serum-mediated Vasculitis in Swine: Potential Relevance to Early Treatment in Mitigation of Coronary Arteritis in Kawasaki Disease.

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Philip, Saji; Lee, Wen-Chuan; Cherian, Kotturathu Mammen; Wu, Mei-Hwan; Lue, Hung-Chi

2017-08-01

Horse serum-induced immune complex coronary vasculitis in swine is the first experimental model to mimic most of the pictures of Kawasaki disease. Immune complex mechanism has been implicated as one of the possible mechanisms in the pathogenesis of vasculitis in Kawasaki disease. Antioxidants have a significant role in the reduction of cardiovascular diseases in both human and animal studies. We tried giving vitamins A, E, and C to treat immune complex vasculitis, in the hope of mitigating coronary vasculitis in Kawasaki disease. Our study group consisted of 30 pure bred male piglets of 2-3 months of age, and they were divided into test and control groups. The test (AEC) group (n = 20) received two doses of horse serum, 10 mL (0.65 g protein)/kg body weight at 5-day intervals, and oral vitamins A, E, and C once daily for 14 days. The control group (n = 10) was further divided into the saline group (n = 3) receiving two doses of normal saline and the horse serum group (n = 7) receiving two doses of horse serum at 5-day intervals. Piglets were observed for the rashes and coronary artery dimensions. Both the AEC and the control horse serum group developed rashes after horse serum infusions, but the AEC group developed significantly fewer rashes, and no rashes were seen in the saline group. The control horse serum group (mean ± standard deviation = 2.13 ± 0.72) showed significant coronary artery dilatation, whereas there was no significant dilatation in the AEC group (mean ± standard deviation = 0.81 ± 0.58) or the control saline group (p = 0.002). Serum sickness is a prototype of immune complex vasculitis, and the severity can be ameliorated with antioxidants. A trial of therapeutic dosages of vitamins A, E, and C in acute phase of Kawasaki disease, may be effective in mitigation of coronary artery lesion in addition to intravenous immunoglobulin and aspirin. Copyright © 2017. Published by Elsevier B.V.

Role of Antioxidants in Horse Serum-mediated Vasculitis in Swine: Potential Relevance to Early Treatment in Mitigation of Coronary Arteritis in Kawasaki Disease

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Saji Philip

2017-08-01

Conclusion: Serum sickness is a prototype of immune complex vasculitis, and the severity can be ameliorated with antioxidants. A trial of therapeutic dosages of vitamins A, E, and C in acute phase of Kawasaki disease, may be effective in mitigation of coronary artery lesion in addition to intravenous immunoglobulin and aspirin.

Histopathologic Overlap between Fibrosing Mediastinitis and IgG4-Related Disease

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Tobias Peikert

2012-01-01

Full Text Available Fibrosing mediastinitis (FM and IgG4-related disease (IgG4-RD are two fibroinflammatory disorders with potentially overlapping clinical and radiological features. In this paper, we looked for histopathologic features of IgG4-RD and enumerated infiltrating IgG4-positive plasma cells within mediastinal tissue biopsies from FM patients. We identified 15 consecutive FM surgical mediastinal tissue biopsies between 1985 and 2006. All patients satisfied the clinical and radiological diagnostic criteria for FM. All patients had either serological or radiological evidence of prior histoplasmosis or granulomatous disease, respectively. Formalin-fixed paraffin-embedded tissue sections of all patients were stained for H&E, IgG, and IgG4. Three samples met the predefined diagnostic criteria for IgG4-RD. In addition, characteristic histopathologic changes of IgG4-RD in the absence of diagnostic numbers of tissue infiltrating IgG4-positive plasma cells were seen in a number of additional cases (storiform cell-rich fibrosis in 11 cases, lymphoplasmacytic infiltrate in 7 cases, and obliterative phlebitis/arteritis in 2 cases. We conclude that up to one-third of histoplasmosis or granulomatous-disease-associated FM cases demonstrate histopathological features of IgG4-RD spectrum. Whether these changes occur as the host immune response against Histoplasma or represent a manifestation of IgG4-RD remains to be determined. Studies to prospectively identify these cases and evaluate their therapeutic responses to glucocorticoids and/or other immunosuppressive agents such as rituximab are warranted.

Advances in the use of biologic agents for the treatment of systemic vasculitis

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Chung, Sharon A.; Seo, Philip

2010-01-01

Purpose of review Due to the well-known toxicities of cyclophosphamide, substantial interest exists in finding other therapies to treat primary systemic vasculitis. Biologic agents have been proposed as an alternative to cyclophosphamide for these disorders because of their recent success in treating other rheumatic diseases. This article reviews the current state-of-the-art with regards to the use of biologic agents as a treatment for systemic vasculitis. Recent findings The greatest amount of experience with these agents for the treatment of systemic vasculitis is with anti-tumor necrosis factor agents, pooled intravenous immunoglobulin, and anti-B cell therapies such as rituximab. Intravenous immunoglobulin is already a standard therapy for Kawasaki's disease, but should also be considered for the treatment of ANCA-associated vasculitis when standard therapies are either ineffective or contraindicated. Early experience with tumor necrosis factor inhibitors indicates that they may be effective for the treatment of Takayasu's arteritis, but their role in the treatment of other forms of vasculitis remains controversial. Early experience with rituximab for the treatment of several forms of vasculitis has been quite promising, but must be confirmed by ongoing randomized clinical trials. Summary Biologic agents represent the next evolution in treatment for the primary systemic vasculitides. Greater understanding of these diseases has allowed use to move further away from non-specific, highly toxic therapies towards a more directed approach. As our experience with these agents increases, they will likely form the keystone of treatment in the near future. PMID:19077713

Isolated pulmonary vasculitis: case report and literature review.

Science.gov (United States)

Riancho-Zarrabeitia, Leyre; Zurbano, Felipe; Gómez-Román, Javier; Martínez-Meñaca, Amaya; López, Marta; Hernández, Miguel A; Pina, Trinitario; González-Gay, Miguel A

2015-04-01

Single-organ vasculitis has been reported to affect the skin, kidneys, central nervous system, peripheral nerves, genitourinary tract, calf muscles, aorta, coronary arteries, retina, or gastrointestinal tract. However, isolated pulmonary vasculitis is a very rare entity. Our aims were to describe a case of localized pulmonary vasculitis affecting medium-sized vessels and review the literature. A patient with localized pulmonary vasculitis affecting medium-sized vessels that presented as pulmonary arterial hypertension is described. A MEDLINE database search of cases with localized pulmonary vasculitis was also conducted. A 30-year-old man presented with pulmonary hypertension due to isolated pulmonary medium-sized vessel vasculitis that was confirmed histologically. Initially he responded to corticosteroids and vasodilator treatment, but therapy eventually lost efficacy. Treatment with rituximab was not effective, and as the clinical situation worsened, lung transplant was performed. Isolated large pulmonary vessel disease, often related to Takayasu disease or giant cell arteritis, may present as pulmonary artery hypertension, thus mimicking chronic thromboembolic disease. Medium- and small-vessel pulmonary vasculitis usually develops in the context of a systemic disease. Some cases of isolated small-vessel vasculitis have been reported presenting as diffuse alveolar hemorrhage. In contrast, our case developed pulmonary artery hypertension secondary to medium-sized vessels vasculitis. To our knowledge, this is the first case of lung transplantation in isolated pulmonary vasculitis. Pulmonary isolated vasculitis is a rare cause of pulmonary hypertension but it must be taken into consideration after more common disorders are excluded. Copyright © 2014 Elsevier Inc. All rights reserved.

Imaging of systemic vasculitis in childhood

Energy Technology Data Exchange (ETDEWEB)

Soliman, Magdy [The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Cairo University, Department of Medical Imaging, Cairo (Egypt); Laxer, Ronald; Yeung, Rae [The Hospital for Sick Children, Department of Rheumatology, Toronto, ON (Canada); Manson, David; Doria, Andrea S. [The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada)

2015-08-15

The term ''systemic vasculitis'' encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children. (orig.)

Chronic graft-versus-host disease in the rat radiation chimera: I. clinical features, hematology, histology, and immunopathology in long-term chimeras

Energy Technology Data Exchange (ETDEWEB)

Beschorner, W.E.; Tutschka, P.J.; Santos, G.W.

1982-04-01

The clinical features, pathology, and immunopathology of chronic graft-versus-host disease (GVHD) developing in the long-term rat radiation chimera are described. At 6 to 12 months post-transplant, the previously stable ACI/LEW chimeras developed patchy to diffuse severe hair loss and thickened skin folds, and had microscopic features resembling scleroderma, Sjogren's syndrome, and chronic hepatitis. Skin histology showed dermal inflammation and acanthosis with atrophy of the appendages, with progression to dermal sclerosis. The liver revealed chronic hepatitis with bile duct injury and proliferation and periportal piecemeal necrosis. The tongue had considerable submucosal inflammation, muscular necrosis, and atrophy and arteritis. The serous salivary glands, lacrimal glands, and bronchi had lymphocytic inflammation and injury to duct, acinar, and mucosal columnar epithelium. The thymus had lymphocyte depletion of the medulla with prominent epithelium. The spleen and lymph nodes had poorly developed germinal centers but increased numbers of plasma cells. IgM was observed along the basement membrane and around the basal cells of the skin and tongue and along the basement membrane of the bile ducts. IgM was present also in the arteries of the tongue. Immunoglobulins eluted from the skin, cross-reacted with the bile duct epithelium and usually with both ACI and Lewis skin. Increased titers of speckled antinuclear antibodies were present in the serum of rats with chronic (GVHD). Chronic GVHD in the long-term rat radiation chimera is very similar to human chronic GVHD and is a potentially excellent model for autoimmune disorders including scleroderma, Sjorgren's syndrome, and chronic hepatitis.

Partial volume effect estimation and correction in the aortic vascular wall in PET imaging

International Nuclear Information System (INIS)

Burg, S; Le Guludec, D; Dupas, A; Stute, S; Dieudonné, A; Huet, P; Buvat, I

2013-01-01

We evaluated the impact of partial volume effect (PVE) in the assessment of arterial diseases with 18 FDG PET. An anthropomorphic digital phantom enabling the modeling of aorta related diseases like atherosclerosis and arteritis was used. Based on this phantom, we performed GATE Monte Carlo simulations to produce realistic PET images with a known organ segmentation and ground truth activity values. Images corresponding to 15 different activity-concentration ratios between the aortic wall and the blood and to 7 different wall thicknesses were generated. Using the PET images, we compared the theoretical wall-to-blood activity-concentration ratios (WBRs) with the measured WBRs obtained with five measurement methods: (1) measurement made by a physician (Expert), (2) automated measurement supposed to mimic the physician measurements (Max), (3) simple correction based on a recovery coefficient (Max-RC), (4) measurement based on an ideal VOI segmentation (Mean-VOI) and (5) measurement corrected for PVE using an ideal geometric transfer matrix (GTM) method. We found that Mean-VOI WBRs values were strongly affected by PVE. WBRs obtained by the physician measurement, by the Max method and by the Max-RC method were more accurate than WBRs obtained with the Mean-VOI approach. However Expert, Max and Max-RC WBRs strongly depended on the wall thickness. Only the GTM corrected WBRs did not depend on the wall thickness. Using the GTM method, we obtained more reproducible ratio values that could be compared across wall thickness. Yet, the feasibility of the implementation of a GTM-like method on real data remains to be studied. (paper)

Bentall Procedure Using Cryopreserved Valved Aortic Homografts

Science.gov (United States)

Christenson, Jan T.; Sierra, Jorge; Trindade, Pedro T.; Didier, Dominique; Kalangos, Afksendiyos

2004-01-01

The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 ± 21 years (range, 15–74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 ± 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6–72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft. PMID:15745290

Bentall procedure using cryopreserved valved aortic homografts: mid- to long-term results.

Science.gov (United States)

Christenson, Jan T; Sierra, Jorge; Trindade, Pedro T; Dominique, Didier; Kalangos, Afksendiyos

2004-01-01

The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 +/- 21 years (range, 15-74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 +/- 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6-72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft.

Histopathological changes and inflammatory response induced by Tityus discrepans scorpion venom in rams.

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D'Suze, G; Salazar, V; Díaz, P; Sevcik, C; Azpurua, H; Bracho, N

2004-12-15

Anesthetized rams envenomed s.c. with 40 microg/kg Tityus discrepans scorpion venom developed fasciculation, hypothermia, polyuria, pulmonary wet rales, tachypnea, respiratory distress and arrhythmia. Rams developed a cascade of inflammation reactions, characterized by activation of macrophages, fibroblasts and neutrophils, neutrophil infiltration and aggregation, vasculitis, arteritis and abundant fibrin deposition. At the inoculation site, venom was detected by immunohistochemistry in the extra cellular matrix, lymphatic vessels' and venules' lumen, inside macrophages and surrounding nerves. Extra cellular matrix was degraded at the inoculation site perhaps by activated neutrophils. Envenoming produced hepatocytes with Mallory body-like vacuoles which may be due to the increased plasmatic levels of TNF-alpha and IL6. Venom produced degranulation and vacuolization of acinary cells as well as interstitial swelling and necrosis. Necrosis of the Langerhan's islets occurred occasionally. Lungs showed the most deleterious effects developing wall collapse and necrosis, diffuse injury of the alveolar capillary barrier, interstitial and alveolar fibrin deposits with strong neutrophil infiltration. Massive infiltration of lymphocytes and macrophage occurred in the intestinal submucose, to the point that it modified villi and intestinal folding morphology. Envenomation developed a marked leukocyte aggregation surrounding nerves at the inoculation site. This study reveals that beyond its neurotoxicity, Tityus venom produces a severe and widespread inflammatory syndrome, expressed as histopathological changes at the site of inoculation, as well as in remote organs such as pancreas, lungs, intestine and liver. Our results suggest that not all remote targets are directly affected by the venom but that, as proposed earlier, are modified by inflammation by products produced elsewhere.

Imaging of systemic vasculitis in childhood

International Nuclear Information System (INIS)

Soliman, Magdy; Laxer, Ronald; Yeung, Rae; Manson, David; Doria, Andrea S.

2015-01-01

The term ''systemic vasculitis'' encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children. (orig.)

Heterogeneity of Human Research Ethics Committees and Research Governance Offices across Australia: An observational study.

Science.gov (United States)

De Smit, Elisabeth; Kearns, Lisa S; Clarke, Linda; Dick, Jonathan; Hill, Catherine L; Hewitt, Alex W

2016-01-01

Conducting ethically grounded research is a fundamental facet of all investigations. Nevertheless, the administrative burdens of current ethics review are substantial, and calls have been made for a reduction in research waste. To describe the heterogeneity in administration and documentation required by Human Research Ethics Committees (HRECs) and Research Governance Offices (RGOs) across Australia. In establishing a nationwide study to investigate the molecular aetiology of Giant Cell Arteritis (GCA), for which archived pathological specimens from around Australia are being recruited, we identified variation across separate HREC and RGO requirements. Submission paperwork and correspondence from each collaborating site and its representative office for research were reviewed. This data was interrogated to evaluate differences in current guidelines. Twenty-five pathology departments across seven Australian States collaborated in this study. All states, except Victoria, employed a single ethics review model. There was discrepancy amongst HRECs as to which application process applied to our study: seven requested completion of a "National Ethics Application Form" and three a "Low Negligible Risk" form. Noticeable differences in guidelines included whether electronic submission was sufficient. There was variability in the total number of documents submitted (range five to 22) and panel review turnaround time (range nine to 136 days). We demonstrate the challenges and illustrate the heavy workload involved in receiving widespread ethics and governance approval across Australia. We highlight the need to simplify, homogenise, and nationalise human ethics for non-clinical trial studies. Reducing unnecessary administration will enable investigators to achieve research aims more efficiently.

Heterogeneity of Human Research Ethics Committees and Research Governance Offices across Australia: An observational study

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Elisabeth De Smit

2016-02-01

Full Text Available Background Conducting ethically grounded research is a fundamental facet of all investigations. Nevertheless, the administrative burdens of current ethics review are substantial, and calls have been made for a reduction in research waste. Aims To describe the heterogeneity in administration and documentation required by Human Research Ethics Committees (HRECs and Research Governance Offices (RGOs across Australia. Methods In establishing a nationwide study to investigate the molecular aetiology of Giant Cell Arteritis (GCA, for which archived pathological specimens from around Australia are being recruited, we identified variation across separate HREC and RGO requirements. Submission paperwork and correspondence from each collaborating site and its representative office for research were reviewed. This data was interrogated to evaluate differences in current guidelines. Results Twenty-five pathology departments across seven Australian States collaborated in this study. All states, except Victoria, employed a single ethics review model. There was discrepancy amongst HRECs as to which application process applied to our study: seven requested completion of a “National Ethics Application Form” and three a “Low Negligible Risk” form. Noticeable differences in guidelines included whether electronic submission was sufficient. There was variability in the total number of documents submitted (range five to 22 and panel review turnaround time (range nine to 136 days. Conclusion We demonstrate the challenges and illustrate the heavy workload involved in receiving widespread ethics and governance approval across Australia. We highlight the need to simplify, homogenise, and nationalise human ethics for non-clinical trial studies. Reducing unnecessary administration will enable investigators to achieve research aims more efficiently

Chronic graft-versus-host disease in the rat radiation chimera: I. clinical features, hematology, histology, and immunopathology in long-term chimeras

International Nuclear Information System (INIS)

Beschorner, W.E.; Tutschka, P.J.; Santos, G.W.

1982-01-01

The clinical features, pathology, and immunopathology of chronic graft-versus-host disease (GVHD) developing in the long-term rat radiation chimera are described. At 6 to 12 months post-transplant, the previously stable ACI/LEW chimeras developed patchy to diffuse severe hair loss and thickened skin folds, and had microscopic features resembling scleroderma, Sjogren's syndrome, and chronic hepatitis. Skin histology showed dermal inflammation and acanthosis with atrophy of the appendages, with progression to dermal sclerosis. The liver revealed chronic hepatitis with bile duct injury and proliferation and periportal piecemeal necrosis. The tongue had considerable submucosal inflammation, muscular necrosis, and atrophy and arteritis. The serous salivary glands, lacrimal glands, and bronchi had lymphocytic inflammation and injury to duct, acinar, and mucosal columnar epithelium. The thymus had lymphocyte depletion of the medulla with prominent epithelium. The spleen and lymph nodes had poorly developed germinal centers but increased numbers of plasma cells. IgM was observed along the basement membrane and around the basal cells of the skin and tongue and along the basement membrane of the bile ducts. IgM was present also in the arteries of the tongue. Immunoglobulins eluted from the skin, cross-reacted with the bile duct epithelium and usually with both ACI and Lewis skin. Increased titers of speckled antinuclear antibodies were present in the serum of rats with chronic (GVHD). Chronic GVHD in the long-term rat radiation chimera is very similar to human chronic GVHD and is a potentially excellent model for autoimmune disorders including scleroderma, Sjorgren's syndrome, and chronic hepatitis

First reported outbreak of severe spirorchiidiasis in Emys orbicularis, probably resulting from a parasite spillover event.

Science.gov (United States)

Iglesias, Raúl; García-Estévez, José M; Ayres, César; Acuña, Antonio; Cordero-Rivera, Adolfo

2015-02-10

The importance of disease-mediated invasions and the role of parasite spillover as a substantial threat to the conservation of global biodiversity are now well known. Although competition between invasive sliders Trachemys scripta elegans and indigenous European turtles has been extensively studied, the impact of this invasive species on diseases affecting native populations is poorly known. During winter 2012-2013 an unusual event was detected in a population of Emys orbicularis (Linnaeus, 1758) inhabiting a pond system in Galicia (NW Spain). Most turtles were lethargic and some had lost mobility of limbs and tail. Necropsies were performed on 11 turtles that were found dead or dying at this site. Blood flukes belonging to the species Spirorchis elegans were found inhabiting the vascular system of 3 turtles, while numerous fluke eggs were trapped in the vascular system, brain, lung, heart, liver, kidney, spleen, and/or gastrointestinal tissues of all necropsied animals. Characteristic lesions included miliary egg granulomas, which were mostly found on serosal surfaces, particularly of the small intestine, as well as endocarditis, arteritis, and thrombosis. The most probable cause of death in the 3 turtle specimens which were also examined histologically was a necrotic enteritis with secondary bacterial infection associated with a massive egg embolism. The North American origin of S. elegans, the absence of prior recorded epizootics in the outbreak area, and the habitual presence of its type host, the highly invasive red-eared slider, in this area suggest a new case of parasite spillover resulting in a severe emerging disease.

Intracardiac thrombus in Behçet’s disease

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I. Ben Ghorbel

2016-12-01

Full Text Available Behçet’s disease (BD is a multisystem inflammatory disorder. Intracardiac thrombus (ICT formation is an uncommon but important complication of BD. Of the cases of Behçet’s disease, we selected those with ICT. All patients fulfilled the diagnostic criteria of the International Study Group of Behçet’s disease. The ICT in each case was confirmed by ultrasonography, computed tomography and MRI. Clinical features and laboratory parameters were determined. Among our 518 patients with BD, 8 were diagnosed as having intracardiac thrombus (ICT. All were male; the mean age at the time of the ICT diagnosis was 30.8 years. The main presenting symptoms were hemoptysis, chest pain, and dyspnea. It was associated with pulmonary artery aneurysm and vena cava thrombosis in 3 cases each, pulmonary embolism, and lower limbs deep venous thrombosis in 1 case each. The coexistence of other cardiac complications was as follows: pericarditis in 2 cases, myocarditis, endomyocardial fibrosis, and coronary arteritis with consequent myocardial infarction in one case each. In all cases, echocardiography was sufficient to reach the diagnosis. Chest computed tomography performed in all cases led to the diagnosis of associated pulmonary vasculo-Behçet lesions in 4 cases. All patients received colchicine, anticoagulation, and corticosteroids. Seven patients were on immunosuppressant agents (2 patients received azathioprine and 5 cyclophosphamide. Clinical remission with ICT resolution was observed in 5 cases. Combined immunosuppressive therapy with prednisone and cyclophosphamide might be needed to treat ICT due to BD.

Effects of Oral Prednisone Administration on Serum Cystatin C in Dogs.

Science.gov (United States)

Muñoz, J; Soblechero, P; Duque, F J; Macías-García, B; Ruiz, P; Zaragoza, C; Barrera, R

2017-11-01

Oral administration of glucocorticoid alters serum cystatin C (sCysC) concentration in humans. To determine if oral administration of prednisone alters sCysC in dogs without pre-existing renal disease. Forty six dogs were included: 10 dogs diagnosed with steroid responsive meningitis arteritis (SRMA; group A), 20 dogs diagnosed of pituitary-dependent hyperadrenocorticism (PDH; group B), and 16 healthy control dogs (group C). Retrospective observational study. SRMA diagnosed dogs were administered prednisone 4 mg/kg/24 h PO 7 days, reducing the dose to 2 mg/kg/24 h 7 days before medication withdrawal. In group A, sampling was performed at days 0, 7, 14 and a final control at day 21. Blood and urine samples were collected in the 3 groups, and in group A, sampling was performed at all time points (days 1, 7, 14, and 21). In group A, sCysC was significantly higher at day 7 compared to the control group (0.4 ± 0.04 mg/L vs. 0.18 ± 0.03 mg/L mean ± SEM respectively P 0.05). Dogs with PDH included in group B did not have significant differences in sCysC (0.22 ± 0.03 mg/L) compared to control (P > 0.05). Oral administration of prednisone unlike altered endogenous glucocorticoid production, increases sCysC in dogs in a dose-dependent fashion. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

MRI Findings of Early-Stage Hyperacute Hemorrhage Causing Extramedullary Compression of the Cervical Spinal Cord in a Dog with Suspected Steroid-Responsive Meningitis-Arteritis

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Adriano Wang-Leandro

2017-09-01

Full Text Available A 9-month-old female Weimaraner was presented to the emergency service due to episodes of fever and neck pain. Physical examination revealed a stiff neck posture and elevated body temperature. Shortly after clinical examination was performed, the dog developed peracute onset of non-ambulatory tetraparesis compatible with a C1–C5 spinal cord (SC lesion. Immediately thereafter (<1 h, MRI of the cervical SC was performed with a 3-T scanner. A left ventrolateral intradural-extramedullary SC compression caused by a round-shaped structure at the level of C3––C4 was evidenced. The structure was iso- to slightly hyperintense in T1-weighted (T1W sequences compared to SC parenchyma and hyperintense in T2-weighted, gradient echo, and fluid-attenuated inversion recovery. Moreover, the structure showed a strong homogeneous contrast uptake in T1W sequences. Cerebrospinal fluid (CSF analysis revealed a mixed pleocytosis, as well as elevated protein and erythrocyte count. Early-stage hyperacute extramedullary hemorrhage was suspected due to immune mediated vasculitis. The dog was maintained under general anesthesia and artificial ventilation for 24 h and long-term therapy with corticosteroids and physiotherapy was initiated. Eight weeks after initial presentation, the dog was ambulatory, slightly tetraparetic. Follow-up MRI showed a regression of the round-shaped structure and pleocytosis was not evident in CSF analysis. This report describes an early-stage hyperacute extramedullary hemorrhage, a condition rarely recorded in dogs even in experimental settings.

Artkunskap och intresse för arter hos blivande lärare för grundskolan. "Student teachers’ knowledge of and interest in species"

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Irmeli Palmberg

2012-12-01

Full Text Available According to recent research, the knowledge of species, interest in nature, and nature experiences arethe factors that best promote interest in and understanding of environmental issues and sustainable life style. However, during the past 20 years the knowledge of species has decreased alarmingly among pupils, but also among their teachers. The aim of this study is to make a survey of student teachers’ level of knowledge of species and of factors that have influenced their interest in and capacity for identifying species. Totally 335 student teachers were tested through a species identification test, a questionnaire, and completing interviews. Pupils in grades 7 and 9 and adults were used as reference groups. Student teachers had very varying levels of knowledge of species. Most of them, however, considered it useful to know the most common species of plants and animals in their local environment. The student teachers who had nature-related hobbies as well as practical nature studies in their education, had a considerably better level of knowledge than the others. More than 25 % of the student teachers, however, had a lower level of knowledge (of species than the average pupils ingrades 7 and 9.

A Review of Recent Advances Using Tocilizumab in the Treatment of Rheumatic Diseases.

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Rubbert-Roth, Andrea; Furst, Daniel E; Nebesky, Jan Michael; Jin, Angela; Berber, Erhan

2018-06-01

Tocilizumab (TCZ) is the first humanized anti-interleukin-6 (IL-6) receptor monoclonal antibody approved for the treatment of patients with rheumatoid arthritis (RA), Castleman's disease, polyarticular and systemic juvenile idiopathic arthritis, and, most recently, giant cell arteritis as well as for the treatment of chimeric antigen receptor T cell therapy-induced cytokine release syndrome. The global clinical development program for TCZ provides a wealth of clinical data on intravenous TCZ, and more recent studies in patients with RA have provided evidence characterizing the role of intravenous TCZ as monotherapy in early disease and led to the introduction of a subcutaneous formulation of TCZ. In addition, recently published open-label extension and observational studies continue to support the long-term efficacy and safety of TCZ in both clinical trial and real-world settings. Given the involvement of IL-6-mediated signaling in inflammatory disorders, TCZ is also being investigated in other immunological diseases. In particular, a phase 2 trial on the safety and efficacy of subcutaneous TCZ in adults with systemic sclerosis shows clinically relevant improvements in skin sclerosis and lung function in these patients. Another anti-IL-6 receptor agent, sarilumab, targeting the IL6 receptor alpha subunit, was recently approved for the treatment of patients with RA, although long-term data for this biologic are not yet published. In this article we review the placement of TCZ in current treatment guidelines; recent clinical trial data, including quality of life in patients with RA; recent updates to the TCZ safety profile; recent investigations of TCZ in other immunological diseases; and the clinical development of other novel IL-6-targeted agents.

Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

International Nuclear Information System (INIS)

Kannan, Anusha; Srinivasan, Sivasubramanian

2012-01-01

We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

Energy Technology Data Exchange (ETDEWEB)

Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)

2012-09-15

We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

A novel case of renal pathergy reaction in a Behçet's disease patient complicated by IgA vasculitis.

Science.gov (United States)

Higashihara, Takaaki; Okada, Akira; Kusano, Taiko; Ishigaki, Kazuyoshi; Shimizu, Akira; Takano, Hideki

2017-01-28

A pathergy reaction is defined as a hyperreactivity of the skin in response to minimal trauma, which is important in the diagnosis of Behçet's disease (BD). However, a pathergy reaction may not be restricted to the skin, and little is known about whether an invasive medical procedure can induce the reaction. Here we present a pathergy reaction induced by renal biopsy, an invasive procedure. A 46-year-old man who was diagnosed with IgA vasculitis (IgAV) at the age of 38 was treated with prednisolone and mizoribine. However, complications such as common carotid arteritis or recurrent oral ulcer suggested the possibility of another pathophysiology. Later, increasing urine protein developed, suggesting disease aggravation. However, renal biopsy showed arteriosclerotic changes caused mainly by hypertension, negating exacerbation. After renal biopsy, his renal dysfunction and body temperature fluctuated, and detailed examinations revealed recurrent oral and genital ulcers and a folliculitis-like rash on his scrotum. Later, he complained of myodesopsia caused by hemorrhage in the ocular fundus due to occlusive vasculitis. Complete BD was diagnosed after development of the symptoms, and he was treated with prednisolone and colchicine. Co-occurrence of BD with IgAV is very rare and may be associated with immune disorders. Interestingly, a renal biopsy revealed BD, which was masked by the presence of IgAV, and elucidated the etiology of the unexplainable symptoms. To the best of our knowledge, this is the first report of renal pathergy. This case enlightens clinicians to the fact that not only a needle stimulation but also an invasive procedure can cause a pathergy reaction.

Breast Gangrene

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Husasin Irfan

2011-08-01

Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging.

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Mavrogeni, Sophie; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-01

Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18FDG-PET will show FDG uptake at the area of the lesion. CMR, due to its capability to perform function and tissue characterisation, can offer an integrated imaging of aorta, coronary arteries and the heart, assessment of disease acuity, extent of fibrosis and guide further treatment. However, multimodality imaging may be necessary for assessment of disease activity and fibrosis extent in those cases with multifocal CV involvement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stroke in tuberculous meningitis.

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Misra, Usha Kant; Kalita, Jayantee; Maurya, Pradeep Kumar

2011-04-15

Stroke in tuberculous meningitis (TBM) occurs in 15-57% of patients especially in advance stage and severe illness. The majority of strokes may be asymptomatic because of being in a silent area, deep coma or associated pathology such as spinal arachnoiditis or tuberculoma. Methods of evaluation also influence the frequency of stroke. MRI is more sensitive in detecting acute (DWI) and chronic (T2, FLAIR) stroke. Most of the strokes in TBM are multiple, bilateral and located in the basal ganglia especially the 'tubercular zone' which comprises of the caudate, anterior thalamus, anterior limb and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal and thalamostriate arteries which are embedded in exudates and likely to be stretched by a coexistent hydrocephalus. Cortical stroke can also occur due to the involvement of proximal portion of the middle, anterior and posterior cerebral arteries as well as the supraclinoid portion of the internal carotid and basilar arteries which are documented in MRI, angiography and autopsy studies. Arteritis is more common than infarction in autopsy study. The role of cytokines especially tumor necrosis factor (TNFα), vascular endothelial growth factor (VEGF) and matrix metaloproteineases (MMPs) in damaging the blood brain barrier, attracting leucocytes and release of vasoactive autocoids have been suggested. The prothrombotic state may also contribute to stroke in TBM. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in reducing strokes has not been proven. Aspirin also reduces mortality and its role in reducing stroke in TBM needs further studies. Copyright © 2010 Elsevier B.V. All rights reserved.

Reindeer (Rangifer tarandus tarandus feeding on lichens and mushrooms: traditional ecological knowledge among reindeer-herding Sami in northern Sweden

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Berit Inga

2009-01-01

äriserar ett bra vinterbetesland. Informanterna hävdade att lavar företrädesvis betas under vintern, men även kan betas under sommaren då vädret är kallt och fuktigt. Svampar betas under höstmånaderna augusti och september, men enligt några informanter kan svamp även betas senare på hösten (från oktober när den är frusen och under snön. Renskötarna har namn på lavar som i generella termer beskriver deras utseende och växtplats. För svampar använder de enbart ett samiskt namn, guoppar. Av de marklevande lavarna ansåg informanterna att renarna föredrar Cladonia-arter (renlavar, medan kväve-fixerade arter som Nephroma arcticum (norrlandslav och Stereocaulon pascale (påskrislav inte ansågs föredras av renarna. Snöförhållandena är mycket viktiga, och ju mindre snö (och ju lösare den är desto bättre. Växtplatser där renskötarna vet av erfarenhet att snöförhållandena kan bli problematisk, t.ex. i fuktiga och öppna områden med små träd, används till bete tidigt under vintern (oktober-januari innan för mycket snö har fallit. Ett bra vinterbetesområde ska ha gott om lavar. Det bästa är en torr tallhed (Pinus sylvestris med stora och gamla träd med vida kronor som fångar upp snön som upplega och på det viset skyddar marken från snö, vilket gör det lättare för renarna att gräva.

Intracranial arterial wall enhancement using gadolinium-enhanced 3D black-blood T1-weighted imaging

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Takano, Koichi, E-mail: k-takano@fukuoka-u.ac.jp; Hida, Kosuke; Kuwabara, Yasuo; Yoshimitsu, Kengo

2017-01-15

Purpose: We investigated the enhancement of the intracranial arterial walls with gadolinium-enhanced, black-blood three-dimensional T1-weighted imaging (Gd-3DBB) by using an improved motion-sensitized driven-equilibrium (iMSDE)—prepared volumetric isotropic turbo spin-echo acquisition (VISTA). Methods: A total of 115 patients underwent FLAIR, 3D-TOF-MRA and Gd-3DBB with a 1.5-T scanner. The degree and distribution of the arterial wall enhancement on Gd-3DBB was assessed. The association of the degree of wall enhancement with brain infarction/ischemic lesions on FLAIR, luminal changes on 3D-TOF-MRA, and cardiovascular risk factors (CVRFs) was investigated by univariate and multiple logistic regression analyses. Results: Strong enhancement of the arterial walls was observed in 77 vertebral arteries (33.5%), 4 basilar arteries (3.5%), 31 supraclinoid internal carotid arteries (ICAs) (13.5%) and 8 middle cerebral arteries (3.5%). In addition, 221 intrapetrous ICAs (96.1%) showed strong enhancement. After adjusting for confounding factors, multivariate analyses showed that the patient age was independently associated with the strong wall enhancement of the arteries for both the posterior (OR, 1.088; 95% CI, 1.034–1.146) and the anterior circulation (OR, 1.098, 95% CI 1.029–1.172). In addition, the presence of the supratentorial brain infarctions was independently associated with the strong wall enhancement in the anterior circulation excluding the intrapetrous ICAs (OR, 4.097; 95% CI, 1.483–11.319). Conclusions: Although the arterial wall enhancement on the Gd-3DBB probably reflects normal aging, the enhancement in the anterior circulation might be related to brain infarctions. On the other hand, the intrapetrous ICA enhancement is considered a nonspecific finding and should not be mistaken for arterial pathologies such as atherosclerosis or arteritis.

Radiological effect of single massive irradiation on the liver hilum of rabbits

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Todoroki, Takeshi; Tsunemoto, Hiroshi; Usui, Sadahito; Iwasaki, Yoji.

1976-01-01

In order to decide the irradiation dosage, the liver hilum of rabbits had a irradiation of single 3,000 to 5,000 rads of electron beam during the operation. In the acute period from 2 days to 4 weeks after the irradiation, histological studies were carried out to examine the effects on the liver, extrahepatic bile duct, proper hepatic artery and portal vein. On the mucous epithelium of the extrahepatic bile duct, the proliferative changes such as swelling of nuclei, dense arrangement of the nuclei in the epithelial cells were observed. Two weeks later, it was restored to the conditions of the control mucous epitherlium. With 5,000 rads irradiation, even on the 4th week, the recovery was insufficient. The epithelial cells showed atrophy, and nuclei tended to be concentrated. Fibrosis around the bile duct mucous epithelium occurred according to the irradiation doses. It was remarkable with 5,000 rads. The liver reacted the most sensitively, and sporadical and circumscribed necrotic lesions appeared in the parenchyma of the liver. Four weeks after the irradiation of 3,000 rads, necrotic lesions were reduced to become scar and were restored. With 5,000 rads, the necrotic change was stronger than that with 3,000 rads. Although 4 weeks later, necrotic lesion was reduced to become scar, fibrosis of the liver mainly consisting of Glisson's capsule. with 3,000 rads, there was no remarkable change in proper hepatic artery and portal vein. Four weeks after the irradiation of 5,000 rads, thickening of intima and proliferation of intimal cells were observed in part of proper hepatic artery, but there were no hemorrhage or arteral obstruction. Therefore, it can be said that single irradiation of 3,000 rads of electron beam is within the dose to which tissues can tolerate. (N. Kanao)

Protective Effect of the Persian Gulf brittle star Ophiocoma Erinaceus extract on carbon tetrachloride (CCl4 induced liver damage in adult male Wistar rats

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Aida Soheili

2015-12-01

Full Text Available Background and Aim:  Brittle star possess  bioactive compounds which confer the wound healing capacity and regenerative potency of damaged  arms and organisms to this creature. The aim of the current study was to assess the   protective  effect  of  the  star extract on liver damages induced by carbon tetrachloride in adult male Wistar rats. Materials and Methods: In this experimental study, 32 adult male rats were randomly divided into 4 equal groups: control, Sham exposed, experimental 1 (treated with %25 extract and experimental 2 (treated with %50 extract of star Ophiocoma Erinaceus. The control group received no treatment. The sham exposed groups received carbon tetrachloride .(50% in olive oil .0.5 ml/kg for 7 days. The experimental groups firstly received carbon tetrachloride, then received %25, %50 brittle star extract as intragastric for 7 days. Finally, the animals were sacrificed, and their bodies and livers were weighed. Then, the livers sections were prepared and were examined by means of light microscope. Finally, the obtained  quantitative data was analyzed using SPSS (V; 20, Mini Tab software, ANOVA, and Tukey. at the significant level of P<0.001. Results: Carbon tetrachloride significantly decreased the rats’ body weight, but it increased their livers weight (P<0.001. Histopathological evaluations showed .extensive liver damage. On the other hand, treatment with brittle star extract .ncreased liver weight, reduced. body weight and significantly altered other induced changes by carbon tetrachloride on liver structure such as hepatocytes number, Kupffer cells, and arteritis, which indicated  the improvement of damaged liver tissue (P<0.001. Conclusion: It was found that brittle star extract can exert protective effects on  liver damages induced by carbon tetrachloride on male Wistar rat.

Molecular epidemiology and pathology of spirorchiid infection in green sea turtles (Chelonia mydas

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Phoebe A. Chapman

2017-04-01

Full Text Available Spirorchiid blood fluke infections affect endangered turtle populations globally, and are reported as a common cause of mortality in Queensland green sea turtles. Both the flukes and their ova are pathogenic and can contribute to the stranding or death of their host. Of particular interest are ova-associated brain lesions, which have been associated with host neurological deficits. Accurate estimations of disease frequency and the relative effect of infection relating to different spirorchiid species are made difficult by challenges in morphological identification of adults of some genera, and a lack of species-level identifying features for ova. A new specifically designed molecular assay was used to detect and identify cryptic spirorchiids and their ova in Queensland green sea turtle tissues collected from 2011 to 2014 in order to investigate epidemiology, tissue tropisms and pathology. Eight spirorchiid genotypes were detected in 14 distinct tissues, including multiple tissues for each. We found no evidence of a characteristic pathway of the eggs to the exterior; instead the results suggest that a high proportion of eggs become lost in dead-end tissues. The most common lesions observed were granulomas affecting most organs with varying severity, followed by arteritis and thrombi in the great vessels. The number of spirorchiid types detected increased with the presence and severity of granulomatous lesions. However, compared with other organs the brain showed relatively low levels of spirorchiid diversity. An inverse relationship between host age and spirorchiid diversity was evident for the liver and kidneys, but no such relationship was evident for other organs. Molecular data in this study, the first of its kind, provides the first species-level examination of spirorchiid ova and associated pathology, and paves the way for the future development of targeted ante-mortem diagnosis of spirorchiidiasis.

Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

International Nuclear Information System (INIS)

Bae, Tae Yeong; Park, Jae Hyung; Kim, Seung Hyup; Han, Man Chung

1987-01-01

This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed

Clinical Spectrum of Medium-Sized Vessel Vasculitis.

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Alibaz-Oner, Fatma; Koster, Matthew J; Crowson, Cynthia S; Makol, Ashima; Ytterberg, Steven R; Salvarani, Carlo; Matteson, Eric L; Warrington, Kenneth J

2017-06-01

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis of medium-sized visceral vessels. However, cutaneous arteritis (CA) and gastrointestinal (GI) vasculitis are forms of single-organ vasculitis having indistinguishable histopathologic findings from PAN. The aim of this study was to evaluate and compare the clinical characteristics, treatment, and outcomes of patients with systemic PAN, CA, and GI vasculitis. Retrospective cohorts were assembled, consisting of patients with PAN, CA, and GI vasculitis between 1980 and 2014. The demographics, clinical characteristics, treatment, and outcomes of patients were abstracted from medical records. We included 48 patients with PAN, 41 patients with CA, and 19 patients with GI vasculitis. The disease of 1 patient evolved from CA to systemic PAN during the disease course. At diagnosis, 94% of patients with PAN, 93% of patients with CA, and 67% of patients with GI vasculitis were treated with glucocorticoids. Additional immunosuppressive agents were used in 67% of PAN, 37% of GI vasculitis, and 32% of CA cases. The 5-year cumulative relapse rate was 45.2% in CA, and only 9.6% in PAN during a followup of approximately 6 years. No deaths were observed in the CA group. The survival rate at 10 years was 66% in the PAN group and 61% in the GI vasculitis group. Systemic PAN, CA, and GI vasculitis take different clinical courses and therefore may be different diseases, rather than existing on a spectrum of the same disease. Progression of CA to systemic PAN is very rare. Relapse risk is low during followup in PAN. Patients with CA have a higher relapse rate than those with systemic PAN, possibly due to less use of immunosuppressive therapy in CA. © 2016, American College of Rheumatology.

An intense and short-lasting burst of neutrophil activation differentiates early acute myocardial infarction from systemic inflammatory syndromes.

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Norma Maugeri

Full Text Available BACKGROUND: Neutrophils are involved in thrombus formation. We investigated whether specific features of neutrophil activation characterize patients with acute coronary syndromes (ACS compared to stable angina and to systemic inflammatory diseases. METHODS AND FINDINGS: The myeloperoxidase (MPO content of circulating neutrophils was determined by flow cytometry in 330 subjects: 69 consecutive patients with acute coronary syndromes (ACS, 69 with chronic stable angina (CSA, 50 with inflammation due to either non-infectious (acute bone fracture, infectious (sepsis or autoimmune diseases (small and large vessel systemic vasculitis, rheumatoid arthritis. Four patients have also been studied before and after sterile acute injury of the myocardium (septal alcoholization. One hundred thirty-eight healthy donors were studied in parallel. Neutrophils with normal MPO content were 96% in controls, >92% in patients undergoing septal alcoholization, 91% in CSA patients, but only 35 and 30% in unstable angina and AMI (STEMI and NSTEMI patients, compared to 80%, 75% and 2% of patients with giant cell arteritis, acute bone fracture and severe sepsis. In addition, in 32/33 STEMI and 9/21 NSTEMI patients respectively, 20% and 12% of neutrophils had complete MPO depletion during the first 4 hours after the onset of symptoms, a feature not observed in any other group of patients. MPO depletion was associated with platelet activation, indicated by P-selectin expression, activation and transactivation of leukocyte β2-integrins and formation of platelet neutrophil and -monocyte aggregates. The injection of activated platelets in mice produced transient, P-selectin dependent, complete MPO depletion in about 50% of neutrophils. CONCLUSIONS: ACS are characterized by intense neutrophil activation, like other systemic inflammatory syndromes. In the very early phase of acute myocardial infarction only a subpopulation of neutrophils is massively activated, possibly via

Polymyalgia rheumatica: observations of disease evolution without corticosteroid treatment

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Brawer AE

2016-04-01

Full Text Available Arthur E Brawer Division of Rheumatology, Department of Medicine, Monmouth Medical Center, Long Branch, NJ, USA Objectives: The diagnostic diversity of polymyalgia rheumatica (PMR can easily be obscured by the widespread use of corticosteroids (CSs early in the disease course. This study observed the course of PMR without CSs and determined whether alternative medication could be useful. Methods: Seventy patients with new-onset PMR comprised phase 1. Eight were removed with specific diagnoses (four with giant cell arteritis [GCA]. The remaining 62 were treated with nonsteroidal anti-inflammatory drugs (NSAIDs alone until enough time had elapsed to ascertain whether their PMR had evolved into another rheumatologic inflammatory condition. Hydroxychloroquine (HCQ was then added to their regimen. Twenty-five additional patients with PMR comprised phase 2. Twenty-two were immediately treated with HCQ prior to the anticipated disease progression. Results: In phase 1, 52/62 developed synovitis in multiple other joints 9 months from PMR onset; 48/52 received HCQ, and 42/48 (87.5% achieved complete remission. In phase 2, during HCQ induction, 21 patients developed similar synovitis; after 6 months of HCQ use, 80% achieved remission. In 73/95 (77%, a definite diagnosis of rheumatoid arthritis (RA could be made on average 8.5 months from PMR onset. Only 12/95 (13% stayed true to form with their PMR and did not develop another specific diagnosis. Conclusion: In this study, true PMR was infrequent in the absence of GCA. PMR in most patients evolved into seronegative RA, which was dramatically responsive to HCQ use. Treatment of acute PMR with HCQ was a rational alternative to CS use even if progressive additive synovitis had not yet occurred. Keywords: polymyalgia rheumatica, rheumatoid arthritis, corticosteroids

Aspergillus niger: an unusual cause of invasive pulmonary aspergillosis

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Person, A. K.; Chudgar, S. M.; Norton, B. L.; Tong, B. C.; Stout, J. E.

2010-01-01

Infections due to Aspergillus species cause significant morbidity and mortality. Most are attributed to Aspergillus fumigatus, followed by Aspergillus flavus and Aspergillus terreus. Aspergillus niger is a mould that is rarely reported as a cause of pneumonia. A 72-year-old female with chronic obstructive pulmonary disease and temporal arteritis being treated with steroids long term presented with haemoptysis and pleuritic chest pain. Chest radiography revealed areas of heterogeneous consolidation with cavitation in the right upper lobe of the lung. Induced bacterial sputum cultures, and acid-fast smears and cultures were negative. Fungal sputum cultures grew A. niger. The patient clinically improved on a combination therapy of empiric antibacterials and voriconazole, followed by voriconazole monotherapy. After 4 weeks of voriconazole therapy, however, repeat chest computed tomography scanning showed a significant progression of the infection and near-complete necrosis of the right upper lobe of the lung. Serum voriconazole levels were low–normal (1.0 μg ml−1, normal range for the assay 0.5–6.0 μg ml−1). A. niger was again recovered from bronchoalveolar lavage specimens. A right upper lobectomy was performed, and lung tissue cultures grew A. niger. Furthermore, the lung histopathology showed acute and organizing pneumonia, fungal hyphae and oxalate crystallosis, confirming the diagnosis of invasive A. niger infection. A. niger, unlike A. fumigatus and A. flavus, is less commonly considered a cause of invasive aspergillosis (IA). The finding of calcium oxalate crystals in histopathology specimens is classic for A. niger infection and can be helpful in making a diagnosis even in the absence of conidia. Therapeutic drug monitoring may be useful in optimizing the treatment of IA given the wide variations in the oral bioavailability of voriconazole. PMID:20299503

Estimating the incidence of connective tissue diseases and vasculitides in a defined population in Northern Savo area in 2010.

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Elfving, P; Marjoniemi, O; Niinisalo, H; Kononoff, A; Arstila, L; Savolainen, E; Rutanen, J; Kaipiainen-Seppänen, O

2016-07-01

Objective of the study was to evaluate the annual incidence and distribution of autoimmune connective tissue diseases and vasculitides during 2010. All units practicing rheumatology in the Northern Savo area, Finland, participated in the study by collecting data on newly diagnosed adult patients with autoimmune connective tissue disease or vasculitis over 1-year period. Seventy-two cases with autoimmune connective tissue disease were identified. The annual incidence rates were as follows: systemic lupus erythematosus 3.4/100,000 (95 % CI 1.4-7.0), idiopathic inflammatory myopathies 1.9 (0.5-5.0), systemic sclerosis 4.4 (2.0-8.3), mixed connective tissue disease 1.0 (0.1-3.5), Sjögren's syndrome 10.7 (6.7-16.1) and undifferentiated connective tissue disease 13.6 (9.0-19.6). The annual incidence rates among vasculitis category were as follows: antineutrophil cytoplasmic antibody-associated vasculitis 1.5/100,000 (95 % CI 0.3-4.3), central nervous system vasculitis 0.5 (0-2.7) and Henoch-Schönlein purpura 1.5 (0.3-4.3). The annual incidence of giant cell arteritis in the age group of 50 years or older was 7.5/100,000 (95 % CI 3.2-14.8). The longest delay from symptom onset to diagnosis occurred in systemic sclerosis. The incidences of autoimmune connective tissue diseases and vasculitides were comparable with those in published literature. The present study showed female predominance in all connective tissue diseases, excluding idiopathic inflammatory muscle diseases and mean age at onset of disease around 50 years of age. Despite improved diagnostic tools, diagnostic delay is long especially among patients with systemic sclerosis.

[Incidence and characteristics of calciphylaxis in Martinique (2006-2012)].

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Aoun, A; Baubion, E; Banydeen, R; Djiconkpode, I; Ekindi, N; Ureña-Torres, P; Riaux, A; Sadreux, T; Dueymes, J-M; Quist, D; Derancourt, C

2014-12-01

Calciphylaxis is a rare and severe disease with an annual incidence of around 1 % in dialysis patients. The main study aim was to determine its incidence in Martinique, where there is a significant population of patients on dialysis. All patients diagnosed with calciphylaxis between 2006 and 2012 and living in Martinique were included, retrospectively. Social, demographic, biological, anatomic, pathological, histological and outcome data were analysed. Fifteen patients were included (8 women, 7 men). The incidence of calciphylaxis in this population was about 4.62/1,000,000 inhabitants per year. All patients presented very painful skin ulcerations and necrosis, chiefly on the lower extremities in 53.3 % of cases. All patients were on haemodialysis and two had undergone renal transplantation. Fourteen of the 15 patients were presenting secondary hyperparathyroidism, 12 had hypertension, 9 peripheral arterial disease, 8 obesity and 8 diabetes mellitus. Raised calcium and phosphorus were noted in 8 patients, with hypoalbuminaemia in 9 patients. Treatment with sodium thiosulfate was given for 8 patients, and was beneficial for all after a mean duration of 3.4 months. After 6 months of follow-up, 8 of the 15 patients were cured, 1 showed improvement and 6 had died. To our knowledge, this is the first study to examine the incidence of calciphylaxis in the general population. The relatively large number of patients could be accounted for by the high number of comorbidities in end-stage renal disease patients in Martinique, including obesity, diabetes, hypertension and arteritis. Treatment with sodium thiosulfate was beneficial for 8 patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Amaurosis fugax: risk factors and prevalence of significant carotid stenosis

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Kvickström P

2016-10-01

Full Text Available Pia Kvickström,1 Bertil Lindblom,2,3 Göran Bergström,4,5 Madeleine Zetterberg2,3 1Department of Ophthalmology, Skaraborg Hospital, Skövde, 2Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, 3Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 4Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, 5Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden Purpose: The purpose of this study was to describe clinical characteristics and prevalence of carotid stenosis in patients with amaurosis fugax (AF.Method: Patients diagnosed with AF and subjected to carotid ultrasound in 2004–2010 in Sahlgrenska University Hospital, Gothenburg (n=302, were included, and data were retrospectively collected from medical records.Results: The prevalence of significant carotid stenosis was 18.9%, and 14.2% of the subjects were subjected to carotid endarterectomy. Significant associations with risk of having ≥70% stenosis were male sex (adjusted odds ratio [aOR]: 2.62; 95% confidence interval [CI]: 1.26–5.46, current smoking (aOR: 6.26; 95% CI: 2.62–14.93, diabetes (aOR: 3.68; 95% CI: 1.37–9.90 and previous vasculitis (aOR: 10.78; 95% CI: 1.36–85.5. A majority of the patients (81.4% was seen by an ophthalmologist prior to the first ultrasound. Only 1.7% of the patients exhibited retinal artery emboli at examination.Conclusion: The prevalence of carotid stenosis among patients with AF is higher than has previously been demonstrated in stroke patients. An association with previously reported vascular risk factors and with vasculitis is seen in this patient group. Ocular findings are scarce. Keywords: amaurosis fugax, carotid stenosis, carotid ultrasound, giant cell arteritis, transient ischemic attack, transient monocular visual loss

Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy

International Nuclear Information System (INIS)

Yilmaz, E.; Akkoclu, A.; Degirmenci, B.; Cooper, R.A.; Sengun, B.; Gulcu, A.; Osma, E.; Ucan, E.S.

2005-01-01

AIM: The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung. METHODS: In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 deg ; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1 s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy. RESULTS: Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695). CONCLUSION: Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities

Effects of neck radiation therapy on extra-cranial carotid arteries atherosclerosis disease prevalence: systematic review and a meta-analysis.

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Khalid Bashar

Full Text Available Radiation arteritis following neck irradiation as a treatment for head and neck malignancy has been well documented. The long-term sequelae of radiation exposure of the carotid arteries may take years to manifest clinically, and extra-cranial carotid artery (ECCA stenosis is a well-recognised vascular complication. These carotid lesions should not be regarded as benign and should be treated in the same manner as standard carotid stenosis. Previous studies have noted increased cerebrovascular events such as stroke in this cohort of patients because of high-grade symptomatic carotid stenosis resulting in emboli.To evaluate the effect of radiation therapy on ECCA atherosclerosis progression.Online search for case-control studies and randomised clinical trials that reported on stenosis in extra-cranial carotid arteries in patients with neck malignancies who received radiation therapy (RT comparing them to patients with neck malignancies who did not receive RT.Eight studies were included in the final analysis with total of 1070 patients - 596 received RT compared to 474 in the control group. There was statistically significant difference in overall stenosis rate (Pooled risk ratio  =  4.38 [2.98, 6.45], P  =  0.00001 and severe stenosis (Pooled risk ratio  =  7.51 [2.78, 20.32], P <0.0001, both being higher in the RT group. Pooled analysis of the five studies that reported on mild stenosis also showed significant difference (Pooled risk ratio  =  2.74 [1.75, 4.30], 95% CI, P  =  0.0001.The incidence of severe ECCA stenosis is higher among patients who received RT for neck malignancies. Those patients should be closely monitored and screening programs should be considered in all patients who receive neck RT.

Asymmetric severity of diabetic retinopathy in Waardenburg syndrome: response to authors

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Gupta A

2012-03-01

Full Text Available Aditi Gupta, Rajiv Raman, Tarun SharmaShri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, IndiaWe read with great interest the recent article by Kashima et al,1 in which the authors report a case of asymmetric severity of diabetic retinopathy in Waardenburg syndrome. We want to highlight some concerns regarding this report. Previous reports have described many systemic and local factors associated with the development of asymmetric diabetic retinopathy.2,3 These include myopia ≥5 D, anisometropia >1 D, amblyopia, unilateral elevated intraocular pressure, complete posterior vitreous detachment, unilateral carotid artery stenosis, ocular ischemic syndrome, and chorioretinal scarring.2,3 In any suspected case of asymmetric diabetic retinopathy, it is prudent to rule out the abovementioned factors first. In the present case, although the authors clearly mention the absence of internal carotid and ophthalmic artery obstruction on magnetic resonance angiography, it would have been more informative if the authors had also provided the refractive error, intraocular pressure, and posterior vitreous detachment status of both the eyes.Likewise, it would have been useful to note the arm-retina time and retinal arteriovenous filling time in both the eyes on fundus fluorescein angiography, which is usually used to diagnose ocular ischemic syndrome by monitoring extension of the retinal circulation time, including time of blood circulation from the arm to the retina and the retinal arteriovenous filling time.4,5 The mere absence of internal carotid obstruction on magnetic resonance angiography cannot rule out the presence of ocular ischemic syndrome because, rarely, ocular ischemic syndrome can also occur secondary to other causes, such as arteritis.6,7 Comparing the arm-retina time and retinal arteriovenous filling time on fundus fluorescein angiography in both the eyes would be more helpful to rule out ocular

Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

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Bae, Tae Yeong; Park, Jae Hyung; Kim, Seung Hyup; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

1987-06-15

This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed.

Evaluation of C-reactive protein as a clinical biomarker in naturally heartworm-infected dogs: a field study.

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Venco, Luigi; Bertazzolo, Walter; Giordano, Guglielmo; Paltrinieri, Saverio

2014-11-15

Canine heartworm disease caused by Dirofilaria immitis is considered a pulmonary disease, which leads to pulmonary hypertension, and in the late stage, may induce right cardiac insufficiency. Adult worms are localized in the pulmonary arteries, which undergo endothelial damage (proliferative endoarteritis), the severity of which depends on the duration of infection and the worm burden. C-reactive protein (CRP) is a major canine acute-phase protein that rapidly increases in a wide range of inflammatory conditions and rapidly decreases when inflammation resolves. CRP is therefore considered a sensitive but nonspecific marker of inflammation. Pulmonary arterial damage in canine heartworm may induce an increase in CRP concentrations similar to what occurs in humans with endoarteritis. The aim of the present study was to investigate whether CRP may be a diagnostic and/or prognostic marker in canine heartworm, whether it may be used for staging and monitoring canine heartworm, and whether its concentration depends on worm burden or on pulmonary arterial damage. Serum CRP concentrations were determined in 57 dogs with heartworm disease, 47 of which were grouped according to parasite burden (low: n=11; high: n=10) or on severity of pulmonary hypertension (mild: n=16; severe: n=10). An additional 23 heartworm-free cardiopathic dogs were grouped on the absence of pulmonary hypertension (n=8), presence of dilated cardiomyopathy (DCM) (n=6), or presence of cardiomyopathy and pulmonary hypertension (n=3) due to previous heartworm disease that had been treated (n=6). Twenty control dogs also were sampled for CRP concentrations. Results show that CRP was significantly increased (pcardiomyopathy compared with concentrations in controls. In the heartworm group, CRP was significantly increased (p29.8 mg/L). In conclusion, CRP can be used as a marker of endothelial arteritis and pulmonary hypertension in dogs with heartworm. Copyright © 2014 Elsevier B.V. All rights reserved.

Experimental induction of malignant catarrhal fever in pigs with ovine herpesvirus 2 by intranasal nebulization.

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Li, Hong; Brooking, Angela; Cunha, Cristina W; Highland, Margaret A; O'Toole, Donal; Knowles, Donald P; Taus, Naomi S

2012-10-12

Malignant catarrhal fever (MCF), a frequently fatal herpesviral disease primarily of ruminant species, has been sporadically reported in pigs. All cases of naturally occurring porcine MCF reported to date have been linked to ovine herpesvirus 2 (OvHV-2), a gammaherpesvirus in the genus Macavirus carried by sheep. Experimental induction of MCF by aerosolization of the virus in nasal secretions collected from infected sheep has been successful in bison, cattle and rabbits. The goals of this study were to determine the susceptibility of pigs to MCF following experimental intranasal inoculation of OvHV-2, and to characterize the disease. Twelve pigs in four groups were nebulized with 10(5), 10(6), 10(7), or 10(8) DNA copies of OvHV-2 from sheep nasal secretions. Three control pigs were nebulized with nasal secretions from uninfected sheep. Three additional pigs were inoculated intravenously with 10(7) DNA copies of OvHV-2 to evaluate this route of infection with cell-free virus. Seven of twelve intranasally challenged pigs became infected with OvHV-2. Five of these seven, all in higher dose groups, developed MCF. Lesions resembled those reported in natural cases of porcine MCF. The most striking and consistent histological lesions were in trachea, lung, kidney and brain. These comprised mucopurulent tracheitis, interstitial pneumonia, necrotizing arteritis-periarteritis, and nonpurulent meningoencephalitis. No infection was established in the intravenously challenged or control groups. The study showed that MCF can be experimentally induced in pigs by aerosol challenge using sheep nasal secretions containing OvHV-2. Domestic pigs are a natural clinically susceptible host for sheep-associated MCF. They represent a useful, cost-effective model for MCF research. Published by Elsevier B.V.

Intracranial arterial wall enhancement using gadolinium-enhanced 3D black-blood T1-weighted imaging

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Takano, Koichi; Hida, Kosuke; Kuwabara, Yasuo; Yoshimitsu, Kengo

2017-01-01

Purpose: We investigated the enhancement of the intracranial arterial walls with gadolinium-enhanced, black-blood three-dimensional T1-weighted imaging (Gd-3DBB) by using an improved motion-sensitized driven-equilibrium (iMSDE)—prepared volumetric isotropic turbo spin-echo acquisition (VISTA). Methods: A total of 115 patients underwent FLAIR, 3D-TOF-MRA and Gd-3DBB with a 1.5-T scanner. The degree and distribution of the arterial wall enhancement on Gd-3DBB was assessed. The association of the degree of wall enhancement with brain infarction/ischemic lesions on FLAIR, luminal changes on 3D-TOF-MRA, and cardiovascular risk factors (CVRFs) was investigated by univariate and multiple logistic regression analyses. Results: Strong enhancement of the arterial walls was observed in 77 vertebral arteries (33.5%), 4 basilar arteries (3.5%), 31 supraclinoid internal carotid arteries (ICAs) (13.5%) and 8 middle cerebral arteries (3.5%). In addition, 221 intrapetrous ICAs (96.1%) showed strong enhancement. After adjusting for confounding factors, multivariate analyses showed that the patient age was independently associated with the strong wall enhancement of the arteries for both the posterior (OR, 1.088; 95% CI, 1.034–1.146) and the anterior circulation (OR, 1.098, 95% CI 1.029–1.172). In addition, the presence of the supratentorial brain infarctions was independently associated with the strong wall enhancement in the anterior circulation excluding the intrapetrous ICAs (OR, 4.097; 95% CI, 1.483–11.319). Conclusions: Although the arterial wall enhancement on the Gd-3DBB probably reflects normal aging, the enhancement in the anterior circulation might be related to brain infarctions. On the other hand, the intrapetrous ICA enhancement is considered a nonspecific finding and should not be mistaken for arterial pathologies such as atherosclerosis or arteritis.

The primary vascular dysregulation syndrome: implications for eye diseases

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2013-01-01

Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide

Serosurveillance of infectious agents in equines of the Central Valley of Costa Rica.

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Jiménez, D; Romero-Zuñiga, J J; Dolz, G

2014-01-01

Blood samples from 181 equines from the Central Valley of Costa Rica were collected in the year 2012 to determine the presence of antibodies against selected infectious agents in horses and to determine the risk factors associated with these agents. The presence of antibodies against Equine Infectious Anemia Virus (EIAV), Equine Herpes Virus 1 and 4 (EHV-1 and EHV-4), West Nile Virus (WNV), Influenza A Virus (IAV), Equine Viral Arteritis Virus (EVAV), Babesia caballi, Theileria equi, Neospora caninum and Chlamydia abortus was determined using commercial assays, and risk factors associated with seropositivity to the different infectious agents was established. The most seroprevalent agent detected was EHV-4 (96.7%), followed by WNV (44.2%), and IAV (41.8%). Horses >3 years, used for work or sports, and with access to pastures, had significantly increased probability to be seropositive to WNV, whereas horses used for breeding and recreational purposes, being stabled, and without access to pastures, had significantly greater probability to be seropositive to IAV. Seroprevalence to B. caballi (19.9%) was lower than to T. equi (38.1%). For B. caballi, access to pastures was determined as a risk factor, whereas being older than 3 years was established as a risk factor for T. equi. Low seroprevalences were determined for EHV-1 (5.0%), EVAV (5.0%), C. abortus (4.8%), and N. caninum (4.4%). Mares having history of abortion were more likely to be seropositive to EHV-1, whereas horses >3 years, used for work and sports, and mares having multiple parturitions, were more likely to be seropositive to N. caninum. None of the horses were seropositive to EIAV. Earlier, only diseases caused by EIAV, WNV and piroplasmosis were reported in Costa Rica. The present study however, determined the presence of carriers for EHV-1, EHV-4, and EIAV.

Serosurveillance of infectious agents in equines of the Central Valley of Costa Rica

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D. Jiménez

2014-11-01

Full Text Available Blood samples from 181 equines from the Central Valley of Costa Rica were collected in the year 2012 to determine the presence of antibodies against selected infectious agents in horses and to determine the risk factors associated with these agents. The presence of antibodies against Equine Infectious Anemia Virus (EIAV, Equine Herpes Virus 1 and 4 (EHV-1 and EHV-4, West Nile Virus (WNV, Influenza A Virus (IAV, Equine Viral Arteritis Virus (EVAV, Babesia caballi, Theileria equi, Neospora caninum and Chlamydia abortus was determined using commercial assays, and risk factors associated with seropositivity to the different infectious agents was established. The most seroprevalent agent detected was EHV-4 (96.7%, followed by WNV (44.2%, and IAV (41.8%. Horses >3 years, used for work or sports, and with access to pastures, had significantly increased probability to be seropositive to WNV, whereas horses used for breeding and recreational purposes, being stabled, and without access to pastures, had significantly greater probability to be seropositive to IAV. Seroprevalence to B. caballi (19.9% was lower than to T. equi (38.1%. For B. caballi, access to pastures was determined as a risk factor, whereas being older than 3 years was established as a risk factor for T. equi. Low seroprevalences were determined for EHV-1 (5.0%, EVAV (5.0%, C. abortus (4.8%, and N. caninum (4.4%. Mares having history of abortion were more likely to be seropositive to EHV-1, whereas horses >3 years, used for work and sports, and mares having multiple parturitions, were more likely to be seropositive to N. caninum. None of the horses were seropositive to EIAV. Earlier, only diseases caused by EIAV, WNV and piroplasmosis were reported in Costa Rica. The present study however, determined the presence of carriers for EHV-1, EHV-4, and EIAV.

Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients

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Lee, Michael S; Grossman, Daniel; Arnold, Anthony C.; Sloan, Frank A

2011-01-01

Objective Previous studies have identified a higher prevalence of diabetes mellitus (DM) among patient cohorts with non-arteritic anterior ischemic optic neuropathy (NAION). We sought to determine the development of incident NAION among a group of newly diagnosed patients with DM and to estimate the incidence of NAION among the elderly. Design Medicare 5% database study. Participants 25,515 patients with DM and an equal number of age- and gender-matched non-diabetics. Methods Query of Medicare 5% claims files identified patients with new diagnosis of DM in 1994. A randomly selected control group was created using one-to-one propensity score matching. Patients with a diagnosis of giant cell arteritis, pre-existing DM, and age 95 years were excluded. Patients with DM and controls were followed for the development of NAION over the following 4,745 days. Main Outcome Measures Incidence of anterior ischemic optic neuropathy (AION) among patients with and without DM. Results Each group was 85% White, 11% Black, and 4% other race, aged 76.4 years, and 40% male with a mean followup time of 7.6 years. In the diabetes group, 188 individuals developed AION (0.7%) compared to 131 individuals (0.5%; p<0.01) in the control group. In unadjusted Cox regression analysis, having diabetes mellitus was associated with a 43% increased risk (Hazard ratio [HR]: 1.431; 95% confidence interval [CI]: 1.145,1.789) of developing AION. After adjusting for other covariates, the risk of developing AION among individuals with DM was reduced to 40% (HR: 1.397; 95% CI: 1.115,1.750). Male gender increased an individual's risk of developing AION by 32% (HR: 1.319; 95% CI: 1.052,1.654). No other covariate was statistically significantly associated with developing AION. The annual incidence of NAION was 82 per 100,000. Conclusions DM significantly increased the risk of the diagnosis NAION. The incidence of NAION among patients older than 67 years may be higher than previously reported. PMID:21439645

The pathogenesis of single experimental infections with Strongylus vulgaris in foals.

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Duncan, J L; Pirie, H M

1975-01-01

The clinical signs, pathology and clinical pathology associated with single experimental infections of Strongylus vulgaris in worm-free pony foals are described. The major clinical signs which became apparent in the infected foals during the first three weeks were pyrexia, anorexia, dullness and abdominal pain. Within the first two weeks of infection lesions were confined to the intestine and terminal branches of the intestinal arteries and consisted of mucosal, submucosal and serosal haemorrhage together with arteritis of submucosal and serosal arteries and also a marked inflammatory reaction. The main lesion seen three weeks after infection was gross thrombosis of the anterior mesenteric artery or one of its major branches. On section these affected arteries showed marked intimal thickening with infiltration of plasma cells, lymphocytes, macrophages and neutrophils. Between one and four months after infection the gross lesions were predominantly in the arteries and consisted of fibrous thickening of the arterial wall and thrombosis associated with the presence of developing fourth stage larvae. Four months after infection the arterial lesions were still prominent and microscopically there was fibrosis of the wall of the affected artery with wide-spread disruption of the intima. In the adventitia organised thrombi were apparent in the vasa vasorum and resulted in the obliteration of their lumina. The typical lesion associated with the return of fifth stage larvae to the intestine was nodule formation in close proximity to thrombosed terminal intestinal arteries and sections of parasites were seen in the intestinal wall surrounded by neutrophils and necrotic debris. By nine months after infection the arterial lesion had healed, but histologically there was fibrosis of the intima and macrophages containing haemosiderin were seen in the arterial wall. The most significant haematological findings during the experimental period were a marked polymorphonuclear

Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial.

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Hofmeijer, Jeannette; Kappelle, L Jaap; Algra, Ale; Amelink, G Johan; van Gijn, Jan; van der Worp, H Bart

2009-04-01

Patients with space-occupying hemispheric infarctions have a poor prognosis, with case fatality rates of up to 80%. In a pooled analysis of randomised trials, surgical decompression within 48 h of stroke onset reduced case fatality and improved functional outcome; however, the effect of surgery after longer intervals is unknown. The aim of HAMLET was to assess the effect of decompressive surgery within 4 days of the onset of symptoms in patients with space-occupying hemispheric infarction. Patients with space-occupying hemispheric infarction were randomly assigned within 4 days of stroke onset to surgical decompression or best medical treatment. The primary outcome measure was the modified Rankin scale (mRS) score at 1 year, which was dichotomised between good (0-3) and poor (4-6) outcome. Other outcome measures were the dichotomy of mRS score between 4 and 5, case fatality, quality of life, and symptoms of depression. Analysis was by intention to treat. This trial is registered, ISRCTN94237756. Between November, 2002, and October, 2007, 64 patients were included; 32 were randomly assigned to surgical decompression and 32 to best medical treatment. Surgical decompression had no effect on the primary outcome measure (absolute risk reduction [ARR] 0%, 95% CI -21 to 21) but did reduce case fatality (ARR 38%, 15 to 60). In a meta-analysis of patients in DECIMAL (DEcompressive Craniectomy In MALignant middle cerebral artery infarction), DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY), and HAMLET who were randomised within 48 h of stroke onset, surgical decompression reduced poor outcome (ARR 16%, -0.1 to 33) and case fatality (ARR 50%, 34 to 66). Surgical decompression reduces case fatality and poor outcome in patients with space-occupying infarctions who are treated within 48 h of stroke onset. There is no evidence that this operation improves functional outcome when it is delayed for up to 96 h after stroke onset

[Cardiac involvement in Churg-Strauss syndrome].

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Brucato, Antonio; Maestroni, Silvia; Masciocco, Gabriella; Ammirati, Enrico; Bonacina, Edgardo; Pedrotti, Patrizia

2015-09-01

Churg-Strauss syndrome, recently renamed eosinophilic granulomatosis with polyangiitis (EGPA), is a rare form of systemic vasculitis, characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring among patients with asthma and tissue eosinophilia. EGPA is classified as a small and medium-sized vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) and the hypereosinophilic syndrome. Typical clinical features include asthma, sinusitis, transient pulmonary infiltrates and neuropathy. Blood eosinophils are often >1500/µl or more than 10% on the differential leukocyte count. Blood eosinophils should always be tested in unexplained cardiac disorders, and may normalize even after low doses of corticosteroids. ANCA are positive in 40-60% of cases, mainly anti-myeloperoxidase. Heart involvement occurs in approximately 15-60% of EGPA patients, especially those who are ANCA negative. Any cardiac structure can be involved, and patients present with myocarditis, heart failure, pericarditis, arrhythmia, coronary arteritis, valvulopathy, intracavitary cardiac thrombosis. Although cardiovascular involvement is usually an early manifestation, it can also occur later in the course of the disease. A significant proportion of patients with cardiac involvement is asymptomatic. In the absence of symptoms and major ECG abnormalities, cardiac involvement may be detected in nearly 40% of the patients. All patients with EGPA should be studied not only with a detailed history of cardiac symptoms and ECG, but also with echocardiography; if abnormalities are detected, a cardiac magnetic resonance study should be performed. Coronary angiography and endomyocardial biopsy should be reserved to selected cases. Heart involvement carries a poor prognosis and causes 50% of the deaths of these patients. It is often insidious and underestimated. Optimal therapy is therefore important and based on high-dose corticosteroids plus immunosuppressive

[What's new in internal medecine?

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Jachiet, M; Rybojad, M; Bouaziz, J-D

2016-12-01

Answering the question « what's new in internal medecine in 2016? » is very challenging. We used 3 methods of article selection to reduce the selection bias: 3 authors, a systematic review of the articles discussed in the weekly bibliographic meeting of our unit (Dermatology department, Saint-Louis Hospital, Paris, France) and a selection of the best articles by several internal medecine practitioners in Paris. Eleven « hot topics » were analyzed: i/lowering cholesterol level but not blood blessure has a significant impact on cardiovascular morbi-mortality in cardiovascular intermediate risk patients; ii/the « treat to treat target » is efficient in psoriatic arthritis; iii/ a genotype/ phenotype correlation favors the separation of ileal Crohn's disease, colonic Crohn's disease and ulcerative colitis; iv/ tocilizumab treatment (anti-IL-6 monoclonal antibody ) is very efficient in giant cell arteritis and slightly efficient in systemic sclerosis; v/ combination therapy using methotrexate plus steroids compared with steroids alone becomes the « gold standard » treatment for juvenile dermatomyositis; vi/ dupilumab treatment (antibody blocking IL-4 and IL-13 receptors) is not only efficient in atopic dermatitis but also in asthma; vii/ think of eosinophilic oesophagitis in a patient with atopic dermatitis and dypshagia or food impaction; viii/ genetic A2 protein dysfunction induces NF-kB hyperactivation and an autoinflammatory disorder with features similar to Behcet's disease; ix/ no new biotherapies have shown high efficacy in systemic lupus erythematosus; x/ nanoparticles loaded with autoantigens induce Tregs and Bregs and may be a promising therapeutic option to treat auto-immune disease in the future; xi/ ipilimumab treatment (anti-CTLA4 antibody, immune checkpoint inhibitor) may induce complete remission in acute myeloid leukemia patients relapsing after haematological stem cell transplantation. Year 2016 is full of great discoveries in internal medicine

[VASCULITIDES IN CHILDHOOD: A RETROSPECTIVE STUDY IN A PERIOD FROM 2002 TO 2012 AT THE DEPARTMENT OF PAEDIATRICS, UNIVERSITY HOSPITAL CENTRE ZAGREB].

Science.gov (United States)

Jelusić, Marija; Kostić, Lucija; Frković, Marijan; Davidović, Masa; Malcić, Ivan

2015-01-01

The aim of our study was to analyze clinical features, laboratory findings, treatment, course and outcome of different types of vasculitis in children. All children aged up to 18 years that have been diagnosed with a vasculitis disorder from 2002. to 2012. at the Department of Paediatric, University Hospital Centre Zagreb according to EULAR/PRES/PRINTO criteria were included in the study. Vasculitis was diagnosed in 180 children, 101 girls and 79 boys, mean age 7.19 ± 3.7 years, with an average follow-up of 5.58 ± 3.28 years. Most of the children (155 or 86%) were diagnosed with Henoch-Shönlein purpura (HSP), polyarteritis nodosa (PAN) was diagnosed in 6 children (3.3%), isolated cutaneous leukocytoclastic vasculitis in 5 (2.8%), Takayasu arteritis (TA) and Kawasaki disease in 2 (1.1%) respectively, hypocomplementemic urticarial vasculitis in one patient (0.5%) and other types of vasculitis in 10 (5.5%) patients (vasculitides in systemic connective tissue disorders in 7 and unclassified vasculitides in 3 patients). All patients had elevated inflammatory markers (C-reactive protein and erythrocyte sedimentation rate). Anti-neutrophil cytoplasmatic antibodies (ANCA) were positive only in one patient, suffering from microscopic polyangiitis. Treatment modality in most patients were NSAIDs, while children with kidney or gastrointestinal system affection were treated with glucocorticoids and/or immunosuppresive drugs. Biological therapy (anti-CD20, rituximab) was used in patients with most severe symptoms. One child (0.56%), suffering from microscopic polyangiitis, died due to kidney failure during the follow-up. Forty patients (22.6%) had one disease relapse, while 6 (3.4%) had two relapses. In conclusion, we found some differences in laboratory parameters (e.g. lower incidence of elevated antistreptolysin O titer in HSP) and epidemiological data (e.g. higher prevalence of PAN in female children) in comparison to data from available studies, while other clinical

Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

International Nuclear Information System (INIS)

Suga, K.; Yasuhiko, K.; Iwanaga, H.; Tokuda, O.; Matsunaga, N.

2009-01-01

Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is