WorldWideScience

Sample records for called leukocytoclastic vasculitis

  1. Imipenem-cilastatin-induced leukocytoclastic vasculitis.

    Science.gov (United States)

    Reiner, M R; Brunetti, V A

    1997-05-01

    A maculopapular rash has been associated with the administration of imipenem-cilastatin, an antibiotic that was used for treatment of a postoperative infection. This is a first-time association of imipenem with a leukocytoclastic vasculitic reaction. Leukocytoclastic vasculitis has been previously documented with ciprofloxacin, zidovudine, piperazine, and lithium. PMID:9158321

  2. Ulcerative colitis Presenting as leukocytoclastic vasculitis of skin

    Institute of Scientific and Technical Information of China (English)

    Sabiye Akbulut; Ersan Ozaslan; Firdevs Topal; Levent Albayrak; Burcak Kayhan; Cumali Efe

    2008-01-01

    A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD),including pyoderma gangrenosum, erythema nodosum,perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

  3. A case of leukocytoclastic vasculitis with membranoproliferative glomerulonephritis

    Directory of Open Access Journals (Sweden)

    Akgün C et al.

    2013-09-01

    Full Text Available Henoch-Schonlein purpura is the most common vasculitis in childhood with the pathogenesis of immunoglobulin A deposition in small-vessel wall. As the end-organ vasculature involved, this disease is characterized by palpable purpura, abdominal pain, arthritis, and renal disease. Renal involvement may present with isolated haematuria and/or proteinuria from mild to severe as nephrotic levels. Membranoproliferative glomerulonephritis is the most common cause of chronic glomerulonephritis in older children and young adults and also one of the major causes of nephrotic syndrome. In this case, we reported the concurrent of leukocytoclastic vasculitis with membranoproliferative glomerulonephritis.

  4. Severe leukocytoclastic vasculitis secondary to the use of a naproxen and requiring amputation: a case report

    Directory of Open Access Journals (Sweden)

    Martin Jeanine

    2010-07-01

    Full Text Available Abstract Introduction Leukocytoclastic vasculitis (also known as hypersensitivity vasculitis and cutaneous necrotizing vasculitis can present with various manifestations, which often delays the diagnosis and treatment. In order to show the importance of the early recognition of leukocytoclastic vasculitis, we present a case which occurred secondary to the use of a common pharmaceutical, naproxen. We were unable to find a case of leukocytoclastic vasculitis secondary to naproxen in the literature. Case presentation We present the case of a 33-year-old African American woman with below the knee and bilateral digital gangrene from hypersensitivity vasculitis secondary to the non-steroidal anti-inflammatory medication naproxen. Conclusion This is an original case report focusing on the rheumatologic management of leukocytoclastic vasculitis. However, other specialties, such as internal medicine, dermatology, infectious disease, general surgery and pathology, can gain valuable information by reviewing this case report. Reporting a case of leukocytoclastic vasculitis secondary to treatment with naproxen will advance our understanding of this disease etiology by adding yet another non-steroidal anti-inflammatory drug to the list of potential causes of leukocytoclastic vasculitis.

  5. Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Senol Kobak

    2014-01-01

    Full Text Available A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later.

  6. Etiologies and prognostic factors of leukocytoclastic vasculitis with skin involvement

    Science.gov (United States)

    Bouiller, Kévin; Audia, Sylvain; Devilliers, Hervé; Collet, Evelyne; Aubriot, Marie Hélène; Leguy-Seguin, Vanessa; Berthier, Sabine; Bonniaud, Philippe; Chavanet, Pascal; Besancenot, Jean-François; Vabres, Pierre; Martin, Laurent; Samson, Maxime; Bonnotte, Bernard

    2016-01-01

    Abstract In this study, outcomes of patients with leukocytoclastic vasculitis (LCV) were analyzed focusing on clinical, histopathology and laboratory findings, relapses, and survival. Data from patients with cutaneous vasculitis diagnosed between January 1, 2000, and December 31, 2010, at Dijon University Hospital (France) were retrospectively reviewed. LCV was defined as perivascular neutrophilic infiltrate, endothelial cell nuclear swelling, extravasation of red blood cells, and/or fibrin deposition in vessels. Patients were classified according to the 2012 Chapel Hill Consensus Conference. Relapses were defined as the recurrence of vasculitis symptoms after a period of remission >1 month. Time to relapse and/or death was calculated from the date of diagnosis. Univariate and multivariate (Cox model) analyses were performed. A total of 112 patients (57 males and 55 females), with a mean age of 60 ± 19 (18–98) years, were analyzed. Overall follow-up was 61 ± 38 months. At diagnosis, all patients had skin lesions, purpura being the most common (n = 83). Lesions were associated with systemic involvement in 55 (51%) patients. Only 41 (36.6%) patients received specific treatment: glucocorticoids in 29 of 41 (70.7%) and immunosuppressants in 9 of 41 (22%). Sixty-two patients (55%) had LCV due to underlying causes, 29 (25.9%) had single-organ cutaneous small vessel vasculitis (SoCSVV), and 21 (18.8%) had unclassifiable LCV. Twenty patients of the cohort (18%) experienced relapse, 14 ± 13 (1–40) months after the diagnosis of LCV. None of the 29 patients with SoCSVV relapsed. Independent risk factors for relapse were vascular thrombosis in the biopsy [hazard ratio (HR) = 4.9; P = 0.017], peripheral neuropathy (HR = 9.8; P = 0.001), hepatitis (HR = 3.1; P = 0.004), and positive antineutrophil cytoplasm antibodies (ANCA, HR = 5.9 P = 0.005). In contrast, SoCSVV was a protective factor for relapse (HR = 0.12; P = 0.043). The 1-, 3-, and 6-year overall

  7. Leukocytoclastic vasculitis: A window to systemic Churg Strauss syndrome

    Directory of Open Access Journals (Sweden)

    Sudhir V Medhekar

    2012-01-01

    Full Text Available A twenty year old male presented with purpuric lesions with chronic painful ulcers over the lower extremities and a recurrent pruritic rash on the trunk for 10 years. He was diagnosed as idiopathic leukocytoclastic vasculitis (LCV after investigations failed to reveal a systemic association. He was treated with immunosuppressants at each visit with partial remission. In 2004, he was diagnosed with bronchial asthma and allergic rhinitis. In his recent admission, he showed necrotic ulcers on legs and extensive shiny, truncal micropapules. Examination revealed maxillary sinus tenderness and loss of sensation on the medial aspect of the left lower limb. Biopsy of ulcer and the micropapules showed the presence of extravascular eosinophils, while hematological investigations showed peripheral eosinophilia of 18%, raised serum Immunoglobulin E (IgE, Anti nuclear antibody (ANA positivity and negative antineutrophil cytoplasmic antibody (ANCA. Radiography confirmed maxillary sinusitis, nerve conduction studies revealed mononeuritis of the anterior tibial nerve and pulmonary function tests (PFT were normal. Clinical examination and investigations pointed towards the diagnosis of Churg-Strauss syndrome (CSS. This report highlights the development of full-blown CSS over a period of 12 years in a patient initially diagnosed as idiopathic LCV, emphasizing the need for regular follow-up of resistant and recurrent cases of LCV.

  8. Radiocontrast-Related Leukocytoclastic Vasculitis Misdiagnosed as Diabetic Foot Ulcer in a Type 2 Diabetic Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Barış Sarıakçalı

    2013-09-01

    Full Text Available The skin is the most affected tissue by many vasculitis syndromes. Leukocytoclastic vasculitis is the most common type of vasculitis syndrome and involves the small vessels. A long list of causative factors has been reported for leukocytoclastic vasculitis. Here, we present a type 2 diabetic patient who had purpuric skin lesions predominantly on the lower limbs and acute renal failure overriding to underlying chronic kidney disease due to leukocytoclastic vasculitis associated with radiocontrast administration. He was initially diagnosed as having diabetic foot ulcer at our outpatient clinic. After single dose betamethasone depot (9.6 mg i.m., skin eruptions paled and improved; renal function showed an improvement on the following days. There are few case reports on the relationship of radiocontrast agent with leucocytoclastic vasculitis. Our case had leukocytoclastic vasculitis due to radiocontrast agent exposure which is very rare in the literature. Turk Jem 2013; 17: 78-80

  9. Leukocytoclastic vasculitis and polyarthralgia in scrub typhus: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Arinaganahalli Subbanna Praveen Kumar

    2013-10-01

    Full Text Available Scrub typhus is an acute, febrile zoonosis caused by an obligate intracellular bacterium Orientia tsutsugamushi. It is of greatest public health importance in tropical rural Asia. The clinical manifestations of the disease range from sub-clinical to fatal organ failure. The common symptoms are fever, chills, headache, myalgia, dry cough, lymphadenopathy and gastrointestinal disturbances. The first presentation with cutaneous vasculitis and polyarthralgia is rare and unusual. We report a case of scrub typhus that presented with cutaneous vasculitis and polyarthralgia, which is very unusual and patient recovered with doxycycline treatment.

  10. Leukocytoclastic Vasculitis as a Complication of Recombinant Granulocyte Colony-Stimulating Factor Therapy in a Heart Transplant Patient

    Directory of Open Access Journals (Sweden)

    Giovanbattista Ippoliti

    2014-01-01

    Full Text Available Recombinant granulocyte colony-stimulating factor (rG-CSF is a myeloid growth factor that is widely used in haematology to recover neutropenia secondary to myelosuppressive chemotherapy. Leukocytoclastic vasculitis is an acknowledged side effect of the above therapy. Its pathogenesis involves many mechanisms that collectively induce an increase in neutrophil function and a subsequent release of cytokines. Here, we report a case of leukocytoclastic vasculitis proven by skin biopsy, following the use of rG-CSF in a heart transplant patient with leukopenia secondary to immunosuppressive therapy.

  11. [Digoxin-related leukocytoclastic vasculitis in a very elderly woman: A case report].

    Science.gov (United States)

    Ludwig-Béal, S; Vernier, N; Popitean, L; Levêque, L; Combret, S; Manckoundia, P

    2016-05-01

    Even though digoxin causes many side effects, few cases of skin involvement are recorded in the French Pharmacovigilance Database. We report a case of leukocytoclastic vasculitis (LV) very probably due to digoxin. A 91-year-old woman, hospitalized following a fall, presented cardiac decompensation in a context of rapid atrial fibrillation requiring treatment with digoxin. Eight days later, a rash appeared on her back and trunk. It was neither itchy, nor painful and persisted despite local treatment. There were no other clinical anomalies. After a few days, the rash spread with appearance of bullous lesions, ulcerations and a necrosis on lymphedema of the two legs. Among the complementary examinations, skin biopsy revealed LV with necrosis and subepidermal detachment suggested toxic dermal necrolysis, while direct immunofluorescence was negative. The rash resolved progressively once the digoxin was stopped. The pharmacovigilance department recorded that digoxin was the probable cause. The evidence allowed us to conclude that digoxin was the cause. PMID:26970812

  12. Successful rechallenge with reduced dose of erlotinib in a patient with lung adenocarcinoma who developed erlotinib-associated leukocytoclastic vasculitis: A case report

    OpenAIRE

    SU, BO-AN; SHEN, WAN-LIN; CHANG, SHENG-TSUNG; FENG, LI-YIA; Wu, Chia-Jung; Feng, Yin-Hsun

    2012-01-01

    The oral tyrosine kinase inhibitors of epidermal growth factor, erlotinib and gefitinib, are active in the treatment of non-small cell lung cancer (NSCLC). However, a number of skin manifestations have been found in patients receiving erlotinib therapy. Leukocytoclastic vasculitis is a rare side-effect of erlotinib therapy. However, whether or not erlotinib treatment should be continued when disseminated ulceration of leukocytoclastic vasculitis is encountered remains to be determined. In thi...

  13. Influenza vaccination induced leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis.

    Science.gov (United States)

    Yanai-Berar, N; Ben-Itzhak, O; Gree, J; Nakhoul, F

    2002-09-01

    Influenza vaccination is a widely accepted practice, particularly among the elderly and high-risk individuals. Minor and transitory side effects following the vaccination are common, while systemic complications are infrequently reported. We describe here a case of a patient who presented to the emergency room with arthralgia, myalgias and purpura, following influenza vaccination. Necrotizing vasculitis associated with pauci-immune glomerulonephritis was observed on kidney biopsy. With increasing use of influenza vaccination, attention should be drawn to the possible expression of systemic adverse effects such as vasculitis and glomerulonephritis. PMID:12356192

  14. Brucellosis with p-ANCA-associated renal failure, leukocytoclastic vasculitis and endocarditis: Case report

    OpenAIRE

    Murat Turgay, Esin Ertuğrul, Orhan Küçükşahin, Ali Şahin

    2011-01-01

    The relationship between brucellosis and p-antinuclear cytoplasmic antibody (p-ANCA)-associated vasculitis (pAAV) is a rare condition. Herein, we report a 52-year-old man who was diagnosed as rapidly progressive glomerulonephritis (RPGN) and endocarditis due to brucellosis. He was treated with antimicrobial agents, steroids, plasmapheresis, renal replacement therapy and aortic valve replacement. According to our best of knowledge, no similar case has been reportedpreviously in the literature ...

  15. Brucellosis with p-ANCA-associated renal failure, leukocytoclastic vasculitis and endocarditis: Case report

    Directory of Open Access Journals (Sweden)

    Murat Turgay, Esin Ertuğrul, Orhan Küçükşahin, Ali Şahin

    2011-06-01

    Full Text Available The relationship between brucellosis and p-antinuclear cytoplasmic antibody (p-ANCA-associated vasculitis (pAAV is a rare condition. Herein, we report a 52-year-old man who was diagnosed as rapidly progressive glomerulonephritis (RPGN and endocarditis due to brucellosis. He was treated with antimicrobial agents, steroids, plasmapheresis, renal replacement therapy and aortic valve replacement. According to our best of knowledge, no similar case has been reportedpreviously in the literature in regard to p-ANCA anti-lactoferrin antibodies associated-glomerulonephritis with brucellosis and endocarditis. J Microbiol Infect Dis 2011;1(1:31-34.

  16. Urticarial Vasculitis

    Science.gov (United States)

    ... Store Home / Resources / Forms of Vasculitis / Urticarial Vasculitis Urticarial Vasculitis Urticarial vasculitis is a form of vasculitis that ... of complements; it’s called hypocomplementemic vasculitis. What causes Urticarial Vasculitis? The cause of most cases of urticarial vasculitis ...

  17. Leukocytoclastic vasculitis as early manifestation of Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly.

    Science.gov (United States)

    Zoroquiain, Pablo; González, Sergio; Molgó, Montserrat; Rodríguez, Alejandra; Valbuena, José R

    2012-05-01

    Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of cases reported are associated with hematolymphoid neoplasms. Histologically, most cases of ENV represent leukocytoclastic vasculitis (LCV). Here we report the clinicopahological features of a 68-year-old man with ENV associated to a Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, a newly recognized lymphoproliferative disorder, most likely representing a paraneoplastic manifestation. The patient was treated with standard chemotherapy regimen for malignant lymphoma. Due to the extensive involvement of the extremities by ENV, surgical debridement was not feasible and a novel therapy based on CHITOSAN apposits was initiated with overall good response and subsequent re-epithelization of the skin lesions. The patient died of sepsis secondary to a Pseudomona pneumonia 17 months after diagnosis. PMID:22197862

  18. Vasculite leucocitoclástica: mais uma "imitação" da sífilis Leukocytoclastic vasculitis: another condition that mimics syphilis

    Directory of Open Access Journals (Sweden)

    Fabricio Cecanho Furlan

    2010-10-01

    Full Text Available A sífilis, doença de importante morbiletalidade no passado, tem ressurgido nos últimos anos, graças, sobretudo, às alterações nos comportamentos de risco. Um grupo epidemiológico, frequentemente, acometido é a população com infecção pelo HIV: estes pacientes podem apresentar características peculiares nas manifestações e evolução da doença. Relatamos o caso de um paciente masculino, HIV-positivo, que desenvolveu um quadro florido de secundarismo: além da roséola sifilítica, apresentou pan-uveíte bilateral e acometimento do sistema nervoso central. A investigação, apresentou fenomeno pro-zona e no estudo histologico, mostrou a presenca de vasculite leucocitoclastica achado este extremamente raro e pouco documentado.Syphilis, a disease that in the past was associated with significant morbidity and lethality rates, has resurged in recent years principally as a consequence of changes in risk behavior. An epidemiological group that is commonly affected is the HIV-infected population. The characteristics of the disease and its progression may differ in these patients. The present report describes a case of an HIV-positive male patient, who developed florid secondary syphilis: in addition to syphilitic roseola, he also presented with bilateral panuveitis and involvement of the central nervous system. Investigation revealed the prozone phenomenon and histological examination of the skin lesions showed the presence of leukocytoclastic vasculitis. This finding is extremely rare and few cases have been documented.

  19. Retinite por citomegalovirus (CMV após terapia imunossupressora para vasculite leucocitoclástica Cytomegalovirus (CMV retinitis after immunossupressive therapy for leukocytoclastic vasculitis

    Directory of Open Access Journals (Sweden)

    Carlos Ewerton Maia Rodrigues

    2009-02-01

    Full Text Available A retinite por citomegalovírus (CMV é uma doença rara que acomete principalmente pacientes com a síndrome da imunodeficiência adquirida (AIDS. No entanto, outros pacientes imunossuprimidos, como os transplantados, os que estão em uso de quimioterápicos, pacientes com lúpus eritematoso sistêmico (LES ou em tratamento com drogas imunossupressoras também podem ser acometidos. O quadro clínico caracteriza-se por visão turva, diminuição da acuidade ou alterações de campo visual, geralmente unilateral, podendo ocorrer deslocamento de retina. A perda visual é progressiva, evolui em ritmo variável até a completa amaurose do olho acometido. O presente relato de caso descreve um paciente com vasculite leucocitoclástica grave submetido à terapia com corticoide em dose imunossupressora que evoluiu com glaucoma, panuveíte por CMV, perda da acuidade visual e infecção bacteriana secundária.Cytomegalovirus (CMV retinitis is a rare disease which mainly affects patients with acquired immunodeficiency syndrome (AIDS. Nevertheless, other immunosuppressed patients, such as the organ transplant recipients, the ones using chemotherapy, patients with systemic lupus erythematosus (SLE or in treatment with immunosuppressive drugs can also be attacked. The clinical characteristics are blurred vision, decrease of the visual acuity or visual field alterations, generally unilateral, with the possibility of retinal detachment. The visual loss is progressive, evolving in a variable rate until complete amaurosis of the attacked eye. The present case report describes a patient with severe leukocytoclastic vasculitis, submitted to corticosteroid therapy in immunosuppressive doses that evolved with glaucoma, panuveitis by CMV, loss of visual acuity and secondary bacterial infection.

  20. Hepatitis C virus (HCV) in cryoglobulinaemic leukocytoclastic vasculitis (LCV): could the presence of HCV in skin lesions be related to T CD8+ lymphocytes, HLA-DR and ICAM-1 expression?

    Science.gov (United States)

    Bernacchi, E; Civita, L L; Caproni, M; Zignego, A L; Bianchi, B; Monti, M; Fabbri, P; Pasero, G; Ferri, C

    1999-12-01

    An association between mixed cryoglobulinaemia (MC) and hepatotropic viruses, chiefly hepatitis C virus (HCV), has been widely reported. The presence of HCV genomic sequences or HCV-related viral proteins in the serum, purified cryoglobulins, peripheral blood mononuclear cells and into several tissues has suggested an important triggering role for HCV in MC patients. However, only few reports investigated the presence of HCV in cutaneous vasculitis and its potential pathogenetic role. Biopsies of cutaneous purpuric lesions from 5 MC female patients (aged from 40 to 80 years) were carried out for virological and histopathological evaluation. A leukocytoclastic vasculitis pattern was found in 4/5 subjects, while the presence of HCV RNA was detected in 3/5. In only 3 cases biopsy specimens were sufficient for immunohistochemical and direct immunofluorescence (DIF) studies. Immunohistochemical evaluation was performed by means of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP) immune-complexes. In the same skin specimen APAAP and DIF findings were compared with the presence/absence of HCV genomic sequences (PCR technique). In 1 MC patient, the detection of HCV-RNA was associated to a prevalent CD8+ T suppressor pattern with a perivascular and subjunctional distribution as well as an intense expression of second class (HLA-DR) and intercellular adhesion (ICAM-1) molecules on basal keratinocytes, endothelial cells and perivascular infiltrate. These findings suggest a marked inflammatory activation that spreads from endothelial cells to keratinocytes and Langerhans cells. In the 2 HCV-RNA negative specimens the scanty immunopathological staining could indicate a residual activity due to the previous inflammatory event triggered by cryoglobulins. The deposition of circulating HCV-containing immune complexes (CIC) in the skin could be the initial pathogenic event for cryoglobulinemic vasculitis; subsequently CIC could spread from the vascular bed to

  1. Hypocomplementemic Urticarial Vasculitis in Systemic Lupus Erythematosus

    OpenAIRE

    Her, Min Young; Song, Joo Yeon; Kim, Dong Yook

    2009-01-01

    Urticarial vasculitis is characterized clinically by urticarial skin lesions and histologically by leukocytoclastic vasculitis. Hypocomplementemic urticarial vasculitis is associated with connective tissue diseases such as systemic lupus erythematosus (SLE). We report a case of urticarial vasculitis that preceded manifestations of SLE.

  2. Unusual Synchronous Presentation of Maxillary Sinus Fibrosarcoma and Gemistocytic Astrocytoma with a Complication Called Leukocytoclastic Vasculitis: A Case Report

    OpenAIRE

    Cadir, Bilge; Nermin KARAHAN; Nasir, Serdar; AYDIN, M ASIM; Turkaslan, S. Suha

    2009-01-01

    Fibrosarcoma of the paranasal sinuses is extremely rare pathology and there is limited report in the literature. We report synchronous presentation of maxillary sinus fibrosarcoma and gemistocytic astrocytoma which is, to our knowledge, unique in the literature. Both tumors metastases to other organ rarely and the metastatic spread of gemistocytic astrocytoma to fibrosarcoma or vice versa have also not been reported in the literature yet. This report discusses the clinical course of the disea...

  3. Urticarial Vasculitis in Northern Spain

    OpenAIRE

    Loricera, Javier; Calvo-Río, Vanesa; Mata, Cristina; Ortiz-Sanjuán, Francisco; González-López, Marcos A.; Alvarez, Lino; González-Vela, M. Carmen; Armesto, Susana; Fernández-Llaca, Héctor; Rueda-Gotor, Javier; Miguel A. González-Gay; Blanco, Ricardo

    2014-01-01

    Abstract Urticarial vasculitis (UV) is a subset of cutaneous vasculitis (CV), characterized clinically by urticarial skin lesions of more than 24 hours’ duration and histologically by leukocytoclastic vasculitis. We assessed the frequency, clinical features, treatment, and outcome of a series of patients with UV. We conducted a retrospective study of patients with UV included in a large series of unselected patients with CV from a university hospital. Of 766 patients with CV, UV was diagnosed...

  4. Hypocomplementemic urticarial vasculitis complicated with diffuse alveolar hemorrhage: a case report and review of literature

    OpenAIRE

    Paola Gnerre; Sandra Buscaglia; Alessandro Cattana; Andrea Pestarino; Silvia Ardoino; Ezio Venturino; Lionello Parodi

    2014-01-01

    Urticarial vasculitis is a small-vessel vasculitis characterized clinically by urticaria and microscopically by leukocytoclastic vasculitis. Hypocomplementemic urticarial vasculitis syndrome is a rare subtype of urticarial vasculitis with organ involvement and persistent, acquired hypocomplementemia. Pulmonary involvement, usually seen as diffuse alveolar damage, is an uncommon complication and a significant cause of morbidity and mortality. Here we present a rare case of hypocomplementemic u...

  5. Urticarial vasculitis.

    Science.gov (United States)

    Venzor, Joe; Lee, Wai L; Huston, David P

    2002-10-01

    Urticarial vasculitis is a clinico-pathologic entity typified by recurrent episodes of urticaria that have the histopathologic features of leukocytoclastic vasculitis. The cutaneous features may include painful, burning or pruritic skin lesions, the persistence of individual lesions greater than 24 hours, palpable purpura, pronounced central clearing of lesions, and residual hyperpigmentation following resolution. However, because clinical characteristics of urticarial vasculitis may overlap with those of allergic urticaria, confirmation of the diagnosis requires a lesional skin biopsy. This condition is idiopathic in many patients but can also occur in the context of autoimmune disorders, infections, drug reactions, or as a paraneoplastic syndrome. In idiopathic urticarial vasculitis common laboratory findings are an elevation of erythrocyte sedimentation rate and reduction of serum complement. An association between urticarial vasculitis and systemic lupus erythematosus has been hypothesized as some clinical manifestations of disease overlap and C1q autoantibodies may be present in both diseases. Normo-complementemic patients usually have minimal or no systemic involvement and often have a better prognosis. On-the-other-hand, hypocomplementemic patients have the propensity to have more severe multi-organ involvement. Response to treatment is variable and a wide variety of therapeutic agents may be efficacious. Initial recommendations for treatment of urticarial vasculitis manifest only as non-necrotizing skin lesions include antihistamines, dapsone, colchicine, hydroxychloroquine or indomethacin, but corticosteroids are often required. With necrotizing skin lesions or visceral involvement, corticosteroids are regularly indicated. Cases of severe corticosteroid resistant urticarial vasculitis or where corticosteroid morbidity is evident [table: see text] may require treatment with other immunosuppressive agents such as azathioprine, cyclophosphamide, or

  6. Hypocomplementemic urticarial vasculitis complicated with diffuse alveolar hemorrhage: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Paola Gnerre

    2014-03-01

    Full Text Available Urticarial vasculitis is a small-vessel vasculitis characterized clinically by urticaria and microscopically by leukocytoclastic vasculitis. Hypocomplementemic urticarial vasculitis syndrome is a rare subtype of urticarial vasculitis with organ involvement and persistent, acquired hypocomplementemia. Pulmonary involvement, usually seen as diffuse alveolar damage, is an uncommon complication and a significant cause of morbidity and mortality. Here we present a rare case of hypocomplementemic urticarial vasculitis syndrome complicated by diffuse alveolar damage and describe the beneficial effect of cyclophosphamide-dexamethasone.

  7. Petechiae and vasculitis in asymptomatic primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Diederichsen, H; Sørensen, P G; Mickley, H; Hage, E; Schultz-Larsen, F

    1985-01-01

    vasculitis in all three patients. Direct immunofluorescent studies showed deposits of IgM, C3 and fibrinogen in and around the walls of the small vessels of the skin of two and C3 as well as fibrinogen in one patient. It is suggested that leukocytoclastic vasculitis may be a microscopic feature of the...

  8. Urticarial vasculitis reveals unsuspected thyroiditis.

    Science.gov (United States)

    Ferreira, Olga; Mota, Alberto; Baudrier, Teresa; Azevedo, Filomena

    2012-01-01

    A 38-year-old woman presented with erythematous, violaceous plaques with a serpiginous and unusual appearance located on the left shoulder, left thigh, and right buttock, evolving for 5 days, which eventually became generalized. A skin biopsy revealed leukocytoclastic vasculitis and a diagnosis of urticarial vasculitis was made. The complete blood count, biochemistry, complement levels, and other immunological test results were unremarkable. However, antithyroid antibody titers were increased. Despite having normal thyroid function tests and an absence of specific symptoms, the patient underwent a thyroid ultrasound, which revealed features of thyroiditis, and was subsequently referred to an endocrinologist. Several diseases can be associated with urticarial vasculitis, namely infections and autoimmune connective-tissue disorders such as systemic lupus erythematosus and Sjögren syndrome. Thyroiditis is an uncommon association. PMID:23000939

  9. Allergic vasculitis

    Science.gov (United States)

    ... Cutaneous vasculitis Images Vasculitis on the palm Vasculitis Vasculitis, urticarial on the hand References Stone JH. The systemic vasculitides. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. ... small vessel vasculitis. In: Firestein GS, Budd RC, Gabriel SE, McInnes ...

  10. Cutaneous polyarteritis nodosa: A rare isolated cutaneous vasculitis

    Directory of Open Access Journals (Sweden)

    Praveen Kumar A Subbanna

    2012-01-01

    Full Text Available Cutaneous polyarteritis nodosa (CPAN is a rare form of cutaneous vasculitis that involves small and medium sized arteries of the dermis and subcutaneous tissue without systemic involvement. It presents with tender subcutaneous nodules, digital gangrene, livedo reticularis and subcutaneous ulcerations. The diagnosis is by skin biopsy and characteristic pathologic feature is a leukocytoclastic vasculitis in the small to medium-sized arterioles of the dermis. We report a rare case of benign cutaneous PAN in a 14-year-old girl who presented with history of fever, subcutaneous nodules with cutaneous ulcer and digital gangrene. The skin biopsy showed leukocytoclastic vasculitis with fibrinoid necrosis in the dermal vessels. She received treatment with steroids and lesions resolved completely over a period of month.

  11. Vasculitis Foundation

    Science.gov (United States)

    ... fund the most promising studies. Support the Vasculitis Foundation Donate Now Join VF Team Brandon and Victory ... map feature to find a doctor or Vasculitis Foundation chapter near you. Participate in research Help find ...

  12. Cutaneous lesions and finger clubbing uncovering hypocomplementemic urticarial vasculitis and hepatitis C with mixed cryoglobulinemia*

    OpenAIRE

    Pinto-Almeida, Teresa; Caetano, Mónica; Alves, Rosário; Selores, Manuela

    2013-01-01

    Urticarial vasculitis is a rare clinicopathologic entity characterized by urticarial lesions that persist for more than 24 hours and histologic features of leukocytoclastic vasculitis. Patients can be divided into normocomplementemic or hypocomplementemic. The authors report the case of a healthy 49-year-old woman with a 1-year history of highly pruritic generalized cutaneous lesions and finger clubbing. Laboratory tests together with histopathologic examination allowed the diagnosis of hypoc...

  13. Livedo vasculitis Livedo vasculitis

    Directory of Open Access Journals (Sweden)

    RE Achenbach

    Full Text Available La livedo vasculitis representa un patrón de respuesta a múltiples causas, que confluyen en un estado procoagulante de los vasos de la dermis y subcutis superficial, resultando en úlceras dolorosas con localización en miembros inferiores y cicatrices características. Efectuamos una revisión de las múltiples sinonimias, aspectos clínicos e histológicos de tres casos, los que respondieron aceptablemente al tratamiento con pentoxifilina vía bucal.Livedo is not a specific disease, but a distinctive clinicopathologic pattern of changes, that may occur in a variety of different circunstances. The main pathogenic mechanism is considered to be intraluminal thrombosis of dermal vessels, with a common pathway and a prothrombotic state. A glossary, clinical, histological and therapeutic aspects are reviewed.

  14. Immunoglobulin A Vasculitis Complicated with Clostridium difficile Infection: a Rare Case Report and Brief Review of the Literature.

    Science.gov (United States)

    Cojocariu, Camelia; Stanciu, Carol; Ancuta, Codrina; Danciu, Mihai; Chiriac, Stefan; Trifan, Anca

    2016-06-01

    Immunoglobulin A (IgA) vasculitis, formerly called Henoch-Schönlein purpura, is a leukocytoclastic type of vasculitis affecting small vessels with a deposition of immune IgA complexes, clinically characterized by the classic tetrad of nonthrombocytopenic palpable purpura, arthralgia (or arthritis), and gastrointestinal and renal involvement. Although the cause of the disease remains unknown, immune complexes of IgA and unidentified antigens seem to play a central pathogenic role. The diagnosis is easily established in the presence of purpura, but may be challenging in its absence, especially when colicky abdominal pain precedes the cutaneous lesions. IgA vasculitis is usually a self-limited disease with a benign course and symptomatic treatment is sufficient for most; in severe cases, however, corticosteroids are necessary. We describe the case of a young adult male presenting with severe abdominal pain, vomiting and fever (38.4ºC). Clinical examination, abdominal ultrasound and plain abdominal radiography excluded an acute abdomen. The occurrence of arthralgia involving both knees and erosive duodenitis at endoscopy, 48 hours upon admission, suggested the diagnosis of IgA vasculitis, confirmed on the following day by the presence of typical purpuric rash on the lower extremities. Corticosteroid therapy led to the resolution of all gastrointestinal and joint manifestations as well as to a significant improvement of cutaneous purpura. However, during the 3rd week of corticosteroid treatment, the patient developed watery diarrhea and the clinical suspicion of Clostridium difficile infection (CDI) was confirmed. The treatment with metronidazole led to the resolution of diarrhea.The peculiarity of this case resides in several aspects: the gastrointestinal and joint manifestations preceded purpura, making diagnosis more difficult; CDI is an extremely rare complication of IgA vasculitis, being, in fact, the second case reported in adults in the literature. PMID

  15. Vasculitis Pregnancy Registry

    Science.gov (United States)

    2016-09-08

    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

  16. Autoimmunity in chronic urticaria and urticarial vasculitis.

    Science.gov (United States)

    Napoli, D C; Freeman, T M

    2001-07-01

    In contrast to acute urticaria, etiology cannot be identified in most cases of chronic urticaria. Recent evidence suggests that a subset of patients with chronic urticaria may have an autoimmune basis for their condition. The demonstration of antithyroid autoantibodies in some patients with chronic idiopathic urticaria (CIU) provides support for an association. However, the discovery of a positive skin test response to intradermal injection of autologous serum in as many as 60% of patients with CIU led to the identification of autoantibodies to IgE and the alpha-chain of the high-affinity IgE receptor, Fc epsilon RI alpha. Additional studies have demonstrated that some of these autoantibodies are capable of releasing histamine from donor basophils and mast cells. This article reviews the literature that addresses a possible autoimmune etiology in a subset of patients with CIU. Urticarial vasculitis is differentiated from chronic urticaria based on clinical features and biopsy findings of leukocytoclastic vasculitis. Most cases of urticarial vasculitis are secondary to an underlying systemic disease. The presence of autoantibodies has also been demonstrated in a subset of patients with primary urticarial vasculitis. This article briefly reviews some of this data. PMID:11892055

  17. Pediatric Vasculitis.

    Science.gov (United States)

    Singh-Grewal, Davinder; Durkan, Anne Maria

    2016-02-01

    Vasculitis is defined as inflammation of the blood vessels and can result in stenosis or aneurysm, which may in turn lead to occlusion or rupture of the vessel compromising tissue perfusion. The manifestations of these diseases depend on the size and site of the vessels effected. Vasculitis can be secondary to numerous inflammatory and infectious diseases but this review will concentrate on the systemic primary vasculitides and aims to discuss the presentations and approaches to management of a number of these conditions. PMID:26365154

  18. Pediatric Vasculitis Initiative

    Science.gov (United States)

    2015-07-16

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

  19. Cutaneous lesions and finger clubbing uncovering hypocomplementemic urticarial vasculitis and hepatitis C with mixed cryoglobulinemia.

    Science.gov (United States)

    Pinto-Almeida, Teresa; Caetano, Mónica; Alves, Rosário; Selores, Manuela

    2013-01-01

    Urticarial vasculitis is a rare clinicopathologic entity characterized by urticarial lesions that persist for more than 24 hours and histologic features of leukocytoclastic vasculitis. Patients can be divided into normocomplementemic or hypocomplementemic. The authors report the case of a healthy 49-year-old woman with a 1-year history of highly pruritic generalized cutaneous lesions and finger clubbing. Laboratory tests together with histopathologic examination allowed the diagnosis of hypocomplementemic urticarial vasculitis, chronic hepatitis C and type II mixed cryoglobulinemia. The patient started symptomatic treatment and was referred to a gastroenterologist for management of the hepatitis C, with progressive improvement of the skin condition. The development of hypocomplementemic urticarial vasculitis in the context of chronic hepatitis C is exceedingly rare and possible pathogenic mechanisms are discussed. PMID:24474109

  20. 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

  1. Cefoperazone induced hypersensitivity vasculitis

    OpenAIRE

    Katiyar Subodh; Prakash Shivesh

    2009-01-01

    Cefoperazone has been reported to cause vasculitic complications only once before. Here, we report yet another case of hypersensitivity vasculitis associated with cefoperazone. A 28-year-old lady with pneumococcal pneumonia developed hypersensitivity vasculitis on the fifth day of cefoperazone therapy. Hypersensitivity vasculitis resolved gradually after removal of the agent and did not recur. Although hypersensitivity vasculitis has multiple causes, coexistence of hypersensitivity vasculitis...

  2. Urticarial vasculitis and urticarial autoinflammatory syndromes.

    Science.gov (United States)

    Marzano, A V; Tavecchio, S; Venturini, M; Sala, R; Calzavara-Pinton, P; Gattorno, M

    2015-02-01

    Urticaria is a frequent disorder classified as acute and chronic forms, which presents with wheals that can be associated with angioedema. Several entities may manifest with urticarial skin lesions, encompassing a heterogeneous group of conditions that have to be differentiated from ordinary urticaria. This review is focused on two of these urticarial syndromes: urticarial vasculitis (UV), which represents the most important differential diagnosis with common urticaria, and autoinflammatory diseases such as cryopyrin-associated periodic syndromes (CAPS) and Schnitzler's Syndrome, both rare multisystem forms that may masquerade as common urticaria. UV is a small-vessel vasculitis with predominant skin involvement, characterized by wheals persisting for more than 24 hours, burning rather than itching and resolving with hyperpigmentation as well as by other cutaneous manifestations including purpura, papules, vesicles, bullae and necrotic-ulcerative lesions. Histology shows a classic pattern of leukocytoclastic vasculitis, with possible presence of upper dermal edema. CAPS are classified as three distinct entities: familial cold autoinflammatory syndrome, Muckle-Wells Syndrome and chronic infantile neurological cutaneous and articular syndrome, which represent a spectrum of disorders caused by different mutations in a single gene, NLRP3 (NOD-like receptor 3). This gene encodes for cryopyrin, an inflammasome protein that activates interleukin-1β, leading to an overproduction of this pivotal proinflammatory cytokine. Histologically, urticarial lesions are generally characterized by a perivascular neutrophilic infiltrate. Unlike urticaria, neither UV nor urticarial autoinflammatory syndromes do respond to antihistamines: thus, it is important not to misdiagnose such conditions in order to give the patients specific treatments, potentially preventing serious systemic complications. PMID:25586657

  3. Urticarial vasculitis in infancy

    Directory of Open Access Journals (Sweden)

    Kaur S

    2003-05-01

    Full Text Available Urticarial vasculitis is an uncommon manifestation of cutaneous vasculitis closely resembling chronic urticaria. It is an immune complex deposition disorder, which is not commonly observed in children. We report an 9-month-old infant with urticarial vasculitis and discuss its clinical course and differentiation from common urticaria.

  4. Urticarial vasculitis in infancy

    OpenAIRE

    Kaur S; Thami G

    2003-01-01

    Urticarial vasculitis is an uncommon manifestation of cutaneous vasculitis closely resembling chronic urticaria. It is an immune complex deposition disorder, which is not commonly observed in children. We report an 9-month-old infant with urticarial vasculitis and discuss its clinical course and differentiation from common urticaria.

  5. Urticarial vasculitis%荨麻疹性血管炎

    Institute of Scientific and Technical Information of China (English)

    李萌萌; 郭在培

    2013-01-01

    荨麻疹性血管炎(urticarial vasculitis,UV)是一种常见的临床病理综合征,皮损主要表现为荨麻疹样风团持续24小时以上,通常风团消退后留有色素沉着或瘀斑,可伴有瘙痒、疼痛、烧灼感或无明显自觉症状;组织病理示白细胞碎裂性血管炎改变.本文复习文献,对UV的病因及发病机制、临床表现、辅助检查、诊断及治疗进行简要综述.%Urticarial vasculitis ( UV) is a common clinicopathologic entity with histopathologic features of leukocytoclastic vasculitis. The typical urticarial wheals of UV persist for more than 24 hours,and usually subside with hyperpigmentation or purpura. The cutaneous features of UV may include itch, pain, burning or symptomless. The etiology, pathogenesis, clinical characteristics, accessory examinations, diagnosis, and management of this disease are reviewed in the paper.

  6. Omalizumab for Urticarial Vasculitis

    DEFF Research Database (Denmark)

    Ghazanfar, Misbah Nasheela; Thomsen, Simon Francis

    2015-01-01

    include oral antihistamines, oral corticosteroids, dapsone, colchicine or hydroxychloroquine. We describe a male patient with urticarial vasculitis who was treated with omalizumab (anti-IgE) with convincing results and provide a review of previous reports of patients with urticarial vasculitis treated...

  7. Urticarial vasculitis in northern Spain: clinical study of 21 cases.

    Science.gov (United States)

    Loricera, Javier; Calvo-Río, Vanesa; Mata, Cristina; Ortiz-Sanjuán, Francisco; González-López, Marcos A; Alvarez, Lino; González-Vela, M Carmen; Armesto, Susana; Fernández-Llaca, Héctor; Rueda-Gotor, Javier; González-Gay, Miguel A; Blanco, Ricardo

    2014-01-01

    Urticarial vasculitis (UV) is a subset of cutaneous vasculitis (CV), characterized clinically by urticarial skin lesions of more than 24 hours' duration and histologically by leukocytoclastic vasculitis. We assessed the frequency, clinical features, treatment, and outcome of a series of patients with UV. We conducted a retrospective study of patients with UV included in a large series of unselected patients with CV from a university hospital. Of 766 patients with CV, UV was diagnosed in 21 (2.7%; 9 male and 12 female patients; median age, 35 yr; range, 1-78 yr; interquartile range, 5-54 yr). Eight of the 21 cases were aged younger than 20 years old. Potential precipitating factors were upper respiratory tract infections and drugs (penicillin) (n = 4; in all cases in patients aged urticarial lesions, other features such as palpable purpura (n = 7), arthralgia and/or arthritis (n = 13), abdominal pain (n = 2), nephropathy (n = 2), and peripheral neuropathy (n = 1) were observed. Hypocomplementemia (low C4) with low C1q was disclosed in 2 patients. Other abnormal laboratory findings were leukocytosis (n = 7), increased erythrocyte sedimentation rate (n = 6), anemia (n = 4), and antinuclear antibody positivity (n = 2). Treatment included corticosteroids (n = 12), antihistaminic drugs (n = 6), chloroquine (n = 4), nonsteroidal antiinflammatory drugs (n = 3), colchicine (n = 2), and azathioprine (n = 1). After a median follow-up of 10 months (interquartile range, 2-38 mo) recurrences were observed in 4 patients. Apart from 1 patient who died because of an underlying malignancy, the outcome was good with full recovery in the remaining patients. In conclusion, our results indicate that UV is rare but not exceptional. In children UV is often preceded by an upper respiratory tract infection. Urticarial lesions and joint manifestations are the most frequent clinical manifestation. Low complement serum levels are observed in a minority of cases. The prognosis is generally good

  8. Types of Vasculitis

    Science.gov (United States)

    ... muscle and joint aches, including pain in the calf muscles that develops over weeks or months. Other ... the cases of IgA vasculitis follow an upper respiratory tract infection, a throat ... and lungs. The disease mainly occurs in middle-aged people; it affects ...

  9. Telmisartan induced urticarial vasculitis

    OpenAIRE

    Mahajan, Vikram K.; Ravinder Singh; Mrinal Gupta; Rashmi Raina

    2015-01-01

    A 53-year-old man developed urticarial vasculitis following ingestion of telmisartan and hydrochlorothiazide combination for hypertension. Treatment with prednisolone and cetirizine was curative, but his lesions recurred when he continued telmisartan and hydrochlorothiazide against medical advice. Re-challenge with the same doses of telmisartan precipitated similar lesions with telmisartan and not with hydrochlorothiazide. This uncommon cutaneous adverse reaction of angiotensin II receptor bl...

  10. CMR in inflammatory vasculitis

    OpenAIRE

    Raman Subha V; Aneja Ashish; Jarjour Wael N

    2012-01-01

    Abstract Vasculitis, the inflammation of blood vessels, can produce devastating complications such as blindness, renal failure, aortic rupture and heart failure through a variety of end-organ effects. Noninvasive imaging with cardiovascular magnetic resonance (CMR) has contributed to improved and earlier diagnosis. CMR may also be used in serial evaluation of such patients as a marker of treatment response and as an indicator of subsequent complications. Unique strengths of CMR favoring its u...

  11. Telmisartan induced urticarial vasculitis.

    Science.gov (United States)

    Mahajan, Vikram K; Singh, Ravinder; Gupta, Mrinal; Raina, Rashmi

    2015-01-01

    A 53-year-old man developed urticarial vasculitis following ingestion of telmisartan and hydrochlorothiazide combination for hypertension. Treatment with prednisolone and cetirizine was curative, but his lesions recurred when he continued telmisartan and hydrochlorothiazide against medical advice. Re-challenge with the same doses of telmisartan precipitated similar lesions with telmisartan and not with hydrochlorothiazide. This uncommon cutaneous adverse reaction of angiotensin II receptor blockers has implication for the clinicians as more such cases may become apparent with their wider use than in premarketing studies. PMID:26600649

  12. Telmisartan induced urticarial vasculitis

    Directory of Open Access Journals (Sweden)

    Vikram K Mahajan

    2015-01-01

    Full Text Available A 53-year-old man developed urticarial vasculitis following ingestion of telmisartan and hydrochlorothiazide combination for hypertension. Treatment with prednisolone and cetirizine was curative, but his lesions recurred when he continued telmisartan and hydrochlorothiazide against medical advice. Re-challenge with the same doses of telmisartan precipitated similar lesions with telmisartan and not with hydrochlorothiazide. This uncommon cutaneous adverse reaction of angiotensin II receptor blockers has implication for the clinicians as more such cases may become apparent with their wider use than in premarketing studies.

  13. Vasculite leucocitoclástica cutânea associada à tuberculose pulmonar Cutaneous leukocytoclastic vasculitis accompanied by pulmonary tuberculosis

    OpenAIRE

    Maurício Carvalho; Robson Luiz Dominoni; Denise Senchechen; Artur Furlaneto Fernandes; Ismael Paulo Burigo; Eloisa Doubrawa

    2008-01-01

    Relatamos o caso de um homem de 50 anos com uma rara associação: tuberculose pulmonar e vasculite leucocitoclástica cutânea. O paciente procurou o pronto atendimento em razão do quadro de cefaléia, artralgia, rash cutâneo e perda ponderal (4 kg) nos últimos 20 dias. A radiografia de tórax, solicitada em consulta ambulatorial prévia, demonstrava cavitação nos lobos médio e superior do pulmão direito, confirmada por tomografia computadorizada. Apresentou baciloscopia de escarro (coloração de Zi...

  14. Novel CFI mutation in a patient with leukocytoclastic vasculitis may redefine the clinical spectrum of Complement Factor I deficiency

    DEFF Research Database (Denmark)

    Bay, Jakob Thaning; Katzenstein, Terese Lea; Kofoed, Kristian;

    2015-01-01

    Factor I is an important regulator of the complement system. Lack of Factor I causes uncontrolled activation of the complement system leading to consumption of C3. Complete deficiency of Factor I is a rare condition and only around 40 cases has been reported in the literature. The clinical...... involvement, and without increased infection tendency. Initial testing showed low C3 concentration and a detailed complement evaluation absence of complement Factor I. Sequencing revealed a homozygous missense mutation in exon 2 of the CFI gene (SCV000221312). Even though the clinical symptoms of CFI...

  15. Urticarial vasculitis and Schnitzler syndrome.

    Science.gov (United States)

    Zuberbier, Torsten; Zuberbier, H C Torsten; Maurer, Marcus

    2014-02-01

    Both urticarial vasculitis and Schnitzler syndrome are serious diseases but a recently gained better understanding of their underlying pathomechanism allows better treatment options than only a decade ago. PMID:24262694

  16. Acute subdural effusion in vasculitis

    Directory of Open Access Journals (Sweden)

    Raghavendra Seetharam

    2008-01-01

    Full Text Available We report a 29-year-old man with a unique presentation of vasculitis as acute unilateral subdural effusion and meningoencephalitis. Magnetic resonance imaging showed a brainstem lesion that spread to the thalamus over time. There were no systemic features of vasculitis other than a positive pathergy test. Histopathological examination from the pathergy site showed neutrophilic infiltrate and leucocytoclastic vasculitis. The condition was steroid responsive and he remained in remission at two years′ follow-up. The anatomy of the brainstem lesion, absence of other inflammatory and infective conditions on evaluation suggests a vasculitic pathology either as primary central nervous system angiitis or as neurological presentation of systemic vasculitis like Behηet′s disease although the international diagnostic criteria for Behηet′s were not fulfilled.

  17. Differential Diagnosis of Retinal Vasculitis

    Science.gov (United States)

    Abu El-Asrar, Ahmed M.; Herbort, Carl P.; Tabbara, Khalid F.

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings. PMID:20404987

  18. Differential Diagnosis of Retinal Vasculitis

    OpenAIRE

    Abu El-Asrar Ahmed; Herbort Carl; Tabbara Khalid

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein a...

  19. Differential diagnosis of retinal vasculitis

    Directory of Open Access Journals (Sweden)

    Abu El-Asrar Ahmed

    2009-01-01

    Full Text Available Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  20. An unusual presentation of childhood vasculitis presenting in adulthood: A challenging diagnosis of Henoch-Schönlein Purpura

    Directory of Open Access Journals (Sweden)

    Charat Thongprayoon

    2014-01-01

    Full Text Available Context: Henoch-Schφnlein purpura (HSP, a systemic IgA vascultitis, is uncommon in adults, with an incidence rate of 0.1 to 1.2 per million in adults over 20 years old. This vasculitic syndrome can present as an uncommon cause of intestinal obstruction in older patients. We report a case of an older woman with HSP presenting with small bowel obstruction and vasculitic rash. Case Report: We report a 67-year-old woman who presented with small bowel obstruction and skin rash. Skin biopsy revealed leukocytoclastic vasculitis with +IgA granular deposition within the walls of superficial dermal vessels. Kidney biopsy confirmed the diagnosis of HSP with mild mesangial proliferative IgA nephropathy. Her abdominal pain and small bowel obstruction were improved with conservative treatment. She continued to do well with normal kidney function at a 3-month follow-up visit. Conclusion: HSP, a systemic IgA vasculitis, is a predominantly pediatric vasculitis and is uncommon in adults. In adults, the disease process is identical to that in children. However, gastrointestinal manifestation is less common in older patients, and bowel perforation and obstruction are rare. Intestinal obstruction with skin rash and renal involvement should raise suspicions of HSP.

  1. Pulmonary vasculitis associated with cholangiocarcinoma of liver.

    OpenAIRE

    Ong, E L; Evans, S; Hanley, S. P.

    1989-01-01

    A 62 year old woman presented with an acute pulmonary vasculitis which responded to treatment with oral steroids. Investigations over one year revealed a cholangiocarcinoma of the liver. The association of vasculitis with neoplastic diseases remains a diagnostic challenge.

  2. The ANCA Vasculitis Questionnaire (AAV-PRO©)

    Science.gov (United States)

    2016-05-10

    Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss) (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (Wegener's) (GPA); Wegener Granulomatosis (WG); Microscopic Polyangiitis (MPA); ANCA-Associated Vasculitis (AAV); Vasculitis

  3. Cocaine/levamisole-induced systemic vasculitis with retiform purpura and pauci-immune glomerulonephritis

    Directory of Open Access Journals (Sweden)

    F.V. Veronese

    2016-01-01

    Full Text Available Levamisole has been increasingly used as an adulterant of cocaine in recent years, emerging as a public health challenge worldwide. Levamisole-associated toxicity manifests clinically as a systemic vasculitis, consisting of cutaneous, hematological, and renal lesions, among others. Purpura retiform, cutaneous necrosis, intravascular thrombosis, neutropenia, and less commonly crescentic nephritis have been described in association with anti-neutrophil cytoplasmic antibodies (ANCAs and other autoantibodies. Here we report the case of a 49-year-old male who was a chronic cocaine user, and who presented spontaneous weight loss, arthralgia, and 3 weeks before admission purpuric skin lesions in the earlobes and in the anterior thighs. His laboratory tests on admission showed serum creatinine of 4.56 mg/dL, white blood count 3,800/μL, hemoglobin 7.3 g/dL, urinalysis with 51 white blood cells/μL and 960 red blood cells/μL, and urine protein-to-creatinine ratio 1.20. Serum ANCA testing was positive (>1:320, as well as serum anti-myeloperoxidase and anti-proteinase 3 antibodies. Urine toxicology screen was positive for cocaine and levamisole, with 62.8% of cocaine, 32.2% of levamisole, and 5% of an unidentified substance. Skin and renal biopsies were diagnostic for leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis, respectively. The patient showed a good clinical response to cocaine abstinence, and use of corticosteroids and intravenous cyclophosphamide. Last serum creatinine was 1.97 mg/dL, white blood cell count 7,420/μL, and hemoglobin level 10.8 g/dL. In levamisole-induced systemic vasculitis, the early institution of cocaine abstinence, concomitant with the use of immunosuppressive drugs in severe cases, may prevent permanent end organ damage and associate with better clinical outcomes.

  4. Cerebral vasculitis associated with cocaine abuse

    International Nuclear Information System (INIS)

    A case of cerebral vasculitis in a previously healthy 22-year-old man with a history of cocaine abuse is described. Cerebral angiograms showed evidence of vasculitis. A search for possible causes other than cocaine produced no results. The authors include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis

  5. ERYTHEMA NODOSUM: VASCULITIS OR PANNICULITIS?

    Directory of Open Access Journals (Sweden)

    Boris Sergeyevich Belov

    2009-01-01

    Full Text Available Erythema nodosum (EN as an individual entity has been known for more than 200 years. The long-term study of the disease by rheumatologists, pulmonologists, dermatologists, and other specialists has allowed them to state a variety of etiotropic factors and polymorphism of its clinical symptomatology. Up to now, the discussion of the histopathomorphological nature of EN (vasculitis or panniculitis? has been continued. The described case makes it possible to regard EN as a manifestation of vasculitis to a greater extent. Further clinical studies are needed depending on the stage of the disease and etiotropic factors.

  6. Visual recovery in orbital vasculitis.

    OpenAIRE

    Bagegni, A; Lyness, R W; Johnston, P B; Douglas, J. F.

    1988-01-01

    A 46-year-old woman with polyarteritis nodosa and chronic renal failure developed sudden loss of vision which was associated with orbital vasculitis. Treatment with cyclophosphamide produced rapid improvement in vision, which has been preserved with maintenance doses of cyclophosphamide and prednisolone.

  7. Urticarial Vasculitis-Associated Intestinal Ischemia

    Directory of Open Access Journals (Sweden)

    Uni Wong

    2016-01-01

    Full Text Available Urticarial vasculitis (UV is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia.

  8. Urticarial Vasculitis-Associated Intestinal Ischemia.

    Science.gov (United States)

    Wong, Uni; Yfantis, Harris; Xie, Guofeng

    2016-01-01

    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia. PMID:27190661

  9. 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

  10. One year in review: systemic vasculitis.

    Science.gov (United States)

    Elefante, Elena; Tripoli, Alessandra; Ferro, Francesco; Baldini, Chiara

    2016-01-01

    Systemic vasculitis are complex and heterogenous disorders. During the past months great efforts have been made aimed at clarifying disease pathogenesis and at improving patient management and treatment. In this review we summarise the most important scientific contributions on vasculitis pathogenesis, diagnostic tools and treatment published in 2015. PMID:27214397

  11. Large vessel adventitial vasculitis characterizes patients with critical lower limb ischemia with as compared to without human immunodeficiency virus infection.

    Directory of Open Access Journals (Sweden)

    Martin Brand

    Full Text Available Whether a human immunodeficiency virus (HIV-associated vasculitis in-part accounts for occlusive large artery disease remains uncertain. We aimed to identify the histopathological features that characterize large vessel changes in HIV sero-positive as compared to sero-negative patients with critical lower limb ischemia (CLI.Femoral arteries obtained from 10 HIV positive and 10 HIV negative black African male patients admitted to a single vascular unit with CLI requiring above knee amputation were subjected to histopathological assessment. None of the HIV positive patients were receiving antiretroviral therapy.As compared to HIV negative patients with CLI, HIV positive patients were younger (p<0.01 and had a lower prevalence of hypertension (10 vs 90%, p<0.005 and diabetes mellitus (0 vs 50%, p<0.05, but a similar proportion of patients previously or currently smoked (80 vs 60%. 90% of HIV positive patients, but no HIV negative patient had evidence of adventitial leukocytoclastic vasculitis of the vasa vasorum (p<0.0001. In addition, 70% of HIV positive, but no HIV negative patient had evidence of adventitial slit-like vessels. Whilst T-lymphocytes were noted in the adventitia in 80% of HIV positive patients, T-lymphocytes were noted only in the intima in HIV negative patients. The presence of femoral artery calcified multilayered fibro-atheroma was noted in 40% of HIV positive and 90% of HIV negative patients with CLI.An adventitial vasculitis which characterizes large artery changes in CLI in HIV-infected as compared to non-infected patients, may contribute toward HIV-associated occlusive large artery disease.

  12. Damage assessment in ANCA-associated vasculitis.

    Science.gov (United States)

    Bhamra, Kuljeet; Luqmani, Raashid

    2012-12-01

    Antineutrophil cytoplasm antibody associated vasculitis has been transformed from life-threatening conditions to chronic relapsing long-term diseases as a result of significant advances in immunosuppressive therapy. Although mortality still occurs, it is much less frequent, with an average 5-year survival of over 70 %. In the setting of chronic conditions, it becomes increasingly important to monitor the burden of disease in terms of both active inflammation requiring immunosuppression and chronic damage (scarring) from vasculitis and its treatment and associated comorbidity. The damage that accumulates in patients with vasculitis does not respond to immunosuppressive treatment. It is important to distinguish disease activity from disease damage to prevent unnecessary immunosuppression, but it is equally important to recognize damage for what it is, so that it can be addressed appropriately. Damage is an inevitable consequence of long-term vasculitis for over 80 % of patients, which should not surprise us given the severity of the original illness. There is potential value in measuring damage as a means of providing prognostic information. Using a quantified score such as the Vasculitis Damage Index (VDI) allows us to predict mortality. Patients with at least five items of damage on the VDI score have substantially worse mortality (7- to 11-fold worse risk), as compared with those with lesser amounts of damage. These findings should be taken into context when planning the management of patients with vasculitis, as well as in clinical trials of vasculitis. Disease damage is an important surrogate for long-term outcome in vasculitis, and studies should be designed to limit the amount of damage accumulating as a result of therapeutic intervention, rather than simply controlling disease activity, as is currently the aim in recent randomized controlled trials in vasculitis. Furthermore, careful cataloguing of damage, as well as disease activity items, provides much

  13. Behcet's disease with cerebral vasculitis

    International Nuclear Information System (INIS)

    The case presented illustrates the diagnostic dilemma off neurological involvement in Behcet's disease and other inflammatory diseases. 'Psychiatric' symptoms were present for 2 years without abnormalities on SPECT or MRI and without CSF pleocytosis. Even at the time of fitting, no CSF abnormalities were observed. The preceding psychiatric presentations may have been due to cerebral vasculitis that was exacerbated by withdrawal of steroids. Magnetic resonance imaging is currently the most sensitive imaging modality. Lesions are usually in the brainstem, cerebellum, basal ganglia region or periventricular white matter, and the pons and the mesencephalon are commonly affected. In our patient there was no diencephalic or brainstem involvement. The inflammatory process can appear as a very large lesion, with gadolinium enhancement and significant mass effect, as in our patient. Brain magnetic resonance imaging. Postgadolinium-diethylenetriamine pentaacetic acid, axial image shows two large lesions in the right frontal lobe, with the larger, posterior lesion demonstrating vivid ring enhancement. A central nodule is isodense, with the cerebral white matter within the larger lesion. Surrounding low T1 signal involves the hemispheric white matter without cortical extension and is consistent with vasogenic oedema. Minor mass effect is demonstrated with bowing of the anterior falx cerebri to the left. Biopsy shows prominent fibrinoid necrosis in small calibre postcapillary venules and cerebral white matter. There are surrounding acute and chronic inflammatory cells and nuclear debris, consistent with vasculitis

  14. Measurement of damage in systemic vasculitis: a comparison of the Vasculitis Damage Index with the Combined Damage Assessment Index

    DEFF Research Database (Denmark)

    Suppiah, Ravi; Flossman, Oliver; Mukhtyar, Chetan; Alberici, Federico; Baslund, Bo; Brown, Denise; Hasan, Nadeem; Holle, Julia; Hruskova, Zdenka; Jayne, David; Judge, Andrew; Little, Mark A; Merkel, Peter A; Palmisano, Alessandra; Seo, Philip; Stegeman, Coen; Tesar, Vladimir; Vaglio, Augusto; Westman, Kerstin; Luqmani, Raashid

    2011-01-01

    To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis.......To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis....

  15. Vasculitis

    Science.gov (United States)

    ... RhMSUS FAQs RhMSUS Designees RhMSUS Volunteer Opportunities Publications & Communications Journals A&R Table of Contents AC&R Table ... by the American College of Rheumatology Committee on Communications and Marketing. This information is provided for general education only. ...

  16. Systemic paraneoplastic vasculitis secondary to papillary carcinoma of the thyroid.

    Science.gov (United States)

    Guerouaz, N; Alaoui, M; Raiss, M; Hassam, B; Senouci, K

    2016-08-01

    Systemic vasculitis secondary to thyroid carcinomas is exceptional. We report the case of a 55-year-old woman who presented with systemic vasculitis involving leucocytoclastic cutaneous vasculitis and renal disorders secondary to papillary thyroid carcinoma (PTC). Her symptoms resolved completely after total thyroidectomy. Other causes of vasculitis were excluded. To our knowledge, this is only the second case reported of systemic vasculitis associated with PTC in a paraneoplastic manner. PMID:27416971

  17. Vasculitis por Propiltiouracilo: reporte de un caso

    OpenAIRE

    Donato A. Salas-Segura; Juan I Padilla-Cuadra; Juliana Salas-Segura

    2002-01-01

    Se reporta el caso clínico de una paciente femenina de 43 años que presentó dos complicaciones secundarias al uso de propiltiouracilo: vasculitis y agranulocitosis.La vasculitis asociada con el tratamiento antitiroideo es una entidad clínica bien documentada, pero rara, y de un mecanismo patogénico no claro aún. Hay pocos casos reportados de asociación entre la ingesta de propiltiouracilo, la aparición de anticuerpos anticitoplasmáticos antineutrófilos y vasculitis ANCA positiva. Este es prob...

  18. Vasculitis por Propiltiouracilo: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Donato A. Salas-Segura

    2002-06-01

    Full Text Available Se reporta el caso clínico de una paciente femenina de 43 años que presentó dos complicaciones secundarias al uso de propiltiouracilo: vasculitis y agranulocitosis.La vasculitis asociada con el tratamiento antitiroideo es una entidad clínica bien documentada, pero rara, y de un mecanismo patogénico no claro aún. Hay pocos casos reportados de asociación entre la ingesta de propiltiouracilo, la aparición de anticuerpos anticitoplasmáticos antineutrófilos y vasculitis ANCA positiva. Este es probablemente uno de ellos.

  19. Biotherapies in large vessel vasculitis.

    Science.gov (United States)

    Ferfar, Y; Mirault, T; Desbois, A C; Comarmond, C; Messas, E; Savey, L; Domont, F; Cacoub, P; Saadoun, D

    2016-06-01

    Giant cell arteritis (GCA) and Takayasu's arteritis (TA) are large vessel vasculitis (LVV) and aortic involvement is not uncommon in Behcet's disease (BD) and relapsing polychondritis (RP). Glucocorticosteroids are the mainstay of therapy in LVV. However, a significant proportion of patients have glucocorticoid dependance, serious side effects or refractory disease to steroids and other immunosuppressive treatments such as cyclophosphamide, azathioprine, mycophenolate mofetil and methotrexate. Recent advances in the understanding of the pathogenesis have resulted in the use of biological agents in patients with LVV. Anti-tumor necrosis factor-α drugs seem effective in patients with refractory Takayasu arteritis and vascular BD but have failed to do so in giant cell arteritis. Preliminary reports on the use of the anti-IL6-receptor antibody (tocilizumab), in LVV have been encouraging. The development of new biologic targeted therapies will probably open a promising future for patients with LVV. PMID:26883459

  20. Vasculitis: determinants of disease patterns.

    Science.gov (United States)

    Hoffman, Gary S; Calabrese, Leonard H

    2014-08-01

    The vasculitides are a large group of heterogeneous diseases for which it has been assumed that pathogenesis is largely autoimmune. As clinicians, we distinguish one form of vasculitis from another on the basis of observed patterns of organ injury, the size of the vessels affected and histopathological findings. The terms 'small-vessel', 'medium-vessel' and 'large-vessel' vasculitis are useful clinical descriptors, but fail to inform us about why vessels of a certain calibre are favoured by one disease and not another. Classification based on vessel size also fails to consider that vessels of a specific calibre are not equally prone to injury. Distinct vulnerabilities undoubtedly relate to the fact that same-size vessels in different tissues may not be identical conduits. In fact, vessels become specialized, from the earliest stages of embryonic development, to suit the needs of different anatomical locations. Vessels of the same calibre in different locations and organs are as different as the organ parenchymal cells through which they travel. The dialogue between developing vessels and the tissues they perfuse is designed to meet special local needs. Added to the story of vascular diversity and vulnerability are changes that occur during growth, development and ageing. An improved understanding of the unique territorial vulnerabilities of vessels could form the basis of new hypotheses for the aetiopathogenesis of the vasculitides. This Review considers how certain antigens, including infectious agents, might become disease-relevant and how vascular diversity could influence disease phenotypes and the spectrum of vascular inflammatory diseases. PMID:24934189

  1. Biologics Will Pump Up the Vasculitis Market

    OpenAIRE

    Fellner, Chris

    2016-01-01

    Vasculitis, a group of heterogeneous disorders characterized by inflammation and necrosis of the blood vessels, has but one treatment approved by the Food and Drug Administration. However, six novel biologic candidates are in late-stage development.

  2. [Vasculitis caused by Pseudomonas: a case report].

    Science.gov (United States)

    Escamilla, Y; Gutiérrez, M; Martínez, T; Bodoque, M; Gómez, J M; Moreno, A

    1996-01-01

    Pseudomona vasculitis is an exceptional disease. Only a few cases have been reported, non with oropharyngeal involvement. The case of a 30-year-old, HIV-positive man who suddenly developed septicemia and necrotizing lesions with tissue destruction of the oropharynx is reported. Histological study confirmed vasculitis. Pseudomona aeruginosa was isolated in peripheral blood and in the biopsy of the palatal lesion. Antibiotic treatment produced satisfactory results. PMID:8991411

  3. Urticarial Vasculitis-Associated Intestinal Ischemia

    OpenAIRE

    Uni Wong; Harris Yfantis; Guofeng Xie

    2016-01-01

    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a ca...

  4. Churg-Strauss vasculitis and ascaris infection.

    OpenAIRE

    Chauhan, A.; Scott, D G; Neuberger, J; Gaston, J. S.; Bacon, P A

    1990-01-01

    A patient with Churg-Strauss vasculitis presenting with mononeuritis multiplex, who developed obstructive jaundice, is described. On investigation the jaundice proved to be due to ascaris infestation. As the immune abnormalities associated with ascaris infection are also typical of those seen in the Churg-Strauss syndrome it is speculated that the vasculitis occurred because of a failure to regulate the anti-ascaris immune response.

  5. Vasculitis por Propiltiouracilo: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Donato A. Salas-Segura

    2002-06-01

    Full Text Available Se reporta el caso clínico de una paciente femenina de 43 años que presentó dos complicaciones secundarias al uso de propiltiouracilo: vasculitis y agranulocitosis.La vasculitis asociada con el tratamiento antitiroideo es una entidad clínica bien documentada, pero rara, y de un mecanismo patogénico no claro aún. Hay pocos casos reportados de asociación entre la ingesta de propiltiouracilo, la aparición de anticuerpos anticitoplasmáticos antineutrófilos y vasculitis ANCA positiva. Este es probablemente uno de ellos.We report a case of 43-year-old woman who developed two complications associated with the use of propylthiouracil: vasculitis and agranulocytosis. Vasculitis associated with antithyroid therapy is a rare well-documented clinical entity with a pathogenic mechanism not clear yet. There a few published reports of an association between treatment with propylthiouracil, and the occurrence of ANCA positivity and ANCA-associated vasculitis. This is probably one more.

  6. Vasculite urticariforme hipocomplementêmica como primeira manifestação do lúpus eritematoso sistêmico Hypocomplementaemic urticarial vasculitis as first manifestation of systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    I.A. Pereira

    1997-12-01

    Full Text Available A síndrome vasculite urticariforme hipocomplementêmica é uma vasculite leucocitoclástica que se apresenta com lesões urticariformes, associada a febre, artralgias, artrite e cólica abdominal. Outras manifestações sistêmicas incluem a presença de glomerulonefrite, uveíte, episclerite, doença pulmonar obstrutiva e alterações neurológicas. Alguns casos associados ao lúpus eritematoso sistêmico (LES têm sido descritos, com o diagnóstico baseando-se na presença de critérios bem definidos de LES prévia ou concomitantemente ao aparecimento da vasculite urticariforme. A apresentação de vasculite urticariforme precedendo o diagnóstico de LES é rara, o que motivou o relato destes dois casos. Enfatiza-se a positivação do anticorpo anti-Ro/SS-A por ocasião do diagnóstico de LES, alertando para a necessidade de avaliação periódica nos casos de vasculite urticariforme.Hypocomplementaemic urticarial vasculitis syndrome is a leukocytoclastic vasculitis characterized by urticarial lesions, associated with fever, arthralgias, arthritis and abdominal pain. Other systemic manifestations include glomerulonephritis, uveitis, episcleritis, chronic obstructive pulmonary disease and neurological abnormalities. Some cases associated with systemic lupus erythematosus have been described and SLE diagnosis was made by previous or concomitant diagnostic criteria before onset of urticarial vasculitis. Urticarial vasculitis prior to SLE diagnosis is rare. The development of anti-Ro/SS-A antibody for the diagnosis of SLE is emphasized. The authors alert to the importance of periodically searching for this marker in patients with urticarial vasculitis.

  7. A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis.

    LENUS (Irish Health Repository)

    Suppiah, Ravi

    2011-05-01

    Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis.

  8. Historia del tratamiento de las vasculitis primarias History of treatment of primary vasculitis

    Directory of Open Access Journals (Sweden)

    Antonio Iglesias-Gamarra

    2012-07-01

    Full Text Available Las vasculitis primarias constituyen un grupo de enfermedades reumáticas con expresión clínica variable y pronóstico reservado cuando no se tratan adecuadamente. En esta revisión haremos un análisis pormenorizado del tratamiento en las diferentes formas de vasculitis primaria, iniciando con el uso de los corticoides, desde casi su descubrimiento en 1949, pasando por otros inmunosupresores como: ciclofosfamida, metotrexate, azatioprina, mofetil, micofenolato, al igual que medicamentos biológicos como rituximab y anti-TNF. Una mención especial se hace sobre las guías de tratamientos para las vasculitis, tanto de grandes como de pequeños vasos, implementadas desde 2009 por el Grupo Europeo de Estudio de las Vasculitis.Primary vasculitis is one of the rheumatic diseases with variable clinical expression and poor prognosis when not treated properly. In this review we analyze detailed treatment of this disease in different forms of primary vasculitis, starting with the use of corticosteroids from almost its discovery in 1949, to other immunosuppressant's such as cyclophosphamide, methotrexate, azathioprine, mycophenolate mofetil, as well as biological drugs such as rituximab and anti-TNF. Special mention is made on the guidelines of treatment for vasculitis of both large and small vessel, implemented since 2009 by the European Group Study of Vasculitis.

  9. 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. PMID:26093659

  10. [Pathogenesis of large vessel vasculitis].

    Science.gov (United States)

    Samson, M; Bonnotte, B

    2016-04-01

    Giant cell arteritis (GCA) and Takayasu's arteritis (TA) are two granulomatous vasculitis affecting large arteries that present specific epidemiological and clinical features. Their pathogenesis is not fully understood but major advances have been obtained during the last years, thus allowing the emergence of new therapeutic strategies. GCA and TA develop on a specific genetic background but share some similarities regarding the immunological pathways involved in their pathogenesis. The trigger of these diseases is not clearly identified but it is thought that an infectious agent could activate and lead to the maturation of dendritic cells that are localized in the adventitia of arteries. Then, the cells of the adaptative immune response are recruited and activated: CD4 T cells that polarize into Th1 and Th17 cells, cytotoxic CD8 T cells and Natural Killer cells. Furthermore, the T regulatory cells (Treg) are decreased both in GCA and TA. Humoral immune response seems also to be involved, especially in TA. Then, the cytokines produced by T lymphocytes (especially IL-17 and IFN-γ) trigger the recruitment and activation of monocytes and their differentiation into macrophages and multinuclear giant cells that produce IL-1β and IL-6 that are responsible for general symptoms of GCA and TA, and cytotoxic mediators and growth factors that trigger the remodeling of the arterial wall leading to aneurysms and ischemic manifestations of GCA an TA. PMID:26620872

  11. Ischemic Retinal Vasculitis and Its Management

    Directory of Open Access Journals (Sweden)

    Lazha Talat

    2014-01-01

    Full Text Available Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet’s disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet’s disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.

  12. Vasculitis Syndromes of the Central and Peripheral Nervous Systems

    Science.gov (United States)

    ... About NINDS Vasculitis Syndromes of the Central and Peripheral Nervous Systems Fact Sheet See a list of all NINDS ... 496-5717 "Vasculitis Syndromes of the Central and Peripheral Nervous Systems Fact Sheet", NINDS, Publication date July 2011. NIH ...

  13. Plasmapheresis in a Patient With "Refractory" Urticarial Vasculitis

    OpenAIRE

    Kartal, Ozgur; Gulec, Mustafa; Caliskaner, Zafer; Nevruz, Oral; Cetin, Turker; Sener, Osman

    2012-01-01

    Immune complexes are found in the circulation of 30%-75% of patients with urticarial vasculitis and much evidence supports the role of these immune complexes in the pathogenesis of urticarial vasculitis. Plasmapheresis is effective for removing these immune complexes; however, there are few reports on the use of plasmapheresis in the treatment of urticarial vasculitis. We describe a case of "refractory" urticarial vasculitis in which the symptoms improved after plasmapheresis treatment. We su...

  14. The long-term outcomes of systemic vasculitis.

    OpenAIRE

    Westman, Kerstin; Flossmann, Oliver; Gregorini, Gina

    2015-01-01

    Patients with generalized ANCA-associated small vessel vasculitis (AAV) have a very poor outcome if the ANCA-associated vasculitis is not diagnosed, evaluated and treated properly. The introduction of treatment with immunosuppressive therapy has improved patient survival dramatically but with considerable side effects. Besides, almost 50% of surviving patients experience a relapse of vasculitis. Since 1995, the European Vasculitis Society (EUVAS) has designed and conducted several clinical tr...

  15. Tumor necrosis factor-like weak inducer of apoptosis and its receptor fibroblast growth factor-inducible 14 are expressed in urticarial vasculitis.

    Science.gov (United States)

    Li, Mengmeng; Chen, Tao; Guo, Zaipei; Li, Jingyi; Cao, Na

    2013-11-01

    Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK), a member of the TNF family, has been implicated as a pro-inflammatory cytokine in many types of autoimmune and infectious diseases. However, information about TWEAK in dermatological diseases is limited. To date, no studies have investigated the roles of TWEAK in patients with urticarial vasculitis (UV). This study aimed to assess serum TWEAK levels, together with TWEAK and fibroblast growth factor-inducible 14 (Fn14) expressions of skin lesions in patients with UV. Serum TWEAK levels in patients with UV, together with patients with cutaneous leukocytoclastic angiitis (CLA) and healthy controls were detected by enzyme-linked immunosorbent assay; TWEAK and Fn14 expressions of skin lesions were analyzed by immunohistochemistry. Results showed that TWEAK and Fn14 were abundantly expressed in the dermal vessel wall of lesional skin in patients with UV but not healthy controls. Serum TWEAK levels in the acute stage in patients with UV were significantly higher than those in the convalescent stage and healthy controls. Serum TWEAK levels were elevated significantly in patients with CLA compared with those in healthy controls. Our previous study indicated that TWEAK may be an important mediator for the development of vascular inflammation in skin. In addition, we also found that TWEAK blockade substantially reduced vascular damage and perivascular leukocyte infiltrates in lipopolysaccharide-induced cutaneous vasculitis. Our study shows that TWEAK may be associated with the pathogenesis of UV; it is therefore suggested that TWEAK may be a potential therapeutic target for UV and other types of cutaneous vasculitis. PMID:23968277

  16. Neuroimaging of cerebral vasculitis; Bildgebung zerebraler Vaskulitiden

    Energy Technology Data Exchange (ETDEWEB)

    Wengenroth, M. [Universitaetsklinikum Schleswig-Holstein, Campus Luebeck, Institut fuer Neuroradiologie, Luebeck (Germany); Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer klinische Radiologie, Muenchen (Germany); Saam, T. [Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer klinische Radiologie, Muenchen (Germany); Haehnel, S. [Universitaetsklinikum Heidelberg, Abteilung Neuroradiologie, Heidelberg (Germany)

    2016-01-15

    Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [German] Die zerebrale Vaskulitis kann viele Ursachen haben. Daher ist die klinische und radiologische Diagnose schwierig, auch weil es etliche vaskulitistypische Symptome und MR-Befunde bei anderen Erkrankungen gibt. Die ZNS-Vaskulitis kann zahlreiche andere neurologische Erkrankungen imitieren, die unterschiedlicher Therapie beduerfen. MRT und MR-Angiographie (MRA) sind die Verfahren der Wahl, mit denen die radiologische Diagnostik begonnen werden sollte, um den Parenchymschaden und den Gefaessbefall zu beurteilen. Bei unklaren Befunden kann eine digitale Subtraktionsangiographie (DSA) ergaenzt werden, um auch mittelgrosse Gefaesse beurteilen zu koennen. Der Befall kleiner Gefaesse kann nur bioptisch nachgewiesen werden. In der folgenden Uebersicht stellen wir das diagnostische Herangehen bei zerebraler Vaskulitis vor, praesentieren zahlreiche Befunde und diskutieren die wichtigsten radiologischen Differenzialdiagnosen. (orig.)

  17. Cerebral Vasculitis in a Patient with SLE

    Directory of Open Access Journals (Sweden)

    Farnood Rajabzadeh*

    2012-05-01

    Full Text Available A young woman aged 25 was admitted to the hospital with malar rash, swelling in the extremities and malaise. During hospitalizationshe showed change in mood and tonic clonic seizure. Brain MRI showed wide areas of signal changes in the frontal and parietal, cerebellar hemispheres, right middle cerebellar peduncle and right thalamus. There were also areas of restricted diffusion at DW images and ADC map at the right parietal. The differential diagnoses are SLE, MS, HSV, other vasculitis such as Behcet and polyarteritis nodosa (PAN, Susac's syndrome, lyme and small vessel vasculitis.

  18. ANCA-associated vasculitis and malignancy

    DEFF Research Database (Denmark)

    Mahr, Alfred; Heijl, Caroline; Le Guenno, Guillaume; Faurschou, Mikkel

    2013-01-01

    In this review, we summarise the current understanding of the potential link between cancer and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), including granulomatosis with polyangiitis (Wegener's; GPA) and microscopic polyangiitis (MPA). As is true for many autoimmune or infla...

  19. Urticarial Reactions: Vascular Erythema, Urticaria, Vasculitis

    OpenAIRE

    Sibbald, R. Gary

    1987-01-01

    Vascular erythemas, including urticaria and vasculitis, represent diagnostic and therapeutic challenges. A careful systemic approach to history and physical examination should be followed by appropriate investigations to rule out systemic disease. Chronic urticaria patients should be physically tested to identify cholinergic, dermagraphic, and cold-induced responses. Food diaries and careful drug history may be important to identify exacerbating factors in chronic urticaria.

  20. Hypocomplementemic Urticarial Vasculitis Syndrome: A Case Report and Literature Review

    OpenAIRE

    Buck, Andrew; Christensen, Jim; McCarty, Morgan

    2012-01-01

    Hypocomplementemic urticarial vasculitis syndrome, as opposed to urticarial vasculitis or urticarial vasculitis syndrome, is a rare disease process where the exact pathophysiology remains unknown. This article discusses the case of a 34-year-old Hispanic man with an ongoing history of chronic urticaria comprising episodes induced by low ambient temperatures, emotional stress, and spontaneous occurrences. This article serves as a consolidated reference for specialists to comprehensively review...

  1. Long- term outcome of paediatric patients with ANCA vasculitis

    OpenAIRE

    Arulkumaran, Nishkantha; Jawad, Susan; Smith, Stuart W.; Harper, Lorraine; Brogan, Paul; Charles D. Pusey; Salama, Alan D

    2011-01-01

    Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a follow up ti...

  2. Long- term outcome of paediatric patients with ANCA vasculitis

    OpenAIRE

    Pusey Charles D; Brogan Paul; Harper Lorraine; Smith Stuart W; Jawad Susan; Arulkumaran Nishkantha; Salama Alan D

    2011-01-01

    Abstract Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a fol...

  3. Imaging of systemic vasculitis in childhood

    International Nuclear Information System (INIS)

    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.)

  4. 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.)

  5. Phenytoin-Associated Granulomatous Pulmonary Vasculitis.

    Science.gov (United States)

    Kheir, Fayez; Daroca, Philip; Lasky, Joseph

    2016-01-01

    Phenytoin was introduced in 1938 for the control of seizure disorders and remains widely used today. Since that time, many cases of phenytoin-induced allergic reactions and clinical pulmonary disease have been reported. However, pulmonary vascular pathology from phenytoin use has been only very rarely described. We report a case of phenytoin-associated vasculitis in a 39-year-old African American man presenting with progressive dyspnea and abnormal chest imaging. The importance of reviewing the medication history along with familiarity with the array of drug-associated lung diseases is crucial to recognize and treat pneumotoxicity. PMID:24247101

  6. Cerebral large vessel vasculitis in systemic lupus erythematosus.

    Science.gov (United States)

    Böckle, B C; Jara, D; Aichhorn, K; Junker, D; Berger, T; Ratzinger, G; Sepp, N T

    2014-11-01

    Neuropsychiatric systemic lupus erythematosus (NPSLE) is defined by involvement of the central nervous system in systemic lupus erythematosus (SLE), with a wide range of both neurological and psychiatric manifestations. Although its aetiopathogenesis is not fully elucidated, NPSLE seems to be a consequence of cerebral vascular pathology including thromboembolism, small-vessel vasculopathy and, in rare cases, true vasculitis. Cerebral vasculitis is rare, and cerebral large-vessel vasculitis in SLE is even more unusual. We report the case of a female patient with the diagnosis of SLE. She presented with stroke-like symptoms, headache and vertigo, and palpable purpura on her legs. Further investigations revealed that she suffered from both vasculitis of the cerebral large vessels and coexisting cutaneous small-vessel vasculitis. PMID:24969082

  7. Membranoproliferative glomerulonephritis presenting as arthropathy and cardiac valvulopathy in hypocomplementemic urticarial vasculitis: a case report

    OpenAIRE

    Park, Chuiyoung; Choi, Seung Won; Kim, Misung; Park, Jongha; Lee, Jong Soo; Chung, Hyun Chul

    2014-01-01

    Introduction Hypocomplementemic urticarial vasculitis syndrome is a rare disorder characterized by chronic urticarial vasculitis, arthralgia, arthritis, and hypocomplementemia. Previously, only six patients with concomitant hypocomplementemic urticarial vasculitis syndrome, Jaccoud’s arthropathy, and valvular heart disease have been reported. Case presentation A 30-year-old Korean man presented with hypocomplementemic urticarial vasculitis syndrome. In addition to urticarial cutaneous lesions...

  8. Experimental Autoimmune Vasculitis : An Animal Model of Anti-neutrophil Cytoplasmic Autoantibody-Associated Systemic Vasculitis

    OpenAIRE

    Little, Mark A.; Smyth, Lucy; Salama, Alan D; Mukherjee, Sriparna; Smith, Jennifer; Haskard, Dorian; Nourshargh, Sussan; Cook, H. Terence; Charles D. Pusey

    2009-01-01

    The morbidity burden associated with anti-neutrophil cytoplasmic autoantibody-associated vasculitis is increasing, and many novel biological therapies are now entering the drug development pipeline. There is thus an urgent need to develop a representative animal model to facilitate testing of these agents. We previously examined the effect of antineutrophil cytoplasmic autoantibody on leukocyte-endothelial interactions in WKY rats via immunization with human myeloperoxidase. We now seek to ex...

  9. Churg-Strauss syndrome and hemorragic vasculitis

    Directory of Open Access Journals (Sweden)

    Rui Moreira Marques

    2011-12-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the lefthand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome.

  10. Current and emerging techniques for ANCA detection in vasculitis.

    Science.gov (United States)

    Csernok, Elena; Moosig, Frank

    2014-08-01

    Detection of antineutrophil cytoplasmic antibodies (ANCAs) is a well-established diagnostic test used to evaluate suspected necrotizing vasculitis of small blood vessels. Conditions associated with these antibodies, collectively referred to as ANCA-associated vasculitides, include granulomatosis with polyangiitis (formerly known as Wegener granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). The diagnostic utility of ANCA testing depends on the type of assay performed and on the clinical setting. Most laboratories worldwide use standard indirect immunofluorescence tests (IFT) to screen for ANCA and then confirm positive IFT results with antigen-specific tests for proteinase 3 (PR3) and myeloperoxidase (MPO). Developments such as automated image analysis of immunofluorescence patterns, so-called third-generation PR3-ANCA and MPO-ANCA ELISA, and multiplex technology have improved the detection of ANCAs. However, challenges in routine clinical practice remain, including methodological aspects of IFT performance, the diverse antigen-specific assays available, the diagnostic value of testing in clinical settings and the prognostic value of serial ANCA monitoring in the prediction of disease relapse. This Review summarizes the available data on ANCA testing, discusses the usefulness of the various ANCA assays and advises on the clinical indications for the use of ANCA testing. PMID:24890776

  11. Intracerebral haemorrhage and vasculitis secondary to amphetamine use.

    OpenAIRE

    Salanova, V.; Taubner, R.

    1984-01-01

    We report a case of amphetamine-related intracranial haemorrhage and vasculitis, responding to immunosuppressants. Angiograms obtained before and after therapy are shown; the importance of immunosuppressive therapy is discussed.

  12. Could we abandon cyclophosphamide in systemic vasculitis and lupus nephritis?

    NARCIS (Netherlands)

    Kallenberg, Cees G. M.

    2013-01-01

    Cyclophosphamide has greatly improved prognosis in antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) and proliferative lupus nephritis (LN). However, the side effects of long-term cyclophosphamide treatment are considerable prompting a search for alternatives to cyclophosphamide. F

  13. Genetically Distinct Subsets within ANCA-Associated Vasculitis

    NARCIS (Netherlands)

    Lyons, Paul A.; Rayner, Tim F.; Trivedi, Sapna; Holle, Julia U.; Watts, Richard A.; Jayne, David R. W.; Baslund, Bo; Brenchley, Paul; Bruchfeld, Annette; Chaudhry, Afzal N.; Tervaert, Jan Willem Cohen; Deloukas, Panos; Feighery, Conleth; Gross, Wolfgang L.; Guillevin, Loic; Gunnarsson, Iva; Harper, Lorraine; Hruskova, Zdenka; Little, Mark A.; Martorana, Davide; Neumann, Thomas; Ohlsson, Sophie; Padmanabhan, Sandosh; Pusey, Charles D.; Salama, Alan D.; Sanders, Jan-Stephan F.; Savage, Caroline O.; Segelmark, Mrten; Stegeman, Coen A.; Tesar, Vladimir; Vaglio, Augusto; Wieczorek, Stefan; Wilde, Benjamin; Zwerina, Jochen; Rees, Andrew J.; Clayton, David G.; Smith, Kenneth G. C.

    2012-01-01

    BACKGROUND Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a severe condition encompassing two major syndromes: granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) and microscopic polyangiitis. Its cause is unknown, and there is debate about whether it i

  14. Genetically distinct subsets within ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Lyons, Paul A; Rayner, Tim F; Trivedi, Sapna;

    2012-01-01

    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a severe condition encompassing two major syndromes: granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) and microscopic polyangiitis. Its cause is unknown, and there is debate about whether it is a sing...

  15. Pulmonary and cutaneous vasculitis following hepatitis B vaccination

    OpenAIRE

    Allen, Martin B; Cockwell, Paul; Page, Richard L.

    1993-01-01

    The case history is presented of a previously healthy non-atopic woman who developed cutaneous vasculitis, confirmed by biopsy, and pulmonary problems after inoculation with recombinant hepatitis B vaccine.

  16. Immune-Complex Allergic Vasculitis in Association with the Immune-Complex Allergic Vasculitis in Association with the Development of Transverse Myelitis: A Case Report

    OpenAIRE

    Nikol, Sigrid; Huehns, Tanya Y.; Pilz, Günter; Scheidt, Wolfgang von

    1996-01-01

    A severe vasculitis, probably therapy related, in a sixty-four-year-old man being treated for possible subacute bacterial endocarditis, was associated with the development of transverse myelitis. It is hypothesized that the vasculitis affected the small vessels to the spinal cord in the same way that systemic vasculitis can also cause a transverse myelitis.

  17. Hypersensitivity vasculitis after treatment with methylphenidate - case report

    OpenAIRE

    de Sá, Mário Correia; Faria, Carolina; Alves, Marta; Macedo, Liliana; Carvalho, Sónia

    2015-01-01

    Introduction: Hypersensitivity vasculitis is the small blood vessels’ inflammation secondary to the formation and endothelial deposition of immune complexes.Case Report: We describe a case of a 15 year-old female, recently medicated with methylphenidate for attention deficit hyperactivity disorder who presented recurrent episodes of feet pain and purpuric lesions on the toes. The lesions’ histopathological study showed findings consistent with lymphocytic vasculitis.Discussion: The clinical a...

  18. The long-term outcomes of systemic vasculitis.

    Science.gov (United States)

    Westman, Kerstin; Flossmann, Oliver; Gregorini, Gina

    2015-04-01

    Patients with generalized ANCA-associated small vessel vasculitis (AAV) have a very poor outcome if the ANCA-associated vasculitis is not diagnosed, evaluated and treated properly. The introduction of treatment with immunosuppressive therapy has improved patient survival dramatically but with considerable side effects. Besides, almost 50% of surviving patients experience a relapse of vasculitis. Since 1995, the European Vasculitis Society (EUVAS) has designed and conducted several clinical trials on patients with AAV independently of pharmaceutical companies. The studies included patients with newly diagnosed AAV and were stratified according to renal function and generalized versus more localized forms. As the immediate patient survival has improved, the longer term outcome has become more important. There are several reports on outcome of patients with ANCA-associated vasculitis, but the patient groups were heterogeneous regarding diagnosis as well as treatment and follow-up. Therefore, EUVAS decided to further evaluate the effect and possible adverse events of the original randomized trials. This review presents an overview on long-term follow-up of patients with ANCA-associated vasculitis, with focus on relapse rate, patient and renal survival and development of cardiovascular disease and malignancy. PMID:25601266

  19. 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.

  20. Lung vasculitis and alveolar hemorrhage: pathology.

    Science.gov (United States)

    Fishbein, Gregory A; Fishbein, Michael C

    2011-06-01

    Pulmonary vasculitides are a diverse group of limited and systemic disorders associated with inflammation of pulmonary vessels and parenchyma. These diseases often have distinctive clinical, serological, and histopathological features-extrapulmonary sites of involvement, circulating autoantibodies, predispositions for small or large vessels, and others. Some have characteristic inflammatory lesions; others are characterized by the absence of such lesions. Frequently pathological findings overlap, rendering classification, and diagnosis a challenge. The anti-neutrophil cytoplasmic antibody (ANCA)-associated small-vessel diseases constitute the major pulmonary vasculitides. These include Wegener granulomatosis (WG), Churg Strauss syndrome (CSS), and microscopic polyangiitis (MPA). Less frequently, diseases such as polyarteritis nodosa, Takayasu arteritis, Behçet syndrome, and connective tissue diseases may involve pulmonary vessels, but these entities are better associated with extrapulmonary disease. Diffuse alveolar hemorrhage (DAH) is a severe manifestation of pulmonary vasculitis. DAH is most commonly seen in small-vessel vasculitides, specifically MPA and WG. Other syndromes associated with DAH include Goodpasture syndrome, Henoch-Schönlein purpura, and systemic lupus erythematosus. Less commonly, DAH may be secondary to infection or drugs/toxins. Furthermore, in the absence of discernable systemic disease, DAH may be idiopathic-referred to as isolated pulmonary capillaritis (IPC) or idiopathic pulmonary hemosiderosis (IPH), depending on the presence of capillaritis. PMID:21674412

  1. Biological Therapy-Induced Systemic Vasculitis.

    Science.gov (United States)

    Gutiérrez-González, Luis Arturo

    2016-07-01

    The use of biologics has been associated with the paradoxical development of biologics-induced autoimmune diseases. The purpose of this review was to describe the key immunopathogenic mechanisms involved in the development of these conditions, and to discuss the clinical and laboratory characteristics usually described in the medical literature, reviewing case reports as well as records on national biologic therapies (BIOGEAS, RABBIT, BSRBR-RA, BIOBADAVEN). More than 200 cases have so far been reported, all of them diagnosed on the basis of the histopathology or meeting the ACR/Chapel Hill criteria. Over 75 % of the cases were females with a mean age of 48 ± 5 years. More than 50 % had rheumatoid arthritis. Most of the biologics-associated vasculitis developed in 90 ± 31 days. Complete resolution in almost 75 % of the cases was observed upon treatment discontinuation; however, steroid therapy was indicated for all patients and one death was recorded. The use of cyclophosphamide, rituximab or plasma exchange was reserved for the most severe cases. PMID:27165496

  2. CT findings at lupus mesenteric vasculitis

    International Nuclear Information System (INIS)

    Purpose: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. Methods: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesentric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n=11), ascites with slightly increased peritoneal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. Conclusion: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved. (orig.)

  3. Clinical and immunological features of retinal vasculitis in systemic diseases

    Directory of Open Access Journals (Sweden)

    Paović Jelena

    2009-01-01

    Full Text Available Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8% of total uveitis. In more than half of the cases of vasculitis (58.8%, both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5% than periarteritis (4.7%. Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%. Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65% of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis

  4. Review article : The role of CD4(+) T cells in ANCA-associated systemic vasculitis

    NARCIS (Netherlands)

    Abdulahad, Wayel H.; Stegeman, Coen A.; Kallenberg, Cees G. M.

    2009-01-01

    Antineutrophil cytoplasmic autoantibody (ANCA)-associated systemic vasculitis (AASV) constitutes a group of primary vasculitides associated with antineutrophil cytoplasmic autoantibodies, which are either directed to proteinase-3 or myeloperoxidase. In contrast to other forms of vasculitis, immuohis

  5. Radiologic studies in two outbreaks of isolated vasculitis in the central nervous system

    International Nuclear Information System (INIS)

    Cerebral vasculitis is only occasionally diagnosed with angiography. Two outbreaks of isolated central nervous system vasculitis permitted a comparison of the accuracy of diagnostic radiologic studies. Two new radiologic features and methods of diagnosis are discussed

  6. Cutaneous Vasculitis in a Patient with Antiphospholipid Antibody Syndrome.

    Science.gov (United States)

    Sheth, Khushboo; Parke, Ann

    2016-02-01

    Antiphospholipid antibody syndrome (APS) is an acquired thrombophilia, caused by autoantibodies to anticardiolipin (aCL), or antibeta 2 glycoprotein I, or the presence of lupus anticoagulant (LA) in plasma. It is characterized by recurrent venous and/or arterial thrombi and/or pregnancy related morbidities. We present the case of a 52-year-old female with long-standing APS, who developed cutaneous vasculitis following a common cold. Most of the cutaneous manifestations of APS have been found to be thrombotic on histopathology without evidence of perivascular inflammation. Vasculitis is usually seen in APS patients with coexistent Systemic Lupus Erythematosus (SLE). However, our patient had evidence of vasculitis on skin biopsy and did not have SLE. Though rare, this is a disease process which must be considered in patients with primary APS which must be closely monitored for other vasculitic complications of APS, particularly diffuse alveolar hemorrhage. PMID:27024977

  7. A Fatal Case of "Bullous Erysipelas-like" Pseudomonas Vasculitis.

    Science.gov (United States)

    Yang, Sam Shiyao; Chandran, Nisha Suyien; Huang, Jing Xiang; Tan, Kong-Bing; Aw, Derrick Chen-Wee

    2016-01-01

    Erysipelas is a generally benign superficial bacterial skin infection, and its bullous form constitutes a rare and more severe variant. We describe the first and fatal case of "bullous erysipelas-like" septic vasculitis due to Pseudomonas bacteremi. A 69-year-old Chinese man presenting with diarrhea and septic shock initially began to rapidly develop sharply defined erythematous plaques with non-hemorrhagic bullae over his lower limbs. Culture of the aspirate from the bullae was positive for Pseudomonas aeruginosa. This was also consistent with his blood cultures showing Pseudomonas bacteremia. Histology of the skin lesion showed microthrombi and neutrophilic infiltrates in blood vessels with Gram-negative bacilli extruding from the vessel walls, characteristic of septic vasculitis. The bullous erysipelas-like lesions seen in this patient represents a rare manifestation of both septic vasculitis and Pseudomonas infection. PMID:26955132

  8. A Case of Brucellosis with Recurrent Attacks of Vasculitis

    Science.gov (United States)

    Korkmaz, Pınar; Kıdır, Mehtap; Namdar, Nazlı Dizen; Özmen, Ahmet; Uyar, Cemile; Değer, Ayşe Nur

    2016-01-01

    Brucellosis is a zoonosis that affects several organs or systems. Skin involvement is nonspecific and it is reported to range between 0,4 and 17% of the patients with brucellosis. Here, we defined a 36-year-old female patient presented to our clinic with a clinical picture of recurrent attacks of vasculitis due to brucellosis for the first time. Skin involvement and vasculitic lesions as a finding of skin involvement are nonspecific in brucellosis. Therefore, in the regions like Turkey where brucellosis is endemic, brucellosis should be kept in mind necessarily in the differential diagnosis of vasculitis. PMID:27042369

  9. Isolated Central Nervous System Vasculitis Associated with Antiribonuclear Protein Antibody

    Directory of Open Access Journals (Sweden)

    Amer M. Awad

    2011-01-01

    Full Text Available We describe the case of a young woman who was referred to a tertiary care center with unexplained subacute progressive encephalopathy preceded by long-standing severe headaches. Her extensive workup was remarkable for abnormal intracranial angiography suggestive of small- and medium-vessel vasculitis, persistently elevated protein in the cerebrospinal fluid and persistently high titers of antiribonuclear protein antibody. The patient showed a modest response to intravenous high-dose steroids. We propose that the patient's neurologic disease is secondary to immune-mediated central nervous system vasculitis, possibly as an initial manifestation of mixed connective tissue disease.

  10. Infliximab for Idiopathic Deep Cutaneous Vasculitis Refractory to Cyclophosphamide

    Directory of Open Access Journals (Sweden)

    Marcelo Derbli Schafranski

    2010-01-01

    Full Text Available Cutaneous vasculitis can be classified as primary or idiopathic; or secondary, when it presents as a manifestation of connective tissue diseases, infections, drug reactions or malignancies. Although most of the idiopathic cases are self-limited and responsive to supportive measures and nonsteroidal anti-inflammatory drugs, potent immunosuppressants are sometimes required for the management of the refractory situations. Here we describe a case of a 32-year-old Caucasian female patient with history of idiopathic cutaneous deep vasculitis unresponsive to methotrexate, dapsone, and cyclophosphamide who was effectively treated with infliximab.

  11. A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

    DEFF Research Database (Denmark)

    Suppiah, Ravi; Mukhtyar, Chetan; Flossmann, Oliver; Alberici, Federico; Baslund, Bo; Batra, Rajbir; Brown, Denise; Holle, Julia; Hruskova, Zdenka; Jayne, David R W; Judge, Andrew; Little, Mark A; Palmisano, Alessandra; Stegeman, Coen; Tesar, Vladimir; Vaglio, Augusto; Westman, Kerstin; Luqmani, Raashid

    2011-01-01

    and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity. Results. WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [¿¿=¿0.82 (95% CI 0.77, 0.85)], PGA...... [¿¿=¿0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [¿¿=¿0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [¿¿=¿0.18 (95% CI 0.05, 0.30)] or with the VDI [¿¿=¿-0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an...

  12. Critical Involvement of Cytokines and Chemokines in the Pathogenesis of Rheumatoid Vasculitis

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Kasama

    2008-01-01

    Full Text Available Vasculitis in rheumatoid arthritis (rheumatoid vasculitis has a heterogeneous clinical presentation that includes skin disorders, neuropathy, eye symptoms and systemic inflammation. The molecular mechanisms underlying rheumatoid vasculitis are not fully understood; however, the importance of a chronic imbalance of the cytokines and chemokines involved in orchestrating infl ammatory responses is well established in patients with rheumatoid arthritis, and similar dysregulation of these mediators has been suggested to occur in patients with rheumatoid vasculitis. In the present review, we discuss the involvement of cytokines and chemokines in the pathogenesis of rheumatoid vasculitis and evaluate their utility as laboratory parameters of active vasculitic disease. Also the involvement of adhesion molecules is discussed.

  13. Animal models of antineutrophil cytoplasm antibody-associated vasculitis.

    LENUS (Irish Health Repository)

    Salama, Alan D

    2012-01-01

    To provide an update on the experimental models that have been developed recapitulating clinical antineutrophil cytoplasm antibody (ANCA) associated vasculitis. The application of the models in the study of pathogenesis, and the therapeutic implications of this, are covered in the article by van Timmeren and Heeringa in this issue.

  14. Epigenomic functional characterization of genetic susceptibility variants in systemic vasculitis.

    Science.gov (United States)

    Sawalha, Amr H; Dozmorov, Mikhail G

    2016-02-01

    Systemic vasculitides are poorly understood inflammatory diseases of the blood vessels that are frequently associated with significant organ damage. Genetic risk variants contribute to the susceptibility of vasculitis, but functional consequences of these genetic variants are largely unknown. Most genetic risk variants in immune-mediated diseases, including systemic vasculitis, are localized to non-coding genetic regions suggesting they might increase disease risk by influencing regulatory elements within the genome. Long range regulatory interactions pose an additional obstacle in localizing functional consequences associated with risk variants to specific genes or cell types. We used cell-type specific enrichment patterns of histone changes that mark poised, primed, and active enhancers, and DNase hypersensitivity to identify specific immune cells mediating genetic risk in vasculitis. Our data suggest that genetic risk variants in ANCA-associated vasculitis are significantly enriched in enhancer elements in Th17 cells, supporting a role for Th17 cells in this disease. Primed and active enhancer elements in B cells can be potentially affected by genetic risk variants associated with Kawasaki disease. Genetic risk in Behçet's disease and Takayasu arteritis might affect enhancer elements in multiple cell types, possibly explained by influencing enhancers in hematopoietic stem cells. Interestingly, our analyses indicate a role for B cells in Kawasaki disease, Behçet's disease, and Takayasu arteritis, and suggest that further work to characterize the involvement of B cells in these diseases is warranted. PMID:26492816

  15. Genetically distinct subsets within ANCA-associated vasculitis.

    LENUS (Irish Health Repository)

    Lyons, Paul A

    2012-07-19

    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a severe condition encompassing two major syndromes: granulomatosis with polyangiitis (formerly known as Wegener\\'s granulomatosis) and microscopic polyangiitis. Its cause is unknown, and there is debate about whether it is a single disease entity and what role ANCA plays in its pathogenesis. We investigated its genetic basis.

  16. [Hypocomplementemic urticarial vasculitis syndrome. Successful therapy with intravenous immunoglobulins].

    Science.gov (United States)

    Staubach-Renz, P; von Stebut, E; Bräuninger, W; Maurer, M; Steinbrink, K

    2007-08-01

    Autoimmune diseases can initially present as chronic urticaria. We describe the course of a patient with hypocomplementemic urticarial vasculitis syndrome (HUVS) as well as his successful treatment with high-dose intravenous immunoglobulins (IVIG). HUVS was diagnosed clinically and confirmed by histology and laboratory studies. After only one cycle with IVIG (2 g/kg) all HUVS symptoms were significantly decreased. PMID:17453168

  17. Ten year clinical experience with stroke and cerebral vasculitis.

    Science.gov (United States)

    Kempster, Peter A; McLean, Catriona A; Phan, Thanh G

    2016-05-01

    Angiitis of the central nervous system (CNS) is difficult to diagnose but potentially fatal. When stroke occurs in a younger individual or is associated with multiple infarcts on imaging, clinicians must decide how far to pursue a possible diagnosis of vasculitis. The aim of this study is to establish the prevalence of primary and secondary cerebral angiitis among patients presenting with stroke. Hospital attendances over a 10year period were surveyed by searching for diagnostic codes and key words specific for cerebral vasculitis/angiitis. Case notes were reviewed by the authors using two sets of criteria for angiitis of the CNS. Thirty-two patients were initially considered likely to have cerebral angiitis by treating physicians. Thirteen had been admitted to hospital with stroke. During this period, there were 7475 admissions for ischaemic and haemorrhagic stroke. Six patients had a final diagnosis of vasculitic stroke but only one had definite CNS angiitis with a first presentation as ischaemic stroke (0.02%). Most patients who did have cerebral vasculitis developed multifocal or subacute neurological deficits, or already had an immunological disorder known to be associated with secondary CNS angiitis. Of 19 patients given an alternative final diagnosis, the most common were atherosclerotic/embolic cerebrovascular disease (n=9) and reversible cerebral vasoconstriction syndrome (n=7). Stroke is rarely the first manifestation of cerebral vasculitis. Our findings suggest that routine screening for angiitis in stroke patients may not be warranted. PMID:26778046

  18. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  19. ORIGINAL ARTIC LE: LEUCOCYTOCLASTIC VASCULITIS: A CLINICOPATHOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Anila Sunandini

    2015-10-01

    Full Text Available Vasculitis is the inflammation of blood vessels weather it can be arteries , veins or both. In CSVV , the vasculitic process involves just the small blood vessels within the skin , primarily postcapillary venules. The etiology and clinical features are varied but histopathology is characterized by leucocytoclasia. AIMS AND OBJECTIVES : The present study was done to know t h e spectrum of variou s cutaneous manifestations and etiology of leucocytoclastic vasculitis. MATERIALS AND METHODS : The study was carried out on patients who were clinically diagnosed as cutaneous vasculitis , attending the outpatient department of dermatol ogy , venereology and leprosy , K ing George hospital , affiliated to Andhra medical college , Visakhapatnam from January 2013 to December 2013. It is a cross - sectional type of study and a total of 20 cases were studied. INCLUSION CRITERIA : All patients attendi ng to opd , clinically diagnosed as cutaneous vasculitis irrespective of age and sex were included in study. EXCLUSION CRITERIA : Patients with thrombocytopenic purpura , disorders of coagulation and on warfarin/heparin treatment . RESULTS : Out of 20 patients enrolled in study , most common age group is in between 20 - 40 years , female preponderance , and most of patients , 75% presented acutely with lesions less than 6 weeks duration , 70% of patients had symptoms of burning and itching in lesions , 40% had history of low grade fever , 45% had arthralgias , 50% had gastrointestinal symptoms , 20% had history of sore throat , 10% had history of significant drug exposure within 6 weeks of onset of lesions. Majority of patients had elevated ESR (75%. 25% of patients had AS O titres positive , of which only 15% has throat swab positive for beta - hemolytic streptococci , ANA titres were positive in 5% , renal involvement in the form of albuminuria was seen in 20% , hematuria in 10% , urinary tract infection in 10% of cases , histopat hology of all patients showed

  20. Long- term outcome of paediatric patients with ANCA vasculitis

    Directory of Open Access Journals (Sweden)

    Pusey Charles D

    2011-06-01

    Full Text Available Abstract Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a follow up time of greater than 10 years were included. We also reviewed the literature for articles describing the clinical outcome of paediatric patients with ANCA vasculitis. Results We describe the clinical course of 8 adults who presented in childhood with ANCA vasculitis. 7 patients had Wegener's granulomatosis and 1 had microscopic polyangiitis. The median age at presentation was 11.5 years, and follow up time ranged form 11 to 30 years. Induction therapy for all patients was steroids and/or cyclophosphamide. Maintenance therapy was with azathioprine or mycophenolate mofetil. Biological agents were used in 3 patients for relapsed disease in adulthood only. Seven patients achieved complete remission. All patients experienced disease relapse, with a median of 4 episodes. Kidney function was generally well preserved, with median eGFR 76 ml/min. Only one patient developed end-stage renal failure and one patient died after 25 years of disease. Treatment-related morbidity rates were high; 7 suffered from infections, 4 were infertile, 2 had skeletal complications, and 1 developed malignancy. Conclusion Close long- term follow up of paediatric patients with ANCA vasculitis is imperative, as this patient cohort is likely to live long enough to develop significant treatment and disease- related morbidities. Prospective cohort studies with novel therapies including paediatric patients are crucial to help us determine the best approach to managing this complex group

  1. EMERGENCY CALLS

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  2. CUTANEOUS NECROTISING VASCULITIS – THERAPEUTIC FACT -A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kiran

    2012-08-01

    Full Text Available ABSTRACT: INTRODUCTION: Mixed connective tissue disorder, unlike other conn ective tissue disorders have a milder course. MTCD with only nec rotizing cutaneous vasculitis without organ damage respond well to Immunosuppresents and Steroids. CASE REPORT : Middle aged Young lady presented with multiple non healing large pressur e sores and multiple nonblanchable purpuric lesions. She was bedridden, anaemic and wit h significant weight loss. All her major organ functions were normal. Her U 1 RNP Antibody is positive and Skin Biopsy showed positive direct fluorescent test for IgG. She respond ed well to immunosuppresants and steroids. CONCLUSION: This patient who presented with MTCD, with predominant necrotizing cutaneous vasculitis and without major organ involv ement showed good recovery and responded well to cyclophosphamide pulse therapy, daily azathioprine and good wound care

  3. Primary Central Nervous System Vasculitis With Optic Nerve Involvement.

    Science.gov (United States)

    Benson, Christy E; Knezevic, Alexander; Lynch, Shannon C

    2016-06-01

    A 20-year-old woman presented with headache, decreased vision, eye pain, and urinary retention. During her clinical course, visual acuity declined to 20/800, right eye, and 20/50, left eye, associated with bilateral optic disc edema. Brain magnetic resonance imaging revealed enhancement of the leptomeninges, right optic nerve, and right side of the optic chiasm. Extensive evaluation of the central nervous system (CNS) for an infectious cause was negative. Brain biopsy showed a pattern consistent with vasculitis. The patient was treated with prednisone and cyclophosphamide, resulting in improvement of her vision and systemic symptoms. Primary CNS vasculitis is a rare condition that may affect the anterior visual pathways. PMID:26693942

  4. Dividing the Janus vasculitis? Pathophysiology of eosinophilic granulomatosis with polyangitis.

    Science.gov (United States)

    Chaigne, Benjamin; Terrier, Benjamin; Thieblemont, Nathalie; Witko-Sarsat, Véronique; Mouthon, Luc

    2016-02-01

    Eosinophilic granulomatosis with polyangitis (EGPA) is a rare small- and medium-sized vessel vasculitis belonging to the group of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV). It is commonly divided into two phenotypes depending on the presence of ANCAs targeting myeloperoxidase (MPO). MPO-ANCAs are present in 31% to 38% of patients and are associated with a vasculitis phenotype of the disease, whereas patients without MPO-ANCA are at risk of cardiac involvement. Despite significant advances in understanding the overall pathogenesis of the disease, the explanation for this dichotomy is still unclear. In this review, we synthesize our knowledge of the pathogenesis of EGPA and attempt to i) distinguish EGPA from other diseases including other AAVs, asthma, allergy and hypereosinophilic-associated conditions and ii) speculate about the preponderant mechanisms, which could explain the two disease phenotypes. PMID:26506114

  5. Small vessel vasculitis History, classification, etiology, histopathology, clinic, diagnosis and treatment

    International Nuclear Information System (INIS)

    Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with pleomorphic clinical manifestations. The classical clinical phenotype is leucocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leucocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated, The diagnosis of small- vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and anti neutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine liver function tests, urinalysis, radiographic imaging and biopsy. The treatment is based primarily on corticosteroid and immunosuppressive agents

  6. A Case of Brucellosis with Recurrent Attacks of Vasculitis

    OpenAIRE

    Pınar Korkmaz; Mehtap Kıdır; Nazlı Dizen Namdar; Ahmet Özmen; Cemile Uyar; Ayşe Nur Değer

    2016-01-01

    Brucellosis is a zoonosis that affects several organs or systems. Skin involvement is nonspecific and it is reported to range between 0,4 and 17% of the patients with brucellosis. Here, we defined a 36-year-old female patient presented to our clinic with a clinical picture of recurrent attacks of vasculitis due to brucellosis for the first time. Skin involvement and vasculitic lesions as a finding of skin involvement are nonspecific in brucellosis. Therefore, in the regions like Turkey where ...

  7. ORIGINAL ARTIC LE: LEUCOCYTOCLASTIC VASCULITIS: A CLINICOPATHOLOGICAL STUDY

    OpenAIRE

    Anila Sunandini; Guru Prasad; Padmasri Somal; Priyadarshini; Rajesh Kumar; Jyothi; Revathi

    2015-01-01

    Vasculitis is the inflammation of blood vessels weather it can be arteries , veins or both. In CSVV , the vasculitic process involves just the small blood vessels within the skin , primarily postcapillary venules. The etiology and clinical features are varied but histopathology is characterized by leucocytoclasia. AIMS AND OBJECTIVES : The present study was done to know t h e spectrum of variou s cutaneous manifestations and etiology...

  8. Endothelial injury and repair in vasculitis of the young

    OpenAIRE

    Clarke, L

    2009-01-01

    The vasculitides are a wide spectrum of disorders which are characterised by vascular inflammation. Endothelial injury can occur as a consequence of inappropriate inflammation and is central to the pathogenesis of these varied diseases. This thesis documents the development of assays for detection of novel biomarkers of endothelial injury and/or activation and subsequent reparative responses in children with primary systemic vasculitis. It focuses in particular on circulating endothelial cell...

  9. Hypocomplementaemic urticarial vasculitis syndrome: a mimicker of systemic lupus erythematosus

    OpenAIRE

    ROY, KRISHNENDU; Talukdar, Arunansu; Kumar, Bappaditya; Sarkar, Sumanta

    2013-01-01

    A middle aged female patient presented with generalised palpable purpura associated with intense pruritus along with subconjunctival haemorrhage and orbital inflammation. There was extensive dermographism. Other systemic examinations were within normal limits. Haematological profile was normal except raised D-dimer. Skin biopsy revealed the presence of leucocytoclastic vasculitis. Antinuclear antibody was positive in a titre of 1 : 160, but antidouble-stranded DNA was negative. Urine examinat...

  10. Clinical and molecular studies in ANCA associated vasculitis

    OpenAIRE

    Wendt, Mårten

    2014-01-01

    ANCA associated vasculitis (AAV) is a heterogeneous group of diseases characterised by sterile pauci-immune systemic small vessel inflammation and closely associated with the presence of anti-neutrophil cytoplasmatic antibodies (ANCA). Although AAV can affect any organ, the kidney, skin, lungs and upper and lower airways are most commonly involved. In some patients there is granuloma formation and in some asthma and eosinophilia, and based on this patients can be further classi...

  11. Leucocytoclastic vasculitis in a patient with azathioprine hypersensitivity.

    OpenAIRE

    Beckett, C. G.; Hill, P.; Hine, K R

    1996-01-01

    We report the case of a 77-year-old man admitted nine days after being commenced on azathioprine with symptoms initially thought to be secondary to sepsis but in fact due to azathioprine hypersensitivity. He developed histologically proven cutaneous leucocytoclastic vasculitis following the re-introduction of azathioprine. We review the literature concerning adverse reactions to azathioprine and the problems of making the diagnosis as well as highlighting azathioprine as a novel cause of leuc...

  12. Clinical features and outcomes of ANCA-associated renal vasculitis

    Directory of Open Access Journals (Sweden)

    Sidy Mohamed Seck

    2012-01-01

    Full Text Available To determine the patterns and outcomes of the pauci-immune vasculitis in the nephrology department at hospital La Conception in Marseille, we conducted a retrospective study including all patients with diagnosis of pauci-immune renal vasculitis between January 1, 2000 and December 31, 2007. Among 33 cases, 25 were diagnosed as Wegener granulomatosis (WG, seven as microscopic polyangitis (MPA and one as Churg-Strauss syndrome (SCS. The median age of the patients was 57.7 years and the sex-ratio (M/F was 1.6. The visceral mani-festations included kidneys (100% of patients, lungs (75%, ENT (52% of WG, and nervous system (57% of MPA. The mean serum creatinine at admission was 3.3 mg/dL. Renal biopsies revealed a pauci-immune crescentic gromerulonephritis in 96% of the cases. Two patients with WG received plasmapheresis and seven patients required emergency hemodialysis. Induction therapy comprised cyclophosphamide IV and corticosteroids, while maintenance therapy included azathioprine for the majority of patients. Eighty four percent of the patients experienced complete remission after induction therapy. During maintenance therapy relapses were more frequent among patients with MPA (28% compared to WG cases (12%. After 35 months of follow-up, eight patients ended on chronic hemodialysis, and five patients died. ANCA associated vasculitis are frequent in our patients. Long-term outcomes are relatively good despite a mortality rate of 15% and 25% of the patients entering dialysis after three years of follow-up.

  13. Serum soluble interleukin 2 receptor levels in anti-neutrophil cytoplasmic autoantibodies--positive systemic vasculitis.

    OpenAIRE

    Lai, K N; Lockwood, C. M.

    1993-01-01

    Systemic vasculitis is characterized by the presence of autoantibodies to neutrophil cytoplasmic antigens (ANCA). The role of T-lymphocytes in systemic vasculitis remains uncertain. In the present study, we attempted to explore the role of T-lymphocytes in systemic vasculitis by measuring the serum soluble interleukin 2 receptor (sIL2R) levels in seven vasculitic patients and comparing the sequential measurements with the titres of ANCA which satisfactorily reflect the disease activity. The s...

  14. 587 Plasmapheresis in a Patient with “Refractory” Urticarial Vasculitis

    OpenAIRE

    Kartal, Ozgur; Gulec, Mustafa; Caliskaner, Zafer; Nevruz, Oral; Cetin, Turker; Sener, Osman

    2012-01-01

    Background Immune complexes have been found in the circulation approximately 30 to 75% of patients with urticarial vasculitis and much evidence supports the role of these immune complexes in the pathogenesis of urticarial vasculitis. Plasmapheresis is effective in removal of these immune complexes. However, few cases have been reported regarding the use of plasmapheresis in the treatment of urticarial vasculitis. Methods A 35-year-old woman presented with history of recurrent episodes of gene...

  15. Nodular Vasculitis That Developed during Etanercept (Enbrel) Treatment in a Patient with Psoriasis

    OpenAIRE

    Park, Seung-Bae; Chang, In-Kyu; Im, Myung; Lee, Young; Kim, Chang-Deok; Seo, Young-Joon; Lee, Jeung-Hoon

    2015-01-01

    Nodular vasculitis was introduced by Montgomery for cases of erythema induratum-like lesions that were not associated with tuberculosis. Nodular vasculitis has been associated with both nontuberculous infections and noninfectious conditions. However, there has been no report on the development of nodular vasculitis during tumor necrosis factor-α inhibitor treatment. A 28-year-old man visited our clinic for the treatment of severe psoriasis with a 20-year history. Subcutaneous injection of eta...

  16. A rheumatology perspective on cutaneous vasculitis: assessment and investigation for the non-rheumatologist.

    Science.gov (United States)

    Rawlings, Charlotte R; Fremlin, Georgina A; Nash, Julian; Harding, Keith

    2016-02-01

    Vasculitis, by definition, is inflammation of the vasculature. This inflammation can result in either vessel wall destruction causing aneurysm or rupture, or stenosis causing ischaemia or necrosis. This autoimmune response does not always have a clear cause. Vasculitis is a heterogeneous group of disorders that has been categorised not only by primary and secondary causes, but also by the size of the affected vessel. The secondary causes that can trigger vasculitis include infection (particularly hepatitis B and C and haemorrhagic fever);cancer, autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and Sjogren's; drugs or allergic reactions. As vasculitis can affect any part of the vasculature, it can result in a wide range of signs and symptoms. However, one of the most common presentations of vasculitis is a rash, due to small vessel vasculitis, which is most common. A vasculitic rash has certain characteristics that are easily identifiable and differentiate it from other rashes. This is a review from a rheumatologist's perspective of how to identify vasculitis skin changes. If cutaneous vasculitis is suspected, this article identifies other areas of skin that can be affected that need identification, in addition to what to screen for in the history and other differential diagnoses to consider. Subsequently, the article addresses the key investigations to request and a brief overview of the treatment principles for primary vasculitis. PMID:25818263

  17. Necrotizing leptomeningeal vasculitis associated with a compressive meningioma in a cat: a rare paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Les J. Gabor

    2012-02-01

    Full Text Available A 17 year old cat with a compressive meningioma was found to have an intradural, severe necrotizing vasculitis, spatially un associated with the neoplasm. Paraneoplastic vasculitis has been reported in two cases in the human literature associated with meningiomas. This is the first report of such an association in a domestic species.

  18. CRYOGLOBULINEMIC VASCULITIS ASSOCIATED WITH HBV INFECTION: CLINICAL OBSERVATIONS AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    N. V. Dunaeva

    2014-08-01

    Full Text Available Description of two clinical cases of chronic HBV hepatitis at cirrhotic stage associated with type III cryoglobulinemia manifested with symptoms of systemic vasculitis is presented in current article. There were no signs of HCV infection in both patients. In first case cutaneous vasulitis appeared after 19 years since serological finding of HBsAg and vasculitis progressed despite steroid therapy. Initiation of antiviral therapy (entecavir 0.5 g/day induced transient remission. After interruption of antiviral therapy vasculitis reappeared with several vasculitic ulcers on lower legs. Mild improvement of vasculitis was noted after repeated plasmapheresis, steroid and cytostatic treatment with addition of lamivudin. Despite therapy reactivation of HBV infection was detected. Lamivudin was changed to entecavir and rituximab was given in two 500 mg infusions. Combined antiviral and anti-CD20 treatment induced remission of cutaneous vasculitis and healing of leg ulcers. In other case vasculitis manifested after 21 years since detection of HBsAg with cutaneous purpura, arthritis and microhematuria. Entecavir 0.5 g/day induced rapid virological response and complete remission of symptoms related to vasculitis. Similar literature cases were reviewed and available treatment options in refractory cryoglobulinemic vasculitis were discussed.

  19. Diffuse Large B Cell Lymphoma in a Patient with Hypocomplementemic Urticarial Vasculitis

    Directory of Open Access Journals (Sweden)

    Calvo-Romero J

    2003-01-01

    Full Text Available Hypocomplementemic urticarial vasculitis (HUV is known to be associated with malignancies. Urticarial vasculitis has been linked to lymphomas, but to our knowledge, the association of HUV and non-Hodgkin lymphoma has not been described so far. A patient with HUV who developed 10 years later a diffuse large B cell lymphoma is reported here.

  20. Diffuse Large B Cell Lymphoma in a Patient with Hypocomplementemic Urticarial Vasculitis

    OpenAIRE

    Calvo-Romero J

    2003-01-01

    Hypocomplementemic urticarial vasculitis (HUV) is known to be associated with malignancies. Urticarial vasculitis has been linked to lymphomas, but to our knowledge, the association of HUV and non-Hodgkin lymphoma has not been described so far. A patient with HUV who developed 10 years later a diffuse large B cell lymphoma is reported here.

  1. Call Forecasting for Inbound Call Center

    OpenAIRE

    Peter Vinje

    2009-01-01

    In a scenario of inbound call center customer service, the ability to forecast calls is a key element and advantage. By forecasting the correct number of calls a company can predict staffing needs, meet service level requirements, improve customer satisfaction, and benefit from many other optimizations. This project will show how elementary statistics can be used to predict calls for a specific company, forecast the rate at which calls are increasing/decreasing, and determine if the calls may...

  2. Urticarial vasculitis induced by OTC diet pills: a case report

    OpenAIRE

    Chérrez Ojeda, Iván; Loayza, Enrique; Greiding, Leonardo; Calderón, Juan Carlos; Cherrez, Annia; Adum, Farid

    2015-01-01

    Background Urticarial Vasculitis (UV) is in most of the cases idiopathic; however it has been associated with several conditions and drugs. Over the counter (OTC) diet pills are widely available, even on-line, but they are rarely regulated by pharmaceutical control. Case presentation We present the case of a 35-year-old female patient suffering of pruriginous and painful wheals more than 1 cm in diameter, with a burning sensation. The eruption lasted more than 24 hours and was accompanied by ...

  3. ANCA-associated vasculitis in Hispanic Americans: an unrecognized severity.

    Science.gov (United States)

    Sreih, Antoine G; Mandhadi, Ranadeep; Aldaghlawi, Fadi; Khan, Asad; Irshad, Vajiha; Finn, Katherine; Block, Joel A

    2015-05-01

    This study aims to compare the severity and outcomes of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) between Hispanics and Caucasians living in the same geographical area. All patients diagnosed with AAV at two academic institutions in Chicago from January 2006 to December 2012 were retrospectively and prospectively identified. Disease activity was measured with the Birmingham Vasculitis Activity Score (BVAS), and disease damage was measured with the Vasculitis Damage Index (VDI). Student's t test and chi-square tests were employed; p ≤ 0.05 was considered significant. Seventy patients with AAV were identified; 15 patients were excluded. Fifty-five patients were included in the study: 23 Hispanics and 32 Caucasians, 35 patients with granulomatosis with polyangiitis (Wegener's), 12 with microscopic polyangiitis, 7 with eosinophilic granulomatosis with polyangiitis, and 1 with renal-limited vasculitis. Compared to Caucasians, Hispanics had a higher BVAS at presentation (16.3 ± 7.6 versus 10.7 ± 7.5, p = 0.006), a higher VDI at presentation (2.90 ± 1.50 versus 2.06 ± 1.30, p = 0.030), and a cumulative VDI (3.90 ± 1.70 versus 2.50 ± 1.90, p = 0.010). Renal involvement was more common among Hispanics (85 % of Hispanics versus 48 % of Caucasians, p = 0.01). Seventy percent of Hispanics had acute renal failure (mean creatinine = 3.37 ± 4.4 mg/dl) of whom seven (50 %) required dialysis, versus 25 % of Caucasians (mean creatinine = 1.78 ± 1.57 mg/dl, p = 0.03) and only two requiring dialysis. Compared to Caucasians, Hispanics with AAV present with more severe disease and higher damage indices. Larger studies are required to confirm these findings and delineate the respective roles of environment and genetics in the pathogenesis of the disease. PMID:24752347

  4. Disseminated gonococcal infection presenting as vasculitis: a case report

    OpenAIRE

    Jain, Sangita; Win, Htet Nwe; Chalam, Venkat; Yee, Lian

    2007-01-01

    A 50‐year‐old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria go...

  5. Call Center ist nicht gleich Call Center

    OpenAIRE

    Baumgartner, Marc; Udris, Ivars

    2005-01-01

    Untersuchungen in 14 Schweizer Call Centers erbrachten vier Call Center-Typen, die sich hinsichtlich Arbeitstätigkeiten und Kommunikationsrichtung voneinander unterscheiden: (a) Beratungs- und Beschwerdemanagement, (b) Informationsmanagement, (c) Auftragsmanagement und (d) Kunden- und Kampagnenmanagement. Dies hat auch Auswirkungen auf die Personalstruktur, -selektion und -entwicklung der Call Center. Es wird der Frage nachgegangen, welche Kompetenzanforderungen in den unterschiedlichen Call ...

  6. Urticarial vasculitis: an autoimmune disorder following therapy for Hodgkin's disease.

    Science.gov (United States)

    Strickland, D K; Ware, R E

    1995-09-01

    Immunological abnormalities have been described in patients with Hodgkin's disease, both associated with the malignancy itself and occurring secondary to therapy. These abnormalities often manifest as an immunodeficiency state, but can also present as immune dysregulation and autoimmune disease. We report two young patients with Hodgkin's disease who, following successful therapy, developed urticarial vasculitis (UV), a form of cutaneous autoimmune vasculitis. Both patients also had systemic symptoms including fever, an elevated erythrocyte sedimentation rate and serum copper, and abnormal in vitro studies of lymphocyte enumeration and proliferation. Distinguishing UV from recurrent Hodgkin's disease was especially difficult in one patient, and was possible only by lymph node biopsy. One patient has responded well to immunosuppressive therapy, while the other, who has more profound immune dysfunction, has developed a chronic autoimmune disorder. UV may thus occur in patients after therapy for Hodgkin's disease; we hypothesize that immune dysregulation, either associated with the malignancy or resulting from therapy, is important in the pathogenesis of this autoimmune process. PMID:7623731

  7. Eosinophils in vasculitis: characteristics and roles in pathogenesis

    Science.gov (United States)

    Khoury, Paneez; Grayson, Peter C.; Klion, Amy D.

    2016-01-01

    Eosinophils are multifunctional granular leukocytes that are implicated in the pathogenesis of a wide variety of disorders, including asthma, helminth infection, and rare hypereosinophilic syndromes. Although peripheral and tissue eosinophilia can be a feature of many types of small-vessel and medium-vessel vasculitis, the role of eosinophils has been best studied in eosinophilic granulomatosis with polyangiitis (EGPA), where eosinophils are a characteristic finding in all three clinical stages of the disorder. Whereas numerous studies have demonstrated an association between the presence of eosinophils and markers of eosinophil activation in the blood and tissues of patients with EGPA, the precise role of eosinophils in disease pathogenesis has been difficult to ascertain owing to the complexity of the disease process. In this regard, results of clinical trials using novel agents that specifically target eosinophils are providing the first direct evidence of a central role of eosinophils in EGPA. This Review focuses on the aspects of eosinophil biology most relevant to the pathogenesis of vasculitis and provides an update of current knowledge regarding the role of eosinophils in EGPA and other vasculitides. PMID:25003763

  8. Call Forecasting for Inbound Call Center

    Directory of Open Access Journals (Sweden)

    Peter Vinje

    2009-01-01

    Full Text Available In a scenario of inbound call center customer service, the ability to forecast calls is a key element and advantage. By forecasting the correct number of calls a company can predict staffing needs, meet service level requirements, improve customer satisfaction, and benefit from many other optimizations. This project will show how elementary statistics can be used to predict calls for a specific company, forecast the rate at which calls are increasing/decreasing, and determine if the calls may stop at some point.

  9. Omalizumab for Urticarial Vasculitis: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Misbah Nasheela Ghazanfar

    2015-01-01

    Full Text Available Urticarial vasculitis is characterised by inflamed itching or burning red patches or wheals that resemble urticaria but persist for greater than 24 hours. It is often idiopathic but is sometimes associated with collagen-vascular disease, particularly systemic lupus erythematosus. Treatment options include oral antihistamines, oral corticosteroids, dapsone, colchicine or hydroxychloroquine. We describe a male patient with urticarial vasculitis who was treated with omalizumab (anti-IgE with convincing results and provide a review of previous reports of patients with urticarial vasculitis treated with omalizumab.

  10. Omalizumab for Urticarial Vasculitis: Case Report and Review of the Literature.

    Science.gov (United States)

    Ghazanfar, Misbah Nasheela; Thomsen, Simon Francis

    2015-01-01

    Urticarial vasculitis is characterised by inflamed itching or burning red patches or wheals that resemble urticaria but persist for greater than 24 hours. It is often idiopathic but is sometimes associated with collagen-vascular disease, particularly systemic lupus erythematosus. Treatment options include oral antihistamines, oral corticosteroids, dapsone, colchicine or hydroxychloroquine. We describe a male patient with urticarial vasculitis who was treated with omalizumab (anti-IgE) with convincing results and provide a review of previous reports of patients with urticarial vasculitis treated with omalizumab. PMID:26435858

  11. Focal cerebral vasculitis associated with circulating immune complexes and brain irradiation

    International Nuclear Information System (INIS)

    In this report we describe a patient with a benign glioma treated with surgery and radiation. After a period of stability he developed subacute bacterial endocarditis, and deteriorated neurologically. Computed tomographic scans did not show recurrent tumor. An angiogram showed vasculitis restricted to the previously irradiated area. Secondary to subacute bacterial endocarditis was the presence of high levels of circulating immune complexes. His neurological status was unchanged after antibiotics, but improved after treatment with dexamethasone. We interpret the clinical course as an immune-complex-mediated vasculitis superimposed on a subclinical radiation vasculitis. This case supports the hypothesis that immune mechanisms may be involved in delayed radiation injury to the nervous system

  12. Rapid regression of exudative maculopathy in idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome after intravitreal ranibizumab.

    Science.gov (United States)

    Marín-Lambíes, Cristina; Gallego-Pinazo, Roberto; Salom, David; Navarrete, Javier; Díaz-Llopis, Manuel

    2012-05-01

    The idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome is a rare retinal vascular disorder characterized by multiple leaking aneurysmal dilations, retinal vasculitis, neuroretinitis and peripheral vascular ischemia. Visual loss mainly occurs due to the development of retinal neovascularization and/or exudative maculopathy. Although the treatment of choice has not yet been established, retinal photocoagulation seems to be the best option to control the disease and to prevent its progression. Herein, we report a case of idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome with both retinal neovascularization and macular exudation successfully managed with intravitreal ranibizumab (Lucentis(®)) as adjunctive therapy to retinal photocoagulation. PMID:22949913

  13. Disseminated gonococcal infection presenting as vasculitis: a case report.

    Science.gov (United States)

    Jain, Sangita; Win, Htet Nwe; Chalam, Venkat; Yee, Lian

    2007-01-01

    A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted. PMID:17213353

  14. Neutrophilic Dermatoses in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

    Science.gov (United States)

    de Boysson, Hubert; Martin Silva, Nicolas; de Moreuil, Claire; Néel, Antoine; de Menthon, Mathilde; Meyer, Olivier; Launay, David; Pagnoux, Christian; Guillevin, Loïc; Puéchal, Xavier; Bienvenu, Boris; Aouba, Achille

    2016-01-01

    Abstract A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved. We conducted a retrospective study of patients with both conditions. Patients were selected via the French Internal Medicine Society (SNFMI) and the French Vasculitis Study Group (FVSG). A literature review focusing on a combination of both conditions, concentrated only on publications with well-established diagnoses and individual detailed data. Seventeen patients diagnosed with AAV and ND were identified in this cohort. Twelve patients had granulomatosis with polyangiitis (GPA), 4 had microscopic polyangiitis (MPA) and one had eosinophilic GPA (EGPA). Eight patients, all with GPA, displayed pyoderma gangrenosum (PG). Sweet's syndrome was observed in 6 patients (4 with MPA, one with GPA and one with EGPA) and erythema elevatum diutinum in the other three (2 with GPA and 1 with MPA). The literature review identified 33 additional patients with both conditions, including 26 with GPA. Altogether, of the 50 patients (17 from our study and 33 from the literature review), 33 (66%) patients presented with PG associated with GPA in 29 cases (89%). Corticosteroids were the first-line treatment in conjunction with an immunosuppressive agent in most cases. Outcomes were good and a total of 15 patients experienced a relapse. Patients who relapsed were more likely to have ear, nose and throat manifestation than patients who did not [12/15 (80%) relapsing patients vs. 15/35 (43%) non-relapsing patients; p = 0.03)]. In our stud, the most frequent association concerned GPA and PG. ND should be considered and specifically researched within the spectrum of cutaneous manifestations observed in AAV. PMID:26986103

  15. Vasculitis secundaria a infección por Fasciola hepática Secondary vasculitis to infection by Fasciola hepatica

    Directory of Open Access Journals (Sweden)

    Germán Málaga

    2012-09-01

    Full Text Available Se presenta el caso de un paciente varón de 38 años, procedente de una zona endémica para fascioliasis hepática en el Perú. Fue hospitalizado por presentar un cuadro de cuatro semanas de evolución; con fiebre, mialgias intensas, lesiones eritematosas y dolorosas en las regiones de extensión de las extremidades. La electromiografía y la velocidad de conducción nerviosa mostraron una miopatía inflamatoria global. La biopsia de piel evidenció una vasculitis de tipo poliarteritis nodosa. En el proceso de evaluación previa a la terapia inmunosupresora, se hallaron huevos de Fasciola hepática en el examen coproparasitológico. El diagnóstico de fascioliasis se confirmó con fas2-ELISA: 0,46 (VN There is a case of a 38 year-old male patient coming from an area where hepatic fascioliasis is endemic in Peru. He was hospitalized because he showed 4 weeks of symptoms like fever, intense myalgias, erythematous and painful injuries on limb extensions. The electromyography and nerve conduction velocity showed a global inflammatory myopathy. A skin biopsy showed polyarteritis nodosa-type vasculitis. During the evaluation process prior to the immunosuppressive therapy, hepatic Fasciola eggs were found in the parasitological examination of stools. The fascioliasis diagnosis was confirmed by fas2-ELISA: 0.46 (VN <0.20. Clinical symptoms started to subside after treatment with ticlabendazol. Contact with the patient was maintained for a year and there was no evidence of disease recurrence, and he was asymptomatic

  16. Recurrent Bilateral Retinal Vasculitis as a Manifestation of Post-streptococcal Uveitis Syndrome

    OpenAIRE

    Han, Jinu; Lee, Sung Chul; Song, Won Kyung

    2012-01-01

    We report a case of post-streptococcal uveitis mainly presenting with bilateral recurrent retinal vasculitis in Korea. A 14-year-old Asian female presented with decreased visual acuity of 20 / 30 in the right eye and 20 / 25 in the left eye. The patient had a history of glomerulonephritis nine months before onset of uveitis. The manifestation of uveitis was predominantly retinal vasculitis. We presumed post-streptococcal uveitis because probable streptococcal infection was confirmed by anti-s...

  17. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

    OpenAIRE

    Sevgi Akarsu; Turna İlknur; Özlem Özbağçıvan; Emel Fetil

    2015-01-01

    Background and Design: Chronic spontaneous urticaria (CSU), the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV) is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patie...

  18. Omalizumab for Urticarial Vasculitis: Case Report and Review of the Literature

    OpenAIRE

    Misbah Nasheela Ghazanfar; Simon Francis Thomsen

    2015-01-01

    Urticarial vasculitis is characterised by inflamed itching or burning red patches or wheals that resemble urticaria but persist for greater than 24 hours. It is often idiopathic but is sometimes associated with collagen-vascular disease, particularly systemic lupus erythematosus. Treatment options include oral antihistamines, oral corticosteroids, dapsone, colchicine or hydroxychloroquine. We describe a male patient with urticarial vasculitis who was treated with omalizumab (anti-IgE) with co...

  19. Rapid Regression of Exudative Maculopathy in Idiopathic Retinitis, Vasculitis, Aneurysms and Neuroretinitis Syndrome after Intravitreal Ranibizumab

    OpenAIRE

    Marín-Lambíes, Cristina; Gallego-Pinazo, Roberto; Salom, David; Navarrete, Javier; Díaz-Llopis, Manuel

    2012-01-01

    The idiopathic retinitis, vasculitis, aneurysms and neuroretinitis syndrome is a rare retinal vascular disorder characterized by multiple leaking aneurysmal dilations, retinal vasculitis, neuroretinitis and peripheral vascular ischemia. Visual loss mainly occurs due to the development of retinal neovascularization and/or exudative maculopathy. Although the treatment of choice has not yet been established, retinal photocoagulation seems to be the best option to control the disease and to preve...

  20. D-penicillamine-induced ANA (+) ANCA (+) vasculitis in pediatric patients with Wilson's disease.

    Science.gov (United States)

    Lee, Yeonhee; Lee, Sang Taek; Cho, Heeyeon

    2016-05-01

    Anti-neutrophil cytoplasmic antibodies (ANCA) are associated with systemic vasculitis. The pathophysiology of ANCA-associated vasculitis (AAV) has not been clearly proven, and drug-induced ANCA-associated vasculitis has been reported. Wilson's disease is an inborn error of copper metabolism caused by a mutation in the copper transporting gene ATP7B, and traditional treatment is based on copper chelation with agents such as D-penicillamine. There have been rare reports that prolonged D-penicillamine therapy might cause adverse renal events such as membranous nephropathy and minimal change disease, but it is questionable if D-penicillamine induces ANCA-associated vasculitis. We describe 2 patients with Wilson's disease treated with D-penicillamine who presented with ANCA (+) vasculitis and renal involvement. The 2 patients also showed positive results for antinuclear antibody (ANA). Their kidney biopsy findings were compatible with crescentic/necrotizing glomerulonephritis, pauci-immune type. After diagnosis of AAV, D-penicillamine was stopped. Patients were then treated with plasmapheresis and immunosuppressants, including methylprednisolone pulse therapy and intravenous cyclophosphamide. One patient progressed to end-stage renal disease and the other showed persistent proteinuria. These cases suggest that D-penicillamine may induce ANA (+) ANCA (+) vasculitis with severe renal involvement in pediatric patients, and plasmapheresis combined with immunosuppressant should be considered. PMID:26784915

  1. IL-17 production by CSF lymphocytes as a biomarker for cerebral vasculitis

    Science.gov (United States)

    Thom, Vivien; Schmid, Sabrina; Gelderblom, Mathias; Hackbusch, Romy; Kolster, Manuela; Schuster, Simon; Thomalla, Götz; Keminer, Oliver; Pleß, Ole; Bernreuther, Christian; Glatzel, Markus; Wegscheider, Karl; Gerloff, Christian

    2016-01-01

    Objective: To explore the possibility of using interleukin-17 (IL-17) production by CD4+ T cells in the CSF as a potential biomarker for cerebral vasculitis in stroke patients. Methods: In this consecutive case study, we performed prospective analysis of CSF and blood in patients admitted to a university medical center with symptoms of stroke and suspected cerebral vasculitis. Flow cytometry was performed for intracellular detection of inflammatory cytokines in peripheral blood lymphocytes and expanded T cells from CSF. Results: CSF CD4+ lymphocytes from patients with cerebral vasculitis showed significantly higher levels of the proinflammatory cytokine IL-17 compared to patients with stroke not due to vasculitis or with other, noninflammatory neurologic diseases. There was no difference in the production of interferon-γ in the CSF and no overall differences in the relative frequencies of peripheral immune cells. Conclusions: Intracellular IL-17 in CSF cells is potentially useful in discriminating cerebral vasculitis as a rare cause in patients presenting with ischemic stroke. Classification of evidence: This study provides Class II evidence that an increased proportion of IL-17-producing CD4+ cells in CSF of patients presenting with stroke symptoms is indicative of cerebral vasculitis (sensitivity 73%, 95% confidence interval [CI] 39–94%; specificity 100%, 95% CI 74%–100%). PMID:27144213

  2. Necrotizing arteritis occurring in an intralobar pulmonary sequestration of a patient without systemic vasculitis syndrome.

    Science.gov (United States)

    Hashimoto, Hirotsugu; Hara, Kei; Matsumoto, Jun; Nashiro, Tamaki; Nagano, Masaaki; Kusakabe, Masashi; Kurata, Atsushi; Kuroda, Masahiko; Suzuki, Yoshio; Horiuchi, Hajime

    2016-01-01

    Necrotizing arteritis is a complex lesion of pulmonary hypertension, as are plexiform lesions, and is classically recognized as grade 6 in the Heath and Edwards grading scheme for hypertensive pulmonary vascular disease. The vascular changes observed in intralobar pulmonary sequestration have been reported to be similar to those observed in pulmonary hypertension, such as plexiform lesions. However, necrotizing arteritis occurring in an intralobar sequestration of a patient without systemic vasculitis syndrome has never been reported to our knowledge. Here, we report a case of a 38-year-old woman with pulmonary sequestration detected on a medical checkup. She was treated with surgery, and subsequent pathological analyses revealed necrotizing vasculitis in her sequestrated lung. We suspected systemic vasculitis syndromes, such as Takayasu arteritis, polyarteritis nodosa, and antineutrophil cytoplasmic antibody-associated vasculitis. However, physical and blood examination did not show any other abnormalities, and hence, she did not have systemic vasculitis syndrome. Immunohistochemical analyses of the resected specimen showed that inflammatory cells of the arteries were mainly composed of T lymphocytes. T-lymphocytic inflammation with little neutrophil and histiocyte infiltration may be a pathological feature of necrotizing arteritis observed in pulmonary sequestration. This is the first case to our knowledge of necrotizing arteritis in an intralobar pulmonary sequestration of a patient without systemic vasculitis syndrome. PMID:26874730

  3. Profile of retinal vasculitis in a tertiary eye care center in Eastern India

    Directory of Open Access Journals (Sweden)

    Kumar Saurabh

    2011-01-01

    Full Text Available Aims: To provide a fact file on the etiology, clinical presentations and management of retinal vasculitis in Eastern India. Materials and Methods: Retrospective, record based analysis of retinal vasculitis cases in a tertiary care center in Eastern India from January 2007 to December 2009 . Results: One hundred and thirteen eyes of 70 patients of retinal vasculitis were included in this study. Sixty (85.7% patients were male (mean age 33± 11.1 years and 10 (14.3% were female (mean age 32.4 ± 13.6 years. Vasculitis was bilateral in 43 (61.4% and unilateral in 27 (38.6% patients. Commonest symptoms were dimness of vision (73; 64.6% and floaters (36; 31.9%. Vascular sheathing (82; 72.6% and vitritis (51; 45.1% were commonest signs. Mantoux test was positive in 21 (30% patients but tuberculosis was confirmed in only four (5.71% patients. Raised serum angiotensin-converting enzyme level and positive antinuclear antibody level were reported in four (5.71% patients each. Human leukocyte antigen B5 (HLA B5 marker was present in one (1.4% patient. However, none of the total 70 patients were found to have a conclusively proven systemic disease attributable as the cause of retinal vasculitis. Oral corticosteroid (60; 85.7% was the mainstay of treatment. Forty-eight (42.5% eyes maintained their initial visual acuity and 43 (38% gained one or more line at mean follow-up of 16.6± 6.3 months. Conclusion: Retinal vasculitis cases had similar clinical presentations and common treatment plan. There was no systemic disease association with vasculitis warranting a careful approach in prescribing investigations.

  4. [Rare forms of hypertension : From pheochromocytoma to vasculitis].

    Science.gov (United States)

    Haller, H; Limbourg, F; Schmidt, B M; Menne, J

    2015-03-01

    Secondary hypertension affects only 5-10 % of hypertensive patients. Screening is expensive and time-consuming and should be performed only in patients for whom there is a high clinical suspicion of secondary hypertension. Clinical signs of secondary forms of hypertension are new-onset hypertension in patients without other risk factors (i.e., family history, obesity, etc.), sudden increase of blood pressure (BP) in a previously stable patient, increased BP in prepubertal children, resistant hypertension, and severe hypertension or hypertensive emergencies. In adults, renal parenchymal and vascular diseases as well as obstructive sleep apnea are the most common causes of secondary hypertension. Medication-induced hypertension and non-adherence to medication have to be ruled out. Of the endocrine causes associated with hypertension, primary aldosteronism is the most common. Other endocrine causes of hypertension such as thyroid disease (hypo- or hyperthyroidism), hypercortisolism (Cushing's syndrome), hyperparathyroidism, and pheochromocytoma are rare. Monogenetic forms of hypertension are mostly of tubular origin and associated with alterations in mineralocorticoid handling or signaling. Rare causes of hypertension also include inflammatory vascular disease. Acute forms of vasculitis may present as "malignant" hypertension with associated thrombotic microangiopathy and organ damage/failure. It is important to diagnose these rare forms of hypertension in order to prevent acute organ damage in these patients or unnecessary invasive treatment strategies. PMID:25700646

  5. Florid urticarial vasculitis heralding a flare up of ulcerative colitis.

    Science.gov (United States)

    Boules, Evon; Lyon, Calum

    2014-01-01

    A 75-year-old man with ulcerative colitis (UC) and diet controlled diabetes mellitus presented with a 3-week history of slightly itchy, red plaques on both lower limbs ascending gradually to cover the trunk and arms. One week later, he developed a flare up of his UC. Routine blood tests showed modest drop in haemoglobin (122 g/L) and C reactive protein (85 mg/L). Serology was remarkable for high antiproteinase 3 (c-ANCA). Serum electrophoresis showed a mildly positive paraprotein band (γ region). Stool culture was negative. Urine analysis showed proteinuria. Skin biopsy showed features of urticarial vasculitis (UV). He underwent a flexible sigmoidoscopy after the flare up showed mildly active UC. The patient was given hydrocortisone for 7 days and then prednisolone. Both rash and UC subsided. Electrophoresis was repeated 4 weeks later showing normal pattern. Prednisolone has been gradually reduced. Although rare, UV can be considered as one of the skin manifestations of UC. PMID:25535230

  6. Mast cells contribute to peripheral tolerance and attenuate autoimmune vasculitis.

    Science.gov (United States)

    Gan, Poh-Yi; Summers, Shaun A; Ooi, Joshua D; O'Sullivan, Kim M; Tan, Diana S Y; Muljadi, Ruth C M; Odobasic, Dragana; Kitching, A Richard; Holdsworth, Stephen R

    2012-12-01

    Mast cells contribute to the modulation of the immune response, but their role in autoimmune renal disease is not well understood. Here, we induced autoimmunity resulting in focal necrotizing GN by immunizing wild-type or mast cell-deficient (Kit(W-sh/W-sh)) mice with myeloperoxidase. Mast cell-deficient mice exhibited more antimyeloperoxidase CD4+ T cells, enhanced dermal delayed-type hypersensitivity responses to myeloperoxidase, and more severe focal necrotizing GN. Furthermore, the lymph nodes draining the sites of immunization had fewer Tregs and reduced production of IL-10 in mice lacking mast cells. Reconstituting these mice with mast cells significantly increased the numbers of Tregs in the lymph nodes and attenuated both autoimmunity and severity of disease. After immunization with myeloperoxidase, mast cells migrated from the skin to the lymph nodes to contact Tregs. In an ex vivo assay, mast cells enhanced Treg suppression through IL-10. Reconstitution of mast cell-deficient mice with IL-10-deficient mast cells led to enhanced autoimmunity to myeloperoxidase and greater disease severity compared with reconstitution with IL-10-intact mast cells. Taken together, these studies establish a role for mast cells in mediating peripheral tolerance to myeloperoxidase, protecting them from the development of focal necrotizing GN in ANCA-associated vasculitis. PMID:23138486

  7. Clinical features and etiology of retinal vasculitis in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Supanut Apinyawasisuk

    2013-01-01

    Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

  8. A Case Of Primary Central Nervous System Vasculitis Who Presented With Status Epilepticus

    Directory of Open Access Journals (Sweden)

    Sırma Geyik

    2014-12-01

    Full Text Available Primary central nervous system vasculitis (PCNV is limited with central nervous system and rare vasculitis that mostly seen in middle-aged men. PCNV vasculitis is usually presented that headache, dementia, stroke and multifocal common neurological symptoms. PCNV especially involves small medium-sized leptomeningeal and cortical arteries. 43 years old male patient who have been progressive forgetfulness and headache for 3 years. He applied with recurrent that before starting right focal and than sprawling whole body which generalized tonic-clonic seizures to us. During management that he was transfered to the intensive care unit due to status epilepticus (SE. Later than we found right hemiparesis, motor aphasia and right babinski positivity in neurologic examination. Diffusion restriction was revealed in left MCA territory in diffusion magnetic resonance imaging(MRI. EEG showed two types abnormality that a slow background ritm and epileptiform activity. Biochemistry of blood, complete blood count, blood sedimentation rate, CRP and markers of vasculitis were found in the normal range. Cerebral anjiography revealed that irregularities in the distal vascular areas and fusiform aneurysm at the top of basilar artery. He was consulted with rheumatology and diagnosed central nervous system vasculitis with the existing findings. Biopsy couldn't be taken from the brain to verify the diagnosis. Finally, we applied treatment that pulse steroid and cyclophosphamide to patient. This case has been presented due to emphasize that PCNV rarely may play a role in the etiology of recurrent stroke and status epilepticus.

  9. Decreased neutrophil apoptosis in quiescent ANCA-associated systemic vasculitis.

    Directory of Open Access Journals (Sweden)

    Mohamed Abdgawad

    Full Text Available BACKGROUND: ANCA-Associated Systemic Vasculitis (AASV is characterized by leukocytoclasis, accumulation of unscavenged apoptotic and necrotic neutrophils in perivascular tissues. Dysregulation of neutrophil cell death may contribute directly to the pathogenesis of AASV. METHODS: Neutrophils from Healthy Blood Donors (HBD, patients with AASV most in complete remission, Polycythemia Vera (PV, Systemic Lupus Erythematosus (SLE, Rheumatoid Arthritis (RA and renal transplant recipients (TP were incubated in vitro, and the rate of spontaneous apoptosis was measured by FACS. Plasma levels of cytokines and sFAS were measured with cytometric bead array and ELISA. Expression of pro/anti-apoptotic factors, transcription factors C/EBP-α, C/EBP-β and PU.1 and inhibitors of survival/JAK2-pathway were measured by real-time-PCR. RESULTS: AASV, PV and RA neutrophils had a significantly lower rate of apoptosis compared to HBD neutrophils (AASV 50 ± 14% vs. HBD 64 ± 11%, p<0.0001. In RA but not in AASV and PV, low apoptosis rate correlated with increased plasma levels of GM-CSF and high mRNA levels of anti-apoptotic factors Bcl-2A1 and Mcl-1. AASV patients had normal levels of G-CSF, GM-CSF and IL-3. Both C/EBP-α, C/EBP-β were significantly higher in neutrophils from AASV patients than HBD. Levels of sFAS were significantly higher in AASV compared to HBD. CONCLUSION: Neutrophil apoptosis rates in vitro are decreased in AASV, RA and PV but mechanisms seem to differ. Increased mRNA levels of granulopoiesis-associated transcription factors and increased levels of sFAS in plasma were observed in AASV. Additional studies are required to define the mechanisms behind the decreased apoptosis rates, and possible connections with accumulation of dying neutrophils in regions of vascular lesions in AASV patients.

  10. Web Call Example Application

    OpenAIRE

    Li, Shanbo

    2009-01-01

    Web Call Example Application from Ericsson Developer Connection is an application that hosted at a web server and supplies functionality of VoIP phone calls. Users can access the service from desktop browser, mobile phone browser or Java ME Client. Users can also manage their contact books. Each user can have more than one VoIP service accounts, so they can choose the cheapest on when they make phone call. The Web Call Example Application supports two kinds of VoIP phone call connection: Rela...

  11. Ischemic retinal vasculitis in an 18-year-old man with chickenpox infection

    Directory of Open Access Journals (Sweden)

    Poonyathalang A,Sukavatcharin S

    2014-02-01

    Full Text Available Anuchit Poonyathalang, Somsiri Sukavatcharin, Tharikarn Sujirakul Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Abstract: Ocular involvement after primary infection with varicella zoster virus is very rare. We report a case of a healthy 18-year-old man who presented with unilateral ischemic retinal vasculitis 10 days after the onset of chickenpox. He developed acute severe visual loss and a relative afferent pupillary defect in his right eye. Fundus imaging, optical coherence tomography, fundus fluorescence angiography, and electrophysiologic studies confirmed the diagnosis of retinal vasculitis, which led to generalized retinal ischemia. Although aggressive treatment with systemic steroids and antiviral drugs was administered, a poor visual outcome still resulted. Keywords: ischemic retinal vasculitis, chickenpox, varicella zoster virus

  12. Cytomegalovirus (CMV-related cutaneous necrotizing vasculitis: case report and literature review

    Directory of Open Access Journals (Sweden)

    Ferhat Arslan

    2012-10-01

    Full Text Available Cytomegalovirus (CMV infection is usually asymptomatic in immunocompetent patients. A mononucleosis-like syndrome may develop in some patients. Various organ involvements (eg: encephalitis, meningitis, retinitis, myocarditis, pneumonia, hepatitis, enterocolitis, neuritis, which rarely occur in immunocompetent patients, have also been reported. Cutaneous necrotizing vasculitis caused by CMV infection has been reported very rarely in the literature. Here, a case with a very rare clinical form of CMV infection, presenting with persistent fever and livedo reticularis on the extremities and cutaneous necrotizing vasculitis of the toes, is described, and the relevant literature is reviewed. This case report aims to highlight the possibility of CMV infection to be a cause of cutaneous necrotizing vasculitis.

  13. Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis

    Directory of Open Access Journals (Sweden)

    Dania Khoulani

    2014-01-01

    Full Text Available Diffuse alveolar hemorrhage (DAH is a serious complication of the small vessel vasculitis syndromes and carries a high mortality. Recombinant activated factor VII (rFVIIa is used to treat bleeding in patients with hemophilia and antibodies to factor VIII or IX. It is increasingly being used in life-threatening hemorrhage in a variety of other settings in which conventional therapy is unsuccessful. Randomized controlled trials of rFVIIa in DAH are lacking. However, several case reports have described a complete or sustained control of DAH using rFVIIa after patients failed to respond to medical treatment. There are no case reports in the literature describing the use or the failure of rFVIIa in DAH associated with cryoglobulinemic vasculitis. We here report the failure of rFVIIa to control DAH in a patient with CD5+ B-cell non-Hodgkin’s lymphoma and cryoglobulinemic vasculitis.

  14. Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acute posterior multifocal placoid epitheliopathy

    Directory of Open Access Journals (Sweden)

    Jong Hoon Park

    2013-01-01

    Full Text Available A 55-year-old female presented with bilateral progressive retinal vasculitis. She was on systemic and intravitreal steroids on the basis of uveitis work-up result (negative result including rapid plasma reagin, but her visual acuity continued to deteriorate to light perception only. Ocular examination showed retinal vasculitis, multiple yellow placoid lesions and severe macula edema in both eyes. Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid. Ocular syphilis was diagnosed. And intravenous penicillin G resulted in rapid resolution of vasculitis and macular edema. To avoid delay in the diagnosis of ocular syphilis, high index of suspicion and repeating serological tests (including both treponemal and non-treponemal tests are warranted.

  15. Urticaria Vasculitis: Estudio retrospectivo de 20 casos y protocolo diagn??stico-terap??utico

    OpenAIRE

    Soriano Hern??ndez, Isabel; Orgaz Molina, Jacinto; Arias Santiago, Salvador; El-Ahmed, Husein; Ortego Centeno, Norberto; Callejas, Jos?? L.; Fern??ndez Pugnaire, M. Antonia; Naranjo Sintes, Ram??n Jos??

    2011-01-01

    La urticaria vasculitis es una enfermedad cr??nica que se caracteriza por episodios urticariales o de angioedema que puede asociarse a niveles bajos de complemento. Hemos realizado un estudio descriptivo retrospectivo que incluye a 20 pacientes con urticaria vasculitis diagnosticados en los ??ltimos 5 a??os donde analizamos los s??ntomas m??s frecuentes y los tratamientos que se han empleado. A continuaci??n se ha dise??ado un protocolo diagn??stico-terap??utico de Urticaria Vascu...

  16. A case of hypocomplementaemic urticarial vasculitis with a high serum level of rheumatoid factor.

    Science.gov (United States)

    Ashida, Atsuko; Murata, Hiroshi; Ohashi, Atsuko; Ogawa, Eisaku; Uhara, Hisashi; Okuyama, Ryuhei

    2013-08-01

    We report a case of hypocomplementaemic urticarial vasculitis with an elevated serum rheumatoid factor level. Hypocomplementaemic urticarial vasculitis is an immune complex-mediated disease characterised by urticarial eruptions. High levels of rheumatoid factor may be associated with hypocomplementaemia due to the consumption of complement, because the rheumatoid factor can form immune complexes with immunoglobulin. It is necessary to pay attention to the amounts of complement in cases of urticarial eruptions with elevated rheumatoid factor level. The eruptions were relieved with a combination of prednisolone and colchicine. PMID:23905981

  17. Two Cases with Normocomplementhemic Urticarial Vasculitis: The Other Reasons Should Be Determined

    Directory of Open Access Journals (Sweden)

    Onur Balcı

    2015-04-01

    Full Text Available Urticaria is mainly a fast consisting, scabious, erythematous and swelling lesions of the skin. Acute urticaria usually occurs after having a medicine or food. On the other hand, in the chronic urticaria, the process is longer, more scabious, and the skin lesions are more dramatic. In urticarial vasculitis, the lesions exist longer than 24 hours with pain or swelter instead of itchiness. It can be distinguished from basic urticaria with the damage of the small vessels by histopathologically. Here we present two normocomplementhemic urticarial vasculitis cases.

  18. Inflammatory myositis complicating hypocomplementemic urticarial vasculitis despite on-going immunosuppression.

    Science.gov (United States)

    Chew, Gary Y J; Gatenby, Paul A

    2007-08-01

    We present a patient with previously diagnosed hypocomplementemic urticarial vasculitis syndrome, with skin, lung, and renal involvement, who presented with congestive cardiac failure. During the course of her hospitalization, she was also found to have profound proximal muscle weakness in both upper and lower limbs associated with raised creatinine kinase levels. A muscle biopsy was performed, which demonstrated evidence of an inflammatory myositis with vasculitis, which had returned despite on-going immunosuppression. This occurrence of a new autoimmune disease may well be an example of the "waste disposal" hypothesis. PMID:16944070

  19. Ischemic colitis associated with intestinal vasculitis: Histological proof in systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    Jeong Rok Lee; Chang Nyol Paik; Jin Dong Kim; Woo Chul Chung; Kang-Moon Lee; Jin Mo Yang

    2008-01-01

    Ischemic colitis is an uncommon complication in patients with systemic lupus erythematosus (SIE). In previously reported cases of colitis caused by SLE, intestinal vasculitis is implicated as the causative process, but is rarely confirmed histologically. We described a case of a 32-year-old man with increased activity of SLE, who presented with hematochezia and abdominal pain due to ischemic colitis with small vessel vasculitis which was proven by sigmoidoscopic biopsy. The clinical course of the patient was improved after steroid and conservative management.

  20. Callings and Organizational Behavior

    Science.gov (United States)

    Elangovan, A. R.; Pinder, Craig C.; McLean, Murdith

    2010-01-01

    Current literature on careers, social identity and meaning in work tends to understate the multiplicity, historical significance, and nuances of the concept of calling(s). In this article, we trace the evolution of the concept from its religious roots into secular realms and develop a typology of interpretations using occupation and religious…

  1. Call Center Capacity Planning

    DEFF Research Database (Denmark)

    Nielsen, Thomas Bang

    The main topics of the thesis are theoretical and applied queueing theory within a call center setting. Call centers have in recent years become the main means of communication between customers and companies, and between citizens and public institutions. The extensively computerized infrastructure...

  2. Important role of CCR2 in a murine model of coronary vasculitis

    Directory of Open Access Journals (Sweden)

    Martinez Hernan G

    2012-10-01

    Full Text Available Abstract Background Chemokines and their receptors play a role in the innate immune response as well as in the disruption of the balance between pro-inflammatory Th17 cells and regulatory T cells (Treg, underlying the pathogenesis of coronary vasculitis in Kawasaki disease (KD. Results Here we show that genetic inactivation of chemokine receptor (CCR-2 is protective against the induction of aortic and coronary vasculitis following injection of Candida albicans water-soluble cell wall extracts (CAWS. Mechanistically, both T and B cells were required for the induction of vasculitis, a role that was directly modulated by CCR2. CAWS administration promoted mobilization of CCR2-dependent inflammatory monocytes (iMo from the bone marrow (BM to the periphery as well as production of IL-6. IL-6 was likely to contribute to the depletion of Treg and expansion of Th17 cells in CAWS-injected Ccr2+/+ mice, processes that were ameliorated following the genetic inactivation of CCR2. Conclusion Collectively, our findings provide novel insights into the role of CCR2 in the pathogenesis of vasculitis as seen in KD and highlight novel therapeutic targets, specifically for individuals resistant to first-line treatments.

  3. Vasculitis and infections : Contribution to the issue of autoimmunity reviews devoted to "autoimmunity and infection"

    NARCIS (Netherlands)

    Kallenberg, Cees G. M.; Tadema, Henko

    2008-01-01

    Infections are associated with secondary forms of vasculitis. However, there is increasing evidence that microbial agents play a role also in primary systemic vasculitides. For a long time it has been noted that Hepatitis B virus (HBV) is involved in polyarteritis nodosa (PAN) although the incidence

  4. Candida albicans-associated necrotizing vasculitis producing life-threatening gastrointestinal hemorrhage.

    LENUS (Irish Health Repository)

    Sargent, Jeremy

    2012-02-01

    Patients undergoing treatment of acute lymphoblastic leukemia are at risk for fungal infections including disseminated candidiasis. We describe a case of systemic Candida albicans infection associated with life-threatening gastrointestinal hemorrhage due to unusual necrotizing vasculitis involving the gastrointestinal tract. We explore the association between Candida and such vasculopathy.

  5. HBV-Associated Cryoglobulinemic Vasculitis: Remission after Antiviral Therapy with Entecavir

    Directory of Open Access Journals (Sweden)

    Mauro Viganò

    2014-06-01

    Full Text Available Background/Aims: Cryoglobulinemic vasculitis remains an uncommon complication of hepatitis B virus infection. Methods: We report the case of a 40-years old female Chinese patient with chronic hepatitis B developing cryoglobulinemic vasculitis with multiple organ involvement (liver, kidney, and skin coupled with weakness, arthralgias, haemolytic anaemia, and autoimmune thyroiditis. She received entecavir mono-therapy at dose adjusted for estimated glomerular filtration rate. Results: Within five months of entecavir treatment, hepatitis B viraemia decreased below the limit of detection with normal serum amino-transferase levels, HBeAg clearance occurred, vasculitis regressed with disappearance of purpura and ascites; in addition, renal function normalized and nephritic syndrome remitted. After a five-year follow-up, the patient is asymptomatic with intact kidney function, proteinuria in the normal range, and normal liver biochemistry, despite the antiviral treatment was withdrawn and the patient remained HBsAg positive. Conclusions: This is the second case of hepatitis B virus-related cryoglobulinemic vasculitis successfully treated with entecavir suggesting that effective antiviral therapy may counteract both the hepatic and extra-hepatic manifestations of infection by hepatitis B virus.

  6. Plasma exchange in antineutrophil cytoplasmic antibody-associated vasculitis--a 25-year perspective

    DEFF Research Database (Denmark)

    Szpirt, Wladimir M

    2015-01-01

    Demonstration of a pathogenic role for antineutrophil cytoplasmic antibodies (ANCA) underlies the scientific rationale for plasma exchange (PLEX) in the treatment of ANCA-associated vasculitis (AAV). Most clinical evidence of efficacy concerns the use of PLEX for the recovery of renal function in...

  7. Clinical Outcomes of Remission Induction Therapy for Severe Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

    NARCIS (Netherlands)

    Miloslavsky, E. M.; Specks, U.; Merkel, P. A.; Seo, P.; Spiera, R.; Langford, C. A.; Hoffman, G. S.; Kallenberg, C. G. M.; St Clair, E. W.; Tchao, N. K.; Viviano, L.; Ding, L.; Sejismundo, L. P.; Mieras, K.; Ikle, D.; Jepson, B.; Mueller, M.; Brunetta, P.; Allen, N. B.; Fervenza, F. C.; Geetha, D.; Keogh, K.; Kissin, E. Y.; Monach, P. A.; Peikert, T.; Stegeman, C.; Ytterberg, S. R.; Stone, J. H.

    2013-01-01

    Objective. To evaluate the reasons that complete remission is not achieved or maintained with original treatment in some patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treated with rituximab (RTX) or with cyclophosphamide/azathioprine (CYC/AZA). Methods. The Rit

  8. The role of KIR2DL3/HLA-C*0802 in Brazilian patients with rheumatoid vasculitis

    Directory of Open Access Journals (Sweden)

    Wester Eidi Nishimura

    2015-06-01

    Full Text Available OBJECTIVES: Rheumatoid arthritis is a polygenically controlled systemic autoimmune disease. Rheumatoid vasculitis is an important extra-articular phenotype of rheumatoid arthritis that can result in deep cutaneous ulcers. The objective of this study was to establish a correlation between the frequency of major histocompatibility complex class I/II alleles and killer immunoglobulin-like receptor genotypes in patients with cutaneous rheumatoid vasculitis. METHODS: Using the Scott & Bacon 1984 criteria to diagnose rheumatoid vasculitis and after excluding any other causes such as diabetes, atherosclerosis, adverse drug reactions, infection, and smoking, patients who met the criteria were selected. All of the selected rheumatoid vasculitis patients presented deep cutaneous ulcers. Identification of the major histocompatibility complex class I/II and killer immunoglobulin-like receptor genotypes was performed by polymerase chain reaction assays of samples collected from the 23 rheumatoid vasculitis patients as well as from 80 controls (40 non-rheumatoid vasculitis RA control patients and 40 healthy volunteers. RESULTS: An association between the presence of the HLA-DRB1*1402 and HLA-DRB1*0101 alleles and cutaneous lesions in rheumatoid vasculitis patients and a correlation between the inhibitor KIR2DL3 and the HLA-C*0802 ligand in rheumatoid vasculitis patients were found. CONCLUSION: An association was found between the presence of the HLA-DRB1*1402 and HLA-DRB1*0101 alleles and the development of cutaneous lesions in rheumatoid vasculitis patients. Additionally, the HLA-C*0802 ligand protects these individuals from developing cutaneous lesions.

  9. Calling Dunbar's Numbers

    OpenAIRE

    MacCarron, Pádraig; Kaski, Kimmo; Dunbar, Robin

    2016-01-01

    The social brain hypothesis predicts that humans have an average of about 150 relationships at any given time. Within this 150, there are layers of friends of an ego, where the number of friends in a layer increases as the emotional closeness decreases. Here we analyse a mobile phone dataset, firstly, to ascertain whether layers of friends can be identified based on call frequency. We then apply different clustering algorithms to break the call frequency of egos into clusters and compare the ...

  10. Características generales de 29 pacientes con vasculitis de pequeños vasos General characteristics of 29 patients with small vessel vasculitis

    Directory of Open Access Journals (Sweden)

    Nicolás Di Benedetto

    2010-04-01

    Full Text Available El objetivo de esta serie fue describir las características generales y manifestaciones clínicas de pacientes con vasculitis de pequeños vasos que concurrieron al servicio de autoinmunidad de un hospital de la comunidad y compararlas con la literatura. Se revisaron de manera retrospectiva las historias clínicas archivadas bajo el rótulo de vasculitis en un período de 16 años. Se seleccionaron aquellos pacientes que cumplieran criterios diagnósticos de vasculitis de pequeños vasos. Se extrajeron los datos de interés y se constató la supervivencia mediante contacto telefónico. Posteriormente se realizó una búsqueda bibliográfica y se compararon los resultados. Se incluyeron 13 pacientes con granulomatosis de Wegener, 6 con síndrome de Churg Strauss y 10 con poliangeítis microscópica. El 55% (16 fueron menores de 55 años al diagnóstico y hubo predominio del sexo femenino (2.6:1. La demora diagnóstica fue mayor a un año en el 46% de los casos. Los sistemas más frecuentemente afectados fueron respiratorio y otorrinolaringológico. El 79% presentó anticuerpos anti-citoplasma de neutrófilos (ANCA positivos. La mortalidad fue del 24% (7/29. Al comparar las características de los pacientes incluidos en esta serie con lo descripto en la literatura, se hallaron diferencias en cuanto a la forma de presentación, sistemas comprometidos y porcentaje de pacientes ANCA positivos; además se observó que el resultado negativo de este marcador parece asociarse con mayor demora diagnóstica y en consecuencia peor pronóstico, lo que remarca su importancia como herramienta adicional no invasiva al momento del diagnóstico.The objective of this series was to describe the general characteristics and clinical manifestations of patients with small vessel vasculitis who were assisted in the autoimmunity department of a community public hospital and to compare the results with the literature. Clinical records under the label of vasculitis in a

  11. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial

    DEFF Research Database (Denmark)

    de Groot, Kirsten; Harper, Lorraine; Jayne, David R W;

    2009-01-01

    BACKGROUND: Current therapies for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are limited by toxicity. OBJECTIVE: To compare pulse cyclophosphamide with daily oral cyclophosphamide for induction of remission. DESIGN: Randomized, controlled trial. Random assignments were...

  12. Transitant per Calle Mayor

    OpenAIRE

    Mestre Pérez, Rosanna

    2000-01-01

    RESUM Aquest treball és una lectura crítica de la pel.lícula Calle Mayor, dirigida per Juan Antonio Bardem en 1956, on pretenem analitzar de quina manera el film construeix un agosarat discurs de crítica social. Malgrat les dures limitacions extradiscursives en què la pel.lícula va veure la llum (censura oficial, empresonament del director durant el rodage...), Calle Mayor va aconseguir tractar allò del que no shi podia parlar (crítica sociopolítica) a través dun argument de...

  13. Too close to call

    DEFF Research Database (Denmark)

    Kurrild-Klitgaard, Peter

    2012-01-01

    The note briefly outlines a new model for the explanation of US presidential elections, founded on (a) recent economic growth and (b) a measure of what may be called “’the cost of ruling”. The former is based in changes in real disposable income for the period following a mid-term election, while...... a number of other frequent explanations and is found to be quite robust. When augmented with approval ratings for incumbent presidents, the explanatory power increases to 83 pct. and only incorrectly calls one of the last 15 US presidential elections. Applied to the 2012 election as a forecasting...

  14. Hypocomplementemic Urticarial Vasculitis Syndrome in an 8-year-old Boy: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Zakiya Saleh Adnan Al Mosawi

    2013-07-01

    Full Text Available Hypocomplementemic urticarial vasculitis syndrome is an immune complex-mediated disease of unknown etiology. The clinical course is characterized by urticaria, conjunctivitis, joint pain, and hypocomplementemia. We here report a case of a child with hypocomplementemic urticarial vasculitis syndrome that progressed to nephritis. Renal biopsy was consistent with diffuse proliferative glomerulonephritis with diffuse subendothelial immune deposits. He responded well to a combination of steroid and mofetil micofenolate.

  15. Hypocomplementemic Urticarial Vasculitis Syndrome in an 8-year-old Boy: A Case Report and Review of Literature

    OpenAIRE

    Zakiya Saleh Adnan Al Mosawi; Badriya Ebrahim Ahmed Al Hermi

    2013-01-01

    Hypocomplementemic urticarial vasculitis syndrome is an immune complex-mediated disease of unknown etiology. The clinical course is characterized by urticaria, conjunctivitis, joint pain, and hypocomplementemia. We here report a case of a child with hypocomplementemic urticarial vasculitis syndrome that progressed to nephritis. Renal biopsy was consistent with diffuse proliferative glomerulonephritis with diffuse subendothelial immune deposits. He responded well to a combination of steroid an...

  16. Hypocomplementemic Urticarial Vasculitis Syndrome in an 8-year-old Boy: A Case Report and Review of Literature.

    Science.gov (United States)

    Al Mosawi, Zakiya Saleh Adnan; Al Hermi, Badriya Ebrahim Ahmed

    2013-07-01

    Hypocomplementemic urticarial vasculitis syndrome is an immune complex-mediated disease of unknown etiology. The clinical course is characterized by urticaria, conjunctivitis, joint pain, and hypocomplementemia. We here report a case of a child with hypocomplementemic urticarial vasculitis syndrome that progressed to nephritis. Renal biopsy was consistent with diffuse proliferative glomerulonephritis with diffuse subendothelial immune deposits. He responded well to a combination of steroid and mofetil micofenolate. PMID:23904922

  17. A retrospective analysis of treatment outcomes in patients with hepatitis C related systemic vasculitis receiving intravenous methylprednisolone and cyclophosphamide.

    Science.gov (United States)

    Shahin, Amira A; El Desouky, Soha M; Zayed, Hania S

    2011-05-01

    The aim of this work is to describe the outcome of a series of patients with hepatitis C virus (HCV)-related vasculitis who were treated with corticosteroids and I.V. cyclophosphamide without receiving any antiviral therapy. The data of 16 patients with HCV infection and vasculitis were retrospectively analyzed for the treatment outcome in the present study. Eleven patients were females (68.8%) with a mean age of 49.6 ± 10.0 years. Nine patients (56.2%) had medium-sized vessel vasculitis (group A) and seven patients (43.8%) had small vessel vasculitis (group B). Disease activity was assessed using the Birmingham Vasculitis Activity Score (BVAS 2003) and organ damage was assessed by the Vasculitis Damage Index (VDI). HCV infection was confirmed in all patients by the detection of antibodies to HCV in serum by ELISA and HCV RNA using qualitative PCR. Quantitative PCR was done using the branched DNA technique. None of our study patients had received antiviral therapy, but they all received I.V.-pulsed cyclophosphamide monthly for 6 months, then every 3 months for six times if needed, preceded by I.V. methylprednisolone. Twelve patients (75%) had undetectable viral load by the quantitative technique. The drop in mean BVAS recorded at different intervals was highly significant. Although there was a drop in the VDI mean between the first and second reading, it was not statistically significant. All patients responded to treatment. Seven patients (43.8%) had relapse. Two patients died (12.5%). One patient died from renal failure (group B) and another died from sepsis (group A). The treatment outcomes were not statistically significant between the two vasculitis groups. A subset of patients with HCV-related vasculitis and with low levels of viremia can be safely treated with corticosteroids and cyclophosphamide alone. Despite successful treatment, a significant proportion of patients relapse and some develop severe complications and death. PMID:20924628

  18. A call for surveys

    DEFF Research Database (Denmark)

    Bernstein, Philip A.; Jensen, Christian S.; Tan, Kian-Lee

    2012-01-01

    The database field is experiencing an increasing need for survey papers. We call on more researchers to set aside time for this important writing activity. The database field is growing in population, scope of topics covered, and the number of papers published. Each year, thousands of new papers ...

  19. CALLING AQUARIUM LOVERS...

    CERN Multimedia

    2002-01-01

    CERN's anemones will soon be orphans. We are looking for someone willing to look after the aquarium in the main building, for one year. If you are interested, or if you would like more information, please call 73830. (The anemones living in the aquarium thank you in anticipation.)

  20. Artificial Intelligence and CALL.

    Science.gov (United States)

    Underwood, John H.

    The potential application of artificial intelligence (AI) to computer-assisted language learning (CALL) is explored. Two areas of AI that hold particular interest to those who deal with language meaning--knowledge representation and expert systems, and natural-language processing--are described and examples of each are presented. AI contribution…

  1. Perfusion and spectroscopy magnetic resonance imaging in a case of lymphocytic vasculitis mimicking brain tumor

    International Nuclear Information System (INIS)

    Lymphocytic vasculitis of the central nervous system is an uncommon subtype of primary angiitis of the central nervous system (PACNS) – a rare inflammatory disorder affecting parenchymal and leptomeningeal arteries and veins. Establishing diagnosis on the basis of neuroimaging only is difficult, as it can mimic a brain tumor. Thus, histological diagnosis is essential for appropriate management. We present a case of biopsy-proven lymphocytic vasculitis mimicking a brain tumor on neuroimaging that was subsequently successfully treated with steroid therapy. We also discuss the findings in perfusion MR (PWI) and MR spectroscopy (MRS). Regional hypoperfusion on PWI and elevation of glutamate and glutamine levels on MRS (without associated typical tumor spectra) are common findings in inflammatory disorders, including PACNS, and can be useful in differential diagnosis with tumors

  2. Juvenile gangrenous vasculitis of the scrotum: Is it a variant of pyoderma gangrenosum?

    Science.gov (United States)

    Caputo, Ruggero; Marzano, Angelo V; Di Benedetto, Alessandra; Ramoni, Stefano; Cambiaghi, Stefano

    2006-08-01

    Juvenile gangrenous vasculitis of the scrotum was described by Piñol et al in 1974 as a unique variant of scrotal gangrene of unknown origin, occurring exclusively in young individuals. It was characterized by an acute onset of skin ulcers undergoing complete resolution after appropriate therapy, with no relapses. We present a typical case of this extremely rare disease affecting a 16-year-old boy in whom the scrotal ulcerations were preceded by an episode of pharyngitis with fever. The condition promptly regressed after administration of intramuscular betamethasone in combination with oral ciprofloxacin. According to Piñol et al, juvenile gangrenous vasculitis of the scrotum, although poorly known to dermatologists, should be regarded as a distinctive entity within the wide group of scrotal gangrenes. On the other hand, the hypothesis that this condition may well represent a variant of pyoderma gangrenosum is discussed. PMID:16843125

  3. Orbital phlebography for differentiation between multiple sclerosis and venous vasculitis in subacute blindness

    International Nuclear Information System (INIS)

    Thirteen consecutive patients with subacute unilateral loss of vision and periorbital pain but without pathology of the fundus or increased erythrocyte sedimentation rate, were investigated with visual evoked response, electrophoresis of serum and cerebrospinal fluid, and orbital phlebography. Seven of these patients were found to suffer from multiple sclerosis. The remaining 6 were considered to have venous vasculitis. There was a spontaneous recovery from visual impairment in all patients with multiple sclerosis, but not in patients with venous vasculitis. Of the latter patients, only two, who were treated with steroids within the first four days after onset of symptoms, regained vision. It appears that orbital phlebography is the diagnostic procedure of choice for proper management of patients with subacute loss of vision. (orig.)

  4. Upper Respiratory Tract Symptoms, Renal Involvement and Vasculitis: A Case Report and Review of Wegener Granulomatosis

    OpenAIRE

    Said, Mohd Shahrir Mohamed

    2010-01-01

    Wegener’s Granulomatosis is a condition associated with systemic vasculitis which can present with upper respiratory tract symptoms initially. On September 2001, a 15-year-old girl presented with symptoms of nasal block for 3 weeks. She later developed joint pains and worsening renal status requiring dialysis. A renal biopsy was performed which showed pauci-immune cresentric glomerulonephritis. Her cANCA levels were positive. She was treated with oral cyclophosphamide and steroids and later r...

  5. Bioinspired engineering study of Plantae vascules for self-healing composite structures.

    Science.gov (United States)

    Trask, R S; Bond, I P

    2010-06-01

    This paper presents the first conceptual study into creating a Plantae-inspired vascular network within a fibre-reinforced polymer composite laminate, which provides an ongoing self-healing functionality without incurring a mass penalty. Through the application of a 'lost-wax' technique, orthogonal hollow vascules, inspired by the 'ray cell' structures found in ring porous hardwoods, were successfully introduced within a carbon fibre-reinforced epoxy polymer composite laminate. The influence on fibre architecture and mechanical behaviour of single vascules (located on the laminate centreline) when aligned parallel and transverse to the local host ply was characterized experimentally using a compression-after-impact test methodology. Ultrasonic C-scanning and high-resolution micro-CT X-ray was undertaken to identify the influence of and interaction between the internal vasculature and impact damage. The results clearly show that damage morphology is influenced by vascule orientation and that a 10 J low-velocity impact damage event is sufficient to breach the vasculature; a prerequisite for any subsequent self-healing function. The residual compressive strength after a 10 J impact was found to be dependent upon vascule orientation. In general, residual compressive strength decreased to 70 per cent of undamaged strength when vasculature was aligned parallel to the local host ply and a value of 63 per cent when aligned transverse. This bioinspired engineering study has illustrated the potential that a vasculature concept has to offer in terms of providing a self-healing function with minimum mass penalty, without initiating premature failure within a composite structure. PMID:19955122

  6. Two Cases with Normocomplementhemic Urticarial Vasculitis: The Other Reasons Should Be Determined

    OpenAIRE

    Onur Balcı; Sedat Işıkay; Celal Varan; Arda Mehmet Kılınç; Mehmet Almacıoğlu

    2015-01-01

    Urticaria is mainly a fast consisting, scabious, erythematous and swelling lesions of the skin. Acute urticaria usually occurs after having a medicine or food. On the other hand, in the chronic urticaria, the process is longer, more scabious, and the skin lesions are more dramatic. In urticarial vasculitis, the lesions exist longer than 24 hours with pain or swelter instead of itchiness. It can be distinguished from basic urticaria with the damage of the small vessels by histopathologically. ...

  7. Atypical acute urticaria in children and its relationship with urticarial vasculitis

    OpenAIRE

    ARSLAN, Zafer; ÖZMEN, Serap; SÜRMELİ, Sara; ARDA, Nilüfer

    2011-01-01

    In childhood, urticarial lesions are sometimes associated with purpura. This form might be identified as atypical, and may also be related to urticarial vasculitis (UV). The aim of this study was to assess the clinicopathologic characteristics of UV in children with atypical urticaria. Materials and methods: Fifteen children with atypical urticaria were evaluated with medical history, physical examination, and laboratory and skin punch biopsy findings. Results: Infections were detected as...

  8. Incidence of Cancer in ANCA-Associated Vasculitis: A Meta-Analysis of Observational Studies

    OpenAIRE

    Shang, Weifeng; Ning, Yong; Xu, Xiu; Li, Menglan; Guo, Shuiming; Han, Min; Zeng, Rui; Ge, Shuwang; Xu, Gang

    2015-01-01

    Objective The purpose of this paper is to examine cancer incidence in patients with ANCA-associated vasculitis (AASV) derived from population-based cohort studies by means of meta-analysis. Methods Relevant electronic databases were searched for studies characterizing the associated risk of overall malignancy in patients with AASV. Standardized incidence rates (SIRs) with 95% confidence intervals (CIs) were used to evaluate the strength of association. We tested for publication bias and heter...

  9. Postoperative spinal infection mimicking systemic vasculitis with titanium-spinal implants

    Directory of Open Access Journals (Sweden)

    Stathopoulos Konstantinos

    2011-09-01

    Full Text Available Abstract Background Secondary systemic vasculitis after posterior spinal fusion surgery is rare. It is usually related to over-reaction of immune-system, to genetic factors, toxicity, infection or metal allergies. Case Description A 14 year-old girl with a history of extended posterior spinal fusion due to idiopathic scoliosis presented to our department with diffuse erythema and nephritis (macroscopic hemuresis and proteinuria 5 months post surgery. The surgical trauma had no signs of inflammation or infection. The blood markers ESR and CRP were increased. Skin tests were positive for nickel allergy, which is a content of titanium alloy. The patient received corticosteroids systematically (hydrocortisone 10 mg for 6 months, leading to total recess of skin and systemic reaction. However, a palpable mass close to the surgical wound raised the suspicion of a late infection. The patient had a second surgery consisting of surgical debridement and one stage revision of posterior spinal instrumentation. Intraoperative cultures were positive to Staphylococcus aureus. Intravenous antibiotics were administered. The patient is now free of symptoms 24 months post revision surgery without any signs of recurrence of either vasculitis or infection. Literature Review Systemic vasculitis after spinal surgery is exceptionally rare. Causative factors are broad and sometimes controversial. In general, it is associated with allergy to metal ions. This is usually addressed with metal on metal total hip bearings. In spinal surgery, titanium implants are considered to be inert and only few reports have presented cases with systemic vasculitides. Therefore, other etiologies of immune over-reaction should always be considered, such as drug toxicity, infection, or genetic predisposition. Purposes and Clinical Relevance Our purpose was to highlight the difficulties during the diagnostic work-up for systemic vasculitis and management in cases of posterior spinal surgery.

  10. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  12. Two uncommon manifestations of leptospirosis:Sweet’s syndrome and central nervous system vasculitis

    Institute of Scientific and Technical Information of China (English)

    Peter George

    2011-01-01

    To leptospirosis is the commonest spirocheatal infection in the tropical and temperate countries of Indian sub-continent and Africa and the most common zoonosis worldwide. The protean manifestation of this infectious disease is a challenge for practising clinicians across the world. In poor developing countries, at most clinical suspicion it is essential in the diagnosis of this disease. In this report, we are able to document two uncommon manifestations of leptospirosis, namely Sweet’s syndrome and central nervous system vasculitis.

  13. Systemic Lupus Erythematosus Presenting with a Fatal Intestinal Vasculitis: a Case Report

    OpenAIRE

    Nozari, Neda; Divsalar, Parisa

    2014-01-01

    This case report demonstrates fatal gastrointestinal vasculitis as a rare presentation of systemic lupus erythematosus. A 34-year-old woman presented with abdominal pain and diarrhea. Anti nuclear antibody was positive and high titre of anti-ds DNA antibody was also reported. Treatment with corticosteroid and supportive cares were started; however, her condition worsened. Eventually, she was considered as a candidate for diagnostic laparoscopy. Immediately after laparoscopy, she developed res...

  14. Recurrent small bowel infarction in a young man: polycythaemia or vasculitis?

    OpenAIRE

    Hussain, Abdulzahra; Ansari, Taj; Mahmood, Hind; Ellul, Joe

    2009-01-01

    A 29-year-old man presented with a 3 day history of right lower quadrant pain, nausea and vomiting. There was tenderness in the right lower quadrant. At surgery the appendix was normal but an infarcted terminal ileum segment was found and resected. Histopathological examination was suggestive of vasculitis. The patient was discharged in good condition and follow-up for the first year was unremarkable. Unfortunately he developed another episode of bowel ischaemia in the second year and underwe...

  15. Calling Dunbar's Numbers

    CERN Document Server

    MacCarron, Pádraig; Dunbar, Robin

    2016-01-01

    The social brain hypothesis predicts that humans have an average of about 150 relationships at any given time. Within this 150, there are layers of friends of an ego, where the number of friends in a layer increases as the emotional closeness decreases. Here we analyse a mobile phone dataset, firstly, to ascertain whether layers of friends can be identified based on call frequency. We then apply different clustering algorithms to break the call frequency of egos into clusters and compare the number of alters in each cluster with the layer size predicted by the social brain hypothesis. In this dataset we find strong evidence for the existence of a layered structure. The clustering yields results that match well with previous studies for the innermost and outermost layers, but for layers in between we observe large variability.

  16. Flight calls and orientation

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Andersen, Bent Bach; Kropp, Wibke;

    2008-01-01

      In a pilot experiment a European Robin, Erithacus rubecula, expressing migratory restlessness with a stable orientation, was video filmed in the dark with an infrared camera and its directional migratory activity was recorded. The flight overhead of migrating conspecifics uttering nocturnal...... flight calls was simulated by sequential computer controlled activation of five loudspeakers placed in a linear array perpendicular to the bird's migration course. The bird responded to this stimulation by changing its migratory course in the direction of that of the ‘flying conspecifics' but after about...... 30 minutes it drifted back to its original migration course. The results suggest that songbirds migrating alone at night can use the flight calls from conspecifics as additional cues for orientation and that they may compare this information with other cues to decide what course to keep....

  17. A Call for Justice

    OpenAIRE

    Marques-Silva, Joao; Brahmachari, Debahuti; Sakallah, Karem; Lynce, Ines

    2015-01-01

    Abstract A new development can be identified within the civil society in Malaysia. A development that has resulted in a general call for justice, voiced through coalition groups that cut across categories of affiliation. This development is triggered by an increasing inculcation of Islamic values into the political system, which has interfered with the understanding of Malaysia as a country that can provide a framework for coexistence within a multicultural society. This thesis seeks ...

  18. Multimodality and CALL

    OpenAIRE

    Guichon, Nicolas; Cohen, Cathy

    2016-01-01

    This chapter explores the issues pertaining to multimodality, which has always been considered as a defining characteristic of CALL (Chapelle 2009). The chapter begins by critically examining the various definitions of multimodality, especially in the field of second language acquisition and cognitive psychology and explores the distinction between mode, modality and channel. With reference to specific studies conducted in the field, we then investigate the potential of multimodality for seco...

  19. Clinical implications of serum thrombomodulin in PR3-ANCA-associated vasculitis

    Directory of Open Access Journals (Sweden)

    Zycinska K

    2009-12-01

    Full Text Available Abstract Background Vascular injury is the main mechanism in pathophysiology of PR3-ANCA-associated vasculitis. Soluble serum thrombomodulin (sTM is a membrane-bound receptor for thrombin expressed by vascular endothelial cells. Objective The aim of study was to determine the blood levels of sTM in patients with PR3-ANCA-associated vasculitis. Material and methods Twenty five patients with Wegener's granulomatosis (WG, 13 with generalized WG and 12 with limited WG, with histologically proven disease, and 15 healthy subjects as a control were investigated. An ELISA for detection of sTM and PR3-ANCA was performed. The disease activity was evaluated according to BVAS and DEI indexes. Results Significant increases in sTM were found in both active generalized and limited active WG compared with control values: 108 ± 12, 56 ± 2, and 12 ± 4 ng/ml, respectively. Elevated ANCA titer correlated with disease activity, but more weakly than sTM levels did. Elevated sTM concentration is a result of vascular endothelial injury in the course of PR3-ANCA associated vasculitis. Conclusions Soluble serum thrombomodulin is a promising, both diagnostic and therapeutic, marker of endothelial cell injury in relation to disease activity and progression in autoimmune disorders, reflecting the degree of endothelial cell damage.

  20. Increased serum levels of soluble vascular endothelial-cadherin in patients with systemic vasculitis.

    Science.gov (United States)

    Chen, Tao; Guo, Zai-Pei; Cao, Na; Qin, Sha; Li, Meng-Meng; Jia, Rui-Zhen

    2014-08-01

    Henoch-Schönlein purpura (HSP) is a commonest systemic vasculitis (SV) in childhood characterized by an inflammatory reaction directed at vessels. Endothelial damage and perivascular leukocyte infiltrates are vital in the development of HSP. Vascular endothelial (VE)-cadherin is an endothelial cell-specific adhesion molecule, which plays critical roles in angiogenesis and endothelial integrity. Herein, we investigated the serum levels of soluble VE-cadherin (sVE-cadherin) in patients with HSP and other forms of SV. The serum levels of sVE-cadherin in 30 patients with HSP, together with patients with urticarial vasculitis, allergic vasculitis, Behcet disease, psoriasis vulgaris (PV) and atopic dermatitis (AD) and 26 health controls were measured by enzyme-linked immunosorbent assay. Serum levels of sVE-cadherin were significantly increased in patients with HSP in acute stage and patients with other forms of SV but not in patients with PV or AD. Moreover, Serum sVE-cadherin levels in HSP patients were correlated with the severity of this disease and serum concentrations of IgA anticardiolipin antibodies and vascular endothelial growth factor. Taken together, we show firstly that serum sVE-cadherin is abnormally increased in HSP patients. Increased serum levels of sVE-cadherin might be a novel biomarker for evaluating the severity of HSP and useful for identifying the presence of SV in inflammatory skin conditions. PMID:24469639

  1. Phospholipid Syndrome and Vasculitis as a presentation of Systemic Lupus Erythematosus. Case report.

    Directory of Open Access Journals (Sweden)

    Sila Castellón Mortera

    2013-09-01

    Full Text Available The systemic Lupus Erythematosus is presented, generally, as a poli articular syndrome, with a long period of fever nephritico or nephrotico; other clinical ways are: neuropsychiatry, vasculitis, etc. They appeared in a progressive manner; but in rare cases as a sickness debutant. It has not being reported in Sancti Spiritus Province patients in which matches the debut of the systemic Lupus Erythematosus with the manifestations of phospholipid syndrome. A Woman with 24 years of age is hospitalized having vasculitis, articular pains, thrombose in her right foot, detecting anticoagulante lupico and possitive Rematoideo factor with periferic pattern diffused in the Inmunoelectroforesis. 5 years later was hospitalized again with poliserositis. She had a positive evolution with a dose in a month of Intacglobin and anticoagulante treatment. Two years later she was hospitalized with articular pains proving she had livedo reticular on her left knee and Raynaud phenomenon on her foot. Beta Prebeta Index and high triglycerides. Lupico anticoagulant positive again. A treatment with Intacglobin and Prednisona was given to the patient with a better clinic without being hospitalized again. There is no evidence (at 17 years of age of a sickness debut of renal dissorder. It is about a Systemic Lupus Eritematoso which debut was a vasculitis and a Phospholipid Syndrome associated.

  2. Kidney Lesions Associated with Systemic Vasculitis: Report of 25 Cases in Morocco

    Directory of Open Access Journals (Sweden)

    Abdou Niang

    2001-01-01

    Full Text Available In this retrospective study, we report 25 patients with renal injury caused by systemic vasculitis. These patients were hospitalized at the department of nephrology-hemodialysis in Ibn Rochd hospital from 1985 to 1998. The mean age of the patients was 36 years (range 3 to 57 years with male predominance (68%. The clinical presentations included cutaneous purpura in 80% of the patients, arthritis in 60% and pulmonary hemorrhage in 20%. The renal injury manifested as abnormal urinary sediment in 20 of the study patients (80%, nephritic syndrome in 14 (56%, renal failure in nine (36%. Three patients (12% had renal failure as the initial presentation followed by the other manifestations of vasculitis. The anti-neutrophil cytoplasmic antibodies (ANCA have been checked in only six patients of whom four were positive. Henoch-Schonlein purpura was the most common clinical sign in 11 patients (44% followed by Behcet′s disease in five (20%. The treatment was variable in type and duration but generally included corticoids alone or in combination with immunosuppressants. The prognosis of the renal injury was variable. The renal function remained stable in those with Henoch-Schonlein purpura, but was less favorable with the other etiologies with more predominance of renal failure and end-stage renal disease. This retrospective analysis of our experience is given to throw light on the pattern of vasculitis in our region.

  3. Acute vasculitis resulting in free flap failure: the importance of early recognition and options for management.

    Science.gov (United States)

    Brennan, P A; Colbert, S; Spedding, A V; Herd, M K; Mellor, T K; Anand, R; McCrae, F

    2012-11-01

    Unusual or unexpected medical causes for free flap failure do occur but are uncommon. We present a rare case of a fibula free flap failure due to an acute vasculitis which was undiagnosed until after the flap had failed. In addition to two successful flap salvages and intravenous heparin, an epoprostenol infusion was commenced but a third salvage was not successful. The vasculitis resulted in marked blood vessel wall thickening, and cutaneous manifestations which presented as late signs. High peri-nuclear anti nuclear cytoplasmic antibody (pANCA) and myeloperoxidase (MOP) titres were subsequently found and histology from several blood vessels showed marked inflammation throughout the wall. A diagnosis of microscopic polyangiitis was made and high dose steroids were subsequently commenced. Interestingly, he had vasculitis several years previously treated with oral steroids but had been discharged from the rheumatology clinic. This rare case illustrates the potential hazards of free flap surgery in the vasculitides and discusses the warning signs and various management options to reduce the likelihood of flap failure in these patients. PMID:22534125

  4. Morphologic features and development of granulomatous vasculitis in feline infectious peritonitis.

    Science.gov (United States)

    Kipar, A; May, H; Menger, S; Weber, M; Leukert, W; Reinacher, M

    2005-05-01

    Feline infectious peritonitis (FIP) is a fatal, coronavirus (CoV)-induced systemic disease in cats, characterized by granulomas in organs and granulomatous vasculitis. This study describes the morphologic features of granulomatous vasculitis in FIP as well as its development in the course of monocyte-associated feline CoV (FCoV) viremia in five naturally infected Domestic Shorthair cats with FIP. Monocyte-associated FCoV viremia was demonstrated by immunohistology, RNA in situ hybridization, and electron micropscopy. Granulomatous phlebitis at different stages of development was observed. Vasculitic processes ranged from attachment and emigration of FCoV-infected monocytes to vascular/perivascular granulomatous infiltrates with destruction of the vascular basal lamina. Monocytes as well as perivascular macrophages were activated because they were strongly positive for CD18 and expressed cytokines (tumor necrosis factor-alpha and interleukin-1beta) and matrix metalloproteinase-9. In addition, general activation of endothelial cells, represented by major histocompatibility complex II upregulation, was observed in all cases. These results confirm FIP as a monocyte-triggered systemic disease and demonstrate the central role of activated monocytes in FIP vasculitis. PMID:15872378

  5. Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Einspieler, Ingo; Pyka, Thomas; Eiber, Matthias [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich (Germany); Thuermel, Klaus; Wolfram, Sabine; Moog, Philipp [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nephrology, Munich (Germany); Reeps, Christian [Technische Universitaet Muenchen, Department of Vascular Surgery, Klinikum rechts der Isar, Munich (Germany); Essler, Markus [Rheinische Friedrich-Wilhelms-Universitaet, Department of Nuclear Medicine, Universitaetsklinikum Bonn, Bonn (Germany)

    2015-04-16

    The aim of this study was to evaluate the feasibility of hybrid [{sup 18}F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI in patients with large vessel vasculitis (LVV) by comparing visual and quantitative parameters to that of PET/CT. Furthermore, the value of PET/MRI in disease activity and extent of LVV was assessed. A total of 16 [{sup 18}F]FDG PET/MRI and 12 [{sup 18}F]-FDG PET/CT examinations were performed in 12 patients with LVV. MRI of the vessel wall by T1-weighted and T2-weighted sequences was used for anatomical localization of FDG uptake and identification of morphological changes associated with LVV. In addition, contrast-enhanced (CE) magnetic resonance angiography (MRA) was performed. The vascular FDG uptake in the vasculitis group was compared to a reference group of 16 patients using a four-point visual score. Visual scores and quantitative parameters [maximum standardized uptake value (SUV{sub max}) and target to background ratio (TBR)] were compared between PET/MRI and PET/CT. Furthermore, correlations between C-reactive protein (CRP) and quantitative PET results, as well the extent of vasculitis in PET, MRI/CE-MRA and combined PET/MRI, were analysed. TBRs, SUV{sub max} values and visual scores correlated well between PET/MRI and PET/CT (r = 0.92, r = 0.91; r = 0.84, p < 0.05). There was no significant difference between both modalities concerning SUV{sub max} measurements and visual scores. In PET/MRI, PET alone revealed abnormal FDG uptake in 86 vascular regions. MRI/CE-MRA indicated 49 vessel segments with morphological changes related to vasculitis, leading to a total number of 95 vasculitis regions in combination with PET. Strong and significant correlations between CRP and disease extent in PET alone (r = 0.75, p = 0.0067) and PET/MRI (r = 0.92, p < 0.0001) in contrast to MRI/CE-MRA only were observed. Regarding disease activity, no significant correlations were seen between quantitative PET results and CRP, although there

  6. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  7. An Island Called Cuba

    Directory of Open Access Journals (Sweden)

    Jean Stubbs

    2011-06-01

    Full Text Available Review of: An Island Called Home: Returning to Jewish Cuba. Ruth Behar, photographs by Humberto Mayol. New Brunswick NJ: Rutgers University Press, 2007. xiii + 297 pp. (Cloth US$ 29.95 Fidel Castro: My Life: A Spoken Autobiography. Fidel Castro & Ignacio Ramonet. New York: Scribner/Simon & Schuster, 2008. vii + 724 pp. (Paper US$ 22.00, e-book US$ 14.99 Cuba: What Everyone Needs to Know. Julia E. Sweig. New York: Oxford University Press, 2009. xiv + 279 pp. (Paper US$ 16.95 [First paragraph] These three ostensibly very different books tell a compelling story of each author’s approach, as much as the subject matter itself. Fidel Castro: My Life: A Spoken Autobiography is based on a series of long interviews granted by the then-president of Cuba, Fidel Castro, to Spanish-Franco journalist Ignacio Ramonet. Cuba: What Everyone Needs to Know, by U.S. political analyst Julia Sweig, is one of a set country series, and, like Ramonet’s, presented in question/answer format. An Island Called Home: Returning to Jewish Cuba, with a narrative by Cuban-American anthropologist Ruth Behar and photographs by Cuban photographer Humberto Mayol, is a retrospective/introspective account of the Jewish presence in Cuba. While from Ramonet and Sweig we learn much about the revolutionary project, Behar and Mayol convey the lived experience of the small Jewish community against that backdrop.

  8. Call for volunteers

    CERN Multimedia

    2008-01-01

    CERN is calling for volunteers from all members of the Laboratory for organizing the two exceptional Open days.CERN is calling for volunteers from all members of the Laboratory’s personnel to help with the organisation of these two exceptional Open Days, for the visits of CERN personnel and their families on the Saturday and above all for the major public Open Day on the Sunday. As for the 50th anniversary in 2004, the success of the Open Days will depend on a large number of volunteers. All those working for CERN as well as retired members of the personnel can contribute to making this event a success. Many guides will be needed at the LHC points, for the activities at the surface and to man the reception and information points. The aim of these major Open Days is to give the local populations the opportunity to discover the fruits of almost 20 years of work carried out at CERN. We are hoping for some 2000 volunteers for the two Open Days, on the Saturday from 9 a.m. to ...

  9. Anti-proteinase 3 anti-neutrophil cytoplasm autoantibodies recapitulate systemic vasculitis in mice with a humanized immune system.

    Directory of Open Access Journals (Sweden)

    Mark A Little

    Full Text Available Evidence is lacking for direct pathogenicity of human anti-proteinase-3 (PR3 antibodies in development of systemic vasculitis and granulomatosis with polyangiitis (GPA, Wegener's granulomatosis. Progress in study of these antibodies in rodents has been hampered by lack of PR3 expression on murine neutrophils, and by different Fc-receptor affinities for IgG across species. Therefore, we tested whether human anti-PR3 antibodies can induce acute vasculitis in mice with a human immune system. Chimeric mice were generated by injecting human haematopoietic stem cells into irradiated NOD-scid-IL2Rγ⁻/⁻ mice. Matched chimera mice were treated with human IgG from patients with: anti-PR3 positive renal and lung vasculitis; patients with non-vasculitic renal disease; or healthy controls. Six-days later, 39% of anti-PR3 treated mice had haematuria, compared with none of controls. There was punctate bleeding on the surface of lungs of anti-PR3 treated animals, with histological evidence of vasculitis and haemorrhage. Anti-PR3 treated mice had mild pauci-immune proliferative glomerulonephritis, with infiltration of human and mouse leukocytes. In 3 mice (17% more severe glomerular injury was present. There were no glomerular changes in controls. Human IgG from patients with anti-PR3 autoantibodies is therefore pathogenic. This model of anti-PR3 antibody-mediated vasculitis may be useful in dissecting mechanisms of microvascular injury.

  10. Anti-proteinase 3 anti-neutrophil cytoplasm autoantibodies recapitulate systemic vasculitis in mice with a humanized immune system.

    LENUS (Irish Health Repository)

    Little, Mark A

    2012-01-01

    Evidence is lacking for direct pathogenicity of human anti-proteinase-3 (PR3) antibodies in development of systemic vasculitis and granulomatosis with polyangiitis (GPA, Wegener\\'s granulomatosis). Progress in study of these antibodies in rodents has been hampered by lack of PR3 expression on murine neutrophils, and by different Fc-receptor affinities for IgG across species. Therefore, we tested whether human anti-PR3 antibodies can induce acute vasculitis in mice with a human immune system. Chimeric mice were generated by injecting human haematopoietic stem cells into irradiated NOD-scid-IL2Rγ⁻\\/⁻ mice. Matched chimera mice were treated with human IgG from patients with: anti-PR3 positive renal and lung vasculitis; patients with non-vasculitic renal disease; or healthy controls. Six-days later, 39% of anti-PR3 treated mice had haematuria, compared with none of controls. There was punctate bleeding on the surface of lungs of anti-PR3 treated animals, with histological evidence of vasculitis and haemorrhage. Anti-PR3 treated mice had mild pauci-immune proliferative glomerulonephritis, with infiltration of human and mouse leukocytes. In 3 mice (17%) more severe glomerular injury was present. There were no glomerular changes in controls. Human IgG from patients with anti-PR3 autoantibodies is therefore pathogenic. This model of anti-PR3 antibody-mediated vasculitis may be useful in dissecting mechanisms of microvascular injury.

  11. To be called upon

    DEFF Research Database (Denmark)

    Kublitz, Anja

    2015-01-01

    When Danish Muslims explain what made them decide to travel to the Middle East and take up arms in the wake of the Arab Spring, they say that they were called upon. Displayed on videos on social media, women and sometimes children begged them to come to their rescue. In light of some of the...... responses to the Arab spring among Danish Muslims, this paper will offer some preliminary reflections on how we can understand ‘the mass’ and an ‘intimacy of the mass’ when the mass is no longer a crowd. According to Marx the mass grows quantitatively from the local to the global, but what happens to the...... mass if it is no longer a causal phenomenon that expands from small to big, but rather a simultaneous multitude of one to one relations that are neither local nor global? How are the one and the many related in this specific setting? Furthermore, many of the videos display dead bodies. How can we...

  12. Epitope analysis of anti-myeloperoxidase antibodies in patients with ANCA-associated vasculitis.

    Directory of Open Access Journals (Sweden)

    Shen-Ju Gou

    Full Text Available OBJECTIVE: Increasing evidences have suggested the pathogenic role of anti-neutrophil cytoplasmic antibodies (ANCA directing myeloperoxidase (MPO in ANCA-associated vasculitis (AAV. The current study aimed to analyze the association between the linear epitopes of MPO-ANCA and clinicopathological features of patients with AAV. METHODS: Six recombinant linear fragments, covering the whole length amino acid sequence of a single chain of MPO, were produced from E.coli. Sera from 77 patients with AAV were collected at presentation. 13 out of the 77 patients had co-existence of serum anti-GBM antibodies. Ten patients also had sequential sera during follow up. The epitope specificities were detected by enzyme-linked immunosorbent assay using the recombinant fragments as solid phase ligands. RESULTS: Sera from 45 of the 77 (58.4% patients with AAV showed a positive reaction to one or more linear fragments of the MPO chain. The Birmingham Vasculitis Activity Scores and the sera creatinine were significantly higher in patients with positive binding to the light chain fragment than that in patients without the binding. The epitopes recognized by MPO-ANCA from patients with co-existence of serum anti-GBM antibodies were mainly located in the N-terminus of the heavy chain. In 5 out of the 6 patients, whose sera in relapse recognize linear fragments, the reactivity to linear fragments in relapse was similar to that of initial onset. CONCLUSION: The epitope specificities of MPO-ANCA were associated with disease activity and some clinicopathological features in patients with ANCA-associated vasculitis.

  13. Traumatic endophthalmitis presenting as isolated retinal vasculitis and white-centered hemorrhages: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Nidhi Relhan

    2012-01-01

    Full Text Available The article reports a case and review of the literature of endophthalmitis presenting as isolated retinal vasculitis. A 26-year-old male was observed to have white-centered retinal hemorrhages and retinal vasculitis following an occult scleral perforation. At presentation, the visual acuity was 20/60. With clinical suspicion of early endophthalmitis, he underwent wound exploration, scleral tear repair, vitreous biopsy and administration of intravitreal antibiotics. Microbiology evaluation revealed significant presence of methicillin-resistant coagulase-negative Staphylococcus epidermidis. Final visual acuity improved to 20/20 at 6 weeks postoperatively. Literature search revealed eight similar cases, all of them due to Staphylococcus species. Retinal vasculitis and white-centered retinal hemorrhages can be a presenting sign of early endophthalmitis, especially with non-fulminant pathogens like S. epidermidis.

  14. Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis

    International Nuclear Information System (INIS)

    The diagnosis and management of Wegener's granulomatosis and microscopic polyarteritis are complicated by the lack of specific diagnostic tests. The diagnostic performance of a solid-phase radioimmunoassay, which detects the autoantibodies against neutrophil cytoplasm present in these disorders, was assessed in a prospective study of patients with suspected vasculitis and/or rapidly progressive nephritis. The assay had a sensitivity and specificity of 96% when carried out in combination with a specific inhibition stage and indirect immunofluorescence staining of alcohol-fixed normal neutrophils. (author)

  15. Is rituximab effective for induction of remission in ANCA-associated vasculitis?

    OpenAIRE

    Carmen Rain; Tatiana Yáñez; Gabriel Rada

    2015-01-01

    La adición de rituximab al tratamiento con corticoides se ha planteado como alternativa terapéutica para inducir remisión en las vasculitis asociadas a anticuerpos anticitoplasma de neutrófilos (ANCA), especialmente en pacientes con deseo de preservar fertilidad que persisten activos después del tratamiento estándar, o en aquellos que tienen contraindicación o mala tolerancia a ciclofosfamida. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases d...

  16. Levamisole adulterated cocaine and pulmonary vasculitis: Presentation of two lethal cases and brief literature review.

    Science.gov (United States)

    Karch, Steven B; Busardò, Francesco Paolo; Vaiano, Fabio; Portelli, Francesca; Zaami, Simona; Bertol, Elisabetta

    2016-08-01

    The first case reports of levamisole-related disease in cocaine users were published in 2010, although levamisole adulteration of cocaine was first recognized several years earlier. Currently, more than 70% of street cocaine seizures, in the US and the EU, contain levamisole, which could potentially be converted to aminorex, though the reasons for this practice still remain obscure. Here we report two fatal cases of isolated pulmonary vasculitis in abusers of levamisole-adulterated cocaine, where a complete autopsy, full toxicological analysis by gas chromatography-mass spectrometry (GC-MS) using a previously published method of Karch et al. and histological examination were performed. A control group composed of 11 cases of cocaine related deaths, where the presence of levamisole was excluded in blood, urine and hair, was used. Recent literature on the human pharmacokinetics of levamisole and aminorex is also reviewed. The toxicological analysis revealed positive qualitative and quantitative results for cocaine, benzoylecgonine and levamisole in both cases. In case 1 levamisole was found at the concentration of 13.5 and 61.3mg/L in blood and urine respectively, whereas in case 2 at 17.9 and 70.2mg/L. The histological examination highlighted in case 1 in heart samples microscopic evidence of the typical remodeling changes associated with chronic stimulant abuse, whereas lungs showed numerous lymphocytes surrounding and infiltrating the wall of small pulmonary vessels and a perivascular fibrosis with transforming fibroblasts. In case 2, the myocardial samples showed wide fields of myocardial necrosis characterized by hypercontraction of the myocytes with thickened Z-lines and short sarcomeres, whereas lung samples showed a significant intimal thickening of arteriole walls and lymphocytic infiltration of the wall and edema. Moreover, there were also numerous perivascular lymphocytic infiltrates. Although the pathological cardiac findings have allowed us to establish

  17. Mesenteric vasculitis in adults with Henoch-Schonlein purpura: a not-so-benign condition.

    LENUS (Irish Health Repository)

    Sibartie, V

    2009-02-07

    INTRODUCTION: The gastrointestinal manifestations of Henoch-Schonlein purpura (HSP) are well characterised, but their recognition can be difficult when they occur in isolation. Furthermore, HSP can run a more serious course in adults, compared to children, in whom the disease usually occurs. MATERIALS AND METHODS: We describe two cases that illustrate the challenges of HSP with mesenteric vasculitis and the outcome in adults. CONCLUSION: Although self-limiting in most patients, the outcome of HSP in adults can be far from benign and even fatal.

  18. Vasculitis defects by brain SPECT in mixed connective tissue disease. A case report

    International Nuclear Information System (INIS)

    Full text: Cerebrovascular involvement including vasculitis in mixed connective tissue disease (MCTD) is reported to be uncommon. We describe the clinical findings and course of a 45 years old black women followed and diagnosed with depression and cognitive impairment including mental confusion, visual an auditive hallucination. Complete neuropsychological evaluation established the diagnosis of psychotic disorder. Laboratory tests, computed tomography of the skull were completely normal. The patient was referred to a brain SPECT which showed a focal area of decrease regional cerebral blood flow in right parietal-occipital region. Increasing the corticosteroids dose and with the use of neuroleptics, the patient improve clinically and the SPECT turned out to be normal

  19. Erdheim-Chester Disease: An Unusual Cause of Intracranial Vasculitis and Progressive Leukoencephalopathy.

    Science.gov (United States)

    Sagnier, Sharmila; Debruxelles, Sabrina; Lepreux, Sébastien; Sibon, Igor

    2016-05-01

    Erdheim-Chester disease (ECD) is a non-Langerhans histiocytosis affecting multiple organs. Stroke as symptom onset of ECD with intracranial vasculitis is unusual. We report the case of a 64-year-old man who presented with an acute ischemic stroke associated with a moderate leukoencephalopathy and intracranial arteries stenosis. Four years later, he developed movement disorders with dysarthria and cognitive impairment. Neuroradiological findings demonstrated a rapidly progressive and diffuse leukoencephalopathy associated with brain atrophy and infiltration of the intracranial vertebral artery wall. Brain postmortem evaluation confirmed the diagnosis of ECD. This diagnosis should be evoked in patients with cryptogenic stroke, progressive leukoencephalopathy, and infiltration of the arterial wall. PMID:26996751

  20. A case of precocious emphysema and lung cancer in a woman with a history of hypocomplementemic urticarial vasculitis.

    Science.gov (United States)

    Jamison, Suzanna C; Brierre, Stephen; Sweet, Jon; de Boisblanc, Ben

    2008-03-01

    Severe emphysema developed in a white woman with a 26-pack-year history of tobacco use. Serum alpha(1)-antitrypsin levels were normal. A history of autoimmune hemolytic anemia, angioedema, low complement, and recurrent urticaria prompted an immunologic workup that ultimately led to a diagnosis of hypocomplementemic urticarial vasculitis syndrome. Treatment with oral prednisone and inhaled bronchodilators improved symptoms, but 4 months after diagnosis non-small cell lung cancer was discovered and she ultimately died. Hypocomplementemic urticarial vasculitis is an uncommon cause of precocious emphysema and has not previously been reported in a patient with bronchogenic carcinoma. PMID:18321906

  1. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Science.gov (United States)

    Watanabe, Kae; Rajderkar, Dhanashree A.; Modica, Renee F.

    2016-01-01

    Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors' knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition. PMID:27018080

  2. Lymphoma and cerebral vasculitis in association with X-linked lymphoproliferative disease

    Institute of Scientific and Technical Information of China (English)

    Jia Zhu; Yu Zhang; Zi-Jun Zhen; Yan Chen; Juan Wang; Rui-Qing Cai; Xiao-Fei Sun

    2013-01-01

    Lymphoma is seen in up to 30% of patients with X-linked lymphoproliferative disease (XLP), but cerebral vasculitis related with XLP after cure of Burkitt lymphoma is rarely reported. We describe a case of a 5-year-old boy with XLP who developed cerebral vasculitis two years after cure of Burkitt lymphoma. He had Burkitt lymphoma at the age of 3 years and received chemotherapy (non-Hodgkin’s lymphoma-Berlin-Frankfurt-Milan-90 protocol plus rituximab), which induced complete remission over the following two years. At the age of 5 years, the patient first developed headache, vomiting, and then intel ectual and motorial retrogression. His condition was not improved after anti-infection, dehydration, or dexamethasone therapy. No tumor cells were found in his cerebrospinal fluid. Magnetic resonance imaging showed multiple non-homogeneous, hypodense masses along the bilateral cortex. Pathology after biopsy revealed hyperplasia of neurogliocytes and vessels, accompanied by lymphocyte infiltration but no tumor cell infiltration. Despite aggressive treatment, his cognition and motor functions deteriorated in response to progressive cerebral changes. The patient is presently in a vegetative state. We present this case to inform clinicians of association between lymphoma and immunodeficiency and explore an optimal treatment for lymphoma patients with compromised immune system.

  3. Long-term efficacy and safety of tocilizumab in giant cell arteritis and large vessel vasculitis

    Science.gov (United States)

    Evans, Jobie; Steel, Lauren; Borg, Frances; Dasgupta, Bhaskar

    2016-01-01

    Giant cell arteritis (GCA) is a chronic systemic vasculitis affecting large-sized and medium-sized vessels. Glucocorticoids are currently the mainstay of treatment for GCA and associated large vessel vasculitis (LVV) but are associated with frequent adverse events. Methotrexate has only demonstrated a modest benefit while anti-TNF biological agents (infliximab and etanercept) have been inefficacious. Elevated levels of interleukin-6 (IL-6), a proinflammatory cytokine, has been associated with GCA. Tocilizumab (TCZ), a humanised antihuman IL-6 receptor antibody, has been used successfully in several reports as a treatment for GCA and LVV. We report the potentially long-term successful use of TCZ in 8 cases of refractory LVV. All of our patients achieved a good clinical response to TCZ and C reactive protein reduced from an average of 70.3 to 2.5. In all cases, the glucocorticoid dose was reduced, from an average of 24.6 mg prednisolone prior to TCZ treatment to 4.7 mg, indicating that TCZ may enable a reduction in glucocorticoid-associated adverse events. However, regular TCZ administration was needed for disease control in most cases. TCZ was discontinued in one case due to the development of an empyema indicating the need for careful monitoring of infection when using this treatment. PMID:26819753

  4. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Directory of Open Access Journals (Sweden)

    Kae Watanabe

    2016-01-01

    Full Text Available Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors’ knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition.

  5. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide.

    Science.gov (United States)

    Watanabe, Kae; Rajderkar, Dhanashree A; Modica, Renee F

    2016-01-01

    Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors' knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition. PMID:27018080

  6. Your Wake-Up Call

    Science.gov (United States)

    ... Home Current Issue Past Issues Your Wake-Up Call Past Issues / Summer 2007 Table of Contents For ... infant younger than one year old. Some people call SIDS "crib death" because many babies who die ...

  7. Imaging Findings of Central Nervous System Vasculitis Associated with Goodpasture's Syndrome: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Young; Ahn, Kook Jin; Jung, Jung Im; Jung, So Lyung; Kim, Bum Soo; Hahn, Seong Tae [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-12-15

    We report a rare case of CNS vasculitis associated with Goodpasture's syndrome in a 34-year-old man, who presented with a seizure and sudden onset of right sided weakness. He also had recurrent hemoptysis of one month's duration. Goodpasture's syndrome is histologically diagnosed by intense linear deposits of IgG along the glomerular basement membrane in both renal and lung tissues. oodpasture's syndrome is a rare disease, characterized by rapidly progressive glomerulonephritis, diffuse pulmonary hemorrhage and circulating antiglomerular basement membrane antibody (anti-GBM antibody). Central nervous system (CNS) manifestations in Goodpasture's syndrome are extremely rare, with only a few cases having been reported in the literature (8 10). Therefore, we present our imaging findings of CNS vasculitis associated with Goodpasture's syndrome, together with a review of the relevant literature. In summary, CNS vasculitis associated with Goodpasture's syndrome is extremely rare. Awareness of the imaging findings, as well as the clinical significance of CNS vasculitis associated with Goodpasture's syndrome, can be helpful in making the correct diagnosis and subsequent management of this rare condition.

  8. Plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasm antibody associated vasculitis (PEXIVAS)

    DEFF Research Database (Denmark)

    Walsh, Michael; Merkel, Peter A; Peh, Chen Au;

    2013-01-01

    Granulomatosis with polyangiitis (GPA, Wegener's) and microscopic polyangiitis (MPA) are small vessel vasculitides collectively referred to as anti-neutrophil cytoplasm antibody-associated vasculitis (AAV). AAV is associated with high rates of morbidity and mortality due to uncontrolled disease and...

  9. Circulating microRNA expression pattern separates patients with anti-neutrophil cytoplasmic antibody-associated vasculitis from healthy controls

    DEFF Research Database (Denmark)

    Skoglund, C.; Carlsen, A.; Weiner, M.;

    2015-01-01

    Objective. Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) has an unpredictable course and better biomarkers are needed. Micro-RNAs in body fluids are protected from degradation and might be used as biomarkers for diagnosis and prognosis, here we explore the potential in AAV...

  10. Vasculitis (image)

    Science.gov (United States)

    ... These purplish spots can be felt in the skin. They do not turn white (blanch) when pressed. As the condition progresses, they may become larger and more bruise-like (ecchymotic), and some may develop central ulceration or necrosis (tissue death).

  11. Rheumatoid Vasculitis

    Science.gov (United States)

    ... must usually be made using a combination of history, physical examination, pertinent laboratory investigations, specialized testing (e.g., nerve conduction studies), and sometimes a tissue biopsy. Because the treatment implications for RV are major, ...

  12. Combination anti-VEGF and corticosteroid therapy for idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome.

    Science.gov (United States)

    Sawhney, Gagan K; Payne, John F; Ray, Robin; Mehta, Sonia; Bergstrom, Chris S; Yeh, Steven

    2013-11-01

    Vision loss associated with the idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome most commonly occurs from macular edema or complications related to neovascularization. The authors present a case of advanced IRVAN associated with a massive exudative response characterized by peripheral retinal telangiectasias, exudative retinal detachment, and macular edema with lipid maculopathy. The patient was managed successfully with visual acuity from hand motion to 20/150 using a combination of local corticosteroids, intravitreal bevacizumab, panretinal photocoagulation, and eventually pars plana vitrectomy for progressive vitreomacular traction. VEGF- and non-VEGF-mediated mechanisms appear to be involved in the pathogenesis of IRVAN given the efficacy of combination therapy. [ophthalmic surg lasers imaging retina. 2013;44:599-602.]. PMID:24221466

  13. Systemic panca-associated vasculitis with central nervous involvement causing recurrent myelitis: case report

    Directory of Open Access Journals (Sweden)

    Bull Matthew D

    2010-11-01

    Full Text Available Abstract Background We report on the case of an established perinuclear antineutrophil cytoplasmic antibody (pANCA associated renal vasculitis being treated with prednisolone and rituximab, where the patient presented with leg weakness, urinary and faecal incontinence and buttock pain consistent with transverse myelitis. Case presentation The patient underwent MRI scanning showing patchy cord enhancement from T10 to the conus, which was suggestive of a cord malignancy. Prior to a cord biopsy, he was treated with steroids and a repeat MRI showed resolution of the original lesion with a new similar lesion from C7 to T3. Conclusions He made a marked recovery after further treatment with high dose steroids and plasma exchange.

  14. Severe gastrointestinal cytomegalovirus disease in two patients with renal vasculitis after immunosuppression.

    Science.gov (United States)

    Lee, Kian-Guan; Teo, Su-Hooi; Lim, Cynthia; Loh, Alwin; Chidambaram, Viswanath; Choo, Jason

    2016-09-01

    Although the use of current immunosuppressive regimens has significantly improved the outcomes of autoimmune renal diseases, infectious complications remain an important clinical concern. Cytomegalovirus (CMV) infection has been shown to be one of the major causes of mortality in this group of patients. We report two cases of renal vasculitis (Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)) that developed into severe gastrointestinal CMV disease and manifested with massive small bowel bleeding, resulting in an eventual fatal outcome for one of the patients. Risk factors, pathogenesis, role of immunosuppression in the development of CMV infection, and antiviral treatment are discussed in this review. These cases highlight the need for further research to evaluate the complex mechanisms between immunosuppression and CMV occurrence as well as the role of antiviral prophylaxis in high-risk patients undergoing immunosuppressive therapies.
. PMID:27443566

  15. Unusual cause of flare in antineutrophil cytoplasmic antibody-associated vasculitis.

    Science.gov (United States)

    Glanville, James Robert William; Penn, Henry

    2016-01-01

    A 53-year-old woman attended for a routine outpatient appointment for follow-up of antineutrophil cytoplasmic antibody-positive vasculitis. Her disease had relapsed despite appropriate medical management with mycophenolate mofetil (MMF), as evidenced by rising acute phase response and antimyeloperoxidase titre with ongoing symptoms. On further questioning, she had been taking oral charcoal as part of a detoxification diet, which we postulate was causing significantly impaired MMF absorption. This case report summarises the presentation and highlights the importance of a thorough drug history, and should prompt the reader to keep an open mind with regard to drug interactions and treatment regimen adherence when treatment is, unexpectedly, seemingly failing. PMID:26746838

  16. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

    Directory of Open Access Journals (Sweden)

    Sevgi Akarsu

    2015-03-01

    Full Text Available Background and Design: Chronic spontaneous urticaria (CSU, the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patients with CSU and UV. Materials and Methods: In this study, the files of CSU (n=146 and UV (n=43 patients who had been hospitalized between January 2010-December 2013 were retrospectively reviewed in terms of demographic data, disease-specific history, accompanying diseases, medications and laboratory findings. Results: When comparing between the two groups for statistical differences, it was found that the frequencies of personal atopy and angioedema were significantly higher in patients with CSU; however, the patients with UV had significantly higher rates for female gender and the presence of systemic symptoms compared to those with CSU. It was determined that the mean values for erythrocyte sedimentation rate and C-reactive protein, as well as the rates of antinuclear antibody positivity and hypocomplementemia were significantly higher in the UV group, compared with those in the CSU group. Accompanying factors were determined as infections, medications, autoimmune diseases and malignities in order of frequency in both CSU and UV groups, but only the frequency of autoimmune diseases was significantly higher in patients with UV group. Conclusion: Although various authors have reported that a large number (up to 40-60% of patients with UV may present only with wheals (clinically indistinguishable from CSU; we assumed that it would be more appropriate to be considered UV as a priority in patients especially who had systemic symptom, autoimmune disease

  17. EBNA1 expression in a lung transplant recipient with hypocomplementemic urticarial vasculitis syndrome.

    Science.gov (United States)

    Berggren, Malin A M; Heinlen, Latisha; Isaksson, Asa; Nyström, Ulla; Ricksten, Anne

    2007-07-01

    This article describes a transplant recipient with underlying hypocomplementemic urticarial vasculitis syndrome who expressed persistently Epstein-Barr virus nuclear antigen 1 (EBNA1) in peripheral blood. The patient received a bilateral lung transplant and was subsequently followed with monitoring of EBV expression in peripheral blood. Evaluation of viral expression in peripheral blood, serum, and graft tissue was performed with RT-PCR, Q-PCR, indirect immunofluorescence, anti-peptide assays, and in situ hybridization; samples were collected at various time-points up to 91 days post-transplantation. The patient expressed EBNA1 in 8/10 (80%) of the peripheral blood samples tested during the post-transplantation period, and interestingly, even including the day of transplantation. After analyses of indicative EBV mRNA, EBNA1 expression was found mainly to be Qp-initiated EBNA1, known to be important for EBV maintenance. Anti-EBNA1 epitope mapping showed significantly higher and broader antibody responses to EBNA1 epitopes pre-transplantation when compared to normal controls and a matched lung transplant control. Post-transplantation this response was largely diminished but there were still epitopes significantly higher than controls. Our results show the presence of EBV-positive proliferating cells before onset of intensive immunosuppressive treatment. Although no previous connection between EBV and hypocomplementemic urticarial vasculitis syndrome has been reported, it is tempting to speculate that the continuous EBNA1 expression is not caused by immunosuppression or post-transplant lymphoproliferative disease, but may be a factor involved in the etiology of the autoimmune disease. PMID:17516536

  18. Atualização do tratamento das vasculites associadas a anticorpo anticitoplasma de neutrófilos Treatment of antineutrophil cytoplasmic antibody-associated vasculitis: update

    Directory of Open Access Journals (Sweden)

    Alfredo Nicodemos Cruz Santana

    2011-12-01

    Full Text Available As vasculites antineutrophil cytoplasmic antibody (ANCA, anticorpo anticitoplasma de neutrófilos associadas (VAAs são caracterizadas por uma inflamação sistêmica das artérias de pequeno e médio calibre (especialmente no trato respiratório superior e inferior, e nos rins. As VAAs compreendem a granulomatose de Wegener (agora chamada de granulomatose com poliangeíte, poliangeíte microscópica, VAA limitada ao rim e a síndrome de Churg-Strauss. Neste artigo, discutiremos as fases de tratamento dessas vasculites, como fase de indução (com ciclofosfamida ou rituximab e fase de manutenção (com azatioprina, metotrexato ou rituximab. Além disso, discutiremos como manusear os casos refratários à ciclofosfamida.In its various forms, antineutrophil cytoplasmic antibody (ANCA-associated vasculitis (AAV is characterized by a systemic inflammation of the small and medium-sized arteries (especially in the upper and lower respiratory tracts, as well as in the kidneys. The forms of AAV comprise Wegener's granulomatosis (now called granulomatosis with polyangiitis, microscopic polyangiitis, renal AAV, and Churg-Strauss syndrome. In this paper, we discuss the phases of AAV treatment, including the induction phase (with cyclophosphamide or rituximab and the maintenance phase (with azathioprine, methotrexate, or rituximab. We also discuss how to handle patients who are refractory to cyclophosphamide.

  19. Application of Affect to CALL

    Institute of Scientific and Technical Information of China (English)

    李露

    2006-01-01

    This essay mainly attempts to discuss some affective factors in CALL, with focus on affective influence on English (foreign language) learning and thus concludes that in the process of CALL related affect should be activated and made good use of to better foreign language teaching and learning.

  20. When to Call Your Pediatrician

    Science.gov (United States)

    ... in Action Medical Editor & Editorial Advisory Board Sponsors Sponsorship Opporunities Spread the Word Shop AAP Find a ... to Call Your Pediatrician Page Content Article Body Is it OK to call my child's pediatrician even if I'm not sure my ...

  1. 275 Efficacy of Omalizumab in the Treatment of Urticaria-Vasculitis Associated to Churg-Strauss Syndrome: A Case Report

    OpenAIRE

    Varricchi, Gilda; Detoraki, Aikaterini; Liccardo, Bianca; Spadaro, Giuseppe; de Paulis, Amato; Marone, Gianni; Triggiani, Massimo

    2012-01-01

    Background Churg-Strauss Syndrome (CCS) is a rare systemic necrotizing small vessel vasculitis associated with bronchial asthma, peripheral blood eosinophilia and eosinophilic lung infiltration. Skin changes compatible with vasculitis are present in about 75% of patients. Previous reports suggest that patients with CSS can be treated with anti-IgE (omalizumab) in addition to conventional therapy to achieve asthma control. Here we report the efficacy of a 6-month treatment with omalizumab in a...

  2. La calle de la Lona

    OpenAIRE

    Marín Reñasco, Alejandro

    2014-01-01

    Relato en el que se describe el ambiente cargado de realidad cotidiana de los habitantes de una calle, la calle de la lona. En el transcurso de la mañana de un sábado en una calle ubicado en una zona obrera de una ciudad cualquiera, el autor disecciona con un lenguaje preciso y brillante los juegos de los niños que aprovechan la mañana de libranza escolar para liberarse de la atmósfera cargada de sus casas alejándose del control familiar transgrediendo los límites de la calle…allá donde el mu...

  3. Malware Detection Through Call Graphs

    OpenAIRE

    Kinable, Joris

    2010-01-01

    Each day, anti-virus companies receive large quantities of potentially harmful executables. Many of the malicious samples among these executables are variations of earlier encountered malware, created by their authors to evade pattern-based detection. Consequently, robust detection approaches are required, capable of recognizing similar samples automatically.In this thesis, malware detection through call graphs is studied. In a call graph, the functions of a binary executable are represented ...

  4. Long-term follow-up of cyclophosphamide compared with azathioprine for initial maintenance therapy in ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Walsh, M.; Faurschou, M.; Berden, A.;

    2014-01-01

    BACKGROUND AND OBJECTIVES: Treatment with azathioprine within 3 months of remission induction with cyclophosphamide is a common treatment strategy for patients with ANCA-associated vasculitis. This study comprised patients undergoing long-term follow-up who were randomly allocated to azathioprine...... after 3-6 months or after 12 months of cyclophosphamide treatment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients from 39 European centers between 1995 and 1997 with a new diagnosis of ANCA-associated vasculitis that involved the kidneys or another vital organ were eligible. At the time of...... diagnosis, participants were randomly allocated to convert to azathioprine after 3-6 months (the azathioprine group) or after 12 months of cyclophosphamide (the cyclophosphamide group). Patients who did not achieve a remission within 6 months were excluded. This study assessed relapses, ESRD, and death...

  5. Vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos: Clínica y tratamiento

    OpenAIRE

    2013-01-01

    Las vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos (ANCA) comprenden a un grupo de enfermedades caracterizadas por la inflamación de la pared de pequeños vasos. Analizamos las características epidemiológicas y clínicas en una serie de 47 pacientes: 23 (49%) granulomatosis de Wegener (GW), 15 (32%) poliangeítis microscópica (PAM) y nueve (19%) vasculitis limitada al riñón (VLR). La edad media al inicio de los síntomas fue de 50.7 ± 14.9 años. La manifestación clínica más fre...

  6. Diagnostic Value of Procalcitonin in ANCA-Associated Vasculitis (AAV) to Differentiate Between Disease Activity, Infection and Drug Hypersensitivity

    OpenAIRE

    Herrmann, K; Schinke, S; Csernok, E.; Moosig, F; Holle, J. U.

    2015-01-01

    Objective: Procalcitonin (PCT) is considered to be a specific marker for severe bacterial infections and sepsis. Elevated PCT levels have been reported in active autoimmune diseases without infection. The aim of this study was to assess the diagnostic value of PCT serum levels in ANCA-associated vasculitis (AAV) patients with respect to infection, disease activity and drug fever using a high sensitive PCT detection method. Methods: In 53 AAV patients with elevated C-reactive protein (CRP) PCT...

  7. Evidence for defect of complement-mediated phagocytosis by monocytes from patients with rheumatoid arthritis and cutaneous vasculitis.

    OpenAIRE

    Hurst, N P; Nuki, G

    1981-01-01

    In-vitro measurements of the rate of monocyte phagocytosis of heat-killed yeast preopsonised in human AB serum from 14 patients with rheumatoid arthritis and 14 normal controls showed a significant reduction in five patients with active vasculitis but no change in nine with active arthritis alone. Further studies of complement- and Fc-mediated monocyte phagocytosis in which the rate constants (Kc and KFc respectively) were determined using complement-coated Saccharomyces cerevisiae and Candid...

  8. Serum levels of KL-6 reflect disease activity of interstitial pneumonia associated with ANCA-related vasculitis

    OpenAIRE

    Iwata, Yasunori; Wada, Takashi; Furuichi, Kengo; Kitagawa, Kiyoki; Kokubo, Satoshi; Kobayashi, Motoo; Sakai, Norihiko; Yoshimoto, Keiichi; Shimizu, Miho; Kobayashi, Kenichi; Yokoyama, Hitoshi

    2001-01-01

    Objective. KL-6 is reported to be excreted from the lung alveolar and bronchial epithelial cells and may be a good marker for monitoring disease activity of interstitial pneumonia. This study was designed to ascertain the clinical significance of serum KL-6 levels in interstitial pneumonia associated with anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis. Methods. Serum KL-6 levels were determined by an enzyme-linked immunosorbent assay. Patients. We examined 20 healthy subjects,...

  9. The impact of 18F-FDG PET on the management of patients with suspected large vessel vasculitis

    International Nuclear Information System (INIS)

    We aimed to assess the impact of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of 18F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the 18F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. 18F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of 18F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of 18F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of 18F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. 18F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

  10. Exploration, Development, and Validation of Patient-reported Outcomes in Antineutrophil Cytoplasmic Antibody–associated Vasculitis Using the OMERACT Process

    Science.gov (United States)

    Robson, Joanna C.; Milman, Nataliya; Tomasson, Gunnar; Dawson, Jill; Cronholm, Peter F.; Kellom, Katherine; Shea, Judy; Ashdown, Susan; Boers, Maarten; Boonen, Annelies; Casey, George C.; Farrar, John T.; Gebhart, Don; Krischer, Jeffrey; Lanier, Georgia; McAlear, Carol A.; Peck, Jacqueline; Sreih, Antoine G.; Tugwell, Peter; Luqmani, Raashid A.; Merkel, Peter A.

    2016-01-01

    Objective Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of linked multisystem life- and organ-threatening diseases. The Outcome Measures in Rheumatology (OMERACT) vasculitis working group has been at the forefront of outcome development in the field and has achieved OMERACT endorsement of a core set of outcomes for AAV. Patients with AAV report as important some manifestations of disease not routinely collected through physician-completed outcome tools; and they rate common manifestations differently from investigators. The core set includes the domain of patient-reported outcomes (PRO). However, PRO currently used in clinical trials of AAV do not fully characterize patients’ perspectives on their burden of disease. The OMERACT vasculitis working group is addressing the unmet needs for PRO in AAV. Methods Current activities of the working group include (1) evaluating the feasibility and construct validity of instruments within the PROMIS (Patient-Reported Outcome Measurement Information System) to record components of the disease experience among patients with AAV; (2) creating a disease-specific PRO measure for AAV; and (3) applying The International Classification of Functioning, Disability and Health to examine the scope of outcome measures used in AAV. Results The working group has developed a comprehensive research strategy, organized an investigative team, included patient research partners, obtained peer-reviewed funding, and is using a considerable research infrastructure to complete these interrelated projects to develop evidence-based validated outcome instruments that meet the OMERACT filter of truth, discrimination, and feasibility. Conclusion The OMERACT vasculitis working group is on schedule to achieve its goals of developing validated PRO for use in clinical trials of AAV. (First Release September 1 2015; J Rheumatol 2015;42:2204–9; doi:10.3899/jrheum.141143) PMID:26329344

  11. Call-Routing Schemes for Call-Center Outsourcing

    OpenAIRE

    Noah Gans; Yong-Pin Zhou

    2007-01-01

    Companies may choose to outsource parts, but not all, of their call-center operations. In some cases, they classify customers as high or low value, serving the former with their in-house operations and routing the latter to an outsourcer. Typically, they impose service-level constraints on the time each type of customer waits on hold. This paper considers four schemes for routing low-value calls between the client company and the outsourcer. These schemes vary in the complexity of their routi...

  12. Static and fatigue tensile properties of cross-ply laminates containing vascules for self-healing applications

    Science.gov (United States)

    Luterbacher, R.; Trask, R. S.; Bond, I. P.

    2016-01-01

    The effect of including hollow channels (vascules) within cross-ply laminates on static tensile properties and fatigue performance is investigated. No change in mechanical properties or damage formation is observed when a single vascule is included in the 0/90 interface, representing 0.5% of the cross sectional area within the specimen. During tensile loading, matrix cracks develop in the 90° layers leading to a reduction of stiffness and strength (defined as the loss of linearity) and a healing agent is injected through the vascules in order to heal them and mitigate the caused degradation. Two different healing agents, a commercial low viscosity epoxy resin (RT151, Resintech) and a toughened epoxy blend (bespoke, in-house formulation) have been used to successfully recover stiffness under static loading conditions. The RT151 system recovered 75% of the initial failure strength, whereas the toughened epoxy blend achieved a recovery of 67%. Under fatigue conditions, post healing, a rapid decay of stiffness was observed as the healed damage re-opened within the first 2500 cycles. This was caused by the high fatigue loading intensity, which was near the static failure strength of the healing resin. However, the potential for ameliorating (via self-healing or autonomous repair) more diffuse transverse matrix damage via a vascular network has been shown.

  13. Spotlight on rituximab in the treatment of antineutrophil cytoplasmic antibody-associated vasculitis: current perspectives

    Directory of Open Access Journals (Sweden)

    Moog P

    2015-11-01

    Full Text Available Philipp Moog, Klaus Thuermel Abteilung für Nephrologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany Abstract: A 54-year-old patient presented to his general practitioner because of strong muscle pain in both thighs. Inflammatory parameters (CRP 16.3 mg/dL and white blood cells (15 g/L were elevated. The patient reported a weight loss of 10 kg in 4 weeks. There was no fever or any other specific symptoms. Urine dipstick examination and computed tomography of the chest were unremarkable. Because of increasing symptoms, the patient was referred to our department. Magnetic resonance tomography showed diffuse inflammatory changes of the muscles of both thighs. Neurological examination and electrophysiology revealed axonal sensorimotor neuropathy and ground-glass opacities of both lungs had occurred. Serum creatinine increased to 229 µmol/L within a few days, with proteinuria of 3.3 g/g creatinine. Kidney biopsy showed diffuse pauci-immune proliferative glomerulonephritis. Proteinase 3-specific antineutrophil cytoplasmic antibodies were markedly increased. Birmingham Vasculitis Activity Score was 35. Within 2 days, serum creatinine further increased to 495 µmol/L. Plasma exchange, high-dose glucocorticosteroids, and hemodialysis were started. The patient received cyclophosphamide 1 g twice and rituximab 375 mg/m2 four times according to the RITUXVAS protocol. Despite ongoing therapy, hemodialysis could not be withdrawn and had to be continued over 3 weeks until diuresis normalized. Glucocorticosteroids were tapered to 20 mg after 2 months, and serum creatinine was 133 µmol/L. However, nephritic urinary sediment reappeared. Another dose of 1 g cyclophosphamide was given, and glucocorticosteroids were raised for another 4 weeks. After 6 months, the daily prednisolone dose was able to be tapered to 5 mg. Serum creatinine was 124 µmol/L, proteinuria further decreased to 382 mg/g creatinine, and the Birmingham

  14. Optimizing Programs Using Call Graphs

    Directory of Open Access Journals (Sweden)

    Pravin Kandala

    2014-02-01

    Full Text Available When working with complex software, visualization improves understanding considerably. Thus enhancing the ability of programmers to picture the relationships between components in a complex program not only saves time but becomes progressively mission- critical with increasing software complexity. Call Graph Generation Tool is a visualization tool which provides programmers different metrics to assess the software code. The different metrics include total n umber of lines in the function, total number of executable lines, number of unreachable lines, and cyclomatic complexity of the program. It provides a graphical representation of the function calls in a tree like structure. The tool accepts a „C‟ program and generates a funct ions call graph along with the functional metrics. The call graph generation tool provides both static and dynamic view. The whole programming is done using java technology. Thus, this tool helps the developer to know the program flow and thereby decide the optimality of the program. In situations where in, a single program is to be selected from available programs, this tool helps to figure out it. This paper depicts usage of call graph Generator to assess the reachability and exactness of the programs.

  15. OPTIMIZING PROGRAMS USING CALL GRAPHS

    Directory of Open Access Journals (Sweden)

    Pravin Kandala

    2015-11-01

    Full Text Available When working with complex software, visualization improves understanding considerably. Thus enhancing the ability of programmers to picture the relationships between components in a complex program not only saves time but becomes progressively mission- critical with increasing software complexity. Call Graph Generation Tool is a visualization tool which provides programmers different metrics to assess the software code. The different metrics include total number of lines in the function, total number of executable lines, number of unreachable lines, and cyclomatic complexity of the program. It provides a graphical representation of the function calls in a tree like structure. The tool accepts a „C‟ program and generates a functions call graph along with the functional metrics. The call graph generation tool provides both static and dynamic view. The whole programming is done using java technology. Thus, this tool helps the developer to know the program flow and thereby decide the optimality of the program. In situations where in, a single program is to be selected from available programs, this tool helps to figure out it. This paper depicts usage of call graph Generator to assess the reachability and exactness of the programs.

  16. The Wireless Nursing Call System

    DEFF Research Database (Denmark)

    Jensen, Casper Bruun

    2006-01-01

    This paper discusses a research project in which social scientists were involved both as analysts and supporters during a pilot with a new wireless nursing call system. The case thus exemplifies an attempt to participate in developing dependable health care systems and offers insight into the cha......This paper discusses a research project in which social scientists were involved both as analysts and supporters during a pilot with a new wireless nursing call system. The case thus exemplifies an attempt to participate in developing dependable health care systems and offers insight...

  17. Vasculites pulmonares: novas visões de uma velha conhecida Pulmonary forms of vasculitis: new perspectives on an old acquaintance

    Directory of Open Access Journals (Sweden)

    Thais Thomaz Queluz

    2005-07-01

    Full Text Available A vasculite necrosante foi descrita em 1866 e seu espectro é muito amplo, uma vez que acomete vasos arteriais e venosos de todos os calibres e de vários órgãos, apresenta diversos tipos de infiltrados inflamatórios, tem um significante número de manifestações clínicas e pode ter ou não fatores desencadeantes identificáveis. A sempre controversa classificação das vasculites mudou radicalmente com a descoberta dos anticorpos anticitoplasma de neutrófilos em 1982, contemplando atualmente a doença de Goodpasture, as vasculites associadas aos anticorpos anticitoplasma de neutrófilos, as vasculites por imunocomplexos e outros tipos de vasculites. As evidências de que os anticorpos anticitoplasma de neutrófilos estão envolvidos na patogênese destas lesões trouxeram avanços consideráveis para o seu diagnóstico e tratamento. Granulomatose de Wegener, doença de Churg-Strauss e poliangeíte microscópica, todas vasculites associadas aos anticorpos anticitoplasma de neutrófilos, são as vasculites sistêmicas que mais acometem os pulmões. Suas manifestações clínicas comuns são tosse, hemorragia alveolar difusa ou asma de difícil controle. Na arterite de Takayasu, na doença de Behçet, na púrpura de Henoch-Schönlein e nas vasculites associadas às doenças do colágeno o acometimento pulmonar é mais raro. Em todos os casos há evidências de serem processos de origem imunológica e com base neste princípio são propostas as abordagens terapêuticas.Necrotizing vasculitis was first described in 1866. The condition encompasses a wide spectrum of symptoms, affecting arterial blood vessels of various calibers and in various organs. In addition, it is associated with many types of inflammatory infiltrate, and presents a significant number of clinical manifestations. The causative factor or factors may or may not be identifiable. The eternally controversial classification of the various forms of vasculitis changed radically

  18. Circulating ADAM17 Level Reflects Disease Activity in Proteinase-3 ANCA-Associated Vasculitis.

    Science.gov (United States)

    Bertram, Anna; Lovric, Svjetlana; Engel, Alissa; Beese, Michaela; Wyss, Kristin; Hertel, Barbara; Park, Joon-Keun; Becker, Jan U; Kegel, Johanna; Haller, Hermann; Haubitz, Marion; Kirsch, Torsten

    2015-11-01

    ANCA-associated vasculitides are characterized by inflammatory destruction of small vessels accompanied by enhanced cleavage of membrane-bound proteins. One of the main proteases responsible for ectodomain shedding is disintegrin and metalloproteinase domain-containing protein 17 (ADAM17). Given its potential role in aggravating vascular dysfunction, we examined the role of ADAM17 in active proteinase-3 (PR3)-positive ANCA-associated vasculitis (AAV). ADAM17 concentration was significantly increased in plasma samples from patients with active PR3-AAV compared with samples from patients in remission or from other controls with renal nonvascular diseases. Comparably, plasma levels of the ADAM17 substrate syndecan-1 were significantly enhanced in active AAV. We also observed that plasma-derived ADAM17 retained its specific proteolytic activity and was partly located on extracellular microparticles. Transcript levels of ADAM17 were increased in blood samples of patients with active AAV, but those of ADAM10 or tissue inhibitor of metalloproteinases 3, which inhibits ADAMs, were not. We also performed a microRNA (miR) screen and identified miR-634 as significantly upregulated in blood samples from patients with active AAV. In vitro, miR-634 mimics induced a proinflammatory phenotype in monocyte-derived macrophages, with enhanced expression and release of ADAM17 and IL-6. These data suggest that ADAM17 has a prominent role in AAV and might account for the vascular complications associated with this disease. PMID:25788529

  19. Serum IgG antibodies to C1q in hypocomplementemic urticarial vasculitis syndrome.

    Science.gov (United States)

    Wisnieski, J J; Naff, G B

    1989-09-01

    Urticaria, angioedema, and arthritis are cardinal features of hypocomplementemic urticarial vasculitis syndrome (HUVS). Considered to be an immune complex-mediated disorder, HUVS has been differentiated from systemic lupus erythematosus (SLE), based on its clinical manifestations and the C1q precipitin (C1q-p) reaction, which is manifested as gel precipitation of C1q by a small percentage of HUVS IgG molecules. This phenomenon has been attributed to an Fc region abnormality, and the responsible IgG molecules are said to possess C1q-p activity. We purified IgG from 4 HUVS patients and confirmed that HUVS IgG contains C1q binding activity. F(ab')2 fragments from these patients also bound to C1q, as measured by 2 different C1q binding methods at physiologic ionic strength; HUVS IgG Fc fragments did not bind to C1q. Preincubation of HUVS F(ab')2 fragments with antibody to human F(ab')2 prevented subsequent binding to C1q. We conclude that IgG antibodies to C1q are present in HUVS serum, and it is likely that these antibodies are C1q-p. Because the clinical manifestations of HUVS and the presence of anti-C1q antibodies have been described in patients with SLE, our findings support the concept that HUVS is an autoimmune syndrome related to SLE. PMID:2528353

  20. Nursing care as a calling.

    Science.gov (United States)

    Raatikainen, R

    1997-06-01

    A calling is a deep desire to devote oneself to serving people according to the high values of the task or profession. The aim of this study is to clarify the relationship between a calling experience and professional knowledge, nursing action and motivation. The data were collected from all the registered nurses (n = 179) at five hospitals. The response was 70%. The nurses who were committed to their profession and experienced their job as a calling, had a good knowledge about the ill feeling and maladjustment of their patients and were also good sources of support for their patients. They understood the importance of family ties and offered support to their patients' families. They were aware of the needs of dying patients and their concern with spiritual questions, and satisfied these needs well. It was characteristic for them to collaborate closely within a team, to experience the content of their work as enriching and to possess proficient professional abilities. They were therefore excellent in supporting both the individual patient and his or her family. They had a deep understanding of the whole process of patient care. According to these results the calling experience is not in conflict with professional principles. PMID:9181405

  1. Ultrasound call detection in capybara

    Directory of Open Access Journals (Sweden)

    Selene S.C. Nogueira

    2012-07-01

    Full Text Available The vocal repertoire of some animal species has been considered a non-invasive tool to predict distress reactivity. In rats ultrasound emissions were reported as distress indicator. Capybaras[ vocal repertoire was reported recently and seems to have ultrasound calls, but this has not yet been confirmed. Thus, in order to check if a poor state of welfare was linked to ultrasound calls in the capybara vocal repertoire, the aim of this study was to track the presence of ultrasound emissions in 11 animals under three conditions: 1 unrestrained; 2 intermediately restrained, and 3 highly restrained. The ultrasound track identified frequencies in the range of 31.8±3.5 kHz in adults and 33.2±8.5 kHz in juveniles. These ultrasound frequencies occurred only when animals were highly restrained, physically restrained or injured during handling. We concluded that these calls with ultrasound components are related to pain and restraint because they did not occur when animals were free of restraint. Thus we suggest that this vocalization may be used as an additional tool to assess capybaras[ welfare.

  2. Vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos: Clínica y tratamiento

    Directory of Open Access Journals (Sweden)

    María Virginia Paolini

    2013-04-01

    Full Text Available Las vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos (ANCA comprenden a un grupo de enfermedades caracterizadas por la inflamación de la pared de pequeños vasos. Analizamos las características epidemiológicas y clínicas en una serie de 47 pacientes: 23 (49% granulomatosis de Wegener (GW, 15 (32% poliangeítis microscópica (PAM y nueve (19% vasculitis limitada al riñón (VLR. La edad media al inicio de los síntomas fue de 50.7 ± 14.9 años. La manifestación clínica más frecuente fue el compromiso renal en 41 (87% pacientes, seguido por el pulmonar en 26 (55% y el otorrinolaringológico en 17 (36%. En 26 (55% se asoció compromiso renal y pulmonar. La forma clínica más frecuente fue la generalizada en 23 (49%, seguida por la grave en 18 (38%. El 89% presentaron determinaciones de ANCA positivas. Cuatro (8% no recibieron tratamiento inmunosupresor de inicio. De los 43 que recibieron tratamiento de inicio, 29 (67% tuvieron remisión completa, con un tiempo de remisión promedio de 35.3 meses. Once (26% presentaron recaídas, diez (91% recaídas mayores y uno (9% menor. Doce (28% fallecieron, siete en forma temprana y cinco durante la evolución de la enfermedad. Quince (31% evolucionaron a insuficiencia renal crónica. Los 26 pacientes en seguimiento tuvieron respuesta al tratamiento y 20 (77% de ellos estaban en remisión al finalizar el estudio. Las vasculitis asociadas a ANCA continúan siendo enfermedades de alta morbilidad y mortalidad, a pesar de las mejorías logradas con los tratamientos inmunosupresores.

  3. Identification of Fetal Inflammatory Cells in Eosinophilic/T-cell Chorionic Vasculitis Using Fluorescent In Situ Hybridization.

    Science.gov (United States)

    Katzman, Philip J; Li, LiQiong; Wang, Nancy

    2015-01-01

    Eosinophilic/T-cell chorionic vasculitis (ETCV) is an inflammatory lesion of placental fetal vessels. In contrast to acute chorionic vasculitis, inflammation in ETCV is seen in chorionic vessel walls opposite the amnionic surface. It is not known whether inflammation in ETCV consists of maternal cells from the intervillous space or fetal cells migrating from the vessel. We used fluorescent in situ hybridization (FISH) to differentiate fetal versus maternal cells in ETCV. Placentas with ETCV, previously identified for a published study, were used. Infant sex in each case was identified using the electronic medical record. For male infants, 3-μm sections were cut from archived tissue blocks from placentas involving ETCV and stained with fluorescent X- and Y-chromosome centromeric probes. A consecutive hematoxylin/eosin-stained section was used for correlation. FISH analysis was performed on 400 interphase nuclei at the site of ETCV to determine the proportion of XX, XY, X, and Y cells. Of 31 ETCV cases, 20 were female and 10 were male (1 sex not recorded). Six of 10 cases with male infants had recuts with visible ETCV. In these 6 cases the average percentages (ranges) of XY cells, X-only cells, and Y-only cells in the region of inflammation were 81 (70-90), 11 (6-17), and 8 (2-14), respectively. There was a 2:1 female:male infant ratio in ETCV. Similar to acute chorionic vasculitis, the inflammation in ETCV is of fetal origin. It is still unknown, however, whether the stimulus for ETCV is of fetal or maternal origin. PMID:25756311

  4. Advanced Call Center Supporting WAP Access

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Traditional call centers can be accessed via speech only, and the call center based on web provides both data and speech access, but it needs a powerful terminal-computer. By analyzing traditional call centers and call centers based on web, this paper presents the framework of an advanced call center supporting WAP access. A typical service is also described in detail.

  5. A 14-year paraneoplastic rash: urticarial vasculitis and dermal binding bullous pemphigoid secondary to chronic lymphocytic leukaemia.

    Science.gov (United States)

    Kassim, J M; Igali, L; Levell, N J

    2015-06-01

    A 72-year-old woman with a 14-year history of urticarial vasculitis (UV) and a 13-year history of bullous pemphigoid (BP) presented with associated progressive chronic lymphocytic leukaemia (CLL). Both skin conditions responded poorly to treatment, until chemotherapy for CLL was commenced. The skin features showed a clear paraneoplastic course, resolving with chemotherapy and recurring when the CLL relapsed and the lymphocyte count rose above 5 × 10(9)/L. No case of UV secondary to CLL, and very few cases of BP related to CLL have been reported, and no paraneoplastic rash of any type lasting 14 years has been reported previously. PMID:25524180

  6. The impact of {sup 18}F-FDG PET on the management of patients with suspected large vessel vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Martin; Rasch, Helmut; Berg, Scott; Ng, Quinn K.T.; Mueller-Brand, Jan; Walter, Martin A. [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland); Briel, Matthias [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, ON (Canada); Daikeler, Thomas; Tyndall, Alan [University Hospital Basel, Department of Rheumatology, Basel (Switzerland); Walker, Ulrich A. [Felix Platter Spital, Department of Rheumatology of Basle University, Basel (Switzerland); Raatz, Heike [University Hospital Basel, Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); Jayne, David [Addenbrooke' s Hospital, Vasculitis and Lupus Unit, Cambridge (United Kingdom); Koetter, Ina [University Hospital Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Blockmans, Daniel [University Hospital Gasthuisberg, Department of General Internal Medicine, Leuven (Belgium); Cid, Maria C.; Prieto-Gonzalez, Sergio [Hospital Clinic, University of Barcelona, IDIBAPS, Department of Systemic Autoimmune Diseases, 08036-Barcelona (Spain); Lamprecht, Peter [University Hospital of Schleswig-Holstein, Department of Rheumatology, Luebeck (Germany); Salvarani, Carlo [Arcispedale S. Maria Nuova, Department of Rheumatology, Reggio Emilia (Italy); Karageorgaki, Zaharenia [Agios Dimitrios General Hospital, 1st Department of Internal Medicine, Thessaloniki (Greece); Watts, Richard [University of East Anglia, Norwich Medical School, Norwich (United Kingdom); Ipswich Hospital NHS Trust, Ipswich (United Kingdom); Luqmani, Raashid [Nuffield Orthopaedic Centre, Department of Rheumatology, Oxford (United Kingdom)

    2012-02-15

    We aimed to assess the impact of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis. An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of {sup 18}F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the {sup 18}F-FDG PET results were compared using logistic regression models. The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. {sup 18}F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of {sup 18}F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of {sup 18}F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of {sup 18}F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication. {sup 18}F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients. (orig.)

  7. Proton density differences in signal characteristics of multiple sclerosis plaques versus white matter lesions of small vessel disease and vasculitis on high-field strength MR images

    International Nuclear Information System (INIS)

    This paper determines if variations in signal intensity characteristics on multi-spin-echo images obtained with a high-field-strength magnet can be useful in differentiating demyelinating plaques of multiple sclerosis from other pathologic white matter processes due to small vessel disease and vasculities. Using the first of two multi-spin-echo images obtained with a General Electric 1.5-T magnet, the investigators compared signal intensity characteristics in 30 patients with a firm clinical diagnosis of multiple sclerosis versus a control group of 30 patients with a known clinical history of small-vessel disease and vasculitis are isodense to gray matter on proton-density images

  8. Reciprocity of mobile phone calls

    CERN Document Server

    Kovanen, Lauri; Kaski, Kimmo

    2010-01-01

    We present a study of the reciprocity of human behaviour based on mobile phone usage records. The underlying question is whether human relationships are mutual, in the sense that both are equally active in keeping up the relationship, or is it on the contrary typical that relationships are lopsided, with one party being significantly more active than the other. We study this question with the help of a mobile phone data set consisting of all mobile phone calls between 5.3 million customers of a single mobile phone operator. It turns out that lopsided relations are indeed quite common, to the extent that the variation cannot be explained by simple random deviations or by variations in personal activity. We also show that there is no non-trivial correlation between reciprocity and local network density.

  9. The structure of call-by-value

    OpenAIRE

    Führmann, Carsten

    2000-01-01

    Understanding procedure calls is crucial in computer science and everyday programming. Among the most common strategies for passing procedure arguments ('evaluation strategies') are 'call-by-name', 'call-by-need', and 'call-by-value', where the latter is the most commonly used. While reasoning about procedure calls is simple for call-by-name, problems arise for call-by-need and call-by-value, because it matters how often and in which order the arguments of a procedure are evaluated. We s...

  10. Aggressive cutaneous vasculitis in a patient with chronic lymphatic leukemia following granulocyte colony stimulating factor injection: a case report

    Directory of Open Access Journals (Sweden)

    El Husseiny Noha M

    2011-03-01

    Full Text Available Abstract Introduction Vasculitis has been reported in a few cases of chronic lymphatic leukemia and with granulocytic colony-stimulating factor therapy. Those with granulocytic colony-stimulating factor occurred after prolonged therapy and there was a rise in total leukocyte count unlike that in our patient who received just a single injection for the first time. Case presentation We report the case of a 64-year-old Egyptian man with chronic lymphatic leukemia who developed progressive cutaneous vasculitic lesions following injection of a single dose of a granulocytic colony stimulating factor before a third cycle of chemotherapy to improve neutropenia. This is an unusual case and the pathogenesis is not fully understood. Our patient was not on any medical treatment except for bisoprolol for ischemic heart disease. Although aggressive management with steroids, anticoagulation and plasmapheresis had been carried out, the condition was aggressive and the patient's consciousness deteriorated. A magnetic resonance imaging scan of his brain revealed multiple ischemic foci that could be attributed to vasculitis of the brain. Conclusion The aim of this case report is to highlight the importance of monitoring patients on granulocytic colony-stimulating factor therapy, especially in the context of other conditions (such as a hematological malignancy that may lead to an adverse outcome.

  11. A case of systemic lupus erythematosus associated with longitudinal extensive transverse myelitis, cerebral neutrophilic vasculitis, and cerebritis.

    Science.gov (United States)

    Modjinou, Dodji; Gurin, Lindsey; Chhabra, Arpit; Mikolaenko, Irina; Lydon, Eileen; Smiles, Stephen

    2014-01-01

    Systemic Lupus erythematosus (SLE) is an autoimmune disease with multiple clinical presentations and manifestations. Here, we report an intriguing case of a 30-year-old female with full-blown SLE, associated with longitudinal extensive transverse myelitis (LETM) on Magnetic Resonance Imaging (MRI) manifested by lower extremity weakness, neurogenic bladder and bowel, and central nervous system (CNS) lupus clinically manifested by changes in mood and behavior as well as neutrophilic vasculitis and cerebritis on pathology. LETM is a rare complication of SLE; however, what makes this case even more intriguing is that it additionally had cerebral lesions consistent with neutrophilic vasculitis and cerebritis, and that it may all have started at least 10 years prior with nonspecific musculoskeletal manifestations subsequently followed by a rash as well as intractable fevers of unknown etiology—much later attributed to her lupus. Although she had a most concerning and dramatic presentation, she, so far, had responded very well to therapy including pulse dose steroids, plasmapheresis, intravenous immunoglobulins (IVIG), cyclophosphamide, and related medications. PMID:25986355

  12. Confirmation of the genetic association of CTLA4 and PTPN22 with ANCA-associated vasculitis

    Directory of Open Access Journals (Sweden)

    Watts Richard A

    2009-12-01

    Full Text Available Abstract Background The genetic contribution to the aetiology of anti-neutrophil cytoplasmic antibody (ANCA-associated vasculitis (AAV is not well defined. Across different autoimmune diseases some genes with immunomodulatory roles, such as PTPN22, are frequently associated with multiple diseases, whereas specific HLA associations, such as HLA-B27, tend to be disease restricted. We studied ten candidate loci on the basis of their immunoregulatory role and prior associations with type 1 diabetes (T1D. These included PTPN22, CTLA4 and CD226, which have previously been associated with AAV. Methods We genotyped the following 11 SNPs, from 10 loci, in 641 AAV patients using TaqMan genotyping: rs2476601 in PTPN22, rs1990760 in IFIH1, rs3087243 in CTLA4, rs2069763 in IL2, rs10877012 in CYP27B1, rs2292239 in ERBB3, rs3184504 in SH2B3, rs12708716 in CLEC16A, rs1893217 and rs478582 in PTPN2 and rs763361 in CD226. Where possible, we performed a meta-analysis with previous analyses. Results Both CTLA4 rs3087243 and PTPN22 rs2476601 showed association with AAV, P = 6.4 × 10-3 and P = 1.4 × 10-4 respectively. The minor allele (A of CTLA4 rs3087243 is protective (odds ratio = 0.84, whereas the minor allele (A of PTPN22 rs2476601 confers susceptibility (odds ratio = 1.40. These results confirmed previously described associations with AAV. After meta-analysis, the PTPN22 rs2476601 association was further strengthened (combined P = 4.2 × 10-7, odds ratio of 1.48 for the A allele. The other 9 SNPs, including rs763361 in CD226, showed no association with AAV. Conclusion Our study of T1D associated SNPs in AAV has confirmed CTLA4 and PTPN22 as susceptibility loci in AAV. These genes encode two key regulators of the immune response and are associated with many autoimmune diseases, including T1D, autoimmune thyroid disease, celiac disease, rheumatoid arthritis, and now AAV.

  13. Incidence of Cancer in ANCA-Associated Vasculitis: A Meta-Analysis of Observational Studies

    Science.gov (United States)

    Shang, Weifeng; Ning, Yong; Xu, Xiu; Li, Menglan; Guo, Shuiming; Han, Min; Zeng, Rui; Ge, Shuwang; Xu, Gang

    2015-01-01

    Objective The purpose of this paper is to examine cancer incidence in patients with ANCA-associated vasculitis (AASV) derived from population-based cohort studies by means of meta-analysis. Methods Relevant electronic databases were searched for studies characterizing the associated risk of overall malignancy in patients with AASV. Standardized incidence rates (SIRs) with 95% confidence intervals (CIs) were used to evaluate the strength of association. We tested for publication bias and heterogeneity and stratified for site-specific cancers. Results Six studies (n = 2,578) were eventually identified, of which six provided the SIR for overall malignancy, five reported the SIR for non-melanoma skin cancer (NMSC), four for leukemia, five for bladder cancer, three for lymphoma, three for liver cancer, four for lung cancer, three for kidney cancer, four for prostate cancer, four for colon cancer and four for breast cancer. Overall, the pooled SIR of cancer in AASV patients was 1.74 (95%CI = 1.37–2.21), with moderate heterogeneity among these studies (I2 = 65.8%, P = 0.012). In sub-analyses for site-specific cancers, NMSC, leukemia and bladder cancer were more frequently observed in patients with AASV with SIR of 5.18 (95%CI = 3.47–7.73), 4.89 (95%CI = 2.93–8.16) and 3.84 (95%CI = 2.72–5.42) respectively. There was no significant increase in the risk of kidney cancer (SIR = 2.12, 95%CI = 0.66–6.85), prostate cancer (SIR = 1.45, 95%CI = 0.87–2.42), colon cancer (SIR = 1.26, 95%CI = 0.70–2.27), and breast cancer (SIR = 0.95, 95%CI = 0.50–1.79). Among these site-specific cancers, only NMSC showed moderate heterogeneity (I2 = 55.8%, P = 0.06). No publication bias was found by using the Begg’s test and Egger's test. Conclusions This meta-analysis shows that AASV patients treatment with cyclophosphamide (CYC) are at increased risk of late-occurring malignancies, particularly of the NMSC, leukemia and bladder cancer. However, there is no significant

  14. Advanced Call Center Supporting WAP Access

    Institute of Scientific and Technical Information of China (English)

    YUANXiao-hua; CHENJun-liang

    2001-01-01

    Traditional call centers can be accessed via speech only, and the call center based on web provides both da-ta and speech access,but it needs a powerful terminal-computer.By analyzing traditional call centers and call cen-ters based on web, this paper presents the framework of an advanced call center supporting WAP access.A typical service is also described in detail.

  15. HLA-DR4, DR13(6) and the ancestral haplotype A1B8DR3 are associated with ANCA-associated vasculitis and Wegeners granulomatosis

    NARCIS (Netherlands)

    Stassen, Patricia M.; Cohen-Tervaert, Jan W.; Lems, Simon P. M.; Hepkema, Bouke G.; Kallenberg, Cees G. M.; Stegeman, Coen A.

    2009-01-01

    Objectives. As the HLA system is involved in recognition of self and non-self, an association with the development of ANCA-associated vasculitis (AAV) seems probable. In this study, the relation between HLA antigens and AAV and its severity were investigated. Methods. Consecutive patients diagnosed

  16. The function of migratory bird calls

    DEFF Research Database (Denmark)

    Reichl, Thomas; Andersen, Bent Bach; Larsen, Ole Næsbye;

    The function of migratory bird calls: do they influence orientation and navigation?   Thomas Reichl1, Bent Bach Andersen2, Ole Naesbye Larsen2, Henrik Mouritsen1   1Institute of Biology, University of Oldenburg, Oldenburg, D-26111 Oldenburg, Germany 2Institute of Biology, University of Southern...... Denmark, Odense, DK-5230 Odense M, Denmark   Many migrating passerines emit special calls during nocturnal flight, the so-called flight calls. Several functions of the calls have been suggested but largely remain speculative. Flight calls have been hypothesized to maintain groups during nocturnal...... migration and to stimulate migratory restlessness in conspecifics. We wished to test if conspecific flight calls influence the flight direction of a nocturnal migrant, the European Robin (Erithacus rubecula), i.e. if flight calls help migrants keeping course. Wild caught birds showing migratory restlessness...

  17. Sequential occurrence of anti-glomerular basement membrane disease 9 years after anti-neutrophil cytoplasmic antibody-associated vasculitis

    Science.gov (United States)

    Chan, Pui Shan Julia; Leung, Moon Ho

    2016-01-01

    We report a case of 63-year-old Chinese man, having a history of anti-myeloperoxidase (MPO) antibody anti-neutrophil cytoplasmic antibody (ANCA)-associated pulmonary-renal syndrome 9 years ago, presented with second episode of rapidly progressive glomerulonephritis (RPGN) and alveolar haemorrhage compatible with anti-glomerular basement membrane (GBM) disease. In first presentation, his anti-GBM antibody was negative. This time, anti-MPO antibody was negative, but anti-GBM antibody was positive. The long interval of sequential development of anti-GBM disease after ANCA-associated vasculitis in this patient may provide clues to the potential immunological links between these two distinct conditions. Clinicians should be aware of such double-positive association.

  18. Call packing bounds for overflow queues

    OpenAIRE

    van Dijk; Sluis, van der, B.

    2004-01-01

    Finite queueing loss systems are studied with overflow. For these systems there is no simple analytic expression for the loss probability or throughput. This paper aims to prove and promote easily computable bounds as based upon the so-called call packing principle. Under call packing a standard product form expression is available. It is proven that call packing leads to a guaranteed upper bound for the loss probability. In addition, an analytic error bound for the accuracy is derived which ...

  19. Analysis of a hospital call center

    OpenAIRE

    Budak, Ezel Ezgi

    2012-01-01

    Ankara : The Department of Industrial Engineering and the Graduate School of Engineering and Science of Bilkent University, 2012. Thesis (Master's) -- Bilkent University, 2012. Includes bibliographical refences. In this thesis, we study the call center operations of a particular hospital located in Ankara, namely Güven Hospital. The hospital call center takes role as a medical consulting and appointment center and also domestic call traffic flows over the call center. These ...

  20. C-ANCA-positive IgG fraction from patients with Wegener's granulomatosis induces lung vasculitis in rats

    Science.gov (United States)

    WEIDEBACH, W; VIANA, V S T; LEON, E P; BUENO, C; LEME, A S; ARANTES-COSTA, F M; MARTINS, M A; SALDIVA, P H N; BONFA, E

    2002-01-01

    The aim of the present study was to analyse in rats the ability of C-ANCA-positive IgG fraction in triggering inflammatory response on pulmonary tissue. Wistar rats (n = 18) were injected via the the internal jugular vein with 20 mg of total C-ANCA-positive IgG fraction isolated from serum of three different Wegener's granulomatosis patients obtained before therapy. Similarly, control rats were treated with IgG fraction from two rheumatoid arthritis patients (n = 7), IgG from six normal human sera (n = 15) or saline (n = 18), respectively. Animals were sacrificed after 24h of injection for histological analysis of the lungs. Vasculitis and inflammatory infiltrate were consistently absent in rats injected with rheumatoid arthritis IgG or saline and in 14/15 of normal IgG treated animals. In contrast, marked vasculitis was observed in all 18 animals injected with C-ANCA-positive IgG fraction. The histological features were characterized by the presence of a perivascular pleomorphic cellular sheath, particularly around small vessels, endothelial adherence and diapedesis of polymorphonuclear leucocytes and presence of granuloma-like lesions. A dose–response relationship was observed between protein concentration of C-ANCA IgG sample and the intensity of the inflammatory response in the animals. In addition, IgG fraction with undetectable C-ANCA, obtained from one patient in remission after treatment, was not able to reproduce the pulmonary tissue alterations induced by its paired IgG that was positive for C-ANCA taken before therapy. The experimental model described herein may be useful to characterize more effectively the pathogenic mechanism of C-ANCA in Wegener's disease. PMID:12100022

  1. Neutrophilic Dermatoses in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A French Multicenter Study of 17 Cases and Literature Review.

    Science.gov (United States)

    de Boysson, Hubert; Martin Silva, Nicolas; de Moreuil, Claire; Néel, Antoine; de Menthon, Mathilde; Meyer, Olivier; Launay, David; Pagnoux, Christian; Guillevin, Loïc; Puéchal, Xavier; Bienvenu, Boris; Aouba, Achille

    2016-03-01

    A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved.We conducted a retrospective study of patients with both conditions. Patients were selected via the French Internal Medicine Society (SNFMI) and the French Vasculitis Study Group (FVSG). A literature review focusing on a combination of both conditions, concentrated only on publications with well-established diagnoses and individual detailed data.Seventeen patients diagnosed with AAV and ND were identified in this cohort. Twelve patients had granulomatosis with polyangiitis (GPA), 4 had microscopic polyangiitis (MPA) and one had eosinophilic GPA (EGPA). Eight patients, all with GPA, displayed pyoderma gangrenosum (PG). Sweet's syndrome was observed in 6 patients (4 with MPA, one with GPA and one with EGPA) and erythema elevatum diutinum in the other three (2 with GPA and 1 with MPA). The literature review identified 33 additional patients with both conditions, including 26 with GPA. Altogether, of the 50 patients (17 from our study and 33 from the literature review), 33 (66%) patients presented with PG associated with GPA in 29 cases (89%). Corticosteroids were the first-line treatment in conjunction with an immunosuppressive agent in most cases. Outcomes were good and a total of 15 patients experienced a relapse. Patients who relapsed were more likely to have ear, nose and throat manifestation than patients who did not [12/15 (80%) relapsing patients vs. 15/35 (43%) non-relapsing patients; p = 0.03)].In our stud, the most frequent association concerned GPA and PG. ND should be considered and specifically researched within the spectrum of cutaneous manifestations observed in AAV. PMID:26986103

  2. Higher Serum Angiotensinogen Is an Indicator of IgA Vasculitis with Nephritis Revealed by Comparative Proteomes Analysis.

    Science.gov (United States)

    He, Xuelian; Yin, Wei; Ding, Yan; Cui, Shu-jian; Luan, Jiangwei; Zhao, Peiwei; Yue, Xin; Yu, Chunhua; Laing, Xiaohui; Zhao, YuLan

    2015-01-01

    IgA vasculitis (IgAV), previously named as Henoch-Schönlein purpura, is the most common systematic vasculitis with unknown etiology. Lack of appropriate study system and/or animal model limits the understanding of its molecular pathogenesis and hinders the identification of targets for rational therapy, especially for its long-term complication, IgAV nephritis (IgAVN). In this study, we applied comparative analysis of serum proteomes to obtain an insight about disease pathogenesis. This study has utilized high sensitivity nanoscale ultra performance liquid chromatography-mass spectrometry (nanoLC-MS/MS) to investigate the alterations in serum proteomic profiles in patients with IgAV (n=6), IgAVN (n=6) and healthy subjects (n=7). The differentially expressed proteins were subjected to functional pathway analysis by PANTHER and DAVID software. We identified 107 differentially expressed proteins among three different groups, and functional analysis suggested that, in addition to earlier reported pathways, such as acute phase response, immune response, complement and blood coagulation pathways, hemostasis and Wnt signaling pathway were probably involved in pathogenesis of IgAV. A few differentially abundant proteins identified, such as C4a, serum amyloid A, angiotensinogen, and kininogen 1, were further validated by ELISA. More importantly, we found that angiotensinogen concentration is correlated with IgAVN and could be used as a potential marker for the progression of IgAV. This is the first report of analyzing the proteomic alterations in IgAV patients and the differentially proteins identified in this study may enhance understanding of the pathology of IgAV and a few of them may be used to monitor disease progression. PMID:26098644

  3. Higher Serum Angiotensinogen Is an Indicator of IgA Vasculitis with Nephritis Revealed by Comparative Proteomes Analysis.

    Directory of Open Access Journals (Sweden)

    Xuelian He

    Full Text Available IgA vasculitis (IgAV, previously named as Henoch-Schönlein purpura, is the most common systematic vasculitis with unknown etiology. Lack of appropriate study system and/or animal model limits the understanding of its molecular pathogenesis and hinders the identification of targets for rational therapy, especially for its long-term complication, IgAV nephritis (IgAVN. In this study, we applied comparative analysis of serum proteomes to obtain an insight about disease pathogenesis. This study has utilized high sensitivity nanoscale ultra performance liquid chromatography-mass spectrometry (nanoLC-MS/MS to investigate the alterations in serum proteomic profiles in patients with IgAV (n=6, IgAVN (n=6 and healthy subjects (n=7. The differentially expressed proteins were subjected to functional pathway analysis by PANTHER and DAVID software. We identified 107 differentially expressed proteins among three different groups, and functional analysis suggested that, in addition to earlier reported pathways, such as acute phase response, immune response, complement and blood coagulation pathways, hemostasis and Wnt signaling pathway were probably involved in pathogenesis of IgAV. A few differentially abundant proteins identified, such as C4a, serum amyloid A, angiotensinogen, and kininogen 1, were further validated by ELISA. More importantly, we found that angiotensinogen concentration is correlated with IgAVN and could be used as a potential marker for the progression of IgAV. This is the first report of analyzing the proteomic alterations in IgAV patients and the differentially proteins identified in this study may enhance understanding of the pathology of IgAV and a few of them may be used to monitor disease progression.

  4. Call packing bound for overflow loss systems

    NARCIS (Netherlands)

    N.M. van Dijk; E. van der Sluis

    2009-01-01

    Finite loss queues with overflow naturally arise in a variety of communications structures. For these systems, there is no simple analytic expression for the loss probability. This paper proves and promotes easily computable bounds based on the so-called call packing principle. Under call packing, a

  5. Call packing bounds for overflow queues

    NARCIS (Netherlands)

    N.M. van Dijk; E. van der Sluis

    2004-01-01

    Finite queueing loss systems are studied with overflow. For these systems there is no simple analytic expression for the loss probability or throughput. This paper aims to prove and promote easily computable bounds as based upon the so-called call packing principle. Under call packing a standard pro

  6. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2001-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  7. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2002-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.  

  8. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2001-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note: the number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  9. How to call the Fire Brigade

    CERN Multimedia

    2003-01-01

    The telephone numbers for the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from "wired" telephones, however, from mobile phones it leads to non-CERN emergency services.

  10. HOW TO CALL THE CERN FIRE BRIGADE

    CERN Multimedia

    2002-01-01

    The telephone numbers of the CERN Fire Brigade are: 74444 for emergency calls 74848 for other calls Note The number 112 will stay in use for emergency calls from 'wired' telephones, however, from mobile phones it leads to non-CERN emergency services.

  11. 47 CFR 2.302 - Call signs.

    Science.gov (United States)

    2010-10-01

    ... citations affecting § 2.302, see the List of CFR Sections Affected in the Finding Aids section of this... 47 Telecommunication 1 2010-10-01 2010-10-01 false Call signs. 2.302 Section 2.302... RULES AND REGULATIONS Call Signs and Other Forms of Identifying Radio Transmissions § 2.302 Call...

  12. When to Call the Baby's Doctor

    Science.gov (United States)

    ... g n a n c y When to Call the Baby’s Doctor P rint - and -G o ... for new moms is figuring out when to call the doctor. As a general rule of thumb, ... suspect something is not right, you should always call the doctor. Even small changes in eating, sleeping, ...

  13. Perceiving a Calling, Living a Calling, and Job Satisfaction: Testing a Moderated, Multiple Mediator Model

    Science.gov (United States)

    Duffy, Ryan D.; Bott, Elizabeth M.; Allan, Blake A.; Torrey, Carrie L.; Dik, Bryan J.

    2012-01-01

    The current study examined the relation between perceiving a calling, living a calling, and job satisfaction among a diverse group of employed adults who completed an online survey (N = 201). Perceiving a calling and living a calling were positively correlated with career commitment, work meaning, and job satisfaction. Living a calling moderated…

  14. Bonobos extract meaning from call sequences.

    Directory of Open Access Journals (Sweden)

    Zanna Clay

    Full Text Available Studies on language-trained bonobos have revealed their remarkable abilities in representational and communication tasks. Surprisingly, however, corresponding research into their natural communication has largely been neglected. We address this issue with a first playback study on the natural vocal behaviour of bonobos. Bonobos produce five acoustically distinct call types when finding food, which they regularly mix together into longer call sequences. We found that individual call types were relatively poor indicators of food quality, while context specificity was much greater at the call sequence level. We therefore investigated whether receivers could extract meaning about the quality of food encountered by the caller by integrating across different call sequences. We first trained four captive individuals to find two types of foods, kiwi (preferred and apples (less preferred at two different locations. We then conducted naturalistic playback experiments during which we broadcasted sequences of four calls, originally produced by a familiar individual responding to either kiwi or apples. All sequences contained the same number of calls but varied in the composition of call types. Following playbacks, we found that subjects devoted significantly more search effort to the field indicated by the call sequence. Rather than attending to individual calls, bonobos attended to the entire sequences to make inferences about the food encountered by a caller. These results provide the first empirical evidence that bonobos are able to extract information about external events by attending to vocal sequences of other individuals and highlight the importance of call combinations in their natural communication system.

  15. Current and emerging treatment options for ANCA-associated vasculitis: potential role of belimumab and other BAFF/APRIL targeting agents

    Directory of Open Access Journals (Sweden)

    Lenert A

    2015-01-01

    Full Text Available Aleksander Lenert,1 Petar Lenert21Division of Rheumatology, University of Kentucky, Kentucky Clinic, Lexington, KY, USA; 2Division of Immunology, Department of Internal Medicine, The University of Iowa, Iowa City, IA, USAAbstract: Antineutrophil cytoplasmic antibody (ANCA-associated vasculitis (AAV comprises several clinical entities with diverse clinical presentations, outcomes, and nonunifying pathogenesis. AAV has a clear potential for relapses, and shows unpredictable response to treatment. Cyclophosphamide-based therapies have remained the hallmark of induction therapy protocols for more than four decades. Recently, B-cell depleting therapy with the anti-CD20 antibody rituximab has proved beneficial in AAV, leading to Food and Drug Administration approval of rituximab in combination with corticosteroids for the treatment of AAV in adults. Rituximab for ANCA-associated vasculitis and other clinical trials provided clear evidence that rituximab was not inferior to cyclophosphamide for remission induction, and rituximab appeared even more beneficial in patients with relapsing disease. This raised hopes that other B-cell-targeted therapies directed either against CD19, CD20, CD22, or B-cell survival factors, B-cell activating factor of the tumor necrosis factor family (BAFF and a proliferation-inducing ligand could also be beneficial for the management of AAV. BAFF neutralization with the fully humanized monoclonal antibody belimumab has already shown success in human systemic lupus erythematosus and, along with another anti-BAFF reagent blisibimod, is currently undergoing Phase II and III clinical trials in AAV. Local production of BAFF in granulomatous lesions and elevated levels of serum BAFF in AAV provide a rationale for BAFF-targeted therapies not only in AAV but also in other forms of vasculitis such as Behcet’s disease, large-vessel vasculitis, or cryoglobulinemic vasculitis secondary to chronic hepatitis C infection. BAFF

  16. Synergistic modeling of call center operations

    OpenAIRE

    2006-01-01

    We synergistically apply queueing theory, integer programming, and stochastic simulation to determine an optimal staffing policy for a repair call handling center. A stationary Markovian queueing model is employed to determine minimal staffing levels for a sequence of time intervals with varying call volumes and mean handling times. These staffing requirements populate an integer program model for determining the mix of call agent shifts that will achieve service quality standards at minimum ...

  17. Bonobos extract meaning from call sequences

    OpenAIRE

    Clay, Zanna; Zuberbuehler, Klaus

    2011-01-01

    Studies on language-trained bonobos have revealed their remarkable abilities in representational and communication tasks. Surprisingly, however, corresponding research into their natural communication has largely been neglected. We address this issue with a first playback study on the natural vocal behaviour of bonobos. Bonobos produce five acoustically distinct call types when finding food, which they regularly mix together into longer call sequences. We found that individual call types were...

  18. Long-distance calls in Neotropical primates

    OpenAIRE

    Oliveira Dilmar A.G.; Ades César

    2004-01-01

    Long-distance calls are widespread among primates. Several studies concentrate on such calls in just one or in few species, while few studies have treated more general trends within the order. The common features that usually characterize these vocalizations are related to long-distance propagation of sounds. The proposed functions of primate long-distance calls can be divided into extragroup and intragroup ones. Extragroup functions relate to mate defense, mate attraction or resource defense...

  19. CALL for endangered languages: Challenges and rewards

    OpenAIRE

    Ward, Monica; Van Genabith, Josef

    2003-01-01

    The interaction between CALL and Endangered Languages (EL) is an under-researched and under-exploited field. It is perhaps no surprise that this should be the case as CALL in the EL context has to address additional requirements and deal with extra constraints over and above those that prevail in mainstream CALL. This article introduces the topic of Endangered Languages and lists two classifications for Endangered Languages (Terralingua, 2000; Unesco, 1993). It outlines why a language becomes...

  20. Performance Indicators for Call Centers with Impatience

    OpenAIRE

    Jouini, Oualid; Koole, Ger; Roubos, Alex

    2013-01-01

    International audience An important feature of call center modeling is the presence of impatient customers. In this paper, we consider single-skill call centers including customer abandonments. We study a number of different service level definitions, including all those used in practice, and show how to explicitly compute their performance measures. Based on data from different call centers, new models are defined that extend the common Erlang A model. We show that the new models fit real...

  1. Call Duration Characteristics based on Customers Location

    Directory of Open Access Journals (Sweden)

    Žvinys Karolis

    2014-05-01

    Full Text Available Nowadays a lot of different researches are performed based on call duration distributions (CDD analysis. However, the majority of studies are linked with social relationships between the people. Therefore the scarcity of information, how the call duration is associated with a user's location, is appreciable. The goal of this paper is to reveal the ties between user's voice call duration and the location of call. For this reason we analyzed more than 5 million calls from real mobile network, which were made over the base stations located in rural areas, roads, small towns, business and entertainment centers, residential districts. According to these site types CDD’s and characteristic features for call durations are given and discussed. Submitted analysis presents the users habits and behavior as a group (not an individual. The research showed that CDD’s of customers being them in different locations are not equal. It has been found that users at entertainment, business centers are tend to talk much shortly, than people being at home. Even more CDD can be distorted strongly, when machinery calls are evaluated. Hence to apply a common CDD for a whole network it is not recommended. The study also deals with specific parameters of call duration for distinguished user groups, the influence of network technology for call duration is considered.

  2. Multidimensional views on mobile call network

    Institute of Scientific and Technical Information of China (English)

    Shengqi YANG; Bin WU; Bai WANG

    2009-01-01

    Recent studies on social network have spurred significant interests in human behaviors. Nowadays, various kinds of interpersonal human interactions, from mobile calls to emalls, provide particular avenues to explore the inher-ent properties of communication patterns. In this article, we present a comprehensive study on a massive anonymous call records obtained from a major mobile service operator. The important difference laid in our work and previous mainly topological analyses is that we report on multiple aspects of the dataset. By investigating the calls of the users, we find out that most calls tend to last within one minute. Call du-ration between two females is much longer than that of two males. But calls of males generally involve more stations than that of female, indicating a larger mobile range of the males. We also observed that people tend to communicate more with each other when they share similar characters. Besides, the network is well-connected and robust to random attack. We also demonstrate that the close-knit sub-groups with little discrepancy in the characteristics of its involved users usually evoke more calls. Another interesting discov-ery is that call behaviors among people between workdays and weekends is obviously distinct. Generally speaking, the goal that we research on call network through multidimen-sional analyses is to uncover the intricate patterns of human communications and put up reasonable insights into future service intelligence.

  3. When They Talk about CALL: Discourse in a Required CALL Class

    Science.gov (United States)

    Kessler, Greg

    2010-01-01

    This study investigates preservice teachers' discourse about CALL in a required CALL class which combines theory and practice. Thirty-three students in a Linguistics MA program CALL course were observed over a 10-week quarter. For all of these students, it was their first formal exposure to CALL as a discipline. Communication in the class…

  4. Cutaneous adverse effects of hormonal adjuvant therapy for breast cancer: a case of localised urticarial vasculitis following anastrozole therapy and a review of the literature.

    Science.gov (United States)

    Bock, Vanessa L; Friedlander, Michael; Waring, Dale; Kossard, Steven; Wood, Glenda K

    2014-11-01

    Hormonal therapy with either tamoxifen or aromatase inhibitors is commonly used to treat women with breast cancer in both the adjuvant and recurrent disease setting. Cutaneous adverse reactions to these drugs have been rarely reported in the literature. We report an unusual case of urticarial vasculitis following the aromatase inhibitor anastrozole that localised to the unilateral trunk and mastectomy scar, and review the literature on the cutaneous adverse effects of hormonal therapy for breast cancer. PMID:24575835

  5. Rituximab in Combination with Corticosteroids for the Treatment of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A NICE Single Technology Appraisal

    OpenAIRE

    Latimer, Nicholas R.; Carroll, Christopher; Wong, Ruth; Tappenden, Paul; Venning, Michael C.; Luqmani, Raashid

    2014-01-01

    As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of rituximab (Roche Products) to submit evidence of the clinical and cost effectiveness of rituximab in combination with corticosteroids for treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as...

  6. Plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasm antibody associated vasculitis (PEXIVAS): protocol for a randomized controlled trial

    OpenAIRE

    Walsh, Michael; Merkel, Peter A.; Peh, Chen Au; Szpirt, Wladimir; Guillevin, Loïc; Charles D. Pusey; deZoysa, Janak; Ives, Natalie; Clark, William F.; Quillen, Karen; Winters, Jeffrey L.; Wheatley, Keith; Jayne, David

    2013-01-01

    Background Granulomatosis with polyangiitis (GPA, Wegener’s) and microscopic polyangiitis (MPA) are small vessel vasculitides collectively referred to as anti-neutrophil cytoplasm antibody-associated vasculitis (AAV). AAV is associated with high rates of morbidity and mortality due to uncontrolled disease and treatment toxicity. Small randomized trials suggest adjunctive plasma exchange may improve disease control, while observational evidence suggests that current oral glucocorticoid doses a...

  7. VASCULITIS DE CHURG-STRAUSS: PRESENTACIÓN CLÍNICA COMO GLOMERULONEFRITIS EXTRACAPILAR NECROTIZANTE PAUCI-INMUNE CON NEFRITIS TUBULO-INTERSTICIAL EOSINOFÍLICA.

    Directory of Open Access Journals (Sweden)

    Fernanda da Cunha

    2004-01-01

    Full Text Available RESUMEN: Se presenta el caso clínico de una mujer de 81 años con antecedentes patología pulmonar obstructiva crónica "idiopática" que desarrolló un cuadro de insuficiencia renal aguda aparentemente prerrenal, con posterior oliguria y eosinofilia simulando una nefropatía túbulo-intersticial alérgica. La evolución atípica y la presencia de p-ANCA, sugerían una vasculitis, patología que se confirmó con la biopsia renal. Los resultados anatomopatológicos revelaron la existencia de una glomerulonefritis necrotizante con semilunas e infiltrado eosinófilo. Estos datos y el historial de la paciente llevaron al diagnóstico de vasculitis de Churg-Strauss. El tratamiento inicial con corticoides y ciclofosfamida y posteriormente con Azatioprina mostró excelentes resultados con mejoría de la función renal, de los parámetros inflamatorios y de la clínica sistémica, que la paciente mantuvo posteriormente. ABSTRACT: We report a case of a 81 year-old woman with idiopathic chronic obstructive pulmonary disease, who developed a functional acute renal failure with delayed oliguria and eosinophily, simulating an acute interstitial nephropathy. The unusual clinical course and the presence of antimyeloperoxidase antibodies (p-ANCA suggested a vasculitis; the renal biopsy confirmed this diagnosis. The histology revealed a crescentic glomerulonephritis with eosinophilic infiltration. With these data and the pulmonary history of the patient, a diagnosis of Churg-Struss Vasculitis was made. The initial treatment with steroids and ciclophosphamide switched later to azatioprine, was succeeded with a sustained improvement in renal function, inflammatory markers and clinical course.

  8. Isolation of vascular smooth muscle antigen-reactive CD4(+)αβTh1 clones that induce pulmonary vasculitis in MRL/Mp-Fas(+/+) mice.

    Science.gov (United States)

    Fujita, Yoshimasa; Fujii, Takao; Shimizu, Hironori; Sato, Tomomi; Nakamura, Takuji; Iwao, Haruka; Nakajima, Akio; Miki, Miyuki; Sakai, Tomoyuki; Kawanami, Takafumi; Tanaka, Masao; Masaki, Yasufumi; Fukushima, Toshihiro; Okazaki, Toshiro; Umehara, Hisanori; Mimori, Tsuneyo

    2016-05-01

    Here, we established CD4(+)αβTh1 clones specific for rat vascular smooth muscle antigen (VSMAg) that induced vasculitis lesions in the lungs of MRL/Mp-Fas(+/+) mice following adoptive transfer. Six different T cell clones, MV1b1 (Vβ1), MV1b4 (Vβ4), MV1b8.3 (Vβ8.3), MV1b61 (Vβ6), MV1b62 (Vβ6), and MV1b63 (Vβ6), were isolated from the MV1 T cell line from the regional lymph nodes of immunized MRL/Mp-Fas(+/+) mice; the three (Vβ6) clones had unique CDR3 amino acid sequences. Following stimulation with VSMAg-pulsed antigen presenting cells, MV1b61 and MV1b62 failed to secrete interferon-γ and tumor necrosis factor-α, although the other four clones secreted high levels of both cytokines. In adoptive transfer experiments, MV1b61 and MV1b62 did not induce organ involvement including pulmonary vasculitis. In contrast, MV1b1, MV1b4, MV1b8.3, and MV1b63 induced perivascular mononuclear cell infiltration in pulmonary small arteries. These clones may provide useful tools for investigating the underlying mechanisms of vasculitis syndromes and for developing therapeutic strategies. PMID:27019130

  9. Performance evaluation of Call-center with call redirection: Ocena performanc klicnega centra s preusmerjanjem klicev:

    OpenAIRE

    Efimushkin, Vladimir; Žepič, Drago

    2007-01-01

    The object of investigation is an analytical model for a Call-center functioning with a traffic distribution (call redirection) mechanism. Call-center functioning is described by the Markov process. A solution for stationary distribution is found and expressions for the main performance characteristics for the Call-center functioning are given. The proposed analytical model enables an investigation in different call traffic management schemes for the cases of agents overload and underload. ...

  10. Effect of gender and call duration on customer satisfaction in call center big data

    OpenAIRE

    Quim Llimona; Jordi Luque; Xabier Anguera; Zoraida Hidalgo; Souneil Park; Nuria Oliver

    2015-01-01

    Customer center call data is typically collected by organizations and corporations in order to improve customer experience through the analysis of such call data. In this paper, we report our findings when analysing more than 26 thousand calls to the call centers of a large corporation in a Latin American country. We focus on the impact of gender and call duration on selfreported customer satisfaction. Speech-based gender detection technology is employed to automatically detect the gender...

  11. Core Competencies Of A Call Centre AgentCore Competencies Of A Call Centre Agent

    OpenAIRE

    Christine White; Vera Roos

    2005-01-01

    Call centre agents are becoming increasingly important in the call centre context. They act as a contact point between the customer and the company. Call centre agents should have certain competencies to perform their duties sufficiently. Identifying competencies, required to be effective agents, will ease the task of training and recruitment. Due to the interrelatedness of the call centre agent, the management of a call centre and customers, all relevant role players’ perceptions were taken ...

  12. Coaching "Callings" throughout the Adult Life Cycle.

    Science.gov (United States)

    Hudson, Frederic M.

    2001-01-01

    The process of "callings" continues throughout life. Coaching can connect the present to the future in a meaningful way. Callings represent a value shift requiring revision of the nature and scope of one's central purpose in life and meaningful activities. (JOW)

  13. 78 FR 21891 - Rural Call Completion

    Science.gov (United States)

    2013-04-12

    ... in Rulemaking Proceedings, 63 FR 24121 (1998). Electronic Filers: Comments may be filed..., we propose to apply these obligations to the first facilities-based provider in the call- delivery... call. In cases where the first facilities-based provider serves multiple non-facilities-...

  14. Applying Pedagogical Principles to CALL Courseware Development.

    Science.gov (United States)

    Wyatt, David H.

    This paper on the application of principles to computer-assisted language learning (CALL) first clarifies the the relationships between the capabilities of the computer (and computer-controlled technology) and the main approaches to second language learning. Fourteen common types of CALL programs are briefly reviewed. A "relational" classification…

  15. 78 FR 76218 - Rural Call Completion

    Science.gov (United States)

    2013-12-17

    ... choice. If that reseller making the initial long-distance call path choice uses VoIP technology, in the..., interexchange carriers (IXCs), commercial mobile radio service (CMRS) providers, and VoIP service providers... the prohibition on call blocking; made clear that carriers' blocking of VoIP-PSTN traffic...

  16. Call-Center – Rationalisierung im Dilemma

    OpenAIRE

    Holtgrewe, Ursula; Gundtoft, Lars

    2001-01-01

    Die Verfasser untersuchen Funktionen, Lösungen und Probleme der Organisationsform Call-Center. Aus organisationssoziologischer Sicht werden grundlegende Funktionen und Dilemmata organisationeller Grenzstellen beleuchtet und mit Informationen über Organisations- und Beschäftigtenstruktur, Arbeitsweisen und Kundenbeziehungen der verschiedenen Typen von Call-Centern abgeglichen. Die Untersuchung ist auf drei Ebenen angelegt: Aus systematisch-struktureller Sicht werden Organisationsdilemmata an d...

  17. A CALL for Improved School Leadership

    Science.gov (United States)

    Halverson, Richard; Kelley, Carolyn; Shaw, James

    2014-01-01

    The Comprehensive Assessment of Leadership for Learning (CALL) is a formative assessment that provides feedback to schools on the research-based leadership practices necessary to improve teaching and learning. Instead of focusing on an individual leader, CALL measures leadership practices in tasks carried out by actors across the school and…

  18. Communication cliques in mobile phone calling networks

    CERN Document Server

    Li, Ming-Xia; Jiang, Zhi-Qiang; Zhou, Wei-Xing

    2015-01-01

    People in modern societies form different social networks through numerous means of communication. These communication networks reflect different aspects of human's societal structure. The billing records of calls among mobile phone users enable us to construct a directed calling network (DCN) and its Bonferroni network (SVDCN) in which the preferential communications are statistically validated. Here we perform a comparative investigation of the cliques of the original DCN and its SVDCN constructed from the calling records of more than nine million individuals in Shanghai over a period of 110 days. We find that the statistical properties of the cliques of the two calling networks are qualitatively similar and the clique members in the DCN and the SVDCN exhibit idiosyncratic behaviors quantitatively. Members in large cliques are found to be spatially close to each other. Based on the clique degree profile of each mobile phone user, the most active users in the two calling networks can be classified in to seve...

  19. Call Admission Control in Mobile Cellular Networks

    CERN Document Server

    Ghosh, Sanchita

    2013-01-01

    Call Admission Control (CAC) and Dynamic Channel Assignments (DCA) are important decision-making problems in mobile cellular communication systems. Current research in mobile communication considers them as two independent problems, although the former greatly depends on the resulting free channels obtained as the outcome of the latter. This book provides a solution to the CAC problem, considering DCA as an integral part of decision-making for call admission. Further, current technical resources ignore movement issues of mobile stations and fluctuation in network load (incoming calls) in the control strategy used for call admission. In addition, the present techniques on call admission offers solution globally for the entire network, instead of considering the cells independently.      CAC here has been formulated by two alternative approaches. The first approach aimed at handling the uncertainty in the CAC problem by employing fuzzy comparators.  The second approach is concerned with formulation of CAC ...

  20. Call cultures in orang-utans?

    Directory of Open Access Journals (Sweden)

    Serge A Wich

    Full Text Available BACKGROUND: Several studies suggested great ape cultures, arguing that human cumulative culture presumably evolved from such a foundation. These focused on conspicuous behaviours, and showed rich geographic variation, which could not be attributed to known ecological or genetic differences. Although geographic variation within call types (accents has previously been reported for orang-utans and other primate species, we examine geographic variation in the presence/absence of discrete call types (dialects. Because orang-utans have been shown to have geographic variation that is not completely explicable by genetic or ecological factors we hypothesized that this will be similar in the call domain and predict that discrete call type variation between populations will be found. METHODOLOGY/PRINCIPAL FINDINGS: We examined long-term behavioural data from five orang-utan populations and collected fecal samples for genetic analyses. We show that there is geographic variation in the presence of discrete types of calls. In exactly the same behavioural context (nest building and infant retrieval, individuals in different wild populations customarily emit either qualitatively different calls or calls in some but not in others. By comparing patterns in call-type and genetic similarity, we suggest that the observed variation is not likely to be explained by genetic or ecological differences. CONCLUSION/SIGNIFICANCE: These results are consistent with the potential presence of 'call cultures' and suggest that wild orang-utans possess the ability to invent arbitrary calls, which spread through social learning. These findings differ substantially from those that have been reported for primates before. First, the results reported here are on dialect and not on accent. Second, this study presents cases of production learning whereas most primate studies on vocal learning were cases of contextual learning. We conclude with speculating on how these findings might

  1. External GSM phone calls now made simpler

    CERN Multimedia

    2007-01-01

    On 2 July, the IT/CS Telecom Service introduced a new service making external calls from CERN GSM phones easier. A specific prefix is no longer needed for calls outside CERN. External calls from CERN GSM phones are to be simplified. It is no longer necessary to use a special prefix to call an external number from the CERN GSM network.The Telecom Section of the IT/CS Group is introducing a new system that will make life easier for GSM users. It is no longer necessary to use a special prefix (333) to call an external number from the CERN GSM network. Simply dial the number directly like any other Swiss GSM customer. CERN currently has its own private GSM network with the Swiss mobile operator, Sunrise, covering the whole of Switzerland. This network was initially intended exclusively for calls between CERN numbers (replacing the old beeper system). A special system was later introduced for external calls, allowing them to pass thr...

  2. Vasculite cerebral e uso de cocaína e crack Cerebral vasculitis and cocaine and crack abuse

    Directory of Open Access Journals (Sweden)

    Fernando Madalena Volpe

    1999-09-01

    Full Text Available O abuso de cocaína e crack está associado com importante parcela dos acidentes vasculares cerebrais, especialmente em pacientes jovens. O presente estudo relata o caso de um usuário de cocaína e crack que desenvolveu vasculite do sistema nervoso central, resultando em infartos cerebrais e edema extensos, levando à demência com alterações comportamentais e convulsões. Ressalta-se a importância de suspeitar do uso de drogas em jovens que se apresentam com acidente vascular cerebral, assim como avaliar possíveis lesões cerebrais em usuários de drogas com deterioração cognitiva.Cocaine and crack abuse is strongly related to stroke, particularly in young patients. The present study reports the case of a cocaine and crack abuser who developed central nervous system vasculitis, resulting in extensive cerebral infarctions, leading to dementia, behavioural disturbances and seizures. The relevance of detecting drug abuse in young stroke patients is stressed. Assessing possible brain lesions in drug abusers with cognitive impairment is also important.

  3. Successful use of interleukin 6 antagonist tocilizumab in a patient with refractory cutaneous lupus and urticarial vasculitis.

    Science.gov (United States)

    Makol, Ashima; Gibson, Lawrence E; Michet, Clement J

    2012-03-01

    Tocilizumab (Actemra; Genentech, Inc) is the first biologic therapy targeting the cytokine interleukin 6 (IL-6). It is a humanized monoclonal immunoglobulin G1 antibody against the α-chain of the IL-6 receptor that prevents the binding of IL-6 to membrane-bound and -soluble IL-6 receptor. It was approved by the US Food and Drug Administration in January 2010 for rheumatoid arthritis refractory to other approved therapies and in April 2011 for systemic juvenile idiopathic arthritis. It has been used as an off-label treatment in many autoimmune diseases, where IL-6 plays a major role in pathogenesis. We report a case of refractory systemic lupus erythematosus in a 22-year-old woman with recurrent high-grade fever, polyarthritis, diffuse rash with urticarial vasculitis, and tumid lupus who did not respond to topical corticosteroids, photoprotection, antimalarials, methotrexate, anakinra, mycophenolate mofetil, etanercept, and intravenous immunoglobulin therapy. Symptoms recurred after corticosteroid tapers below 10 mg. She was noted to have an elevated IL-6 level, and tocilizumab was started. She responded favorably with remission of fever, arthritis, and skin manifestations and was able to taper corticosteroid therapy successfully. PMID:22334272

  4. TWEAK enhances E-selectin and ICAM-1 expression, and may contribute to the development of cutaneous vasculitis.

    Directory of Open Access Journals (Sweden)

    Tao Chen

    Full Text Available Our previous work indicated that TWEAK is associated with various types of cutaneous vasculitis (CV. Herein, we investigate the effects of TWEAK on vascular injury and adhesion molecule expression in CV mice. We showed that TWEAK priming in mice induced a local CV. Furthermore, TWEAK priming also increased the extravasation of FITC-BSA, myeloperoxidase activity and the expression of E-selectin and ICAM-1. Conversely, TWEAK blockade ameliorated the LPS-induced vascular damage, leukocyte infiltrates and adhesion molecules expression in LPS-induced CV. In addition, TWEAK treatment of HDMECs up-regulated E-selectin and ICAM-1 expression at both mRNA and protein levels. TWEAK also enhanced the adhesion of PMNs to HDMECs. Finally, western blot data revealed that TWEAK can induce phosphorylation of p38, JNK and ERK in HDMECs. These data suggest that TWEAK acted as an inducer of E-selectin and ICAM-1 expression in CV mice and HDMECs, may contribute to the development of CV.

  5. Churg-Strauss vasculitis and idiopathic hypereosinophyl syndrome: role of molecular biology in the differential diagnosis of hypereosinophyl syndrome

    Directory of Open Access Journals (Sweden)

    A. d'Ascanio

    2011-09-01

    Full Text Available Objective: Hypereosinophilic syndromes are a heterogeneous group of uncommon disorders characterized by the presence of marked peripheral blood eosinophilia, tissue eosinophilia, or both, resulting in a wide variety of clinical manifestations, often without an identifiable cause. Churg-Strauss syndrome is a systemic vasculitis characterized by prominent peripheral eosinophilia, asthma and systemic involvement. The presence of mild to severe eosinophilia and systemic involvement raise the search of many trigger factor that need to be ruled out. Distinguishing CSS from idiopathic hypereosinophilic syndrome may be particularly challenging, especially in ANCA negative patients. Methods: The aim of the present study was to present a small case series of patients referred to a Rheumatology Unit for mild to severe eosinophilia and signs and symptoms of systemic involvement and to outline the clinical significance of molecular biology in the work-up of hypereosinophilia. Results: Eleven patients with moderate to severe peripheral eosinophylia, were referred to our Unit from 1996 to 2007. Female to male ratio was 7/4, mean age 40.54 (range 22-75. Three out of eleven patients resulted positive for molecular biology. The diagnosis of idiopathic hypereosinophylia was confirmed in one out of three on the basis of the clinical picture and bone marrow biopsy. Conclusions: Molecular biology may be useful in the screening and in the follow-up of a new hypereosinophylic patient.

  6. Kaposi′s sarcoma with HHV8 infection and ANCA-associated vasculitis in a hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Lilia Ben Fatma

    2013-01-01

    Full Text Available The association between Kaposi′s sarcoma (KS and human herpes virus eight (HHV-8 infection is rarely reported in hemodialysis (HD patients. We report here the rare association of KS, HHV-8 and hepatitis C virus (HCV infection as well as syphilis in a HD patient. We report the case of a 72-year-old woman who presented with microscopic polyangiitis with alveolar hemorrhage and pauci-immune necrosing and crescentic glomerulonephritis as well as renal failure requiring HD. Biological tests showed positive HCV and syphilis tests. The patient was treated by HD and intravenous pulse, followed by oral corticosteroids and six cyclophosphamide monthly pulses with remission of the alveolar hemorrhage, but without renal functional recovery as the patient remained HD dependent. Five months after the first treatment administration, she developed extensive purpuric lesions on her lower limbs, abdomen face and neck. A skin biopsy showed KS. The HHV-8 test was positive, with positive polymerase chain reaction-HHV8 in the serum and skin. After immunosuppression withdrawal, the KS skin lesions regressed rapidly without relapse after 12 months of follow-up, but alveolar hemorrhage relapsed after 16 months of follow-up. Our case showed that the immunosuppressed state related to multiple factors such as aging, vasculitis, HHV-8, HCV, syphilis, immunosuppressive therapy and HD may all have contributed to the development of KS in our patient.

  7. Performance of Call to Order - photographs

    OpenAIRE

    Ritter, Kathleen; Maxwell, James; PARRC

    2012-01-01

    Call to Order is the translation—into musical sound—of the meeting minutes of the organizations behind Institutions by Artists: The Convention (PAARC, Fillip, and ARCA). Call to Order uses a prosaic form of administration as material for creative production. Musical scores were created from the meeting minutes of each organization by mapping Robert’s Rules of Order onto the implied rules of Piston’s Harmony and using both texts as comparative guides. Call to Order is the musical sound of a...

  8. Mourning Dove Call-count Survey

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Mourning Dove (Zenaida macroura) Call-Count Survey was developed to provide an index to population size and to detect annual changes in mourning dove breeding...

  9. Engineers call for US nuclear safety fix

    Science.gov (United States)

    Gwynne, Peter

    2016-04-01

    Seven Nuclear Regulatory Commission (NRC) engineers have called on the commission to force the owners of US nuclear reactors to repair a design flaw that could affect the safe operation of emergency core cooling systems.

  10. 17 CFR 31.18 - Margin calls.

    Science.gov (United States)

    2010-04-01

    ... after contact is effected in which to respond to a margin call. Twenty-four hours, excluding Saturdays... contract for a period of 5 business days at the then prevailing bid price in the case of a long...

  11. 76 FR 4896 - Call for Candidates

    Science.gov (United States)

    2011-01-27

    ... accepted accounting principles for federal government entities. Generally, non-federal Board members are... From the Federal Register Online via the Government Publishing Office FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Call for Candidates AGENCY: Federal Accounting Standards Advisory Board. ACTION:...

  12. 76 FR 36130 - Call for Candidates

    Science.gov (United States)

    2011-06-21

    ... establish generally accepted accounting principles for federal government entities. Generally, non- federal... From the Federal Register Online via the Government Publishing Office FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Call for Candidates AGENCY: Federal Accounting Standards Advisory Board. ACTION: Request...

  13. Anti-laminin autoantibodies in collagen vascular diseases: the use of adequate controls in studies of autoimmune responses to laminin.

    OpenAIRE

    Cohen, D E; Kaufman, L D; Varma, A A; Seibold, J R; Stiller, M.; Gruber, B L

    1994-01-01

    OBJECTIVES--To determine the significance of anti-laminin antibodies in patients with collagen vascular diseases using a large control population of normal individuals. METHODS--Anti-laminin antibodies of IgG isotypes were determined using an ELISA assay in a population consisting of 73 patients with systemic sclerosis, 10 with urticarial vasculitis, five with leukocytoclastic vasculitis, 13 with giant cell arteritis, and eight with dermatomyositis. Sera from 134 healthy individuals served as...

  14. Calling patterns in human communication dynamics

    OpenAIRE

    Jiang, Zhi-Qiang; Xie, Wen-Jie; Li, Ming-Xia; Podobnik, Boris; Zhou, Wei-Xing; Stanley, H. Eugene

    2013-01-01

    Modern technologies not only provide a variety of communication modes, e.g., texting, cellphone conversation, and online instant messaging, but they also provide detailed electronic traces of these communications between individuals. These electronic traces indicate that the interactions occur in temporal bursts. Here, we study the inter-call durations of the 100,000 most-active cellphone users of a Chinese mobile phone operator. We confirm that the inter-call durations follow a power-law dis...

  15. Malware Classification based on Call Graph Clustering

    OpenAIRE

    Kinable, Joris; Kostakis, Orestis

    2010-01-01

    Each day, anti-virus companies receive tens of thousands samples of potentially harmful executables. Many of the malicious samples are variations of previously encountered malware, created by their authors to evade pattern-based detection. Dealing with these large amounts of data requires robust, automatic detection approaches. This paper studies malware classification based on call graph clustering. By representing malware samples as call graphs, it is possible to abstract certain variations...

  16. Application for call center data analysis

    OpenAIRE

    KLEMENČIČ, DAMJAN

    2015-01-01

    Graduation thesis describes the planning and design of desktop application CTI Server that is used in call and dispatch centers, where they have communication server (PBX) Siemens. Application collects data that is sent from communication server and stores them in data base for subsequent processing. It also displays current status of agents and telephony connections, call history and agent logs for a certain period of time. With the data obtained from communication server the application ...

  17. Towards Building an Intelligent Call Routing System

    OpenAIRE

    Thien Khai Tran; Dung Minh Pham; Binh Van Huynh

    2016-01-01

    This paper presents EduICR - an Intelligent Call Routing system. This system can route calls to the most appropriate agent using routing rules built by the text classifier. EduICR includes the following main components: telephone communication network; Vietnamese speech recognition; Text classifier/ Natural language processor and Vietnamese speech synthesis. To our best knowledge, this is one of the first systems in Vietnam to implement the integration mechanism of text processing and speech ...

  18. Identifying users profiles from mobile calls habits

    OpenAIRE

    Furletti, Barbara; Gabrielli, Lorenzo; Rinzivillo, Salvatore; Renso, Chiara

    2012-01-01

    The huge quantity of positioning data registered by our mobile phones stimulates several research questions, mainly originating from the combination of this huge quantity of data with the extreme heterogeneity of the tracked user and the low granularity of the data. We propose a methodology to partition the users tracked by GSM phone calls into profiles like resident, commuters, in transit and tourists. The methodology analyses the phone calls with a combination of top-down and bottom up tech...

  19. Call-Center-Forschung: Ergebnisse und Theorien

    OpenAIRE

    Holtgrewe, Ursula

    2003-01-01

    "In den letzten Jahren haben sich ForscherInnen aus unterschiedlichen Richtungen der Industrie-, Arbeits- und Organisationssoziologie für Call Center interessiert. Der Grund dafür liegt nicht allein darin, dass es sich um einen schnell expandierenden Bereich der Dienstleistungsarbeit handelt. Es scheint vielmehr, dass sich in den Call Centern exemplarisch eine Reihe von Themen und Tendenzen bündelt, die die Arbeit in Dienstleistungs- und Wissensgesellschaften bestimmen. So s...

  20. Optimal Balanced Control for Call Centers

    OpenAIRE

    Bhulai, Sandjai; Farenhorst-Yuan, Taoying; Heidergott, Bernd; van der Laan, Dinard

    2010-01-01

    In this paper we study a challenging call center operation problem. The goal of our analysis is to identify an optimal policy for allocating tasks to agents. As a first step, we discuss promising randomized policies and use stochastic approximation for finding the optimal randomized policy when implemented via a Bernoulli scheme. As we will show in this paper, the performance of the call center can be improved if the randomized policy is implemented by a deterministic sequence satisfying some...

  1. BUSINESS MODELS FOR EXTENDING OF 112 EMERGENCY CALL CENTER CAPABILITIES WITH E-CALL FUNCTION INSERTION

    OpenAIRE

    Pop Dragos Paul; Botezatu Cornelia Paulina; Botezatu Cezar; Carutasu George

    2010-01-01

    The present article concerns present status of implementation in Romania and Europe of eCall service and the proposed business models regarding eCall function implementation in Romania. eCall system is used for reliable transmission in case of crush between In Vehicle System and Public Service Answering Point, via the voice channel of cellular and Public Switched Telephone Network (PSTN). eCall service could be initiated automatically or manual the driver. All data presented in this article a...

  2. Partition Decomposition for Roll Call Data

    CERN Document Server

    Leibon, Greg; Rockmore, Daniel N; Savell, Robert

    2011-01-01

    In this paper we bring to bear some new tools from statistical learning on the analysis of roll call data. We present a new data-driven model for roll call voting that is geometric in nature. We construct the model by adapting the "Partition Decoupling Method," an unsupervised learning technique originally developed for the analysis of families of time series, to produce a multiscale geometric description of a weighted network associated to a set of roll call votes. Central to this approach is the quantitative notion of a "motivation," a cluster-based and learned basis element that serves as a building block in the representation of roll call data. Motivations enable the formulation of a quantitative description of ideology and their data-dependent nature makes possible a quantitative analysis of the evolution of ideological factors. This approach is generally applicable to roll call data and we apply it in particular to the historical roll call voting of the U.S. House and Senate. This methodology provides a...

  3. Communication cliques in mobile phone calling networks

    Science.gov (United States)

    Li, Ming-Xia; Xie, Wen-Jie; Jiang, Zhi-Qiang; Zhou, Wei-Xing

    2015-11-01

    People in modern societies form different social networks through numerous means of communication. These communication networks reflect different aspects of human's societal structure. The billing records of calls among mobile phone users enable us to construct a directed calling network (DCN) and its Bonferroni network (SVDCN) in which the preferential communications are statistically validated. Here we perform a comparative investigation of the cliques of the original DCN and its SVDCN constructed from the calling records of more than nine million individuals in Shanghai over a period of 110 days. We find that the statistical properties of the cliques of the two calling networks are qualitatively similar and the clique members in the DCN and the SVDCN exhibit idiosyncratic behaviors quantitatively. Members in large cliques are found to be spatially close to each other. Based on the clique degree profile of each mobile phone user, the most active users in the two calling networks can be classified in to several groups. The users in different groups are found to have different calling behaviors. Our study unveils interesting communication behaviors among mobile phone users that are densely connected to each other.

  4. 47 CFR 22.921 - 911 call processing procedures; 911-only calling mode.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false 911 call processing procedures; 911-only calling mode. 22.921 Section 22.921 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... procedures; 911-only calling mode. Mobile telephones manufactured after February 13, 2000 that are capable...

  5. Behavioral Preferences for Individual Securities : The Case for Call Warrants and Call Options

    NARCIS (Netherlands)

    Ter Horst, J.R.; Veld, C.H.

    2002-01-01

    Since 1998, large investment banks have flooded the European capital markets with issues of call warrants.This has led to a unique situation in the Netherlands, where now call warrants, traded on the stock exchange, and long-term call options, traded on the options exchange, exist.Both entitle their

  6. Behavioral Preferences for Individual Securities : The Case for Call Warrants and Call Options

    OpenAIRE

    Ter Horst, J.R.; Veld, C.H.

    2002-01-01

    Since 1998, large investment banks have flooded the European capital markets with issues of call warrants.This has led to a unique situation in the Netherlands, where now call warrants, traded on the stock exchange, and long-term call options, traded on the options exchange, exist.Both entitle their holders to buy shares of common stock.We use the long-term call options in order to price the call warrants.Using the model of Black and Scholes (1973), the Square Root model version of the Consta...

  7. Call-by-name, call-by-value, call-by-need and the linear lambda calculus

    OpenAIRE

    Maraist, J.; Odersky, M.; Turner, D.N.; Wadler, P.

    1999-01-01

    Girard described two translations of intuitionistic logic into linear logic, one where A→B maps to (!A⊸B) and another where it maps to !(A⊸B). We detail the action of these translations on terms and show that the first corresponds to a call-by-name calculus, while the second corresponds to call-by-value. We further show that if the target of the translation is taken to be an affine calculus, where! controls contraction but weakening is allowed everywhere, then the second translation correspon...

  8. Call-by-name, Call-by-value, Call-by-need, and the Linear Lambda Calculus

    OpenAIRE

    Maraist, John; Odersky, Martin; Turner, David N.; Wadler, Philip

    1995-01-01

    Girard described two translations of intuitionistic logic into linear logic, one where A -> B maps to (!A) -o B, and another where it maps to !(A -o B). We detail the action of these translations on terms, and show that the first corresponds to a call-by-name calculus, while the second corresponds to call-by-value. We further show that if the target of the translation is taken to be an affine calculus, where ! controls contraction but weakening is allowed everywhere, then the second transl...

  9. Calling patterns in human communication dynamics

    CERN Document Server

    Jiang, Zhi-Qiang; Li, Ming-Xia; Podobnik, Boris; Zhou, Wei-Xing; Stanley, H Eugene; 10.1073/pnas.1220433110

    2013-01-01

    Modern technologies not only provide a variety of communication modes, e.g., texting, cellphone conversation, and online instant messaging, but they also provide detailed electronic traces of these communications between individuals. These electronic traces indicate that the interactions occur in temporal bursts. Here, we study the inter-call durations of the 100,000 most-active cellphone users of a Chinese mobile phone operator. We confirm that the inter-call durations follow a power-law distribution with an exponential cutoff at the population level but find differences when focusing on individual users. We apply statistical tests at the individual level and find that the inter-call durations follow a power-law distribution for only 3460 individuals (3.46%). The inter-call durations for the majority (73.34%) follow a Weibull distribution. We quantify individual users using three measures: out-degree, percentage of outgoing calls, and communication diversity. We find that the cellphone users with a power-law...

  10. Dynamic routing based on call quality

    CERN Document Server

    Hammami, Oussama; Gabrielyan, Emin

    2009-01-01

    The telephony over IP (ToIP) is becoming a new trend in technology widely used nowadays in almost all business sectors. Its concepts rely on transiting the telephone communications through the IP network. Today, this technology is deployed increasingly what the cause of emergence of companies is offering this service as Switzernet. For several highly demanded destinations, recently fake vendors appeared in the market offering voice termination but providing only false answer supervision. The answered signal is returned immediately and calls are being charged without being connected. Different techniques are used to keep the calling party on the line. One of these techniques is to play a record of a ring back tone (while the call is already being charged). Another, more sophisticated technique is to play a human voice randomly picked up from a set of records containing contents similar to: hello, hello, I cannot hear you Apart the fact that the fallaciously established calls are charged at rates of real calls,...

  11. Automated detection of Antarctic blue whale calls.

    Science.gov (United States)

    Socheleau, Francois-Xavier; Leroy, Emmanuelle; Pecci, Andres Carvallo; Samaran, Flore; Bonnel, Julien; Royer, Jean-Yves

    2015-11-01

    This paper addresses the problem of automated detection of Z-calls emitted by Antarctic blue whales (B. m. intermedia). The proposed solution is based on a subspace detector of sigmoidal-frequency signals with unknown time-varying amplitude. This detection strategy takes into account frequency variations of blue whale calls as well as the presence of other transient sounds that can interfere with Z-calls (such as airguns or other whale calls). The proposed method has been tested on more than 105 h of acoustic data containing about 2200 Z-calls (as found by an experienced human operator). This method is shown to have a correct-detection rate of up to more than 15% better than the extensible bioacoustic tool package, a spectrogram-based correlation detector commonly used to study blue whales. Because the proposed method relies on subspace detection, it does not suffer from some drawbacks of correlation-based detectors. In particular, it does not require the choice of an a priori fixed and subjective template. The analytic expression of the detection performance is also derived, which provides crucial information for higher level analyses such as animal density estimation from acoustic data. Finally, the detection threshold automatically adapts to the soundscape in order not to violate a user-specified false alarm rate. PMID:26627784

  12. Displasia fibromuscular: um diagnóstico diferencial para as vasculites Fibromuscular dysplasia: a differential diagnosis of vasculitis

    Directory of Open Access Journals (Sweden)

    Thaís de Carvalho Pontes

    2012-02-01

    unknown, despite many theories. A genetic component is suspected to exist, because the pathology affects primarily Caucasians. Association between FMD and the HLA-DRw6 histocompatibility antigen has also been described. The major sites affected are renal, cerebral, carotid, visceral, iliac, subclavian, brachial and popliteal arteries. Clinical manifestations correlate with the affected site, arterial hypertension being a frequent symptom, resulting from the involvement of the renal arteries in 60%-75% of the cases. The diagnosis of FMD is made by histopathology and/or angiography. FMD can manifest as a systemic vascular disease, mimicking vasculitis. This understanding is important because vasculitis and FMD can both have a severe clinical course, but require distinct treatments. The differential diagnosis can be difficult in face of an atypical clinical presentation or lack of histopathologic confirmation. Isolated cases of FMD have been reported mimicking the following conditions: polyarteritis nodosa, Ehlers-Danlos's syndrome, Alport's syndrome, pheochromocytoma, Marfan's syndrome, and Takayasu's arteritis. Rheumatologists should be aware of this differential diagnosis. Treatment of FMD is recommended only in symptomatic cases, and consists in revascularization, which may be either surgical or via percutaneous transluminal angioplasty. In FMD, the effects of corticotherapy can directly and rapidly harm the vascular wall, aggravating the lesions

  13. Synergistic modeling of call center operations

    Directory of Open Access Journals (Sweden)

    Jon G. Vaver

    2006-05-01

    Full Text Available We synergistically apply queueing theory, integer programming, and stochastic simulation to determine an optimal staffing policy for a repair call handling center. A stationary Markovian queueing model is employed to determine minimal staffing levels for a sequence of time intervals with varying call volumes and mean handling times. These staffing requirements populate an integer program model for determining the mix of call agent shifts that will achieve service quality standards at minimum cost. Since the analytical modeling requires simplifying assumptions, expected performance of the optimal staffing policy is evaluated using stochastic simulation. Computational efficiency of the simulation is improved dramatically by employing the queueing model to generate an analytic control variate.

  14. Malware Classification based on Call Graph Clustering

    CERN Document Server

    Kinable, Joris

    2010-01-01

    Each day, anti-virus companies receive tens of thousands samples of potentially harmful executables. Many of the malicious samples are variations of previously encountered malware, created by their authors to evade pattern-based detection. Dealing with these large amounts of data requires robust, automatic detection approaches. This paper studies malware classification based on call graph clustering. By representing malware samples as call graphs, it is possible to abstract certain variations away, and enable the detection of structural similarities between samples. The ability to cluster similar samples together will make more generic detection techniques possible, thereby targeting the commonalities of the samples within a cluster. To compare call graphs mutually, we compute pairwise graph similarity scores via graph matchings which approximately minimize the graph edit distance. Next, to facilitate the discovery of similar malware samples, we employ several clustering algorithms, including k-medoids and DB...

  15. Call Center 服务创新

    Institute of Scientific and Technical Information of China (English)

    陈克胜

    2001-01-01

    @@ 市场的竞争说道底就是优质服务的竞争,所以提升服务的质量是各商家看好的利润增长点.电子商务被商家认为是减少成本增加收入的利器,而拥有call center 的电子商务才更为完善.call center已成功地在业界尤其是在金融业得到了运用,使客户服务水平有了根本的改观.而且在金融业,call center正在由成本中心向效益中心转型.

  16. Echolocation calls and communication calls are controlled differentially in the brainstem of the bat Phyllostomus discolor

    Directory of Open Access Journals (Sweden)

    Schuller Gerd

    2005-08-01

    Full Text Available Abstract Background Echolocating bats emit vocalizations that can be classified either as echolocation calls or communication calls. Neural control of both types of calls must govern the same pool of motoneurons responsible for vocalizations. Electrical microstimulation in the periaqueductal gray matter (PAG elicits both communication and echolocation calls, whereas stimulation of the paralemniscal area (PLA induces only echolocation calls. In both the PAG and the PLA, the current thresholds for triggering natural vocalizations do not habituate to stimuli and remain low even for long stimulation periods, indicating that these structures have relative direct access to the final common pathway for vocalization. This study intended to clarify whether echolocation calls and communication calls are controlled differentially below the level of the PAG via separate vocal pathways before converging on the motoneurons used in vocalization. Results Both structures were probed simultaneously in a single experimental approach. Two stimulation electrodes were chronically implanted within the PAG in order to elicit either echolocation or communication calls. Blockade of the ipsilateral PLA site with iontophoretically application of the glutamate antagonist kynurenic acid did not impede either echolocation or communication calls elicited from the PAG. However, blockade of the contralateral PLA suppresses PAG-elicited echolocation calls but not communication calls. In both cases the blockade was reversible. Conclusion The neural control of echolocation and communication calls seems to be differentially organized below the level of the PAG. The PLA is an essential functional unit for echolocation call control before the descending pathways share again the final common pathway for vocalization.

  17. Metacognitive knowledge, metacognitive strategies, and CALL

    OpenAIRE

    Hauck, M

    2005-01-01

    CALL Research Perspectives creates a foundation for the study and practice of computer-assisted language learning and provides an overview of ways to conceptualize and to conduct research in CALL. Its core assumptions are that all approaches to research have a place, and that researchers, teachers, and students all have a role to play in the study of computer-enhanced language learning. This is not a how-to-do-research text. Written by top researchers in the field, it offers an open-ended ...

  18. Optimization of Overflow Policies in Call Centers

    DEFF Research Database (Denmark)

    Koole, G.M.; Nielsen, B.F.; Nielsen, T.B.

    2015-01-01

    We examine how overflow policies in a multi-skill call center should be designed to accommodate performance measures that depend on waiting time percentiles such as service level. This is done using a discrete Markovian approximation of the waiting time of the first customers waiting in line. A...... Markov decision chain is used to determine the optimal policy. This policy outperforms considerably the ones used most often in practice, which use a fixed threshold. The present method can be used also for other call-center models and other situations where performance is based on actual waiting times...

  19. Remote Procedures Calls Implementing using Distributed Algorithm

    Directory of Open Access Journals (Sweden)

    G. MURALI

    2011-11-01

    Full Text Available Remote Procedure Call (RPC is a powerful primitive used for communication and synchronization between distributed processes. RPC poses a problem that it reduces the amount of parallelism, because of its synchronous nature. This paper shows how simple processes can be used to find a way of avoiding a difficulty in this problem. The combination of blocking RPC calls and light-weightprocesses provides both simple semantics and efficient exploitation of parallelism.We will describe how two important classes of algorithms, branch and bound can be run in a parallel way using this RPC. The results of some experiments comparing this algorithms on a single processor discussed

  20. Optimal balanced control for call centers

    OpenAIRE

    Bhulai, S.; Farenhorst - Yuan, T.; Heidergott, B.F.; Laan, van der, G.

    2010-01-01

    This discussion paper led to a publication in 'Annals op Operations Research' , 2012, 201(1), 39-62. In this paper we study a challenging call center operation problem. The goal of our analysis is to identify an optimal policy for allocating tasks to agents. As a first step, we discuss promising randomized policies and use stochastic approximation for finding the optimal randomized policy when implemented via a Bernoulli scheme. As we will show in this paper, the performance of the call cente...

  1. Securing Remote Procedure Calls over HTTPS

    CERN Document Server

    Kale, Ajinkya; Pradhan, Sudeep

    2009-01-01

    Remote Procedure Calls (RPC) are widely used over the Internet as they provide a simple and elegant way of interaction between the client and the server. This paper proposes a solution for securing the remote procedure calls (RPC) by tunneling it through HTTPS (Hypertext Transfer Protocol over Secure Socket Layer). RPC over HTTP actually uses the Secure Socket Layer (SSL) protocol as a transport for the traffic. SSL mandates that the server authenticates itself to the client using a digital certificate (and associated private key). SSL is normally configured to encrypt traffic before transmitting it between the server and client and vice versa.

  2. Don't Call It School

    Science.gov (United States)

    Robb, Daniel

    2006-01-01

    "Homeschooling," "deschooling," and "unschooling" are commonly used terms in the alternative-education world, but each lacks specificity. In this article, the author describes what he discovered during several visits to North Star. Known officially as North Star: Self-Directed Learning for Teens, it is not as structured as a so-called "free"…

  3. 76 FR 17934 - Infrastructure Protection Data Call

    Science.gov (United States)

    2011-03-31

    ... SECURITY Infrastructure Protection Data Call AGENCY: National Protection and Programs Directorate, DHS... of Infrastructure Protection (IP), will submit the following Information Collection Request to the... infrastructure and key resources (CIKR). At DHS, this responsibility is managed by IP within NPPD. Beginning...

  4. Using Software Design Methods in CALL

    Science.gov (United States)

    Ward, Monica

    2006-01-01

    The phrase "software design" is not one that arouses the interest of many CALL practitioners, particularly those from a humanities background. However, software design essentials are simply logical ways of going about designing a system. The fundamentals include modularity, anticipation of change, generality and an incremental approach. While CALL…

  5. Modeling and simulation of call centers.

    OpenAIRE

    Avramidis, A.N.; L'Ecuyer, P.

    2006-01-01

    In this review, we introduce key notions and describe the decision problems commonly encountered in call center management. Main themes are the central role of uncertainty throughout the decision hierarchy and the many operational complexities and relationships between decisions. We make connections to analytical models in the literature, emphasizing insights gained and model limitations. The high operational complexity and the prevalent uncertainty suggest th...

  6. Authenticity in CALL: Three Domains of "Realness"

    Science.gov (United States)

    Buendgens-Kosten, Judith

    2013-01-01

    This paper discusses the role of authenticity and authenticity claims in computer assisted language learning (CALL). It considers authenticity as the result of a social negotiation process rather than an innate feature of a text, object, person, or activity. From this basis, it argues that authenticity claims play an important role in both second…

  7. Make a 21st century phone call

    CERN Document Server

    Katarina Anthony

    2014-01-01

    Want to avoid roaming charges? Click to call anyone at CERN? How about merging your CERN landline with your existing smartphone? That's all easily done with Lync, CERN's new opt-in service that can take your calls to the next level.   The Lync application on Windows (left) and iPhone (right). Lync unites CERN's traditional telephone service with the digital sphere. "Lync gives you the gift of mobility, by letting you access your CERN landline on the go," explains Pawel Grzywaczewski, service manager of the Lync system. "Once you've registered your CERN telephone with the service, you can run the Lync application and make calls from a range of supported devices. No matter where you are in the world - be it simply out to lunch or off at an international conference - you can make a CERN call as though you were in the office. All you need is an Internet connection!" Following a recent upgrade, CERN's Lync service now has...

  8. Looking Back: Tracing Trends in Canadian CALL

    Science.gov (United States)

    Craven, Mary-Louise; Sinyor, Roberta

    2011-01-01

    "CCALLNET" ("The Canadian Computer-Assisted Language Learning Network at the Post-Secondary Level") was a semi-annual newsletter published from 1987 to 2002 that was distributed to colleagues across Canada who taught languages to university students. Its objective was to create a network of Canadian faculty interested in CALL by informing them…

  9. A Call for School Counseling Practitioner Research

    Science.gov (United States)

    Kaffenberger, Carol J.

    2012-01-01

    Despite the repeated call to increase the number of practitioner research manuscripts being published in counseling publications, practitioner research accounts for less than five percent of all manuscripts published. This article describes the challenges faced by practitioners seeking to publish their research, defines practitioner research, and…

  10. Long-distance calls in Neotropical primates

    Directory of Open Access Journals (Sweden)

    Dilmar A.G. Oliveira

    2004-06-01

    Full Text Available Long-distance calls are widespread among primates. Several studies concentrate on such calls in just one or in few species, while few studies have treated more general trends within the order. The common features that usually characterize these vocalizations are related to long-distance propagation of sounds. The proposed functions of primate long-distance calls can be divided into extragroup and intragroup ones. Extragroup functions relate to mate defense, mate attraction or resource defense, while intragroup functions involve group coordination or alarm. Among Neotropical primates, several species perform long-distance calls that seem more related to intragroup coordination, markedly in atelines. Callitrichids present long-distance calls that are employed both in intragroup coordination and intergroup contests or spacing. Examples of extragroup directed long-distance calls are the duets of titi monkeys and the roars and barks of howler monkeys. Considerable complexity and gradation exist in the long-distance call repertoires of some Neotropical primates, and female long-distance calls are probably more important in non-duetting species than usually thought. Future research must focus on larger trends in the evolution of primate long-distance calls, including the phylogeny of calling repertoires and the relationships between form and function in these signals.Chamados de longo alcance são comuns em primatas. Muitas pesquisas enfocaram tais vocalizações em uma única ou em poucas espécies, enquanto poucos estudos lidaram com padrões mais gerais dentro da ordem. As características comuns que geralmente distinguem estas vocalizações são relacionadas com a transmissão de sons a longa distância. As funções propostas para estas vocalizações podem ser divididas entre intragrupais e extragrupais. Funções extragrupais se relacionam com a defesa e atração de parceiros sexuais ou com a defesa de recursos, enquanto as fun

  11. SNP calling, genotype calling, and sample allele frequency estimation from new-generation sequencing data

    DEFF Research Database (Denmark)

    Nielsen, Rasmus; Korneliussen, Thorfinn Sand; Albrechtsen, Anders;

    2012-01-01

    calculated using a dynamic programming algorithm and numerically optimized using analytical derivatives. We then use a bayesian method for estimating the sample allele frequency in a single site, and show how the method can be used for genotype calling and SNP calling. We also show how the method can be...

  12. BUSINESS MODELS FOR EXTENDING OF 112 EMERGENCY CALL CENTER CAPABILITIES WITH E-CALL FUNCTION INSERTION

    Directory of Open Access Journals (Sweden)

    Pop Dragos Paul

    2010-12-01

    Full Text Available The present article concerns present status of implementation in Romania and Europe of eCall service and the proposed business models regarding eCall function implementation in Romania. eCall system is used for reliable transmission in case of crush between In Vehicle System and Public Service Answering Point, via the voice channel of cellular and Public Switched Telephone Network (PSTN. eCall service could be initiated automatically or manual the driver. All data presented in this article are part of researches made by authors in the Sectorial Contract Implementation study regarding eCall system, having as partners ITS Romania and Electronic Solution, with the Romanian Ministry of Communication and Information Technology as beneficiary.

  13. Calling Card Analysis in Budding Yeast.

    Science.gov (United States)

    Mayhew, David; Mitra, Robi D

    2016-02-01

    Calling card analysis is a high-throughput method for identifying the genomic binding sites of multiple transcription factors in a single experiment in budding yeast. By tagging a DNA-binding protein with a targeting domain that directs the insertion of the Ty5 retrotransposon, the genomic binding sites for that transcription factor are marked. The transposition locations are then identified en masse by Illumina sequencing. The calling card protocol allows for simultaneous analysis of multiple transcription factors. By cloning barcodes into the Ty5 transposon, it is possible to pair a unique barcode with every transcription factor in the experiment. The method presented here uses expression of transcription factors from their native loci; however, it can also be altered to measure binding sites of transcription factors overexpressed from a plasmid. PMID:26832687

  14. Towards Building an Intelligent Call Routing System

    Directory of Open Access Journals (Sweden)

    Thien Khai Tran

    2016-01-01

    Full Text Available This paper presents EduICR - an Intelligent Call Routing system. This system can route calls to the most appropriate agent using routing rules built by the text classifier. EduICR includes the following main components: telephone communication network; Vietnamese speech recognition; Text classifier/ Natural language processor and Vietnamese speech synthesis. To our best knowledge, this is one of the first systems in Vietnam to implement the integration mechanism of text processing and speech processing. This allows voice applications to be more intelligent, able to communicate with humans in natural language with high accuracy and reasonable speed. Having been built and tested in real environment, our system proves its accuracy attaining more than 95%.

  15. CALL Implementation Strategies:A Case Study

    OpenAIRE

    BRIERLEY, Mark; Orlandini, Andrea

    2010-01-01

    This paper will begin by discussing changes in CALL (Computer Assisted Language Learning) over the past decade, identifying three modes: computers as teachers; computers used for communication between teachers and students; and communication among students. Next, we will investigate how key components of the Moodle LMS (Learning Management System), such as quizzes, forums and wikis can contribute to language acquisition by facilitating comprehensible input through task-based, communicative le...

  16. Sustainability Science: A Call to Collaborative Action

    OpenAIRE

    David D. Hart; Bell, Kathleen P.

    2013-01-01

    Sustainability science is an emerging field directed at advancing sustainable development. Informed by recent scholarship and institutional experiments, we identify key roles for economists and encourage their greater participation in this research. Our call to collaborative action comes from positive experiences with the Sustainability Solutions Initiative based at the University of Maine, where economists collaborate with other experts and diverse stakeholders on real-world problems involvi...

  17. First Class Call Stacks: Exploring Head Reduction

    OpenAIRE

    Johnson-Freyd, Philip; Downen, Paul; Ariola, Zena M.

    2016-01-01

    Weak-head normalization is inconsistent with functional extensionality in the call-by-name $\\lambda$-calculus. We explore this problem from a new angle via the conflict between extensionality and effects. Leveraging ideas from work on the $\\lambda$-calculus with control, we derive and justify alternative operational semantics and a sequence of abstract machines for performing head reduction. Head reduction avoids the problems with weak-head reduction and extensionality, while our operational ...

  18. Parental alarm calls suppress nestling vocalization.

    OpenAIRE

    Platzen, Dirk; Magrath, Robert D.

    2004-01-01

    Evolutionary models suggest that the cost of a signal can ensure its honesty. Empirical studies of nestling begging imply that predator attraction can impose such a cost. However, parents might reduce or abolish this cost by warning young of the presence of danger. We tested, in a controlled field playback experiment, whether alarm calls cause 5-, 8- and 11-day-old nestlings of the white-browed scrubwren, Sericornis frontalis, to suppress vocalization. In this species, nestlings vocalize when...

  19. Call Admission Control in Mobile Wireless

    OpenAIRE

    Goril, J.; Dobos, L.

    2002-01-01

    Some problems related to wireless network access are discussed in the article. Special attention is paid to Medium Access Control and Call Admission Control. Both have direct impact on communication link accession. While the first one dictates how to, the second one decides who can access the link. The problems with wireless medium access are mentioned and requirements on MAC protocols are named. Also need for CAC algorithms is illustrated and simple functional example is proposed. Finally, t...

  20. Message Classification in the Call Center

    OpenAIRE

    Busemann, Stephan; Schmeier, Sven; Arens, Roman G.

    2000-01-01

    Customer care in technical domains is increasingly based on e-mail communication, allowing for the reproduction of approved solutions. Identifying the customer's problem is often time-consuming, as the problem space changes if new products are launched. This paper describes a new approach to the classification of e-mail requests based on shallow text processing and machine learning techniques. It is implemented within an assistance system for call center agents that is used in a commercial se...

  1. Hepatic and Mesenteric Vasculitis as Presenting Manifestation of Mixed Cryoglobulinemia Related to Chronic Hepatitis C Virus Infection in a Female Patient.

    Science.gov (United States)

    Calle Toro, Juan S; Davalos, Diana M; Charry, Jose D; Arrunategi, Ana M; Tobon, Gabriel

    2016-06-01

    Approximately 80% of patients with hepatitis C virus infection develop chronic liver disease as cirrhosis, and 40% develop autoimmune complications as mixed cryoglobulinemia (MC). Gastrointestinal involvement in MC is rare, and even more so is hepatic involvement. We report a case of an 87-year-old woman with a 10-year history of blood transfusion-acquired hepatitis C virus infection, without treatment. She consulted the emergency department for diffuse abdominal pain, associated with vomiting. After 2 weeks of hospitalization in the intensive care unit, a diagnosis of MC was made; cirrhosis and secondary mesenteric and hepatic vasculitis were confirmed by a diagnostic laparoscopy. Unfortunately the condition of the patient worsened with sepsis and resulted in death in the fourth week from admission. This case highlights the importance of having in mind gastrointestinal tract vasculitis as a medical cause of abdominal pain in patients with chronic hepatitis C virus infection and using data laboratory tests, images, and histopathologic studies to aid with the diagnosis. PMID:27219310

  2. Low Serum Complement C3 Levels at Diagnosis of Renal ANCA-Associated Vasculitis Is Associated with Poor Prognosis

    Science.gov (United States)

    Augusto, Jean-François; Langs, Virginie; Demiselle, Julien; Lavigne, Christian; Brilland, Benoit; Duveau, Agnès; Poli, Caroline; Chevailler, Alain; Croue, Anne; Tollis, Frederic; Sayegh, Johnny; Subra, Jean-François

    2016-01-01

    Background Recent studies have demonstrated the key role of the complement alternative pathway (cAP) in the pathophysiology of experimental ANCA-associated vasculitis (AAV). However, in human AAV the role of cAP has not been extensively explored. In the present work, we analysed circulating serum C3 levels measured at AAV onset and their relation to outcomes. Methods We conducted a retrospective observational cohort study including 45 consecutive patients with AAV diagnosed between 2000 and 2014 with serum C3 measurement at diagnosis, before immunosuppressive treatment initiation. Two groups were defined according to the median serum C3 level value: the low C3 group (C3C3 level group (C3≥120 mg/dL). Patient and renal survivals, association between C3 level and renal pathology were analysed. Results Serum complement C3 concentration remained in the normal range [78–184 mg/dL]. Compared with the high C3 level, the patients in the low C3 level group had lower complement C4 concentrations (P = 0.008) and lower eGFR (P = 0.002) at diagnosis. The low C3 level group had poorer patient and death-censored renal survivals, compared with the high C3 level group (P = 0.047 and P = 0.001, respectively). We observed a significant negative correlation between C3 levels and the percentage of glomeruli affected by cellular crescent (P = 0.017, r = -0.407). According to the Berden et al renal histologic classification, patients in the crescentic/mixed category had low C3 levels more frequently (PC3 level, long term renal survival was significantly greater in the high C3 level group than in the low C3 level group (100% vs 40.7% at 6 years, p = 0.046). No relationship between serum C4 and renal outcome was observed. Conclusion A Low C3 serum level in AAV patients at diagnosis is associated with worse long-term patient and renal survival. PMID:27391243

  3. Una propuesta urbana para la Calle Mayor

    OpenAIRE

    Sambricio, Carlos

    1996-01-01

    Estudiar el desarrollo y la configuración de la Calle Mayor de Madrid supone enfrentarse a uno de los hechos originarios en configuración urbana. La historia urbana -diferenciada de lo que tras entienden como "Historia de la ciudad"- se ha planteado generalmente desde el análisis del desarrollo, transformación e intervención en el hecho histórico. Frente a las políticas de vivienda, a la contraposición entre Ensanche o Extrarradio, a la definición de operaciones de reforma interior o propuest...

  4. Designing a Call Center with Impatient Customers

    OpenAIRE

    O. Garnet; Mandelbaum, A.; M. Reiman

    2002-01-01

    The most common model to support workforce management of telephone call centers is the M/M/N/B model, in particular its special cases M/M/N (Erlang C, which models out busy signals) and M/M/N/N (Erlang B, disallowing waiting). All of these models lack a central prevalent feature, namely, that impatient customers might decide to leave (abandon) before their service begins. In this paper, we analyze the simplest abandonment model, in which customers' patience is exponentially distributed and th...

  5. The so-called nuclear waste affair

    International Nuclear Information System (INIS)

    The so-called nuclear waste affair has placed the Hanau nuclear fuel company NUKEM and its daughter Transnuklear in the centre of public discussions about nuclear safety. The disclosed and alleged irregularities have led to preliminary investigation by the public prosecutor, a parliamentary inquiry commission has been set in, and the Hanau companies have been re-organised by order of the state: Transnuklear has been dissolved, and NUKEM will discontinue fuel element fabrication. The article in hand explains the foundation and the history of the NUKEM company and its daughter companies in order to reveal the significance of the current events. (orig./DG)

  6. Asymptotic analysis of American call options

    OpenAIRE

    Roland Mallier; Ghada Alobaidi

    2001-01-01

    American call options are financial derivatives that give the holder the right but not the obligation to buy an underlying security at a pre-determined price. They differ from European options in that they may be exercised at any time prior to their expiration, rather than only at expiration. Their value is described by the Black-Scholes PDE together with a constraint that arises from the possibility of early exercise. This leads to a free boundary problem for the optimal exercise boundary, w...

  7. Call center. Centrados en el cliente

    OpenAIRE

    Leal-Alonso-de-Castañeda, José Enrique

    2003-01-01

    La empresa actual ha de estar preparada para responder al Cliente tal y como éste espera, porque no se busca un cliente puntual, sino un cliente fiel. La globalización de la economía y del acceso a los mercados exige que la empresa sea capaz de atraer al cliente no sólo con un servicio de calidad, sino además con una atención de calidad. La implantación de un Call Center (Centro de Atención al Cliente, Centro de Atención de Llamadas) constituye por todo ello una estrategia de negocio qu...

  8. Applicative Bisimilarities for Call-by-Name and Call-by-Value λμ-Calculus

    OpenAIRE

    Biernacki, Dariusz; Lenglet, Sergueï

    2014-01-01

    We propose the first sound and complete bisimilarities for the call-by-name and call-by-value untyped λµ-calculus, defined in the applicative style. We give equivalence examples to illustrate how our relations can be used; in particular, we prove David and Py's counter-example, which cannot be proved with Lassen's preexisting normal form bisimilarities for the λµ-calculus.

  9. "That's why they call it practice".

    Science.gov (United States)

    Fogarty, Colleen T; Mauksch, Larry B

    2014-12-01

    The authors discuss how, as their residency family medicine practices are transforming into Patient-Centered Medical Homes, they are witnessing shifting expectations for everyone: medical assistant, faculty and resident physician, licensed practical nurse, behavioral health clinician. At all levels of experience and expertise, they are called on to change. In the health care context, "practice" has multiple meanings. Practice, in the sense of "the clinical scope of work we do every day" corresponds to Merriam Webster's first definition of the word, "to be professionally engaged in" or "to do or perform often, customarily, or habitually." In this editorial, the authors call upon their colleagues to recognize the second definition of "practice" and build in opportunities to "train by repeated exercises" within day to day clinical activity. By this they mean, build in mechanisms to prompt reflection on your work, every day, seeking and incorporating feedback from others on your team. Effective primary care systems protect time for practice and learning. These organizations demonstrate "adaptive reserve," consisting of action and reflection cycles, facilitative leadership, a learning culture, the ability to improvise, and effective relationships and communication. PMID:25485824

  10. Detecting Motifs in System Call Sequences

    CERN Document Server

    Wilson, William O; Aickelin, Uwe

    2010-01-01

    The search for patterns or motifs in data represents an area of key interest to many researchers. In this paper we present the Motif Tracking Algorithm, a novel immune inspired pattern identification tool that is able to identify unknown motifs which repeat within time series data. The power of the algorithm is derived from its use of a small number of parameters with minimal assumptions. The algorithm searches from a completely neutral perspective that is independent of the data being analysed, and the underlying motifs. In this paper the motif tracking algorithm is applied to the search for patterns within sequences of low level system calls between the Linux kernel and the operating system's user space. The MTA is able to compress data found in large system call data sets to a limited number of motifs which summarise that data. The motifs provide a resource from which a profile of executed processes can be built. The potential for these profiles and new implications for security research are highlighted. A...

  11. Postavení a úloha call center

    OpenAIRE

    Blažej, Michal

    2008-01-01

    Tato diplomová práce zpracovává téma Postavení a Úloha Call Center v Telekomunikaci. Práce pojednává o alternativních způsobech komunikace zákazníka s mobilním operátorem, převážně prostřednictvím telefonu. Obsahem diplomové práce je charakteristika služeb, výčet jednotlivých způsobů komunikace mezi zákazníkem a mobilním operátorem, popis produktů T-Mobile CZ využívajících alternativních způsobů komunikace s operátorem, přehled činností Call centra T-Mobile CZ a výzkumná část. Cílem práce je ...

  12. Milton Nascimento: una calle llamada mundo

    Directory of Open Access Journals (Sweden)

    Alberto Carlos De Souza

    2011-08-01

    Full Text Available El punto de partida de este estudio consistirá en la exploración de la musicalidad de Milton Nascimento y de sus compañeros del “movimiento” “Clube da Esquina”, destacándose la relevancia del conjunto de esa obra para la cultura brasilera. El referido “movimiento” floreció en Minas Gerais en el auge de uno de los períodos más críticos de la historia contemporánea brasilera: la dictadura militar. En tanto, el “Clube da Esquina” – dado a la diversidad de los temas tratados en sus letras y su singularidad poética -, luego se difundió por todo el espacio cultural brasilero. Hablar del “Clube da Esquina” no es tarea fácil porque hay una dolorosa ausencia o pálida presencia de este movimiento en estudios que se ocupan de nuestra música popular. El “Clube da Esquina” fue un círculo de amigos que se reunieron en un pequeño pub en la esquina de la Calle Divinópolis y Calle Paraisópolis, en un bucólico barrio de Belo Horizonte (Minas Gerais - Brasil, llamado Santa Teresa. Era parte de esa hermandad, interesada en música, cine y poesía, Milton Nascimento, Wagner Tiso, Fernando Brant, Toninho Horta, Beto Guedes, Moura Tavinho, los hermanos Lô y Marcio Borges, Robertinho Silva, Nivaldo Ornelas, Ronaldo Bastos, Murilo Antunes Nelson Angelo y Novelli, entre otros. En estas reuniones, regadas con mucha cerveza, Milton Nascimento y sus compañeros. Milton fue y sigue siendo la mayor referencia del movimiento “Clube da Esquina”. Abstract The starting point of this study will explore the music of Milton Nascimento and his fellow "movement" "Clube da Esquina", highlighting the relevance of all this work to the Brazilian culture. The aforementioned "movement" flourished in Minas Gerais at the height of one of the most critical periods in Brazilian contemporary history: the military dictatorship. Meanwhile, the "Clube da Esquina" - given the diversity of topics in his lyrics and his unique poetic - and then spread

  13. Beware of the Spirits that You Call!

    DEFF Research Database (Denmark)

    Vasquez, Consuelo; Schoeneborn, Dennis; Sergi, Viviane

    This article proposes to study the constitution of organization by acknowledging the fundamentally intertwined nature of order and disorder. Adopting a dialectical lens, we explore the (dis)ordering properties of communication by focusing on both the symbolic and the material dimensions of language...... use in texts. Drawing on empirical material from three qualitative case studies on project organizing, we show that attempts to create order through texts (i.e. by closing and fixing meaning) simultaneously trigger disorder (i.e. open up the possibility of multiple meanings). As we argue, this dynamic...... plays a key role in the development of projects (and more broadly organizations), keeping them in motion by calling forth continuous processes of meaning negotiation....

  14. Acoustic signal detection of manatee calls

    Science.gov (United States)

    Niezrecki, Christopher; Phillips, Richard; Meyer, Michael; Beusse, Diedrich O.

    2003-04-01

    The West Indian manatee (trichechus manatus latirostris) has become endangered partly because of a growing number of collisions with boats. A system to warn boaters of the presence of manatees, that can signal to boaters that manatees are present in the immediate vicinity, could potentially reduce these boat collisions. In order to identify the presence of manatees, acoustic methods are employed. Within this paper, three different detection algorithms are used to detect the calls of the West Indian manatee. The detection systems are tested in the laboratory using simulated manatee vocalizations from an audio compact disc. The detection method that provides the best overall performance is able to correctly identify ~=96% of the manatee vocalizations. However the system also results in a false positive rate of ~=16%. The results of this work may ultimately lead to the development of a manatee warning system that can warn boaters of the presence of manatees.

  15. Comprometimento organizacional de trabalhadores de call center

    Directory of Open Access Journals (Sweden)

    Kely César Martins Paiva

    2015-09-01

    Full Text Available RESUMOO Neste artigo, analisa-se como se apresenta o comprometimento organizacional de trabalhadores de um call center, localizado em Belo (A Horizonte (Minas Gerais, Brasil. Após o delineamento conceitual UJ do tema central, são expostos os resultados de um estudo de caso descritivo, realizado com abordagens quantitativa e qualitativa. Os dados de 399 questionários e 22 entrevistas são, respectivamente, tratados estatisticamente e submetidos à análise de conteúdo. A base de comprometimento que predominou entre esses infoproletários foi "obrigação pelo desempenho" e, em menor grau, "afetiva". Foi observado que quanto maior é o seu tempo de experiência nesse tipo de organização, menores são os níveis de comprometimento de modo geral, fatos esclarecidos, parcialmente, por meio das entrevistas.

  16. MILTON NASCIMENTO: UNA CALLE LLAMADA MUNDO

    Directory of Open Access Journals (Sweden)

    Alberto Carlos de Souza

    2011-12-01

    Full Text Available El punto de partida de este estudio consistirá en la exploración de la musicalidad de Milton Nascimento y de sus compañeros del “movimiento” “Clube da Esquina”, destacándose la relevancia del conjunto de esa obra para la cultura brasilera. El referido “movimiento” floreció en Minas Gerais en el auge de uno de los períodos más críticos de la historia contemporánea brasilera: la dictadura militar. En tanto, el “Clube da Esquina” – dado a la diversidad de los temas tratados en sus letras y su singularidad poética -, luego se difundió por todo el espacio cultural brasilero. Hablar del “Clube da Esquina” no es tarea fácil porque hay una dolorosa ausencia o pálida presencia de este movimiento en estudios que se ocupan de nuestra música popular. El “Clube da Esquina” fue un círculo de amigos que se reunieron en un pequeño pub en la esquina de la Calle Divinópolis y Calle Paraisópolis, en un bucólico barrio de Belo Horizonte (Minas Gerais - Brasil, llamado Santa Teresa. Era parte de esa hermandad, interesada en música, cine y poesía, Milton Nascimento, Wagner Tiso, Fernando Brant, Toninho Horta, Beto Guedes, Moura Tavinho, los hermanos Lô y Marcio Borges, Robertinho Silva, Nivaldo Ornelas, Ronaldo Bastos, Murilo Antunes Nelson Angelo y Novelli, entre otros. En estas reuniones, regadas con mucha cerveza, Milton Nascimento y sus compañeros. Milton fue y sigue siendo la mayor referencia del movimiento “Clube da Esquina”.

  17. Sharing programming resources between Bio* projects through remote procedure call and native call stack strategies

    DEFF Research Database (Denmark)

    Prins, Pjotr; Goto, Naohisa; Yates, Andrew;

    2012-01-01

    Open-source software (OSS) encourages computer programmers to reuse software components written by others. In evolutionary bioinformatics, OSS comes in a broad range of programming languages, including C/C++, Perl, Python, Ruby, Java, and R. To avoid writing the same functionality multiple times...... for different languages, it is possible to share components by bridging computer languages and Bio* projects, such as BioPerl, Biopython, BioRuby, BioJava, and R/Bioconductor. In this chapter, we compare the two principal approaches for sharing software between different programming languages: either by remote...... procedure call (RPC) or by sharing a local call stack. RPC provides a language-independent protocol over a network interface; examples are RSOAP and Rserve. The local call stack provides a between-language mapping not over the network interface, but directly in computer memory; examples are R bindings, RPy...

  18. Sharing programming resources between Bio* projects through remote procedure call and native call stack strategies.

    Science.gov (United States)

    Prins, Pjotr; Goto, Naohisa; Yates, Andrew; Gautier, Laurent; Willis, Scooter; Fields, Christopher; Katayama, Toshiaki

    2012-01-01

    Open-source software (OSS) encourages computer programmers to reuse software components written by others. In evolutionary bioinformatics, OSS comes in a broad range of programming languages, including C/C++, Perl, Python, Ruby, Java, and R. To avoid writing the same functionality multiple times for different languages, it is possible to share components by bridging computer languages and Bio* projects, such as BioPerl, Biopython, BioRuby, BioJava, and R/Bioconductor. In this chapter, we compare the two principal approaches for sharing software between different programming languages: either by remote procedure call (RPC) or by sharing a local call stack. RPC provides a language-independent protocol over a network interface; examples are RSOAP and Rserve. The local call stack provides a between-language mapping not over the network interface, but directly in computer memory; examples are R bindings, RPy, and languages sharing the Java Virtual Machine stack. This functionality provides strategies for sharing of software between Bio* projects, which can be exploited more often. Here, we present cross-language examples for sequence translation, and measure throughput of the different options. We compare calling into R through native R, RSOAP, Rserve, and RPy interfaces, with the performance of native BioPerl, Biopython, BioJava, and BioRuby implementations, and with call stack bindings to BioJava and the European Molecular Biology Open Software Suite. In general, call stack approaches outperform native Bio* implementations and these, in turn, outperform RPC-based approaches. To test and compare strategies, we provide a downloadable BioNode image with all examples, tools, and libraries included. The BioNode image can be run on VirtualBox-supported operating systems, including Windows, OSX, and Linux. PMID:22399473

  19. Reference-free SNP calling: improved accuracy by preventing incorrect calls from repetitive genomic regions

    Directory of Open Access Journals (Sweden)

    Dou Jinzhuang

    2012-06-01

    Full Text Available Abstract Background Single nucleotide polymorphisms (SNPs are the most abundant type of genetic variation in eukaryotic genomes and have recently become the marker of choice in a wide variety of ecological and evolutionary studies. The advent of next-generation sequencing (NGS technologies has made it possible to efficiently genotype a large number of SNPs in the non-model organisms with no or limited genomic resources. Most NGS-based genotyping methods require a reference genome to perform accurate SNP calling. Little effort, however, has yet been devoted to developing or improving algorithms for accurate SNP calling in the absence of a reference genome. Results Here we describe an improved maximum likelihood (ML algorithm called iML, which can achieve high genotyping accuracy for SNP calling in the non-model organisms without a reference genome. The iML algorithm incorporates the mixed Poisson/normal model to detect composite read clusters and can efficiently prevent incorrect SNP calls resulting from repetitive genomic regions. Through analysis of simulation and real sequencing datasets, we demonstrate that in comparison with ML or a threshold approach, iML can remarkably improve the accuracy of de novo SNP genotyping and is especially powerful for the reference-free genotyping in diploid genomes with high repeat contents. Conclusions The iML algorithm can efficiently prevent incorrect SNP calls resulting from repetitive genomic regions, and thus outperforms the original ML algorithm by achieving much higher genotyping accuracy. Our algorithm is therefore very useful for accurate de novo SNP genotyping in the non-model organisms without a reference genome. Reviewers This article was reviewed by Dr. Richard Durbin, Dr. Liliana Florea (nominated by Dr. Steven Salzberg and Dr. Arcady Mushegian.

  20. Non HCV-related infectious cryoglobulinemia vasculitis: Results from the French nationwide CryoVas survey and systematic review of the literature.

    Science.gov (United States)

    Terrier, Benjamin; Marie, Isabelle; Lacraz, Adeline; Belenotti, Pauline; Bonnet, Fabrice; Chiche, Laurent; Graffin, Bruno; Hot, Arnaud; Kahn, Jean-Emmanuel; Michel, Catherine; Quemeneur, Thomas; de Saint-Martin, Luc; Hermine, Olivier; Léger, Jean-Marc; Mariette, Xavier; Senet, Patricia; Plaisier, Emmanuelle; Cacoub, Patrice

    2015-12-01

    In patients with infectious cryoglobulinemia vasculitis (CryoVas) in the absence of hepatitis C virus infection, data on presentation, therapeutic management and outcome are lacking. We conducted a nationwide survey that included patients with HCV-negative CryoVas. We describe here the presentation, therapeutic management and outcome of 18 patients with non-HCV infectious CryoVas and 27 additional patients identified form a systematic review of the literature. We included 18 patients, mean age 57.9±13.5 years. Infectious causes were viral infections in 8 patients [hepatitis B virus (HBV) in 4, and cytomegalovirus, Epstein Barr virus, parvovirus B19 and human immunodeficiency virus in one case each], pyogenic bacterial infection in 6 patients, parasitic infection in 2 patients, and leprosy and candidiasis in one case each. Baseline manifestations were purpura (78%), glomerulonephritis (28%), arthralgia (28%), peripheral neuropathy (22%), skin necrosis (22%), cutaneous ulcers (17%), and myalgia (11%). Cryoglobulinemia was type II in 2/3 of cases. Most cases received specific anti-infectious therapy as first-line therapy, sometimes associated with corticosteroids, achieving sustained remission in the majority of cases. Refractory or relapsing patients, frequently related to HBV infection, showed a complete remission after rituximab in addition to antiviral therapy. In contrast, corticosteroids and/or immunosuppressive agents used in the absence of anti-infectious agents were frequently associated with refractory CryoVas. Viral and pyogenic bacterial infections represent the main causes of non-HCV infectious CryoVas. Antimicrobial therapy is commonly associated with sustained remission. Immunosuppressive agents should be considered only as a second-line option in patients with refractory vasculitis. PMID:26320984

  1. Vasculitis: the main pathogenetic reason of Restless leg syndrome%血管炎:不宁腿的一个常见原因

    Institute of Scientific and Technical Information of China (English)

    杨欢; 谢光洁; 肖波

    2001-01-01

    Objective To investigate the main pathogenetic reason inducing restless leg syndrome and the relationship about vasculitis with it. Method The laboratory examinations, electromyogramms and gastrocnemius biopsies were studied in 37 patients with restless leg syndrome who were not found other primary disease . Result It was shown that 2 of 37 cases were caused by diabetes, 1 was anemia and 1 was rheumatoid arthritis. 25 case gastrocnemius biopsies were all found vasculitic changes, and 7 of them were reported that the lectrogramms had myopathic changes , others laboratory examinations were normal . Conclusion These findings suggest that the vasculitis is one of the main pathogenetic reason of restless leg syndrome.%目的 探讨不宁腿的常见原因及其与血管炎的关系。方法 观察37例临床表现为不宁腿而暂未发现其它原发病患者的实验室检查、肌电图及腓肠肌活检情况。结果 检查发现37例患者中2例糖尿病;1例贫血;1例类风湿性关节炎;25例患者腓肠肌活检发现存在血管炎性改变,其中7例EMG报告有肌源性损害,其它实验室检查均未发现异常。结论 血管炎是不宁腿的一个较常见原因。

  2. IAEA Director General calls for DPRK restraint

    International Nuclear Information System (INIS)

    Full text: The IAEA received today a letter from Mr. Ri Je Son, Director General of the General Department of Atomic Energy of the Democratic People's Republic of Korea (DPRK), informing the IAEA of the DPRK's decision to 'lift the freeze' on its nuclear facilities maintained pursuant to the DPRK-USA Agreed Framework and to resume operations of these facilities for power generation. Dr. ElBaradei called on the DPRK to act with restraint in this tense situation- and not to take any unilateral action that might further complicate the IAEA's ability to determine whether the DPRK's inventory of nuclear material subject to safeguards was complete and correct. The DPRK's letter requests that the IAEA remove seals and monitoring cameras on all of its nuclear facilities. The Director General said, 'it is essential that the containment and surveillance measures which are currently in place continue to be maintained, and that the DPRK not take any steps unilaterally to remove or impede the functioning of such seals or cameras. Any such action,' he added, 'would not be in compliance with the requirements of the IAEA-DPRK Safeguards Agreement.' Dr. ElBaradei also asked the DPRK to agree to an urgent meeting of technical experts to discuss the practical arrangements involved in moving from the 'freeze' to normal safeguards operations, and particularly how the IAEA will fulfil its verification requirements under the IAEA-DPRK Safeguards Agreement. He called upon all concerned parties to the Agreed Framework to renew their commitment to its terms and to enter into a dialogue aimed at a resolution of the issue by peaceful means. 'The Agreed Framework was key to overcoming the 1994 nuclear crisis in DPRK and continues to serve as an important instrument for maintaining peace and stability on the Korean Peninsula,' Dr. ElBaradei said. The Agreed Framework was concluded in 1994 with the aim of ensuring that the DPRK comes into full compliance with its safeguards agreement, in return

  3. Radiation budget is called to account

    International Nuclear Information System (INIS)

    Our atmosphere could absorb much more radiation from the Sun than previously thought - with far-reaching consequences for climate modelling and the evaporation and condensation of water. Earlier this year a group of some 70 scientists spent an intense week in the foothills of the Rocky Mountains in Colorado reviewing the current understanding of the radiation budget of the atmosphere. The meeting, the latest in the series of Chapman Conferences organized by the American Geophysical Union, focused on the so-called anomalous absorption of solar radiation in the atmosphere. Evidence gathered over the past 20 years has increasingly shown that the absorption of solar radiation predicted by models is significantly less than the absorption measured experimentally. Current models predict that, on a global average, the atmosphere absorbs about 65 W m-2, whereas observations from the top of the atmosphere and the Earth's surface show that the actual absorption is 95 W m-2. This mismatch of some 30 W m-2 corresponds to about 10% of the globally averaged incoming solar radiation, suggesting that some extra anomalous absorption needs to be added to the models. (U.K.)

  4. Another call to increase STEM education

    Science.gov (United States)

    Showstack, Randy

    2011-07-01

    As science, technology, engineering, and mathematics (STEM) education becomes increasingly important, U.S. students are lagging behind other nations on international assessments, according to a recent Trends in International Mathematics and Science study. A 22 June report from the U.S. National Research Council (NRC) calls for increasing the focus on STEM education in the United States. “To make progress in improving STEM education for all students, policy makers at the national, state, and local levels should elevate science to the same level of importance as reading and mathematics,” states the report, “Successful K-12 STEM Education: Identifying Effective Approaches in Science, Technology, Engineering, and Mathematics.” It outlines several goals: expand the number of students who pursue advanced degrees and careers in STEM fields; expand the STEM-capable workforce, while also broadening the participation of women and minorities; and increase STEM literacy for all students, whether or not they pursue STEM-related careers or additional study in those areas.

  5. McNamara calls for action now.

    Science.gov (United States)

    1992-05-01

    Robert McNamara outlined a 6 point global family planning (FP) program he designed to expand FP services to answer unmet need. The plan calls for Fp spending to increase to US$8 billion by 2000. For the US this would mean an increase from US$800 million to US$3.5 billion. This amount is very, very small compared to the total amount spent on official development assistance projected for Organization for Economic Cooperation and Development (OECD) countries. It is easily within the capabilities of OECD countries to meet this goal. The plan would develop a system in which the World Bank and the UNFPA would work together with each developing country to establish population target levels. The World Bank would assume responsibility for organizing external financing and serve as a last resort source of financing. Japan must also begin to take a leadership role more in line with its economic power. Currently it spends only .32% of its GNP to aid developing countries, despite the fact that its per capita income is 20% larger than any other OECD member. This means raising spending form US$9 billion to US$14.5 billion. This could be done easily by raising it US$500 million/year and planning to increase this US$1 billion by 2000. PMID:12285117

  6. REMINDER: In a medical emergency call 74444

    CERN Multimedia

    2005-01-01

    What happened? A CERN colleague, complaining of pains that might indicate serious heart problem, went to the ?infirmary' on the Prévessin site for medical aid. He was unaware that the ?infirmary' was in fact no such thing, but the office of the French contractors' medical practitioner, and, on top of that, it was closed. He therefore took his own car and went to the CERN Fire Station on the Meyrin Site (Building 65). The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? You must call the CERN internal number 74444 in the event of serious and acute illness, and do not have to present yourself in person or get somebody to go with you. This number is not reserved exclusively for accident, pollution, fire etc. The Firemen can prodice professional assistance at all times as required: first aid on the spot, amulance transport and medical assistance as necessary. ...

  7. Mitigating Handoff Call Dropping in Wireless Cellular Networks: A Call Admission Control Technique

    Science.gov (United States)

    Ekpenyong, Moses Effiong; Udoh, Victoria Idia; Bassey, Udoma James

    2016-06-01

    Handoff management has been an important but challenging issue in the field of wireless communication. It seeks to maintain seamless connectivity of mobile users changing their points of attachment from one base station to another. This paper derives a call admission control model and establishes an optimal step-size coefficient (k) that regulates the admission probability of handoff calls. An operational CDMA network carrier was investigated through the analysis of empirical data collected over a period of 1 month, to verify the performance of the network. Our findings revealed that approximately 23 % of calls in the existing system were lost, while 40 % of the calls (on the average) were successfully admitted. A simulation of the proposed model was then carried out under ideal network conditions to study the relationship between the various network parameters and validate our claim. Simulation results showed that increasing the step-size coefficient degrades the network performance. Even at optimum step-size (k), the network could still be compromised in the presence of severe network crises, but our model was able to recover from these problems and still functions normally.

  8. Glucocorticoid and androgen signaling pathways diverge between advertisement calling and non-calling fish.

    Science.gov (United States)

    Genova, Rachel M; Marchaterre, Margaret A; Knapp, Rosemary; Fergus, Daniel; Bass, Andrew H

    2012-09-01

    Behavioral and neuroendocrine mechanisms of social vocalization in teleost fish are influenced by the glucocorticoid cortisol and the androgen 11-ketotestosterone (11kT). The relative abundance of both 11kT, which binds to androgen receptors (ARα, ARβ), and cortisol, which binds to glucocorticoid receptors (GR-1, GR-2), is regulated by 11β-hydroxylase (11βH) that converts 11-deoxycortisol to cortisol and testosterone to 11β-OH-testosterone, and 11β-hydroxysteroid dehydrogenase (11βHSD) that converts cortisol to the inactive metabolite cortisone and 11β-OH-testosterone to 11kT. In midshipman fish, we tested the hypothesis that plasma steroid levels, mRNA abundance for 11βH and 11βHSD in the vocal muscle and testis (known site of 11kT synthesis), and mRNA abundances for ARs and GRs in vocal muscle, would differ between males that did or did not recently produce 'hum' advertisement calls. Quantitative real-time PCR demonstrated that non-calling male vocal muscle had significantly higher mRNA levels for all receptors except ARα, and a strong trend for higher 11βHSD; 11βH was similar to that in calling males. Calling males had higher plasma and testis 11kT, but lower plasma cortisol, levels. Testis enzyme levels did not differ between male groups, although calling males showed a positive linear correlation between plasma 11kT and testis 11βHSD mRNA levels, consistent with testis being the main source of plasma 11kT. We propose that higher vocal muscle 11βHSD levels in non-calling males reflect increased local conversion of elevated cortisol to cortisone, providing protection from cortisol-related toxicity, while increased receptor expression in non-calling males functions as a preparatory mechanism for meeting the physiological demands of future vocalization. PMID:22884426

  9. The advertisement call of the giant spiny frog Paa spinosa

    OpenAIRE

    Baogen YU, Rongquan ZHENG

    2009-01-01

    We analyzed the advertisement call of Paa spinosa at Yuliang Mountain, Lanxi, Zhejiang province, in eastern China. Temporal and spectral call parameters were analyzed, along with call intensity. Calls comprised of three to seven notes, the last of which had the longest duration. Three formants (harmonics) were clearly distinguishable from the audio spectrogram. The dominant frequency ranged from 411-1534Hz, and was either the first or the second formant. The number of notes within a call was ...

  10. Optimal temporal placement of the call in beach volleyball

    Directory of Open Access Journals (Sweden)

    Stefan Künzell

    2016-05-01

    Full Text Available The call is a tactical component in beach volleyball attacks. Through the call, the setter indicates to his or her teammate an open spot in the opponent’s court. In two experimental conditions, we investigated the interval between the call and the ball-hand contact (“call shot interval”, CSI of top-level athletes. We show that the probability that a given call is followed is dependent on the duration of the CSI and the number of call options. Longer CSIs result in an increased probability that the given call will be followed, whilst increasing the call options results in a decrease in probability. On average, there is a 50% probability that the call will be followed if the call precedes the shot by 460 ms and if a single call option (“line” is expected. If the attacker has to choose between three call options (“line”, “cut”, “no-one” a 50% probability that the call will be followed is observed at an CSI of 542 ms. It did not appear that gender influenced the ability to follow a call. We recommend that in practice and in competition, players and coaches should consider the proper duration of the CSI for effective calling.

  11. Calling SNPs without a reference sequence

    Directory of Open Access Journals (Sweden)

    Schuster Stephan C

    2010-03-01

    Full Text Available Abstract Background The most common application for the next-generation sequencing technologies is resequencing, where short reads from the genome of an individual are aligned to a reference genome sequence for the same species. These mappings can then be used to identify genetic differences among individuals in a population, and perhaps ultimately to explain phenotypic variation. Many algorithms capable of aligning short reads to the reference, and determining differences between them have been reported. Much less has been reported on how to use these technologies to determine genetic differences among individuals of a species for which a reference sequence is not available, which drastically limits the number of species that can easily benefit from these new technologies. Results We describe a computational pipeline, called DIAL (De novo Identification of Alleles, for identifying single-base substitutions between two closely related genomes without the help of a reference genome. The method works even when the depth of coverage is insufficient for de novo assembly, and it can be extended to determine small insertions/deletions. We evaluate the software's effectiveness using published Roche/454 sequence data from the genome of Dr. James Watson (to detect heterozygous positions and recent Illumina data from orangutan, in each case comparing our results to those from computational analysis that uses a reference genome assembly. We also illustrate the use of DIAL to identify nucleotide differences among transcriptome sequences. Conclusions DIAL can be used for identification of nucleotide differences in species for which no reference sequence is available. Our main motivation is to use this tool to survey the genetic diversity of endangered species as the identified sequence differences can be used to design genotyping arrays to assist in the species' management. The DIAL source code is freely available at http://www.bx.psu.edu/miller_lab/.

  12. Stress, anxiety, and depression among call handlers employed in international call centers in the national capital region of Delhi

    OpenAIRE

    Dinesh Raja Jeyapal; Sanjiv Kumar Bhasin; Anjur Tupil Kannan; Manjeet Singh Bhatia

    2015-01-01

    Background: Call handlers employed in call centers repeatedly undergo stress in their day-to-day lives and this can have deleterious effects on their health. Objectives: The objectives were to study the levels of stress, anxiety, and depression, and their predictors among call handlers employed in international call centers in the National Capital Region (NCR) of Delhi. Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 375 call handlers aged 18-39 years. ...

  13. Cutaneous vasculitides: Clinico-pathological correlation

    Directory of Open Access Journals (Sweden)

    Gupta Suruchi

    2009-01-01

    Full Text Available Background: Cutaneous vasculitis presents as a mosaic of clinical and histological findings. Its pathogenic mechanisms and clinical manifestations are varied. Aims: To study the epidemiological spectrum of cutaneous vasculitides as seen in a dermatologic clinic and to determine the clinico-pathological correlation. Methods: A cohort study was conducted on 50 consecutive patients clinically diagnosed as cutaneous vasculitis in the dermatology outdoor; irrespective of age, sex and duration of the disease. Based on the clinical presentation, vasculitis was classified according to modified Gilliam′s classification. All patients were subjected to a baseline workup consisting of complete hemogram, serum-creatinine levels, serum-urea, liver function tests, chest X-ray, urine (routine and microscopic examination besides antistreptolysin O titer, Mantoux test, cryoglobulin levels, antineutrophilic cytoplasmic antibodies and hepatitis B and C. Histopathological examination was done in all patients while immunofluorescence was done in 23 patients. Results: Out of a total of 50 patients diagnosed clinically as cutaneous vasculitis, 41 were classified as leukocytoclastic vasculitis, 2 as Heinoch−Schonlein purpura, 2 as urticarial vasculitis and one each as nodular vasculitis, polyarteritis nodosa and pityriasis lichenoid et varioliforme acuta. Approximately 50% of the patients had a significant drug history, 10% were attributed to infection and 10% had positive collagen workup without any overt manifestations, while 2% each had Wegener granulomatosis and cryoglobulinemia. No cause was found in 26% cases. Histopathology showed features of vasculitis in 42 patients. Only 23 patients could undergo direct immunofluorescence (DIF, out of which 17 (73.9% were positive for vasculitis. Conclusions: Leukocytoclastic vasculitis was the commonest type of vaculitis presenting to the dermatology outpatient department. The workup of patients with cutaneous vasculitis

  14. Calling under pressure: Short-finned pilot whales make social calls during deep foraging dives

    DEFF Research Database (Denmark)

    Jensen, Frants Havmand; Marrero Perez, Jacobo; Johnson, Mark;

    2011-01-01

    Toothed whales rely on sound to echolocate prey and communicate with conspecifics, but little is known about how extreme pressure affects pneumatic sound production in deep-diving species with a limited air supply. The short-finned pilot whale (Globicephala macrorhynchus) is a highly social species...... among the deep-diving toothed whales, in which individuals socialize at the surface but leave their social group in pursuit of prey at depths of up to 1000 m. To investigate if these animals communicate acoustically at depth and test whether hydrostatic pressure affects communication signals, acoustic...... DTAGs logging sound, depth and orientation were attached to 12 pilot whales. Tagged whales produced tonal calls during deep foraging dives at depths of up to 800 m. Mean call output and duration decreased with depth despite the increased distance to conspecifics at the surface. This shows that the...

  15. Call Center Outsourcing: Coordinating Staffing Level and Service Quality

    OpenAIRE

    Z. Justin Ren; Yong-Pin Zhou

    2008-01-01

    In this paper, we study the contracting issues in an outsourcing supply chain consisting of a user company and a call center that does outsourcing work for the user company. We model the call center as a G/G/s queue with customer abandonment. Each call has a revenue potential, and we model the call center's service quality by the percentage of calls resolved (revenue realized). The call center makes two strategic decisions: how many agents to have and how much effort to exert to achieve servi...

  16. Effectiveness of the Call in Beach Volleyball Attacking Play

    Directory of Open Access Journals (Sweden)

    Künzell Stefan

    2014-12-01

    Full Text Available In beach volleyball the setter has the opportunity to give her or his hitter a “call”. The call intends that the setter suggests to her or his partner where to place the attack in the opponent’s court. The effectiveness of a call is still unknown. We investigated the women’s and men’s Swiss National Beach Volleyball Championships in 2011 and analyzed 2185 attacks. We found large differences between female and male players. While men called in only 38.4% of attacks, women used calls in 85.5% of attacks. If the male players followed a given call, 63% of the attacks were successful. The success rate of attacks without any call was 55.8% and 47.6% when the call was ignored. These differences were not significant (χ2(2 = 4.55, p = 0.103. In women’s beach volleyball, the rate of successful attacks was 61.5% when a call was followed, 35% for attacks without a call, and 42.6% when a call was ignored. The differences were highly significant (χ2(2 = 23.42, p < 0.0005. Taking into account the findings of the present study, we suggested that the call was effective in women’s beach volleyball, while its effect in men’s game was unclear. Considering the quality of calls we indicate that there is a significant potential to increase the effectiveness of a call.

  17. Purpose, Mission, and Context: The Call for Educating Future Leaders

    Science.gov (United States)

    Chunoo, Vivechkanand; Osteen, Laura

    2016-01-01

    This chapter calls on higher education to reclaim its role in leadership education. Specifically it examines higher education's purpose, context, and mission as clarion calls to embed leadership education throughout higher education institutions and focuses on why this is important.

  18. The call-by-need lambda calculus (unabridged).

    OpenAIRE

    Maraist, John; Odersky, Martin; Wadler, Phil

    2007-01-01

    We present a calculus that captures the operational semantics of call-by-need.We demonstrate that the calculus is confluent and standardizable and entails the same observational equivalences as call-by-name lambda calculus.

  19. Interday Forecasting and Intraday Updating of Call Center Arrivals

    OpenAIRE

    Haipeng Shen; Huang, Jianhua Z.

    2008-01-01

    Accurate forecasting of call arrivals is critical for staffing and scheduling of a telephone call center. We develop methods for interday and dynamic intraday forecasting of incoming call volumes. Our approach is to treat the intraday call volume profiles as a high-dimensional vector time series. We propose first to reduce the dimensionality by singular value decomposition of the matrix of historical intraday profiles and then to apply time series and regression techniques. Our approach takes...

  20. Titi monkey call sequences vary with predator location and type.

    OpenAIRE

    Casar, C.; Zuberbuhler, K.; Young, R. J.; Byrne, R.W.

    2013-01-01

    Animal alarm calls can encode information about a predator's category, size, distance or threat level. In non-human primates, alarm calls typically refer to broad classes of disturbances, in some instances to specific predators. Here, we present the results of a field experiment with a New World primate, the black-fronted titi monkey (Callicebus nigrifrons), designed to explore the information conveyed by their alarm call system. Adults produced sequences consisting of two main alarm call typ...

  1. Untrained Forward Observer (UFO) translator for call for fire

    OpenAIRE

    King, Regan R.

    2013-01-01

    Approved for public release; distribution is unlimited Many observers need indirect fire but are not proficient in Call for Fire, the procedure used to request indirect fire. To alleviate this, we propose the development of an application, which we call the Untrained Forward Observer (UFO) Translator, capable of assisting untrained observers in performing Call for Fire by asking a series of simple questions to generate a Call for Fire in the proper format. As a prior Forward Observer with ...

  2. Male monkeys remember which group members have given alarm calls

    OpenAIRE

    Wich, Serge A.; Vries, Han de

    2005-01-01

    Primates give alarm calls in response to the presence of predators. In some species, such as the Thomas langur (Presbytis thomasi), males only emit alarm calls if there is an audience. An unanswered question is whether the audience's behaviour influences how long the male will continue his alarm calling. We tested three hypotheses that might explain the alarm calling duration of male Thomas langurs: the fatigue, group size and group member behaviour hypotheses. Fatigue and group size did not ...

  3. A General Study on the Major Features of CALL

    Institute of Scientific and Technical Information of China (English)

    喻晖

    2009-01-01

    As Computer Assisted language Learning (CALL) has become a hot issue in the second language acquisition, this paper attempts to discuss two of the important features of CALL: the student-centered and interactiveness. It is ex-plained in the paper that these two features are the most important features characterized by CALL and they can be bet-ter realized in a CALL class than in a traditional class.

  4. Is a Convertible Bond Call Really Bad News?

    OpenAIRE

    Ederington, Louis H; Goh, Jeremy C

    2001-01-01

    We test and reject the hypothesis that managers call in-the-money convertibles when they view a decline in the value of the firm as likely. Inconsistent with this view, we find that insiders generally buy equity before conversion-forcing calls. Also, analysts tend to raise their earnings forecasts following a call. Thus, our evidence supports the alternative hypothesis that the price decline immediately following conversion-forcing calls is a purely transitory decline caused by the anticipate...

  5. The Structure and Function of Male Thomas Langur Loud Calls

    OpenAIRE

    Wich, Serge Alexander

    2002-01-01

    This study has addressed the acoustical structure of male loud calls and their function in Thomas langur social organisation. Thomas langurs are medium sized primate that lives in Sumatra, Indonesia. Ome of the characteristics of this species is the loud call of males. Several functions for loud calls have been suggested such as mate-defence, resource-defence and mate-attraction. In this study playback studies were applied to determine that loud calls function in between-group spacing and res...

  6. Electoronic Performance Monitoring in Call Centers: An Ethical Decision Model

    OpenAIRE

    Perkins, David

    2013-01-01

    Ever since it emerged on a widespread basis in the 1990s, electronic performance monitoring of employees has received significant scrutiny in the literature. Call centers have been the focus of many of these studies. This particular study addresses the issue of electronic performance monitoring in call centers from an ethical perspective. The following ethical dilemma is offered: "Is it ethical for a call center manager to evaluate the performance of a call center employee using electronic pe...

  7. On the modeling and forecasting of call center arrivals

    OpenAIRE

    Ibrahim, Rouba; Ye, Han; L'Ecuyer, Pierre; Shen, Haipeng

    2015-01-01

    International audience The effective management of call centers is a challenging task mainly because managers are consistently facing considerable uncertainty. Among important sources of uncertainty are call arrival rates which are typically time-varying, stochastic, dependent across time periods and across call types, and often affected by external events. Accurately modeling and forecasting future call arrival volumes is a complicated issue which is critical for making important operatio...

  8. Smart Grid Technology and Consumer Call Center Readiness

    OpenAIRE

    Schamber, Kelsey L.

    2010-01-01

    The following reasearch project deals with utility call center readiness to address customer concerns and questions about the Smart Grid and smart meter technology. Since consumer engagement is important for the benefits of the Smart Grid to be realized, the readiness and ability of utilities to answer consumer questions is an important issue. Assessing the readiness of utility call centers to address pertinant customer concerns was accomplished by calling utility call centers with Smart Grid...

  9. The So-Called 'Face on Mars'

    Science.gov (United States)

    2002-01-01

    (Released 13 April 2002) The Science The so called 'Face on Mars' can be seen slightly above center and to the right in this THEMIS visible image. This 3-km long knob, located near 10o N, 40o W (320o E), was first imaged by the Viking spacecraft in the 1970's and was seen by some to resemble a face carved into the rocks of Mars. Since that time the Mars Orbiter Camera on the Mars Global Surveyor spacecraft has provided detailed views of this hill that clearly show that it is a normal geologic feature with slopes and ridges carved by eons of wind and downslope motion due to gravity. A similar-size hill in Phoenix, Arizona resembles a camel lying on the ground, and Phoenicians whimsically refer to it as Camelback Mountain. Like the hills and knobs of Mars, however, Camelback Mountain was carved into its unusual shape by thousands of years of erosion. The THEMIS image provides a broad perspective of the landscape in this region, showing numerous knobs and hills that have been eroded into a remarkable array of different shapes. Many of these knobs, including the 'Face', have several flat ledges partway up the hill slopes. These ledges are made of more resistant layers of rock and are the last remnants of layers that once were continuous across this entire region. Erosion has completely removed these layers in most places, leaving behind only the small isolated hills and knobs seen today. Many of the hills and ridges in this area also show unusual deposits of material that occur preferentially on the cold, north-facing slopes. It has been suggested that these deposits were 'pasted' on the slopes, with the distinct, rounded boundary on their upslope edges being the highest remaining point of this pasted-on layer. In several locations, such as in the large knob directly south of the 'Face', these deposits occur at several different heights on the hill. This observation suggests the layer once draped the entire knob and has since been removed from all but the north

  10. Heterospecific Acoustic Interference: Effects on Calling in Oophaga pumilio.

    Science.gov (United States)

    Wong, Stefanie; Parada, Humberto; Narins, Peter M

    2009-01-01

    Call rate suppression is a common short-term solution for avoiding acoustic interference in animals. It has been widely documented between and within frog species, but the effects of non-anuran calling on frog vocalizations is less well known. Heterospecific acoustic interference on the calling of Oophaga pumilio (Bauer, 1994) (formerly Dendrobates pumilio) males was studied in a lowland, wet tropical forest in SE Nicaragua. Acoustic playback experiments were conducted to characterize the responses of O. pumilio males to interfering calls of cicadas, two species of crickets and a sympatric dendrobatid frog, Phyllobates lugubris. Call rate, call bout duration, percent of time calling, dominant frequency and latency to first-call were analyzed. Significant call rate suppression was observed during all stimulus playbacks, yet no significant differences were found in spontaneous call rates during pre- and post-playback trials. Dominant frequency significantly decreased after P. lugubris playback and first-call latency significantly decreased in response to both cicada and tree cricket playbacks. These results provide robust evidence that O. pumilio males can dynamically modify their calling pattern in unique ways, depending on the source of the heterospecific acoustic interference. PMID:20953296

  11. Bats aloft: Variation in echolocation call structure at high altitudes

    Science.gov (United States)

    Bats alter their echolocation calls in response to changes in ecological and behavioral conditions, but little is known about how they adjust their call structure in response to changes in altitude. This study examines altitudinal variation in the echolocation calls of Brazilian free-tailed bats, T...

  12. Evolution of advertisement calls in African clawed frogs

    Science.gov (United States)

    Tobias, Martha L.; Evans, Ben J.; Kelley, Darcy B.

    2014-01-01

    Summary For most frogs, advertisement calls are essential for reproductive success, conveying information on species identity, male quality, sexual state and location. While the evolutionary divergence of call characters has been examined in a number of species, the relative impacts of genetic drift or natural and sexual selection remain unclear. Insights into the evolutionary trajectory of vocal signals can be gained by examining how advertisement calls vary in a phylogenetic context. Evolution by genetic drift would be supported if more closely related species express more similar songs. Conversely, a poor correlation between evolutionary history and song expression would suggest evolution shaped by natural or sexual selection. Here, we measure seven song characters in 20 described and two undescribed species of African clawed frogs (genera Xenopus and Silurana) and four populations of X. laevis. We identify three call types — click, burst and trill — that can be distinguished by click number, call rate and intensity modulation. A fourth type is biphasic, consisting of two of the above. Call types vary in complexity from the simplest, a click, to the most complex, a biphasic call. Maximum parsimony analysis of variation in call type suggests that the ancestral type was of intermediate complexity. Each call type evolved independently more than once and call type is typically not shared by closely related species. These results indicate that call type is homoplasious and has low phylogenetic signal. We conclude that the evolution of call type is not due to genetic drift, but is under selective pressure. PMID:24723737

  13. The Additional Uses of CALL in the Endangered Language Context

    Science.gov (United States)

    Ward, Monica

    2004-01-01

    This paper considers the additional uses of CALL in the Endangered Language (EL) context. It briefly reviews ELs and reports on CALL for ELs in general. It then reviews the extra uses of CALL for ELs; these include changing negative attitudes towards the language, arousing interest in the language and contributing to language maintenance and…

  14. 47 CFR 25.284 - Emergency Call Center Service.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Emergency Call Center Service. 25.284 Section... SATELLITE COMMUNICATIONS Technical Operations § 25.284 Emergency Call Center Service. (a) Providers of mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call...

  15. Evolution of advertisement calls in African clawed frogs.

    Science.gov (United States)

    Tobias, Martha L; Evans, Ben J; Kelley, Darcy B

    2011-01-01

    For most frogs, advertisement calls are essential for reproductive success, conveying information on species identity, male quality, sexual state and location. While the evolutionary divergence of call characters has been examined in a number of species, the relative impacts of genetic drift or natural and sexual selection remain unclear. Insights into the evolutionary trajectory of vocal signals can be gained by examining how advertisement calls vary in a phylogenetic context. Evolution by genetic drift would be supported if more closely related species express more similar songs. Conversely, a poor correlation between evolutionary history and song expression would suggest evolution shaped by natural or sexual selection. Here, we measure seven song characters in 20 described and two undescribed species of African clawed frogs (genera Xenopus and Silurana) and four populations of X. laevis. We identify three call types - click, burst and trill - that can be distinguished by click number, call rate and intensity modulation. A fourth type is biphasic, consisting of two of the above. Call types vary in complexity from the simplest, a click, to the most complex, a biphasic call. Maximum parsimony analysis of variation in call type suggests that the ancestral type was of intermediate complexity. Each call type evolved independently more than once and call type is typically not shared by closely related species. These results indicate that call type is homoplasious and has low phylogenetic signal. We conclude that the evolution of call type is not due to genetic drift, but is under selective pressure. PMID:24723737

  16. 76 FR 43688 - Committee Meeting via Conference Call

    Science.gov (United States)

    2011-07-21

    ... HUMAN SERVICES Administration for Children and Families Committee Meeting via Conference Call AGENCY..., August 16, 2011, from 1 p.m. to 2:30 pm E.S.T. This meeting, to be held via audio conference call, is open to the public. Details for accessing the full Committee Conference Call are cited below: Toll...

  17. 78 FR 35956 - Utah Resource Advisory Council Subgroup Conference Call

    Science.gov (United States)

    2013-06-14

    ... Bureau of Land Management Utah Resource Advisory Council Subgroup Conference Call AGENCY: Bureau of Land Management, Interior. ACTION: Conference Call. SUMMARY: In accordance with the Federal Land Policy and... Advisory Council (RAC) Subgroup will host a conference call. DATES: The Utah RAC Subgroup will host...

  18. 46 CFR 169.750 - Radio call sign.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Radio call sign. 169.750 Section 169.750 Shipping COAST... Control, Miscellaneous Systems, and Equipment Markings § 169.750 Radio call sign. Each vessel certificated for exposed or partially protected water service must have its radio call sign permanently...

  19. 29 CFR 785.17 - On-call time.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false On-call time. 785.17 Section 785.17 Labor Regulations... On-call time. An employee who is required to remain on call on the employer's premises or so close thereto that he cannot use the time effectively for his own purposes is working while “on call”....

  20. 76 FR 17429 - Notice of FHA Debenture Call

    Science.gov (United States)

    2011-03-29

    ... URBAN DEVELOPMENT Notice of FHA Debenture Call AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This Notice announces a debenture call of... the approval of the Secretary of the Treasury, announces the call of all FHA debentures, with a...

  1. 75 FR 16163 - Notice of FHA Debenture Call

    Science.gov (United States)

    2010-03-31

    ... URBAN DEVELOPMENT Notice of FHA Debenture Call AGENCY: Office of the Assistant Secretary for Housing... the Secretary of the Treasury, announces the call of all FHA debentures, with a coupon rate of 5..., ``outstanding'' as of March 31, 2010. The date of the call is July 1, 2010. The debentures will be redeemed...

  2. 77 FR 18258 - Notice of FHA Debenture Call

    Science.gov (United States)

    2012-03-27

    ... URBAN DEVELOPMENT Notice of FHA Debenture Call AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This Notice announces a debenture call of... impairments may access this number through TTY by calling the toll-free Federal Relay Service at...

  3. 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)

    This study was performed to investigate the value of18F-fluorodeoxyglucose positron emission tomography ([18F]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 [18F]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 [18F]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 [18F]FDG-PET results by logistic regression. [18F]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 18F]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.)

  4. Efficacy of TNF-α antagonist and other immunomodulators in the treatment of patients with ophthalmologic manifestations of Behcet's disease and HLA B51 positive vasculitis

    Directory of Open Access Journals (Sweden)

    Zlatanović Gordana

    2012-01-01

    Full Text Available Bacground/Aim. Behcet's disease is genetically conditioned, immune-mediated multisystem occlusive vasculitis of small blood vessels, espesially venules, of unknown etiology. The aim of this study was to analyze the clinical features, disease activity and therapy of the patients with ophthalmologic manifestation of Behcet's disease. Methods. In this study symptoms and signs of the disease were analyzed both prospectively and retrospectively during the active manifestation of the disease. The diagnosis was reached according to the International Criteria for Behcet's Disease (2006. The treatment effects were evaluated based on the presence of the best corrected visual acuity and the inflammation of the vitreous humour before and after the application of our therapeutic method. The applied therapeutic modality consisted of the primary application of corticosteroid therapy in the active stage of the disease complemented with the choice of drugs from the immunosuppressive group. In this study there drugs were cyclosporine or methotrexate. A treatment refractory patients with poor vision prognosis were treated with a third drug, the biological preparation infliximab, a tumor necrosis factor-alpha (TNF-α antagonist. Results. The mean age of 11 patients with ophthalmologic manifestation of Behcet's disease was 50.6 years. HLA B-5(51 was positive in 81% of the patients while 36% of the patients had positive pathergy test. Changes in affected eyes included vitritis (100%, posterior uveitis (45%, panuveitis (54%, retinal vasculitis (54%, cystoid macular edema (54%, and cystoid degeneration (18%. Increased intraocular pressure was observed in 27% of the patients. There was no statistically significant variation in disease activity parameters in any of the patients (p > 0.05. A statistically significant improvement in visual acuity (p < 0.05 and a high statistically significant decrease of inflammation of the worst affected eyes (p = 0.001 were detected

  5. The prognostic value of baseline 18F-FDG PET/CT in steroid-naive large-vessel vasculitis: introduction of volume-based parameters

    International Nuclear Information System (INIS)

    The aim of this study was to analyse if the result of a baseline 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, in large-vessel vasculitis (LVV) patients, is able to predict the course of the disease, not only in terms of presence/absence of final complications but also in terms of favourable/complicated progress (response to steroid therapy, time to steroid suspension, relapses, etc.). A total of 46 consecutive patients, who underwent 18F-FDG PET/CT between May 2010 and March 2013 for fever of unknown origin (FUO) or suspected vasculitis (before starting corticosteroid therapy), were enrolled. The diagnosis of LVV was confirmed in 17 patients. Considering follow-up results, positive LVV patients were divided into two groups, one characterized by favourable (nine) and the other by complicated progress (eight), on the basis of presence/absence of vascular complications, presence/absence of at least another positive PET/CT during follow-up and impossibility to comply with the tapering schedule of the steroid due to biochemical/symptomatic relapse. Vessel uptake in subjects of the two groups was compared in terms of intensity and extension. To evaluate the extent of active disease, we introduced two volume-based parameters: ''volume of increased uptake'' (VIU) and ''total lesion glycolysis'' (TLG). The threshold used to calculate VIU on vessel walls was obtained by the ''vessel to liver'' ratio by means of receiver-operating characteristic analysis and was set at 0.92 x liver maximum standardized uptake value in each patient. Measures of tracer uptake intensity were significantly higher in patients with complicated progress compared to those with a favourable one (p < 0.05). Measures of disease extension were even more significant and TLG emerged as the best parameter to separate the two groups of patients (p = 0.01). This pilot study shows that, in LVV patients, the combined

  6. The prognostic value of baseline {sup 18}F-FDG PET/CT in steroid-naive large-vessel vasculitis: introduction of volume-based parameters

    Energy Technology Data Exchange (ETDEWEB)

    Dellavedova, L. [Ospedale Civile di Legnano, PET/CT Center - Nuclear Medicine Department, Legnano (Italy); University of Milan, Department of Health Sciences, Milan (Italy); Carletto, M.; Maffioli, L.S. [Ospedale Civile di Legnano, PET/CT Center - Nuclear Medicine Department, Legnano (Italy); Faggioli, P.; Sciascera, A.; Mazzone, A. [Ospedale Civile di Legnano, Internal Medicine Department, Legnano (Italy); Del Sole, A. [University of Milan, Department of Health Sciences, Milan (Italy)

    2016-02-15

    The aim of this study was to analyse if the result of a baseline {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, in large-vessel vasculitis (LVV) patients, is able to predict the course of the disease, not only in terms of presence/absence of final complications but also in terms of favourable/complicated progress (response to steroid therapy, time to steroid suspension, relapses, etc.). A total of 46 consecutive patients, who underwent {sup 18}F-FDG PET/CT between May 2010 and March 2013 for fever of unknown origin (FUO) or suspected vasculitis (before starting corticosteroid therapy), were enrolled. The diagnosis of LVV was confirmed in 17 patients. Considering follow-up results, positive LVV patients were divided into two groups, one characterized by favourable (nine) and the other by complicated progress (eight), on the basis of presence/absence of vascular complications, presence/absence of at least another positive PET/CT during follow-up and impossibility to comply with the tapering schedule of the steroid due to biochemical/symptomatic relapse. Vessel uptake in subjects of the two groups was compared in terms of intensity and extension. To evaluate the extent of active disease, we introduced two volume-based parameters: ''volume of increased uptake'' (VIU) and ''total lesion glycolysis'' (TLG). The threshold used to calculate VIU on vessel walls was obtained by the ''vessel to liver'' ratio by means of receiver-operating characteristic analysis and was set at 0.92 x liver maximum standardized uptake value in each patient. Measures of tracer uptake intensity were significantly higher in patients with complicated progress compared to those with a favourable one (p < 0.05). Measures of disease extension were even more significant and TLG emerged as the best parameter to separate the two groups of patients (p = 0.01). This pilot study shows that, in LVV patients, the

  7. Investigating on-call work in rail infrastructure maintenance

    OpenAIRE

    Cebola, Nuno M.F.

    2014-01-01

    The use of on-call work in industry has now surpassed that of shiftwork and night work. Industries as a whole make use of on-call work daily as a way to maintain 24/7 operations whilst also reducing costs. Despite this, on-call work remains underresearched and no best practice or management guidelines are available. As the first substantial piece of human factors work examining on-call work in the rail industry, this thesis has the overall aim of increasing the understanding of on-call sc...

  8. Spatial diffusion patterns of call-centers in the Netherlands

    OpenAIRE

    Bruinsma, Frank; Rietveld, Piet; Beekman, Michiel

    2002-01-01

    The focus in this paper is on spatial diffusion patterns of call centers in The Netherlands. The number of call centers has increased rapidly in the last decade and it seems that impacts of call centers on the labor market still underestimated. We will pay attention to two spatial levels: first urban versus rural and second local. Given the labor intensity and quality required by call centers and the absence of physical contacts with consumers one might expect that most call centers are locat...

  9. Does Vessel Noise Affect Oyster Toadfish Calling Rates?

    Science.gov (United States)

    Luczkovich, Joseph J; Krahforst, Cecilia S; Hoppe, Harry; Sprague, Mark W

    2016-01-01

    The question we addressed in this study is whether oyster toadfish respond to vessel disturbances by calling less when vessels with lower frequency spectra are present in a sound recording and afterward. Long-term data recorders were deployed at the Neuse (high vessel-noise site) and Pamlico (low vessel-noise site) Rivers. There were many fewer toadfish detections at the high vessel-noise site than the low-noise station. Calling rates were lower in the high-boat traffic area, suggesting that toadfish cannot call over loud vessel noise, reducing the overall calling rate, and may have to call more often when vessels are not present. PMID:26611015

  10. SIMULATION MODELS OF CALL ADMISSION CONTROL SCHEMES USING GPSS

    Directory of Open Access Journals (Sweden)

    Vassilya ABDULOVA

    2014-01-01

    Full Text Available In cellular wireless networks, a variety of channel allocation schemes have been developed for achieving high capacity with minimal interference. The choice of channel allocation scheme impacts the performance of the system, particularly as how calls are managed when a mobile user is handed off from one cell to another. Call Admission Control schemes take into account the effect of handoffs in the performance of the system, particularly call blocking probability and call dropping probability. In this study, we present simulation models and programs of some popular Call Admission Control schemes using GPSS simulation tool.

  11. Divergence of a stereotyped call in northern resident killer whales.

    Science.gov (United States)

    Grebner, Dawn M; Parks, Susan E; Bradley, David L; Miksis-Olds, Jennifer L; Capone, Dean E; Ford, John K B

    2011-02-01

    Northern resident killer whale pods (Orcinus orca) have distinctive stereotyped pulsed call repertoires that can be used to distinguish groups acoustically. Repertoires are generally stable, with the same call types comprising the repertoire of a given pod over a period of years to decades. Previous studies have shown that some discrete pulsed calls can be subdivided into variants or subtypes. This study suggests that new stereotyped calls may result from the gradual modification of existing call types through subtypes. Vocalizations of individuals and small groups of killer whales were collected using a bottom-mounted hydrophone array in Johnstone Strait, British Columbia in 2006 and 2007. Discriminant analysis of slope variations of a predominant call type, N4, revealed the presence of four distinct call subtypes. Similar to previous studies, there was a divergence of the N4 call between members of different matrilines of the same pod. However, this study reveals that individual killer whales produced multiple subtypes of the N4 call, indicating that divergence in the N4 call is not the result of individual differences, but rather may indicate the gradual evolution of a new stereotyped call. PMID:21361462

  12. Inbreeding and courtship calling in the cricket Teleogryllus commodus.

    Science.gov (United States)

    Drayton, J M; Milner, R N C; Hall, M D; Jennions, M D

    2011-01-01

    Male field crickets produce two acoustic signals for mating: advertisement calls and courtship calls. While the importance of advertisement calling in mate attraction is well understood, the function of courtship calling is less clear. Here, we tested if the courtship call of male crickets Teleogryllus commodus signals aspects of male quality by comparing the calls of inbred and outbred males. We examined the effect of one generation of full sibling mating on fine-scale call structure, along with several life history traits. Inbreeding reduced nymph survival but had no significant effect on weight or development time. Inbreeding resulted in a small but significant change in two of the six call parameters measured. We then tested if inbreeding affects call trait combinations that are important to females by using the results of a previous selection analysis to compare the multivariate attractiveness of the calls of inbred and outbred males. There was no difference. We conclude that the courtship call of T. commodus is not a reliable signal of aspects of male quality that are affected by inbreeding (which generally reduces fitness-enhancing traits). It might, however, signal components of male fitness that are not affected by changes in heterozygosity. PMID:21054622

  13. The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

    Directory of Open Access Journals (Sweden)

    Sherwin E. Phillips

    2012-01-01

    Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

  14. New aspects of MRI for diagnostics of large vessel vasculitis and primary angiitis of the central nervous system; Neue Aspekte der MRT-Bildgebung zur Diagnostik der Grossgefaessvaskulitiden sowie der primaeren Angiitis des zentralen Nervensystems

    Energy Technology Data Exchange (ETDEWEB)

    Saam, T.; Habs, M.; Cyran, C.C.; Grimm, J.; Reiser, M.F.; Nikolaou, K. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Pfefferkorn, T. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Neurologie, Muenchen (Germany); Schueller, U. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Zentrum fuer Neuropathologie, Muenchen (Germany)

    2010-10-15

    Vasculitis is a rare disease and clinical symptoms are often unspecific. Accurate and early diagnosis is mandatory in order to prevent complications, such as loss of vision or stroke. Imaging techniques can contribute to establishing a definite diagnosis and to evaluate disease activity and the extent of the disease in various vascular regions. Conventional imaging methods, such as computed tomography (CT) and magnetic resonance (MR) angiography, as well as digital subtraction angiography allow the vessel lumen but not the vessel wall to be depicted. However, vasculitis is a disease which primarily affects the vessel wall, therefore conventional imaging modalities often fail to make a definite diagnosis. Recently black-blood high resolution MR in vivo imaging has been used to visualize cervical and intracranial vasculitis. This review article presents imaging protocols for intracranial and cervical black-blood MR imaging and clinical cases with large vessel vasculitis and vasculitis of the central nervous system. Furthermore the current literature, examples of the most common differential diagnoses of cervical and cranial arteriopathy and the potential of other imaging modalities, such as PET/CT and ultrasound will be discussed. (orig.) [German] Vaskulitiden sind seltene Erkrankungen, deren klinische Symptome oft unspezifisch sind und deren genaue und fruehzeitige Diagnose daher eine besondere Herausforderung fuer jeden Kliniker darstellt. Hierzu kann die Bildgebung einen wertvollen Beitrag leisten und ist insbesondere in der Lage, das Ausmass der Erkrankung und die Anzahl der betroffenen Gefaesse zu bestimmen. Die klassischen bildgebenden Verfahren wie CT- (CTA) oder MR-Angiographie (MRA) sowie die digitale Subtraktionsangiographie (DSA) fokussieren dabei hauptsaechlich auf Veraenderungen des Lumendurchmessers, die Gefaesswand wird mit diesen Verfahren in der Regel nur unzureichend dargestellt. Ultraschalluntersuchungen lassen zwar eine Beurteilung des Lumens und

  15. Effect of CALL-based and Non-CALL Based Methods of Teaching on L2 Vocabulary Learning

    OpenAIRE

    Effat Bagheri; Ali Roohani; Dariush Nejad Ansari

    2012-01-01

    The use of Computer Assisted Language Learning (CALL) in the field of education has increased remarkably in recent years due to the swift and modern changes in language software. However, CALL is not widely employed in the field of second/foreign (L2) language learning in Iran. Interested in the application of CALL, this study examines two methods of vocabulary teaching/learning (CALL-based versus non-CALL based) in the short and long-term learning in the area of L2 vocabulary. It seeks to se...

  16. Vasculite na hanseníase mimetizando doenças reumáticas Vasculitis in leprosy mimicking rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Sandra Lúcia Euzébio Ribeiro

    2007-04-01

    Full Text Available Os autores alertam para o múltiplo espectro de apresentação clínica da hanseníase, destacando as lesões cutâneas necrosantes e manifestações articulares simulando doenças reumáticas, confundindo o diagnóstico e o tratamento correto. Nesses aspectos, são relatados dois casos do sexo feminino com hanseníase virchowiana e dimorfa cujas manifestações iniciais foram de lesões eritêmato-violáceas, necróticas e ulceradas, livedo reticular, oligoartrite, poliartralgias, mialgias e edema de membros inferiores, que mimetizaram algumas doenças reumáticas como o lúpus eritematoso sistêmico e a vasculite sistêmica (poliarterite nodosa.Leprosy has a large spectrum of clinical manifestations, including necrotizing skin lesions and joint complaints that sometimes mimic a primary rheumatic disease, confounding the correct diagnosis and treatment. Herein, the authors report two cases of women with leprosy, respectively virchowian and dimorphic forms, presenting initially with purple-reddish skin lesions, evolving with necrosis and ulceration, livedo reticularis, joint pain, oligoarthritis, myalgia, and leg edema. The differential diagnosis with systemic lupus erythematosus (SLE and systemic vasculitis such as polyarteritis nodosa (PAN is discussed.

  17. Comparison of autoantibodies to the collagen-like region of C1q in hypocomplementemic urticarial vasculitis syndrome and systemic lupus erythematosus.

    Science.gov (United States)

    Wisnieski, J J; Jones, S M

    1992-03-01

    Hypocomplementemic urticarial vasculitis syndrome (HUVS) is an apparent autoimmune disorder that resembles SLE. We previously showed that C1q precipitins in HUVS sera are IgG autoantibody to human C1q. We have compared HUVS anti-C1q autoantibody to a similar autoantibody in the serum of some patients with SLE. As with anti-C1q autoantibody in SLE sera, the HUVS autoantibody binds only to the collagen-like region (CLR) of C1q. In both HUVS and SLE, IgG2 is the predominant subclass of IgG autoantibody and IgM autoantibody to C1q is uncommon. In both diseases, anti-C1q autoantibodies bind preferentially to surface-adsorbed C1q or CLR fragments compared to these antigens in solution. Finally, when HUVS or SLE autoantibodies were added to CLR-coated wells already bound, respectively, by SLE or HUVS autoantibodies, no increases in CLR binding were observed, suggesting that HUVS and SLE autoantibodies to C1q bind to the same CLR epitope(s). PMID:1538123

  18. An empirical analysis of the corporate call decision

    International Nuclear Information System (INIS)

    An economic study of the the behaviour of financial managers of utility companies was presented. The study examined whether or not an option pricing based model of the call decision does a better job of explaining callable preferred share prices and call decisions compared to other models. In this study, the Rust (1987) empirical technique was extended to include the use of information from preferred share prices in addition to the call decisions. Reasonable estimates were obtained from data of shares of the Pacific Gas and Electric Company (PGE) for the transaction costs associated with a call. It was concluded that the managers of the PGE clearly take into account the value of the option to delay the call when making their call decisions

  19. The advertisement call of the giant spiny frog Paa spinosa

    Directory of Open Access Journals (Sweden)

    Baogen YU, Rongquan ZHENG

    2009-12-01

    Full Text Available We analyzed the advertisement call of Paa spinosa at Yuliang Mountain, Lanxi, Zhejiang province, in eastern China. Temporal and spectral call parameters were analyzed, along with call intensity. Calls comprised of three to seven notes, the last of which had the longest duration. Three formants (harmonics were clearly distinguishable from the audio spectrogram. The dominant frequency ranged from 411-1534Hz, and was either the first or the second formant. The number of notes within a call was positively correlated to air temperature, so that calls contained more notes during the day. Also, the dominant frequency appeared to be lower at the highest temperature [Current Zoology 55 (6: 411 –415, 2009].

  20. In- and Out-of-the-Money Convertible Bond Calls

    DEFF Research Database (Denmark)

    Bechman, Ken; Lunde, Asger; Zebedee, Allan

    2014-01-01

    call is predominantly explained by the subsequent order imbalances; and the stock market's reaction is spread over an entire trading day, which is consistent with the price pressure effect. In contrast, the announcement effect for the out-of-the-money call is driven by the size of the called......Convertible bond calls typically cause significant reactions in equity prices. The empirical research largely finds negative and positive announcement effects for the in-the-money and the out-of-the-money calls respectively. However, this research has difficulty distinguishing between the two main...... theoretical explanations: the signaling effect and the price pressure effect. In this paper, we differentiate between these two effects by using a unique data set of the in- and the out-of-the-money calls in the United States during the period of 1993 to 2007. We find that the announcement effect for the in-the-money...