In Vivo skin hydration and anti-erythema effects of Aloe vera, Aloe ferox and Aloe marlothii gel materials after single and multiple applications

Science.gov (United States)

Fox, Lizelle T.; du Plessis, Jeanetta; Gerber, Minja; van Zyl, Sterna; Boneschans, Banie; Hamman, Josias H.

2014-01-01

Objective: To investigate the skin hydrating and anti-erythema activity of gel materials from Aloe marlothii A. Berger and A. ferox Mill. in comparison to that of Aloe barbadensis Miller (Aloe vera) in healthy human volunteers. Materials and Methods: Aqueous solutions of the polisaccharidic fractions of the selected aloe leaf gel materials were applied to the volar forearm skin of female subjects. The hydration effect of the aloe gel materials were measured with a Corneometer® CM 825, Visioscan® VC 98 and Cutometer® dual MPA 580 after single and multiple applications. The Mexameter® MX 18 was used to determine the anti-erythema effects of the aloe material solutions on irritated skin areas. Results: The A. vera and A. marlothii gel materials hydrated the skin after a single application, whereas the A. ferox gel material showed dehydration effects compared to the placebo. After multiple applications all the aloe materials exhibited dehydration effects on the skin. Mexameter® readings showed that A. vera and A. ferox have anti-erythema activity similar to that of the positive control group (i.e. hydrocortisone gel) after 6 days of treatment. Conclusion: The polysaccharide component of the gel materials from selected aloe species has a dehydrating effect on the skin after multiple applications. Both A. vera and A. ferox gel materials showed potential to reduce erythema on the skin similar to that of hydrocortisone gel. PMID:24991119

Erythema multiforme and persistent erythema as early cutaneous manifestations of Lyme disease

NARCIS (Netherlands)

Schuttelaar, M L; Laeijendecker, R; Heinhuis, R J; Van Joost, T

1997-01-01

We report two cases of borreliosis (Lyme disease) with unusual cutaneous manifestations, erythema multiforme, and persistent erythema. The lesions in both of our patients had distinctive histopathologic features. To our knowledge, this is the first report of erythema multiforme and persistent

Old condition caused by modern technology - erythema ag igne

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Sara Ferreira

2016-02-01

Full Text Available Introduction:Erythema ab igne is a rare reticular pigmented dermatosis, caused by prolonged and repeated exposure to heat. Multiple heat sources have been reported to cause this condition, as fire or stove in proximity with the skin. Case report:We report a case of a diabetic teenager with erythema ab igne induced by a laptop computer. Conclusions: Laptop induced erythema ab igne is an underdiagnosed clinical entity. In the future maybe it will be more frequent due to the improper use of these devices. The possible irreversibility of skin lesions and the potential severe complications reinforce the need to be aware for this disease.

Multiple sclerosis and positive lyme serology

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Marco Aurélio Lana-Peixoto

1994-12-01

Full Text Available As Lyme neuroborreliosis (LNB may clinically mimick multiple sclerosis (MS the presence of antibodies to Borrelia burgdorferi in serum of patients with a MS-like disease in non-edemic areas for Lyme disease may be troublesome. We report the case of a 45-year-old white female with the diagnosis of relapsing/ remitting form of MS due to a 15-year history of optic neuritis and recurrent episodes of motor and sensation disturbance in the upper right limb and in both lower extremites associated with bladder dysfunction. A magnetic resonance imaging of the brain revealed multiple high intensity periventricular white matter lesions. The patient had been exposed to ticks but did not recall the presence of erythema migrans. ELISA for Lyme disease was positive in two different laboratories and the positive serology was confirmed by Western blotting. No convincing reponse followed treatment with ceftriaxone. Although it is clear that the patient had been infect by Borrelia burgdorferi the relationship of this spirochetal infection with the neurological disease could not be ascertained.

Cutaneous larva migrans in northern climates. A souvenir of your dream vacation.

Science.gov (United States)

Edelglass, J W; Douglass, M C; Stiefler, R; Tessler, M

1982-09-01

Three young women recently returned to the metropolitan Detroit area with cutaneous larva migrans. All three had vacationed at a popular club resort on the Caribbean island of Martinique. Cutaneous larva migrans is frequently seen in the southern United States, Central and South America, and other subtropical areas but rarely in northern climates. Several organisms can cause cutaneous larva migrans, or creeping eruption. The larvae of the nematode Ancylostoma braziliense are most often the causative organisms. Travel habits of Americans make it necessary for practitioners in northern climates to be familiar with diseases contracted primarily in warmer locations. The life cycle of causative organisms and current therapy are reviewed.

ERYTHEMA NODOSUM REVEALING ACUTE MYELOID LEUKEMIA

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Chebbi Wafa

2013-07-01

Full Text Available Introduction: Erythema nodosum (EN is the most common type of panniculitis. It may be idiopathic or secondary to various etiologies. However, the occurrence of erythema nodosum in malignant hemopathy had rarely been reported. Case report: A 42 year-old woman presented with a four week history of recurrent multiple painful erythematous nodules developed on the lower limbs associated with arthralgia of the ankles and fever. The clinical features of skin lesions with contusiform color evolution allowed establishing the diagnosis of EN. No underlying cause was found. The skin lesions were improved with non-steroidal anti-inflammatory drugs and colchicine. Three months later, the patient consulted for recurrence of EN associated with fever, inflammatory polyarthralgia and hepatosplenomegaly. The peripheral blood count revealed pancytopenia. A bone marrow examination confirmed the diagnosis of acute myeloid leukemia type 2. Initiation of chemotherapy was followed by the complete disappearance of skin lesions of EN. Conclusion: Paraneoplastic erythema nodosum is a rare entity. In the literature, a few cases of association with leukemia have been reported. Exploration for solid neoplasms or hemopathy in case of recurrent EN or resistance to conventional treatment should be systematic

Cutaneous horn and thermal keratosis in erythema AB igne

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Sood Apra

2002-01-01

Full Text Available A 46 - year - old Kashmiri lady developed erythema ab igne on both legs. She subsequently developed multiple keratoses and a cutaneous horn in the involved skin. An uncommon association of these three clinical conditions is being presented.

Lyme disease testing in children in an endemic area.

Science.gov (United States)

Al-Sharif, Bashar; Hall, Matthew C

2011-10-01

The purpose of this study was to determine clinician adherence to recommendations regarding diagnostic testing for Lyme disease (LD). The specific aims were to determine the rate of inappropriate test ordering for a diagnosis of erythema migrans and tack of confirmatory test ordering for positive LD screening tests. Using the data warehouse of Marshfield Clinic Research Foundation's Bioinformatics Research Center, cases were identified from 2002 through 2007. A retrospective chart abstraction was performed using Marshfield Clinic's electronic medical record. The study involved children (testing occurred after a clinical diagnosis of erythema migrans was made. Patients with any symptom in addition to erythema migrans were more likely to have testing (odds ratio (OR) = 3.52, 1.75-7.08). A positive LD screening test was not confirmed 24% of the time. Lack of ordering confirmatory testing was not associated with any clinical factors or site of the evaluation. This study found that some clinicians in an LD-endemic area do not follow guidelines for diagnosing children suspected to have Lyme disease.

Diagnostic challenges of early Lyme disease: Lessons from a community case series

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Schwarzwalder Alison

2009-06-01

Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

Human case of visceral larva migrans syndrome: pulmonary and hepatic involvement

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Almatary A. M.

2016-12-01

Full Text Available Visceral Larva Migrans (VLM syndrome is commonly caused by larvae of roundworms Toxocara canis or Toxocara cati. Human toxocarosis is a soil-transmitted zoonosis, which may result in partial or general pathological changes in host tissues. We reported a case of 14-year-old boy presented with severe dry cough without dyspnea, mild chest and abdominal pain with general fatigue. Examination of peripheral blood showed marked increase in eosinophils. The chest radiography showed an infiltrative shadow in the lung fields. Chest CT demonstrated multiple opacities in both lungs. Abdominal CT showed multiple low attenuation areas in the liver. Ultrasound guided liver biopsy revealed granulomas with severe eosinophilic infiltration. The boy was treated with albendazole and responded radically. It is worth mentioning that this is the first case of hepato-pulmonary VLM syndrome in Egypt.

Use of liquid nitrogen and albendazole in successfully treating cutaneous larva migrans.

Science.gov (United States)

Kapadia, Naseema; Borhany, Tasneem; Farooqui, Maria

2013-05-01

To determine the efficacy of combination treatment of Albendazole along with liquid nitrogen in cutaneous larva migrans. Quasi-experimental study. Abbasi Shaheed Hospital and The Aga Khan Hospital, Karachi, from December 2008 to December 2010. Eighteen cases of cutaneous larva migrans were collected and divided into two groups. Group-A was administered oral Albendazole 400 mg once per day along with topical steroid and oral cetrizine 10 mg once at night for 7 days. Group-B also received oral Albendazole 400 mg once per day along with cetrizine 10 mg once at night but they also received single application of liquid nitrogen to freeze the larva. It was found that in Group-A only 2 out of 9 (22%) showed improvement whereas 78% had to be given liquid nitrogen cryotherapy 3 - 7 days after Albendazole to prevent migration of larva. In Group-B, the improvement was 100% and all 9 patients were successfully treated. Use of liquid nitrogen along with oral anti-helminths is very effective in treating cutaneous larva migrans than Albendazole alone.

Erythema a computatro.

Science.gov (United States)

Gauglitz, G G; Ruzicka, T; Herzinger, T

2013-01-01

Historically, erythema ab igne (EAI) was commonly seen on the shins of individuals working in front of coal stoves or sitting close to a fireplace. In the more recent past, this condition has been primarily observed after repeated application of heating pads. Today, unintentional and unperceived exposure to heat from laptop computers needs to be considered as a potential trigger. A rising number of laptop-induced cases of EAI have been reported recently. For this modern-age version of classic EAI, we propose thus the more accurate neo-Latin term erythema a computatro.

Cutaneous larva migrans – a threat to divers in the tropics

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Olszański Romuald

2016-09-01

Full Text Available The article presents a dermatosis that occurs in tropical and subtropical countries. Though the definitive hosts of the cutaneous larva migrans parasite are animals, humans can become accidental hosts and they are infected when their skin comes into contact with damp soil, most frequently sand. The disease is only present in the epidermis where an itch is brought about by the mining activity of the larva. Sunbathers and divers who put on their gear on a beach, on account of the epidermis maceration caused by a prolonged exposure to water, are particularly susceptible to the penetrative activities of the larva. In Poland the cutaneous larva migrans is in most cases mistaken for nettle rash or eczema.

RELASI SUAMI ISTERI DALAM KONTEKS KELUARGA BURUH MIGRAN

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Jamilah Jamilah

2013-06-01

Full Text Available This research aims at analyzing spouse relation construction  among  migrant  worker families in Patok Picis Village, Wajak, Malang with wives as the additional bread winner. This research is descriptive empirical research by applying qualitative method on spouse relationship phenomenon in migrant workers family context. Deep interview technique is used to collect data through interview with migrant workers worker’ husbands. The results of this research reveal three main findings; 1 the relation is mainly determined by the ability of wife and husband to be main and additional breadwinner. 2 the relation which is build is not based on justice and equity principle and it tends to be subordination after the wife ends the contract. 3 Husband states that the relation socially which must be built in the family must put husband’s position higher than wife’s. Penelitian ini bertujuan untuk mengkaji konstruksi relasi suami istri yang dibangun oleh keluarga buruh migran di desa Patok Picis kecamatan Wajak Kabupaten Malang dengan kondisi  istri  yang  bekerja  sebagai  pencari  nafkah  tambahan.  Penelitian  ini  merupakan penelitian  empirik  yang  bersifat  deskriftif  terhadap  fenomena  relasi  suami  istri  dalam konteks keluarga buruh migran. Teknik wawancara secara mendalam digunakan untuk mengumpulkan data melalui wawancara dengan suami buruh migran. Hasil penelitian menyimpulkan antara lain; 1 relasi yang dibangun sangat ditentukan oleh kemampuan suami atau istri dalam mencari nafkah utama dan tambahan.2 relasi yang dibangun tidak berdasarkan prinsip keadilan dan kesetaraan akan tetapi cenderung subordinasi ketika istri selesai  menjadi  buruh  migrant.  3  Suami  berpendapat  bahwa  secara  social,  relasi  yang harus dibentuk dalam keluarga adalah kedudukan suami lebih tinggi dari istri.

Erythema a computatro

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G.G. Gauglitz

2013-03-01

Full Text Available Historically, erythema ab igne (EAI was commonly seen on the shins of individuals working in front of coal stoves or sitting close to a fireplace. In the more recent past, this condition has been primarily observed after repeated application of heating pads. Today, unintentional and unperceived exposure to heat from laptop computers needs to be considered as a potential trigger. A rising number of laptop-induced cases of EAI have been reported recently. For this modern-age version of classic EAI, we propose thus the more accurate neo-Latin term erythema a computatro.

Erythema multiforme associated with gemfibrozil monotherapy.

Science.gov (United States)

Yaçsar, Hamiyet Yilmaz; Ertuğrul, Ozden; Deniz, Coçskun

2010-01-01

A case of erythema multiforme associated with gemfibrozil monotherapy. A 46-year-old man with hyperlipidemia was treated with 600 mg gemfibrozil twice a day. On the fifth day of treatment, skin lesions consistent with erythema multiforme appeared. With the discontinuation of the treatment and start of a topical steroid treatment, the lesions recovered after 4 weeks. After 6 months, when gemfibrozil therapy was restarted, lesions reappeared on the fourth day of therapy. Lesions recovered again following the previous treatment strategies after 4 weeks. An objective casualty assessment suggests that erythema multiforme was probably related to gemfibrozil monotherapy. Patients starting gemfibrozil therapy should be warned about the occurrence of erythema multiforme in addition to previous reported and established side effects.

Use of liquid nitrogen and albendazole in successfully treating cutaneous larva migrans

International Nuclear Information System (INIS)

Kapadia, N.; Farooqui, M.; Borhany, T.

2013-01-01

Objective: To determine the efficacy of combination treatment of Albendazole along with liquid nitrogen in cutaneous larva migrans. Study Design: Quasi-experimental study. Place and Duration of Study: Abbasi Shaheed Hospital and The Aga Khan Hospital, Karachi, from December 2008 to December 2010. Methodology: Eighteen cases of cutaneous larva migrans were collected and divided into two groups. Group-A was administered oral Albendazole 400 mg once per day along with topical steroid and oral cetrizine 10 mg once at night for 7 days. Group-B also received oral Albendazole 400 mg once per day along with cetrizine 10 mg once at night but they also received single application of liquid nitrogen to freeze the larva. Results: It was found that in Group-A only 2 out of 9 (22%) showed improvement whereas 78% had to be given liquid nitrogen cryotherapy 3 - 7 days after Albendazole to prevent migration of larva. In Group-B, the improvement was 100% and all 9 patients were successfully treated. Conclusion: Use of liquid nitrogen along with oral anti-helminths is very effective in treating cutaneous larva migrans than Albendazole alone. (author)

Souvenir from the Hamptons - a case of cutaneous larva migrans of six months' duration.

Science.gov (United States)

Esser, A C; Kantor, I; Sapadin, A N

1999-01-01

Cutaneous larva migrans is a distinctive serpiginous eruption caused by a reaction to burrowing hookworms. The infection is usually self-limited, normally lasting 2-8 weeks, but may persist for more than a year if misdiagnosed. Biopsies of the creeping eruption rarely reveal an organism. Thus, it is important for the infection to be recognized clinically, so that effective treatment may begin. We found topical thiabendazole to be fast and effective in treating this case of cutaneous larva migrans of six months' duration.

Recall of UVB-induced erythema in breast cancer patient receiving multiple drug chemotherapy

DEFF Research Database (Denmark)

Andersen, Klaus Ejner; Lindskov, R

1984-01-01

One day after sunbathing, a breast cancer patient received intravenous methotrexate, cyclophosphamide and 5-fluorouracil and had a recall of her UV erythema over the following week. Phototesting with UVA and UVB prior to and after a subsequent chemotherapy treatment showed a UVB-induced recall...

Erythema after laser skin resurfacing.

Science.gov (United States)

Ruiz-Esparza, J; Barba Gomez, J M; Gomez de la Torre, O L; David, L

1998-01-01

Erythema after laser skin resurfacing is seen by many as a necessary evil in order to get good results from the procedure. A critical review of widely accepted concepts may lead to diminishing the length of postoperative erythema in patients undergoing laser resurfacing. The authors report on two previously unrecognized factors in the causation of this problem.

Cutaneous larva migrans: a bad souvenir from the vacation.

Science.gov (United States)

Criado, Paulo Ricardo; Belda, Walter; Vasconcellos, Cidia; Silva, Cristiana Silveira

2012-06-15

Cutaneous larva migrans (CLM) is a common endemic disease in tropical and subtropical countries. This condition is caused by skin-penetrating larvae of nematodes, mainly of the hookworm Ancylostoma braziliense and other nematodes of the family Ancylostomidae. We report three cases of CLM acquired during vacations in different regions of Brazil.

Hierarchical feature selection for erythema severity estimation

Science.gov (United States)

Wang, Li; Shi, Chenbo; Shu, Chang

2014-10-01

At present PASI system of scoring is used for evaluating erythema severity, which can help doctors to diagnose psoriasis [1-3]. The system relies on the subjective judge of doctors, where the accuracy and stability cannot be guaranteed [4]. This paper proposes a stable and precise algorithm for erythema severity estimation. Our contributions are twofold. On one hand, in order to extract the multi-scale redness of erythema, we design the hierarchical feature. Different from traditional methods, we not only utilize the color statistical features, but also divide the detect window into small window and extract hierarchical features. Further, a feature re-ranking step is introduced, which can guarantee that extracted features are irrelevant to each other. On the other hand, an adaptive boosting classifier is applied for further feature selection. During the step of training, the classifier will seek out the most valuable feature for evaluating erythema severity, due to its strong learning ability. Experimental results demonstrate the high precision and robustness of our algorithm. The accuracy is 80.1% on the dataset which comprise 116 patients' images with various kinds of erythema. Now our system has been applied for erythema medical efficacy evaluation in Union Hosp, China.

Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area.

Science.gov (United States)

van den Wijngaard, Cees C; Hofhuis, Agnetha; Simões, Mariana; Rood, Ente; van Pelt, Wilfrid; Zeller, Herve; Van Bortel, Wim

2017-07-06

Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe. Erythema migrans (EM), an early, localised skin rash, is its most common presentation. Dissemination of the bacteria can lead to more severe manifestations including skin, neurological, cardiac, musculoskeletal and ocular manifestations. Comparison of LB incidence rates in the European Union (EU)/European Economic Area (EEA) and Balkan countries are difficult in the absence of standardised surveillance and reporting procedures. We explored six surveillance scenarios for LB surveillance in the EU/EEA, based on the following key indicators: (i) erythema migrans, (ii) neuroborreliosis, (iii) all human LB manifestations, (iv) seroprevalence, (v) tick bites, and (vi) infected ticks and reservoir hosts. In our opinion, neuroborreliosis seems most feasible and useful as the standard key indicator, being one of the most frequent severe LB manifestations, with the possibility of a specific case definition. Additional surveillance with erythema migrans as key indicator would add value to the surveillance of neuroborreliosis and lead to a more complete picture of LB epidemiology in the EU/EEA. The other scenarios have less value as a basis for EU-level surveillance, but can be considered periodically and locally, as they could supply complementary insights. This article is copyright of The Authors, 2017.

Radiator-induced erythema ab igne in 8-year-old girl.

Science.gov (United States)

Brzezinski, Piotr; Ismail, Samir; Chiriac, Anca

2014-04-01

The cutaneous lesion of erythema ab Igne are characterized by a reticulate erythema, hyperpigmentation, fine scaling, epidermal atrophy and telangiectasias, and reticulated erythema. We report a case of erythema ab igne on the hands of a 8-year-old girl, induced by classic homemade radiator.

Analysis of erythema after Er:YAG laser skin resurfacing.

Science.gov (United States)

Ko, Na Young; Ahn, Hyo-Hyun; Kim, Soo-Nam; Kye, Young-Chul

2007-11-01

Postoperative erythema can be expected to occur in every patient after laser resurfacing, and pigmentary disturbances may be related to the intensity and the duration of erythema. This study was undertaken to assess the clinical features of erythema, the factors that influence its duration, and the relation between the duration of erythema and the incidence of hyperpigmentation and hypopigmentation in skin of Asian persons after Er:YAG laser resurfacing. A total of 218 patients (skin phototypes III to V) were recruited and treated with a short-pulsed Er:YAG laser, a variable-pulsed Er:YAG laser, or a dual-mode Er:YAG laser for skin resurfacing. Clinical assessments were performed retrospectively using medical charts and serial photographs. Postoperative erythema was observed in all patients after Er:YAG laser resurfacing with a mean duration of 4.72 months. In 98.2% of patients, erythema faded completely within 12 months. Postinflammatory hyperpigmentation was observed in 38.1% of patients after Er:YAG laser resurfacing. Skin phototype, level of ablation, and depth of thermal damage caused by a long-pulsed laser appear to be important factors that affect the duration of erythema. Moreover, prolonged erythema was related to the risk of postinflammatory hyperpigmentation.

A Case of Laptop Computer-Induced Erythema Ab Igne

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Nurettin Özgür Doğan

2014-12-01

Full Text Available Erythema ab igne, also known as toasted skin syndrome, is a skin reaction characterized by reticulate erythema, brown pigmentation, and telangiectasia. In some cases, epidermal atrophy and scaling are also identified. The condition is usually caused by prolonged exposure to a source of heat or infrared radiation. Here, we report a case of erythema ab igne associated with laptop computer use.

Oxymetazoline hydrochloride cream for facial erythema associated with rosacea.

Science.gov (United States)

Patel, Nupur U; Shukla, Shweta; Zaki, Jessica; Feldman, Steven R

2017-10-01

Rosacea is a chronic skin condition characterized by transient and persistent erythema of the central face. The symptom of persistent erythema can be particularly frustrating for both patients and physicians as it is difficult to treat. Areas covered: Current treatment options for the treatment of rosacea include metronidazole, azelaic acid, sodium sulfacetamide-sulfur, and brimonidine. Until recently, brimonidine gel was the only option approved specifically for the treatment of facial erythema. However, oxymetazoline hydrochloride 1% cream is a newly FDA approved topical medication for adult rosacea patients. A primarily alpha-1a agonist, oxymetazoline hydrochloride (HCl) is thought to diminish erythema through vasoconstriction. Our paper seeks to evaluate evidence for topical oxymetazoline HCl with respect to its efficacy and safety for its approved indication of treating the persistent erythema associated with rosacea. Expert commentary: While assessment of available clinical trial data indicates that the medication is as effective as other available treatment for controlling rosacea-associated erythema with minimal risk of adverse effects, studies of long-term duration and direct comparison will be necessary to establish its place in treatment guidelines and clinical practice. As further evidence becomes available, the real-world clinical potential of topical oxymetazoline cream will become clearer.

Erythema-index of clinical patch test reactions

DEFF Research Database (Denmark)

Jemec, G B; Johansen, J D

1995-01-01

that the method could be used for the grading of eczematous reactions in a clinical setting as well. OBJECTIVE: To assess the usefulness of the erythema index for the quantification of eczematous reactions using the Derma-Spectrometer (Cortex technology, Hadsund, Denmark) in a clinical setting. METHOD......: The erythema index of 56 patch test reactions ranging from +? to +++, was compared to regional controls and negative patch tests (189). The effects of intrumental application pressure was studied in 5 volunteers. Statistical analysis was carried out using Mann-Whitney and Jonckheere-Terpstra tests. RESULTS......: The erythema-index was significantly higher in all degrees of patch test reactions than in uninvolved regional skin or negative patch tests. It also showed a significant positive trend for higher values in +, ++ and +++ reactions (P

Erythema Nodosum in a Child with Celiac Disease

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Andrew Fretzayas

2011-01-01

Full Text Available Erythema nodosum is an acute, nodular, erythematous eruption usually limited to the extensor aspects of the lower legs. It could be idiopathic or associated with other systemic diseases. We, herein, report a phenotypically healthy, ten-year-old boy who presented with erythema nodosum in whom serological tests of autoimmunity and intestinal histological examination were compatible with celiac disease. The eruption resolved within 2 months following a gluten-free diet. Therefore, the possibility that erythema nodosum represents an extraintestinal manifestation of celiac disease should be kept in mind accordingly in cases where other common causes of this rash are ruled out.

Fifth Disease (Erythema Infectiosum)

Science.gov (United States)

... complications. Also called erythema infectiosum, it's caused by parvovirus B19. It's especially common in kids ages 5 to ... to become ill. The virus that causes it (parvovirus B19) can temporarily slow down or stop the body's ...

PROFIL MORALITAS ANAK BURUH MIGRAN INDONESIA

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Asmaul Chusna

2017-03-01

Full Text Available The purpose of this study is to discover the description of the morality of children of Indonesian Migrant Labor (Buruh Migran Indonesia in Tulungagung Regency which is measured through three moral aspects, namely moral knowledge, moral feeling, and moral action. The research approach and design employed a descriptive quantitative survey. The research instrument of this research was Psychological Scale of Morality Quality by field test by 87 respondents. Sampling technique of this study employed random sampling with 210 respondents from 4 research sites representing each area in Tulungagung regency. In this research, the data obtained were analyzed using descriptive test with frequency analysis technique with SPPS release 20.0 for windows. The results of the research are summed up as follows: (1 in the aspect of moral knowledge there are 3 indicators that categorize as low category, namely moral awareness, moral values, and moral thinking, (2 one indicator that categorize as the low category is self-control, (3 in the aspect of moral action there is one low indicator that is the indicator of desire. Tujuan penelitian ini adalah untuk mengetahui deskripsi moralitas anak BMI (Buruh Migran Indonesia di Kabupaten Tulungagung yang di ukur melalui tiga aspek moral, yaitu pengetahuan moral, perasaan moral, dan tindakan moral. Pendekatan dan rancangan penelitian dalam tesis ini menggunakan kuantitatif deskriptif survei. Instrument penelitian menggunakan Skala Psikologis Kualitas Moralitas dengan dilakukan uji lapangan oleh 87 responden. Teknik pengambilan sampel dengan pengambilan sampel acak dengan 210 responden dari 4 lokasi penelitian yang mewakili masing-masing area di wilayah kabupaten Tulungagung. Dalam penelitian ini menggunakan uji deskriptif dengan teknik analisis frekuensi menggunakan bantuan SPPS release 20.0 for windows. Hasil penelitian mengenai profil moralitas anak BMI di Kabupaten Tulungagung, yakni (1 dalam aspek pengetahuan moral

Objective assessment of psoriasis erythema for PASI scoring.

Science.gov (United States)

Ahmad Fadzil, M H; Ihtatho, Dani; Mohd Affandi, Azura; Hussein, S H

2009-01-01

Skin colour is vital information in dermatological diagnosis as it reflects the pathological condition beneath the skin. It is commonly used to indicate the extent of diseases such as psoriasis, which is indicated by the appearance of red plaques. Although there is no cure for psoriasis, there are many treatment modalities to help control the disease. To evaluate treatment efficacy, the current gold standard method, PASI (Psoriasis Area and Severity Index), is used to determine severity of psoriasis lesion. Erythema (redness) is one parameter in PASI and this condition is assessed visually, thus leading to subjective and inconsistent results. Current methods or instruments that assess erythema have limitations, such as being able to measure erythema well for low pigmented skin (fair skin) but not for highly pigmented skin (dark skin) or vice versa. In this work, we proposed an objective assessment of psoriasis erythema for PASI scoring for different (low to highly pigmented) skin types. The colour of psoriasis lesions are initially obtained by using a chromameter giving the values L*, a*, and b* of CIELAB colour space. The L* value is used to classify skin into three categories: low, medium and highly pigmented skin. The lightness difference (DeltaL*), hue difference (Deltah(ab)), chroma (DeltaC*(ab)) between lesions and the surrounding normal skin are calculated and analysed. It is found that the erythema score of a lesion can be distinguished by their Deltah(ab) value within a particular skin type group. References of lesion with different scores are obtained from the selected lesions by two dermatologists. Results based on 38 lesions from 22 patients with various level of skin pigmentation show that PASI erythema score for different skin types i.e. low (fair skin) to highly pigmented (dark skin) skin types can be determined objectively and consistent with dermatology scoring.

[Lyme disease--clinical manifestations and treatment].

Science.gov (United States)

Stock, Ingo

2016-05-01

Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings.

Share of erythema dose of solar radiation in high mountains

International Nuclear Information System (INIS)

Blumthaler, M.; Ambach, W.

1987-01-01

The erythema dose was measured using a Robertson-Berger Sunburn Meter. The spectral sensitivity of the detector is adapted to an erythema action spectrum with the optical center at about 300 nm. The erythema dose is expressed in the biologically relevant Sunburn Units (SU). The Robertson-Berger Sunburn Meter has been recommended by the WMO for global monitoring of solar UV-B erythema dose. UV-A radiation was measured with a UV-radiometer. The spectral sensitivity of the detector has a flat maximum at 345 nm and a half band width of +- 25 nm. Global radiation was measured using a pyranometer. All detectors were placed horizontally and calibrated several times. Readings were taken in intervals of one minute

Erythema multiforme as the result of taking carbamazepine

Directory of Open Access Journals (Sweden)

Maharani Laillyza Apriasari

2010-06-01

Full Text Available Background: Erythema multiforme is an acute mucocutaneus disease which is caused by the hypersensitivity reaction. It is characterized by target lesions on the skin or ulcerative oral lesion. Etiology of the disease is unknown, it is currently considered as immunologic disease. The triggering factors is the use of certain type of drugs like antibiotics, anticonvulsant, and NSAID. Most of the dentists do not know about it is mechanism, so a lot of people consider it as a malpractice. Purpose: This paper reported a case of a man, 46 years old which had ulcerative oral mucous, peeled and pain lips after taking carbamazepine drugs. Case: The clinical diagnosis of this case was erythema multiforme because of the hypersensitivity reaction as the result of taking carbamazepine. Case management: The final diagnosis based on anamnesis history of taking systemic drugs and clinical manifestation of erythema multiforme in the oral cavity. The drugs therapy that had been given were antihistamine, oral corticosteroid, gargle liquid contained of topical anesthetic, corticosteroid, and antibiotic. Conclusion: In this case, it can be concluded that erythema multiforme appeared was triggered by taking carbamazepine as the drug of choice for trigeminal neuralgia therapy. These drugs can cause type III hypersensitivity reaction. The final diagnosis based on anamnesis history of taking carbamazepine before lesions erupted and the characterized clinical manifestation.Latar belakang: Erythema multiforme adalah penyakit mukokutaneus akut yang menyerang kulit dan mukosa sebagai akibat dari reaksi hipersensitivitas. Secara karakteristik ditandai oleh lesi target pada kulit atau lesi ulserasi pada mukosa rongga mulut. Etiologi penyakit ini belum jelas, diduga karena adanya reaksi imunologi. Pencetusnya dikarenakan adanya pemakaian obat-obatan tertentu seperti antibiotik, antikonvulsan dan NSAID. Banyak dokter gigi kurang memahami mekanisme timbulnya penyakit ini, sehingga

Cutaneous larva migrans after a trip to the Caribean

OpenAIRE

García-Fernández, Lisset; Calderón, María

2014-01-01

La larva migrans cutánea es una parasitosis ocasionada por las larvas de Ancylostoma braziliense y Ancylostoma caninum, cuyo vehículo es la arena de playas infestadas. Los perros y gatos son los hospederos definitivos. Esta parasitosis es endémica en las costas del Caribe, África, Australia y Asia. Presentamos el caso clínico de una mujer de 27 años de edad, quien tras haber realizado un viaje al Caribe mexicano y haber estado en contacto con arena de playa, presentó unas lesiones en el pie d...

To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis

NARCIS (Netherlands)

Dessau, R. B.; van Dam, A. P.; Fingerle, V.; Gray, J.; Hovius, J. W.; Hunfeld, K.-P.; Jaulhac, B.; Kahl, O.; Kristoferitsch, W.; Lindgren, P.-E.; Markowicz, M.; Mavin, S.; Ornstein, K.; Rupprecht, T.; Stanek, G.; Strle, F.

2018-01-01

Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. The most frequent clinical manifestations are erythema migrans and Lyme neuroborreliosis. Currently, a large volume of diagnostic testing for LB is reported, whereas the incidence of clinically relevant

Erythema multiforme due to contact with laurel oil.

Science.gov (United States)

Athanasiadis, G I; Pfab, F; Klein, A; Braun-Falco, M; Ring, J; Ollert, M

2007-08-01

Erythema multiforme is a relatively common skin disorder. The best known cause is herpes simplex virus infection. We report the first case of erythema multiforme due to contact with laurel oil. The diagnosis was confirmed by the positive patch test to laurel oil, the histopathological studies of the lesions and the histopathological studies of the positive patch test to laurel oil.

Erythema multiformas sociated with herpes virus: case report

Directory of Open Access Journals (Sweden)

Anibal Manrique A

2016-02-01

Full Text Available Erythema multiforme (EM is a hypersensitivity reaction that affects the skin and/or mucous membranes, in response to infections, drugs, or other comorbidities. Presentation of EM can be Minor (Mild EM, characterized for presenting target lesions or Major (Severe EM, that occurs also with mucous membranes involvement. The case of a 36 year old male patient presenting to emergency of HNAL with fever, malaise, itching and painful ulcer type lesions in oral cavity, multiple target lesions in upper and lower limbs, penis, and perianal region is reported. The diagnosis was EM Major. Ulcerous lesions in oral cavity and target lesions in hands were the most salient.

Reliability of a Skin Diagnostic Device in Assessing Hydration and Erythema.

Science.gov (United States)

Huimin, Koh; Rowledge, Alexandra M; Borzdynski, Caroline J; Miller, Charne; Frescos, Nicoletta; McKenzie, Gayle; Perry, Elizabeth; McGuiness, William

2017-10-01

To examine the reliability of a skin diagnostic device, the SD202 (Courage+Khazaka GmBH, Cologne, Germany), in assessing hydration and erythema of periwound skin and pressure injury-prone areas. Intrarater reliabilities from 3 cross-sectional and prospective studies are reported. Patients attending an outpatient, nurse-led wound dressing clinic (n = 16), a podiatrist-led high-risk foot clinic (n = 17), and residents (n = 38) at a single residential aged-care facility. Skin hydration and erythema levels assessed using the SD202. High internal consistency was maintained for consecutive skin hydration and erythema measures at a single point on the venous leg ulcer periwound (α > .996 and α > .970 for hydration and erythema, respectively) and for the pressure-prone areas of the sacrum (α > .916), right (α > .994) and left (α > .967) ischium, right (α > .989) and left (α > .916) trochanter, right (α > .985) and left (α > .992) calcaneus, and right (α > .991) and left (α > .990) lateral malleolus. High consistency was also found for the measures obtained at 4 different locations around the periwound for the venous leg ulcer (α > .935 and α > .870 for hydration and erythema, respectively). In diabetic foot ulcer assessment, acceptable internal consistency of hydration measures around the periwound was observed (α > .634). Internal consistency of erythema measures was variable, ranging from low to high reliability, particularly among predebridement measures. Using the protocols outlined in this study, the SD202 demonstrates high reliability for assessing skin hydration and erythema levels. It is possible that the SD202 can be used in clinical practice as an appropriate tool for skin hydration and erythema assessment.

Time-dose relationship of erythema in high energy photon irradiation therapy

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Hidetoshi (Gifu Prefectural Tajimi Hospital (Japan)); Sakuma, Sadayuki

1992-01-01

Skin doses of 100 patients who were treated with high energy ionizing irradiation during conventional irradiation therapy were measured by thermoluminescence dosimeter (TLD). In 87 of the 100 patients, acute hyperemic change of the skin (erythema) of the irradiated region was observed. In the other 13 patients, alopetia of the scalp was observed. The following conclusions were reached. The time-dose relationship was linear when erythema tolerance was used as an index, but not when alopecia was used. The tolerance dose for erythema was lower than previously reported. The slope of the isoeffect curve on the log-log plot of total absorbed skin dose against total number of days after the first irradiation was 0.68 when erythema was used as an index. This number is larger than previously reported results. We considered that erythema is significantly influenced by fraction size and that hyperfractionation is a promising method of irradiation, especially in Japan. Combined use of chemotherapeutic agents, such as 5-FU, accelerated erythema. The slope of combined treatment was 0.86. Observing acute hyperemic change of skin is considered to be a useful method of investigating the combined effects of chemotherapeutic agents on irradiation. (author).

PERILAKU PENCEGAHAN DIRI TERHADAP PENULARAN HIV/AIDS PADA KELOMPOK CALON TENAGA BURUH MIGRAN/TKI/TKW DI PONOROGO

Directory of Open Access Journals (Sweden)

Sulistyo . Andarmoyo

2016-02-01

Full Text Available AIDS (Acquired Immuno Deificiency Syndrom masih merupakan permasalahan global. Dewasa ini ada trend atau kecenderungan dimana TKI juga turut serta menyumbang andil besar terhadap penularan HIV/AIDS. pemahaman pekerja migran Indonesia terhadap HIV/AIDS masih rendah mengakibatkan tenaga kerja di luar negeri mudah terinfeksi virus mematikan ini. Penelitian ini bertujuan untuk mengetahui bagaimanakah perilaku pencegahan diri terhadap penularan HIV/AIDS pada kelompok calon tenaga buruh Migran/TKI/TKW di Ponorogo. Desain penelitian ini adalah observasional analitik dengan rancangan cross sectional. Tempat Penelitian di PJTKI Cipta Karsa Bumi Lestari Ponorogo dengan alasan mudah dijangkau oleh peneliti dan ketersediaan veriabel pada tempat tersebut. Populasi dan sampel adalah TKI/TKW di PJTKI tersebut, dengan tehnik pengambilan sampel Simple Random Sampling Hasil penelitian menunjukkan bahwa perilaku pencegahan diri terhadap penularan HIV/AIDS pada kelompok calon buruh migran/TKI/TKW di Ponorogo sebagian besar (63,3% atau 19 responden perilaku pencegahan diri terhadap penularan HIV/AIDS negatif dan selebihnya sebanyak (36,7% berperilaku positif. Dibutuhkan penangganan yang komprehensif dalam mencegah resiko penularan penyakit tersebut. langkah-langkah yang strategis dari pihak terkait dalam meningkatkan pengetahuan merupakan aspek mendasar yang harus dperhatikan saat ini sehingga pada akhirnya dapat meningkatkan perilaku yang baik pula dalam pencegahan diri terhadap penularan HIV/ AIDS.

Ventral dermatitis in rowi (Apteryx rowi) due to cutaneous larval migrans.

Science.gov (United States)

Gartrell, B D; Argilla, L; Finlayson, S; Gedye, K; Gonzalez Argandona, A K; Graham, I; Howe, L; Hunter, S; Lenting, B; Makan, T; McInnes, K; Michael, S; Morgan, K J; Scott, I; Sijbranda, D; van Zyl, N; Ward, J M

2015-04-01

The rowi is a critically endangered species of kiwi. Young birds on a crèche island showed loss of feathers from the ventral abdomen and a scurfy dermatitis of the abdominal skin and vent margin. Histology of skin biopsies identified cutaneous larval migrans, which was shown by molecular sequencing to be possibly from a species of Trichostrongylus as a cause of ventral dermatitis and occasional ulcerative vent dermatitis. The predisposing factors that led to this disease are suspected to be the novel exposure of the rowi to parasites from seabirds or marine mammals due to the island crèche and the limited management of roost boxes. This is the first instance of cutaneous larval migrans to be recorded in birds. Severe and fatal complications of the investigation resulted in the death of eight birds of aspergillosis and pulmonary complications associated with the use of bark as a substrate in hospital. Another bird died of renal failure during the period of hospitalisation despite oral and intravenous fluid therapy. The initiating cause of the renal failure was not determined. These complications have the potential to undermine the working relationship between wildlife veterinarians and conservation managers. This case highlights that intensive conservation management can result in increased opportunities for novel routes of cross-species pathogen transmission.

Epidemiology of Lyme borreliosis and other tick-borne diseases in the Netherlands

NARCIS (Netherlands)

Hofhuis, Agnetha

2017-01-01

Lyme borreliosis is caused by Borrelia burgdorferi sensu lato bacteria, and transmitted through tick bites. The disease most commonly manifests as erythema migrans, a slowly expanding skin lesion at the site of the tick bite. Disseminated Lyme borreliosis can develop when the infection spreads to

Prolonged ultraviolet light-induced erythema and the cutaneous carcinoma phenotype

International Nuclear Information System (INIS)

Tanenbaum, L.; Parrish, J.A.; Haynes, H.A.; Fitzpatrick, T.B.; Pathak, M.A.

1976-01-01

A considerable amount of evidence exists in support of the role of ultraviolet radiation as a major etiologic factor in human skin cancer, both melanoma and carcinoma types. On the basis of epidemiologic studies a phenotype has been described which helps to identify the persons who are more susceptible to skin cancer. In an attempt to further define this population, patients with cutaneous carcinoma and a normal control group were exposed to artificial ultraviolet light (UVL) and the erythema and tanning responses of each group were measured over a 21-day period. UVL-induced erythema was prolonged in a significantly higher percentage of patients with skin cancer than in control patients, lasting two to three weeks after single exposures to 6 and 8 times the patient's minimal erythema dose. The presence of prolonged erythema correlated with this history of previous skin cancer but did not correlate with other established risk factors for cutaneous carcinoma, i.e., fair skin, light hair and light eyes, easy sunburning and poor tanning, and Celtic ancestry. Prolonged erythema following UVL radiation may therefore represent an additional risk factor and help to identify the skin cancer-susceptible population

Klinik, diagnostik og behandling af Lyme-borreliose

DEFF Research Database (Denmark)

Ocias, Lukas Frans; Jensen, Bo Bødker; Knudtzen, Fredrikke Christie

2017-01-01

Lyme borreliosis is an infection caused by the Borrelia burgdorferi sensu lato complex and transmitted by Ixodes ricinus ticks in Denmark. It can manifest itself in several different forms of which erythema migrans is the most common and is diagnosed by clinical assessment of the characteristic...

Peran Serikat Buruh Migran Indonesia dalam Melindungi Hak Tenaga Kerja Indonesia di Luar Negeri

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Fenny Sumardiani

2014-12-01

Full Text Available Permasalahan yang dihadapi Tenaga Kerja Indonesia baik pada fase pra penempatan, selama masa penempatan sampai dengan pasca penempatan dari waktu ke waktu perlu diperbaiki karena memang sangat luas dan membutuhkan koordinasi banyak pihak baik Pemerintah, PPTKIS, maupun organisasi yang membantu menyuarakan hak Tenaga Kerja Indonesia yang biasa disebut dengan Serikat Buruh Migran Indonesia dan Tenaga Kerja Indonesia itu sendiri. Koordinasi yang dimaksudkan terutama adalah dalam melindungi hak Tenaga Kerja Indonesia yang bermasalah. Penelitian ini bertujuan untuk menganalisis peran Serikat Buruh Migran Indonesia dalam melindungi Hak Tenaga Kerja Indonesia yang bermasalah di Kabupaten Kendal serta kendala yang dihadapi Serikat Buruh Migran dalam memperjuangkan hak-hak TKI yang bermasalah di Kabupaten Kendal serta serta upaya apa yang dilakukan untuk mengatasi kendala tersebut. Metode yang digunakan dalam penelitian ini adalah metode pendekatan yuridis sosiologis dengan metode analisa data kualitatif. Hasil penelitian ini menunjukan bahwa peran Serikat Buruh Migran Indonesia dalam menagani masalah TKI dengan memberikan pendampingan kepada tenaga kerja indonesia dan keluarganya yang mengalami masalah pada saat bertugas maupun purna tugas; memberikan pendidikan kritis; memberikan pemberdayaan ekonomi dalam peningkatan kesejahteraan bagi para anggota dan keluarganya; memberikan pelatihan bagi para tenaga kerja indonesia yang sudah kembali ke indonesia. The problem faced by Indonesian Manpower both the phase pre placement, during placement until after placement from time to time need to be fixed because it is very broad and requires coordination of many parties, both Governments, PPTKIS, as well as organizations that help expressing the rights of Indonesian Workers usual called the Indonesian Migrant Workers Union and Labour Indonesia itself. Coordination is intended primarily to protect the rights of Indonesian Workers are problematic. This study aims

A case of Lyme disease in a Japanese woman

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Seki M

2018-04-01

Full Text Available Masafumi Seki,1 Yuji Watanabe,2 Hiroki Kawabata3 1Division of Infectious Diseases and Infection Control, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Miyagi, Japan; 2Laboratory for Clinical Microbiology, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Miyagi, Japan; 3Department of Bacteriology-1, National Institute of Infectious Diseases, Tokyo, Japan Abstract: This report presents the case of a Japanese patient who developed Lyme disease. The patient was a 44-year-old woman who had general fatigue and the inability to open her mouth. She was initially suspected of having mild tetanus with lockjaw; however, she reported a past history of a tick bite while camping in the USA and had erythema migrans 2 months before this visit. Finally, Lyme disease was serologically confirmed. A few cases of Lyme disease are annually reported in Japan; however, this infectious disease should also be suspected. Keywords: Borrelia burgdorferi, Clostridium tetani, tetracycline, facial nerve palsy, erythema migrans

The glucagonoma syndrome and necrolytic migratory erythema : A clinical review

NARCIS (Netherlands)

van Beek, André P.; de Haas, Ellen R.M.; van Vloten, Willem A.; Lips, Cees J.M.; Roijers, Janine F.M.; Canninga-van Dijk, Marijke R.

2004-01-01

The glucagonoma syndrome is a rare disease in which a typical skin disorder, necrolytic migratory erythema, is often one of the first presenting symptoms. Weight loss and diabetes mellitus are two other prevalent characteristics of this syndrome. Necrolytic migratory erythema belongs to the recently

Discrimination between cutaneous pigmentation and erythema: comparison of the skin colorimeters Dermacatch and Mexameter.

Science.gov (United States)

Baquié, M; Kasraee, B

2014-05-01

Reproducibility and specificity of the present skin colorimeters is still limited as alterations in erythema can bias the measurement of melanin and vice versa. Here, Dermacatch(®) , a new colorimeter covering the visible light spectrum, has been compared with Mexameter(®) , an established narrow-band reflectance spectrophotometer. Repeated measurements with both devices were initially collected on colour charts. Then, measures were compared on 12 human volunteers before and after exposure to UVB, and/or modulation of skin erythema. In vitro sensitivity of Dermacatch to erythema/melanin covered a broader wavelength spectrum than Mexameter while in vivo sensitivity of both devices was similar. Interestingly, Mexameter's melanin and erythema values were falsely affected by an increase in erythema or variation in pigmentation respectively. On the contrary, Dermacatch's melanin and erythema values remained constant in the same circumstances. Furthermore, as Mexameter was at least twice less reproducible than Dermacatch, Mexameter showed an increased risk of a confusion over the detection of erythema or melanin fluctuations. The analysis of more than 18,000 measures indicated that, Dermacatch has a significantly higher specificity and reproducibility than Mexameter in the measurement of skin pigmentation and erythema. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Recidiverende erythema multiforme udløst af herpes simplex-virus

DEFF Research Database (Denmark)

Vestergård Grejsen, Dorthe; Henningsen, Emil

2012-01-01

We describe two cases of recurrent erythema multiforme, both associated to infection with herpes simplex virus. The importance of subclinical herpes is illustrated. Antiviral and additional treatment is described.......We describe two cases of recurrent erythema multiforme, both associated to infection with herpes simplex virus. The importance of subclinical herpes is illustrated. Antiviral and additional treatment is described....

Erythema-directed digital photography for the enhanced evaluation of topical treatments for acne vulgaris.

Science.gov (United States)

Micali, G; Dall'Oglio, F; Tedeschi, A; Lacarrubba, F

2018-01-31

Erythema-directed digital photography is a novel method for evaluating the efficacy and tolerability of topical acne treatments. Here, we describe three case reports in which erythema-directed digital photography was used to evaluate acne before and after up to 12 weeks of treatment with clindamycin 1%/tretinoin 0.025% (Clin-RA). Erythema-directed digital photography was used to evaluate acne in three patients with mild-to-moderate facial acne, two of whom had refused to continue previous topical acne treatment (benzoyl peroxide 5% and clindamycin 1%/benzoyl peroxide 5%) due to persistent irritation. Acne lesions and erythema were evaluated using standard clinical photography and erythema-directed digital photography (VISIA-CR ™ system) before and after 8-12 weeks of treatment with Clin-RA. Erythema-directed digital photography revealed background erythema from previous topical acne treatments that was not evident from standard clinical photographs and allowed a better visualization of both inflammatory and non-inflammatory lesions. In all patients, there was a clear improvement in background erythema and a reduction in acne lesions following treatment with Clin-RA. This study has demonstrated for the first time that erythema-directed digital photography can enhance the evaluation of the efficacy and tolerability of topical acne treatments. These cases show that Clin-RA was associated with improved efficacy and tolerability vs previous treatments with topical monotherapy (benzoyl peroxide 5%) or a topical fixed-dose combination (clindamycin 1%/benzoyl peroxide 5%). © 2018 The Authors. Skin Research and Technology Published by John Wiley & Sons Ltd.

T2 Magnetic Resonance Assay-Based Direct Detection of Three Lyme Disease-Related Borrelia Species in Whole-Blood Samples.

Science.gov (United States)

Snyder, Jessica L; Giese, Heidi; Bandoski-Gralinski, Cheryl; Townsend, Jessica; Jacobson, Beck E; Shivers, Robert; Schotthoefer, Anna M; Fritsche, Thomas R; Green, Clayton; Callister, Steven M; Branda, John A; Lowery, Thomas J

2017-08-01

In early Lyme disease (LD), serologic testing is insensitive and seroreactivity may reflect active or past infection. In this study, we evaluated a novel assay for the direct detection of three species of Borrelia spirochetes in whole blood. The T2 magnetic resonance (T2MR) assay platform was used to amplify Borrelia DNA released from intact spirochetes and to detect amplicon. Analytical sensitivity was determined from blood spiked with known concentrations of spirochetes, and the assay's limit of detection was found to be in the single-cell-per-milliliter range: 5 cells/ml for B. afzelii and 8 cells/ml for Borrelia burgdorferi and Borrelia garinii Clinical samples ( n = 66) from confirmed or suspected early LD patients were also analyzed. B. burgdorferi was detected using T2MR in 2/2 (100%) of blood samples from patients with confirmed early LD, based on the presence of erythema migrans and documentation of seroconversion or a positive real-time blood PCR. T2MR detected B. burgdorferi in blood samples from 17/54 (31%) of patients with probable LD, based on the presence of erythema migrans without documented seroconversion or of documented seroconversion in patients with a compatible clinical syndrome but without erythema migrans. Out of 21 clinical samples tested by real-time PCR, only 1 was positive and 13 were negative with agreement with T2MR. An additional 7 samples that were negative by real-time PCR were positive with T2MR. Therefore, T2MR enables a low limit of detection (LoD) for Borrelia spp. in whole blood samples and is able to detect B. burgdorferi in clinical samples. Copyright © 2017 American Society for Microbiology.

Effects of ultraviolet radiation, visible light, and infrared radiation on erythema and pigmentation: a review.

Science.gov (United States)

Sklar, Lindsay R; Almutawa, Fahad; Lim, Henry W; Hamzavi, Iltefat

2013-01-01

The effects of ultraviolet radiation, visible light, and infrared radiation on cutaneous erythema, immediate pigment darkening, persistent pigment darkening, and delayed tanning are affected by a variety of factors. Some of these factors include the depth of cutaneous penetration of the specific wavelength, the individual skin type, and the absorption spectra of the different chromophores in the skin. UVB is an effective spectrum to induce erythema, which is followed by delayed tanning. UVA induces immediate pigment darkening, persistent pigment darkening, and delayed tanning. At high doses, UVA (primarily UVA2) can also induce erythema in individuals with skin types I-II. Visible light has been shown to induce erythema and a tanning response in dark skin, but not in fair skinned individuals. Infrared radiation produces erythema, which is probably a thermal effect. In this article we reviewed the available literature on the effects of ultraviolet radiation, visible light, and infrared radiation on the skin in regards to erythema and pigmentation. Much remains to be learned on the cutaneous effects of visible light and infrared radiation.

Photoreactivation of UV-induced pyrimidine dimers and erythema in the marsupial Monodelphis domestica

International Nuclear Information System (INIS)

Ley, R.D.

1985-01-01

Post-UV treatment of the gray, short-tailed opossum Monodelphis domestica with photoreactivating light (320-400 nm) suppressed the appearance of UV-induced erythema as evidenced by an increase in the dose of UV required to elicit an erythemal response. Pre-UV exposure to photoreactivating light had no effect on the UV induction of erythema. The dose-response for the photoreversal of pyrimidine dimers in epidermal DNA of M. domestica was similar to that for the photoreactivation of erythema induction. These data not only support the notion that DNA is the primary chromophore involved in the induction of erythema but also identify pyrimidine dimers as the major DNA change responsible for its induction. These results also identify M. domestica as a useful whole-animal system with which to determine the role of pyrimidine dimers in other photobiological responses of mammalian skin

Etoricoxib-induced pretibial erythema and edema

Directory of Open Access Journals (Sweden)

Pramod Kumar

2015-01-01

Full Text Available Cyclooxygenase inhibitors were developed in the quest of enhanced analgesic efficacy devoid of gastric side effects. Etoricoxib is a second-generation cox-2 inhibitor and as its use increases so do the reports of side effects. We report a case of extoricoxib-induced pretibial erythema and edema; and review the literature.

Discoid Lupus Erythematosus Presenting as Upper Eyelid Edema and Erythema

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Abbas Darjani

2017-09-01

Full Text Available Discoid Lupus Erythematosus (DLE is an autoimmune disorder that usually occurs on sun exposed areas of head and neck. Infrequently it could be presented by palpebral involvement and rarely unilateral upper eye lid edema and erythema have been reported as the sole manifestation of DLE. We describe a 38-year-old woman with chronic left upper eye lid edema and erythema from one year ago which was induced by steroid injection for left eyebrow alopecia. Histopathologic and direct immunofluorescent studies were made on palpebral skin tissue and confirmed DLE diagnosis. Antinuclear antibody (ANA titer was 1/160 with speckled pattern. She was treated by oral hydroxychloroquine (400 mg daily with moderate improvement after three months. We should think about DLE in cases with chronic upper eye lid edema and erythema. The aim of this case report is to emphasize that ophthalmologist and dermatologists should be aware of different presentations of DLE in the periorbital area to prevent misdiagnosis.

Larva migrans cutánea en Lima. Reporte de 3 casos.

OpenAIRE

Legua, Pedro; Guerra, Jorge; Bussalleu, Alejandro

2014-01-01

Larva migrans cutánea o “erupción reptante” es una erupción cutánea causada por la migración de la larva de un nemátodo en forma errática en la piel. Ocurre usualmente como resultado de la exposición de la piel a las larvas filariformes infectantes de uncinarias propias de felinos y cánidos, que están presentes en suelos húmedos y arenosos en los que estos animales defecan (playas, jardines, parques, etc.).La larvainfectante no puede completar su ciclo vital en el hospedero humano y entonces ...

Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review.

Science.gov (United States)

Sanchez, Edgar; Vannier, Edouard; Wormser, Gary P; Hu, Linden T

2016-04-26

Lyme disease, human granulocytic anaplasmosis (HGA), and babesiosis are emerging tick-borne infections. To provide an update on diagnosis, treatment, and prevention of tick-borne infections. Search of PubMed and Scopus for articles on diagnosis, treatment, and prevention of tick-borne infections published in English from January 2005 through December 2015. The search yielded 3550 articles for diagnosis and treatment and 752 articles for prevention. Of these articles, 361 were reviewed in depth. Evidence supports the use of US Food and Drug Administration-approved serologic tests, such as an enzyme immunoassay (EIA), followed by Western blot testing, to diagnose extracutaneous manifestations of Lyme disease. Microscopy and polymerase chain reaction assay of blood specimens are used to diagnose active HGA and babesiosis. The efficacy of oral doxycycline, amoxicillin, and cefuroxime axetil for treating Lyme disease has been established in multiple trials. Ceftriaxone is recommended when parenteral antibiotic therapy is recommended. Multiple trials have shown efficacy for a 10-day course of oral doxycycline for treatment of erythema migrans and for a 14-day course for treatment of early neurologic Lyme disease in ambulatory patients. Evidence indicates that a 10-day course of oral doxycycline is effective for HGA and that a 7- to 10-day course of azithromycin plus atovaquone is effective for mild babesiosis. Based on multiple case reports, a 7- to 10-day course of clindamycin plus quinine is often used to treat severe babesiosis. A recent study supports a minimum of 6 weeks of antibiotics for highly immunocompromised patients with babesiosis, with no parasites detected on blood smear for at least the final 2 weeks of treatment. Evidence is evolving regarding the diagnosis, treatment, and prevention of Lyme disease, HGA, and babesiosis. Recent evidence supports treating patients with erythema migrans for no longer than 10 days when doxycycline is used and prescription

[Erythema nodosum during the course of idiopathic granulomatous mastitis].

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Fahmy, J; Halabi-Tawil, M; Bagot, M; Tournant, B; Petit, A

2015-01-01

Idiopathic granulomatous mastitis (IGM) is a benign, aseptic inflammatory disease of unknown origin, which must be distinguished from tumoral and infectious processes that affect the breast, including tuberculosis. IGM is a rare cause of erythema nodosum, but it is useful for dermatologists to be aware of this association. A 32-year-old nulliparous woman presented with erythema nodosum, arthralgia and fever. On examination, she had a firm and painful mass of 5cm in the right breast with retraction and axillary adenopathy. The breast lump developed gradually over the preceding 4 months. Although two biopsies showed no evidence of atypical cells, inflammatory areas and a granulomatous process were seen. Culture of breast tissue for mycobacteria was negative. A diagnostic of idiopathic granulomatous mastitis was made. Systemic corticosteroids led to a reduction in size of the mass, but relapse occurred in the contralateral breast on dose-reduction of the corticosteroids. IGM is a rare disease of unknown aetiology. Diagnosis is based on characteristic histological features and exclusion of other granulomatous diseases. Extra-mammary signs are rare and include erythema nodosum, arthralgia and episcleritis. Management is poorly codified. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Creeping eruption of the hand in an Iranian patient: Cutaneous larva migrans

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Zabihollah Shahmoradi

2014-01-01

Full Text Available Cutaneous larva migrans (CLM, a serpiginous cutaneous eruption is the most commonly acquired tropical dermatosis. It is caused by infection with hookworm larvae in tropical and sub-tropical areas, and people who have a history of travel in these countries. The most frequent location of CLM is the distal lower extremities or buttocks. We describe a case of 57-year-old Iranian female patient with CLM of hand (unusual site without traveling to endemic countries that was successfully treated with oral albendazole. To the best of our knowledge, this is the first report of CLM in Iran.

Clinical Study of Phlebitis Migrans and Incompetence of the Leg’s Superficial Vein in Buerger Disease

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Iwai, Takehisa; Sato; Kume, Hiroko; Inoue, Yoshinori; Umeda, Makoto; Kagayama, Tomoko; Hirokawa, Masayuki

2012-01-01

Three of four (75%) vein biopsy samples from four patients (all male, mean onset: age 33.0, mean biopsy: age 59.7) of chronic phase phlebitis migrans showed positive periodontal bacteria DNA under the PCR (polymerase chain reaction) method. Of the 24 cases of Buerger disease (22 males, 2 females, mean onset: age 31.9, mean examination: age 62.6) that were investigated in our vascular laboratory, 65% of the patients suffered from moderate to severe varicose veins. Eight cases had a history of phlebitis migrans and three had an active ulcer or uncontrollable erosion in the foot. The rate of incidence was significantly higher than that of the well-matched control group. Other findings included one instance of deep vein thrombosis, and one instance of deep vein reflux. We could suggest that some intractable ulcer or erosion cases of Buerger disease may be complicated by superficial vein incompetence or other deep vein insufficiency. We also we need to check Buerger disease patients with duplex for vein reflux and other insufficiencies. Treatment of the varicose veins (including elastic stockings) was effective for all of the patients. (English Translation of Jpn J Phlebology 2011; 22: 25–31.) PMID:23555485

Lymphogranuloma venereum presenting with erythema nodosum.

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Borsje, Annemiek; van der Reijden, Wil; Soetekouw, Robin

2016-12-01

Lymphogranuloma venereum is a sexually transmitted infection caused by Chlamydia trachomatis serovar L1, L2 or L3. Anorectal infections in HIV-positive men who have sex with men comprise the majority of cases in the developed world. We present the case of a 30-year-old HIV-negative man with inguinal type lymphogranuloma venereum accompanied by erythema nodosum. © The Author(s) 2016.

Cytokines, Fatigue, and Cutaneous Erythema in Early Stage Breast Cancer Patients Receiving Adjuvant Radiation Therapy

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Vitaliana De Sanctis

2014-01-01

Full Text Available We investigated the hypothesis that patients developing high-grade erythema of the breast skin during radiation treatment could be more likely to present increased levels of proinflammatory cytokines which may lead, in turn, to associated fatigue. Forty women with early stage breast cancer who received adjuvant radiotherapy were enrolled from 2007 to 2010. Fatigue symptoms, erythema, and cytokine levels (IL-1β, IL-2, IL6, IL-8, TNF-α, and MCP-1 were registered at baseline, during treatment, and after radiotherapy completion. Seven (17.5% patients presented fatigue without associated depression/anxiety. Grade ≥2 erythema was observed in 5 of these 7 patients. IL-1β, IL-2, IL-6, and TNF-α were statistically increased 4 weeks after radiotherapy (P<0.05. After the Heckman two-step analysis, a statistically significant influence of skin erythema on proinflammatory markers increase (P = 0.00001 was recorded; in the second step, these blood markers showed a significant impact on fatigue (P = 0.026. A seeming increase of fatigue, erythema, and proinflammatory markers was observed between the fourth and the fifth week of treatment followed by a decrease after RT. There were no significant effects of hormone therapy, breast volume, and anemia on fatigue. Our study seems to suggest that fatigue is related to high-grade breast skin erythema during radiotherapy through the increase of cytokines levels.

The management of oral erythema multiforme in juvenile patient

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Diah Savitri Ernawati

2007-12-01

Full Text Available Erythema multiforme is an acute inflammatory disease of the skin and mucous membranes that causes a variety of the skin lesionhence the name ‘multiforme’.The oral mucosa looks severely inflamed, but the feature are non specific and usually a biopsy is required in order to confirm the diagnosis. Cracked, bleeding, Crusted, swollen and ulcers of the lips is very characteristic of erythema multiforme, and lip involvement may cause significant morbidity. EM is assumed as an immune complex disorder which rises as a result of an immune response to an external agent such as herpes simplex virus or various drugs. We reported: 14-year girl, complained she suffered from painful oral ulceration for one week. One weeks advance the patient received a treatment of paracetamol and paramex for febris, headache and cough. Clinical examination of the skin showed no signs of cutaneous involvement. Other site such as the conjunctival, and genital were also free of lesions. The patients had several red-based superficial erosions on the upper and lower lips accompanied by crusting and bleeding. Intra oral findings showed multiple irregular erosions, ulcers and intense erythematous areas, mainly on the labial mucosa. The clinical diagnosis of EM was concluded by anamnesis and clinical appearance, with differential diagnosis of secondary herpes infection (herpes labialis and pemphigus vulgaris. Systemic and topical corticosteroid therapy is frequently used to treat EM Although it may partially suppress the disease. Objective: This report explains and describes the management of patients with EM which may help dentists to determine an accurate diagnosis to avoid further complication and to give medical intervention to the disease. Conclusion: Early recognition of this disease may prevent delayed diagnosis and incorrect treatment.

Measurement of erythema and tanning responses in human skin using a tri-stimulus colorimeter.

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Seitz, J C; Whitmore, C G

1988-01-01

A 'Minolta Tri-Stimulus Colorimeter II' was evaluated for obtaining objective measurements of early changes in erythema and tanning. The meter showed a subtle, continuous transition between the primary erythematous response and the delayed tanning of skin which was below the visual threshold for detection. Thereafter, the a* (redness) value of the meter showed a significant linear correlation with the dermatologist's perception of erythema while the b* (yellow) value showed a significant correlation with the perception of tanning. This capability of the tri-stimulus colorimeter to simultaneously evaluate the hue and saturation of skin color affords an improved opportunity to quantitate the transition from erythema to tanning without subjective bias.

Development and clinical validation of a novel photography-based skin erythema evaluation system: a comparison with the calculated consensus of dermatologists.

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Cho, M; Lee, D-H; Doh, E J; Kim, Y; Chung, J H; Kim, H C; Kim, S

2017-08-01

Erythema is the most common presenting sign in patients with skin diseases, and various methods to treat erythema symptoms have become common. To evaluate changes in erythema, a reliable device that can support objective diagnosis is required. We developed a novel photography-based system for erythema diagnosis that provides a high-resolution three-view photograph taken in a consistent photography environment with a curved surface light source and can be integrated with optimized image processing algorithms. A new diagnostic algorithm was applied to photographs from 32 patients to determine areas of erythema automatically. To assess the performance in comparison to dermatologists' evaluations, five dermatologists independently evaluate the areas of erythema, and we defined an area called the clinical consensus area of erythema (CCAE), which is based on the majority opinion of dermatologists during evaluation. The CCAE values obtained were compared with the erythema areas determined by the system's diagnostic algorithm. Forty-one photographs with areas of erythema were evaluated by the proposed system and by dermatologists. The results obtained with the proposed system had a mean accuracy of 93.18% with a standard deviation of 3.52% when compared with the CCAE results. The results also showed that the proposed system could detect erythema areas without any pigmentation. In contrast to assessments by individual dermatologists, use of the CCAE reduced the amount of error that occurred owing to bias or subjectivity. A new erythema evaluation system was developed and validated through CCAE, suggesting that the system can support dermatologists' objective diagnoses of erythema. © 2017 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Seronegative necrolytic acral erythema: A distinct clinical subset?

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Panda S

2010-01-01

Full Text Available A patient was referred to us with asymptomatic, erythematous, nonitchy, scaly lesions present bilaterally on the dorsa of his feet and toes since the last 2 months. Both the legs had pitting edema as well. There were hyperkeratosis, focal parakeratosis, acanthosis and scattered spongiosis in the epidermis, and proliferation of capillaries with perivascular infiltration of lymphomononuclear cells in the dermis. There was no serological evidence of hepatitis C virus. Laboratory investigations revealed hypoalbuminemia and low-normal serum zinc. On clinicopathological correlation, we made a diagnosis of necrolytic acral erythema (NAE. The lesions responded dramatically to oral zinc sulfate and topical clobetasol propionate within 3 weeks with disappearance of edema and scaling and only a minimal residual erythema. This is the first reported case of NAE from Eastern India. NAE with negative serology for hepatitis C may be viewed as a distinct subset of the condition that had been originally described.

Erythema gyratum repense like eruption in bullous pemphigoid: A case report

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Hojat Eftekhari

2016-07-01

Full Text Available Bullous pemphigoid (BP is an autoimmune disease characterized by presence of bullous eruption on the trunk and extremities especially flexural aspects of the limbs. This disease usually occurs in the elderly. The initial presentation of BP is variable. An urticarial or erythematous rash may precede the appearance of the blister formation and can be associated with itch or pruritus. We presented 87 year old bedridden man diagnosed with BP who initially presented with erythema gyratum repens like eruption before blister formation. This case report discusses the presentation of figurate erythema in non-bullous phase of BP for clinicians.

Erythema elevatum diutinum in association with dermatitis herpetiformis

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Shanmuga Sekar Chandrasekaran

2014-01-01

Full Text Available Erythema elevatum diutinum (EED is a rare skin disease that initially presents as leucocytoclastic vasculitis and later resolves with fibrosis. Dermatitis herpetiformis is an autoimmune blistering disease characterized by granular deposits of immunoglobulin A (IgA in dermal papillae. We report a rare association of these two disorders.

Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin

International Nuclear Information System (INIS)

Delattre, J.Y.; Safai, B.; Posner, J.B.

1988-01-01

In 15 months we encountered eight patients with intracranial tumors who developed erythema multiforme (EM) or erythema multiforme bullosa (Stevens-Johnson syndrome). All occurred shortly after use of phenytoin (DPH) and brain radiation therapy (WBRT). The clinical picture differed from the classic form of EM in that the erythema began on the scalp and spread to the extremities, progressing in three cases to extensive bullous formation. There were no cases of EM among patients who received either DPH or radiotherapy alone. The combination of DPH, WBRT, and tapering of steroids seems to predispose to EM. The pathogenesis of the disorder is probably immunologic. In the absence of seizures, anticonvulsants should not be given routinely to patients with brain tumors. When anticonvulsants are necessary in patients scheduled for WBRT, DPH may not be the drug of choice

Erythema Dyschromicum Perstans: A Case Report

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Engin, Ragip Ismail; Pala, Erdal; Sivrikoz, Oya Nermin

2016-01-01

Erythema dyschromicum perstans (EDP) is an acquired dermatosis characterized by ash gray (ashy dermatosis) or blue macules. It can appear at any ageö but is more common in young adults. Lesions may occur on the neck, chest arms and face, but most frequently on the back. It does not generally lead to subjective complaints, but may rarely cause itching. Diagnosis is made with clinical findings and can be corroborated by histopathological examination. This report describes the case of a 15-year-...

Leprosy type 1 reactions and erythema nodosum leprosum

OpenAIRE

Kahawita,Indira P.; Walker,Stephen L.; Lockwood,Diana N.J.

2008-01-01

Leprosy reactions are a major cause of nerve damage and morbidity in a significant proportion of leprosy patients. Reactions are immunologically mediated and can occur even after successful completion of multi-drug therapy. This review focuses on the epidemiology, pathology and treatment of leprosy type 1 reactions, erythema nodosum leprosum and silent neuropathy.

Lyme borreliosis.

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Steere, Allen C; Strle, Franc; Wormser, Gary P; Hu, Linden T; Branda, John A; Hovius, Joppe W R; Li, Xin; Mead, Paul S

2016-12-15

Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

A clinical approach to Lyme disease.

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Nadelman, R B; Wormser, G P

1990-05-01

Lyme disease (also known as Lyme borreliosis) is an emerging, newly described infectious disease with diverse clinical manifestations. The disease is caused by the spirochetal agent Borrelia burgdorferi, which is transmitted to humans by the bite of certain species of Ixodes ticks harboring the organism. The most readily identifiable clinical feature is the distinctive skin lesion, erythema migrans. If recently infected patients go untreated, approximately 15% will develop neurologic conditions (most commonly facial nerve palsy), 8% will develop myocarditis (typically with heart block), and 60% will develop migratory mono- or pauci-articular arthritis. Diagnosis depends on clinical suspicion, recognition of the characteristic signs and symptoms, and appropriate testing for antibody to B. burgdorferi. Serology for Lyme disease, although in need of better standardization, is most useful in diagnosing patients with manifestations of Lyme disease other than erythema migrans. All manifestations of Lyme disease are potentially treatable with either a beta-lactam antibiotic (for instance penicillin, amoxicillin, or ceftriaxone) or a tetracycline preparation. However, the optimal antimicrobial regimen, including choice of drug, drug dose, route of administration, and length of therapy, is unknown. Other important areas for future research include Ixodes biology and control, improved laboratory tests for diagnosis and for assessing response to therapy, and vaccine development.

Erythema multiforme and Stevens-Johnson syndrome following radiotherapy

International Nuclear Information System (INIS)

Yoshitake, Tadamasa; Nakamura, Katsumasa; Shioyama, Yoshiyuki

2007-01-01

Erythema multiforme (EM) and Stevens-Johnson syndrome (SJS) are thought to be hypersensitivity syndromes with various causes, and radiotherapy might be one of the causes of these syndromes. We herein report two cases of EM/SJS following radiotherapy. The first case was a 63-year-old woman with breast cancer. At the end of postoperative radiotherapy with 60 Gy, severe pruritic erythema appeared in the irradiated area and spread over the whole body. She was diagnosed with EM by a skin biopsy. The second case was a 77-year-old woman with uterine cervical cancer who underwent postoperative radiotherapy. At a dose of 30.6 Gy, pruritic redness appeared in the irradiated area and the precordial region, and it became widespread rapidly with polymorphic transformation. Although without any histological confirmation, SJS was strongly suspected because of her pruritic conjunctivitis. Because both patients were given medicines during irradiation, radiotherapy may not be the only cause of EM/SJS. However, it should be noted that radiotherapy might trigger EM/SJS. (author)

Angioplastic necrolytic migratory erythema. Unique association of necrolytic migratory erythema, extensive angioplasia, and high molecular weight glucagon-like polypeptide

International Nuclear Information System (INIS)

Franchimont, C.; Pierard, G.E.; Luyckx, A.S.; Gerard, J.; Lapiere, C.M.

1982-01-01

A diabetic patient developed necrolytic migratory erythema with extensive angioplasia and high molecular weight glucagon-like polypeptide. There was no associated neoplasm such as glucagonoma. Lesions in the skin were studied by standard optical microscopy and by radioautography after incorporation of tritiated thymidine. Alterations in the skin begin as focal necrosis in the epidermis and in epithelial structures of adnexa, followed by marked angioplasia and a superficial and deep perivascular dermatitis

Erythema multiforme like allergic contact dermatitis associated with laurel oil: a rare presentation.

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Uzuncakmak, Tugba Kevser; Karadag, Ayse Serap; Izol, Belcin; Akdeniz, Necmettin; Cobanoglu, Bengu; Taskin, Secil

2015-04-16

Allergic contact dermatitis is a common skin disease, which affects approximately 20% of the population. This reaction may present with several clinical manifestations. Erythema multiforme-like allergic contact dermatitis is a rare type of non-eczematous contact dermatitis, which may lead to difficulty in diagnosis.Essential oil of Laurus nobilis is widely used in massage therapy for antiinflammatory and analgesic effects. Laurus nobilis induced contact dermatitis has been reported in the literature but an erythema multiforme-like presentation is rare.

Erythema induratum of Bazin associated with Addison's disease: first description

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Rodrigo Antonio Brandão Neto

Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.

Objective assessment in digital images of skin erythema caused by radiotherapy

International Nuclear Information System (INIS)

Matsubara, H.; Matsufuji, N.; Tsuji, H.; Yamamoto, N.; Karasawa, K.; Nakajima, M.; Karube, M.; Takahashi, W.

2015-01-01

Purpose: Skin toxicity caused by radiotherapy has been visually classified into discrete grades. The present study proposes an objective and continuous assessment method of skin erythema in digital images taken under arbitrary lighting conditions, which is the case for most clinical environments. The purpose of this paper is to show the feasibility of the proposed method. Methods: Clinical data were gathered from six patients who received carbon beam therapy for lung cancer. Skin condition was recorded using an ordinary compact digital camera under unfixed lighting conditions; a laser Doppler flowmeter was used to measure blood flow in the skin. The photos and measurements were taken at 3 h, 30, and 90 days after irradiation. Images were decomposed into hemoglobin and melanin colors using independent component analysis. Pixel values in hemoglobin color images were compared with skin dose and skin blood flow. The uncertainty of the practical photographic method was also studied in nonclinical experiments. Results: The clinical data showed good linearity between skin dose, skin blood flow, and pixel value in the hemoglobin color images; their correlation coefficients were larger than 0.7. It was deduced from the nonclinical that the uncertainty due to the proposed method with photography was 15%; such an uncertainty was not critical for assessment of skin erythema in practical use. Conclusions: Feasibility of the proposed method for assessment of skin erythema using digital images was demonstrated. The numerical relationship obtained helped to predict skin erythema by artificial processing of skin images. Although the proposed method using photographs taken under unfixed lighting conditions increased the uncertainty of skin information in the images, it was shown to be powerful for the assessment of skin conditions because of its flexibility and adaptability

Objective assessment in digital images of skin erythema caused by radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Matsubara, H., E-mail: matubara@nirs.go.jp; Matsufuji, N.; Tsuji, H.; Yamamoto, N.; Karasawa, K.; Nakajima, M.; Karube, M. [National Institute of Radiological Sciences (NIRS), Chiba 263-8555 (Japan); Takahashi, W. [Department of Radiology, University of Tokyo Hospital, Tokyo 113-8655 (Japan)

2015-09-15

Purpose: Skin toxicity caused by radiotherapy has been visually classified into discrete grades. The present study proposes an objective and continuous assessment method of skin erythema in digital images taken under arbitrary lighting conditions, which is the case for most clinical environments. The purpose of this paper is to show the feasibility of the proposed method. Methods: Clinical data were gathered from six patients who received carbon beam therapy for lung cancer. Skin condition was recorded using an ordinary compact digital camera under unfixed lighting conditions; a laser Doppler flowmeter was used to measure blood flow in the skin. The photos and measurements were taken at 3 h, 30, and 90 days after irradiation. Images were decomposed into hemoglobin and melanin colors using independent component analysis. Pixel values in hemoglobin color images were compared with skin dose and skin blood flow. The uncertainty of the practical photographic method was also studied in nonclinical experiments. Results: The clinical data showed good linearity between skin dose, skin blood flow, and pixel value in the hemoglobin color images; their correlation coefficients were larger than 0.7. It was deduced from the nonclinical that the uncertainty due to the proposed method with photography was 15%; such an uncertainty was not critical for assessment of skin erythema in practical use. Conclusions: Feasibility of the proposed method for assessment of skin erythema using digital images was demonstrated. The numerical relationship obtained helped to predict skin erythema by artificial processing of skin images. Although the proposed method using photographs taken under unfixed lighting conditions increased the uncertainty of skin information in the images, it was shown to be powerful for the assessment of skin conditions because of its flexibility and adaptability.

Effects of emollients on ultraviolet-radiation-induced erythema of the skin

International Nuclear Information System (INIS)

Schleider, N.R.; Moskowitz, R.S.; Cort, D.H.; Horwitz, S.N.; Frost, P.

1979-01-01

Several commonly used emollients were studied as to their effectiveness in absorbing and filtering erythema-causing ultraviolet radiation in the 280 to 315 nm range (UVB). Planter's Peanut Oil (Standard Brands) and Mazola Corn Oil (Best Foods Inc.) had no effect; Alpha Keri Bath Oil (Westwood Pharmaceuticals), mineral oil, and Johnson's Baby Oil (Johnson and Johnson Co) had minimal effects. Vaseline Petroleum Jelly (Chesebrough-Ponds Inc.), petrolatum, and hydrophilic ointment substantially reduced the erythema that was induced by exposure to low doses of UVB radiation. Therefore, these emollients may interfere with the therapeutic effects of the ultraviolet radiation component of the Goeckerman treatment when it is administered in low doses to patients with psoriasis

ERYTHEMA ELEVATUM DIUTINUM AS MOST PROBABLE DIAGNOSIS: A CASE REPORT

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Erick Francisco Sanchez Jimenez

2013-07-01

Full Text Available Cutaneous vasculitis can be cause by multiple disorders or can be idiopathic. Many diseases can present with similar findings, therefore histopathologic examination is always require for confirming the right diagnosis. The erythema elevatum diutinum (EED is a localized vasculitis, classified as a neutrophilic dermatosis. It’s a rare cutaneous condition, distribute on the extensor surface of the extremities, more frequently in the dorsum of the hands, knees and elbows. They have a symmetric distribution and can be asymptomatic, painful; or pruritic, sometimes accompanied paresthesias. The most common clinical presentation is round erythematous papules which become erythemato-violaceous or purpuric plaques. There are not pathognomonic histopathological findings, but can present as a leukocytoclastic vasculitis with perivascular neutrophilic infiltration in the middle and superficial dermis. I presented the case of a 61-year-old female, with erythematous purpuric painful plaques, irregular, symmetric and elevated, located in both thenar regions of her hands and paresthesias. The patient’s presentation is consistent with multiple characteristics of EED such as the description of the lesions, the anatomical location, the symmetric distribution and the histopathological findings of an initial disease. This patient does not have all the clinical progression and outcome, due to the initial stage of the disease.

The elusive gene for keratolytic winter erythema | Hull | South ...

African Journals Online (AJOL)

Keratolytic winter erythema (KWE), also known as Oudtshoorn skin disease, is characterised by a cyclical disruption of normal epidermal keratinisation affecting primarily the palmoplantar skin with peeling of the palms and soles, which is worse in the winter. It is a rare monogenic, autosomal dominant condition of unknown ...

Long term variations in erythema effective solar UV at Chilton, UK, from 1991 to 2015.

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Hooke, R J; Higlett, M P; Hunter, N; O'Hagan, J B

2017-11-08

In this paper erythema effective UV radiant exposure data from the PHE solar network Chilton site for the 25 year period from 1991 to 2015 are presented. The year with the highest average daily erythema effective radiant exposure was 2003 at 1577 J m -2 and the year with the lowest average daily radiant exposure was 2010 at 1149 J m -2 . Overall, the average daily radiant exposure per year ranged from 5655 J m -2 to 9.98 J m -2 with the average being 1306 J m -2 . A preliminary analysis of the data set is carried out. A statistically significant (p = 0.01) increase in annual radiant exposure of 4.4% per year was observed from 1991-1995. Thereafter a small decrease in annual erythema effective radiant exposure of 0.8% (p = 0.002) per year was observed from 1995-2015 with a slightly faster rate of decrease from 2000-2015 of 1.0% (p = 0.007) per year. In terms of seasonal analyses, a statistically significant increase in erythema effective UV radiant exposure of 5.1% (p = 0.02) per year in the summer during 1991-1995 has been found along with small decreases in spring and summer during 1995-2015 (-1.0%; p = 0.01 and -0.7%; p = 0.01 respectively) and 2000-2015 (-1.1%; p = 0.03 and -1.2%; p = 0.003 respectively). The data suggest that the erythema effective UV dose available for impacting public health has been decreasing in recent years.

In silico evaluation of PCR - primers for detection of Lyme Borrelia

OpenAIRE

Sultan, Nasir

2016-01-01

Lyme borreliosis (LB) or Lyme disease is the most prevalent vector-borne disease in US and Europe. The etiologic is some species of tick-borne spirochetes Borrelia burgdorferi sensu lato (B. burgdorferi sl) complex. The most common clinical symptoms of LB is the erythema migrans (EM). The pathogen is transmitted to humans through the tick bite of Ixodes species, and spread to cause more severe manifestations such as Acrodermatitis Chronica Atrophicans (ACA), Lyme arthritis, and neuroborrelios...

Topical microemulsion containing Punica granatum extract: its control over skin erythema and melanin in healthy Asian subjects.

Science.gov (United States)

Parveen, Rashida; Akhtar, Naveed; Mahmood, Tariq

2014-12-01

Punica granatum is apotent source of polyphenolic compounds with strong free radicals scavenging activity. The skin lightening effects of Punica granatum are assumed due to ellagic acid which acts by chelating copper at the active site of tyrosinase. To explore a topical microemulsion (O/W) of pomegranate (Punica granatum) extract for its control on skin erythema and melanin. Microemulsions were formulated using a polysorbate surfactant (Tween 80(®)) along with cosurfactant (propylene glycol) and were characterized regarding their stability. The placebo microemulsion (without extract) and the active microemulsion (containing Punica extract) were applied in a split face fashion by the volunteers (n = 11) for a period of 12 weeks. Skin erythema and melanin were measured at baseline and after every 15 days to determine any effect produced by these formulations. Active formulation showed a significant impact on skin erythema and melanin (p Punica granatum extract for conditions where elevated skin melanin and erythema have significantly prone skin physiology.

Exposure to larva migrans syndromes in squares and public parks of cities in Chile

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Mercado Rubén

2004-01-01

Full Text Available Between November 2001 and December 2002, 600 dog fecal samples were collected in main squares and public parks of 13 cities in Chile, from the extreme north to the extreme south of the country. The samples were processed in the laboratory by centrifugal sedimentation and the Harada-Mori methods. T. canis eggs were found in 12 cities. Detection rates ranged from 1.9 to 12.5% with an average of 5.2%. Seven percent of the samples had eggs and 9.5% had rhabditoid and/or filariform larvae of Ancylostomatidae. Strongyloides stercoralis were not found. Squares and public parks in Chile pose a potential risk of exposure to visceral, ocular, and/or cutaneous larva migrans syndromes.

Skin Erythema, Pigmentation and Hydration Kinetics after Ultraviolet Radiation-induced Photodamage in Southern Chinese Women.

Science.gov (United States)

Wan, Miaojian; Hu, Rong; Xie, Xiaoyuan; Gong, Zijian; Yi, Jinling; Chen, Haiyan; Xie, Lin; Guan, Xiaomin; Guan, Lei; Lai, Wei

2017-10-01

Although there have been some studies about changes of skin erythema and pigmentation following ultraviolet radiation in other races, the relevant data in Chinese have never been achieved. Thus, we evaluated the long-time course of skin erythema, pigmentation and hydration changes after different doses of solar-simulated ultraviolet (SSUV) irradiation in 26 Chinese women for 168 days. The erythema index increased abruptly and peaked during 3 days of SSUV exposure, then slowly returned to the baseline level starting at day 7 and completely recovered during 168-day course of this study only in one minimal erythema doses (MED) SSUV irradiation. The melanin index started to slowly increase at day 3 of SSUV exposure, peaking at day 14 and gradually returned to the baseline level thereafter, but did not return to the baseline level during 168-day course in all doses. Skin hydration slowly declined at day 3 of exposure, hitting the lowest point at day 7, then slowly recovered starting at day 14 and completely returned to the baseline level at day 28 only in 1.5MED. These results will serve as baseline data on Chinese skin and provide useful references for the treatment of serious skin photodamage in Chinese. © 2017 The American Society of Photobiology.

Impact of the anthelminthic treatment of dogs in environmental contamination of sidewalks by Larva Migrans agents

OpenAIRE

Ramires, Lívia Magosso

2014-01-01

As geohelmintoses são importantes doenças que acometem seres humanos. Além de serem ocasionadas por parasitos que têm o homem como hospedeiro definitivo, cães e gatos podem ser responsáveis pela contaminação ambiental por agentes com potencial zoonótico. Entres esses agentes, destacam-se Toxocara spp. e Ancylostoma spp., que podem ocasionar as síndromes de Larva migrans visceral/ocular e cutânea, respectivamente. O número crescente de pessoas que criam cães e gatos sem controle parasitário e ...

Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

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Maxwell Eyram Afari

2016-01-01

Full Text Available Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis

DEFF Research Database (Denmark)

Dessau, Ram B; van Dam, Alje P; Fingerle, Volker

2018-01-01

rational use of laboratory testing in patients with clinically suspected Lyme borreliosis. SOURCES: This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national...... and international guidelines and supplemented with specific citations. IMPLICATIONS: The main recommendations according to current European case definitions for Lyme borreliosis are as follows: Typical erythema migrans should be diagnosed clinically and does not require laboratory testing, the diagnosis of Lyme...

Aceclofenac-induced erythema annulare centrifugum

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Dilip Meena

2018-01-01

Full Text Available Erythema annulare centrifugum (EAC is characterised by slowly enlarging annular erythematous lesions and is thought to represent a clinical reaction pattern to infections, medications, and rarely, underlying malignancy. Causative drugs include chloroquine, cimetidine, gold sodium thiomalate, amitriptyline, finasteride, etizolam etc. We present a case of 40-year-old woman who presented to us with a 10 days history of nonpruritic, peripherally growing annular erythematous eruption. She had a history of recent onset of joint pain, for which she was taking aceclofenac 90 mg once a day for 5 days prior to the onset of the rash. This was confirmed on biopsy as EAC. The rash promptly subsided after stopping the drug. We report this case as there was no previous report of aceclofenac induced EAC.

Underprediction of human skin erythema at low doses per fraction by the linear quadratic model

International Nuclear Information System (INIS)

Hamilton, Christopher S.; Denham, James W.; O'Brien, Maree; Ostwald, Patricia; Kron, Tomas; Wright, Suzanne; Doerr, Wolfgang

1996-01-01

Background and purpose. The erythematous response of human skin to radiotherapy has proven useful for testing the predictions of the linear quadratic (LQ) model in terms of fractionation sensitivity and repair half time. No formal investigation of the response of human skin to doses less than 2 Gy per fraction has occurred. This study aims to test the validity of the LQ model for human skin at doses ranging from 0.4 to 5.2 Gy per fraction. Materials and methods. Complete erythema reaction profiles were obtained using reflectance spectrophotometry in two patient populations: 65 patients treated palliatively with 5, 10, 12 and 20 daily treatment fractions (varying thicknesses of bolus, various body sites) and 52 patients undergoing prostatic irradiation for localised carcinoma of the prostate (no bolus, 30-32 fractions). Results and conclusions. Gender, age, site and prior sun exposure influence pre- and post-treatment erythema values independently of dose administered. Out-of-field effects were also noted. The linear quadratic model significantly underpredicted peak erythema values at doses less than 1.5 Gy per fraction. This suggests that either the conventional linear quadratic model does not apply for low doses per fraction in human skin or that erythema is not exclusively initiated by radiation damage to the basal layer. The data are potentially explained by an induced repair model

Duplicated Enhancer Region Increases Expression of CTSB and Segregates with Keratolytic Winter Erythema in South African and Norwegian Families

NARCIS (Netherlands)

Ngcungcu, T.; Oti, M.O.; Sitek, J.C.; Haukanes, B.I.; Linghu, B.; Bruccoleri, R.; Stokowy, T.; Oakeley, E.J.; Yang, F; Zhu, J.; Sultan, M.; Schalkwijk, J.; Vlijmen-Willems, I.M.J.J. van; Lippe, C.; Brunner, H.G.; Ersland, K.M.; Grayson, W.; Buechmann-Moller, S.; Sundnes, O.; Nirmala, N.; Morgan, T.M.; Bokhoven, H. van; Steen, V.M.; Hull, P.R.; Szustakowski, J.; Staedtler, F.; Zhou, H.; Fiskerstrand, T.; Ramsay, M.

2017-01-01

Keratolytic winter erythema (KWE) is a rare autosomal-dominant skin disorder characterized by recurrent episodes of palmoplantar erythema and epidermal peeling. KWE was previously mapped to 8p23.1-p22 (KWE critical region) in South African families. Using targeted resequencing of the KWE critical

Towards understanding the pathology of erythema nodosum leprosum.

Science.gov (United States)

Kahawita, I P; Lockwood, D N J

2008-04-01

Erythema nodosum leprosum (ENL) is an immune-mediated complication of leprosy presenting with inflammatory skin nodules and involvement of multiple organ systems, often running a protracted course. Immune complex production and deposition as well as complement activation have long been regarded as the principal aetiology of ENL. However, new data show that cell-mediated immunity is also important. We have performed a critical analysis of studies on the pathology of ENL. Our main findings are as follows. ENL is characterised by an inflammatory infiltrate of neutrophils with vasculitis and/or panniculitis. There is deposition of immune complexes and complement together with Mycobacterium leprae antigens in the skin. Changes in serum levels of Igs indicate a transient, localised immune response. The major T-cell subtype in ENL is the CD4 cell, in contrast to lepromatous leprosy where CD8 cells predominate. The cytokines TNFalpha and IL-6 are consistently found whilst IL-4 is low or absent in ENL lesions, indicating a T(H)1 type response. Keratinocyte 1a and intercellular adhesion molecule-1 (ICAM-1) have been shown to be present in the epidermis in ENL, which is evidence of a cell-mediated immune response. Co-stimulatory molecules such as B7-1 have also been studied but further work is needed to draw strong conclusions. We also highlight potential areas for future research.

Lyme disease with facial nerve palsy: rapid diagnosis using a nested polymerase chain reaction-restriction fragment length polymorphism analysis.

Science.gov (United States)

Hashimoto, Y; Takahashi, H; Kishiyama, K; Sato, Y; Nakao, M; Miyamoto, K; Iizuka, H

1998-02-01

A 64-year-old woman with Lyme disease and manifesting facial nerve palsy had been bitten by a tick on the left frontal scalp 4 weeks previously. Erythema migrans appeared on the left forehead, accompanied by left facial paralysis. Nested polymerase chain reaction-restriction fragment length polymorphism analysis (nested PCR-RFLP) was performed on DNA extracted from a skin biopsy of the erythema on the left forehead. Borrelia flagellin gene DNA was detected and its RFLP pattern indicated that the organism was B. garinii, Five weeks later, B. garinii was isolated by conventional culture from the erythematous skin lesion, but not from the cerebrospinal fluid. After treatment with ceftriaxone intravenously for 10 days and oral administration of minocycline for 7 days, both the erythema and facial nerve palsy improved significantly. Nested PCR and culture taken after the lesion subsided, using skin samples obtained from a site adjacent to the original biopsy, were both negative. We suggest that nested PCR-RFLP analysis might be useful for the rapid diagnosis of Lyme disease and for evaluating therapy.

Time of erythema onset after application of methyl nicotinate ointments as response parameter: influence of penetration kinetics and enhancing agents.

Science.gov (United States)

Remane, Y; Leopold, C S

2006-01-01

The time of erythema onset may be used as a response parameter for quantification of the cutaneous erythema response induced by methyl nicotinate. The vehicles light mineral oil (LMO; test) and medium chain triglycerides (MCT; standard) were compared with regard to the pharmacodynamic response. Moreover, the influence of penetration enhancers on the time of erythema onset was investigated under zero order penetration kinetics. The enhancers dimethyl sulfoxide, diethylene glycol monoethyl ether and three different glycerides in different concentrations were added to MCT as a standard vehicle. All preparations were applied to the forearms of volunteers under infinite dose conditions at different thermodynamic drug activity levels (0.2-3.2% of the saturation level) and different drug concentrations (0.051-0.816%), respectively. Different penetration kinetics do not influence data of erythema onset, as these data are comparable to those obtained under finite dose conditions (first order penetration kinetics). With regard to the penetration enhancers, a significantly enhanced penetration of methyl nicotinate could be observed only for diethylene glycol monoethyl ether and dimethyl sulfoxide. However, no significant difference between light mineral oil and MCT could be found with regard to penetration enhancement. The time of erythema onset is an easy and efficient parameter for quantification of the pharmacodynamic response caused by nicotinates.

Erythema nodosum and the risk of tuberculosis in a high incidence setting

DEFF Research Database (Denmark)

Bjorn-Mortensen, Karen; Ladefoged, Karin; Simonsen, Jacob

2016-01-01

OBJECTIVE: This study estimates the erythema nodosum (EN) incidence in a tuberculosis (TB) endemic setting and evaluates the likelihood of a subsequent TB diagnosis among individuals with Mycobacterium tuberculosis infection (MTI) with or without EN. DESIGN: We estimated EN incidence rates (IRs...

A placebo controlled clinical trial investigating the efficacy of a homeopathic after-bite gel in reducing mosquito bite induced erythema.

Science.gov (United States)

Hill, N; Stam, C; Tuinder, S; van Haselen, R A

1995-01-01

A randomised, placebo controlled clinical trial was conducted to examine the efficacy of a homeopathic after-bite gel in the symptomatic relief of mosquito bites. Sixty eight healthy volunteers were bitten under laboratory conditions by Aedes aegypti mosquitoes at three spots, on the ventral aspect of the forearm. One bite was treated with the homeopathic after-bite gel, another bite with a placebo gel which was identical in appearance and smell to the homeopathic after-bite gel, and the third bite remained untreated. Immediately after the bites and 1, 3, 6, 26 and 31 hours post-bite, the length and width of the erythema were measured with a calliper, and photographs were taken of the bite sites from which the size of the erythema was subsequently determined. This was followed by assessment of the extent of itching with a verbal analogue scale, and finally treatment took place. For each spot the total erythema was calculated as the area under the plotted curve of the erythema at different time points (mm2*h) and the total sum of the itch scores was determined. For the bites treated with the homeopathic after-bite gel the median total erythema was 10.500 mm2*h. For the spots treated with the placebo gel and the untreated spots the median total erythema was 12.900 mm2*h and 13.300 mm2*h, respectively. The difference between the spots treated with the homeopathic after-bite gel and the untreated spots came close to significance (two-tailed P = 0.06), which was not the case for the difference between the spots treated with the homeopathic after-bite gel and the spots treated with placebo gel (P = 0.13). After pooling the data of a very similar previous pilot study and the present study (ntotal = 83), the homeopathic after-bite gel was significantly superior to no treatment (two-tailed P = 0.003) as well as to placebo gel (two-tailed P = 0.03). Comparing itching after the three treatments, no significant differences could be demonstrated. The extent of itching was

Chlamydia pneumoniae infection-associated erythema multiforme

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Shinsaku Imashuku

2013-06-01

Full Text Available There is a well-known correlation between Herpes simplex (HSV infection and erythema multiforme (EM. More recently, in Japan, it was found that Chlamydia pneumoniae (Cp may promote the development of EM. All cases of Cp infection-associated EM that had been diagnosed in our clinic over the past two years (from 2011 to 2012 were analyzed. Cp infection was diagnosed on the basis of a significant increase (>2.00 in anti-Cp IgM titers, as measured by the HITAZYME-ELISA test. There were 7 cases of Cp-EM, one male and 6 females. Median age was 13 years (range 3-29 years. It is recommended that the possible involvement of Cp infection, besides HSV or Mycoplasma pneumoniae infections, should be considered in all cases of EM.

100-μsec pulsed CO2 laser resurfacing of lower eyelids: erythema and rhytides reduction

Science.gov (United States)

Bell, Thomas; Harris, David M.; Schachter, Daniel; Burkart, John

1997-05-01

Lower eyelid skin is very thin with a low density of adnexal structures. Attempts to remove rhytides and improve surface appearance with chemical peels and dermabrasion have been disappointing. Laser resurfacing offers a new modality that may improve the outcome. We evaluated a very short duration (100 microsecond(s) ec) pulsed carbon-dioxide laser (Tru-PulseTM) in terms of healing time (duration of erythema) and efficacy (wrinkle reduction). Female patients aged 35 - 75 received laser resurfacing in a variety of cosmetic zones but only data from lower lids are reported here. Dosimetry varied from total fluences of 5 to 20 J/cm2 (9 mm2 spot, 250 - 500 mJ pulse, 1 to 4 passes). Patients followed a strict regime of post-op wound care. Pre-treatment and follow-up photographs were taken in a studio with constant photographic parameters. Projected 35 mm slides were evaluated side-by-side for clinical improvement and presence of erythema. Within the first 4 days post-op all (100%) lower eyelids exhibited erythema and swelling, at 7 days: 71%, 12 days: 60%, 3 weeks: 25%, and one (1) month or longer 7%. In our sample the longest duration of post-op lower lid erythema lasted 5 weeks. Most patients experienced 70 -80% wrinkle reduction with a range of 0 - 100%. Regression analysis was used to evaluate the relationships between percent wrinkle reduction and the treatment, demographic, and evaluation variables. There was a significant trend for wrinkles to improve over the 3 to 9 month evaluation period. Older patients improved slightly more than younger patients. There was no relationship between total energy density and wrinkle reduction.

ENLIST 1: An International Multi-centre Cross-sectional Study of the Clinical Features of Erythema Nodosum Leprosum.

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Stephen L Walker

Full Text Available Erythema nodosum leprosum (ENL is a severe multisystem immune mediated complication of borderline lepromatous leprosy and lepromatous leprosy. ENL is associated with skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects. ENL and its treatment is associated with increased mortality and economic hardship. Improved, evidence-based treatments for ENL are needed; however, defining the severity of ENL and outcome measures for treatment studies is difficult because of the multiple organ systems involved. A cross-sectional study was performed, by the members of the Erythema Nodosum Leprosum International STudy (ENLIST Group, of patients with ENL attending seven leprosy referral centres in Brazil, Ethiopia, India, Nepal, the Philippines and the United Kingdom. We systematically documented the clinical features and type of ENL, its severity and the drugs used to treat it. Patients with chronic ENL were more likely to be assessed as having severe ENL. Pain, the most frequent symptom, assessed using a semi-quantitative scale was significantly worse in individuals with "severe" ENL. Our findings will determine the items to be included in a severity scale of ENL which we are developing and validating. The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

An atypical presentation of erythema elevatum diutinum

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Mariana Quirino Tubone

2013-04-01

Full Text Available Erythema elevatum diutinum is a rare chronic leukocytoclastic vasculitis of unknown etiology. Lesions are usually asymptomatic, although burning and itchiness can occur. The typical clinical presentation is characterized by persistent, symmetrical, papules and nodules that may coalesce to form larger nodules or plaques. It may be associated with various pathologies and the diagnosis is based on clinical and histopathological findings. Treatment is based on the use of dapsone and sulfonamides, first-line therapies, and other options such as niacinamide, tetracycline, colchicine, chloroquine and corticosteroids. We describe the case of a 65-year-old male patient that presented a single lesion on the dorsum of the hand, an unusual clinical presentation.

The Evaluation of Minimal Erythema Dose For Narrowband UVB in Patients Receiving Isotretinoin Treatment

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Tuba Çetiner

2012-09-01

Full Text Available Background and Design: Although photosensitivity is considered as one of the side effects of retinoids, there is no consensus on this issue. In this study, we aimed to evaluate the minimal erythema dose (MED for narrowband ultraviolet B in patients receiving isotretinoin treatmentMaterial and Method: Phototesting was done by narrowband ultraviolet B irradiation on fifty patients for whom isotretinoin treatment was planned. MED values were calculated before treatment (MED1 and during treatment after reaching half of the target dose (kgx120 mg (MED2, and it was evaluated whether there was statistically significant difference between the two MED values. In addition, the patients were assessed according to their skin phototypes in this respect. Results: When the mean values of MED1 and MED2 were compared in all patients who were treated with 0.5-0.7 mg/kg/day isotretinoin, the mean of MED2 values was found to be lower than the mean of MED1 values. Clinically, sunburn erythema was seen in only 3 (6% patients during the treatment. When the patients were evaluated according to their skin phototypes, significant difference between the means of MED 1 and MED 2 values was not determined. Conclusion: Although isotretinoin treatment does not cause clinically sunburn erythema, it was associated with decrease in MED values.

A Case of Erythema Annulare Centrifigum with Sjögren Syndrome

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İlgen Ertam

2010-03-01

Full Text Available Erythema annulare centrifigum is a dermatose which is frequently seen in adults. It is characterized by erythematous lesions which spread asymmetrically to periphery and have a collarette desquamation. Although infection, tumor, food allergy, drug reaction can play a role in the aetiology, most of the cases are idiopathic. A forty-nine years old, female patient presented to our clinic with erythematous lesions on both of her lower extremities. Six weeks prior to her referral, she treated with quinine for Sjogren syndrome. She had a diagnosis of granuloma annulare in her personal history. There was no significance in her family history. In dermatologic examination; annular erythematous plaques and collarette desquamation were detected on lower extremities. Histopathologic examination of the lesional biopsy specimen revealed focal spongiosis in the epidermis, dermal oedema, vascular proliferation and perivascular infiltration of lymphocytes, eosinophils and histiocytes. In the laboratory examination; blood count, liver and kidney function tests, sedimentation, C-reactive protein was normal. Rheumatoid factor was 30. Antinuclear antibody was 1/640 granular pattern. A case of erythema annulare centrifigum with Sjögren Syndrome is discussed with the other skin findings of the disease.

Erythema persists longer than one year in split-thickness skin graft donor sites

DEFF Research Database (Denmark)

Danielsen, Patricia L; Jorgensen, Lars N; Jørgensen, Bo

2013-01-01

on the thigh using a pneumatic dermatome in 19 consecutive Caucasian patients, median age 70 years, age range 44-86 years, who were undergoing skin graft surgery for leg ulcers. Transepidermal water loss (TEWL), erythema and pigmentation were measured quantitatively using non-invasive devices...

Fixed pigmented erythema due to cimetidine

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Almamy Diabaté

2017-07-01

Full Text Available Fixed pigmented erythema (EPF is pathognomonic of drug-induced toxicity. Antisecretory drugs are among the most commonly not responsible drugs. EPF secondary to cimetidine administration has rarely been described. We report an EPF case during a cimetidine-based treatment in Bouake. A 43-year-old patient, HIV negative, consults for an EPF located on both sides of the breasts, on the 5th day of an antiulcer treatment comprising compressed cimetidine and gastric dressing based on phosphatase d ‘aluminum. The diagnosis is made in front of the characteristic aspect of the lesion of EPF and the early reappearance of lesions recurring exactly in the same places, after the reintroduction of cimetidine. The discovery of an EPF imposes a strict etiological approach in search of the responsible drug. During anti-ulcer treatment, the practitioner should bear in mind the potential role of cimetidine.

Clinical characteristics, treatment and outcome of children with Lyme arthritis in Nova Scotia.

Science.gov (United States)

Glaude, Pier Diane; Huber, Adam M; Mailman, Timothy; Ramsey, Suzanne; Lang, Bianca; Stringer, Elizabeth

2015-10-01

Lyme disease is an emerging problem in Nova Scotia. Lyme arthritis is a late manifestation of Lyme disease. To describe the demographic characteristics, referral patterns and clinical course of children diagnosed with Lyme arthritis in a tertiary care pediatric rheumatology clinic in Nova Scotia. In the present retrospective chart review, subjects diagnosed with Lyme arthritis between 2006 and 2013 were identified through the clinic database. Demographic variables, referral patterns, clinical presentation and information regarding treatment course and outcome were collected. Seventeen patients were identified; 76% presented in 2012 and 2013. In 37.5% of cases, the referring physician suspected Lyme disease. Most patients presented with one or more painful and/or swollen joints; 94% had knee involvement. Only three of 17 patients had a history of erythema migrans and four of 17 recalled a tick bite. Five patients had a history of neurological manifestations consistent with Lyme disease, although, none had a diagnosis made at the time. Arthritis usually resolved after treatment with standard antibiotics; however, at last follow-up, two patients had antibiotic refractory Lyme arthritis, with one having joint damage despite aggressive arthritis treatment. A significant increase in cases of Lyme arthritis has recently been recognized in a pediatric rheumatology clinic in Nova Scotia. A history of a tick bite or erythema migrans were not sensitive markers of Lyme arthritis, and this diagnosis was often not considered by the referring physician. Educational initiatives should be undertaken to increase local awareness of this treatable cause of arthritis in children.

Management approaches for suspected and established Lyme disease used at the Lyme disease diagnostic center.

Science.gov (United States)

Wormser, Gary P; McKenna, Donna; Nowakowski, John

2016-01-14

2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for Lyme disease-related facial palsy and/or radiculopathy is a 2-week course of doxycycline. Patients who are hospitalized for Lyme meningitis are usually treated at least initially with ceftriaxone. We have not seen convincing cases of encephalitis or myelitis solely due to Borrelia burgdorferi infection in the absence of laboratory evidence of concomitant deer tick virus infection (Powassan virus). We have also never seen Lyme encephalopathy or a diffuse axonal peripheral neuropathy and suggest that these entities are either very rare or nonexistent.We have found that Lyme disease rarely presents with fever without other objective clinical manifestations. Prior cases attributed to Lyme disease may have overlooked an asymptomatic erythema migrans skin lesion or the diagnosis may have been based on nonspecific IgM seroreactivity. More research is needed on the appropriate management and significance of IgG seropositivity in asymptomatic patients who have no history of Lyme disease.

Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.

Science.gov (United States)

Sterner, Eila; Fossum, Bjöörn; Berg, Elisabeth; Lindholm, Christina; Stark, André

2014-08-01

Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

MRI features of Lyme arthritis of the hips

International Nuclear Information System (INIS)

Amini, Behrang; Geller, Matthew D.; Mathew, Manesh; Gerard, Perry

2007-01-01

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

MRI features of Lyme arthritis of the hips

Energy Technology Data Exchange (ETDEWEB)

Amini, Behrang [Maimonides Medical Center, Department of Surgery, Brooklyn, NY (United States); Geller, Matthew D. [New York College of Osteopathic Medicine, Old Westbury, NY (United States); Mathew, Manesh; Gerard, Perry [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States)

2007-11-15

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

A curious case of cholestasis: oral terbinafine associated with cholestatic jaundice and subsequent erythema nodosum.

Science.gov (United States)

Kumar, Kartik; Gill, Anna; Shafei, Rachelle; Wright, Janine L

2014-12-05

Terbinafine is a commonly prescribed antifungal agent used in the treatment of trichophytic onychomycosis and chronic cutaneous mycosis that are resistant to other treatments. This case report highlights a rarely documented but important adverse hepatic reaction that was caused by the use of oral terbinafine. A woman in her thirties presented with a 3-week history of jaundice, malaise, itching, nausea, decreased appetite, weight loss, dark orange urine and intermittent non-radiating epigastric pain. She had recently finished a 3-week course of oral terbinafine for a fungal nail infection. Liver biopsy findings were consistent with chronic active hepatitis secondary to a drug reaction. A few days after initial presentation, the patient developed erythema nodosum. Delayed development of erythema nodosum secondary to terbinafine could not be excluded. 2014 BMJ Publishing Group Ltd.

The minimal melanogenesis dose/minimal erythema dose ratio declines with increasing skin pigmentation using solar simulator and narrowband ultraviolet B exposure

DEFF Research Database (Denmark)

Ravnbak, Mette H; Philipsen, Peter A; Wulf, Hans Christian

2010-01-01

To investigate the relation between pre-exposure skin pigmentation and the minimal melanogenesis dose (MMD)/minimal erythema dose (MED) ratio after a single narrowband ultraviolet B (nUVB) and solar simulator (Solar) exposure.......To investigate the relation between pre-exposure skin pigmentation and the minimal melanogenesis dose (MMD)/minimal erythema dose (MED) ratio after a single narrowband ultraviolet B (nUVB) and solar simulator (Solar) exposure....

MRI findings of spinal visceral larva migrans of Toxocara canis

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Lee, In Ho, E-mail: leeinho1974@hanmail.ne [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Department of Radiology, Chungnam National University Hospital, 33 Munhwa-ro, Jung-gu, Daejeon 301-721 (Korea, Republic of); Kim, Sung Tae, E-mail: st7.kim@hotmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Oh, Dae Kun, E-mail: odk6464@nate.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Hyung-Jin, E-mail: hyungkim@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Keon Ha, E-mail: somatom@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Jeon, Pyoung, E-mail: drpjeon@gmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Byun, Hong Sik, E-mail: byun5474@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of)

2010-08-15

Purpose: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord. Materials and methods: We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response. Results: Total 8 patients (M = 8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients. Conclusion: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.

MRI findings of spinal visceral larva migrans of Toxocara canis

International Nuclear Information System (INIS)

Lee, In Ho; Kim, Sung Tae; Oh, Dae Kun; Kim, Hyung-Jin; Kim, Keon Ha; Jeon, Pyoung; Byun, Hong Sik

2010-01-01

Purpose: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord. Materials and methods: We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response. Results: Total 8 patients (M = 8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients. Conclusion: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.

Pulse photodynamic therapy reduces inflammation without compromising efficacy in the treatment of multiple mild actinic keratoses of the face and scalp

DEFF Research Database (Denmark)

Wiegell, S R; Petersen, Bibi Øager; Wulf, H C

2016-01-01

BACKGROUND: The main side-effects of photodynamic therapy (PDT) for actinic keratoses (AKs) are post-treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated with the treatment. OBJECTIVES: To evaluate in a randomized intraindividual...... on the face and scalp. The use of a short MAL application time and topical corticosteroid did not affect the efficacy of PDT and may be an easy way to make PDT treatment of large visible areas more acceptable.......BACKGROUND: The main side-effects of photodynamic therapy (PDT) for actinic keratoses (AKs) are post-treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated with the treatment. OBJECTIVES: To evaluate in a randomized intraindividual...... study whether pulse-PDT and corticosteroid pulse-PDT would reduce treatment-induced erythema compared with conventional PDT. METHODS: Twenty-two patients with multiple mild AKs on the face and scalp were treated with methyl aminolaevulinate (MAL)-PDT in three similar areas. Two areas were incubated...

Ultraviolet spectral distribution and erythema-weighted irradiance from indoor tanning devices compared with solar radiation exposures.

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Sola, Yolanda; Baeza, David; Gómez, Miguel; Lorente, Jerónimo

2016-08-01

Concern regarding the impact of indoor tanning devices on human health has led to different regulations and recommendations, which set limits on erythema-weighted irradiance. Here, we analyze spectral emissions from 52 tanning devices in Spanish facilities and compare them with surface solar irradiance for different solar zenith angles. Whereas most of the devices emitted less UV-B radiation than the midday summer sun, the unweighted UV-A irradiance was 2-6 times higher than solar radiation. Moreover, the spectral distributions of indoor devices were completely different from that of solar radiation, differing in one order of magnitude at some UV-A wavelengths, depending on the lamp characteristics. In 21% of the devices tested, the erythema-weighted irradiance exceeded 0.3Wm(-2): the limit fixed by the European standard and the Spanish regulation. Moreover, 29% of the devices fall within the UV type 4 classification, for which medical advice is required. The high variability in erythema-weighted irradiance results in a wide range of exposure times to reach 1 standard erythemal dose (SED: 100Jm(-2)), with 62% of devices requiring exposures of UV-A dose during this time period would be from 1.4 to 10.3 times more than the solar UV-A dose. Copyright © 2016 Elsevier B.V. All rights reserved.

Hair-dye induced erythema multiforme like allergic contact dermatitis

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Mrinal Gupta

2017-04-01

Full Text Available Erythema multiforme (EM is an acute, self limited skin disease characterized by the sudden eruption of symmetrical lesions in typical targetoid fashion usually confined to face and extremities. The most commonly implicated factors include infections like herpes simplex, mycoplasma, drugs like antibiotics and anticonvulsants and vaccinations. Contact dermatitis induced EM is a rarely reported entity. Herein we present a case of a 40 year old female who presented with EM due to contact sensitivity to p-Paraphenylenediamine (PPD, a common coloring agent in hair-dyes and a potent sensitizer. Till date, there have been only a few case reports of PPD induced EM.

Immune reconstitution inflammatory syndrome unmasking erythema nodosum leprosum: A rare case report

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Geeta Kiran Arakkal

2015-01-01

Full Text Available Immune reconstitution inflammatory syndrome (IRIS occurs as an acute symptomatic expression of a latent infection during the recovery of immune system in response to antiretroviral therapy in HIV patients. IRIS triggers both opportunistic and non-opportunistic infections. We report a case of IRIS in a patient with HIV, presenting as erythema nodosum leprosum (ENL, which led to unmasking of lepromatous leprosy following anti-retroviral therapy (ART.

Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

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Weitzner, Erica; McKenna, Donna; Nowakowski, John; Scavarda, Carol; Dornbush, Rhea; Bittker, Susan; Cooper, Denise; Nadelman, Robert B; Visintainer, Paul; Schwartz, Ira; Wormser, Gary P

2015-12-15

Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years. Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS. One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi. PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Changes in photoinduced cutaneous erythema with topical application of a combination of vitamins C and E before and after UV exposure.

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Aguilera, José; de Gálvez, María Victoria; Sánchez, Cristina; Herrera-Ceballos, Enrique

2012-06-01

Ultraviolet radiation is harmful for human skin, and photodamaging pathologies such as actinic erythema, are formerly described as a consequence of UV direct effect on DNA and indirectly by local immune reactions. However, the degree of participation of oxidative stress in actinic erythema and the role of antioxidants in photoprotection are still not fully understood. To evaluate the possible palliative role of a combination of the antioxidants vitamins C and E in human cutaneous erythema when applied topically before and after UV exposure. The study included 20 volunteers of phototypes II, II-III and III with no solar exposure for two months prior to the study. The volunteers were submitted to a phototest consisting on the analysis of the minimal erythemal dose (MED) under different treatments: 1. Untreated irradiated skin; 2. Irradiated skin previously treated with vehicle; 3. Irradiated skin previously treated with a combination of vitamins (2.5% vit E-5% vit C); and 4. Skin treated with the antioxidant combination after irradiation. Cutaneous erythema was evaluated 24h after exposure and the MED was calculated for each treatment. The application of vehicle did not significantly affect the MED compared to untreated irradiated skin. Application of the antioxidant combination, prior to irradiation, increased the MED in all phototypes compared with untreated irradiated skin with an average increase of 36.9%. Antioxidants applied after exposure promoted an average increase of the MED by 19.8%. Combination of topical antioxidants (vitamins C and E) shows photoprotection activity against erythema, mainly owing to their high absorption properties. Moreover, their antioxidant activity could be considered as additive, and independent of their optical properties. Copyright © 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

Release by ultraviolet B (u.v.B) radiation of nitric oxide (NO) from human keratinocytes: a potential role for nitric oxide in erythema production

International Nuclear Information System (INIS)

Deliconstantinos, G.; Villiotou, V.; Stravrides, J.C.

1995-01-01

The mechanism of human sunburn is poorly understood but its characteristic features include the development of erythema. In this study we attempted to determine whether human keratinocytes possess a nitric oxide (NO) synthase (NOS), if this enzyme could be activated to release NO following exposure to ultraviolet B (u.v.B) and to define whether this photo-induced response could be involved in the pathogenesis of sunburn erythema. The present results indicate that u.v.B radiation acts as a potent stimulator of NOS in keratinocytes. NO is lipophilic and may diffuse out of the keratinocytes, activating sGC in endothelial cells and neighbouring smooth muscle cells. This may be a major part of the integrated response of the skin leading to vasodilatation and erythema. (author)

Epidemiological and clinical features of erythema infectiosum in children in Novi Sad from 2000 to 2009

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Prćić Sonja

2013-01-01

Full Text Available Background/Aim. Erythema infectiosum (EI is a common childhood illness, caused by human parvovirus B19. It occurs sporadically or in epidemics and is characterized by mild constitutional symptoms and a blotchy or maculopapular lacy rash on the cheeks (slapped-cheek spreading primarily to the extremities and trunk. The aim of our study was to analyse the epidemiological and clinical characteristics of erythema infectiosum in children. Methods. This study included 88 children observed in the Department of Dermatology of the Institute for Child and Youth Health Care of Vojvodina, in Novi Sad, during the period January 2000-December 2009. We compared the data about the clinical characteristics during and after the outbreak of EI observed from December 2001 to September 2002. The data were retrieved from the hospital database. Results. During the study period, EI was detected in 88 children (44 females and 44 males, 0.213% of the total number of 4 1345 children observed in the Department of Dermatology. An outbreak of erythema infectiosum was observed from December 2001 to September 2002, with the peak frequency in April and May 2002 and 39 diagnosed cases, and stable number of cases from 2005 to 2009 (a total of 49 diagnosed cases. The average age of infected children was 7.59 ± 3.339. Eleven (12.5% children were referred from primary care pediatricians with the diagnosis of urticaria or rash of allergic origin. The most constant clinical sign was reticular exanthema on the limbs, present in 100% of the cases, followed by 89.77% of cheek erythema. Pruritus was present in 9.09% of the children, mild constitutional symptoms in 5.68% and palpable lymph glands in 3.41% of the children. In all the cases the course of the disease was without complications. Conclusion. The results of this study confirm the presence of EI (the fifth disease in our area with a mild course in the majority of patients. Since the diagnosis of EI is usually based on clinical

Drug eruption (erythema multiforme type) following chemoradiotherapy with mitomycin C and 5-fluorouracil administration for squamous cell carcinoma of the anal canal

International Nuclear Information System (INIS)

Arikawa, Shunji; Uchida, Masafumi; Ogoh, Etsuyo

2010-01-01

We report a case of drug eruption (erythema multiforme type) in a 54-year-old woman, following concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal. Chemotherapy comprised one cycle of mitomycin C 10 mg/m 2 /day (intravenous bolus injection) on day 1 and 5-fluorouracil (5-FU) 1, 000 mg/m 2 /day (continuous intravenous infusion) on days 1-4 of radiotherapy. External irradiation of the pelvic space was performed, using daily fractions of 1.5 Gy (total dose, 33 Gy). From day 4 after chemoradiotherapy, erythema appeared proximal to the forearm site used for drug administration. On day 6, erythema was noted on the trunk, hip and thigh. We suspected erythema multiforme based on the appearance of wheals and target lesions of the skin and a patient history of chemoradiotherapy. Steroids were administered orally, which resolved systemic eruption at week 2. The patient also experienced grade 3 leukocytopenia, neutropenia, thrombopenia, diarrhea, and anorexia. Although we could not provide sufficient chemotherapy and radiation therapy due to severe side effects, squamous cell carcinoma of the anal canal responded extremely well with a marked decrease in complete response. We surmise that the drug eruption was associated with 5-FU. Concurrent chemoradiotherapy is safe and effective for squamous cell carcinoma of the anal canal, but care is required to prevent drug eruption during treatment. (author)

Erythromycin as a safe and effective treatment option for erythema annulare centrifugum

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Fu-Chen Chuang

2015-01-01

Full Text Available Background: Erythema annulare centrifugum (EAC is an inflammatory dermatosis with unknown etiology. It is usually self-limited, but chronic disease may be difficult to treat. We observed incidentally the therapeutic effect of erythromycin for EAC among patients taking erythromycin for other diseases. Aim: To evaluate the treatment response of erythromycin for EAC. Materials and Methods: During the study period, from July 2007 to February 2011, all patients with EAC were assigned to erythromycin stearate tablet 1000 mg per day for two weeks. EAC was diagnosed by a constellation of clinical and pathological findings. The efficacy (before and after the treatment was assessed clinically by one dermatologist and photographically by two blinded dermatologists. Secondary outcomes included adverse drug effects and recurrence. Results: Eight patients were enrolled in this study. Most patients had chronic relapsing disease with poor response to previous treatment. All the patients showed rapid response with profound reduction in the size of lesion and erythema two weeks after initiation of erythromycin treatment. The response was so obvious and complete that a coincidental response was less likely. Three patients had recurrence of disease and they tended to have more extensive lesions. Readministration of erythromycin was effective. All patients tolerated the treatment well. Conclusion: Our study documented erythromycin as a safe and cost-effective treatment for EAC.

IDIOPATHIC ERYTHEMA NODOSUM AND PREGNANCY: DESCRIPTION OF A CASE

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B S Belov

2009-01-01

Full Text Available Erythema nodosum (EN is a dermatosis of unclear etiology, which is characterized by vascular lesion of the skin; it shows itself as hard painful nodes occurring in the derma or subcutaneous fat on the shins and thighs. EN has been described in many chronic infectious processes with some features of its clinical course. In most cases, the disease is regarded as a nonspecific immunoinflammatory response to a wide spectrum of etiological factors, including that in gestation, which presents certain problems in curing the patient. The example given below supports the need for timely testing for infectious markers in pregnancy and, in case of evolving EN, for using not only nonsteroidal anti-inflammatory drugs, but also pathogenetic treatment.

Photochemistry and photobiology of actinic erythema: defensive and reparative cutaneous mechanisms

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A.C. Tedesco

1997-05-01

Full Text Available Sunlight is part of our everyday life and most people accept it as beneficial to our health. With the advance of our knowledge in cutaneous photochemistry, photobiology and photomedicine over the past four decades, the terrestrial solar radiation has become a concern of dermatologists and is considered to be a major damaging environmental factor for our skin. Most photobiological effects (e.g., sunburn, suntanning, local and systemic immunosuppression, photoaging or dermatoheliosis, skin cancer and precancer, etc. are attributed to ultraviolet radiation (UVR and more particularly to UVB radiation (290-320 nm. UVA radiation (320-400 nm also plays an important role in the induction of erythema by the photosensitized generation of reactive oxygen species (singlet oxygen (1O2, superoxide (O2.- and hydroxyl radicals (.OH that damage DNA and cellular membranes, and promote carcinogenesis and the changes associated with photoaging. Therefore, research efforts have been directed at a better photochemical and photobiological understanding of the so-called sunburn reaction, actinic or solar erythema. To survive the insults of actinic damage, the skin appears to have different intrinsic defensive mechanisms, among which antioxidants (enzymatic and non-enzymatic systems play a pivotal role. In this paper, we will review the basic aspects of the action of UVR on the skin: a photochemical reactions resulting from photon absorption by endogenous chromophores; b the lipid peroxidation phenomenon, and c intrinsic defensive cutaneous mechanisms (antioxidant systems. The last section will cover the inflammatory response including mediator release after cutaneous UVR exposure and adhesion molecule expression

The circadian clock controls sunburn apoptosis and erythema in mouse skin.

Science.gov (United States)

Gaddameedhi, Shobhan; Selby, Christopher P; Kemp, Michael G; Ye, Rui; Sancar, Aziz

2015-04-01

Epidemiological studies of humans and experimental studies with mouse models suggest that sunburn resulting from exposure to excessive UV light and damage to DNA confers an increased risk for melanoma and non-melanoma skin cancer. Previous reports have shown that both nucleotide excision repair, which is the sole pathway in humans for removing UV photoproducts, and DNA replication are regulated by the circadian clock in mouse skin. Furthermore, the timing of UV exposure during the circadian cycle has been shown to affect skin carcinogenesis in mice. Because sunburn and skin cancer are causally related, we investigated UV-induced sunburn apoptosis and erythema in mouse skin as a function of circadian time. Interestingly, we observed that sunburn apoptosis, inflammatory cytokine induction, and erythema were maximal following an acute early-morning exposure to UV and minimal following an afternoon exposure. Early-morning exposure to UV also produced maximal activation of ataxia telangiectasia mutated and Rad3-related (Atr)-mediated DNA damage checkpoint signaling, including activation of the tumor suppressor p53, which is known to control the process of sunburn apoptosis. These data provide early evidence that the circadian clock has an important role in the erythemal response in UV-irradiated skin. The early morning is when DNA repair is at a minimum, and thus the acute responses likely are associated with unrepaired DNA damage. The prior report that mice are more susceptible to skin cancer induction following chronic irradiation in the AM, when p53 levels are maximally induced, is discussed in terms of the mutational inactivation of p53 during chronic irradiation.

Erythema Ab igne after footbath with Chinese herbal remedies

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Jeng-Feng Chen

2011-01-01

Full Text Available Erythema ab igne (EAI is a reticulated, telangiectatic, and hyperpigmented skin eruption resulting from chronic exposure to long-term moderate heat. The incidence has decreased substantially today because of the advent of modern central heating systems. Recently, we encountered a patient who developed EAI after 2 weeks of footbaths with Chinese herbal remedies, which she used to treat her acute ankle sprain. Alternative Chinese medicine, such as herbal footbath, is a prevalent medical practice to treat acute pains as well as many chronic musculoskeletal ailments among Chinese and Asian populations. It has also become increasingly popular in Western countries in the past decade. Herein, we would like to report an uncommon case of iatrogenic EAI caused by footbath and raise the attention of clinicians to such rare, potentially malignant-transforming, dermatosis.

Association of single nucleotide polymorphisms in the genes ATM, GSTP1, SOD2, TGFB1, XPD and XRCC1 with risk of severe erythema after breast conserving radiotherapy

International Nuclear Information System (INIS)

Raabe, Annette; Derda, Katharina; Reuther, Sebastian; Szymczak, Silke; Borgmann, Kerstin; Hoeller, Ulrike; Ziegler, Andreas; Petersen, Cordula; Dikomey, Ekkehard

2012-01-01

To examine the association of polymorphisms in ATM (codon 158), GSTP1 (codon 105), SOD2 (codon 16), TGFB1 (position −509), XPD (codon 751), and XRCC1 (codon 399) with the risk of severe erythema after breast conserving radiotherapy. Retrospective analysis of 83 breast cancer patients treated with breast conserving radiotherapy. A total dose of 50.4 Gy was administered, applying 1.8 Gy/fraction within 42 days. Erythema was evaluated according to the Radiation Therapy Oncology Group (RTOG) score. DNA was extracted from blood samples and polymorphisms were determined using either the Polymerase Chain Reaction based Restriction-Fragment-Length-Polymorphism (PCR-RFL) technique or Matrix-Assisted-Laser-Desorption/Ionization –Time-Of-Flight-Mass-Spectrometry (MALDI-TOF). Relative excess heterozygosity (REH) was investigated to check compatibility of genotype frequencies with Hardy-Weinberg equilibrium (HWE). In addition, p-values from the standard exact HWE lack of fit test were calculated using 100,000 permutations. HWE analyses were performed using R. Fifty-six percent (46/83) of all patients developed erythema of grade 2 or 3, with this risk being higher for patients with large breast volume (odds ratio, OR = 2.55, 95% confidence interval, CI: 1.03–6.31, p = 0.041). No significant association between SNPs and risk of erythema was found when all patients were considered. However, in patients with small breast volume the TGFB1 SNP was associated with erythema (p = 0.028), whereas the SNP in XPD showed an association in patients with large breast volume (p = 0.046). A risk score based on all risk alleles was neither significant in all patients nor in patients with small or large breast volume. Risk alleles of most SNPs were different compared to a previously identified risk profile for fibrosis. The genetic risk profile for erythema appears to be different for patients with small and larger breast volume. This risk profile seems to be specific for erythema as

Phase 2 Randomized, Dose-Ranging Study of Oxymetazoline Cream for Treatment of Persistent Facial Erythema Associated With Rosacea.

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DuBois, Janet; Dover, Jeffrey S; Jones, Terry M; Weiss, Robert A; Berk, David R; Ahluwalia, Gurpreet

2018-03-01

Rosacea is a chronic dermatologic condition with limited treatment options. This phase 2 study evaluated the optimal oxymetazoline dosing regimen in patients with moderate to severe persistent facial erythema of rosacea. Patients were randomly assigned to oxymetazoline cream, 0.5%, 1.0%, or 1.5%, or vehicle, administered once daily (QD) or twice daily (BID) for 28 consecutive days. The primary efficacy endpoint was the proportion of patients with ≥2-grade improvement from baseline on the Clinician Erythema Assessment (CEA) and the Subject Self-Assessment of erythema (SSA-1) on day 28. Safety assessments included treatment-emergent adverse events and dermal tolerability. A total of 356 patients were treated (mean age, 50.0 years; 80.1% female). The proportions of patients achieving the primary endpoint were significantly higher with oxymetazoline 0.5% QD (P=0.049), 1.0% QD (P=0.006), 1.5% QD (P=0.012), 1.0% BID (P=0.021), and 1.5% BID (P=0.006) versus their respective vehicles. For both QD and BID dosing, the efficacy of oxymetazoline 1.0% was greater than the 0.5% dose and comparable to the 1.5% dose. Safety and application-site tolerability were similar across groups. Short-term treatment period. Oxymetazoline 1.0% QD provided the optimal dosing regimen and was selected for evaluation in phase 3 clinical studies. J Drugs Dermatol. 2018;17(3):308-316.

Recurrent erythema nodosum and pulmonary lymph node tuberculosis in a patient treated for psoriatic arthritis and psoriasis with TNF inhibitors

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Piotr Parcheta

2014-10-01

Full Text Available Introduction. Psoriasis is a chronic inflammatory disease affecting approximately 2% of the population. Biologic agents are the new treatment options for patients with moderate to severe plaque psoriasis who have failed traditional systemic therapies. The therapy with tumor necrosis factor antagonists significantly increases the risk of reactivation of latent tuberculosis; therefore, screening is important before the introduction of biological treatment. Objective. Presentation of diagnostic difficulties in establishing an etiological factor of recurrent erythema nodosum in a 46-year-old woman treated with anti-TNF-α agents (etanercept and adalimumab for plaque psoriasis and psoriatic arthritis. Case report. We present a case of a 46-year-old woman, treated with etanercept and adalimumab for plaque psoriasis and psoriatic arthritis. Despite prophylactic antituberculosis treatment before introduction of biological therapy, the patient developed erythema nodosum most likely caused by lymph node tuberculosis. Conclusions . The development of erythema nodosum, especially the recurrent form, in a patient with a positive tuberculin skin test and negative IGRA test treated with anti-TNF should always prompt increased vigilance and exclusion of active tuberculosis, which may develop even in patients who have undergone prophylactic antituberculosis treatment.

Non-ablative 1550 nm fractional laser therapy not effective for erythema dyschromicum perstans and postinflammatory hyperpigmentation: a pilot study

NARCIS (Netherlands)

Kroon, Marije W.; Wind, Bas S.; Meesters, Arne A.; Wolkerstorfer, Albert; van der Veen, J. P. Wietze; Bos, Jan D.; van der Wal, Allard C.; Beek, Johan F.

2012-01-01

Background: Erythema dyschromicum perstans and postinflammatory hyperpigmentation (PIH) are characterized by papillary dermal pigmentation or pigment incontinence. To date, no standard treatment is available. Fractional laser therapy (FLT) was recently reported to improve different pigment

Assessing blood flow, microvasculature, erythema and redness in hypertrophic scars: A cross sectional study showing different features that require precise definitions.

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Jaspers, M E H; Stekelenburg, C M; Simons, J M; Brouwer, K M; Vlig, M; van den Kerckhove, E; Middelkoop, E; van Zuijlen, P P M

2017-08-01

In hypertrophic scar assessment, laser Doppler imaging (LDI), colorimetry and subjective assessment (POSAS) can be used to evaluate blood flow, erythema and redness, respectively. In addition, the microvasculature (i.e. presence of microvessels) can be determined by immunohistochemistry. These measurement techniques are frequently used in clinical practice and/or in research to evaluate treatment response and monitor scar development. However, until now it has not been tested to what extent the outcomes of these techniques are associated, whilst the outcome terms are frequently used interchangeably or replaced by the umbrella term 'vascularization'. This is confusing, as every technique seems to measure a specific feature. Therefore, we evaluated the correlations of the four measurement techniques. We included 32 consecutive patients, aged ≥18 years, who underwent elective resection of a hypertrophic scar. Pre-operatively, we performed LDI (measuring blood flow), colorimetry (measuring erythema) and the POSAS (subjective redness) within the predefined scar area of interest (∼1.5cm). Subsequently, the scar was excised and the area of interest was sent for immunohistochemistry, to determine the presence of microvessels. Only a statistically significant correlation was found between erythema values (colorimetry) and subjective redness assessment (POSAS) (r=0.403, p=0.030). We found no correlations between the outcomes of LDI, immunohistochemistry and colorimetry. Blood flow, the presence of microvessels and erythema appear to be different hypertrophic scar features because they show an absence of correlation. Therefore, in the field of scar assessment, these outcome terms cannot be used interchangeably. In addition, we conclude that the term 'vascularization' does not seem appropriate to serve as an umbrella term. The use of precise definitions in research as well as in clinical practice is recommended. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Clinical characteristics associated with Borrelia burgdorferi sensu lato skin culture results in patients with erythema migrans.

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Franc Strle

Full Text Available Clinical characteristics associated with isolation of Borrelia burgdorferi sensu lato from skin have not been fully evaluated. To gain insight into predictors for a positive EM skin culture, we compared basic demographic, epidemiologic, and clinical data in 608 culture-proven and 501 culture-negative adult patients with solitary EM. A positive Borrelia spp. skin culture was associated with older age, a time interval of >2 days between tick bite and onset of the skin lesion, EM ≥ 5 cm in diameter, and location of the lesion on the extremities, whereas several other characteristics used as clinical case definition criteria for the diagnosis of EM (such as tick bite at the site of later EM, information on expansion of the skin lesion, central clearing were not. A patient with a 15-cm EM lesion had almost 3-fold greater odds for a positive skin culture than patients with a 5-cm lesion. Patients with a free time interval between the tick bite and onset of EM had the same probability of a positive skin culture as those who did not recall a tick bite (OR=1.02; however, the two groups had >3-fold greater odds for EM positivity than patients who reported a tick bite with no interval between the bite and onset of the lesion. In conclusion, several yet not all clinical characteristics used in EM case definitions were associated with positive Borrelia spp. skin culture. The findings are limited to European patients with solitary EM caused predominantly by B. afzelii but may not be valid for other situations.

Erythema multiforme in a patient with recurrent non-hodgkins lymphoma/chronic lymphocytic leukemia

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Siva Kumara Shankari

2012-01-01

Full Text Available Erythema multiforme major (EMM is a hypersensitivity reaction usually secondary to medications, viruses or other infections. Its presentation is fairly typical with a symmetrical distribution of vesicles, bullae or targeted lesions on the upper body, arms, legs, palms, feet and oral mucosa. The authors present a delineated case of EMM in association with chronic lymphocytic leukemia (CLL and non-Hodgkin′s lymphoma (NHL with a very unusual clinical presentation evolving overtime into a unique, almost dermatomal distribution. Typical therapies were not initially helpful and intravenous immunoglobulin antibody had to be administered.

Evaluation of a Topical Anti-inflammatory/Antifungal Combination Cream in Mild-to-moderate Facial Seborrheic Dermatitis: An Intra-subject Controlled Trial Examining Treated vs. Untreated Skin Utilizing Clinical Features and Erythema-directed Digital Photography.

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Dall'Oglio, Federica; Tedeschi, Aurora; Guardabasso, Vincenzo; Micali, Giuseppe

2015-09-01

To evaluate if nonprescription topical agents may provide positive outcomes in the management of mild-to-moderate facial seborrheic dermatitis by reducing inflammation and scale production through clinical evaluation and erythema-directed digital photography. Open-label, prospective, not-blinded, intra-patient, controlled, clinical trial (target area). Twenty adult subjects affected by mild-to-moderate facial seborrheic dermatitis were enrolled and instructed to apply the study cream two times daily, initially on a selected target area only for seven days. If the subject developed visible improvement, it was advised to extend the application to all facial affected area for 21 additional days. Efficacy was evaluated by measuring the grade of erythema (by clinical examination and by erythema-directed digital photography), desquamation (by clinical examination), and pruritus (by subject-completed visual analog scale). Additionally, at the end of the protocol, a Physician Global Assessment was carried out. Eighteen subjects completed the study, whereas two subjects were lost to follow-up for nonadherence and personal reasons, respectively. Day 7 data from target areas showed a significant reduction in erythema. At the end of study, a significant improvement was recorded for erythema, desquamation, and pruritus compared to baseline. Physician Global Assessment showed improvement in 89 percent of patients, with a complete response in 56 percent of cases. These preliminary results indicate that the study cream may be a viable nonprescription therapeutic option for patients affected by facial seborrheic dermatitis able to determine early and significant improvement. This study also emphasizes the advantages of using an erythema-directed digital photography system for assisting in a simple, more accurate erythema severity grading and therapeutic monitoring in patients affected by seborrheic dermatitis.

Idiopathic Granulomatous Mastitis Associated with Erythema Nodosum

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Tuğba Özlem Kalaycı

2016-04-01

Full Text Available Background: Idiopathic granulomatous mastitis (IGM is an uncommon benign chronic inflammatory breast disease, and erythema nodosum (EN is an extremely rare systemic manifestation of IGM. Here, we report a rare case of IGM accompanied by EN. Case Report: A 32-year-old patient was admitted to our clinic with a history of a tender mass in the right breast. On physical examination, the right breast contained a hard, tender mass in the lower half with in-drawing of the nipple. She had florid EN affecting both legs. She was evaluated with mammography, ultrasound, power Doppler ultrasound, non-enhancing magnetic resonance imaging (MRI, dynamic contrast-enhanced MRI, fine needle aspiration biopsy (FNAB and excisional biopsy. Time-intensity curves showed a type II pattern on dynamic contrast-enhanced MRI, which has an intermediate probability for malignancy. The FNAB reported a benign cytology suggestive of a granulomatous inflammation, which was also supported by the histopathological findings. A partial mastectomy was performed following medical treatment. There was no recurrence at 1-year follow-up. Conclusion: IGM should be considered in the differential diagnosis of EN. Although histopathological examination remains the only method for the definite diagnosis of IGM, MRI can be helpful in the diagnosis or differentiation of benign lesions from malignant ones.

Minimal erythema dose and minimal melanogenesis dose relate better to objectively measured skin type than to Fitzpatricks skin type

DEFF Research Database (Denmark)

Wulf, Hans Christian; Philipsen, Peter A; Ravnbak, Mette H

2010-01-01

Fitzpatrick skin type (FST I-IV) is a subjective expression of ultraviolet (UV) sensitivity based on erythema and tanning reactivity after a single exposure. Pigment protection factor (PPF) is an objective measurement of skin sensitivity in all skin types after a single exposure....

Lyme Disease Manifestations in the Foot and Ankle: A Retrospective Case Series.

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Miller, Jason R; Dunn, Karl W; Braccia, Domenick; Ciliberti, Louis J; Becker, Dina K; Hollinger, Joshua K; Brand, Shelley M

Lyme disease is the result of Borrelia burgdorferi bacterial infection after exposure from a tick bite. A pathognomonic finding in early-stage Lyme disease is an expanding, red macular ring known as erythema migrans. Lyme arthritis is a late-stage manifestation of this disease, affecting the large, weightbearing joints with intermittent pain and swelling. The existing data on Lyme disease and subsequent arthritis have reported manifestations in the lower extremity, primarily in the knee and ankle and less commonly the small joints of the foot. We present a retrospective case series of 11 cases of painful arthritis in the foot and ankle with confirmatory Lyme disease testing. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

ERYTHEMA NODOSUM AND PROLONGED FEVER ASSOCIATED TO SECONDARY HYPERPARATHYROIDISM

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Galimberti R

2005-08-01

Full Text Available SUMMARYSecondary hyperparathyroidism is one of the main deragements caused by chronic renal failure, and parathyroid hormone is considered one of the toxins of the uremic syndrome. Prolonged fever due to primary hyperparathyroidism have already been described in the literature but not yet as induced by secondary hyperparathyroidism. In this case report a patient suffering from an erythema nodosum and prolonged fever associated to secondary hyperparathyroidism that disappeared through subtotal parathyroidectomy is presented.RESUMENEl hiperparatiroidismo secundario es uno de los principales disturbios causados por la insuficiencia renal crónica, y la paratohormona es considerada una de las toxinas del sindrome urémico. El sindrome febril prolongado secundario a hiperparatiroidismo primario ya ha sido descripto en la literatura, aunque no lo ha sido aun el inducido por hiperparatiroidismo secundario. En el presente reporte se presenta un caso de eritema nodoso y sindrome febril prolongado asociado a hiperparatiroidismo secundario y que resolvió luego de efectuada una paratiroidectomía subtotal.

Characteristics of patients presenting with erythema nodosum and sarcoidosis.

LENUS (Irish Health Repository)

O'Connor, T M

2012-01-31

We explored the relationship between erythema nodosum (EN) and sex, age, serum angiotensin converting enzyme (ACE), bronchoalveolar lavage lymphocytosis (BAL-I), interstitial granulomas and radiological stage in patients presenting with pulmonary sarcoidosis in Ireland. Sixty-nine patients diagnosed with sarcoidosis between 2003 and 2006 were studied. Forty one patients (59%) were male. Sixteen patients (23%) presented with EN. Forty one patients of 65 (63%) had transbronchial biopsies demonstrating non-caseating granulomas. Patients with sarcoidosis presenting with EN were more likely to be female (p=0.042), younger (p=0.012) and have earlier stage pulmonary disease (p=0.02). There were no correlations between serum ACE, interstitial granulomas and disease stage. BAL-I did however predict increasing disease radiological stage (p=0.042). In this study, one quarter of patients with sarcoidosis presented with EN among their presenting features. These patients were more likely to be young females with early stage radiological disease.

Erythema Nodosum and Mycoplasma pneumoniae Infections in Childhood: Further Observations in Two Patients and a Literature Review.

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Greco, Filippo; Catania, Roberta; Pira, Alice Le; Saporito, Marco; Scalora, Luisa; Aguglia, Maria Giovanna; Smilari, Pierluigi; Sorge, Giovanni

2015-04-01

Erythema nodosum (EN) is the most frequent panniculitis in childhood and has been associated with various conditions, such as infectious and autoimmune disorders, medications, and malignancies. The author reports on two children affected with EN associated with Mycoplasma pneumoniae infection, which occurred in one patient without pulmonary detection. The available literature on EN and M. pneumoniae infection in childhood is also reviewed.

Prevention of experimentally induced irritant contact dermatitis by extracts of Isatis tinctoria compared to pure tryptanthrin and its impact on UVB-induced erythema.

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Heinemann, Christian; Schliemann-Willers, Sibylle; Oberthür, Christine; Hamburger, Matthias; Elsner, Peter

2004-05-01

Lipophilic extracts of Isatis tinctoria L. exhibit significant activity against several clinically relevant targets of inflammation. The alkaloid tryptanthrin was identified as one of the active principles in woad and characterised as a potent dual inhibitor of COX-2 and 5-LOX. Here, the anti-inflammatory efficacy of topical application of three different Isatis extracts and tryptanthrin was investigated in human volunteers. Two different models were used, namely the sodium lauryl sulphate (SLS)-induced irritant contact dermatitis (ICD) and UVB-induced erythema. Twenty healthy volunteers without any skin disease participated in the study. Cumulative irritant contact dermatitis was induced on test fields on the volunteers' backs by twice daily application of 0.5 % sodium lauryl sulphate over a period of four days. Half of the test fields were treated with the test substances during the eliciting phase, while the remaining test fields were treated over a period of 4 days after induction of dermatitis. In the second model, a UVB erythema on the volunteers' lower backs was induced using the double minimal erythema dose (MED). Twenty-four hours after irradiation the test fields were treated with the test substances over a period of 3 days. All reactions were assessed visually and by non-invasive bioengineering methods (evaporimetry and chromametry). Treatment with extracts during the ICD eliciting phase led to a significantly smaller increase of visual scores and transepidermal water loss compared to the untreated test field. For tryptanthrin this benefit was also observed, but the improvement was not statistically significant. When treatment was performed after completing the eliciting phase, accelerated resolution of the irritant reaction could not be observed. In the UVB erythema model anti-inflammatory effects of the test substances were not observed.

A case of Cinderella: erythema dyschromicum perstans (ashy dermatosis or dermatosis cinecienta).

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Muñoz, Claudia; Chang, Anne Lynn S

2011-01-01

A 33-year-old healthy Latina (from either Mexico or Central America) woman with Fitzpatrick type V skin complained of a 2-year history of progressive hyperpigmentation on the axillary folds, dorsal hands, upper neck spilling onto the jawline area, and lower abdomen. There was no preceding dermatitis. The lesions were asymptomatic. She did not use any prescription or over-the-counter drugs or any herbal supplements. She denied contact with any new substances and did not start any new activities. A full review of systems was negative. Physical examination revealed diffuse symmetric gray patches on the proximal arms radiating from the axillary folds with extension onto the trunk (Figure 1). This discoloration was also present on the dorsal hands (Figure 2), upper neck and jawline, and lower abdomen. The lesions were nonpalpable and without erythema. Thyroid function test results and morning cortisol levels were normal. Two adjacent 4-mm punch biopsies were performed on the right axillary skin, one consisted of unaffected skin and one of hyperpigmented skin. Figure 3 shows affected axillary skin with an interface dermatitis and significant pigment dropout. There was no evidence of depositional process of substances such as heavy metals, drugs, or tattoo. There was no evidence of an actinic process. Differential diagnosis included erythema dyschromicum perstans (EDP), fixed-drug reaction, or interface drug reaction. As the patient was not taking any medications, the overall clinical and histologic impression was most consistent with EDP. The patient was started on a low-potency topical steroid twice a day to the affected areas. In addition, because the patient was concerned about the cosmetic appearance of the hyperpigmentation, a 4% hydroquinone cream was started twice daily to the neck area.

Erythema Multiforme-Like Reaction Due to Rosewood: Two Case Reports

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Eylem Ceren

2008-12-01

Full Text Available Woods and their dusts can lead to various cutaneous reactions such as folliculitis, contact urticaria, irritant and allergic dermatitis. Erythema multiforme-like (EM cutaneous and respiratory system reactions such as astma and allergic rhinitis were also reported. The cutaneous reactions typically affect the areas such as the face, neck and arms exposed to the dust of the tree and usually occur on carpenters as occupational dermatitis\t. Rosewood is one of the most allergic varieties of the trees leading to contact dermatitis. It is a tropical tree and does not grow up in our country. It is especially used in the production of furniture and music instruments and imported from abroad to our country. A few cases of EM-like reaction were reported in 1976 and 1988 in the literature. Herein, two carpenters with severe EM-like skin reaction due to the rosewood, treated with systemic corticosteroids are reported for the first time in our country

Polymerase chain reaction in diagnosis of Borrelia burgdorferi infections and studies on taxonomic classification

DEFF Research Database (Denmark)

Lebech, Anne-Mette

2002-01-01

Lyme borreliosis caused by the spirochete Borrelia burgdorferi is now the most common vectorborne disease in North America, Europe and Asia. It is a multisystemic infection which may cause skin, neurological, cardiac or rheumatologic disorders. The aims of the present thesis were: (i) to develop...... and different clinical presentations (dermatoborreliosis versus neuroborreliosis) and courses (self-limiting versus chronic disease). Furthermore, strain differences were of importance for selection of suitable antigens for diagnostic assays and for vaccine development. Since then, B. burgdorferi isolates have...... a histological B. burgdorferi specific immunophosphatase-staining method. The utility of the PCR was then tested for identification of B. burgdorferi DNA in skin biopsies from 31 patients with erythema migrans. The sensitivity of PCR was 71%, which was superior to culture and serology. Based on own and otherwise...

The Effect of Eyelid Cooling on Pain, Edema, Erythema, and Hematoma after Upper Blepharoplasty : A Randomized, Controlled, Observer-Blinded Evaluation Study

NARCIS (Netherlands)

Pool, Shariselle M. W.; van Exsel, Denise C. E.; Melenhorst, Wynand B. W. H.; Cromheecke, Michel; van der Lei, Berend

Background: The purpose of this study was to investigate the efficacy of eyelid cooling to reduce postoperative pain, edema, erythema, and hematoma after upper blepharoplasty. Methods: After bilateral upper blepharoplasty in 38 consecutive patients, one eyelid per patient was randomized for cooling

Erythema elevatum et diutinum in a young man coexisting with autoimmune polyglandular syndrome type 3 – case report

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Małgorzata Tupikowska

2015-09-01

Full Text Available Introduction. Erythema elevatum et diutinum (EED is classified as a variant of leukocytoclastic vasculitis. The etiology of this disease is unknown. Erythema elevatum et diutinum may coexist with several systemic disorders including hematologic and rheumatologic diseases as well as type 1 diabetes, thyroid diseases and other endocrinopathies. Autoimmune polyglandular syndromes (APS are rarely diagnosed conditions characterized by the coexistence of at least two autoimmune endocrinopathies and non-endocrine autoimmunopathies. Objective. Presentation of a patient with EED coexisting with APS type 3. Case report. A 23-year-old male patient was admitted to our department due to nodular lesions lasting for 5 months, located on the extremities, which were diagnosed clinically and confirmed histopathologically as EED. In spite of skin lesions the patient suffered from diabetes mellitus type 1, hyperthyroidism, celiac disease, myopathy and idiopathic urticaria – abnormalities characteristic for APS type 3. Substantial clinical improvement was observed after systemic administration of dapsone and, due to upper respiratory tract infection, a few weeks of antibiotic therapy. Conclusions . We present this case due to the rarity of EED, especially coexisting with APS, and the good effect of therapy with dapsone and oral antibiotics.

The optimal UV exposure time for vitamin D3 synthesis and erythema estimated by UV observations in Korea

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Lee, Y. G.; Koo, J. H.

2016-12-01

Solar UV radiation in a wavelength range between 280 to 400 nm has both positive and negative influences on human body. Surface UV radiation is the main natural source of vitamin D, providing the promotion of bone and musculoskeletal health and reducing the risk of a number of cancers and other medical conditions. However, overexposure to surface UV radiation is significantly related with the majority of skin cancer, in addition other negative health effects such as sunburn, skin aging, and some forms of eye cataracts. Therefore, it is important to estimate the optimal UV exposure time, representing a balance between reducing negative health effects and maximizing sufficient vitamin D production. Previous studies calculated erythemal UV and vitamin-D UV from the measured and modelled spectral irradiances, respectively, by weighting CIE Erythema and Vitamin D3 generation functions (Kazantzidis et al., 2009; Fioletov et al., 2010). In particular, McKenzie et al. (2009) suggested the algorithm to estimate vitamin-D production UV from erythemal UV (or UV index) and determined the optimum conditions of UV exposure based on skin type Ⅱ according to the Fitzpatrick (1988). Recently, there are various demands for risks and benefits of surface UV radiation on public health over Korea, thus it is necessary to estimate optimal UV exposure time suitable to skin type of East Asians. This study examined the relationship between erythemally weighted UV (UVEry) and vitamin D weighted UV (UVVitD) from spectral UV measurements during 2006-2010. The temporal variations of the ratio (UVVitD/UVEry) were also analyzed and the ratio as a function of UV index was applied to the broadband UV measured by UV-Biometer at 6 sites in Korea Thus, the optimal UV exposure time for vitamin D3 synthesis and erythema was estimated for diurnal, seasonal, and annual scales over Korea. In summer with high surface UV radiation, short exposure time leaded to sufficient vitamin D and erythema and vice

Skin barrier response to occlusion of healthy and irritated skin: Differences in trans-epidermal water loss, erythema and stratum corneum lipids

DEFF Research Database (Denmark)

Jungersted, J.M.; Høgh, Julie Kaae; Hellgren, Lars

2010-01-01

been damaged by either sodium lauryl sulfate (SLS) or tape stripping, respectively, was determined and compared with that of to non-occluded pre-damaged skin. Skin barrier function was assessed by measurements of trans-epidermal water loss (TEWL) and erythema. In study A, stratum corneum lipids were...

Investigation of the sensitivity of a cross-polarized light visualization system to detect subclinical erythema and dryness in women with vulvovaginitis.

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Farage, Miranda A; Singh, Mukul; Ledger, William J

2009-07-01

An enhanced visualization technique using polarized light (Syris v600 enhanced visualization system; Syris Scientific LLC, Gray, ME) detects surface and subsurface ( approximately 1 mm depth) inflammation. We sought to compare the Syris v600 system with unaided visual inspection and colposcopy of the female genitalia. Erythema and dryness of the vulva, introitus, vagina, and cervix were visualized and scored by each method in patients with and without vulvitis. Subsurface visualization was more sensitive in detecting genital erythema and dryness at all sites whether or not symptoms were present. Subsurface inflammation of the introitus, vagina, and cervix only was detected uniquely in women with vulvar vestibulitis syndrome (VVS). A subset of women presenting with VVS exhibited subclinical inflammation of the vulva vestibule and vagina (designated VVS/lichen sclerosus subgroup). Enhanced visualization of the genital epithelial subsurface with cross-polarized light may assist in diagnosing subclinical inflammation in vulvar conditions heretofore characterized as sensory syndromes.

The diagnostic accuracy of serological tests for Lyme borreliosis in Europe

DEFF Research Database (Denmark)

Leeflang, M M G; Ang, C W; Berkhout, J

2016-01-01

-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50 % (95......BACKGROUND: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe....... We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. RESULTS: Seventy...

Ultraviolet erythema as an indicator of nonspecific reactivity during hemorrhagic vasculitis in children

Energy Technology Data Exchange (ETDEWEB)

Kharitonova, A V

1973-01-01

From 1955 to 1967 studies were carried out on 407 children suffering from hemorrhagic vasculitis. For patients in the severe stage of hemorrhagic vasculitis it is characteristic that there are functional shifts in the central nervous system, which are manifested by a changed sensitivity of the skin to ultraviolet irradiation. The appearance of slowed, inert or paradoxal reactions indicates the predominance of processes in the brain that slow down and decrease the reactivity of the organism. In rheumatoid and abdominal-rheumatoid syndromes of the disease, disturbances in indices to skin light-sensitivity are the most manifest. During the recovery period, the indices of ultraviolet erythema, on approaching normal values, still remain low. This behavior requires extensive outpatient observation and treatment of sick children to avoid recidivism. 9 references. (SJR)

The “Great Masquerader" Strikes Again: Secondary Syphilis Presentation with Erythema Multiforme (EM-Like Lesions

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Adi Brom

2014-12-01

Full Text Available Syphilis is a sexually transmitted disease known to present with highly variable manifestations, especially when left untreated. Patients who present to Internal Medicine Departments with fever and a rash are always a diagnostic challenge since mild viral diseases and life-threatening bacterial infections may manifest themselves similarly. In the following case presentation, we describe a patient with 1 month’s duration of fever and rash on the palms of the hand and soles of the feet, in the form of erythema multiforme (EM-like lesions. His disease was diagnosed as secondary syphilis, once again justifying its name: the “great masquerader".

Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions

Energy Technology Data Exchange (ETDEWEB)

Nystroem, Josefina; Lindholm-Sethson, Britta [Dept. of Chemistry, Umeaa Univ ., Umeaa (Sweden); Centre for Biomedical Engineering and Physics, Umeaa Univ., Umeaa (Sweden); Geladi, Paul [Unit of Biomass Technology and Chemistry, SLU Roebaecksdal en, Umeaa (Sweden); Svensk, Ann-Christine; Larson, Johan; Franzen, Lars [Dept. of Oncology, N orthern Univ. Hospital, Umeaa (Sweden)

2007-10-15

A non-blinded three armed study of the effect of Aloe vera, Essex and no lotion on erythema was performed. The erythema is an effect of radiotherapy treatment in breast cancer patients. The study required testing of objective methods for measuring the erythema. The chosen experimental methods were Near Infrared Spectroscopy, Laser Doppler Imaging and Digital Colour Photography. The experimental setup was made in such a way that in parallel with testing the effect of the lotions there was also a test of the sensitivity of the instruments. Fifty women were selected consecutively to participate in the study. They were all subjected to treatment with high-energy electrons (9-20 MeV) after mastectomy, 2 Gy/day to a total dose of 50 Gy. Measurements were performed before the start of radiotherapy and thereafter once a week during the course of treatment. Aloe vera and Essex lotion were applied twice every radiation day in selected sites. The increase in skin redness could be monitored with all techniques with a detection limit of 8 Gy for Digital Colour Photography and Near Infrared Spectroscopy and 18 Gy for Laser Doppler Imaging. In clinical practice our recommendation is to use Digital Colour Photography. No significant median differences were observed between the pairs no lotion-Essex, no lotion-Aloe vera and Essex-Aloe vera for any of the techniques tested.

Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions

International Nuclear Information System (INIS)

Nystroem, Josefina; Lindholm-Sethson, Britta; Geladi, Paul; Svensk, Ann-Christine; Larson, Johan; Franzen, Lars

2007-01-01

A non-blinded three armed study of the effect of Aloe vera, Essex and no lotion on erythema was performed. The erythema is an effect of radiotherapy treatment in breast cancer patients. The study required testing of objective methods for measuring the erythema. The chosen experimental methods were Near Infrared Spectroscopy, Laser Doppler Imaging and Digital Colour Photography. The experimental setup was made in such a way that in parallel with testing the effect of the lotions there was also a test of the sensitivity of the instruments. Fifty women were selected consecutively to participate in the study. They were all subjected to treatment with high-energy electrons (9-20 MeV) after mastectomy, 2 Gy/day to a total dose of 50 Gy. Measurements were performed before the start of radiotherapy and thereafter once a week during the course of treatment. Aloe vera and Essex lotion were applied twice every radiation day in selected sites. The increase in skin redness could be monitored with all techniques with a detection limit of 8 Gy for Digital Colour Photography and Near Infrared Spectroscopy and 18 Gy for Laser Doppler Imaging. In clinical practice our recommendation is to use Digital Colour Photography. No significant median differences were observed between the pairs no lotion-Essex, no lotion-Aloe vera and Essex-Aloe vera for any of the techniques tested

Caecal cancer presenting as leg erythema and a lung opacity.

Science.gov (United States)

Das, Archik; Hureibi, Khalid; Tayyab, Muhammad; McCullough, Peter

2017-09-07

Necrotising infection of the lower limb is a rare presentation for colorectal malignancy. We report a case of a perforated caecal adenocarcinoma presenting with right leg erythema, pain and swelling in the presence of a right lower lobe lung opacity. Following initial debridement and washout, CT imaging demonstrated a thickened terminal ileum, caecum and appendix, in keeping with primary malignancy. This fed the right-sided lower limb sepsis tracking down from the medial aspect of the psoas muscle to give rise to the multiloculated collection seen in the adductor compartment. The lung lesion measured 16 mm and was metastatic. The patient was successfully managed with a subtotal colectomy and an end ileostomy. The biopsy confirmed an adenocarcinoma (T4N1M1). We highlight the importance of perforated colonic carcinoma as a leading differential for lower limb abscesses. Suspicions should be raised further if accompanied by rounded opacifications on plain film radiography of the lungs. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

NMOSD triggered by yellow fever vaccination - An unusual clinical presentation with segmental painful erythema.

Science.gov (United States)

Schöberl, F; Csanadi, E; Eren, O; Dieterich, M; Kümpfel, T

2017-01-01

Neuromyelitis Optica Spectrum Disorder (NMOSD) is an immune-mediated disease of the central nervous system with the presence of aquaporin 4-antibodies (AQP4-abs) in most cases. We describe a patient who developed NMOSD after a yellow fever vaccination. He presented to us with an unusual painful erythema Th7-9 triggered by touch in the respective skin area due to a cervical spinal cord lesion affecting the dorsolateral parts of C6/7. To our knowledge, this is the first case of NMOSD with such a clinical presentation expanding the clinical spectrum of NMOSD. It is important to be aware of that a yellow fever vaccination can trigger NMOSD. Copyright © 2016 Elsevier B.V. All rights reserved.

Varicella zoster with erythema multiforme in a young girl: a rare association.

Science.gov (United States)

Kishore, B Nanda; Ankadavar, Nandini S; Kamath, Ganesh H; Martis, Jacintha

2014-05-01

Erythema multiforme (EM) is an acute, self-limited, mucocutaneous disorder regarded as a hypersensitivity reaction which is triggered by various factors like infection, drugs, and food. Infectious agents are considered to be a major cause of EM other than idiopathic cause. A young girl presented with fluid-filled lesions all over the body of 3 days duration with history of similar lesions with fever in her sibling 2 weeks prior to admission. This was followed by large fluid-filled lesions with halo 3 days thereafter over the trunk, extremities suggesting target lesions of EM. The diagnosis was confirmed by cytology and positive serology. Varicella zoster virus (VZV) has rarely been reported as an etiological agent, despite its high incidence in childhood. VZV as an etiology of EM in a young girl has not been reported so far. This case was reported for its rare association of EM and varicella zoster and also for its rare presentation in a young girl.

Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood.

Science.gov (United States)

Lekwuttikarn, Ramrada; Tempark, Therdpong; Chatproedprai, Susheera; Wananukul, Siriwan

2017-08-01

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients' satisfaction of 595-nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked-randomized, split-faced 595-nm PDL (fluence 8 J/cm 3 pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was -1.828 on the treated side and 0.103 on the non-treated side of the face, P-value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients' satisfaction on the laser-treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment. © 2017 The International Society of Dermatology.

SYSTEMIC LUPUS ERYTHEMATOSUS AND OPPORTUNISTIC INFECTIONS: PREVALENCE, CLINICAL FEATURES

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O N Egorova

2008-12-01

Subjects and methods. Sixty-seven patients with a 1-to-7 history of SLE who received first-line therapy were examined. Results. The analysis of the history data and the results of a serological survey identified 3 groups of patients: 1 35 patients with viral infection, of them 9 had mixed viral-and-bacterial infections; 2 14 with bacterial infections and 3 18 patients without viral-and-bacterial complications. The analysis of clinical symptoms established a correlation of high titers of antibodies to cytomegalovirus (CMV and Epstein-Barr virus (EBV with symptoms, such as fever, arthritis, lymphadenopathy, carditis, hepatomegaly and erythema migrans eruption. However, having the similar clinical manifestations, CMV and EBV infections had some organ specificity. In SLE, concomitant comorbid infection, viral infection in particular, contributed to the development of the clinical picture polymorphism with the protracted, remitting inflammatory process and the inadequate efficiency of glucocorticoid and immunosuppressive therapy.

Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States.

Science.gov (United States)

Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul; Schriefer, Martin

2016-07-01

In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%-40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%-100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics.

Eritema multiforme mayor desencadenado por antimicrobianos Big multiform erythema triggered by antimicrobials

Directory of Open Access Journals (Sweden)

Ronaldo de Carvalho Raimundo

2010-03-01

Full Text Available El eritema multiforme, aparece como una enfermedad sistémica con la participación de la piel y las membranas mucosas en relación con varios factores como las infecciones bacterianas o virales, y en particular la administración de drogas, analgésicos y antibióticos en general. Se presenta un paciente masculino de 29 años de edad con eritema multiforme mayor desencadenado por antimicrobianos con la aparición de lesiones vesiculares-bulloso-ulcerosas en las regiones de los labios, encías, la lengua y la mucosa genital en tratamiento de una infección del tracto urinario con norfloxacino 400 mg por una semana. Fue realizado un tratamiento de soporte con el uso de colutorios para la higienización bucal y pomada a base de corticoide para protección de las úlceras, antihistamínicos y orientación nutricional de dieta líquida hipercalórica e hiperproteica. Este síndrome está caracterizado como un proceso eruptivo buloso agudo que compromete la calidad de vida del paciente y no hay pruebas de laboratorio específicas por lo que su diagnóstico debe estar basado en la revisión minuciosa de la anamnesis y en los hallazgos clínicos.The multiform erythema appears as a systemic disease where skin and the mucous membranes have participation in relation to some factors such as bacterial or viral infections and in particular the drugs administration, analgesics and antibiotics in general. The aim of present paper was the presentation of case of big multiform erythema triggering by antimicrobials. Authors present the case of a male patient aged 29 with appearance of ulcerous bullous-vesicular lesions in lips, gums, tongue and genital mucosa under treatment with 400 mg norfloxacin due to urinary tract infection for a week. We made support treatment using mouthwashes for oral hygiene and corticoids ointment for ulcer protection, antihistaminics and nutritional guiding of a hypercaloric and hyperprotein liquid diet. This syndrome is characterized

Erythema multiforme-like eruption from a slimming drug preparation cutaneous adverse drug reaction

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Linda Tognetti

2011-01-01

Full Text Available We report a case of a 34-year-old woman presenting with an erythema multiforme (EM-like eruption. Lesions developed after a 12-day treatment with a slimming drug preparation (food integrator with thermogenic activity and a herbal remedy (pilosella tincture. Serological investigations excluded viral or bacterial infections. Patch testing with galenic preparations of both drugs demonstrated sensitization to the slimming drug preparation. According to literature reports and immune-chemical properties, those components that are likely to have triggered the skin eruption are clorazepate dipotassium and theobromine. Their interaction with other two constituents such as pseudoephedrine hydrochloride and dehydrocholic acid may have caused the adverse reaction by means of a summation effect. There are no reports specifically about EM caused by a slimming drug preparation and no studies have identified thermogenic pills as cause of EM/EM-like eruption. Weight-loss compounds in slimming preparations should be kept in mind as a possible cause of drug-induced EM-like eruption.

Expression of CD64 on Circulating Neutrophils Favoring Systemic Inflammatory Status in Erythema Nodosum Leprosum.

Directory of Open Access Journals (Sweden)

Veronica Schmitz

2016-08-01

Full Text Available Erythema Nodosum Leprosum (ENL is an immune reaction in leprosy that aggravates the patient´s clinical condition. ENL presents systemic symptoms of an acute infectious syndrome with high leukocytosis and intense malaise clinically similar to sepsis. The treatment of ENL patients requires immunosuppression and thus needs to be early and efficient to prevent both disabilities and permanent nerve damage. Some patients experience multiple episodes of ENL and prolonged use of immunosuppressive drugs may lead to serious adverse effects. Thalidomide treatment is extremely effective at ameliorating ENL symptoms. Several mechanisms have been proposed to explain the efficacy of thalidomide in ENL, including the inhibition of TNF production. Given its teratogenicity, thalidomide is prohibitive for women of childbearing age. A rational search for molecular targets during ENL episodes is essential to better understand the disease mechanisms involved, which may also lead to the discovery of new drugs and diagnostic tests. Previous studies have demonstrated that IFN-γ and GM-CSF, involved in the induction of CD64 expression, increase during ENL. The aim of the present study was to investigate CD64 expression during ENL and whether thalidomide treatment modulated its expression. Leprosy patients were allocated to one of five groups: (1 Lepromatous leprosy, (2 Borderline leprosy, (3 Reversal reaction, (4 ENL, and (5 ENL 7 days after thalidomide treatment. The present study demonstrated that CD64 mRNA and protein were expressed in ENL lesions and that thalidomide treatment reduced CD64 expression and neutrophil infiltrates-a hallmark of ENL. We also showed that ENL blood neutrophils exclusively expressed CD64 on the cell surface and that thalidomide diminished overall expression. Patient classification based on clinical symptoms found that severe ENL presented high levels of neutrophil CD64. Collectively, these data revealed that ENL neutrophils express CD64

A novel cosmetic antifungal/anti-inflammatory topical gel for the treatment of mild to moderate seborrheic dermatitis of the face: an open-label trial utilizing clinical evaluation and erythema-directed digital photography.

Science.gov (United States)

Dall' Oglio, Federica; Tedeschi, Aurora; Fusto, Carmelinda M; Lacarrubba, Francesco; Dinotta, Franco; Micali, Giuseppe

2017-10-01

Topical cosmetic agents may play a role in the management of facial seborrheic dermatitis by reducing inflammation and scale production. Advanced digital photography, equipped with technology able to provide a detailed evaluation of red skin components corresponding to vascular flare (erythema-directed digital photography), is a useful tool for evaluation of erythema in patients affected by inflammatory dermatoses. The aim of this study was to assess the efficacy and safety of a new cosmetic topical gel containing piroctone olamine, lactoferrin, glycero-phospho-inositol, and Aloe vera for the treatment of facial seborrheic dermatitis by clinical and advanced digital photography evaluation. An open-label, prospective, clinical trial was conducted on 25 patients with mild to moderate facial seborrheic dermatitis. Subjects were instructed to apply the gel twice daily for 45 days. The clinical efficacy was evaluated by measuring at baseline, at day 15 and 45 the degree of desquamation (by clinical examination) and erythema (by digital photography technology via VISIA-CR™ system equipped with RBX™), using a 5-point severity scale, and pruritus (by subject-completed Visual Analogue Scale; scale from 0 to 100 mm). Finally, at baseline and at the end of the study, IGA (Investigator Global Assessment) was performed using a 5-point severity scale (from 0 = worsening to 4 = excellent response). At the end of treatment, a significant reduction (P80% improvement) was recorded in 47.9% of patients, with no case of worsening. No signs of local intolerance were documented. The tested cosmetic topical gel was effective in treating mild to moderate seborrheic dermatitis of the face. Erythema-directed digital photography may represent a noteworthy tool for the therapeutic monitoring of facial seborrheic dermatitis and an important adjunct aid in the dermatologic clinical practice.

Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia

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Palmieri JR

2013-12-01

Full Text Available James R Palmieri,1 Scott King,1 Matthew Case,1 Arben Santo21Department of Microbiology, Infectious and Emerging Diseases, 2Department of Pathology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USAAbstract: A 50-year-old woman from Pulaski, Virginia, presented to a local clinic with headaches, fever, generalized joint pain, excessive thirst and fluid intake, and a progressing rash on her back. On physical examination, she had a large circular red rash on her back with a bull's-eye appearance, 16 × 18 cm in diameter. Serologic tests confirmed a diagnosis of Lyme disease. The patient could recall a walk through the woods 3 weeks prior, although she never noticed a tick on her body. Following a prolonged course of antibiotics, this case report presents a patient with ongoing symptoms consistent with post-treatment Lyme disease.Keywords: arthritis, chronic Lyme disease (CLD, ELISA, erythema migrans, ixodid ticks, Lyme disease, post-treatment Lyme disease syndrome (PTLDS, Western blotting

Characteristics of seroconversion and implications for diagnosis of post-treatment Lyme disease syndrome: acute and convalescent serology among a prospective cohort of early Lyme disease patients.

Science.gov (United States)

Rebman, Alison W; Crowder, Lauren A; Kirkpatrick, Allison; Aucott, John N

2015-03-01

Two-tier serology is often used to confirm a diagnosis of Lyme disease. One hundred and four patients with physician diagnosed erythema migrans rashes had blood samples taken before and after 3 weeks of doxycycline treatment for early Lyme disease. Acute and convalescent serologies for Borrelia burgdorferi were interpreted according to the 2-tier antibody testing criteria proposed by the Centers for Disease Control and Prevention. Serostatus was compared across several clinical and demographic variables both pre- and post-treatment. Forty-one patients (39.4%) were seronegative both before and after treatment. The majority of seropositive individuals on both acute and convalescent serology had a positive IgM western blot and a negative IgG western blot. IgG seroconversion on western blot was infrequent. Among the baseline variables included in the analysis, disseminated lesions (p Lyme disease. Furthermore, these findings underline the difficulty for rheumatologists in identifying a prior exposure to Lyme disease in caring for patients with medically unexplained symptoms or fibromyalgia-like syndromes.

Amplification of the flgE gene provides evidence for the existence of a Brazilian borreliosis

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Elenice Mantovani

2012-06-01

Full Text Available INTRODUCTION: The symptoms of Brazilian borreliosis resemble the clinical manifestations of Lyme disease (LD. However, there are differences between the two in terms of epidemiological and laboratory findings. Primers usually employed to diagnose LD have failed to detect Borrelia strains in Brazil. OBJECTIVE: We aimed to identify the Brazilian Borrelia using a conserved gene that synthesizes the flagellar hook (flgE of Borrelia burgdorferi sensu lato. METHOD: Three patients presenting with erythema migrans and positive epidemiological histories were recruited for the study. Blood samples were collected, and the DNA was extracted by commercial kits. RESULTS: The gene flgE was amplified from DNA of all selected patients. Upon sequencing, these positive samples revealed 99% homology to B. burgdorferi flgE. CONCLUSION: These results support the existence of borreliosis in Brazil. However, it is unclear whether this borreliosis is caused by a genetically modified B. burgdorferi sensu stricto or by a new species of Borrelia spp.

Study of a Cohort of 1,886 Persons To Determine Changes in Antibody Reactivity to Borrelia burgdorferi 3 Months after a Tick Bite

DEFF Research Database (Denmark)

Dessau, Ram B; Fryland, Linda; Wilhelmsson, Peter

2015-01-01

or relative change is defined by dividing the measurement units from the second sample by those from the first sample. The threshold for the minimum level of significant change was defined at the 2.5% level to represent the random error level. The thresholds were a 2.7-fold rise for the flagellar IgG assay......Lyme borreliosis is a tick-borne disease caused by the bacterium Borrelia burgdorferi. The most frequent clinical manifestation is a rash called erythema migrans. Changes in antibody reactivity to B. burgdorferi 3 months after a tick bite are measured using enzyme-linked immunosorbent assays...... (ELISAs). One assay is based on native purified flagellum antigen (IgG), and the other assay is based on a recombinant antigen called C6 (IgG or IgM). Paired samples were taken at the time of a tick bite and 3 months later from 1,886 persons in Sweden and the Åland Islands, Finland. The seroconversion...

Necrolytic migratory erythema associated with glucagonoma syndrome: a case report Eritema necrolítico migratório associado à síndrome glucagonoma: descrição de um caso

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Cassio C. Dal Coleto

2001-12-01

Full Text Available Necrolytic migratory erythema is a rare skin condition that consists of migrating areas of erythema with blisters that heal with hyperpigmentation. It usually occurs in patients with an alpha islet cell tumor of the pancreas-or glucagonoma-and when associated with glucose intolerance, anemia, hyperglucagonemia, and weight loss defines the glucagonoma syndrome. We describe a 52-year-old female patient with necrolytic migratory erythema associated with glucagonoma syndrome who had metastatic disease at presentation and passed away one week after her admission. The autopsy showed a tumor in the body of the pancreas, which was diagnosed as a neuroendocrine tumor and confirmed by immunohistochemistry. The diagnosis of necrolytic migratory erythema is a matter of great importance, since it might be an auxiliary tool for the early detection of glucagonoma.O eritema necrolítico migratório é uma rara condição cutânea que se apresenta como lesões eritematosas, migratórias, com vesículas e bolhas na superfície, evoluindo para cura com hiperpigmentação. É freqüentemente observado em doentes com tumor de células alfa do pâncreas, ou glucagonoma, e quando associado com intolerância a glicose, anemia, hiperglucagonemia, e perda de peso definem a síndrome do glucagonoma. É descrito o caso de uma paciente do sexo feminino, 52 anos, branca, com eritema necrolítico migratório associado à síndrome do glucagonoma com doença metastática na apresentação, vindo a falecer uma semana após sua admissão. A autópsia mostrou um tumor no corpo do pâncreas diagnosticado como tumor neuroendócrino e confirmado pela imuno-histoquímica. O reconhecimento do eritema necrolítico migratório é de grande importância para a possibilidade de diagnóstico precoce do glucagonoma.

Cross-Reactions between Toxocara canis and Ascaris suum in the diagnosis of visceral larva migrans by western blotting technique

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NUNES Cáris Maroni

1997-01-01

Full Text Available Visceral larva migrans (VLM is a clinical syndrome caused by infection of man by Toxocara spp, the common roundworm of dogs and cats. Tissue migration of larval stages causes illness specially in children. Because larvae are difficult to detect in tissues, diagnosis is mostly based on serology. After the introduction of the enzyme-linked immunosorbent assay (ELISA using the larval excretory-secretory antigen of T. canis (TES, the diagnosis specificity was greatly improved although cross-reactivity with other helminths are still being reported. In Brazil, diagnosis is routinely made after absorption of serum samples with Ascaris suum antigens, a nematode antigenicaly related with Ascaris lumbricoides which is a common intestinal nematode of children. In order to identify T. canis antigens that cross react to A. suum antigens we analyzed TES antigen by SDS-PAGE and Western blotting techniques. When we used serum samples from patients suspected of VLM and positive result by ELISA as well as a reference serum sample numerous bands were seen (molecular weight of 210-200 kDa, 116-97 kDa, 55-50 kDa and 35-29 kDa. Among these there is at least one band with molecular weight around 55-66 kDa that seem to be responsible for the cross-reactivity between T. canis e A. suum once it disappears when previous absorption of serum samples with A. suum antigens is performed

Leprosy type 1 reactions and erythema nodosum leprosum Reações hansênicas do tipo 1 e eritema nodoso hansênico

OpenAIRE

Indira P. Kahawita; Stephen L. Walker; Diana N.J. Lockwood

2008-01-01

Leprosy reactions are a major cause of nerve damage and morbidity in a significant proportion of leprosy patients. Reactions are immunologically mediated and can occur even after successful completion of multi-drug therapy. This review focuses on the epidemiology, pathology and treatment of leprosy type 1 reactions, erythema nodosum leprosum and silent neuropathy.As reações hansênicas são a principal causa de dano e morbidade neural em grande parte dos pacientes hansênicos. São imunomediadas ...

ORAL LESIONS OF DRUG INDUCED ERYTHEMA MULTIFORME and ndash; REPORT OF THREE CASES

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Shruthi Hegde

2013-09-01

Full Text Available Abstract: Erythema multiforme (EM is an acute, self-limited, and sometimes recurring skin condition considered to be a hypersensitivity reaction associated with certain infections and medications. A range of medications can trigger the EM. Non-steroidal anti-inflammatory drugs (NSAIDS which are most commonly prescribed for pain relief can also produce rare adverse reactions such as EM. EM is clinically characterized by a and lsquo; and lsquo;minor'' form and a and lsquo; and lsquo;major'' form. Only few reports have stated about oral EM as the third variant of EM. However it is unclear whether EM involving only oral mucosa is a separate entity or is a part of minor form of EM. In this report three cases of EM are discussed , in which two cases involved exclusively oral mucosal lesions and in one case skin manifestations along with oral mucosa was observed. Also the uncommon adverse effects of NSAIDS is highlighted in this report along with its management. [J Contemp Med 2013; 3(3.000: 193-196

Borrelia burgdorferi-specific IgA in Lyme Disease

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Christina D'Arco

2017-05-01

Full Text Available The laboratory diagnosis of Lyme disease is currently dependent on the detection of IgM and IgG antibodies against Borrelia burgdorferi, the causative agent of the disease. The significance of serum IgA against B. burgdorferi remains unclear. The production of intrathecal IgA has been noted in patients with the late Lyme disease manifestation, neuroborreliosis, but production of antigen-specific IgA during early disease has not been evaluated. In the current study, we assessed serum IgA binding to the B. burgdorferi peptide antigens, C6, the target of the FDA-cleared C6 EIA, and FlaB(211-223-modVlsE(275-291, a peptide containing a Borrelia flagellin epitope linked to a modified VlsE sequence, in patients with early and late Lyme disease. Specific IgA was detected in 59 of 152 serum samples (38.8% from early Lyme disease patients. Approximately 50% of early Lyme disease patients who were seropositive for peptide-specific IgM and/or IgG were also seropositive for peptide-specific IgA. In a subpopulation of patients, high peptide-specific IgA could be correlated with disseminated disease, defined as multiple erythema migrans lesions, and neurological disease complications. These results suggest that there may be an association between elevated levels of antigen-specific IgA and particular disease manifestations in some patients with early Lyme disease.

Borrelia burgdorferi-specific IgA in Lyme Disease.

Science.gov (United States)

D'Arco, Christina; Dattwyler, Raymond J; Arnaboldi, Paul M

2017-05-01

The laboratory diagnosis of Lyme disease is currently dependent on the detection of IgM and IgG antibodies against Borrelia burgdorferi, the causative agent of the disease. The significance of serum IgA against B. burgdorferi remains unclear. The production of intrathecal IgA has been noted in patients with the late Lyme disease manifestation, neuroborreliosis, but production of antigen-specific IgA during early disease has not been evaluated. In the current study, we assessed serum IgA binding to the B. burgdorferi peptide antigens, C6, the target of the FDA-cleared C6 EIA, and FlaB(211-223)-modVlsE(275-291), a peptide containing a Borrelia flagellin epitope linked to a modified VlsE sequence, in patients with early and late Lyme disease. Specific IgA was detected in 59 of 152 serum samples (38.8%) from early Lyme disease patients. Approximately 50% of early Lyme disease patients who were seropositive for peptide-specific IgM and/or IgG were also seropositive for peptide-specific IgA. In a subpopulation of patients, high peptide-specific IgA could be correlated with disseminated disease, defined as multiple erythema migrans lesions, and neurological disease complications. These results suggest that there may be an association between elevated levels of antigen-specific IgA and particular disease manifestations in some patients with early Lyme disease. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Histopathological study of ocular erythema nodosum leprosum and post-therapeutic scleral perforation: A case report

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Rathinam S

2008-01-01

Full Text Available Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.

Cytological diagnosis of erythema nodosum leprosum in clinically unsuspected cases: A report of two cases

Directory of Open Access Journals (Sweden)

Shruti Semwal

2018-01-01

Full Text Available Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The manifestations of this disease varies across the spectrum of tuberculoid (TT to lepromatous (LL leprosy.The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Erythema nodosum leprosum (ENL, a type 2 lepra reaction, occurs in lepromatous or borderline lepromatous cases, usually in response to multidrug therapy. Early detection and timely management of these patients is important to reduce the associated morbidity. We report two clinically unusual cases of ENL on fine-needle aspiration cytology. In one case, antileprosy treatment was completed 10 years back, whereas in the other case, ENL was the presenting feature of the disease. Cytological examination of swelling in both the cases showed neutrophils, lymphoid cells, clusters of foamy macrophages, histiocytes, and giant cells. Fite stain was positive, which confirmed the cytological diagnosis of ENL.

Are the current notification criteria for Lyme borreliosis in Norway suitable? Results of an evaluation of Lyme borreliosis surveillance in Norway, 1995–2013

Directory of Open Access Journals (Sweden)

Emily MacDonald

2016-08-01

Full Text Available Abstract Background The approach to surveillance of Lyme borreliosis varies between countries, depending on the purpose of the surveillance system and the notification criteria used, which prevents direct comparison of national data. In Norway, Lyme borreliosis is notifiable to the Surveillance System for Communicable Diseases (MSIS. The current notification criteria include a combination of clinical and laboratory results for borrelia infection (excluding Erythema migrans but there are indications that these criteria are not followed consistently by clinicians and by laboratories. Therefore, an evaluation of Lyme borreliosis surveillance in Norway was conducted to describe the purpose of the system and to assess the suitability of the current notification criteria in order to identify areas for improvement. Methods The CDC Guidelines for Evaluation of Surveillance Systems were used to develop the assessment of the data quality, representativeness and acceptability of MSIS for surveillance of Lyme borreliosis. Data quality was assessed through a review of data from 1996 to 2013 in MSIS and a linkage of MSIS data from 2008 to 2012 with data from the Norwegian Patient Registry (NPR. Representativeness and acceptability were assessed through a survey sent to 23 diagnostic laboratories. Results Completeness of key variables for cases reported to MSIS was high, except for geographical location of exposureThe NPR-MSIS linkage identified 1047 cases in both registries, while 363 were only reported to MSIS and 3914 were only recorded in NPR. A higher proportion of cases found in both registries were recorded as neuroborreliosis in MSIS (84.4 % than those cases found only in MSIS (20.1 %. The trend (average yearly increase or decrease in reported cases of neuroborreliosis in MSIS was not significantly different from the trend for all other clinical manifestations recorded in MSIS in negative binomial regression (p = 0.3. The 16 surveyed laboratories

Duplicated Enhancer Region Increases Expression of CTSB and Segregates with Keratolytic Winter Erythema in South African and Norwegian Families.

Science.gov (United States)

Ngcungcu, Thandiswa; Oti, Martin; Sitek, Jan C; Haukanes, Bjørn I; Linghu, Bolan; Bruccoleri, Robert; Stokowy, Tomasz; Oakeley, Edward J; Yang, Fan; Zhu, Jiang; Sultan, Marc; Schalkwijk, Joost; van Vlijmen-Willems, Ivonne M J J; von der Lippe, Charlotte; Brunner, Han G; Ersland, Kari M; Grayson, Wayne; Buechmann-Moller, Stine; Sundnes, Olav; Nirmala, Nanguneri; Morgan, Thomas M; van Bokhoven, Hans; Steen, Vidar M; Hull, Peter R; Szustakowski, Joseph; Staedtler, Frank; Zhou, Huiqing; Fiskerstrand, Torunn; Ramsay, Michele

2017-05-04

Keratolytic winter erythema (KWE) is a rare autosomal-dominant skin disorder characterized by recurrent episodes of palmoplantar erythema and epidermal peeling. KWE was previously mapped to 8p23.1-p22 (KWE critical region) in South African families. Using targeted resequencing of the KWE critical region in five South African families and SNP array and whole-genome sequencing in two Norwegian families, we identified two overlapping tandem duplications of 7.67 kb (South Africans) and 15.93 kb (Norwegians). The duplications segregated with the disease and were located upstream of CTSB, a gene encoding cathepsin B, a cysteine protease involved in keratinocyte homeostasis. Included in the 2.62 kb overlapping region of these duplications is an enhancer element that is active in epidermal keratinocytes. The activity of this enhancer correlated with CTSB expression in normal differentiating keratinocytes and other cell lines, but not with FDFT1 or NEIL2 expression. Gene expression (qPCR) analysis and immunohistochemistry of the palmar epidermis demonstrated significantly increased expression of CTSB, as well as stronger staining of cathepsin B in the stratum granulosum of affected individuals than in that of control individuals. Analysis of higher-order chromatin structure data and RNA polymerase II ChIA-PET data from MCF-7 cells did not suggest remote effects of the enhancer. In conclusion, KWE in South African and Norwegian families is caused by tandem duplications in a non-coding genomic region containing an active enhancer element for CTSB, resulting in upregulation of this gene in affected individuals. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Not the usual suspect: a case of erythema induration of Bazin in an urban primary care clinic

Directory of Open Access Journals (Sweden)

Ling Xu

2015-12-01

Full Text Available Frontline clinicians in the United States, especially those working in safety net hospitals or with immigrant populations, will likely see cutaneous tuberculosis given the tremendous burden of tuberculosis infection worldwide. The tuberculid is a subtype of cutaneous tuberculosis that poses a diagnostic challenge because organisms are not found in smears or cultures taken from the lesions. Tuberculid lesions can mimic erythema nodosum, thrombophlebitis, and cellulitis. We describe the case of a 57-year-old woman immigrant from China who presented with tender, subcutaneous nodules on her ankle and thigh in the setting of prior exposure to tuberculosis. We describe the clinical, pathophysiologic, and histopathologic features of tuberculids in order to raise awareness among primary care clinicians about this difficult to diagnose but readily treatable manifestation of tuberculosis.

Cluster of atherosclerosis in a captive population of black kites (Milvus migrans subsp.) in France and effect of nutrition on the plasma lipid profile.

Science.gov (United States)

Facon, Charles; Beaufrere, Hugues; Gaborit, Christophe; Albaric, Olivier; Plassiart, Georges; Ammersbach, Melanie; Liegeois, Jean-Louis

2014-03-01

From January 2010 to March 2013, a captive colony of 83 black kites (Milvus migrans subsp.) in France experienced increased mortality related to atherosclerosis with an incidence of 4.4% per year. On histopathology, all kites had advanced atherosclerotic lesions, with several birds presenting abdominal hemorrhage and aortic rupture. In January 2012, a dietary change was instituted and consisted of introducing fish into the kites' diet. During the following 15 mo, the plasma lipid profile was monitored as well as body weight, food offered, and flight activity. Total and low-density lipoprotein cholesterol initially increased, but in December 2012 and March 2013, an overall decrease from initial values was observed. High-density lipoprotein cholesterol also increased during this period. Despite positive plasma lipid changes induced by dietary modifications, there was no decrease in mortality from atherosclerosis, which was probably associated with the severity of the atherosclerotic lesions at time of dietary management. However, owing to the long and progressive development of atherosclerotic lesions, long-term beneficial effects are probable. This report suggests that black kites are particularly susceptible to atherosclerosis and aortic dissection in captivity. To prevent degenerative diseases associated with captivity in birds of prey, species-specific lifestyle and dietary requirements and susceptibility to these diseases should be considered.

Offal dumping sites influence the relative abundance and roosting site selection of Black Kites (Milvus migrans govinda) in urban landscape: a study from Kolkata metropolis, India.

Science.gov (United States)

Mazumdar, Subhendu; Ghose, Dipankar; Saha, Goutam Kumar

2017-12-14

Although Black Kites (Milvus migrans govinda) serve as major scavenging raptor in most of the urban areas, scientific studies on this important ecosystem service provider are almost non-existent in Indian context. The present study was carried out in a metropolis in eastern India to find out the factors influencing relative abundance and roosting site selection of Black Kites. Separate generalized linear models (GLMs) were performed considering encounter rate and roosting Black Kite abundance as response variables. The study conclusively indicated that encounter rates of Black Kites were significantly influenced by the presence of garbage dumps in its vicinity. Numbers of Black Kites were also higher in the roosting sites situated closer to garbage dumps and open spaces. In addition, expected counts of Black Kites significantly increased in roosting sites situated away from buildings and water bodies. However, built-up area and tree cover around the roosting sites had no influence on the abundance of Black Kites therein. With rapid urbanization and changing offal disposal patterns, our findings would be useful to ensure continued availability of food and roosting sites of Black Kites in urban areas.

Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

Science.gov (United States)

Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

2013-06-01

The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia.

Science.gov (United States)

Yap, Felix B; Kiung, Sze T; Yap, Jeffrey B

2016-01-01

There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life. This cross-sectional study was conducted in Hansen's Clinic, Hospital Kuala Lumpur between January 2010 and December 2013 among patients with multibacillary leprosy using the Dermatology Life Quality Index (DLQI). A total of 153 patients participated with 31.4% suffering from ENL. The mean age at presentation was 40.5 ± 16.49 years. The mean DLQI was 7.1 ± 3.72. Patients with ENL were younger (mean age 36.5 vs. 42.4, P = 0.026), had higher mean bacteriologic index (4.3 vs. 3.8, P = 0.004), had physical deformities (47.9% vs. 31.4%, P = 0.049), and had higher mean DLQI score (9.1 vs. 6.2, P leisure. Personal relationship had the lowest effect. Quality of life impairment in patients with leprosy in Malaysia is moderate, with larger effect among patients with ENL. The impairment in ENL is comparable to itchy skin conditions such as urticarial and is worse than chronic skin disease such as psoriasis. Thus, it is essential that management of leprosy incorporate quality of life issues.

Entomologic and demographic correlates of anti-tick saliva antibody in a prospective study of tick bite subjects in Westchester County, New York.

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Schwartz, B S; Nadelman, R B; Fish, D; Childs, J E; Forseter, G; Wormser, G P

1993-01-01

We measured anti-tick saliva antibody (ATSA) by enzyme-linked immunosorbent assay using whole sonicated Ixodes dammini salivary glands as antigen in subjects with 1) a recent and confirmed I. dammini (n = 100) or Dermacentor variabilis bite (n = 3), 2) erythema migrans (n = 15), 3) late-stage Lyme disease (n = 4), and 4) normal controls without a history of tick bites (n = 5). Tick bite subjects had three ATSA determinations over approximately six weeks. On the first ATSA measurement at a mean +/- SD of 18.5 +/- 19.8 hr after removal of the tick, the subjects bitten by I. dammini had a mean ATSA optical density value (95% confidence interval [CI]) of 0.264 (0.223, 0.305); the corresponding value in controls was 0.142 (0.115, 0.169). There was no consistent change in ATSA levels in individuals with time. Multiple linear regression indicated that tick engorgement (P males; P = 0.03) were all independent predictors of ATSA levels. Logistic regression revealed that a bite by I. dammini that became engorged (defined as an engorgement index > or = 3.4) was a risk factor for ATSA seropositivity (odds ratio [95% CI] = 6.2 [1.7, 21.8]). Finally, the ATSA test had a sensitivity of 0.81 and a specificity of 0.56 for a bite by I. dammini that became engorged. Overall, the data are further evidence that ATSA is a biologic marker of tick exposure, in that the engorgement index, a surrogate for tick saliva dose, was the strongest independent predictor of antibody response.

Isolation of Borrelia burgdorferi from the blood of seven patients with Lyme disease.

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Nadelman, R B; Pavia, C S; Magnarelli, L A; Wormser, G P

1990-01-01

Borrelia burgdorferi, the etiologic agent of Lyme disease, has rarely been successfully cultured from blood. We report on seven patients from Westchester County, New York, with B. burgdorferi bacteremia diagnosed between April 1987 and August 1987. One hundred thirty-two attempts to isolate spirochetes were made on blood specimens obtained from 104 patients. Twenty-two of these specimens were obtained from nine patients who had recently been bitten by Ixodes ticks but who were asymptomatic. Heparinized blood or serum specimens (0.2 to 0.4 mL) were inoculated onto 6 mL of modified Barbour-Stoenner-Kelly medium. Lyme serology was performed by enzyme-linked immunosorbent polyvalent, IgM, and IgG assays, fluorescent immunoassay, and microhemagglutination. Four of the seven patients had erythema migrans, two had facial nerve palsy, and one had a flu-like syndrome without rash. These patients represented 21% (four of 19) of all patients with the characteristic skin lesion who had blood cultures for B. burgdorferi, and 40% (two of five) of all those with facial nerve palsy. Serologic testing was frequently nonreactive; two patients had no detectable antibody on multiple sera by five different assays. All patients improved with antibiotic treatment, and had negative subsequent blood cultures, but five of seven had persistent complaints after completion of therapy. Culturing blood for B. burgdorferi may be useful in confirming the diagnosis of Lyme disease in selected patients. Use of spirochete blood cultures may facilitate a better understanding of the pathogenesis and natural history of Lyme disease.

Quantitative assessment of skin erythema due to radiotherapy--evaluation of different measurements

International Nuclear Information System (INIS)

Wengstroem, Yvonne; Forsberg, Christina; Naeslund, Ingemar; Bergh, Jonas

2004-01-01

Background and purpose: Visual assessment is the most common clinical investigation of skin reactions in radiotherapy. Due to the unquantitative and subjective nature of this method additional non-invasive methods are needed for more accurate evaluation of the visible acute adverse skin reactions due to radiotherapy. The purpose of this study was to evaluate a new objective measure with regard to reliability and validity and compare it with an established objective measure and a visual assessment. Patients and methods: A sample of 53 consecutive patients commencing curative tangential radiation therapy to the breast parenchyma were included in the study. The skin area of the treated breast was divided into five sections and assessed individually at 0, 24 and 50 Gy. The RTOG scoring system was used for the visual assessment of the skin reactions. The first objective measure included reflectance spectrometry (DermaSpectrometer) measures at fixed points within the treatment area. For the second objective measure digital images (Camera) were taken with a system using a digital camera and software. The images were analyzed using the Adobe Photoshop 5.0 software program. Results: The results provided significant evidence of the test-retest reliability of the camera. The correlation between the objective measures proved to be significant as the treatment progressed. Conclusions: The results suggest that the camera may be used in a reliable and valid way to measure skin erythema due to radiotherapy

A scanning electron microscope study of the pecten oculi of the black kite (Milvus migrans): possible involvement of melanosomes in protecting the pecten against damage by ultraviolet light

International Nuclear Information System (INIS)

Kiama, S.G.; Maina, J.N.; Bhattacharjee, J.; Weyrauch, K.D.

1994-01-01

The pecten oculi of the black kite (Milvus migrans), a diurnally active bird of prey, has been examined by scanning electron microscopy. In this species the pecten consists of 12 highly vascularised pleats, held together apically by a heavily pigmented 'bridge' and projects freely into the vitreous body in the ventral part of the eye cup. Ascending and descending blood vessels of varying calibre, together with a profuse network of capillaries, essentially constitute the vascular framework of the pecten. A distinct distribution of melansomes is discernible on the pecten, the concentration being highest at its apical end, moderate at the crest of the pleats and least at the basal and lateral margins. Overlying and within the vascular network, a close association between blood vessels and melanocytes is evident. It is conjectured that such an association may have evolved to augment the structural reinforcement of this nutritive organ in order to keep it firmly erectile within the gel-like vitreous. Such erectility may be an essential prerequisite for its optimal functioning, as well as in its overt use as a protective shield against the effects of ultraviolet light, which otherwise might lead to damage of the pectineal vessels. (author)

A scanning electron microscope study of the pecten oculi of the black kite (Milvus migrans): possible involvement of melanosomes in protecting the pecten against damage by ultraviolet light

Energy Technology Data Exchange (ETDEWEB)

Kiama, S.G.; Maina, J.N. [University Coll., Nairobi (Kenya). Faculty of Veterinary Science; Bhattacharjee, J. [Egerton Univ., Njoro (Kenya). Dept. of Zoology; Weyrauch, K.D. [Free University of Berlin (Germany). Inst. of Veterinary Anatomy

1994-12-01

The pecten oculi of the black kite (Milvus migrans), a diurnally active bird of prey, has been examined by scanning electron microscopy. In this species the pecten consists of 12 highly vascularised pleats, held together apically by a heavily pigmented `bridge` and projects freely into the vitreous body in the ventral part of the eye cup. Ascending and descending blood vessels of varying calibre, together with a profuse network of capillaries, essentially constitute the vascular framework of the pecten. A distinct distribution of melansomes is discernible on the pecten, the concentration being highest at its apical end, moderate at the crest of the pleats and least at the basal and lateral margins. Overlying and within the vascular network, a close association between blood vessels and melanocytes is evident. It is conjectured that such an association may have evolved to augment the structural reinforcement of this nutritive organ in order to keep it firmly erectile within the gel-like vitreous. Such erectility may be an essential prerequisite for its optimal functioning, as well as in its overt use as a protective shield against the effects of ultraviolet light, which otherwise might lead to damage of the pectineal vessels. (author).

Assessment of a correlation between Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and selected biophysical skin measures (skin hydration, pH, and erythema intensity) in dogs with naturally occurring atopic dermatitis.

Science.gov (United States)

Zając, Marcin; Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Łukasz R; Pomorski, Zbigniew J H; Sitkowski, Wiesław; Gołyński, Marcin

2015-04-01

Atopic dermatitis is a common allergic skin disease in dogs. The aim of this study was to examine the possibility of a correlation between biophysical skin variables: skin hydration (SH), skin pH, and erythema intensity measured in 10 different body regions and both total Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and CADESI measured in a given region (CADESI L). The study was conducted using 33 dogs with atopic dermatitis. The assessment of the biophysical variables was done in 10 body regions: the lumbar region, right axillary fossa, right inguinal region, ventral abdominal region, right lateral thorax region, internal surface of the auricle, interdigital region of right forelimb, cheek, bridge of nose, and lateral site of antebrachum. Positive correlations were found between SH and CADESI L for the following regions: the inguinal region (r = 0.73) and the interdigital region (r = 0.82), as well as between total CADESI and SH on digital region (r = 0.52). Also, positive correlations were reported for skin pH and CADESI L in the lumbar region (r = 0.57), the right lateral thorax region (r = 0.40), and the lateral antebrachum (r = 0.35). Positive correlations were found in the interdigital region between erythema intensity and the total CADESI-03 (r = 0.60) as well as the CADESI L (r = 0.7). The results obtained suggest that it may be possible to use skin hydration, pH, and erythema intensity to assess the severity of skin lesion but positive correlation was only found in < 13.3% of possible correlations and usage of these measures in dogs is limited.

[Pain syndromes in tick-borne neuroborreliosis. Clinical aspects and differential diagnosis.].

Science.gov (United States)

Kohler, J; Thoden, U

1987-09-01

Tick-borne borreliosis (Borrelia burgdorferi) is a common and complex disorder affecting the skin, the joints and the nervous system. It progresses through different clinical stages. The clinical spectrum of neuroborreliosis has expanded since the introduction and widespread application of specific serological tests. We have investigated 41 patients with Bannwarth's meningopolyneuritis (MPN) as the classical form of neuroborreliosis, in a prospective (26 patients) and a retrospective (15 patients) study. When questioned, 19/41 patients reported a tick bite and only 15/41, erythema migrans as the characteristic early skin lesion. In 34/41 patients typical MPN characterized by painful radiculoneuritis and/or cranial neuritis, especially facial palsy, were seen. Among these, 3 had a complicated form with a progressive remitting relapsing course or focal central nervous system involvement (hemiparesis, cerebellar syndrome); 2 had mild meningitis and facial nerve palsy bilaterally without radicular pain; and in 5 radicular pain was the only symptom. MPN associated with Lyme arthritis was observed only once. In 2 patients in the retrospective study (no antibiotics in the acute stage) we saw a chronic spinal cord disorder with spastic paresis several years after uncomplicated MPN, accompanied in 1 of them by acrodermatitis chronica atrophicans (ACA), the typical late-onset borrelia-induced dermatosis. In the acute stage of the disease 40/41 patients had a cerebrospinal fluid (CSF) syndrome compatible with MPN (mononuclear pleocytosis, blood-brain barrier dysfunction, elevated IgG and/or oligoclonal bands). IgG antibody titers against borrelia antigen were elevated in all patients in the serum and in 21/30 also in the CSF. In all patients pain was an early and prominent symptom; the first symptoms are usually felt in the region of the tick bite or the erythema, initially as diffuse myalgia, arthralgia or pain in the connective tissue. In the further course the migrating

Objective Assessment of Sunburn and Minimal Erythema Doses: Comparison of Noninvasive In Vivo Measuring Techniques after UVB Irradiation

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Lo Pei-Yu

2010-01-01

Full Text Available Military personnel movement is exposed to solar radiation and sunburn is a major problem which can cause lost workdays and lead to disciplinary action. This study was designed to identify correlation parameters in evaluating in vivo doses and epidermis changes following sunburn inflammation. Several noninvasive bioengineering techniques have made objective evaluations possible. The volar forearms of healthy volunteers ( , 2 areas, 20 mm in diameter, were irradiated with UVB 100 mj/ and 200 mj/ , respectively. The skin changes were recorded by several monitored techniques before and 24 hours after UV exposures. Our results showed that chromameter value provides more reliable information and can be adopted with mathematical model in predicting the minimal erythema dose (MED which showed lower than visual assessment by 10 mj/ (Pearson correlation coefficient . A more objective measure for evaluation of MED was established for photosensitive subjects' prediction and sunburn risks prevention.

The effects of topically applied glycolic acid and salicylic acid on ultraviolet radiation-induced erythema, DNA damage and sunburn cell formation in human skin.

Science.gov (United States)

Kornhauser, Andrija; Wei, Rong-Rong; Yamaguchi, Yuji; Coelho, Sergio G; Kaidbey, Kays; Barton, Curtis; Takahashi, Kaoruko; Beer, Janusz Z; Miller, Sharon A; Hearing, Vincent J

2009-07-01

alpha-Hydroxy acids (alphaHAs) are reported to reduce signs of aging in the skin and are widely used cosmetic ingredients. Several studies suggest that alphaHA can increase the sensitivity of skin to ultraviolet radiation. More recently, beta-hydroxy acids (betaHAs), or combinations of alphaHA and betaHA have also been incorporated into antiaging skin care products. Concerns have also arisen about increased sensitivity to ultraviolet radiation following use of skin care products containing beta-HA. To determine whether topical treatment with glycolic acid, a representative alphaHA, or with salicylic acid, a betaHA, modifies the short-term effects of solar simulated radiation (SSR) in human skin. Fourteen subjects participated in this study. Three of the four test sites on the mid-back of each subject were treated daily Monday-Friday, for a total of 3.5 weeks, with glycolic acid (10%), salicylic acid (2%), or vehicle (control). The fourth site received no treatment. After the last treatment, each site was exposed to SSR, and shave biopsies from all four sites were obtained. The endpoints evaluated in this study were erythema (assessed visually and instrumentally), DNA damage and sunburn cell formation. Treatment with glycolic acid resulted in increased sensitivity of human skin to SSR, measured as an increase in erythema, DNA damage and sunburn cell formation. Salicylic acid did not produce significant changes in any of these biomarkers. Short-term topical application of glycolic acid in a cosmetic formulation increased the sensitivity of human skin to SSR, while a comparable treatment with salicylic acid did not.

Objective Assessment of Sunburn and Minimal Erythema Doses: Comparison of Noninvasive In Vivo Measuring Techniques after UVB Irradiation

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Kuo-Sheng Cheng

2010-01-01

Full Text Available Military personnel movement is exposed to solar radiation and sunburn is a major problem which can cause lost workdays and lead to disciplinary action. This study was designed to identify correlation parameters in evaluating in vivo doses and epidermis changes following sunburn inflammation. Several noninvasive bioengineering techniques have made objective evaluations possible. The volar forearms of healthy volunteers (n=20, 2 areas, 20 mm in diameter, were irradiated with UVB 100 mj/cm2 and 200 mj/cm2, respectively. The skin changes were recorded by several monitored techniques before and 24 hours after UV exposures. Our results showed that chromameter a∗ value provides more reliable information and can be adopted with mathematical model in predicting the minimal erythema dose (MED which showed lower than visual assessment by 10 mj/cm2 (Pearson correlation coefficient ℑ=0.758. A more objective measure for evaluation of MED was established for photosensitive subjects' prediction and sunburn risks prevention.

Eritema anular eosinofílico en un adulto Eosinophilic anular erythema in an adult.

Science.gov (United States)

Lobo, Marta Aguado; Gonzalo, Elena Sierra; Jiménez-Reyes, José

2017-10-15

Eosinophilic annular erythema (EAE) is an uncommon eosinophilic dermatosis. Clinically it is characterized by recurrent episodes of annular or figurative plaques. The histopathological study shows a perivascular inflammatory infiltrate in the superficial and deep dermis, composed of lymphocytes and eosinophils. It was originally described in children. We report an adult woman who presented with recurrent erythematous annular plaques on the trunk and extremities. A biopsy showed a mainly perivascular lymphocytic infiltrate with numerous eosinophils in the dermis. Laboratory examinations revealed subclinical hypothyroidism. The lesions resolved with topical corticosteroid spontaneously after 3 months.El eritema anular eosinofílico (EAE) es una dermatosis eosinofílica poco frecuente. Clínicamente se caracteriza por episodios recurrentes de placas anulares o figuradas.El estudio histopatológico muestra un infiltrado inflamatorio en dermis superficial y profunda, de localización perivascular y compuesto por linfocitos y eosinófilos. Se describió originariamente en niños. Presentamos una mujer adulta con episodios recurrentes de placas anulares o figuradas en el tronco y extremidades. La biopsia mostró un infiltrado linfocítico perivascular con numerosos eosinófilos en la dermis. La analítica reveló la presencia de hipotiroidismo subclínico. Las lesiones se resolvieron después de tres meses de tratamiento con una crema de corticoesteriodes.

Examination of the Microbial Spectrum in the Etiology of Erythema Nodosum: A Retrospective Descriptive Study

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Ozlem Ozbagcivan

2017-01-01

Full Text Available Even though infections are the most common cause of erythema nodosum (EN, only certain microorganisms take the great interest such as streptococci in knowledge. Our aim was to examine the frequency and type of infections in EN, to determine the characteristics of patients with an infectious etiology, and to discuss the role of these microbes in EN pathology in the context of their interactions with humans. Charts of 81 patients with EN who were seen between 2003 and 2017 were retrospectively reviewed. Identified etiological factors were classified into three groups: infectious, noninfectious, and idiopathic. While there were no significant demographic and clinical differences between the infectious and idiopathic groups, systemic symptoms (p=0.034 and the number of EN lesions (p=0.016 were significantly lower; the mean erythrocyte sedimentation rate was significantly higher (p=0.049, but the mean aspartate aminotransferase value was significantly lower in the infectious group compared to the noninfectious group (p=0.019. Besides streptococci, many other microbes, including the ones living on and inside us, were identified in the etiology of EN. There is a need for large-scale prospective studies involving control groups for a better understanding of the microbial immunopathology of EN.

Distribution and presentation of Lyme borreliosis in Scotland - analysis of data from a national testing laboratory.

Science.gov (United States)

Mavin, S; Watson, E J; Evans, R

2015-01-01

This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland. Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period. Results The number of laboratory-confirmed cases of Lyme borreliosis in Scotland peaked at 440 in 2010. From 2008 to 2013 the estimated average annual incidence was 6.8 per 100,000 (44.1 per 100,000 in NHS Highland). Of 594 questionnaires from NHS Highland patients: 76% had clinically confirmed Lyme borreliosis; 48% erythema migrans; 17% rash, 25% joint, 15% neurological and 1% cardiac symptoms. Only 61% could recall a tick bite. Conclusion The incidence of Lyme borreliosis may be stabilising in Scotland but NHS Highland remains an area of high incidence. Lyme borreliosis should be considered in symptomatic patients that have had exposure to ticks and not just those with a definite tick bite.

The first case of imported Borrelia miyamotoi disease concurrent with Lyme disease.

Science.gov (United States)

Oda, Rentaro; Kutsuna, Satoshi; Sekikawa, Yoshiyuki; Hongo, Igen; Sato, Kozue; Ohnishi, Makoto; Kawabata, Hiroki

2017-05-01

Borrelia miyamotoi disease (BMD) is an emerging infectious disease caused by B. miyamotoi. Although BMD has been reported in the United States, Europe, and Japan, no case of imported BMD has been described in the world. Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans. Serologic analysis supported our diagnosis, and doxycycline was administered for 14 days. However, we also suspected coinfection with BMD because of his fever, elevated liver function test results and his travel history. The patient was seropositive for the immunoglobulin M antibody to recombinant glycerophosphodiester phosphodiesterase, and was diagnosed with coinfection with BMD. This case suggests that BMD should be considered in febrile travelers returning from the Northeastern and Midwestern regions of the United States, and that BMD and Lyme disease coinfection should be considered to detect cases of imported BMD. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Leprosy type 1 reactions and erythema nodosum leprosum Reações hansênicas do tipo 1 e eritema nodoso hansênico

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Indira P. Kahawita

2008-02-01

Full Text Available Leprosy reactions are a major cause of nerve damage and morbidity in a significant proportion of leprosy patients. Reactions are immunologically mediated and can occur even after successful completion of multi-drug therapy. This review focuses on the epidemiology, pathology and treatment of leprosy type 1 reactions, erythema nodosum leprosum and silent neuropathy.As reações hansênicas são a principal causa de dano e morbidade neural em grande parte dos pacientes hansênicos. São imunomediadas e podem ocorrer mesmo após o término bem sucedido da poliquimioterapia. Esta revisão enfoca a epidemiologia, a patologia e o tratamento das reações hansênicas do tipo 1, do eritema nodoso hansênico e da neuropatia silenciosa.

Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia

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Felix B Yap

2016-01-01

Full Text Available Background: There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL. Thus, we aim to study the effect of ENL on quality of life. Materials and Methods: This cross-sectional study was conducted in Hansen's Clinic, Hospital Kuala Lumpur between January 2010 and December 2013 among patients with multibacillary leprosy using the Dermatology Life Quality Index (DLQI. Results: A total of 153 patients participated with 31.4% suffering from ENL. The mean age at presentation was 40.5 ± 16.49 years. The mean DLQI was 7.1 ± 3.72. Patients with ENL were younger (mean age 36.5 vs. 42.4, P = 0.026, had higher mean bacteriologic index (4.3 vs. 3.8, P = 0.004, had physical deformities (47.9% vs. 31.4%, P = 0.049, and had higher mean DLQI score (9.1 vs. 6.2, P < 0.001. All the DLQI domains were higher in patients suffering from ENL except the treatment domain. Symptoms and feeling was the domain with the largest effect followed by daily activities and leisure. Personal relationship had the lowest effect. Conclusion: Quality of life impairment in patients with leprosy in Malaysia is moderate, with larger effect among patients with ENL. The impairment in ENL is comparable to itchy skin conditions such as urticarial and is worse than chronic skin disease such as psoriasis. Thus, it is essential that management of leprosy incorporate quality of life issues.

Zoonotic Hookworm FAQs

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... larva migrans. What are the clinical manifestations of animal (zoonotic) hookworm in people? Cutaneous larval migrans (CLM) in a person's foot. ... and larvae may be found in dirt where animals have been. People may become infected while walking barefoot or when ...

Objective Assessment of Sunburn and Minimal Erythema Doses: Comparison of Noninvasive In Vivo Measuring Techniques after UVB Irradiation

Science.gov (United States)

Huang, Min-Wei; Lo, Pei-Yu; Cheng, Kuo-Sheng

2010-12-01

Military personnel movement is exposed to solar radiation and sunburn is a major problem which can cause lost workdays and lead to disciplinary action. This study was designed to identify correlation parameters in evaluating in vivo doses and epidermis changes following sunburn inflammation. Several noninvasive bioengineering techniques have made objective evaluations possible. The volar forearms of healthy volunteers ([InlineEquation not available: see fulltext.]), 2 areas, 20 mm in diameter, were irradiated with UVB 100 mj/[InlineEquation not available: see fulltext.] and 200 mj/[InlineEquation not available: see fulltext.], respectively. The skin changes were recorded by several monitored techniques before and 24 hours after UV exposures. Our results showed that chromameter [InlineEquation not available: see fulltext.] value provides more reliable information and can be adopted with mathematical model in predicting the minimal erythema dose (MED) which showed lower than visual assessment by 10 mj/[InlineEquation not available: see fulltext.] (Pearson correlation coefficient [InlineEquation not available: see fulltext.]). A more objective measure for evaluation of MED was established for photosensitive subjects' prediction and sunburn risks prevention.

Seria o Ancylostoma caninum um dos agentes da neurorretinite sub-aguda difusa unilateral (D.U.S.N. no Brasil?

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Casella Antônio Marcelo Barbante

2001-01-01

Full Text Available Os autores apresentam um caso de neurorretinite subaguda difusa unilateral (D.U.S.N confirmada com a identificação da larva em uma criança de 6 anos associada a quadro de larva migrans cutânea, bem como a análise de outros sete casos de D.U.S.N. e sua associação sorológica à toxocaríase e antecedentes de larva migrans cutânea. Este é o primeiro caso descrito na literatura de D.U.S.N. concomitante a larva migrans cutânea na fase ativa.

Dogs’ gastrointestinal parasites and their association with public health in Iran

OpenAIRE

Kohansal Mohammad Hasan; Fazaeli Asghar; Nourian Abbasali; Haniloo Ali; Kamali Koorosh

2017-01-01

Introduction: Dogs harbour zoonotic parasites that cause serious infections in humans, such as visceral larva migrans, ocular larva migrans, cystic echinococcosis, and alveolar echinococcosis. Studies on dogs’ gastrointestinal parasites in different geographical locations are required to increase knowledge of the risk of canine zoonoses in human populations.

Visceral larval migrans masquerading as metastatic disease in a toddler with Wilms tumor

Energy Technology Data Exchange (ETDEWEB)

Anderson, Andrew; Fordham, Lynn Ansley; Bula, Melania L. [University of North Carolina School of Medicine, Department of Radiology, Chapel Hill, NC (United States); Blatt, Julie [University of North Carolina School of Medicine, Department of Pediatrics, Chapel Hill, NC (United States)

2006-03-15

A 22-month-old girl with a renal mass had multiple small pulmonary nodules on CT at her initial presentation. After biopsy and neoadjuvant chemotherapy, a Wilms tumor was resected and the pulmonary nodules were shown to have regressed on CT. Follow-up imaging 4 months after initial diagnosis demonstrated multiple new liver lesions and new pulmonary nodules with peripheral eosinophilia. Lung biopsy revealed granuloma formation with prominent eosinophils. The serum antibody titers for Toxocara canis were elevated. This case illustrates that toxocariasis should be considered as a rare differential diagnostic possibility for multiple liver lesions and multifocal peripheral pulmonary opacities in young children with Wilms tumor. (orig.)

Biomonitoring of organochlorine compounds (PCDDs, PCDFs, PCBs and DDTs) near a municipal solid waste incinerator using black kites (Milvus migrans) as sentinel organism

Energy Technology Data Exchange (ETDEWEB)

Jimenez, B.; Merino, R. [CSIC, Inst. of Organic Chemistry, Madrid (Spain); Olie, K. [Univ. of Amterdam (Netherlands); Blanco, G.; Frias, O. [CSIC, IREC, Ciudad Real (Spain)

2004-09-15

Wildlife has received much attention during last decades as an indicator of ecosystems health. Kubiak at al. (1989) showed that there are significant effect on reproductive success due to organochlorines, not only in hatching success, but also in chick health. Due to the widespread distribution of these xenoestrogens, there is a need for screening and risk evaluation of these endocrine disrupters in living organisms from the global point of view of ecosystems health. Aspects of the life history of the black kites (Milvus migrans) make them a useful species for contaminants monitoring. They are long-lived birds, adapt well to human areas and many feeds at dumps, garbage tips, etc. where a wide range of contaminants can be found3. Effects of chlorinated pollutants have not been widely studied in this species. In 2001, a monitoring program was initiated in order to evaluate the health of a population of black kites nesting in the Regional Park of the Southeastern of Madrid (RPSM), Spain. This study is part of a larger research investigation of the influence of a Municipal Solid Waste Incinerator (MSWI) on the kites'surroundings. Since Municipal Solid Waste Incinerators (MSWI) are suspected to produce some highly toxic POPs (Persistent Organic Pollutants) such as polychlorinated dibenzo-pdioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs) as well as other short of toxic chemicals (e.g. PCBs and heavy metals) this study was initiated with the aim of investigating the potential toxicity of these compounds on the kites population. The purpose of this study was to conduct the evaluation in a non-destructive way. Since eggs are known to reflect the accumulation of lipophilic contaminants in birds, the study was based on the use of unhatched eggs obtained from black kites.

Molecular diversity of human parvovirus B19 during two outbreaks of erythema infectiosum in Brazil

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Rita de Cássia Nasser Cubel Garcia

2017-01-01

Full Text Available This study was conducted to provide information on the genetic diversity of human parvovirus B19 (B19V circulating in the municipality of Niterói, Rio de Janeiro, Southeast Brazil during 1996–2006, a period with two distinct outbreaks of B19V infection: 1999–2000 and 2004–2005. A total of 27 sera from patients with erythema infectiosum and five sera from HIV-infected patients that tested positive for B19V DNA during the study period were analyzed. To genotype B19V strains, a semi-nested PCR for partial amplification of the capsid gene was performed and sequence analysis revealed that 31 sequences belonged to subgenotype 1a (G1a of the main genotype 1 and one sequence was characterized as subgenotype 3b (G3b. The phylogenetic tree supported the division of the G1a into two well-defined clades with 1.3% of divergence. The low diversity of the G1a strains may be explained by the fact that all patients had acute B19V infection and 30/32 sera were collected during two distinct outbreaks. The G3b strain was from an HIV-infected patient who seroconverted to anti-B19 IgG antibodies in September/2005. This is the first report of G3b in the state of Rio de Janeiro.

Erythema induratum of Bazin associated with Addison's disease: first description Eritema indurado de Bazin associado à doença de Addison: primeira descrição

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Rodrigo Antonio Brandão Neto

2012-01-01

Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.CONTEXTO: O eritema indurado de Bazin (EIB é considerado uma reação tuberculoide e consiste de nódulos dolorosos recorrentes. O diagnóstico diferencial inclui doenças como vasculite nodular, perniose, poliarterite nodosa e eritema nodoso. RELATO DE CASO: Nós reportamos o caso de uma mulher com EIB que desenvolveu doença de Addison durante tratamento com drogas tuberculostáticas e com boa resposta com reposição de glicocorticoide. O diagnóstico foi realizado pela apresentação clínica, teste tuberculínico positivo e positividade para BCG (bacilo Calmette-Guérin no espécime histológico. A reposição de glicocorticoides e drogas tuberculostáticas levou ao desaparecimento dos sinais e sintomas. CONCLUSÕES: Este é o primeiro caso reportando a associação entre EIB e doença de Addison. Tuberculose é um importante agente etiológico da doença de Addison.

Importance of sample preparation for molecular diagnosis of lyme borreliosis from urine.

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Bergmann, A R; Schmidt, B L; Derler, A-M; Aberer, E

2002-12-01

Urine PCR has been used for the diagnosis of Borrelia burgdorferi infection in recent years but has been abandoned because of its low sensitivity and the irreproducibility of the results. Our study aimed to analyze technical details related to sample preparation and detection methods. Crucial for a successful urine PCR were (i) avoidance of the first morning urine sample; (ii) centrifugation at 36,000 x g; and (iii) the extraction method, with only DNAzol of the seven different extraction methods used yielding positive results with patient urine specimens. Furthermore, storage of frozen urine samples at -80 degrees C reduced the sensitivity of a positive urine PCR result obtained with samples from 72 untreated erythema migrans (EM) patients from 85% in the first 3 months to samples was proven by hybridization with a GEN-ETI-K-DEIA kit and for a 10 further positive amplicons by sequencing. By using all of these steps to optimize the urine PCR technique, B. burgdorferi infection could be diagnosed by using urine samples from EM patients with a sensitivity (85%) substantially better than that of serological methods (50%). This improved method could be of future importance as an additional laboratory technique for the diagnosis of unclear, unrecognized borrelia infections and diseases possibly related to Lyme borreliosis.

Vaccination against Lyme disease: Are we ready for it?

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Kaaijk, Patricia; Luytjes, Willem

2016-03-03

Lyme disease is the most common tick-borne illness in the Northern hemisphere and is caused by spirochetes of the Borrelia burgdorferi sensu lato complex. A first sign of Borrelia infection is a circular skin rash, erythema migrans, but it can develop to more serious manifestations affecting skin, nervous system, joints, and/or heart. The marked increase in Lyme disease incidence over the past decades, the severity of the disease, and the associated high medical costs of, in particular, the persistent forms of Lyme disease requires adequate measures for control. Vaccination would be the most effective intervention for prevention, but at present no vaccine is available. In the 1990s, 2 vaccines against Lyme disease based on the OspA protein from the predominant Borrelia species of the US showed to be safe and effective in clinical phase III studies. However, failed public acceptance led to the demise of these monovalent OspA-based vaccines. Nowadays, public seem to be more aware of the serious health problems that Lyme disease can cause and seem more ready for the use of a broadly protective vaccine. This article discusses several aspects that should be considered to enable the development and implementation of a vaccine to prevent Lyme disease successfully.

Tick-borne disease.

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Bratton, Robert L; Corey, Ralph

2005-06-15

Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. If no symptoms follow exposure to tick bites, empiric treatment is not indicated. The same tick may harbor different infectious pathogens and transmit several with one bite. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases.

Immunofluorescence in multiple tissues utilizing serum from a patient affected by systemic lupus erythematosus

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Piotr Brzezinski

2012-01-01

Full Text Available Introduction: Lupus erythematosus is a chronic, inflammatory autoimmune disease that can affect multiple organs. Lupus can affect many parts of the body, especially in systemic lupus erythematosus (SLE; affected tissues may include the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Case report: A 46-year-old female presented with pruritus, photosensitivity and edema of the cheeks of about 2 years duration, and was evaluated by a dermatologist. On examination, multiple telangiectasias were present on the cheeks, with erythema, edema and a malar rash observed. A review of systems documented breathing difficulty and pleuitic pain, joint pain and joint edema, photosensitivity, cardiac dysrhythmia, and periodic pain in the back close to the kidneys. Methods: Skin biopsies for hematoxylin and eosin testing, as well for direct and indirect immunofluorescence were performed, in addition to multiple diagnostic blood tests, chest radiography and directed immunologic testing. Results: The blood testing showed elevated C-reactive protein. Direct and indirect immunofluorescence testing utilizing monkey esophagus, mouse and pig heart and kidney, normal human eyelid skin and veal brain demonstrated strong reactivity to several components of smooth muscle, nerves, blood vessels, skin basement membrane zone and sweat gland ducts and skin meibomian glands. Anti-endomysium antibodies were detected as well as others, especially using FITC conjugated Complement/C1q, FITC conjugated anti-human immunoglobulin IgG and FITC conjugated anti-human fibrinogen. Conclusions: We conclude that both direct and indirect immunofluorescence using several substrates can unveil previously undocumented autoantibodies in multiple organs in lupus erythematosus, and that these findings could be utilized to complement existing diagnostic testing for this disorder.

Visceral larva migrans

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... parasites) that are found in the intestines of dogs and cats. Eggs produced by these worms are in the feces of the infected animals. The feces mix with soil. Humans can get sick if they accidentally eat soil ...

An Unexpected Innocent Complication Associated with Azacitidine Treatment of Myelodysplastic Syndrome: Erythema Annulare Centrifugum

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Esra Turan Erkek

2016-03-01

Full Text Available Skin lesions accompanying hematological malignancies can be formed due to either direct tumor infiltration of the skin or indirect effects. Indirectly developing lesions may be a component of paraneoplastic syndrome. Erythema annulare centrifugum (EAC is considered to be a hypersensitivity reaction developed against various antigens associated with infections, drugs, and endocrine diseases. EAC, rarely seen in neoplastic diseases, has been reported in lymphoma, leukemia, histiocytosis, and prostate cancer. Here we report EAC in a patient using a hypomethylating agent, azacitidine. A 69-year-old female patient was admitted to our polyclinic with weakness and ecchymosis in her legs existing for 3 months. She was considered as having refractory anemia with excess blasts-2 according to myelodysplastic syndrome (MDS classification [1]. Because there was only hyperdiploidy in conventional cytogenetic examination, she was classified in group intermediate-2 of the International Prognostic Scoring System. She had a history of radical mastectomy and adjuvant chemoradiotherapy for breast cancer 3 years ago. She said that variously sized round and oval erythematous, itching, painless lesions had formed in the abdominal region on the 4th day of azacitidine usage (75 mg/m2/day, 7 days, s.c. (Figure 1 and 2. There were no concomitant complaints or physical examination findings except fatigue. After azacitidine was stopped, a skin biopsy was taken. In the biopsy, mild perivascular inflammatory infiltration accompanying vascular ectasia in the papillary dermis was detected. The possibility of paraneoplastic syndrome was excluded due to the disappearance of all lesions by 1 week after cessation of treatment. During the second course of azacitidine, the lesions reoccurred on the second day. Subsequently to the second course, the patient died of sepsis, which developed after pneumonia.

Multiple gingival pregnancy tumors with rapid growth

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Wei-Lian Sun

2014-09-01

Full Text Available Pregnancy gingivitis is an acute form of gingivitis that affects pregnant women, with a prevalence of 30%, possibly ranging up to 100%. Sometimes, pregnancy gingivitis shows a tendency toward a localized hyperplasia called gingival pyogenic granuloma. Pregnancy tumor is a benign gingival hyperplasia with the gingiva as the most commonly involved site, but rarely it involves almost the entire gingiva. A 22-year-old woman was referred to our clinic with a chief complaint of gingival swelling that had lasted for 2 days. The lesions progressed rapidly and extensively, and almost all the gingiva was involved a week later. Generalized erythema, edema, hyperplasia, a hemorrhagic tendency, and several typical hemangiomatous masses were noted. Pregnancy was denied by the patient at the first and second visits, but was confirmed 2 weeks after the primary visit. The patient was given oral hygiene instructions. She recovered well, and the mass gradually regressed and had disappeared completely at the end of 12 weeks of pregnancy, without recurrence. The gingival lesions were finally diagnosed as multiple gingival pregnancy tumors. The patient delivered a healthy infant. An extensive and rapid growth of gingival pregnancy tumors during the early first month of pregnancy is a rare occurrence that is not familiar to dentists, gynecologists, and obstetricians. Those practitioners engaged in oral medicine and periodontology, primary care obstetrics, and gynecology should be aware of such gingival lesions to avoid misdiagnosis and overtreatment.

Successful treatment of canine necrolytic migratory erythema (superficial necrolytic dermatitis) due to metastatic glucagonoma with octreotide.

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Oberkirchner, Ursula; Linder, Keith E; Zadrozny, Leah; Olivry, Thierry

2010-10-01

Necrolytic migratory erythema (NME; also known as superficial necrolytic dermatitis) is a syndrome most often associated with certain chronic liver diseases or pancreatic glucagonomas. In humans with glucagonoma-associated NME, skin lesions usually respond to octreotide, a somatostatin analogue that inhibits glucagon release. In this report an 11-year-old golden retriever dog with pancreatic glucagonoma and metastasis to the regional lymph nodes, spleen and liver was diagnosed with NME. The dog exhibited erosions, ulcers and crusts on the paws, pressure points, muzzle, periocular area and prepuce. The dog was also anorexic and had difficulty walking. Because metastasis precluded surgery, treatment was initiated with subcutaneous octreotide (2 μg/kg twice daily). Skin lesions and systemic clinical signs improved markedly within 5 days. The dosage was increased to nearly 3 μg/kg twice daily and signs almost completely resolved within 10 days. Anorexia was the major adverse effect observed. During the following month, both dosage (1-3.7 μg/kg) and frequency (two to four times daily) of the octreotide injections were adjusted to permit control of clinical signs while maintaining adequate appetite. Temporary cessation of octreotide administration resulted in the rapid recurrence of skin lesions. Resuming injections led to improvement of clinical signs within 48 h. The dog was later euthanized because of progressive metastatic disease. In conclusion, subcutaneous octreotide injections were beneficial in this dog with glucagonoma-associated NME. This somatostatin analogue could be a valuable option to treat canine patients with non-resectable or relapsing pancreatic glucagonoma-associated NME. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease

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Eshoo, Mark W.; Crowder, Christopher C.; Rebman, Alison W.; Rounds, Megan A.; Matthews, Heather E.; Picuri, John M.; Soloski, Mark J.; Ecker, David J.; Schutzer, Steven E.; Aucott, John N.

2012-01-01

Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of circulating Borrelia burgdorferi DNA. To address this challenge, we have developed a sensitive strategy to both detect and genotype B. burgdorferi directly from whole blood collected during the initial patient visit. This strategy improved sensitivity by employing 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multi-locus PCR and electrospray ionization mass spectrometry detection assay. We evaluated the assay on blood collected at the initial presentation from 21 endemic area patients who had both physician-diagnosed erythema migrans (EM) and positive two-tiered serology either at the initial visit or at a follow-up visit after three weeks of antibiotic therapy. Results of this DNA analysis showed detection of B. burgdorferi in 13 of 21 patients (62%). In most cases the new assay also provided the B. burgdorferi genotype. The combined results of our direct detection assay with initial physician visit serology resulted in the detection of early Lyme disease in 19 of 21 (90%) of patients at the initial visit. In 5 of 21 cases we demonstrate the ability to detect B. burgdorferi in early Lyme disease directly from whole blood specimens prior to seroconversion. PMID:22590620

[Human parvovirus B19 infection which first presented with petechial hemorrhage, followed by papular-purpuric gloves and socks syndrome and erythema infectiosum].

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Sato, Atsuo; Umezawa, Remi; Kurosawa, Rumiko; Kajigaya, Yasuhiko

2002-11-01

A case of human parvovirus B19 (B19) infection is reported. A 6-year-old previously healthy girl was admitted to our hospital complaining of slight fever and petechial hemorrhage on her neck, trunk and the proximal parts of extremities. On admission, the platelet count was within normal range (180 x 10(3)/microliter) but white blood cells and reticulocytes were moderately suppressed (2.4 x 10(3)/microliter and 1@1000, respectively). The purpura disappeared in a week and the blood cell counts fully recovered without any specific treatment. Detection of B19 DNA and anti-B19 IgM antibody in the serum on admission led to the final diagnosis. Since the cellular receptor for B19, the blood group P antigen, is expressed on vascular endothelial cells as well as erythroid progenitor cells, the purpura was considered to be the result of direct vascular injury. She was very unique as she subsequently exhibited papular-purpuric gloves and socks syndrome and erythema infectiosum during follow-up. This case may provide a new insight into the pathogenesis of cutaneous manifestations of B19 infection.

Pulmonary and hepatic involvement of toxocariasis in an aduIt: case report

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Choi, Soo Jin; Kim, Jee Eun; Park, Chul Hi; Yang, Dal Mo [Gil Medical Center, Incheon (Korea, Republic of)

2004-08-01

Toxocariasis is known as visceral larva migrans in humans and it is caused by T. canis and T. catis, especially in children, but it is less commonly reported in adults. Although several cases of toxocariasis in adults have been reported, there have been no descriptions of toxocariasis involving the liver or, the lungs and the pleura. We report here on a case of T. canis infection in an immunocompetent adult with peripheral eosinophilia, elevated serum levels of Ig E and CT findings displaying multiple focal air space consolidations in the lungs, bilateral pleural effusion and low attenuated hepatic nodules.

Relationships between T-cell-mediated immune response and Pb, Zn, Cu, Cd, and as concentrations in blood of nestling white storks (Ciconia ciconia) and black kites (Milvus migrans) from Doñana (southwestern Spain) after the Aznalcóllar toxic spill.

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Baos, Raquel; Jovani, Roger; Forero, Manuela G; Tella, José L; Gómez, Gemma; Jiménez, Begoña; González, María J; Hiraldo, Fernando

2006-04-01

In the Aznalcóllar mining accident (April 1998), nearly six million cubic meters of toxic wastes were spilled in the surroundings of the Doñana National Park (southwestern Spain). The present study focused on the likely effects of metal pollution on the immune system of nestling white storks (Ciconia ciconia) and black kites (Milvus migrans) sampled in the nearby area. Using the phytohaemagglutinin skin test, we examined cell-mediated immune response (CMI) in relation to Pb, Zn, Cu, Cd, and As concentrations in blood of 281 nestling white storks and of 89 black kites. The former species was monitored along a four-year period (1999, 2001-2003), while black kites were sampled in 1999. Overall, average levels of heavy metals and As were relatively low when compared to those reported for birds in metal-polluted areas. Copper showed a negative effect on CMI in both species, although the relationship was significant only for white storks in 2002. We found no evidence that environmental exposure to Pb, Zn, As, and Cd had any effect on nestlings' CMI. Interannual consistency is revealed as an important factor, supporting the need of long-term studies when assessing the immunotoxic effects of metal exposure in the wild.

Erythema multiforme

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... mouth sores that interferes with eating and drinking Antibiotics for skin infections Corticosteroids to control inflammation Medicines for eye symptoms Good hygiene and staying away from other people may ...

Western blot banding pattern in early Lyme borreliosis among patients from an endemic region of north-eastern Poland.

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Flisiak, R; Wierzbicka, I; Prokopowicz, D

1998-01-01

Aim of this study was evaluation of Western blot banding patterns in different clinical forms of early Lyme borreliosis diagnosed in patients from north-eastern Poland, recognized as endemic for tick-borne diseases. Study was performed on serum samples of 48 patients with Lyme borreliosis and 26 healthy volunteers, as controls. Samples tested routinely for total antibody with enzyme immunoassay were subsequently analysed for specific antibodies with Western blot based on antigen extract of European strain of Borrelia burgdorferi. In patients, IgM antibodies were the most frequently directed against 41 kDa and 58 kDa antigens, whereas in control group only antibodies against 45 kDa and 58 kDa were present. Similar response was observed in respect to IgG antibodies. Evaluation of banding pattern in respect to clinical form of the disease revealed the highest prevalence of IgM and IgG anti-41 kDa antibodies in patients with erythema migrans and Lyme arthritis, and anti-58 kDa in neuroborreliosis patients, who had no anti-21 kDa antibodies. Relatively high frequency of IgG antibodies against 21, 30 and 93 kDa antigens was typical for neuroborreliosis. Bands count was significantly higher in different clinical forms of the disease than in controls, and it was the highest in neuroborreliosis. Combined analysis of Western blot results (IgM/IgG) enabled to achieve higher sensitivity (84%) and specificity (100%) than available with the most recommended EIA kits.

Tick borne illness-Lyme disease.

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Bush, Larry M; Vazquez-Pertejo, Maria T

2018-05-01

Lyme disease is the most commonly reported tick-borneillness in the United States. Thecausative spirochete, Borrelia burgdorferi is transmitted by 4 species of Ixodes tick species. Over 90% of US cases occur in northeasternstates from Maine to Virginia, and in Wisconsin, Minnesota, and Michigan. Infection also takes place in northern California and Oregon. Lyme borreliosis is also diagnosed in parts of Europe, China, and Japan. The white-footed mouse is the primary animal reservoir for B. burgdorferi in the U.S. and the preferred host for nymphal and larval forms of the deer tick. Deer are hosts for the adult ticks but do not carry the spirochete. Signs and symptomsof infection occur in 3 stages; early localized, typified by erythema migrans; early disseminated with a flu-like syndrome, neurologic, and cardiac manifestations; and late, characteristically with arthritis. Although, the term 'Chronic Lyme Disease' has been assigned to many patients with a variety of unexplained symptoms, experts in the field question the validity of this diagnosis and warn against prolonged unproven antimicrobial therapies. Diagnosis relies upon clinical evaluation and is supported by serologic testing using a 2-step process which requires careful interpretation. Treatmentvaries with stage of disease, but normally includes doxycycline, amoxicillin,and ceftriaxone. Currently, no preventative vaccine is available. In some geographic areas, patients may be confected with Babesia, Ehrlichia, and Anaplasma since the same Ixodes ticks transmit these pathogens. Copyright © 2018 Mosby, Inc. All rights reserved.

Detection of IFN-γ Secretion by T Cells Collected Before and After Successful Treatment of Early Lyme Disease.

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Callister, Steven M; Jobe, Dean A; Stuparic-Stancic, Aleksandra; Miyamasu, Misato; Boyle, Jeff; Dattwyler, Raymond J; Arnaboldi, Paul M

2016-05-15

Current serodiagnostics for Lyme disease lack sensitivity during early disease, and cannot determine treatment response. We evaluated an assay based on QuantiFERON technology utilizing peptide antigens derived from Borrelia burgdorferi to stimulate interferon-gamma (IFN-γ) release as an alternative to serodiagnosis for the laboratory detection of Lyme disease. Blood was obtained from patients with erythema migrans before (n = 29) and 2 months after (n = 27) antibiotic therapy. IFN-γ release was measured by enzyme-linked immunosorbent assay (ELISA) following overnight stimulation of whole blood with the peptide antigens, and compared to the results of standard serological assays (C6, ELISA, and Western blot). IFN-γ release was observed in pretreatment blood of 20 of 29 (69%) patients with Lyme disease. Following antibiotic treatment, IFN-γ was significantly reduced (P = .0002), and was detectable in only 4 of 20 (20%) initially positive patients. By contrast, anti-C6 antibodies were detected in pretreatment sera from 17 of 29 (59%) subjects, whereas only 5 of 29 (17%) patients had positive Western blot seroreactivity. Antibody responses persisted and expanded following treatment. Our findings suggest that measurement of IFN-γ after incubating blood with Borrelia antigens could be useful in the laboratory diagnosis of early Lyme disease. Also, after antibiotic treatment, this response appears to be short lived. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Asian-Australian Writers: Bridging the Gap

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Amelberga Vita Astuti

2015-06-01

Full Text Available Artikel ini membahas tentang wawancara (dengan, tulisan, dan karya sastra oleh para penulis wanita migran di Australia yang berasal dari negara-negara di Asia Tenggara. Tulisan ini meneliti kehidupan para penulis ketika tinggal di Australia, yang memiliki perbedaan budaya, sosial dan politik dengan negara asli mereka. Menggunakan gagasan cultural identity and diaspora dari Stuart Hall dan conditional hospitality dari Jaques Derrida, artikel ini mengungkap peran penting penulis migran dalam menjembatani perbedaan antara budaya timur dan barat. Analisis artikel menunjukkan bahwa identitas budaya mereka berubah untuk memperkecil jarak perbedaan dan proses perubahan ini terwujud dalam tulisan mereka.

Disseminated toxocariasis in an immunocompetent host

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Madan Raj Aryal

2014-10-01

Full Text Available Toxocariasis is a zoonotic infection caused by Toxocara canis, or less commonly, Toxocara cati, which is one of the most common zoonotic infections worldwide. It commonly affects the pediatric and immunocompromised population; however, it has rarely been reported in the immunocompetent adults. Two of the well-recognized syndromes in children are visceral larva migrans and ocular larva migrans. Infection in adults usually ranges from asymptomatic to non-specific symptoms which makes the diagnosis challenging. A case of 36 year-old male was presented with disseminated toxocariasis with pulmonary and hepatic involvement and striking peripheral eosinophilia.

An Isolated Bee Sting Involving Multiple Cranial Nerves

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Hassan Motamed

2013-01-01

Full Text Available Hymenoptera stings are self-limiting events or due to allergic reactions. Sometimes envenomation with Hymenoptera can cause rare complications such as acute encephalopathy, peripheral neuritis, acute renal failure, nephrotic syndrome, silent myocardial infarction, rhabdomyolysis, conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. The mechanism of peripheral nervous system damage is not clearly known. In our studied case after bee sting on face between the eyebrows with little erythema and  cm in size, bilateral blindness developed and gradually improved. Lateral movement of eyes was restricted with no pain. Involvement of cranial nerves including II, V, and VI was found. With conservative therapy after a year significant improvement has been achieved.

Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women.

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Heinrich, Ulrike; Neukam, Karin; Tronnier, Hagen; Sies, Helmut; Stahl, Wilhelm

2006-06-01

Dietary antioxidants contribute to endogenous photoprotection and are important for the maintenance of skin health. In the present study, 2 groups of women consumed either a high flavanol (326 mg/d) or low flavanol (27 mg/d) cocoa powder dissolved in 100 mL water for 12 wk. Epicatechin (61 mg/d) and catechin (20 mg/d) were the major flavanol monomers in the high flavanol drink, whereas the low flavanol drink contained 6.6 mg epicatechin and 1.6 mg catechin as the daily dose. Photoprotection and indicators of skin condition were assayed before and during the intervention. Following exposure of selected skin areas to 1.25 x minimal erythemal dose (MED) of radiation from a solar simulator, UV-induced erythema was significantly decreased in the high flavanol group, by 15 and 25%, after 6 and 12 wk of treatment, respectively, whereas no change occurred in the low flavanol group. The ingestion of high flavanol cocoa led to increases in blood flow of cutaneous and subcutaneous tissues, and to increases in skin density and skin hydration. Skin thickness was elevated from 1.11 +/- 0.11 mm at wk 0 to 1.24 +/- 0.13 mm at wk 12; transepidermal water loss was diminished from 8.7 +/- 3.7 to 6.3 +/- 2.2 g/(h x m2) within the same time frame. Neither of these variables was affected in the low flavanol cocoa group. Evaluation of the skin surface showed a significant decrease of skin roughness and scaling in the high flavanol cocoa group compared with those at wk 12. Dietary flavanols from cocoa contribute to endogenous photoprotection, improve dermal blood circulation, and affect cosmetically relevant skin surface and hydration variables.

MIGRASI BERULANG TENAGA KERJA MIGRAN INTERNASIONAL: KASUS PEKERJA MIGRAN ASAL DESA SUKOREJO WETAN, KABUPATEN TULUNGAGUNG

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Mita Noveria

2017-08-01

Full Text Available Working overseas is an attempt to earn higher income and to accumulate financial capitals to run small enterprise in migrants’ place of origins. In fact, many Indonesia returned migrants decided to re-migrate, either to previous countries or to new destination countries. This paper aims to assess factors that cause remigration of the returned labor migrants. This study used quantitative and qualitative data, based on research in one of major international labor migrants sending village in Indonesia, namely Sukorejo Wetan in Tulungagung District. Quantitative data was collected through survey on selected households, while qualitative data was gathered by in-depth interview, focus group discussion (FGD, and observation. The analysis shows four dominant factors that caused returned migrants to re-migrate, namely: (1 the remittances only sufficed consumption needs; (2 the returned migrants faced difficulties in adapting to labor force conditions at place of origins (i.e., job scarceness and low wage; (3 limited ability in entrepreneurship; and (4 availability of social network that facilitates remigration.

Alphabetical Index of Parasitic Diseases

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... Cercarial Dermatitis) Swimming Pools Back To Top T Taeniasis ( Taenia Infection, Tapeworm Infection) Tapeworm Infection (Taeniasis, Taenia Infection) Toxocariasis ( Toxocara Infection, Ocular Larva Migrans, ...

Arthropod-Borne Diseases: The Camper's Uninvited Guests.

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Juckett, Gregory

2015-08-01

Arthropod-borne diseases are a major problem whenever outdoor activities bring arthropods and people into contact. The arthropods discussed here include arachnids (ticks) and insects. Most arthropod bites and stings are minor, with the notable exception being bee-sting anaphylaxis. Ticks cause the most disease transmission. Key hard tick vectors include black-legged (Ixodes), dog (Dermacentor), and lone star (Amblyomma) ticks, which transmit Lyme and various rickettsial diseases. Insect repellents, permethrin sprays, and proper tick inspection reduce this risk significantly. Lyme disease and the milder southern-tick-associated rash illness (STARI) are characterized by the erythema migrans rash followed, in the case of Lyme disease, by early, disseminated, and late systemic symptoms. Treatment is with doxycycline or ceftriaxone. Indefinite treatment of "chronic Lyme disease" based on subjective symptoms is not beneficial. Rickettsial diseases include ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever, which are characterized by fever, headache, and possible rash and should be empirically treated with doxycycline while awaiting laboratory confirmation. Tularemia is a bacterial disease (Francisella) spread by ticks and rabbits and characterized by fever and adenopathy. Treatment is with gentamicin or streptomycin. Babesiosis is a protozoal disease, mimicking malaria, that causes a self-limited flu-like disease in healthy hosts but can be life threatening with immune compromise. Treatment is with atovaquone and azithromycin. Other tick-related conditions include viral diseases (Powassan, Colorado tick fever, heartland virus), tick-borne relapsing fever (Borrelia), and tick paralysis (toxin). Mosquitoes, lice, fleas, and mites are notable for their annoying bites but are increasingly significant disease vectors even in the United States.

A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale.

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Walker, Stephen L; Sales, Anna M; Butlin, C Ruth; Shah, Mahesh; Maghanoy, Armi; Lambert, Saba M; Darlong, Joydeepa; Rozario, Benjamin Jewel; Pai, Vivek V; Balagon, Marivic; Doni, Shimelis N; Hagge, Deanna A; Nery, José A C; Neupane, Kapil D; Baral, Suwash; Sangma, Biliom A; Alembo, Digafe T; Yetaye, Abeba M; Hassan, Belaynesh A; Shelemo, Mohammed B; Nicholls, Peter G; Lockwood, Diana N J

2017-07-01

We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL. Participants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of "Much better", "somewhat better", "somewhat worse" and "much worse" compared with "No change" or "about the same". 447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach's alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change. The 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy. The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research.

Biomonitoring of heavy metals in feathers of eleven common bird species in urban and rural environments of Tiruchirappalli, India.

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Manjula, Menon; Mohanraj, R; Devi, M Prashanthi

2015-05-01

Heavy metals continue to remain as a major environmental concern in spite of emission control measures. In this study, we analyzed the concentrations of heavy metals (Fe, Cr, Mn, Ni, Cu, Zn, and Cd) in the feathers of 11 species of birds collected from urban and rural areas of Tiruchirappalli, Southern India. Metal concentrations followed the order: Fe > Cu > Zn > Cr > Mn > Ni > Cd. Irrespective of sample locations, heavy metals such as Fe, Cr, Ni, Zn, and Cu were detected in high concentrations, while Cd and Mn were observed in lower concentrations. In contrary to our assumption, there were no statistically significant intraspecific and urban-rural differences in the metal concentrations except for Zn. Pairwise comparisons among species irrespective of metal type showed significant interspecific differences between Acridotheres tristis and Centropus phasianinus, A. tristis and Milvus migrans, C. phasianinus and M. migrans, M. migrans and Eudynamys scolopaceus, and Psittacula krameri and E. scolopaceus. Principal component analysis carried out for urban data extracted Ni, Mn, Zn, Fe, and Cu accounting for 48% variance implying dietary intake and external contamination as important sources for metals. In the rural, association of Zn, Cd, Ni, and Cr suggests the impact of metal fabrication industries and leather tanning operations.

Histopathology of nymphal pentastomid infections (Sebekia mississippiensis) in paratenic hosts.

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Boyce, W M; Kazacos, E A

1991-02-01

The histopathologic alterations occurring in mice, hamsters, turtles, and a frog were described following experimental infection with nymphs of Sebekia mississippiensis. Initially, nymphal migration caused traumatic tissue damage and hemorrhage characteristic of larva migrans. Subsequent inflammatory responses included cellular infiltration with eosinophils, macrophages, and lymphocytes, and fibrotic encapsulation of the nymphs. Dead nymphs were surrounded by a necrotic granulomatous response similar to that reported previously in humans and other animals. Differences were not seen in animals given single or multiple infections, but mice and hamsters exhibited a more marked inflammatory response than turtles. Overall, the histopathologic response to nymphal infections resembled those seen in infections resulting from ingestion of eggs, and both sources of infection should be considered in epidemiologic investigations of naturally occurring pentastomiasis.

Investigation of Monnose-Binding Lectin gene Polymorphism in Patients with Erythema Multiforme, Stevens-Johnson Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome

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Sevil Toka

2012-09-01

Full Text Available Objective: Monnose-Binding lectin (MBL appears to play an important role in the immune system. The genetic polymorphisms in the MBL2 gene can result in a reduction of serum levels, leading to a predisposition to recurrent infection. The aim of this study is to investigate the influence of a polymorphism in codon 54 of the MBL2 gene on the susceptibility to Erythema Multiforme, Stevens-Johnson Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome (EM, SJS and SJS/TEN overlap syndrome. Material and Methods: Our study included 64 patients who were clinically and/or histopathologically diagnosed with EM, SJS, and SJS/TEN overlap syndrome and 66 healthy control subjects who were genotyped for the MBL2 gene codon 54 polymorphism using the PCR-RFLP method. For all statistical analyses, the level of significance was set at p<0.05. Results: The prevalence of the B allele was 18% in the EM, SJS and SJS/TEN patient groups and 13% in the control group. No significant differences in allele frequencies of any polymorphism were observed between the patient and control groups, although the B allele was more frequent in the patient groups (p=0.328.Conclusion: Our results provide no evidence of a relationship between MBL2 gene codon 54 polymorphism and the susceptibility to EM, SJS and SJS/TEN overlap syndrome. However, these findings should be confirmed in studies with a larger sample size.

Daytime Changes of Skin Biophysical Characteristics: A Study of Hydration, Transepidermal Water Loss, pH, Sebum, Elasticity, Erythema, and Color Index on Middle Eastern Skin.

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Firooz, Alireza; Zartab, Hamed; Sadr, Bardia; Bagherpour, Leili Naraghi; Masoudi, Aidin; Fanian, Ferial; Dowlati, Yahya; Ehsani, Amir Hooshang; Samadi, Aniseh

2016-01-01

The exposure of skin to ultraviolet radiation and temperature differs significantly during the day. It is reasonable that biophysical parameters of human skin have periodic daily fluctuation. The objective of this study was to study the fluctuations of various biophysical characteristics of Middle Eastern skin in standardized experimental conditions. Seven biophysical parameters of skin including stratum corneum hydration, transepidermal water loss, pH, sebum, elasticity, skin color, and erythema index were measured at three time points (8 a.m., 12 p.m. and 4 p.m.) on the forearm of 12 healthy participants (mean age of 28.4 years) without any ongoing skin disease using the CK MPA 580 device in standard temperature and humidity conditions. A significant difference was observed between means of skin color index at 8 a.m. (175.42 ± 13.92) and 4 p.m. (164.44 ± 13.72, P = 0.025), between the pH at 8 a.m. (5.72 ± 0.48) and 4 p.m. (5.33 ± 0.55, P = 0.001) and pH at 12 p.m. (5.60 ± 0.48) and 4 p.m. (5.33 ± 0.55, P = 0.001). Other comparisons between the means of these parameters at different time points resulted in nonsignificant P values. There are daytime changes in skin color index and pH. Skin color index might be higher and cutaneous pH more basic in the early morning compared to later of the day.

[Larva migrans syndrome or ocular toxocariasis].

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Pizzi, D R; Maffrand, R A; De Lisa, I S; Pizzi, H L; Plaza Ontiveros, R G

2001-01-01

Thirteen cases of ocular toxocariasis attended in the Oftalmology Service of the Pediatric Hospital "Niño Jesús", from Córdoba; and in the Parasitology and Micology Cathedra of the Medicine Collegue of the University of Córdoba were studied from July 1993 till July 1995. The authors determine the needs of taking into account this parasitosis; above all in children and with the antecedent of contact with pets.

Molecular Typing of Borrelia burgdorferi Sensu Lato by Randomly Amplified Polymorphic DNA Fingerprinting Analysis

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Wang, Guiqing; van Dam, Alje P.; Spanjaard, Lodewijk; Dankert, Jacob

1998-01-01

To study whether pathogenic clusters of Borrelia burgdorferi sensu lato strains occur, we typed 136 isolates, cultured from specimens from patients (n = 49) with various clinical entities and from ticks (n = 83) or dogs (n = 4) from different geographic regions, by randomly amplified polymorphic DNA (RAPD) fingerprinting with four arbitrary primers. The RAPD patterns were reproducible up to the 95% similarity level as shown in duplicate experiments. In these experiments the purified DNAs prepared on different days, from different colonies, and after various passages were used as templates. With an intergroup difference of 55%, the 136 strains could be divided into seven genetic clusters. Six clusters comprised and corresponded to the established species B. burgdorferi sensu stricto (n = 23), Borrelia garinii (n = 39), Borrelia afzelii (n = 59), Borrelia japonica (n = 1), Borrelia valaisiana (n = 12), and genomic group DN127 (n = 1). One strain from a patient with erythema migrans (EM) did not belong to any of the species or genomic groups known up to now. The RAPD types of B. burgdorferi sensu stricto, B. garinii, and B. afzelii isolates, which may give rise to human Lyme borreliosis (LB), were associated with their geographic origins. A high degree of genetic diversity was observed among the 39 B. garinii strains, and six subgroups could be recognized. One of these comprised eight isolates from patients with disseminated LB only and no tick isolates. B. afzelii strains from patients with EM or acrodermatitis chronica atrophicans were not clustered in particular branches. Our study showed that RAPD analysis is a powerful tool for discriminating different Borrelia species as well as Borrelia isolates within species. PMID:9508310

Geographical and genospecies distribution of Borrelia burgdorferi sensu lato DNA detected in humans in the USA.

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Clark, Kerry L; Leydet, Brian F; Threlkeld, Clifford

2014-05-01

The present study investigated the cause of illness in human patients primarily in the southern USA with suspected Lyme disease based on erythema migrans-like skin lesions and/or symptoms consistent with early localized or late disseminated Lyme borreliosis. The study also included some patients from other states throughout the USA. Several PCR assays specific for either members of the genus Borrelia or only for Lyme group Borrelia spp. (Borrelia burgdorferi sensu lato), and DNA sequence analysis, were used to identify Borrelia spp. DNA in blood and skin biopsy samples from human patients. B. burgdorferi sensu lato DNA was found in both blood and skin biopsy samples from patients residing in the southern states and elsewhere in the USA, but no evidence of DNA from other Borrelia spp. was detected. Based on phylogenetic analysis of partial flagellin (flaB) gene sequences, strains that clustered separately with B. burgdorferi sensu stricto, Borrelia americana or Borrelia andersonii were associated with Lyme disease-like signs and symptoms in patients from the southern states, as well as from some other areas of the country. Strains most similar to B. burgdorferi sensu stricto and B. americana were found most commonly and appeared to be widely distributed among patients residing throughout the USA. The study findings suggest that human cases of Lyme disease in the southern USA may be more common than previously recognized and may also be caused by more than one species of B. burgdorferi sensu lato. This study provides further evidence that B. burgdorferi sensu stricto is not the only species associated with signs and/or symptoms consistent with Lyme borreliosis in the USA.

Comparison of MKP and BSK-H media for the cultivation and isolation of Borrelia burgdorferi sensu lato.

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Eva Ružić-Sabljić

Full Text Available The isolation of B. burgdorferi sensu lato requires the use of complex cultivation media. The aim of the study was to compare the usefulness of BSK-H (a commercial medium produced by HiMedia, India and MKP medium. MKP and BSK-H media were prepared in accordance with the relevant protocols. Borrelia strains and skin culture biopsies were simultaneously inoculated into both media, incubated and checked for growth. Borrelial growth characteristics, isolation rates and characteristics of the isolated borreliae were analysed and compared. Initially, numbers of spirochaetes were higher in BSK-H than in MKP; however, in comparison with MKP, the strains subcultured in BSK-H medium were more frequently irregular, thin and non-motile, and rapidly died. In addition, the borrelial isolation rate from erythema migrans skin samples was higher in MKP than in BSK-H medium (108/171, 63.2% versus 70/171, 40.9%; p<0.0001. The far most frequently isolated species was Borrelia afzelii (92.9% and 97.2% strains isolated from BSK-H and MKP, respectively. Comparison of strains cultured from individual patients in both media showed differences in plasmid contents in 9/46 (19.6% strain pairs, and protein profiles differed in 30/43 (69.8% strain pairs, most often in the expression of OspC (in 27/28 patients OspC was expressed only in strains growing in MKP. BSK-H medium supports the growth of borrelial strains but MKP is superior with regard to the isolation rate, morphology and motility of strains. BSK-H medium supports fast initial growth of borreliae but this is followed by rapid deformation and death of the spirochaetes.

Long-term assessment of fatigue in patients with culture-confirmed Lyme disease.

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Wormser, Gary P; Weitzner, Erica; McKenna, Donna; Nadelman, Robert B; Scavarda, Carol; Nowakowski, John

2015-02-01

Fatigue is a common symptom with numerous causes. Severe fatigue is thought to be an important manifestation of post-treatment Lyme disease syndrome. The frequency with which severe fatigue occurs as a long-term sequela in prospectively followed patients with Lyme disease is unknown. Patients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fatigue using an 11-item Fatigue Severity Scale (FSS-11) that has been used in studies of post-treatment Lyme disease syndrome. An FSS-11 score of ≥4.0 is indicative of severe fatigue. A total of 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (range, 42-86 years). The mean duration of follow-up was 15.4 years (range, 11-20 years). Nine subjects had severe fatigue but in none as a consequence of Lyme disease. Only 3 subjects were thought to possibly have persistent fatigue from Lyme disease. The FSS-11 value for these 3 individuals was less than 4, averaging 2.27, and none had functional impairment. Severe fatigue was found in 9 patients (9%) with culture-confirmed early Lyme disease at 11 to 20 years after presentation, but was due to causes other than Lyme disease. Fatigue of lesser severity was possibly due to Lyme disease, but was found in only 3% of 100 patients, and therefore is rarely a long-term complication of this infection. Copyright © 2015 Elsevier Inc. All rights reserved.

Interferon-γ-induced protein 10 in Lyme disease.

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Fallahi, P; Elia, G; Bonatti, A

2017-01-01

Lyme disease is an infectious disease caused by bacteria of the Borrelia type, that affects about 300,000 people a year in the USA and 65,000 people a year in Europe. Borrelia infection, and Lyme disease, following occupational exposure has been frequently reported in USA, Europe and Asia. The manifestations of Lyme disease include erythema migrans (EM), arthritis, neuroborrelliosis (NB), and others. Cytokines and chemokines primarily orchestrate leukocyte recruitment to the areas of Borrelia infection, and they are critical mediators of immune and inflammatory responses, in particular of the induction of interferon (IFN)-γ and IFN-γ dependent chemokines. In EM high levels of T helper (Th) 1 cells chemoattranctants [monokine induced by IFN-γ (MIG), IFN-γ-induced protein 10 (IP- 10), and IFN-inducible T cell alpha chemoattractant (I-TAC)] have been shown. Synovial tissues and fluids of patients with Lyme Arthritis (LA) (overall with antibiotic-refractory LA) contained exceptionally high levels of Th1 chemoattractants and cytokines, particularly MIG and IFN-γ. In NB concentrations of IP-10 and I-TAC in the cerebrospinal fluid (CSF) were significantly higher, suggesting that IP-10 and I-TAC create a chemokine gradient between the CSF and serum and recruite C-X-C chemokine receptor 3-expressing memory CD4+ T-cells into the CSF of these patients. A positive association between the disseminating capacity of B. burgdorferi and early type I IFN induction has also been shown. These results suggest that IFN-γ dependent chemokines are important biomarkers to monitor the progression and diffusion of the disease in patients with Borrelia infection; further larger studies are needed.

Accuracy of Clinician Suspicion of Lyme Disease in the Emergency Department.

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Nigrovic, Lise E; Bennett, Jonathan E; Balamuth, Fran; Levas, Michael N; Chenard, Rachel L; Maulden, Alexandra B; Garro, Aris C

2017-12-01

To make initial management decisions, clinicians must estimate the probability of Lyme disease before diagnostic test results are available. Our objective was to examine the accuracy of clinician suspicion for Lyme disease in children undergoing evaluation for Lyme disease. We assembled a prospective cohort of children aged 1 to 21 years who were evaluated for Lyme disease at 1 of the 5 participating emergency departments. Treating physicians were asked to estimate the probability of Lyme disease (on a 10-point scale). We defined a Lyme disease case as a patient with an erythema migrans lesion or positive 2-tiered serology results in a patient with compatible symptoms. We calculated the area under the curve for the receiver operating curve as a measure of the ability of clinician suspicion to diagnose Lyme disease. We enrolled 1021 children with a median age of 9 years (interquartile range, 5-13 years). Of these, 238 (23%) had Lyme disease. Clinician suspicion had a minimal ability to discriminate between children with and without Lyme disease: area under the curve, 0.75 (95% confidence interval, 0.71-0.79). Of the 554 children who the treating clinicians thought were unlikely to have Lyme disease (score 1-3), 65 (12%) had Lyme disease, and of the 127 children who the treating clinicians thought were very likely to have Lyme disease (score 8-10), 39 (31%) did not have Lyme disease. Because clinician suspicion had only minimal accuracy for the diagnosis of Lyme disease, laboratory confirmation is required to avoid both under- and overdiagnosis. Copyright © 2017 by the American Academy of Pediatrics.

Surveillance for Lyme disease in Canada: 2009-2015.

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Gasmi, S; Ogden, N H; Lindsay, L R; Burns, S; Fleming, S; Badcock, J; Hanan, S; Gaulin, C; Leblanc, M A; Russell, C; Nelder, M; Hobbs, L; Graham-Derham, S; Lachance, L; Scott, A N; Galanis, E; Koffi, J K

2017-10-05

To summarize seven years of surveillance data for Lyme disease cases reported in Canada from 2009 to 2015. We describe the incidence over time, seasonal and geographic distribution, demographic and clinical characteristics of reported Lyme disease cases. Logistic regression was used to explore differences between age groups, sex and year to better understand potential demographic risk factors for the occurrence of Lyme disease. The number of reported Lyme disease cases increased more than six-fold, from 144 in 2009 to 917 in 2015, mainly due to an increase in infections acquired in Canada. Most locally acquired cases were reported between May and November. An increase in incidence of Lyme disease was observed in provinces from Manitoba eastwards. This is consistent with our knowledge of range expansion of the tick vectors in this region. In the western provinces the incidence has remained low and stable. All cases reported by Alberta, Saskatchewan and Newfoundland and Labrador were acquired outside of the province, either elsewhere in Canada or abroad. There was a bimodal distribution for Lyme disease by age with peaks at 5-9 and 45-74 years of age. The most common presenting symptom was a single erythema migrans rash (74.2%) and arthritis (35.7%). Variations in the frequency of reported clinical manifestations were observed among age groups and years of study. Lyme disease incidence continues to increase in Canada as does the geographic range of ticks that carry the Lyme disease bacteria. Ongoing surveillance, preventive strategies as well as early disease recognition and treatment will continue to minimize the impact of Lyme disease in Canada.

2-tiered antibody testing for early and late Lyme disease using only an immunoglobulin G blot with the addition of a VlsE band as the second-tier test.

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Branda, John A; Aguero-Rosenfeld, Maria E; Ferraro, Mary Jane; Johnson, Barbara J B; Wormser, Gary P; Steere, Allen C

2010-01-01

Standard 2-tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second-tier IgG blot that performs well throughout the infection. Separate serum sets from LD patients and control subjects were tested independently at 2 medical centers using whole-cell enzyme immunoassays and IgM and IgG immunoblots, with recombinant VlsE added to the IgG blots. The results from both centers were combined, and a new second-tier IgG algorithm was developed. With standard 2-tiered IgM and IgG testing, 31% of patients with active erythema migrans (stage 1), 63% of those with acute neuroborreliosis or carditis (stage 2), and 100% of those with arthritis or late neurologic involvement (stage 3) had positive results. Using new IgG criteria, in which only the VlsE band was scored as a second-tier test among patients with early LD (stage 1 or 2) and 5 of 11 IgG bands were required in those with stage 3 LD, 34% of patients with stage 1, 96% of those with stage 2, and 100% of those with stage 3 infection had positive responses. Both new and standard testing achieved 100% specificity. Compared with standard IgM and IgG testing, the new IgG algorithm (with VlsE band) eliminates the need for IgM testing; it provides comparable or better sensitivity, and it maintains high specificity.

Daytime changes of skin biophysical characteristics: A study of hydration, transepidermal water loss, ph, sebum, elasticity, erythema, and color index on middle eastern skin

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Alireza Firooz

2016-01-01

Full Text Available Background: The exposure of skin to ultraviolet radiation and temperature differs significantly during the day. It is reasonable that biophysical parameters of human skin have periodic daily fluctuation. The objective of this study was to study the fluctuations of various biophysical characteristics of Middle Eastern skin in standardized experimental conditions. Materials and Methods: Seven biophysical parameters of skin including stratum corneum hydration, transepidermal water loss, pH, sebum, elasticity, skin color, and erythema index were measured at three time points (8 a.m., 12 p.m. and 4 p.m. on the forearm of 12 healthy participants (mean age of 28.4 years without any ongoing skin disease using the CK MPA 580 device in standard temperature and humidity conditions. Results: A significant difference was observed between means of skin color index at 8 a.m. (175.42 ± 13.92 and 4 p.m. (164.44 ± 13.72, P = 0.025, between the pH at 8 a.m. (5.72 ± 0.48 and 4 p.m. (5.33 ± 0.55, P = 0.001 and pH at 12 p.m. (5.60 ± 0.48 and 4 p.m. (5.33 ± 0.55, P = 0.001. Other comparisons between the means of these parameters at different time points resulted in nonsignificant P values. Conclusion: There are daytime changes in skin color index and pH. Skin color index might be higher and cutaneous pH more basic in the early morning compared to later of the day.

The response of mouse skin to multiple small doses of radiation

International Nuclear Information System (INIS)

Denekamp, J.; Harris, S.R.

1975-01-01

The response of mouse skin has been tested by irradiating the foot of albino mice and scoring erythema and desquamation during the following month. Multiple small doses of 150, 250 and 350 rad have been given 'daily', and the test dose necessary to achieve a given reaction has been determined one day after the last small fraction. This test dose has been compared with the single dose necessary to produce the same reaction level in previously untreated mice, in order to determine the ratio of the slopes of the dose-response curve at low and high doses: Slope ratio = (single dose - test dose)/total fractionated priming dose. In three separate experiments the slope ratio decreased as the dose per fraction was reduced from 350 to 150 rad. This conflicts with the data of Dutreix et al, who found a constant slope ratio over this dose range. The present data are compared with those obtained by Denekamp using 4, 9 and 14 fractions of 300 rad and by Douglas et al, using the same experimental technique, over the dose range 45 to 200 rad/fraction. In addition, the results from multifraction experiments in which equal dose increments were administered until the requisite skin reaction was achieved are also analysed in terms of their slope ratio (Fowler et al. Douglas et al). When all these results are plotted it is impossible to be sure whether the slope ratio is decreasing over the range 300 to 45 rad per fraction, although it seems likely. Most of the values at low doses lie in the range 0.15 to 0.25, indicating that at low doses the radiation is only 15 to 25% as effective per rad in causing cell death as at higher doses. (author)

Tablas de contingencia incompletas y modelos de cuasi independencia aplicados a las corrientes migratorias en Cuba

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Cristina López-Calleja Hiort-Lorenzen

2011-01-01

Full Text Available El objetivo que se intenta lograr en este trabajo es hacer un análisis exploratorio de las migraciones internas desde el medio rural en Cuba. Hemos construido tablas de movimientos migratorios a partir de la Encuesta Nacional de Migraciones Internas (ENMI para analizar la dinámica de las migraciones internas. El análisis se hace por medio de modelos lineales logarítmicos de cuasi independencia. Utilizamos este modelo, excluyendo la diagonal principal de la matriz de las corrientes migratorias, que contiene la mayor parte de la población, los no migrantes, para que el ajuste refleje los factores que caracterizan a la migración. La matriz tiene la información del lugar de residencia del migrante al nacer y del lugar de residencia en el momento de la Encuesta, con cinco categorías diferenciadas, y cuatro covariables. Como un resultado se obtuvo que la tendencia del movimiento migratorio es gradual, desde los asentamientos rurales hacia los lugares de mayor jerarquía económico-administrativa, lo cual ratifica lo obtenido mediante tablas cruzadas en trabajos basados en la ENMI. Los hombres migran menos que las mujeres, con excepción de la migración entre asentamientos rurales, donde es similar para los dos sexos. Migran mas los jóvenes y migran más las personas con vínculo laboral y las de mayor calificación, en especial las mujeres calificadas.

Tablas de contingencia incompletas y modelos de cuasi independencia aplicados a las corrientes migratorias en Cuba (Incomplete contingency tables and quasi-independence models applied to migration in Cuba

Directory of Open Access Journals (Sweden)

Cristina López-Calleja Hiort-Lorenzen

2011-07-01

Full Text Available El objetivo que se intenta lograr en este trabajo es hacer un análisis exploratorio de las migraciones internas desde el medio rural en Cuba. Hemos construido tablas de movimientos migratorios a partir de la Encuesta Nacional de Migraciones Internas (ENMI para analizar la dinámica de las migraciones internas. El análisis se hace por medio de modelos lineales logarítmicos de cuasi independencia. Utilizamos este modelo, excluyendo la diagonal principal de la matriz de las corrientes migratorias, que contiene la mayor parte de la población, los no migrantes, para que el ajuste refleje los factores que caracterizan a la migración. La matriz tiene la información del lugar de residencia del migrante al nacer y del lugar de residencia en el momento de la Encuesta, con cinco categorías diferenciadas, y cuatro covariables. Como un resultado se obtuvo que la tendencia del movimiento migratorio es gradual, desde los asentamientos rurales hacia los lugares de mayor jerarquía económico-administrativa, lo cual ratifica lo obtenido mediante tablas cruzadas en trabajos basados en la ENMI. Los hombres migran menos que las mujeres, con excepción de la migración entre asentamientos rurales, donde es similar para los dos sexos. Migran mas los jóvenes y migran más las personas con vínculo laboral y las de mayor calificación, en especial las mujeres calificadas.

Development of a Luminex Bead Based Assay for Diagnosis of Toxocariasis Using Recombinant Antigens Tc-CTL-1 and Tc-TES-26.

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John P Anderson

Full Text Available The clinical spectrum of human disease caused by the roundworms Toxocara canis and Toxocara cati ranges from visceral and ocular larva migrans to covert toxocariasis. The parasite is not typically recovered in affected tissues, so detection of parasite-specific antibodies is usually necessary for establishing a diagnosis. The most reliable immunodiagnostic methods use the Toxocara excretory-secretory antigens (TES-Ag in ELISA formats to detect Toxocara-specific antibodies. To eliminate the need for native parasite materials, we identified and purified immunodiagnostic antigens using 2D gel electrophoresis followed by electrospray ionization mass spectrometry. Three predominant immunoreactive proteins were found in the TES; all three had been previously described in the literature: Tc-CTL-1, Tc-TES-26, and Tc-MUC-3. We generated Escherichia coli expressed recombinant proteins for evaluation in Luminex based immunoassays. We were unable to produce a functional assay with the Tc-MUC-3 recombinant protein. Tc-CTL-1 and Tc-TES-26 were successfully coupled and tested using defined serum batteries. The use of both proteins together generated better results than if the proteins were used individually. The sensitivity and specificity of the assay for detecting visceral larval migrans using Tc-CTL-1 plus Tc-TES-26 was 99% and 94%, respectively; the sensitivity for detecting ocular larval migrans was 64%. The combined performance of the new assay was superior to the currently available EIA and could potentially be employed to replace current assays that rely on native TES-Ag.

Stevens Johnson Syndrome in a patient undergoing gynaecological brachytherapy: An association or an incident?

International Nuclear Information System (INIS)

Ferreira, M. R.; Amado, A.; Jorge, M.; Grillo, I. M.

2011-01-01

Background: Stevens Johnson Syndrome and Erythema Multiforme are hypersensitivity skin reactions generally arising in the context of multiple causes. Radiation therapy is considered to be one of these causes, although most reports are hindered by concomitant medications. Aim: The aim of this paper was to present a case of Stevens Johnson Syndrome arising in a patient undergoing gynaecological brachytherapy with an unusual presentation. Case:We describe a case of a 56-year-old woman with endometrial cancer undergoing adjuvant gynaecological radiotherapy. While undergoing a gynaecological brachytherapy boost, she developed bilateral conjunctivitis that progressed to oral mucositis and pruritic erythema with sloughing of the skin on her arms and legs but not the torso or irradiated fields (namely the vaginal mucosa). Conclusion: This case illustrates the association of RT/SJS; however, it also raises the question of patients undergoing RT being more susceptible to SJS as opposed to a direct cause of the disease. (authors)

Use of polymerase chain reaction in the diagnosis of toxocariasis: an experimental study.

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Rai, S K; Uga, S; Wu, Z; Takahashi, Y; Matsumura, T

1997-09-01

In this paper we report the usefulness of polymerase chain reaction technique in the diagnosis of visceral larva migrans in a mouse model. Liver samples obtained from two set of experimentally infected mice (10, 100, 1,000 and 10,000 embryonated Toxocara canis eggs per mouse) along with the eggs of T. canis, T. cati and Ascaris suum were included in this study. Polymerase chain reaction (PCR) was performed using Toxocara primers (SB12). The first PCR product electrophoresis revealed very thin positive bands or no bands in liver samples. However, on second PCR a clear-cut bands were observed. No positive band was shown by A. suum eggs. Our findings thus indicate the usefulness of PCR technic in the diagnosis of visceral larva migrans (VLM) in liver biopsy materials specifically by means of double PCR using the primer SB12.

Eritema multiforme ampollar extenso asociado a infección por virus herpes simplex Extended Bullous Erythema Multiforme Associated To Herpes Simplex Virus Infection

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A Elgueta-Noy

2009-12-01

Full Text Available El Eritema Multiforme (EM es una reacción cutánea aguda generalmente benigna y autolimitada, asociada a la infección por Virus Herpes Simplex (HSV. Se caracteriza por lesiones polimorfas y tipo diana en extremidades y mucosas. Presentamos un paciente de 22 años con pápulas, vesículas y ampollas, que evoluciona con un 90% de la superficie corporal comprometida en tres semanas. Se realizó una reacción de polimerasa en cadena para HSV, resultando positiva en una costra. La biopsia de piel y la tinción de inmunohistoquímica positiva para linfocitos T CD4, fueron compatibles con EM ampollar asociado a HSV. Destacamos la importancia de la correlación clínico patológica, apoyada por el estudio virológico, en el diagnóstico de este caso de presentación atípica. Los hallazgos de laboratorio confirmaron lo descrito en la literatura respecto de la patogenia del EM asociado a HSV.Erythema Multiforme (EM is a generally benign and self-limited acute cutaneous reaction, associated with Herpes Simplex Virus (HSV infection. It is characterized by polymorphic "target" lesions in extremities and mucosal tissues. We report a 22-year old patient with papules, vesicles and blisters, which evolved to cover 90% of the body in three weeks. We performed a PCR study for HSV, which was positive in a crust. A skin biopsy and positive immunohistochemical stain for LT CD4+ were compatible with bullous EM associated with HSV. We underline the importance of pathological clinical correlation, reinforced by a virological study, in the diagnosis of this case with atypical symptoms. The laboratory findings confirmed literature descriptions with respect to the pathogenicity of EM associated with HSV.

Antiradiation UV Vaccine: UV Radiation, Biological effects, lesions and medical management - immune-therapy and immune-protection.

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Popov, Dmitri; Jones, Jeffrey; Maliev, Slava

Key Words: Ultraviolet radiation,Standard Erythema Dose(SED), Minimal Erythema Dose(MED), Sun Burns, Solar Dermatitis, Sun Burned Disease, DNA Damage,Cell Damage, Antiradiation UV Vaccine, Immune-Prophylaxis of Sun Burned Diseases, Immune-Prophylaxis of Sun Burns, Immune-Therapy of Sun-Burned Disease and Sun Burns,Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), Toxic Epidermal Necrolysis(TEN). Introduction: High doses of UV generated by solar source and artificial sources create an exposure of mammals and other species which can lead to ultraviolet(UV)radiation- associated disease (including erythema, epilation, keratitis, etc.). UV radiation belongs to the non-ionizing part of the electromagnetic spectrum and ranges between 100 nm and 400 nm with 100 nm having been chosen arbitrarily as the boundary between non-ionizing and ionizing radiation, however EMR is a spectrum and UV can produce molecular ionization. UV radiation is conventionally categorized into 3 areas: UV-A (>315-400 nm),UV-B (>280-315 nm)and UV-C (>100-280 nm) [IARC,Working Group Reports,2005] An important consequence of stratospheric ozone depletion is the increased transmission of solar ultraviolet (UV)radiation to the Earth's lower atmosphere and surface. Stratospheric ozone levels have been falling, in certain areas, for the past several decades, so current surface ultraviolet-B (UV-B) radiation levels are thought to be close to their modern day maximum. [S.Madronich et al.1998] Overexposure of ultraviolet radiation a major cause of skin cancer including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) { collectively referred to as “non-melanoma" skin cancer (NMSC) and melanoma as well, with skin cancers being the most common cancer in North America. [Armstrong et al. 1993, Gallagher et al. 2005] Methods and Experimental Design: Our experiments and testing of a novel UV “Antiradiation Vaccine” have employed a wide variety of laboratory animals which include : Chinchilla

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African Journals Online (AJOL)

Items 151 - 200 of 3286 ... Vol 25, No 1 (2016), An appeal for large scale production of ... Dziedzom Komi de Souza, Irene Offei Owusu, Joseph Otchere, Michelle ... treatment of cutaneous larva migrans in an adult Ghanaian male: a case report ...

ETOS PENDIDIKAN DAN KESEJAHTERAAN MIGRAN MUSLIM STUDI KASUS DI PEMUKIMAN MIGRAN PANGKOH KAB. PULANG PISAU PROVINSI KALIMANTAN TENGAH

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Abdul Qodir

2012-06-01

Full Text Available Muslim migrants in society Pangkoh much success in the field of education, work, and life is better in the third decade (2002-2011. In fact, at the beginning of the decade arrived I (1982-1991, a small portion has a secondary education, the majority of elementary school, all start a new life. MasaIahnya ethos is focused on education and welfare. This research is descriptive qualitative, which is closely related to cultural studies. The approach used in this study is ethnography in an effort to understand the ethos of education and prosper in migrant communities Pangkoh. Subjects were Pangkoh Muslim migrants. In collecting the data, using primary techniques are in-depth interviews and observations hooks with problems. The data were analyzed qualitatively ie by way of narrative and interpretive description of the phenomenon and welfare ethos that has been found in the Muslim migrant families studied. This study shows that, first, the Muslim migrant communities in the early arriving (1982 educated middle or slightly higher in the second decade increased by taking up a bachelor S.1 for himself and family. The principal work of this group some Muslim migrants increased in rank and the task of leading the school. Increased revenue from the allowances and benefits lead educator certification. Second, Muslim migrant communities that early arrival basic education, primary school or its equivalent, has the educational ethos that indirectly, in three decades.

Human normal tissue reactions in radiotherapy

International Nuclear Information System (INIS)

Taniike, Keiko

1990-01-01

Acute and late normal tissue reactions in radiotherapy have not been considered to be major problems with conventional fractionation. But they may cause certain problems when newer schedules such as hyperfractionation or accelerated fractionation are used. In opposing parallel radiotherapy, the dose fractionation of skin or subcutaneous connective tissue are different between in one portal and two portals daily. So we examined acute skin erythema and late connective tissue fibrosis in the two groups (one and two portals) of the patients with uterus cancer. Acute skin erythema and late connective tissue fibrosis were slightly stronger in case of one portal daily. In relation to the anatomical site of skin, acute skin erythema was stronger at the buttocks than the lower abdomen, but late fibrosis was reverse to that. So the degree of acute skin erythema did not predict the degree of late connective tissue fibrosis. The number of Time Dose Fractionation Factor could roughly estimate the degree of erythema and fibrosis. Late fibrosis in 36 fractions increased with an increase of abdominal thickness, but acute erythema did not. (author)

[Toxocariasis in an adult manifested as hypereosinophilic syndrome with predominant neurological involvement. Clinical case].

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Ardiles, A; Chanqueo, L; Reyes, V; Araya, L

2001-07-01

Hypereosinophilic syndrome is characterized by persistent hypereosinophilia and signs or symptoms due to organ involvement, specially nervous system, heart and skin. It can be primary or secondary to allergies, parasites or cancer. Toxocariasis is an uncommon parasitic disease in adults. There is a variant, called visceral larva migrans, that can involve different organs, and among those, the central nervous system. We report a 61 years old male, with a cerebrovascular disease. There were focalizing symptoms, the CAT scan showed multiple ischemic lesions and a peripheral eosinophilia of 12,152 cells/mm3 was present. Anti toxocara IgG antibody titers were 1/1000. The patient was treated with albendazole for 14 days. After a 2 years follow up the patients is in good conditions and, for the first time, his eosinophil count is within normal limits.

[Sun exposure at school: Evaluation of risk (erythema dose), benefits (vitamin-D synthesis) and behaviour among children in France].

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Mahé, E; de Paula Corrêa, M; Vouldoukis, I; Godin-Beekmann, S; Sigal, M-L; Beauchet, A

2016-01-01

To better understand the potential risk associated with sun exposure during the school year, we decided to evaluate behaviour, risk [UV index (UVI), minimal erythema dose (MED)] and benefits (vitamin-D synthesis) of sun exposure in primary schoolchildren in France, as well as the various sun protection methods used for children. We performed the study on a sunny day (July 24) in a school in Antony (France). Evaluation of UVI (with calculation of MED) and the amount of vitamin D synthesized according to exposed body surface area and phototype were performed every 15minutes from 9 a.m. to 5 p.m. The effects of albedo and shade on UVI were assessed in 8 different locations at the school. The sun-protection measures used by the children were systematically evaluated. Fifty-seven children were evaluated; the maximum UVI was 7.2 and the maximum temperature was 30.7°C. Irrespective of phototype and clothing, 1 MED was reached and an adequate level of vitamin D was synthesized in the skin before midday. Albedo had little impact on irradiation. The amount of protection afforded by shadow varied greatly, with the highest level occurring in the covered courtyard (99.5% reduction of UVI) and the lowest in the shadow of buildings (53.7% reduction of UVI). With strict sun protection measures concerning dress, children reached 1 MED before synthesizing 1000IU of vitamin D, but with clothing "suited to high temperatures", 1000IU of vitamin D were synthetized before 1 MED was reached. Compliance with photoprotection measures was poor. Regardless of duration of exposure during the day (minimal model: two play breaks+lunchtime break) and of skin phototype, at least 1.5 MED was reached during the day. This was an experimental study ignoring children's actual behaviour (movement, sweating, application of sun protection products, etc.). Moreover, due to weather conditions, the study was performed at a recreation centre in July and not during the "standard" school year. Sun

Reducing Tick-Borne Disease in Alabama: Linking Health Risk Perception with Spatial Analysis Using the NASA Earth Observing System

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Hemmings, S.; Renneboog, N.; Firsing, S.; Capilouto, E.; Harden, J.; Hyden, R.; Tipre, M.; Zhang, Y.

2010-01-01

Lyme disease (LD) accounts for most vector-borne disease reports in the U.S., and although its existence in Alabama remains controversial, other tick-borne illnesses (TBI) such as Southern Tick-Associated Rash Illness (STARI) pose a health concern in the state. Phase One of the Marshall Space Flight Center-UAB DEVELOP study of TBI identified the presence of the chain of infection for LD (Ixodes scapularis ticks carrying Borrelia burgdorferi bacteria) and STARI (Amblyomma americanum ticks and an as-yet-unconfirmed agent) in Alabama. Both LD and STARI are associated with the development of erythema migrans rashes around an infected tick bite, and while treatable with oral antibiotics, a review of educational resources available to state residents revealed low levels of prevention information. To improve prevention, recognition, and treatment of TBI in Alabama, Phase Two builds a health communication campaign based on vector habitat mapping and risk perception assessment. NASA Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite imagery identified likely tick habitats using remotely sensed measurements of vegetation vigor (Normalized Difference Vegetation Index) and soil moisture. Likely tick habitats, identified as those containing both high vegetation density and soil moisture, included Oak Mountain State Park, Bankhead National Forest, and Talladega National Forest. To target a high-risk group -- outdoor recreation program participants at Alabama universities -- the study developed a behavior survey instrument based on existing studies of LD risk factors and theoretical constructs from the Social Ecological Model and Health Belief Model. The survey instrument was amended to include geographic variables in the assessment of TBI knowledge, attitudes, and prevention behaviors, and the vector habitat model will be expanded to incorporate additional environmental variables and in situ data. Remotely sensed environmental data combined with

The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis.

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Leeflang, M M G; Ang, C W; Berkhout, J; Bijlmer, H A; Van Bortel, W; Brandenburg, A H; Van Burgel, N D; Van Dam, A P; Dessau, R B; Fingerle, V; Hovius, J W R; Jaulhac, B; Meijer, B; Van Pelt, W; Schellekens, J F P; Spijker, R; Stelma, F F; Stanek, G; Verduyn-Lunel, F; Zeller, H; Sprong, H

2016-03-25

Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe. We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50% (95% CI 40% to 61%); neuroborreliosis 77% (95% CI 67% to 85%); acrodermatitis chronica atrophicans 97% (95% CI 94% to 99%); unspecified Lyme borreliosis 73% (95% CI 53% to 87%). Specificity was around 95% in studies with healthy controls, but around 80% in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches. The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.

Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease

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Weiner, Zachary P.; Crew, Rebecca M.; Brandt, Kevin S.; Ullmann, Amy J.; Schriefer, Martin E.; Molins, Claudia R.

2015-01-01

Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. PMID:26376927

Mimicry of lyme arthritis by synovial hemangioma.

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Hospach, Toni; Langendörfer, M; Kalle, T V; Tewald, F; Wirth, T; Dannecker, G E

2011-12-01

To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports

Serological and molecular evidence for spotted fever group Rickettsia and Borrelia burgdorferi sensu lato co-infections in The Netherlands.

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Koetsveld, Joris; Tijsse-Klasen, Ellen; Herremans, Tineke; Hovius, Joppe W R; Sprong, Hein

2016-03-01

Only a few reported cases indicate that Rickettsia helvetica and Rickettsia monacensis can cause disease in humans. Exposure to these two spotted fever group (SFG) rickettsiae occurs through bites of Ixodes ricinus, also the primary vector of Lyme borreliosis in Europe. To date, it is unclear how often exposure to these two microorganisms results in infection or disease. We show that of all the Borrelia burgdorferi s.l.-positive ticks, 25% were co-infected with rickettsiae. Predominantly R. helvetica was detected while R. monacensis was only found in approximately 2% of the ticks. In addition, exposure to tick-borne pathogens was compared by serology in healthy blood donors, erythema migrans (EM)-patients, and patients suspected of Lyme neuroborreliosis (LNB). As could be expected, seroreactivity against B. burgdorferi sensu lato was lower in blood donors (6%) compared to EM patients (34%) and suspected LNB cases (64%). Interestingly, seroreactivity against SFG Rickettsia antigens was not detected in serum samples from blood donors (0%), but 6% of the EM patients and 21% of the LNB suspects showed anti-rickettsial antibodies. Finally, the presence of B. burgdorferi s.l. and Rickettsia spp. in cerebrospinal fluid samples of a large cohort of patients suspected of LNB (n=208) was investigated by PCR. DNA of B. burgdorferi s.l., R. helvetica and R. monacensis was detected in seventeen, four and one patient, respectively. In conclusion, our data show that B. burgdorferi s.l. and SFG rickettsiae co-infection occurs in Dutch I. ricinus and that Lyme borreliosis patients, or patients suspected of Lyme borreliosis, are indeed exposed to both tick-borne pathogens. Whether SFG rickettsiae actually cause disease, and whether co-infections alter the clinical course of Lyme borreliosis, is not clear from our data, and warrants further investigation. Copyright © 2015 Elsevier GmbH. All rights reserved.

Serum carnitine concentration is decreased in patients with Lyme borreliosis

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Alina Kępka

2016-03-01

Full Text Available Background: Lyme borreliosis (LB is a serious infectious disease. Carnitine plays a crucial role in metabolism and inflammatory responses. Carnitine may be important in improving neuronal dysfunction and loss of neurons. Aim: To evaluate serum carnitine concentration in adult patients with various clinical types of LB. Material/Methods: Groups: 1 patients with erythema migrans (EM, n=16, 2 neuroborreliosis (NB, n=10, 3 post-Lyme disease (PLD, n=22 and healthy controls (HC, n=32. Total (TC and free (FC carnitine were determined with the spectrophotometric method. Results: TC levels (44.9±10.4, 28.0±8.4, 35.9±15.6 μmol/L in the EM, NB and PLD patients were lower than in HC (54.0±11.4 μmol/L, p < 0.001. FC levels (32.7±7.7, 23.6±6.8, 26.3±11.2 μmol/L in the EM, NB and PLD patients were lower than in HC (40.5±7.6 μmol/L, p < 0.001. AC levels (12.2±5.2, 4.4±2.6, 9.6±7.4 μmol/L in the EM, NB and PLD patients were lower in the NB and PLD patients than in HC (13.5±8.40 μmol/L, p <0.001. AC/FC ratio was 0.31±0.14, 0.18±0.09, 0.39±0.33 in the EM, NB and PLD patients. Conclusions: LB patients exhibit a significant decrease of their serum carnitine concentrations. The largest changes were in the NB and PLD patients. To prevent late complications of the disease a possibility of early supplementation with carnitine should be considered. Further studies are required to explain the pathophysiological significance of our findings.

Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease.

Science.gov (United States)

Weiner, Zachary P; Crew, Rebecca M; Brandt, Kevin S; Ullmann, Amy J; Schriefer, Martin E; Molins, Claudia R; Gilmore, Robert D

2015-11-01

Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Evaluation of the C6 Lyme Enzyme Immunoassay for the Diagnosis of Lyme Disease in Children and Adolescents.

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Lipsett, Susan C; Branda, John A; McAdam, Alexander J; Vernacchio, Louis; Gordon, Caroline D; Gordon, Catherine R; Nigrovic, Lise E

2016-10-01

The commercially-available C6 Lyme enzyme immunoassay (EIA) has been approved to replace the standard whole-cell sonicate EIA as a first-tier test for the diagnosis of Lyme disease and has been suggested as a stand-alone diagnostic. However, the C6 EIA has not been extensively studied in pediatric patients undergoing evaluation for Lyme disease. We collected discarded serum samples from children and adolescents (aged ≤21 years) undergoing conventional 2-tiered testing for Lyme disease at a single hospital-based clinical laboratory located in an area endemic for Lyme disease. We performed a C6 EIA on all collected specimens, followed by a supplemental immunoblot if the C6 EIA result was positive but the whole-cell sonicate EIA result was negative. We defined a case of Lyme disease as either a clinician-diagnosed erythema migrans lesion or a positive standard 2-tiered serologic result in a patient with symptoms compatible with Lyme disease. We then compared the performance of the C6 EIA alone and as a first-tier test followed by immunoblot, with that of standard 2-tiered serology for the diagnosis of Lyme disease. Of the 944 specimens collected, 114 (12%) were from patients with Lyme disease. The C6 EIA alone had sensitivity similar to that of standard 2-tiered testing (79.8% vs 81.6% for standard 2-tiered testing; P = .71) with slightly lower specificity (94.2% vs 98.8% 2; P Lyme disease, the C6 EIA could guide initial clinical decision making, although a supplemental immunoblot should still be performed. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Autoimmune Arthritides, Rheumatoid Arthritis, Psoriatic Arthritis, or Peripheral Spondyloarthritis Following Lyme Disease.

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Arvikar, Sheila L; Crowley, Jameson T; Sulka, Katherine B; Steere, Allen C

2017-01-01

To describe systemic autoimmune joint diseases that develop following Lyme disease, and to compare their clinical features with those of Lyme arthritis (LA). We reviewed records of all adult patients referred to our LA clinic over a 13-year period, in whom we had diagnosed a systemic autoimmune joint disease following Lyme disease. For comparison, records of patients enrolled in our LA cohort over the most recent 2-year period were analyzed. Levels of IgG antibodies to Borrelia burgdorferi and to 3 Lyme disease-associated autoantigens were measured. We identified 30 patients who had developed a new-onset systemic autoimmune joint disorder a median of 4 months after Lyme disease (usually manifested by erythema migrans [EM]). Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthritis (SpA). The 30 patients typically had polyarthritis, and those with PsA or SpA often had previous psoriasis, axial involvement, or enthesitis. In the comparison group of 43 patients with LA, the usual clinical picture was monoarticular knee arthritis, without prior EM. Most of the patients with systemic autoimmune joint disorders were positive for B burgdorferi IgG antibodies, as detected by enzyme-linked immunosorbent assay, but had significantly lower titers and lower frequencies of Lyme disease-associated autoantibodies than patients with LA. Prior to our evaluation, these patients had often received additional antibiotics for presumed LA, without benefit. We prescribed antiinflammatory agents, most commonly disease-modifying antirheumatic drugs, resulting in improvement. Systemic autoimmune joint diseases (i.e., RA, PsA, SpA) may follow Lyme disease. Development of polyarthritis after antibiotic-treated EM, previous psoriasis, or low-titer B burgdorferi antibodies may provide insight into the correct diagnosis. © 2016, American College of Rheumatology.

Lyme Disease: Emergency Department Considerations.

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Applegren, Nathan D; Kraus, Chadd K

2017-06-01

Lyme disease (LD) is the most common vector-borne illness in North America. Reported cases of LD have increased from approximately 10,000 cases annually in 1991 to >25,000 cases in 2014. Greater recognition, enhanced surveillance, and public education have contributed to the increased prevalence, as have geographic expansion and the number of infected ticks. Cases are reported primarily in the Northeastern United States, Wisconsin, and Minnesota, with children having the highest incidence of LD among all age groups. The increased incidence and prevalence of LD in the United States makes it increasingly more common for patients to present to the emergency department (ED) for tick bites and LD-related chief complaints, such as the characteristic erythema migrans skin manifestation. We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations. In this review, ED considerations for LD are presented and clinical presentations and management of the disease at different stages is discussed. Delayed sequelae that have significant morbidity, including Lyme carditis and Lyme neuroborreliosis, are discussed. Diagnostic tests and management are described in detail. The increasing prevalence and growing geographic reach of Lyme disease makes it critically important for emergency physicians to consider the diagnosis in patients presenting with symptoms suggestive of LD and to initiate appropriate treatment to minimize the potential of delayed sequelae. Special consideration should be made for the epidemiology of LD and a high clinical suspicion should be present for patients in endemic areas or with known exposures to ticks. Emergency physicians can play a critical role in the recognition, diagnosis, and treatment of LD. Copyright © 2017 Elsevier Inc. All rights reserved.

CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study

Science.gov (United States)

Soloski, Mark J.; Rebman, Alison W.; Crowder, Lauren A.; Wagner, Catriona A.; Robinson, William H.; Bechtold, Kathleen T.

2016-01-01

Approximately 10% to 20% of patients optimally treated for early Lyme disease develop persistent symptoms of unknown pathophysiology termed posttreatment Lyme disease syndrome (PTLDS). The objective of this study was to investigate associations between PTLDS and immune mediator levels during acute illness and at several time points following treatment. Seventy-six participants with physician-documented erythema migrans and 26 healthy controls with no history of Lyme disease were enrolled. Sixty-four cytokines, chemokines, and inflammatory markers were measured at each visit for a total of 6 visits over 1 year. An operationalized definition of PTLDS incorporating symptoms and functional impact was applied at 6 months and 1 year following treatment completion, and clinical outcome groups were defined as the return-to-health, symptoms-only, and PTLDS groups. Significance analysis of microarrays identified 7 of the 64 immune mediators to be differentially regulated by group. Generalized logit regressions controlling for potential confounders identified posttreatment levels of the T-cell chemokine CCL19 to be independently associated with clinical outcome group. Receiver operating characteristic analysis identified a CCL19 cutoff of >111.67 pg/ml at 1 month following treatment completion to be 82% sensitive and 83% specific for later PTLDS. We speculate that persistently elevated CCL19 levels among participants with PTLDS may reflect ongoing, immune-driven reactions at sites distal to secondary lymphoid tissue. Our findings suggest the relevance of CCL19 both during acute infection and as an immunologic risk factor for PTLDS during the posttreatment phase. Identification of a potential biomarker predictor for PTLDS provides the opportunity to better understand its pathophysiology and to develop early interventions in the context of appropriate and specific clinical information. PMID:27358211

Lyme disease: a rigorous review of diagnostic criteria and treatment.

Science.gov (United States)

Borchers, Andrea T; Keen, Carl L; Huntley, Arthur C; Gershwin, M Eric

2015-02-01

Lyme disease was originally identified in Lyme, Connecticut, based upon an unusual cluster of what appeared to be patients with juvenile rheumatoid arthritis. It was subsequently identified as a new clinical entity originally called Lyme arthritis based on the observation that arthritis was a major clinical feature. However, Lyme arthritis is now called Lyme disease based upon the understanding that the clinical features include not only arthritis, but also potential cardiac, dermatologic and neurologic findings. Lyme disease typically begins with an erythematous rash called erythema migrans (EM). Approximately 4-8% of patients develop cardiac, 11% develop neurologic and 45-60% of patients manifest arthritis. The disease is transmitted following exposure to a tick bite containing a spirochete in a genetically susceptible host. There is considerable data on spirochetes, including Borrelia burgdorferi (Bb), the original bacteria identified in this disease. Lyme disease, if an organism had not been identified, would be considered as a classic autoimmune disease and indeed the effector mechanisms are similar to many human diseases manifest as loss of tolerance. The clinical diagnosis is highly likely based upon appropriate serology and clinical manifestations. However, the serologic features are often misinterpreted and may have false positives if confirmatory laboratory testing is not performed. Antibiotics are routinely and typically used to treat patients with Lyme disease, but there is no evidence that prolonged or recurrent treatment with antibiotics change the natural history of Lyme disease. Although there are animal models of Lyme disease, there is no system that faithfully recapitulates the human disease. Further research on the effector mechanisms that lead to pathology in some individuals should be further explored to develop more specific therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multiple-Ring Digital Communication Network

Science.gov (United States)

Kirkham, Harold

1992-01-01

Optical-fiber digital communication network to support data-acquisition and control functions of electric-power-distribution networks. Optical-fiber links of communication network follow power-distribution routes. Since fiber crosses open power switches, communication network includes multiple interconnected loops with occasional spurs. At each intersection node is needed. Nodes of communication network include power-distribution substations and power-controlling units. In addition to serving data acquisition and control functions, each node acts as repeater, passing on messages to next node(s). Multiple-ring communication network operates on new AbNET protocol and features fiber-optic communication.

Larva migrans: a case report and review

Directory of Open Access Journals (Sweden)

Velho Paulo Eduardo Neves Ferreira

2003-01-01

Full Text Available A case of massive Ancylostoma sp. larval infestation is presented in a patient who had received systemic corticosteroid therapy. What attracts attention in this case is the exuberance and rarity of clinical manifestation. Based on the pertinent literature, we discuss the mechanisms of parasital infection, the natural history of the disease and its treatment.

Multiple Input - Multiple Output (MIMO) SAR

Data.gov (United States)

National Aeronautics and Space Administration — This effort will research and implement advanced Multiple-Input Multiple-Output (MIMO) Synthetic Aperture Radar (SAR) techniques which have the potential to improve...

MULTIPLE OBJECTS

Directory of Open Access Journals (Sweden)

A. A. Bosov

2015-04-01

Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

Multiple constant multiplication optimizations for field programmable gate arrays

CERN Document Server

Kumm, Martin

2016-01-01

This work covers field programmable gate array (FPGA)-specific optimizations of circuits computing the multiplication of a variable by several constants, commonly denoted as multiple constant multiplication (MCM). These optimizations focus on low resource usage but high performance. They comprise the use of fast carry-chains in adder-based constant multiplications including ternary (3-input) adders as well as the integration of look-up table-based constant multipliers and embedded multipliers to get the optimal mapping to modern FPGAs. The proposed methods can be used for the efficient implementation of digital filters, discrete transforms and many other circuits in the domain of digital signal processing, communication and image processing. Contents Heuristic and ILP-Based Optimal Solutions for the Pipelined Multiple Constant Multiplication Problem Methods to Integrate Embedded Multipliers, LUT-Based Constant Multipliers and Ternary (3-Input) Adders An Optimized Multiple Constant Multiplication Architecture ...

The multiple Dirichlet product and the multiple Dirichlet series

OpenAIRE

Onozuka, Tomokazu

2016-01-01

First, we define the multiple Dirichlet product and study the properties of it. From those properties, we obtain a zero-free region of a multiple Dirichlet series and a multiple Dirichlet series expression of the reciprocal of a multiple Dirichlet series.

Preliminary open-label clinical evaluation of the soothing and reepithelialization properties of a novel topical formulation for rosacea

Directory of Open Access Journals (Sweden)

Sparavigna A

2014-10-01

Full Text Available Adele Sparavigna, Beatrice Tenconi, Ileana De Ponti Derming Srl, Monza, Italy Background: Rosacea is a common, incurable skin barrier disorder characterized by relapses and remissions. Purpose: To evaluate the efficacy of Farmaka Rosacea Cream (FRC, a novel topical formulation for rosacea. Methods: This single-center, open-label pilot study comprised a single-dose substudy in 20 healthy subjects and a long-term, repeat-dose substudy in 22 subjects with rosacea. The 2-hour, controlled, single-dose substudy assessed the soothing and reepithelialization properties of FRC after stripping-induced erythema based on the erythema index, transepidermal water loss, skin hydration, and clinical assessments of erythema. In the long-term substudy, subjects applied FRC twice daily for 8 weeks. Clinical assessments included vascular and pigmentary homogeneity and erythema and hemoglobin indices. Subjects completed questionnaires to assess FRC efficacy and cosmetic acceptability. Results: Greater reductions were seen in FRC-treated areas compared with untreated areas for the erythema index (-16% versus -8%; P<0.001 and mean transepidermal water loss (-35.8% versus -10.1%; P<0.001 30 minutes after stripping. Significant improvements over untreated areas were maintained 2 hours after stripping. Skin hydration and clinical erythema assessments also indicated that FRC soothed rosacea symptoms and promoted skin reepithelialization. Erythema and hemoglobin indices were significantly reduced from baseline after 4 and 8 weeks of treatment. Clinically assessed parameters were significantly improved following FRC application. Subjects assessed FRC positively. Conclusion: Improvement of rosacea symptoms was noted with FRC application. The main film-forming ingredients of FRC (trehalose, cholesterol, ceramide, and fatty acids, combined with other soothing and calming ingredients and ultraviolet filters, could explain its efficacy. Keywords: rosacea, erythema, skin

Carboxytherapy for treatment of localized chronic plaque psoriasis: Clinical and histopathologic evaluation.

Science.gov (United States)

Kamel, Abeer Mostafa; Abdelghani, Rania

2018-01-17

Multiple treatment options are introduced in treatment of chronic localized plaque psoriasis but with poor adherence and poor patients' satisfaction resulting in poor treatment outcome. In this pilot study, we investigated the safety and efficacy of carboxytherapy in treatment of chronic localized plaque psoriasis. Thirty adult patients with chronic localized plaque psoriasis were enrolled in this study. The patients received carboxytherapy injection once/week for 8 weeks. Patients were clinically and histpathologically evaluated 2 weeks after the last treatment. Clinical response was evaluated by investigator's global assessment, total sign score, and 5-point scale for perilesional erythema. We performed 10-point visual analog scale for patient's satisfaction, and side effects. Three months after the last session we evaluate recurrence using 10-point scale. Carboxytherapy achieved treatment success in 26.6% according to investigator's global assessment and total sign score and 70% of the patients demonstrated absence of perilesional erythema. Patients were satisfied with no reported side effects. Recurrence area was within 1% -10% of the baseline area in 83.3% of the improved patients. © 2018 Wiley Periodicals, Inc.

Neurotoxocarosis Neurotoxocaríase

Directory of Open Access Journals (Sweden)

Josef Finsterer

2007-10-01

Full Text Available Infection of humans with embryonated eggs of Toxocara canis (larva migrans remains asymptomatic, or results in covert or common toxocarosis, visceral larva migrans syndrome, or ophthalmologic and neurologic impairment. Though neurological manifestations of Toxocara canis larvae are rare, toxocarosis remains an important differential diagnosis of various neurological disorders. Manifestations of the central nervous system are dementia, meningo-encephalitis, myelitis, cerebral vasculitis, epilepsy, or optic neuritis. Manifestations of the peripheral nervous system comprise radiculitis, affection of cranial nerves, or musculo-skeletal involvement. If toxocarosis is neglected, ignored, or refused as a differential of these abnormalities, it may be easily overlooked for years. Early recognition and treatment of the infection is, however, of paramount importance since it reduces morbidity and mortality and the risk of secondary superinfection. Like the visceral manifestations, neurological manifestations of toxocarosis are treated by benzimidazole components, most frequently albendazole, corticosteroids, or diethylcarbamazine. If detected and treated early, the prognosis of neurological manifestations of toxocarosis is favourable.Infecção humana com ovos embrionados de Toxocara canis (larva migrans pode permanecer assintomática ou resultar em toxocaríase acentuada ou comum, síndrome da larva migrans visceral ou manifestações neurológicas ou oftalmológicas. Embora manifestações neurológicas das larvas de Toxocara canis sejam raras, a toxocaríase permanece como importante diagnóstico diferencial de várias manifestações neurológicas. Manifestações do sistema nervoso central são demência, meningoencefalite, mielite, vasculite cerebral, epilepsia, ou neurite ótica. Manifestações do sistema nervoso periférico compreendem radiculite, agressão de nervos cranianos ou envolvimento músculo-esquelético. Se a toxocaríase �

Validation of self-reported erythema

DEFF Research Database (Denmark)

Petersen, B; Thieden, E; Lerche, C M

2013-01-01

Most epidemiological data of sunburn related to skin cancer have come from self-reporting in diaries and questionnaires. We thought it important to validate the reliability of such data.......Most epidemiological data of sunburn related to skin cancer have come from self-reporting in diaries and questionnaires. We thought it important to validate the reliability of such data....

A comparison between a tristimulus colorimeter (Minolta ChromaMeter CR-200) and two spectrophotometers (Minolta Spectrophotometer CM-508i and CM-2002). Quantification of UV-B induced erythema in a hairless guinea pig model.

Science.gov (United States)

Fullerton, A; Keiding, J

1997-11-01

A comparison was made between a tristimulus colorimeter (Minolta ChromaMeter CR 200) and two spectrophotometers (Minolta CM-508i and CM-2002). The object was to compare skin colour data in the CIE 1976 L*a*d*colour space system obtained with the different instruments after UV-B exposure. Guinea pigs were exposed on their dorsal trunk with UV-B light for different time periods. Skin colour in the L*a*b* system was measured 6 and 24 h after exposure. Reproducible and objective measurements expressed in the CIE system were obtained with all three instruments. A strong correlation was found between the Minolta Chromameter CR200 and each of the two spectrophotometers. However, absolute values found with the Minolta ChromaMeter CR 200, especially for b*, differed from values obtained with the two spectrophotometers. The instruments were, despite minor inter-instrumental variation, suited for objective evaluation of erythema. The spectrophotometers were somewhat cumbersome to use due to their heavy weight and difficulties in positioning within the test sites; the Minolta CromaMeter CR200 (or later versions) is thus preferable for simple routine measurements. Use of the spectophotometers appears only indicated where specific information about skin pigments or photoactive substances relative to wavelength is needed.

Leukemia cutis in three children: clinical and immunohistochemical studies.

Science.gov (United States)

Koga, M; Furukawa, S

1996-01-01

We report 3 children with leukemia cutis observed at the initial diagnosis of systemic leukemia. Leukemia subtypes in the three children were congenital monocytic, acute undifferentiated, and acute monocytic, respectively. The patients were girls age 10 days, 14 years, and 11 months, respectively, at diagnosis. We describe the clinical features of the cases and the results of immunohistochemical studies on paraffin-embedded skin biopsy specimens. The skin lesions were tumors and areas of reddish purple erythema in the first child, pigmented erythema in the second, and bright red erythema in the first child, pigmented erythema in the second, and bright red erythema in the third. In the first two patients skin lesion biopsy specimens had dense leukemic infiltrates in the dermis with reactive T lymphocytes scattered among them. In the third patient, the infiltrating cells were almost all reactive T lymphocytes, with a few leukemic cells. A relationship between the leukemic-reactive cell ratio and the prognosis was suggested; dense leukemic cell infiltrates may be associated with a poor prognosis.

Mixed multiplicities for arbitrary ideals and generalized Buchsbaum-Rim multiplicities

International Nuclear Information System (INIS)

Callejas-Bedregal, R.; Jorge Perez, V.H.

2005-12-01

We introduce first the notion of mixed multiplicities for arbitrary ideals in a local d-dimensional noetherian ring (A, m) which, in some sense, generalizes the concept of mixed multiplicities for m-primary ideals. We also generalize Teissier's Product Formula for a set of arbitrary ideals. We also extend the notion of the Buchsbaum-Rim multiplicity (in short, we write BR-multiplicity) of a submodule of a free module to the case where the submodule no longer has finite colength. For a submodule M of A p we introduce a sequence e BR k (M), k = 0,...,d + p - 1 which in the ideal case coincides with the multiplicity sequence c 0 (I, A),...,c d (I, A) defined for an arbitrary ideal I of A by Achilles and Manaresi in [AM]. In case that M has finite colength in A p and it is totally decomposable we prove that our BR-multiplicity sequence essentially falls into the standard BR-multiplicity of M. (author)

Skin color analysis using a spectrophotometer in Asians.

Science.gov (United States)

Yun, In Sik; Lee, Won Jai; Rah, Dong Kyun; Kim, Yong Oock; Park, Be-young Yun

2010-08-01

To objectively describe skin color, the Commission International d'Eclairage (CIE) L*a*b* color coordinates and melanin and erythema indexes are used. However, it was difficult to understand the relationship among these parameters and to convert them into each other. We introduced a new technique to measure L*a*b* color coordinates and the melanin and erythema indexes at the same time. We analyzed the skin color of normal Asians using this method. The skin color of the forehead, cheek, upper inner arm, dorsum of hand, and anterior chest of 148 volunteers was measured using a spectrophotometer. Using a computer analysis program, L*a*b* values and the melanin and erythema indexes were presented at the same time. The averages of these data were shown according to gender, age, body parts, and correlations among the melanin and erythema indexes and L*a*b* color coordinates, and then they were analyzed. The averages of the melanin and erythema indexes of 148 participants were 1.10 +/- 0.29 and 1.29 +/- 0.38, respectively. The averages of the L*, a*, and b* values were 64.15 +/- 4.86, 8.96 +/- 2.65, and 18.34 +/- 2.39, respectively. The melanin and erythema indexes were higher in males than in females. While the correlation of the melanin index with the L* value was negative, it was positively correlated with the a* and b* values. While the erythema index showed a weak correlation with the b* value, its correlation was negative with the L* value and positive with the a* value. Our method of skin color measurement is useful. We consider the data of this study valuable basic data for the evaluation of colors of pigmental skin diseases and scars in the future.

A Clinicopathologic Study of Oral Changes in Gastroesophageal Reflux Disease, Gastritis, and Ulcerative Colitis.

Science.gov (United States)

Vinesh, E; Masthan, Kmk; Kumar, M Sathish; Jeyapriya, S Marytresa; Babu, Aravindha; Thinakaran, Meera

2016-11-01

The aim and objectives of this study are to identify oral changes in certain gastrointestinal (GI) diseases, namely gastroesophageal reflux disease (GERD), ulcerative colitis, gastritis, and to evaluate these oral symptoms as indicators for assessing GI disorders. In this study, the oral manifestations of various GI disorders were assessed in a varying age group of 250 patients in Government Stanley Medical College and Hospital, Chennai. Out of 250 patients, 142 were affected by GERD, 99 were affected by gastritis, and 9 patients were affected by ulcerative colitis. Of these patients, 177 were males and 73 were females. Evaluation of patients with gastritis revealed that 66.7% affected with gingivitis, 19.2% with dental erosion on the palatal and lingual aspects of maxillary and mandibular teeth predominantly in the anterior region, 10.1% with periodontitis, 2% with gingival erythema. Among the patients with GERD, 44% of the cases showed dental erosion, 25.5% periodontitis, 9.9% gingivitis, 5.7% gingival erythema, 2.8% palatal erythema, 2.1% gingival ulcers, glossitis 2%, 1.4% floor of the mouth erythema, and 0.7% erythema of the tongue. Patients with ulcerative colitis showed 44.4% of gingival erythema, 33.3% of dental erosions, and 22.2% of gingival ulcers and periodontitis. In our study of 250 patients, oral manifestations were observed in 88% of the patients. Both soft tissue and hard tissue changes were evident. There was a high correlation between various GI disease and dental erosion, erythema at various sites of the oral cavity, oral ulcers, gingivitis, periodontitis, and glossitis. Careful evaluation of oral cavity may unveil many GI disorders and help the patient by providing early diagnosis, which further facilitates the prognosis.

Epidemiology of human toxocariasis in Poland – A review of cases 1978–2009

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Anna Borecka

2015-02-01

Full Text Available Toxocariasis is a helminthozoonosis due to the infection of humans with larvae belonging to the Toxocara genus. Humans become infected as a result of accidental consumption of infected eggs containing third stage larvae (L3 nematodes from Toxocara canis or Toxocara cati species. Toxocariasis was recognized for the first time in the early 1950s, and the first cases of toxocariasis in Poland were described a few years later. Toxocariasis is clinically classified into several types: classic and incomplete visceral larva migrans (VLM syndrome, ocular larva migrans (OLM syndrome, neurological toxocariasis (NLM, covert toxocariasis and asymptomatic toxocariasis. In 1994–2005, 18,367 sera of people suspected of being infected with Toxocara were analysed, 1.8–76% had anti- Toxocara antibodies. In the period 1978–2009, 1,022 clinical cases of toxocariasis were recognized in Poland. In the opinion of the authors, in order to reduce the frequency of toxocariasis in human populations, some prophylaxis should undertaken, e.g. public education of zoonotic diseases, systematic control of animal, deworming of pets, cleaning pets’ faeces by the owners.

[Current therapeutic indications of thalidomide and lenalidomide].

Science.gov (United States)

Ordi-Ros, Josep; Cosiglio, Francisco Javier

2014-04-22

Thalidomide is a synthetic glutamic acid derivative first introduced in 1956 in Germany as an over the counter medications. It was thought to be one of the safest sedatives ever produced as it was effective in small doses, was not addictive, and did not have acute side-effects such as motor impairment, but was quickly removed from market after it was linked to cases of severe birth defects. The Food and Drug Administration approved use in the treatment of erythema nodosum leprosum. Further, it was shown its effectiveness in unresponsive dermatological conditions such as actinic prurigo, adult Langerhans cell hystiocytosis, aphthous stomatitis, Behçet syndrome, graft-versus-host disease, cutaneous sarcoidosis, erythema multiforme, Jessner-Kanof lymphocytic infiltration of the skin, Kaposi sarcoma, lichen planus, lupus erythematosus, melanoma, prurigo nodularis, pyoderma gangrenosum and others. In May 2006, it was approved for the treating multiple myeloma. New thalidomide analogues have been developed but lack clinical experience. This paper is a review of the history, pharmacology, mechanism of action, clinical applications and side effects of thalidomide and its analogues. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Programa de conservacion para aves migratorias neotropicales

Science.gov (United States)

Deborah Finch; Marcia Wilson; Roberto Roca

1992-01-01

Mas de 250 especies de aves terrestres migran a Norte America durante la epoca reproductiva para aprovechar los sistemas templados. No obstante, las aves migratorias neotropicales pasan la mayor parte de su ciclo de vida en los habitat tropicales y subtropicales de paises latinoamericanos y caribefios donde viven en una asociacion cercana con las aves residentes. Para...

Determinants of skin sensitivity to solar irradiation

NARCIS (Netherlands)

Broekmans, W.; Vink, A.A.; Boelsma, E.; Klöpping-Ketelaars, W.A.A.; Tijburg, L.B.M.; Veer, van 't P.; Poppel, van G.; Kardinaal, A.F.M.

2003-01-01

Background: Acute effects of UV irradiation include UV-induced erythema. Sunlight plays an important role in the development of skin cancer. Several predictive factors of UV-induced erythema could also be predictive for skin cancer. Objective: Our objective was to quantitatively assess phenotypical

Robust multiple frequency multiple power localization schemes in the presence of multiple jamming attacks.

Directory of Open Access Journals (Sweden)

Ahmed Abdulqader Hussein

Full Text Available Localization of the wireless sensor network is a vital area acquiring an impressive research concern and called upon to expand more with the rising of its applications. As localization is gaining prominence in wireless sensor network, it is vulnerable to jamming attacks. Jamming attacks disrupt communication opportunity among the sender and receiver and deeply impact the localization process, leading to a huge error of the estimated sensor node position. Therefore, detection and elimination of jamming influence are absolutely indispensable. Range-based techniques especially Received Signal Strength (RSS is facing severe impact of these attacks. This paper proposes algorithms based on Combination Multiple Frequency Multiple Power Localization (C-MFMPL and Step Function Multiple Frequency Multiple Power Localization (SF-MFMPL. The algorithms have been tested in the presence of multiple types of jamming attacks including capture and replay, random and constant jammers over a log normal shadow fading propagation model. In order to overcome the impact of random and constant jammers, the proposed method uses two sets of frequencies shared by the implemented anchor nodes to obtain the averaged RSS readings all over the transmitted frequencies successfully. In addition, three stages of filters have been used to cope with the replayed beacons caused by the capture and replay jammers. In this paper the localization performance of the proposed algorithms for the ideal case which is defined by without the existence of the jamming attack are compared with the case of jamming attacks. The main contribution of this paper is to achieve robust localization performance in the presence of multiple jamming attacks under log normal shadow fading environment with a different simulation conditions and scenarios.

Optimizing antiemetic therapy in multiple-day and multiple cycles of chemotherapy

DEFF Research Database (Denmark)

Ellebaek, E.; Herrstedt, J.

2008-01-01

PURPOSE OF REVIEW: Only a few studies have investigated the effect of antiemetic therapy in patients treated with multiple-day or multiple cycles of chemotherapy. The present review will assess the available data, highlight the current recommendations and draw attention towards the remaining...... of chemotherapy the addition of a NK1-receptor antagonist aprepitant to standard antiemetic therapy has increased the antiemetic effect, and multiple cycle extension studies have demonstrated that this increment in effect is sustained during multiple cycles of chemotherapy. A recent study indicated...... that the dopamine D2-receptor antagonist metopimazine has some additive effect on delayed symptoms induced by multiple-day chemotherapy. SUMMARY: The development of the NK1-receptor antagonist aprepitant has significantly improved the antiemetic control in patients treated with multiple cycles of chemotherapy. Far...

Multiple sclerosis

Science.gov (United States)

... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

Beyond KNO multiplicative cascades and novel multiplicity scaling laws

CERN Document Server

Hegyi, S

1999-01-01

The collapse of multiplicity distributions P/sub n/ onto a universal scaling curve arises when P/sub n/ is expressed as a function of the standardized multiplicity (n-c)/ lambda with c and lambda being location and scale parameters governed by leading particle effects and the growth of average multiplicity. It is demonstrated that self- similar multiplicative cascade processes such as QCD parton branching naturally lead to a novel type of scaling behavior of P/sub n/ which manifests itself in Mellin space through a location change controlled by the degree of multifractality and a scale change governed by the depth of the cascade. Applying the new scaling rule it is shown how to restore data collapsing behavior of P/sub n/ measured in hh collisions at ISR and SPS energies. (21 refs).

Quantum theory of multiple-input-multiple-output Markovian feedback with diffusive measurements

International Nuclear Information System (INIS)

Chia, A.; Wiseman, H. M.

2011-01-01

Feedback control engineers have been interested in multiple-input-multiple-output (MIMO) extensions of single-input-single-output (SISO) results of various kinds due to its rich mathematical structure and practical applications. An outstanding problem in quantum feedback control is the extension of the SISO theory of Markovian feedback by Wiseman and Milburn [Phys. Rev. Lett. 70, 548 (1993)] to multiple inputs and multiple outputs. Here we generalize the SISO homodyne-mediated feedback theory to allow for multiple inputs, multiple outputs, and arbitrary diffusive quantum measurements. We thus obtain a MIMO framework which resembles the SISO theory and whose additional mathematical structure is highlighted by the extensive use of vector-operator algebra.

Generalized internal multiple imaging

KAUST Repository

Zuberi, Mohammad Akbar Hosain

2014-12-04

Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

Generalized internal multiple imaging

KAUST Repository

Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

2014-01-01

Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

Multiplicity: An Explorative Interview Study on Personal Experiences of People with Multiple Selves.

Science.gov (United States)

Ribáry, Gergő; Lajtai, László; Demetrovics, Zsolt; Maraz, Aniko

2017-01-01

Background and aims: Personality psychology research relies on the notion that humans have a single self that is the result of the individual's thoughts, feelings, and behaviors that can be reliably described (i.e., through traits). People who identify themselves as "multiple" have a system of multiple or alternative, selves, that share the same physical body. This is the first study to explore the phenomenon of multiplicity by assessing the experiences of people who identify themselves as "multiple." Methods: First, an Internet forum search was performed using the terms "multiplicity" and "multiple system." Based on that search, people who identified themselves as multiple were contacted. Interviews were conducted by a consultant psychiatrist, which produced six case vignettes. Results: Multiplicity is discussed on Twitter, Tumblr, Google+ and several other personal websites, blogs, and forums maintained by multiples. According to the study's estimates, there are 200-300 individuals who participate in these forums and believe they are multiple. Based on the six interviews, it appears that multiples have several selves who are relatively independent of each other and constitute the personality's system. Each "resident person" or self, has their own unique behavioral pattern, which is triggered by different situations. However, multiples are a heterogeneous group in terms of their system organization, memory functions, and control over switching between selves. Conclusions: Multiplicity can be placed along a continuum between identity disturbance and dissociative identity disorder (DID), although most systems function relatively well in everyday life. Further research is needed to explore this phenomenon, especially in terms of the extent to which multiplicity can be regarded as a healthy way of coping.

Vulvar vestibulitis syndrome: an important factor in the evaluation of lifelong vaginismus?

Science.gov (United States)

Ter Kuile, Moniek M; Van Lankveld, Jacques J D M; Vlieland, Corrie Vliet; Willekes, Christine; Weijenborg, Philomeen T M

2005-12-01

The aim of the study was to investigate the prevalence of vulvar vestibulitis syndrome (VVS) in a sample of women suffering from lifelong vaginismus (N=91). Lifelong vaginismus is defined as "having a history of never having been able to experience penile entry of the vagina". The results with respect to VVS are compared with the results of women who are suffering from pain during intercourse (superficial dyspareunia) (N=84). Both patients groups were recruited from two treatment outcome studies. Using a standard physical examination, erythema was found in 77%, pain "on touch" in 69% and erythema and pain on the same location was seen in 56% of the patients with lifelong vaginismus. Furthermore, it was found that erythema (94%), pain (98%) and erythema and pain on the same location (92%) were more frequently found in patients with dyspareunia compared to women with lifelong vaginismus. It is concluded that pain is an integral part of the experiences in the majority of women with lifelong vaginismus.

Predicting the distribution of four species of raptors (Aves: Accipitridae) in southern Spain: statistical models work better than existing maps

OpenAIRE

Bustamante, Javier; Seoane, Javier

2004-01-01

Aim To test the effectiveness of statistical models based on explanatory environmental variables vs. existing distribution information (maps and breeding atlas), for predicting the distribution of four species of raptors (family Accipitridae): common buzzard Buteo buteo (Linnaeus, 1758), short-toed eagle Circaetus gallicus (Gmelin, 1788), booted eagle Hieraaetus pennatus (Gmelin, 1788) and black kite Milvus migrans (Boddaert, 1783). Location Andalusia, southe...

Multiple purpose electrical profit; Emprendimiento electrico de prestacion multiple

Energy Technology Data Exchange (ETDEWEB)

Assennato, H. [Electrica de Azul Ltda., Buenos Aires (Argentina)

1986-12-31

This paper shows the multiple purpose aspects of electrification projects in rural and isolated areas. The multiple aspects involved in the electrification process may include, over electric power supply: improvement of life quality, irrigation and rural mechanization. 4 figs., 6 tabs., 4 refs.

Multiple myeloma

International Nuclear Information System (INIS)

Sohn, Jeong Ick; Ha, Choon Ho; Choi, Karp Shik

1994-01-01

Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained. 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

Disease: H01473 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H01473 Erythema nodosum leprosum (ENL) Reactional states of leprosy are expression...rsal reaction) and type 2 (Jopling's type II reaction). Erythema Nodosum Leprosum (ENL), the main symptom of a type-2 reaction in lep...rosy, is caused by a humoral immune response to Mycobact

Changes in skin barrier during treatment with systemic alitretinoin: focus on skin susceptibility and stratum corneum ceramides

DEFF Research Database (Denmark)

Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellgren, Lars

2010-01-01

) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months...

Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

International Nuclear Information System (INIS)

Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

1984-01-01

This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed. (orig.)

Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

Energy Technology Data Exchange (ETDEWEB)

Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

1984-07-01

This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed.

Utilization of serology for the diagnosis of suspected Lyme borreliosis in Denmark: Survey of patients seen in general practice

Directory of Open Access Journals (Sweden)

Skarphedinsson Sigurdur

2010-11-01

Full Text Available Abstract Background Serological testing for Lyme borreliosis (LB is frequently requested by general practitioners for patients with a wide variety of symptoms. Methods A survey was performed in order to characterize test utilization and clinical features of patients investigated for serum antibodies to Borrelia burgdorferi sensu lato. During one calendar year a questionnaire was sent to the general practitioners who had ordered LB serology from patients in three Danish counties (population 1.5 million inhabitants. Testing was done with a commercial ELISA assay with purified flagella antigen from a Danish strain of B. afzelii. Results A total of 4,664 patients were tested. The IgM and IgG seropositivity rates were 9.2% and 3.3%, respectively. Questionnaires from 2,643 (57% patients were available for analysis. Erythema migrans (EM was suspected in 38% of patients, Lyme arthritis/disseminated disease in 23% and early neuroborreliosis in 13%. Age 0-15 years and suspected EM were significant predictors of IgM seropositivity, whereas suspected acrodermatitis was a predictor of IgG seropositivity. LB was suspected in 646 patients with arthritis, but only 2.3% were IgG seropositive. This is comparable to the level of seropositivity in the background population indicating that Lyme arthritis is a rare entity in Denmark, and the low pretest probability should alert general practitioners to the possibility of false positive LB serology. Significant predictors for treating the patient were a reported tick bite and suspected EM. Conclusions A detailed description of the utilization of serology for Lyme borreliosis with rates of seropositivity according to clinical symptoms is presented. Low rates of seropositivity in certain patient groups indicate a low pretest probability and there is a notable risk of false positive results. 38% of all patients tested were suspected of EM, although this is not a recommended indication due to a low sensitivity of

T-Helper 17 Cell Cytokine Responses in Lyme Disease Correlate With Borrelia burgdorferi Antibodies During Early Infection and With Autoantibodies Late in the Illness in Patients With Antibiotic-Refractory Lyme Arthritis.

Science.gov (United States)

Strle, Klemen; Sulka, Katherine B; Pianta, Annalisa; Crowley, Jameson T; Arvikar, Sheila L; Anselmo, Anthony; Sadreyev, Ruslan; Steere, Allen C

2017-04-01

Control of Lyme disease is attributed predominantly to innate and adaptive T-helper 1 cell (TH1) immune responses, whereas the role of T-helper 17 cell (TH17) responses is less clear. Here we characterized these inflammatory responses in patients with erythema migrans (EM) or Lyme arthritis (LA) to elucidate their role early and late in the infection. Levels of 21 cytokines and chemokines, representative of innate, TH1, and TH17 immune responses, were assessed by Luminex in acute and convalescent sera from 91 EM patients, in serum and synovial fluid from 141 LA patients, and in serum from 57 healthy subjects. Antibodies to Borrelia burgdorferi or autoantigens were measured by enzyme-linked immunosorbent assay. Compared with healthy subjects, EM patients had significantly higher levels of innate, TH1, and TH17-associated mediators (P ≤ .05) in serum. In these patients, the levels of inflammatory mediators, particularly TH17-associated cytokines, correlated directly with B. burgdorferi immunoglobulin G antibodies (P ≤ .02), suggesting a beneficial role for these responses in control of early infection. Late in the disease, in patients with LA, innate and TH1-associated mediators were often >10-fold higher in synovial fluid than serum. In contrast, the levels of TH17-associated mediators were more variable, but correlated strongly with autoantibodies to endothelial cell growth factor, matrix metalloproteinase 10, and apolipoprotein B-100 in joints of patients with antibiotic-refractory LA, implying a shift in TH17 responses toward an autoimmune phenotype. Patients with Lyme disease often develop pronounced TH17 immune responses that may help control early infection. However, late in the disease, excessive TH17 responses may be disadvantageous by contributing to autoimmune responses associated with antibiotic-refractory LA. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions

Antibody profile to Borrelia burgdorferi in veterinarians from Nuevo León, Mexico, a non-endemic area of this zoonosis

Directory of Open Access Journals (Sweden)

Cassandra M. Skinner-Taylor

2016-07-01

Full Text Available Objectives: Lyme disease is a tick-borne disease caused by infections with Borrelia . Persons infected with Borrelia can be asymptomatic or can develop disseminated disease. Diagnosis and recognition of groups at risk of infection with Borrelia burgdorferi is of great interest to contemporary rheumatology. There are a few reports about Borrelia infection in Mexico, including lymphocytoma cases positive to B. burgdorferi sensu stricto by PCR and a patient with acrodermatitis chronica atrophicans. Veterinarians have an occupational risk due to high rates of tick contact. The aim of this work was to investigate antibodies to Borrelia in students at the Faculty of Veterinary Medicine and Zootechnics, at Nuevo León, Mexico, and determine the antibody profile to B. burgdorferi antigens. Material and methods: Sera were screened using a C6 ELISA, IgG and IgM ELISA using recombinant proteins from B. burgdorferi , B. gariniii and B. afzelii . Sera with positive or grey-zone values were tested by IgG Western blot to B. burgdorferi sensu stricto. Results : All volunteers reported tick exposures and 72.5% remembered tick bites. Only nine persons described mild Lyme disease related symptoms, including headaches, paresthesias, myalgias and arthralgias. None of the volunteers reported erythema migrans. Nine samples were confirmed by IgG Western blot. The profile showed 89% reactivity to OspA, 67% to p83, and 45% to BmpA. Conclusions : Positive sera samples shared antibody reactivity to the markers of late immune response p83 and BmpA, even if individuals did not present symptoms of Lyme arthritis or post-Lyme disease. The best criterion to diagnose Lyme disease in our country remains to be established, because it is probable that different strains coexist in Mexico. This is the first report of antibodies to B. burgdorferi in Latin American veterinarians. Veterinarians and high-risk people should be alert to take precautionary measures to prevent tick

Filler migration and extensive lesions after lip augmentation: Adverse effects of polydimethylsiloxane filler.

Science.gov (United States)

Abtahi-Naeini, Bahareh; Faghihi, Gita; Shahmoradi, Zabihollah; Saffaei, Ali

2018-01-07

Polydimethylsiloxane (PDMS), also called liquid silicone, belongs to a group of polymeric compounds that are commonly referred to as silicones. These filling agents have been used as injectable filler for soft tissue augmentation. There are limited experiences about management of the severe complications related to filler migration associated with PDMS injection. We present a 35-year-old female with severe erythema, edema over her cheeks and neck, and multiple irregularities following cosmetic lip augmentation with PDMS. Further studies are required for management of this complicated case of PDMS injection. © 2018 Wiley Periodicals, Inc.

Multiple homicides.

Science.gov (United States)

Copeland, A R

1989-09-01

A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

Neutron Multiplicity Analysis

Energy Technology Data Exchange (ETDEWEB)

Frame, Katherine Chiyoko [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-06-28

Neutron multiplicity measurements are widely used for nondestructive assay (NDA) of special nuclear material (SNM). When combined with isotopic composition information, neutron multiplicity analysis can be used to estimate the spontaneous fission rate and leakage multiplication of SNM. When combined with isotopic information, the total mass of fissile material can also be determined. This presentation provides an overview of this technique.

[Multiple meningiomas].

Science.gov (United States)

Terrier, L-M; François, P

2016-06-01

Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Multiplicity: An Explorative Interview Study on Personal Experiences of People with Multiple Selves

Directory of Open Access Journals (Sweden)

Gergő Ribáry

2017-06-01

Full Text Available Background and aims: Personality psychology research relies on the notion that humans have a single self that is the result of the individual's thoughts, feelings, and behaviors that can be reliably described (i.e., through traits. People who identify themselves as “multiple” have a system of multiple or alternative, selves, that share the same physical body. This is the first study to explore the phenomenon of multiplicity by assessing the experiences of people who identify themselves as “multiple.”Methods: First, an Internet forum search was performed using the terms “multiplicity” and “multiple system.” Based on that search, people who identified themselves as multiple were contacted. Interviews were conducted by a consultant psychiatrist, which produced six case vignettes.Results: Multiplicity is discussed on Twitter, Tumblr, Google+ and several other personal websites, blogs, and forums maintained by multiples. According to the study's estimates, there are 200–300 individuals who participate in these forums and believe they are multiple. Based on the six interviews, it appears that multiples have several selves who are relatively independent of each other and constitute the personality's system. Each “resident person” or self, has their own unique behavioral pattern, which is triggered by different situations. However, multiples are a heterogeneous group in terms of their system organization, memory functions, and control over switching between selves.Conclusions: Multiplicity can be placed along a continuum between identity disturbance and dissociative identity disorder (DID, although most systems function relatively well in everyday life. Further research is needed to explore this phenomenon, especially in terms of the extent to which multiplicity can be regarded as a healthy way of coping.

Multiple sclerosis

International Nuclear Information System (INIS)

Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P.; Shariat, K.; Kostopoulos, P.

2008-01-01

Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [de

Epidemiology of human toxocariasis in Poland – A review of cases 1978–2009

Directory of Open Access Journals (Sweden)

Anna Borecka

2015-02-01

Full Text Available Toxocariasis is a helminthozoonosis due to the infection of humans with larvae belonging to the [i]Toxocara[/i] genus. Humans become infected as a result of accidental consumption of infected eggs containing third stage larvae (L3 nematodes from [i]Toxocara[/i] canis or [i]Toxocara[/i] cati species. Toxocariasis was recognized for the first time in the early 1950s, and the first cases of toxocariasis in Poland were described a few years later. Toxocariasis is clinically classified into several types: classic and incomplete visceral larva migrans (VLM syndrome, ocular larva migrans (OLM syndrome, neurological toxocariasis (NLM, covert toxocariasis and asymptomatic toxocariasis. In 1994–2005, 18,367 sera of people suspected of being infected with [i]Toxocara[/i] were analysed, 1.8–76% had anti- [i]Toxocara[/i] antibodies. In the period 1978–2009, 1,022 clinical cases of toxocariasis were recognized in Poland. In the opinion of the authors, in order to reduce the frequency of toxocariasis in human populations, some prophylaxis should undertaken, e.g. public education of zoonotic diseases, systematic control of animal, deworming of pets, cleaning pets’ faeces by the owners.

Neutron-multiplication measurement instrument

Energy Technology Data Exchange (ETDEWEB)

Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

1982-01-01

The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results.

Neutron multiplication measurement instrument

International Nuclear Information System (INIS)

Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

1983-01-01

The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results

Neutron-multiplication measurement instrument

International Nuclear Information System (INIS)

Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

1982-01-01

The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results

Caput medusae in alcoholic liver disease | Hari Kumar | Nigerian ...

African Journals Online (AJOL)

Caput medusae and palmar erythema are cardinal signs in cirrhosis of liver with portal hypertension. Palmar erythema is described more often as a marker for alcoholic etiology of chronic liver disease. The peripheral stigmata of chronic liver disease are not routinely seen now a days due to early diagnosis and better ...

Multiple Improvements of Multiple Imputation Likelihood Ratio Tests

OpenAIRE

Chan, Kin Wai; Meng, Xiao-Li

2017-01-01

Multiple imputation (MI) inference handles missing data by first properly imputing the missing values $m$ times, and then combining the $m$ analysis results from applying a complete-data procedure to each of the completed datasets. However, the existing method for combining likelihood ratio tests has multiple defects: (i) the combined test statistic can be negative in practice when the reference null distribution is a standard $F$ distribution; (ii) it is not invariant to re-parametrization; ...

Factors influencing the degree of erythematous skin reactions in humans

International Nuclear Information System (INIS)

Denham, J.W.; Hamilton, C.S.; Simpson, S.A.; Ostwald, P.M.; O'Brien, M.; Kron, T.; Joseph, D.J.; Dear, K.B.G.

1995-01-01

Dose-response relationships have been studied using an ordinal visual scale and reflectance spectrophotometry data from 123 treatment sites on 110 patients treated with 10 dose fractions over 12-14 days. Dose rates varied between 3 and 240 Gy/h and total doses of between 25 and 41 Gy were given using teletherapy apparatus. We found qualitative scoring of erythematous skin reactions to be subject to considerable inter- and intra-observer variation. Reflectance spectrophotometry provided more reproducible information, some of which was undetectable by naked eye. Baseline erythema readings were significantly higher in male patients and at anatomical sites of previous heavy UV exposure. In addition, a pronounced decline in erythema readings during the second week of therapy and 'reciprocal vicinity' (abscopal) effects adjacent to the field, undetected by the eye, were observed in a subset of patients. Meaningful dose-response relationships could be derived only from reflectance data with peak change from the pretreatment baseline measure providing the best discrimination. Peak erythema measures following treatment were found to depend on the age and gender of the patient as well as the treatment site and its baseline erythema measurement. This was independent of the total dose administered or the instantaneous dose rate at which it was delivered. The rate of erythema development was also dose rate dependent but only weakly dependent on the biological dose intensity (Gy equiv./day) of the treatment course. The data raise the question of whether irradiation-induced erythema is exclusively a secondary phenomenon occurring as a result of basal cell killing. The short repair half time value of 0.06 h obtained by direct analysis is perplexing and may reflect a dose rate-dependent physiological vasodilatory response to irradiation and/or a multi-component cellular repair process

Multiple-Input Multiple-Output OFDM with Index Modulation

OpenAIRE

Basar, Ertugrul

2015-01-01

Orthogonal frequency division multiplexing with index modulation (OFDM-IM) is a novel multicarrier transmission technique which has been proposed as an alternative to classical OFDM. The main idea of OFDM-IM is the use of the indices of the active subcarriers in an OFDM system as an additional source of information. In this work, we propose multiple-input multiple-output OFDM-IM (MIMO-OFDM-IM) scheme by combining OFDM-IM and MIMO transmission techniques. The low complexity transceiver structu...

Stability Properties of Network Diversity Multiple Access with Multiple-Antenna Reception and Imperfect Collision Multiplicity Estimation

Directory of Open Access Journals (Sweden)

Ramiro Samano-Robles

2013-01-01

Full Text Available In NDMA (network diversity multiple access, protocol-controlled retransmissions are used to create a virtual MIMO (multiple-input multiple-output system, where collisions can be resolved via source separation. By using this retransmission diversity approach for collision resolution, NDMA is the family of random access protocols with the highest potential throughput. However, several issues remain open today in the modeling and design of this type of protocol, particularly in terms of dynamic stable performance and backlog delay. This paper attempts to partially fill this gap by proposing a Markov model for the study of the dynamic-stable performance of a symmetrical and non-blind NDMA protocol assisted by a multiple-antenna receiver. The model is useful in the study of stability aspects in terms of the backlog-user distribution and average backlog delay. It also allows for the investigation of the different states of the system and the transition probabilities between them. Unlike previous works, the proposed approach considers the imperfect estimation of the collision multiplicity, which is a crucial process to the performance of NDMA. The results suggest that NDMA improves not only the throughput performance over previous solutions, but also the average number of backlogged users, the average backlog delay and, in general, the stability of random access protocols. It is also shown that when multiuser detection conditions degrade, ALOHA-type backlog retransmission becomes relevant to the stable operation of NDMA.

Multiple Primary Tumors

African Journals Online (AJOL)

2017-12-05

Dec 5, 2017 ... Multiple primary tumors occur in clinical practice causing diagnostic dilemma. It is not very .... was estrogen receptor negative, progesterone receptor negative, and ... cervical, ovarian, and urinary bladder cancers. Multiple.

Patients with multiple contact allergies

DEFF Research Database (Denmark)

Carlsen, Berit Christina; Andersen, Klaus Ejner; Menné, Torkil

2008-01-01

Patients with multiple contact allergies, also referred to as polysensitized, are more frequent than predicted from prevalence of single sensitivities. The understanding of why some people develop multiple contact allergies, and characterization of patients with multiple contact allergies...... of developing multiple contact allergies. Evidence of allergen clusters among polysensitized individuals is also reviewed. The literature supports the idea that patients with multiple contact allergies constitute a special entity within the field of contact allergy. There is no generally accepted definition...... of patients with multiple contact allergies. We suggest that contact allergy to 3 or more allergens are defined as multiple contact allergies....

MultipleColposcopyJCO

Science.gov (United States)

Performing multiple biopsies during a procedure known as colposcopy—visual inspection of the cervix—is more effective than performing only a single biopsy of the worst-appearing area for detecting cervical cancer precursors. This multiple biopsy approach

PEMBENTUKAN MODEL PERLINDUNGAN ANAK BURUH MIGRAN DI KABUPATEN BANYUMAS

Directory of Open Access Journals (Sweden)

Riris Ardhanariswari

2012-01-01

Full Text Available This paper discusses about the model of protection children of migrant workers that most appropriate and can be used as a reference for the model of child protection that more comprehensive. The approach used in this study is a qualitative action research approach. The selected research location include two villages that representing the rural and semi-urban areas of two districts which they are the basis of migrant workers, such as Kedondong Village District of Sokaraja (semi-urban and Dawuhan Kulon Village District of Kedungbanteng (rural. Data were selected by using purposive sampling method. Base on research, Model of child protection of migrant workers can be done by more empowering form of social workers in the district by establishing a new institution, the Board for Child Protection of Migrant Workers (BCPMW at sub-district and district levels. Membership BCPMW at district level consisting of components Dinsosnakertrans, prospective migrant workers migrant workers, recruitment agency, social worker and observer problems of migrant workers. In carrying out its functions and duties, BCPMW have partnered with Dinsosnakertrans and BapermasPPKB.   Keywords: children of migrant workers, child protection model of migrant workers

PERCERAIAN DI KALANGAN BURUH MIGRAN DI BANJARSARI, NUSAWUNGU, CILACAP

Directory of Open Access Journals (Sweden)

Muchimah Al Anshor

2016-08-01

Full Text Available Family economy is one of the supporting factors in making household harmony. Various ways are taken by the couple of husband and wife to increase the family economy. One of the ways is working abroad or becoming migrant workers. The majority of husband or wife in Banjarsari, Nusawungu, Cilacap go abroad in reason to improve the family economy that their families hopefully become more harmonious. However, after their family economy are fulfilled, dispute in their domestic household often happens, even it causes divorce. This paper explains the basis of normative and juridical causes of the divorce among the migrant workers in Banjarsari, Nusawungu, Cilacap.

Perlindungan Buruh Migran Indonesia Melalui Pelatihan Paralegal di Banyumas

Directory of Open Access Journals (Sweden)

Sri Wijayanti

2018-03-01

ABSTRACT     The Paguyuban Seruni’s website in  http ://www.seruni.or.id/ and Seruni’s account on facebook are the tools that paguyuban Seruni used to help migrant worker’s problem who are having stay overseas. Through it, Paguyuban Seruni have accepted 15 cases, 6 cases solved but the rest is going to be solved. The research also found that one of obstacles why the cases is going to be solved is lack of the human resources who do not have enough knowledge about law and low skills in dealing with how to handle the case. Consequently, the cases had not been well-handled.Based on that background, this public service focused on improving the quality and quantity of human resources through The Training of Paralegal for Protection of Migrant Workers in Banyumas.The method is used teaching and practicing theories to solve the cases. After they finished the training, there are become braver and braver as a paralegal, moreover they can do help to solve migrant worker’s problems.  They also succeeded to build an organization named Paralegal Banyumas.   Keyword : Case, Paralegal, Migrant Worker, Training

The First Record of the Peregrine Falcon Nesting on a Tree, Russia

Directory of Open Access Journals (Sweden)

Oleg V. Andreenkov

2018-03-01

Full Text Available On April 29, 2017, in the east of the Novosibirsk region, a Peregrine Falcon (Falco peregrinus nest was found on a birch in the old nest of a Black Kite (Milvus migrans. The nesting tree is located under a steep offshore slope on the right bank of the river Inya, so that the nest is well within view from the shore. There were 5 eggs in the clutch.

Human envenomations caused by Portuguese man-of-war (Physalia physalis in urban beaches of São Luis City, Maranhão State, Northeast Coast of Brazil

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Denise Maria Ramalho Ferreira Bastos

Full Text Available ABSTRACT INTRODUCTION: The clinical and epidemiological aspects associated with Portuguese man-of-war envenomation were investigated and characterized. METHODS: Data from recorded envenomation events between 2005 and 2013 were provided by the GBMar (Group of Firemen Maritime of Maranhão State and SEMUSC (Municipal Secretary of Security with Citizenship. RESULTS: Most victims were children, and clinical manifestations included intense pain, edema, erythema, and rare systemic manifestations. CONCLUSIONS: The envenomation events were predictable and based on patterns involving multiple factors (environmental and/or human behavior; however, the initially applied measures did not match the current recommendations of the Health Ministry of Brazil.

Generalized internal multiple imaging

KAUST Repository

Zuberi, M. A. H.

2014-08-05

Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling. If properly imaged, internal multiples (internally scattered energy) can enhance the seismic image. Conventionally, to image internal multiples, accurate, sharp contrasts in the velocity model are required to construct a Green’s function with all the scattered energy. As an alternative, we have developed a generalized internal multiple imaging procedure that images any order internal scattering using the background Green’s function (from the surface to each image point), constructed from a smooth velocity model, usually used for conventional imaging. For the first-order internal multiples, the approach consisted of three steps, in which we first back propagated the recorded surface seismic data using the background Green’s function, then crosscorrelated the back-propagated data with the recorded data, and finally crosscorrelated the result with the original background Green’s function. This procedure images the contribution of the recorded first-order internal multiples, and it is almost free of the single-scattering recorded energy. The cost includes one additional crosscorrelation over the conventional single-scattering imaging application. We generalized this method to image internal multiples of any order separately. The resulting images can be added to the conventional single-scattering image, obtained, e.g., from Kirchhoff or reverse-time migration, to enhance the image. Application to synthetic data with reflectors illuminated by multiple scattering (double scattering) demonstrated the effectiveness of the approach.

December insolation and ultraviolet B radiation are associated with multiple sclerosis mortality in Poland

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Wojciech Cendrowski

2013-06-01

Full Text Available Background: The role of environmental factors (EF determining the occurrence of multiple sclerosis (SM is the subject of current investigations. Objective: To establish association between duration of insolation along with intensity of ultraviolet B (UVB radiation and mortality rates for SM in Poland. Method: The study was based on assemblage of 2172 SM persons (M – 878, F – 1294 who died in Poland in the years 2004–2008. Regional previous duration of insolation was measured in hours, intensity of UVB radiation was monitored in minimal erythema dose units (MED, ozone concentration in the ground layer of atmosphere was recorded in µg/m3 . Measurements of insolation, UVB radiation and ozone concentration were performed at provincial stations and territorial sites of the State Environmental Monitoring. EF were correlated to provincial crude mortality rates (CMR for MS. Correlational test by Pearson was used in the study. Demographic data were obtained from the Central Statistical Office, information on EF was received from the Institute of Meteorology and the Institute of Environmental Protection. Results: Annual, average, crude MR for MS per 100,000 inhabitants in Poland was 1.12 (SD 0.14. In northern part it amounted to 1.20 (SD 0.18 and in southern part reached 1.03 (SD 0.11. Significant inverse correlation was found between previous minimal duration of insolation in December and CMR for SM in the country: r = -0.518, p = 0.044. Borderline significance of inverse correlation was established between minimal intensity of UVB radiation in December and crude death rates for SM in Poland: r = -0.478, p = 0.060. CMR for SM in northern Poland was accompanied not only by lower UVB radiation level, but also by slower spring increase and autumn faster decrease of radiation. No significant correlation was ascertained between the ground atmospheric ozone concentration or the annual number of days with ozone concentration above 120 µg/m3 and MS

Orchestrating Multiple Intelligences

Science.gov (United States)

Moran, Seana; Kornhaber, Mindy; Gardner, Howard

2006-01-01

Education policymakers often go astray when they attempt to integrate multiple intelligences theory into schools, according to the originator of the theory, Howard Gardner, and his colleagues. The greatest potential of a multiple intelligences approach to education grows from the concept of a profile of intelligences. Each learner's intelligence…

MULTIPLE SPINAL CANAL MENINGIOMAS

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Nandigama Pratap Kumar

2016-10-01

Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare. We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date. The search was conducted through http://pubmed.com, a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple

TRAFFICKING: SUATU STUDI TENTANG PERDAGANGAN PEREMPUAN DARI ASPEK SOSIAL, BUDAYA DAN EKONOMI DI KABUPATEN BANYUMAS

Directory of Open Access Journals (Sweden)

Siti Muflichah

2009-05-01

Full Text Available Trafficking or people commerce is a recruitment, transportation, reception centre, sending, moving or reception somaone with threat, harshness, abduction, forgery, deception, abuse of power, trapping of debt or giving payment or profit, so get approval from people holding to conduct of others, both for conducted in inter-states and state for ceploittation or result people exploited. From understanding above, hence form trafficking can in the form of labor migran legal also illegal, worker of hausehold, worker of commercial seks, wedding orger, spurlous child adoption, beggar, pornography industry, circulation of forbidden drug and sale of body organ. Pursuant to research result, trafficking form that happened Banyumas is expressed. Its for ecample that is husemaid labour of migran and worker of commercial seks. Form of him not yet been expressed. Cause factor the happen of trafficking is economic factor or poorness, education which relative lower, patriakhi culture who then push woman motivate to fulfill requirement of economics and fulfill the him of as especial entrpreneur. The trafficking victims less get protection of law, this matter is caused by law and substanstion regulation completely arrangen protection to victim. The adjacent is theoretically conducted in three aspects, its relocation, repatriating, and reintegration, but not all victims get adjacent pattern.

Advances in molecular identification, taxonomy, genetic variation and diagnosis of Toxocara spp.

Science.gov (United States)

Chen, Jia; Zhou, Dong-Hui; Nisbet, Alasdair J; Xu, Min-Jun; Huang, Si-Yang; Li, Ming-Wei; Wang, Chun-Ren; Zhu, Xing-Quan

2012-10-01

The genus Toxocara contains parasitic nematodes of human and animal health significance, such as Toxocara canis, Toxocara cati and Toxocara vitulorum. T. canis and T. cati are among the most prevalent parasites of dogs and cats with a worldwide distribution. Human infection with T. canis and T. cati, which can cause a number of clinical manifestations such as visceral larva migrans (VLMs), ocular larva migrans (OLMs), eosinophilic meningoencephalitis (EME), covert toxocariasis (CT) and neurotoxocariasis, is considered the most prevalent neglected helminthiasis in industrialized countries. The accurate identification Toxocara spp. and their unequivocal differentiation from each other and from other ascaridoid nematodes causing VLMs and OLMs has important implications for studying their taxonomy, epidemiology, population genetics, diagnosis and control. Due to the limitations of traditional (morphological) approaches for identification and diagnosis of Toxocara spp., PCR-based techniques utilizing a range of genetic markers in the nuclear and mitochondrial genomes have been developed as useful alternative approaches because of their high sensitivity, specificity, rapidity and utility. In this article, we summarize the current state of knowledge and advances in molecular identification, taxonomy, genetic variation and diagnosis of Toxocara spp. with prospects for further studies. Copyright © 2012 Elsevier B.V. All rights reserved.

Impact assessment of energy-efficient lighting in patients with lupus erythematosus: a pilot study.

Science.gov (United States)

Fenton, L; Dawe, R; Ibbotson, S; Ferguson, J; Silburn, S; Moseley, H

2014-03-01

Patients with lupus erythematosus (LE) are often abnormally photosensitive. Ultraviolet (UV) exposure can not only induce cutaneous lesions but may also contribute to systemic flares and disease progression. Various forms of energy-efficient lighting have been shown to emit UV radiation. To determine the effects of these emissions on individuals with LE. This assessment investigated cutaneous responses to repeated exposures from three types of lighting: compact fluorescent lamp (CFL), light-emitting diode (LED) and energy-efficient halogen (EEH). The subjects were 15 patients with LE and a control group of five healthy volunteers. No cutaneous LE lesions were induced by any of the light sources. Delayed skin erythema was induced at the site of CFL irradiation in six of the 15 patients with LE and two of the five healthy subjects. Erythema was increased in severity and more persistent in patients with LE. One patient with LE produced a positive delayed erythema to the EEH. A single patient with LE produced immediate abnormal erythemal responses to the CFL, LED and EEH. Further investigation revealed that this patient also had solar urticaria. All other subjects had negative responses to LED exposure. Compact fluorescent lamps emit UV that can induce skin erythema in both individuals with LE and healthy individuals when situated in close proximity. However, this occurs to a greater extent and is more persistent in patients with LE. EEHs emit UVA that can induce erythema in patients with LE. LEDs provide a safer alternative light source without risk of UV exposure. © 2013 British Association of Dermatologists.

Topical application of ST266 reduces UV-induced skin damage

Directory of Open Access Journals (Sweden)

Guan L

2017-11-01

Full Text Available Linna Guan,1 Amanda Suggs,1 Emily Galan,1 Minh Lam,1 Elma D Baron1,2 1Department of Dermatology, Case Western Reserve University, 2Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA Abstract: Ultraviolet radiation (UVR has a significant impact on human skin and is the major environmental factor for skin cancer formation. It is also believed that 80% of the signs of skin aging are attributed to UVR. UVR induces inflammatory changes in the skin via the increase in oxidative stress, DNA damage vascular permeability, and fluctuation in a myriad of cytokines. Acutely, UVR causes skin inflammation and DNA damage, which manifest as sunburn (erythema. ST266 is the secretome of proprietary amnion-derived cells that have been shown to reduce inflammation and accelerate healing of various wounds by promoting migration of keratinocytes and fibroblasts in preclinical animal studies. We hypothesized that ST266 has anti-inflammatory effects that can be used to reduce ultraviolet (UV erythema and markers of inflammation. In this study, we examined the in vivo effects of ST266 on post UV-irradiated skin by measuring erythema, level of cyclobutane pyrimidine dimer (CPD, and expression level of xeroderma pigmentosum, complementation group A (XPA. We demonstrated that ST266 has the potential to reduce the acute effects of UV-induced skin damage when applied immediately after the initial exposure. In addition, ST266 is shown to reduce erythema, increase XPA DNA repair protein, and decrease damaged DNA. Keywords: ST266, photoaging, erythema, CPD, XPA, UV-induced DNA damage

Maltreatment in multiple-birth children.

Science.gov (United States)

Lang, Cathleen A; Cox, Matthew J; Flores, Glenn

2013-12-01

The rate of multiple births has increased over the last two decades. In 1982, an increased frequency of injuries among this patient population was noted, but few studies have evaluated the increased incidence of maltreatment in twins. The study aim was to evaluate the features of all multiple-birth children with substantiated physical abuse and/or neglect over a four-year period at a major children's hospital. A Retrospective chart review was conducted of multiple-gestation children in which at least one child in the multiple set experienced child maltreatment from January 2006 to December 2009. Data regarding the child, injuries, family, and perpetrators were abstracted. We evaluated whether family and child characteristics were associated with maltreatment, and whether types of injuries were similar within multiple sets. For comparison, data from the same time period for single-birth maltreated children also were abstracted, including child age, gestational age at birth, and injury type. There were 19 sets of multiple births in which at least one child had abusive injuries and/or neglect. In 10 of 19 sets (53%), all multiples were found to have a form of maltreatment, and all children in these multiple sets shared at least one injury type. Parents lived together in 63% of cases. Fathers and mothers were the alleged perpetrator in 42% of the cases. Multiple-gestation-birth maltreated children were significantly more likely than single-birth maltreated children to have abdominal trauma (13% vs. 1%, respectively; pchildren often, but not always, were abused. In sets with two maltreated children, children usually shared the same modes of maltreatment. Multiples are significantly more likely than singletons to be younger and experience fractures and abdominal trauma. The findings support the current standard practice of evaluating all children in a multiple set when one is found to be abused or neglected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Multiple sclerosis

DEFF Research Database (Denmark)

Stenager, Egon; Stenager, E N; Knudsen, Lone

1994-01-01

In a cross-sectional study of 117 randomly selected patients (52 men, 65 women) with definite multiple sclerosis, it was found that 76 percent were married or cohabitant, 8 percent divorced. Social contacts remained unchanged for 70 percent, but outgoing social contacts were reduced for 45 percent......, need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap...

UV-indeks og dets betydning

DEFF Research Database (Denmark)

Wulf, Hans Christian; Eriksen, Paul

2010-01-01

The published UV index refers to the expected UV intensity at mid day, when the solar elevation is at its maximum. In Scandinavia, the maximum UV index is seven around midsummer. When the UV index is three, the erythema-weighted dose will be three Standard Erythema Dose (SED) in the hour with max...... a sunburn already when the UV index is higher than two....

Applying Multiple Intelligences

Science.gov (United States)

Christodoulou, Joanna A.

2009-01-01

The ideas of multiple intelligences introduced by Howard Gardner of Harvard University more than 25 years ago have taken form in many ways, both in schools and in other sometimes-surprising settings. The silver anniversary of Gardner's learning theory provides an opportunity to reflect on the ways multiple intelligences theory has taken form and…

Multiple-membrane multiple-electrolyte redox flow battery design

Science.gov (United States)

Yan, Yushan; Gu, Shuang; Gong, Ke

2017-05-02

A redox flow battery is provided. The redox flow battery involves multiple-membrane (at least one cation exchange membrane and at least one anion exchange membrane), multiple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and at least one electrolyte disposed between the two membranes) as the basic characteristic, such as a double-membrane, triple electrolyte (DMTE) configuration or a triple-membrane, quadruple electrolyte (TMQE) configuration. The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte.

Evaluation of the effect of platelet-rich plasma on recovery after ablative fractional photothermolysis.

Science.gov (United States)

Kim, Haena; Gallo, Julio

2015-01-01

Despite the advantages and reduced recovery time of ablative fractional photothermolysis, patients still seek adjuvant treatments to reduce healing time and facilitate their return to normal social and work activity. Platelet-rich plasma (PRP) has been used for many applications in various surgical fields for its ability to improve wound healing, hemostasis, and graft survival. To determine whether PRP will be an effective adjunctive treatment to fractional carbon dioxide resurfacing and reduce healing time and duration of adverse effects. Prospective blinded study of male and female patients 18 years or older and with Fitzpatrick skin types I to IV performed at Miami Institute for Age Management and Intervention. Using a fractional carbon dioxide laser (60 mJ at 150 Hz), a 1-cm2 area was treated on each forearm of every patient. Immediately after the laser treatment, patients were randomized to receive PRP in the right or left forearm and saline in the other forearm. Pictures of each forearm were taken immediately after injection of PRP and then on a daily basis until reepithelialization (eschar formation) occurred. Posttreatment erythema, edema, and reepithelialization. Significant improvement in posttreatment erythema was observed in PRP-treated arms across 94 comparisons in 15 patients. Improvement was defined as the erythema rating of the untreated arm minus the erythema rating of the PRP-treated arm. The mean (standard error of the mean) improvement in grade was 0.26 (0.092; t statistic, 2.83; P = .003). A mean (standard error of the mean) improvement in edema grade of 0.13 (0.059) was also significant across 94 comparisons (t statistic, 2.20; P = .02). Our preliminary results suggest that PRP can objectively reduce erythema and edema following carbon dioxide fractional laser treatment. Most importantly, patients themselves have noticed a reduction in the common posttreatment effects: erythema, edema, pruritus, and discomfort. We anticipate that PRP

Multiplicity: discussion points from the Statisticians in the Pharmaceutical Industry multiplicity expert group.

Science.gov (United States)

Phillips, Alan; Fletcher, Chrissie; Atkinson, Gary; Channon, Eddie; Douiri, Abdel; Jaki, Thomas; Maca, Jeff; Morgan, David; Roger, James Henry; Terrill, Paul

2013-01-01

In May 2012, the Committee of Health and Medicinal Products issued a concept paper on the need to review the points to consider document on multiplicity issues in clinical trials. In preparation for the release of the updated guidance document, Statisticians in the Pharmaceutical Industry held a one-day expert group meeting in January 2013. Topics debated included multiplicity and the drug development process, the usefulness and limitations of newly developed strategies to deal with multiplicity, multiplicity issues arising from interim decisions and multiregional development, and the need for simultaneous confidence intervals (CIs) corresponding to multiple test procedures. A clear message from the meeting was that multiplicity adjustments need to be considered when the intention is to make a formal statement about efficacy or safety based on hypothesis tests. Statisticians have a key role when designing studies to assess what adjustment really means in the context of the research being conducted. More thought during the planning phase needs to be given to multiplicity adjustments for secondary endpoints given these are increasing in importance in differentiating products in the market place. No consensus was reached on the role of simultaneous CIs in the context of superiority trials. It was argued that unadjusted intervals should be employed as the primary purpose of the intervals is estimation, while the purpose of hypothesis testing is to formally establish an effect. The opposing view was that CIs should correspond to the test decision whenever possible. Copyright © 2013 John Wiley & Sons, Ltd.

Multiple primary cancer

International Nuclear Information System (INIS)

Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

1989-01-01

It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

Multiple attenuation to reflection seismic data using Radon filter and Wave Equation Multiple Rejection (WEMR) method

Energy Technology Data Exchange (ETDEWEB)

Erlangga, Mokhammad Puput [Geophysical Engineering, Institut Teknologi Bandung, Ganesha Street no.10 Basic Science B Buliding fl.2-3 Bandung, 40132, West Java Indonesia puput.erlangga@gmail.com (Indonesia)

2015-04-16

Separation between signal and noise, incoherent or coherent, is important in seismic data processing. Although we have processed the seismic data, the coherent noise is still mixing with the primary signal. Multiple reflections are a kind of coherent noise. In this research, we processed seismic data to attenuate multiple reflections in the both synthetic and real seismic data of Mentawai. There are several methods to attenuate multiple reflection, one of them is Radon filter method that discriminates between primary reflection and multiple reflection in the τ-p domain based on move out difference between primary reflection and multiple reflection. However, in case where the move out difference is too small, the Radon filter method is not enough to attenuate the multiple reflections. The Radon filter also produces the artifacts on the gathers data. Except the Radon filter method, we also use the Wave Equation Multiple Elimination (WEMR) method to attenuate the long period multiple reflection. The WEMR method can attenuate the long period multiple reflection based on wave equation inversion. Refer to the inversion of wave equation and the magnitude of the seismic wave amplitude that observed on the free surface, we get the water bottom reflectivity which is used to eliminate the multiple reflections. The WEMR method does not depend on the move out difference to attenuate the long period multiple reflection. Therefore, the WEMR method can be applied to the seismic data which has small move out difference as the Mentawai seismic data. The small move out difference on the Mentawai seismic data is caused by the restrictiveness of far offset, which is only 705 meter. We compared the real free multiple stacking data after processing with Radon filter and WEMR process. The conclusion is the WEMR method can more attenuate the long period multiple reflection than the Radon filter method on the real (Mentawai) seismic data.

Echinococcosis and other parasitic infections in domestic dogs from urban areas of an argentinean Patagonian city

OpenAIRE

Flores, Verónica; Viozzi, Gustavo; Garibotti, Gilda; Zacharias, Daniela; Debiaggi, María Florencia; Kabaradjian, Surpik

2017-01-01

In urban populations of South America, dogs with free access to public areas represent a public health concern. The primary consequence of roaming dogs on human health is the transmission of infectious and parasitic diseases mainly through feces contamination. The main diseases likely to be transmitted are hydatidosis or echinococcosis, larva migrans, and giardiasis. In Argentina, hydatidosis ranks among the most prevalent zoonosis. Although it is considered a rural disease, the circulation o...

Accurate scaling on multiplicity

International Nuclear Information System (INIS)

Golokhvastov, A.I.

1989-01-01

The commonly used formula of KNO scaling P n =Ψ(n/ ) for descrete distributions (multiplicity distributions) is shown to contradict mathematically the condition ΣP n =1. The effect is essential even at ISR energies. A consistent generalization of the concept of similarity for multiplicity distributions is obtained. The multiplicity distributions of negative particles in PP and also e + e - inelastic interactions are similar over the whole studied energy range. Collider data are discussed. 14 refs.; 8 figs

Automatic plankton image classification combining multiple view features via multiple kernel learning.

Science.gov (United States)

Zheng, Haiyong; Wang, Ruchen; Yu, Zhibin; Wang, Nan; Gu, Zhaorui; Zheng, Bing

2017-12-28

Plankton, including phytoplankton and zooplankton, are the main source of food for organisms in the ocean and form the base of marine food chain. As the fundamental components of marine ecosystems, plankton is very sensitive to environment changes, and the study of plankton abundance and distribution is crucial, in order to understand environment changes and protect marine ecosystems. This study was carried out to develop an extensive applicable plankton classification system with high accuracy for the increasing number of various imaging devices. Literature shows that most plankton image classification systems were limited to only one specific imaging device and a relatively narrow taxonomic scope. The real practical system for automatic plankton classification is even non-existent and this study is partly to fill this gap. Inspired by the analysis of literature and development of technology, we focused on the requirements of practical application and proposed an automatic system for plankton image classification combining multiple view features via multiple kernel learning (MKL). For one thing, in order to describe the biomorphic characteristics of plankton more completely and comprehensively, we combined general features with robust features, especially by adding features like Inner-Distance Shape Context for morphological representation. For another, we divided all the features into different types from multiple views and feed them to multiple classifiers instead of only one by combining different kernel matrices computed from different types of features optimally via multiple kernel learning. Moreover, we also applied feature selection method to choose the optimal feature subsets from redundant features for satisfying different datasets from different imaging devices. We implemented our proposed classification system on three different datasets across more than 20 categories from phytoplankton to zooplankton. The experimental results validated that our system

Multiple embryos, multiple nepionts and multiple equatorial layers in Cycloclypeus carpenteri.

Science.gov (United States)

Briguglio, Antonino; Kinoshita, Shunichi; Wolfgring, Erik; Hohenegger, Johann

2016-04-01

In this study, 17 specimens of Cycloclypeus carpenteri have been analyzed by means of microCT scanning. We used CT scanning technique as it enables the visualization and the quantifications of internal structures of hollow specimens without their destruction. It has been observed that many specimens possessing the natural morphology of this taxon, actually contain multiple embryos (up to 16 in one single specimen) and, in some few cases, multiple nepionts each with its own heterosteginid chambers (up to three separated nepionts). The diameter of each proloculus has been measured, and as a result, they are very variable even within the same specimen, therefore questioning the long known theory that schizonts have smaller proloculi than gamonts and also questioning the fact that proloculi in the same species should all have comparable size. Furthermore, we have observed the presence of additional equatorial planes on several specimens. Such additional planes are always connected to what seems to be the main equatorial plane. Such connections are T-shaped and are located at the junction between two equatorial layers; these junctions are made by a chamberlet, which possesses an unusually higher number of apertures. The connections between equatorial planes are always perfectly synchronized with the relative growth step and the same chamber can be therefore followed along the multiple equatorial planes. Apparently there is a perfect geometric relationship between the creation of additional equatorial planes and the position of the nepionts. Whenever the nepionts are positioned on different planes, additional planes are created and the angle of the nepionts is related to the banding angle of the equatorial planes. The presence of additional planes do not hamper the life of the cell, on the contrary, it seems that the cell is still able to build nicely shaped chamberlets and, after volumetric calculations, it seems all specimens managed to keep their logistic growth

Physical stability and clinical efficacy of Crocodylus niloticus oil lotion

Directory of Open Access Journals (Sweden)

Telanie Venter

Full Text Available ABSTRACT The stability and the anti-ageing, skin hydrating and anti-erythema effects of a commercialized Crocodylus niloticus Laurenti, 1768, Crocodylidae, oil lotion was determined. The lotion was stored at controlled conditions over six months during which several stability tests were performed. For the clinical efficacy studies lotion was applied on volar forearm skin (female volunteers and compared to a liquid paraffin-containing reference product. Skin hydrating and anti-ageing effects were determined with a Corneometer®, Cutometer® and Visioscan®, following single (3 h and multiple applications (12 weeks. The Vapometer® and Mexameter® were utilized to determine this lotion's anti-erythema effects on sodium lauryl sulfate irritated skin. The lotion demonstrated good stability over 6 months. The reference product increased skin hydration and decreased skin wrinkles to a larger extent than the C. niloticus lotion after a single application, whereas the C. niloticus lotion decreased skin scaliness better than the reference product. During the long-term study, the reference product overall increased skin hydration more than the C. niloticus lotion, whereas C. niloticus lotion increased skin elasticity to a larger extent than the reference product. C. niloticus lotion increased skin wrinkles and decreased skin scaliness over 12 weeks. Compared to non-treated, irritated skin, C. niloticus lotion demonstrated some potential anti-inflammatory characteristics.

Multiple photon resonances

International Nuclear Information System (INIS)

Elliott, C.J.; Feldman, B.J.

1979-02-01

A detailed theoretical analysis is presented of the interaction of intense near-resonant monochromatic radiation with an N-level anharmonic oscillator. In particular, the phenomenon of multiple photon resonance, the process by which an N-level system resonantly absorbs two or more photons simultaneously, is investigated. Starting from the Schroedinger equation, diagrammatic techniques are developed that allow the resonant process to be analyzed quantitatively, in analogy with well-known two-level coherent phenomena. In addition, multiple photon Stark shifts of the resonances, shifts absent in two-level theory, are obtained from the diagrams. Insights into the nature of multiple photon resonances are gained by comparing the quantum mechanical system with classical coupled pendulums whose equations of motion possess identical eigenvalues and eigenvectors. In certain limiting cases, including that of the resonantly excited N-level harmonic oscillator and that of the equally spaced N-level system with equal matrix elements, analytic results are derived. The influence of population relaxation and phase-disrupting collisions on the multiple photon process are also analyzed, the latter by extension of the diagrammatic technique to the density matrix equations of motion. 11 figures

Multiplication modules over non-commutative rings

International Nuclear Information System (INIS)

Tuganbaev, A A

2003-01-01

It is proved that each submodule of a multiplication module over a regular ring is a multiplicative module. If A is a ring with commutative multiplication of right ideals, then each projective right ideal is a multiplicative module, and a finitely generated A-module M is a multiplicative module if and only if all its localizations with respect to maximal right ideals of A are cyclic modules over the corresponding localizations of A. In addition, several known results on multiplication modules over commutative rings are extended to modules over not necessarily commutative rings

Multiple intelligences: Can they be measured?

OpenAIRE

Kirsi Tirri; Petri Nokelainen; Erkki Komulainen

2013-01-01

This paper is about issues relating to the assessment of multiple intelligences. The first section introduces the authors’ work on building measures of multiple intelligences and moral sensitivities. It also provides a conceptual definition of multiple intelligences based on Multiple Intelligences theory by Howard Gardner (1983). The second section discusses the context specificity of intelligences and alternative approaches to measuring multiple intelligences. The third section analyses the ...

Multiple Intelligences and quotient spaces

OpenAIRE

Malatesta, Mike; Quintana, Yamilet

2006-01-01

The Multiple Intelligence Theory (MI) is one of the models that study and describe the cognitive abilities of an individual. In [7] is presented a referential system which allows to identify the Multiple Intelligences of the students of a course and to classify the level of development of such Intelligences. Following this tendency, the purpose of this paper is to describe the model of Multiple Intelligences as a quotient space, and also to study the Multiple Intelligences of an individual in...

Rehabilitation and multiple sclerosis

DEFF Research Database (Denmark)

Dalgas, Ulrik

2011-01-01

In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point......, a paradigm shift is taking place and it is now increasingly acknowledged that exercise therapy is both safe and beneficial. Robot-assisted training is also attracting attention in multiple sclerosis rehabilitation. Several sophisticated commercial robots exist, but so far the number of scientific studies...... promising. This drug has been shown to improve walking ability in some patients with multiple sclerosis, associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation strategies involving these different approaches, or combinations of them, may be of great use in improving...

The cause multiplicity and the multiple cause style of adverse events in Japanese nuclear power plants

International Nuclear Information System (INIS)

Miyazaki, Takamasa

2008-01-01

An adverse event in a nuclear power plant occurs due to either one cause or multiple causes. To consider ways of preventing adverse events, it is useful to clarify whether events are caused by single or multiple causes. In this study, the multiple causes is expressed using the cause multiplicity and the multiple cause style. Classified causes of adverse events in Japanese nuclear power plants were analyzed, with the following results: the cause multiplicity of serious adverse events is higher than that of minor adverse events, and the multiple cause style can be expressed by combining two styles: series type and parallel type. Also, for a multiple cause event, a new method of displaying the event is presented as a cause-chain chart where the cause items are arranged in a sequential way and are connected considering the mutual relations among the causes. This new display method shows the whole flow of issues concerning the event more simply than the conventional display method of the chain of phenomena, and would be useful for considering the terminating point of the chain of causes. (author)

Hadron multiplicity as the limit of jet multiplicity at high resolution

International Nuclear Information System (INIS)

Lupia, S.; Ochs, W.

1998-01-01

Recently exact numerical results from the evolution equation for parton multiplicities in QCD jets have been obtained. A comparison with various approximate results is presented. A good description is obtained not only of the jet multiplicities measured at LEP-1 but also of the hadron multiplicities for cm s energies above 1.6 GeV in e + e - annihilation. The solution suggests that a final state hadron can be represented by a jet in the limit of small (nonperturbative) k perpendicular to cut-off Q 0 . In this description using as adjustable parameters only the QCD scale Λ and the cut-off Q 0 , the coupling α s can be seen to rise towards large values above unity at low energies. (orig.)

Fatigue and Multiple Sclerosis

Science.gov (United States)

... to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area Donate Donate ... of MS What Causes MS? Who Gets MS? Multiple Sclerosis FAQs Types of MS Related Conditions Symptoms & Diagnosis ...

Correlations in multiple production on nuclei and Glauber model of multiple scattering

International Nuclear Information System (INIS)

Zoller, V.R.; Nikolaev, N.N.

1982-01-01

Critical analysis of possibility for describing correlation phenomena during multiple production on nuclei within the framework of the Glauber multiple seattering model generalized for particle production processes with Capella, Krziwinski and Shabelsky has been performed. It was mainly concluded that the suggested generalization of the Glauber model gives dependences on Ng(Np) (where Ng-the number of ''grey'' tracess, and Np-the number of protons flying out of nucleus) and, eventually, on #betta# (where #betta#-the number of intranuclear interactions) contradicting experience. Independent of choice of relation between #betta# and Ng(Np) in the model the rapidity corrletor Rsub(eta) is overstated in the central region and understated in the region of nucleus fragmentation. In mean multiplicities these two contradictions of experience are disguised with random compensation and agreement with experience in Nsub(S) (function of Ng) cannot be an argument in favour of the model. It is concluded that eiconal model doesn't permit to quantitatively describe correlation phenomena during the multiple production on nuclei

Multiple Voices, Multiple Realities: Self-Defined Images of Self among Adolescent Hispanic English Language Learners

Science.gov (United States)

Ajayi, Lasisi J.

2006-01-01

Acquisition of multiple identities to negotiate new forms of social participation and the concomitant attendant multiple languages and multiple cultures is "sine qua non" to success in English language learning classrooms. This study therefore, investigates how middle school Hispanic students reconceptualize their identities to negotiate…

A systematic approach to systemic contact dermatitis and symmetric drug-related intertriginous and flexural exanthema (SDRIFE): a closer look at these conditions and an approach to intertriginous eruptions.

Science.gov (United States)

Winnicki, Monika; Shear, Neil H

2011-06-01

Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric intertriginous eruption involving

Health Literacy - Multiple Languages

Science.gov (United States)

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Salmonella Infections - Multiple Languages

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Cosmetic Dentistry - Multiple Languages

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... Here: Home → Multiple Languages → All Health Topics → Cosmetic Dentistry URL of this page: https://medlineplus.gov/languages/ ... W XYZ List of All Topics All Cosmetic Dentistry - Multiple Languages To use the sharing features on ...

Rotavirus Infections - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Rotavirus Infections URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotavirus Infections - Multiple Languages To use the sharing features ...

Multiple sclerosis

International Nuclear Information System (INIS)

Sadashima, Hiromichi; Kusaka, Hirofumi; Imai, Terukuni; Takahashi, Ryosuke; Matsumoto, Sadayuki; Yamamoto, Toru; Yamasaki, Masahiro; Maya, Kiyomi

1986-01-01

Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

Neutron source multiplication method

International Nuclear Information System (INIS)

Clayton, E.D.

1985-01-01

Extensive use has been made of neutron source multiplication in thousands of measurements of critical masses and configurations and in subcritical neutron-multiplication measurements in situ that provide data for criticality prevention and control in nuclear materials operations. There is continuing interest in developing reliable methods for monitoring the reactivity, or k/sub eff/, of plant operations, but the required measurements are difficult to carry out and interpret on the far subcritical configurations usually encountered. The relationship between neutron multiplication and reactivity is briefly discussed and data presented to illustrate problems associated with the absolute measurement of neutron multiplication and reactivity in subcritical systems. A number of curves of inverse multiplication have been selected from a variety of experiments showing variations observed in multiplication during the course of critical and subcritical experiments where different methods of reactivity addition were used, with different neutron source detector position locations. Concern is raised regarding the meaning and interpretation of k/sub eff/ as might be measured in a far subcritical system because of the modal effects and spectrum differences that exist between the subcritical and critical systems. Because of this, the calculation of k/sub eff/ identical with unity for the critical assembly, although necessary, may not be sufficient to assure safety margins in calculations pertaining to far subcritical systems. Further study is needed on the interpretation and meaning of k/sub eff/ in the far subcritical system

Connecting the Production Multiple

DEFF Research Database (Denmark)

Lichen, Alex Yu; Mouritsen, Jan

&OP process itself is a fluid object, but there is still possibility to organise the messy Production. There are connections between the Production multiple and the managerial technology fluid. The fluid enacted the multiplicity of Production thus making it more difficult to be organised because there were...... in opposite directions. They are all part of the fluid object. There is no single chain of circulating references that makes the object a matter of fact. Accounting fluidity means that references drift back and forth and enact new realities also connected to the chain. In this setting future research may......This paper is about objects. It follows post ANT trajectories and finds that objects are multiple and fluid. Extant classic ANT inspired accounting research largely sees accounting inscriptions as immutable mobiles. Although multiplicity of objects upon which accounting acts has been explored...

Superresolution Imaging Using Resonant Multiples

KAUST Repository

Guo, Bowen

2017-12-22

A resonant multiple is defined as a multiple reflection that revisits the same subsurface location along coincident reflection raypaths. We show that resonant first-order multiples can be migrated with either Kirchhoff or wave-equation migration methods to give images with approximately twice the spatial resolution compared to post-stack primary-reflection images. A moveout-correction stacking method is proposed to enhance the signal-to-noise ratios (SNRs) of the resonant multiples before superresolution migration. The effectiveness of this procedure is validated by synthetic and field data tests.

Vascular comorbidities in multiple sclerosis

DEFF Research Database (Denmark)

Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils

2016-01-01

To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case-control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980-2005 were identified from the Danish Multiple Sclerosis Registry...... and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique...

Superresolution Imaging Using Resonant Multiples

KAUST Repository

Guo, Bowen; Schuster, Gerard T.

2017-01-01

A resonant multiple is defined as a multiple reflection that revisits the same subsurface location along coincident reflection raypaths. We show that resonant first-order multiples can be migrated with either Kirchhoff or wave-equation migration methods to give images with approximately twice the spatial resolution compared to post-stack primary-reflection images. A moveout-correction stacking method is proposed to enhance the signal-to-noise ratios (SNRs) of the resonant multiples before superresolution migration. The effectiveness of this procedure is validated by synthetic and field data tests.

A multiplicity logic unit

International Nuclear Information System (INIS)

Bialkowski, J.; Moszynski, M.; Zagorski, A.

1981-01-01

The logic diagram principle of operation and some details of the design of the multiplicity logic unit are presented. This unit was specially designed to fulfil the requirements of a multidetector arrangement for gamma-ray multiplicity measurements. The unit is equipped with 16 inputs controlled by a common coincidence gate. It delivers a linear output pulse with the height proportional to the multiplicity of coincidences and logic pulses corresponding to 0, 1, ... up to >= 5-fold coincidences. These last outputs are used to steer the routing unit working with the multichannel analyser. (orig.)

Safe Dynamic Multiple Inheritance

DEFF Research Database (Denmark)

Ernst, Erik

2002-01-01

Multiple inheritance and similar mechanisms are usually only supported at compile time in statically typed languages. Nevertheless, dynamic multiple inheritance would be very useful in the development of complex systems, because it allows the creation of many related classes without an explosion...... in the size and level of redundancy in the source code. In fact, dynamic multiple inheritance is already available. The language gbeta is statically typed and has supported run-time combination of classes and methods since 1997, by means of the combination operator '&'. However, with certain combinations...

Fission neutron multiplicity calculations

International Nuclear Information System (INIS)

Maerten, H.; Ruben, A.; Seeliger, D.

1991-01-01

A model for calculating neutron multiplicities in nuclear fission is presented. It is based on the solution of the energy partition problem as function of mass asymmetry within a phenomenological approach including temperature-dependent microscopic energies. Nuclear structure effects on fragment de-excitation, which influence neutron multiplicities, are discussed. Temperature effects on microscopic energy play an important role in induced fission reactions. Calculated results are presented for various fission reactions induced by neutrons. Data cover the incident energy range 0-20 MeV, i.e. multiple chance fission is considered. (author). 28 refs, 13 figs

Atrial Fibrillation - Multiple Languages

Science.gov (United States)

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Domestic Violence - Multiple Languages

Science.gov (United States)

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Herbal Medicine - Multiple Languages

Science.gov (United States)

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Elder Abuse - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Elder Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Elder Abuse - Multiple Languages To use the sharing features on ...

Zika Virus - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Zika Virus URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Zika Virus - Multiple Languages To use the sharing features on ...

Diabetic Foot - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Diabetic Foot URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Diabetic Foot - Multiple Languages To use the sharing features on ...

Child Abuse - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Child Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Child Abuse - Multiple Languages To use the sharing features on ...

Testing for Nonuniform Differential Item Functioning with Multiple Indicator Multiple Cause Models

Science.gov (United States)

Woods, Carol M.; Grimm, Kevin J.

2011-01-01

In extant literature, multiple indicator multiple cause (MIMIC) models have been presented for identifying items that display uniform differential item functioning (DIF) only, not nonuniform DIF. This article addresses, for apparently the first time, the use of MIMIC models for testing both uniform and nonuniform DIF with categorical indicators. A…

Hadron multiplicity as the limit of jet multiplicity at high resolution

Energy Technology Data Exchange (ETDEWEB)

Lupia, S.; Ochs, W. [Max-Planck-Institut fuer Physik, Muenchen (Germany). Werner-Heisenberg-Institut

1998-05-01

Recently exact numerical results from the evolution equation for parton multiplicities in QCD jets have been obtained. A comparison with various approximate results is presented. A good description is obtained not only of the jet multiplicities measured at LEP-1 but also of the hadron multiplicities for cm s energies above 1.6 GeV in e{sup +}e{sup -} annihilation. The solution suggests that a final state hadron can be represented by a jet in the limit of small (nonperturbative) k {sub perpendicular} {sub to} cut-off Q{sub 0}. In this description using as adjustable parameters only the QCD scale {Lambda} and the cut-off Q{sub 0}, the coupling {alpha}{sub s} can be seen to rise towards large values above unity at low energies. (orig.). 8 refs.

Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

Directory of Open Access Journals (Sweden)

Senol Kobak

2014-01-01

Full Text Available A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren’s syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient’s subjective and laboratory assessments.

Desensitization to darunavir in a pediatric patient

Directory of Open Access Journals (Sweden)

Julio César Cambray-Gutiérrez

2015-07-01

Full Text Available Treatment of HIV infection requires the combination of multiple antiretroviral drugs, known as highly active antiretroviral therapy (HAART; however, up to 84% of patients experience adverse drug effects that lead to discontinuation within first months of treatment. Skin manifestations are reported to 22% of patients. The severity of these is variable, such as erythema multiforme, rash, hives and severe skin reactions at less than 2%. Mild rashes, usually transient and self-limiting, while severe reactions require immediately remove the drug involved to prevent progression of the reaction. Only in those cases where the offending drug does not have another alternative and documented the reaction is mediated type I hypersensitivity mechanisms, can be performed desensitization protocol.

Multiple solid-phase microextraction

NARCIS (Netherlands)

Koster, EHM; de Jong, GJ

2000-01-01

Theoretical aspects of multiple solid-phase microextraction are described and the principle is illustrated with the extraction of lidocaine from aqueous solutions. With multiple extraction under non-equilibrium conditions considerably less time is required in order to obtain an extraction yield that

Formation of multiple networks

DEFF Research Database (Denmark)

Magnani, Matteo; Rossi, Luca

2013-01-01

we introduce the first network formation model for multiple networks. Network formation models are among the most popular tools in traditional network studies, because of both their practical and theoretical impact. However, existing models are not sufficient to describe the generation of multiple...

A Robust Two-Phase Pumped Loop With Multiple Evaporators and Multiple Radiators, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — NASA's future spacecraft require advanced thermal management technologies to provide effective cooling for multiple instruments and reject heat through multiple...

Attenuation of multiples in image space

Science.gov (United States)

Alvarez, Gabriel F.

In complex subsurface areas, attenuation of 3D specular and diffracted multiples in data space is difficult and inaccurate. In those areas, image space is an attractive alternative. There are several reasons: (1) migration increases the signal-to-noise ratio of the data; (2) primaries are mapped to coherent events in Subsurface Offset Domain Common Image Gathers (SODCIGs) or Angle Domain Common Image Gathers (ADCIGs); (3) image space is regular and smaller; (4) attenuating the multiples in data space leaves holes in the frequency-Wavenumber space that generate artifacts after migration. I develop a new equation for the residual moveout of specular multiples in ADCIGs and use it for the kernel of an apex-shifted Radon transform to focus and separate the primaries from specular and diffracted multiples. Because of small amplitude, phase and kinematic errors in the multiple estimate, we need adaptive matching and subtraction to estimate the primaries. I pose this problem as an iterative least-squares inversion that simultaneously matches the estimates of primaries and multiples to the data. Standard methods match only the estimate of the multiples. I demonstrate with real and synthetic data that the method produces primaries and multiples with little cross-talk. In 3D, the multiples exhibit residual moveout in SODCIGs in in-line and cross-line offsets. They map away from zero subsurface offsets when migrated with the faster velocity of the primaries. In ADCIGs the residual moveout of the primaries as a function of the aperture angle, for a given azimuth, is flat for those angles that illuminate the reflector. The multiples have residual moveout towards increasing depth for increasing aperture angles at all azimuths. As a function of azimuth, the primaries have better azimuth resolution than the multiples at larger aperture angles. I show, with a real 3D dataset, that even below salt, where illumination is poor, the multiples are well attenuated in ADCIGs with the new

Body Weight - Multiple Languages

Science.gov (United States)

... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Body Weight URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Body Weight - Multiple Languages To use the sharing features on this page, ...

Applications of Fast Truncated Multiplication in Cryptography

Directory of Open Access Journals (Sweden)

Laszlo Hars

2006-12-01

Full Text Available Truncated multiplications compute truncated products, contiguous subsequences of the digits of integer products. For an n-digit multiplication algorithm of time complexity O(nα, with 1<α≤2, there is a truncated multiplication algorithm, which is constant times faster when computing a short enough truncated product. Applying these fast truncated multiplications, several cryptographic long integer arithmetic algorithms are improved, including integer reciprocals, divisions, Barrett and Montgomery multiplications, 2n-digit modular multiplication on hardware for n-digit half products. For example, Montgomery multiplication is performed in 2.6 Karatsuba multiplication time.

The Future Multiple

DEFF Research Database (Denmark)

Spaniol, Matthew Jon; Rowland, Nicholas James

2015-01-01

/value – The original contribution is in demonstrating how plural futures and the singular future co-exist in practice. Thus, an eclipse of the future by futures can only ever be partial. For “futures” to be conceptually potent, “the future” must be at least provisionally believable and occasionally useful. Otherwise......, if “the future” were so preposterous an idea, then “futures” would cease to be a critical alternative to it. Futures needs the future; they are relationally bound together in a multiplicity. This paper considers what such a logical reality implies for a field that distances itself from the future and self......). Multiplicity, as a post-ANT sensibility, helps one make sense of the empirical materials. This paper examines the possibility that rather than being alternatives to one another, plural futures and the singular future might co-exist in practice, and, thus, constitute a multiplicity. Design...

Multiplicity in difference geometry

OpenAIRE

Tomasic, Ivan

2011-01-01

We prove a first principle of preservation of multiplicity in difference geometry, paving the way for the development of a more general intersection theory. In particular, the fibres of a \\sigma-finite morphism between difference curves are all of the same size, when counted with correct multiplicities.

ALICE Photon Multiplicity Detector

CERN Multimedia

Nayak, T

2013-01-01

Photon Multiplicity Detector (PMD) measures the multiplicity and spatial distribution of photons in the forward region of ALICE on a event-by-event basis. PMD is a pre-shower detector having fine granularity and full azimuthal coverage in the pseudo-rapidity region 2.3 < η < 3.9.

More Popsicle-Stick Multiplication.

Science.gov (United States)

Dunkels, Andrejs

1982-01-01

A way to use tongue depressors in a model of multiplication is presented. The original intent was to use the sticks to teach about fractions, but "mistakes" in student responses led to new ideas. It is felt that teachers should use the model in teaching multiplication. (MP)

Retrospective analysis of the treatment of melasma lesions exhibiting increased vascularity with the 595-nm pulsed dye laser combined with the 1927-nm fractional low-powered diode laser.

Science.gov (United States)

Geddes, Elizabeth R C; Stout, Ashlyn B; Friedman, Paul M

2017-01-01

Melasma presents a significant challenge to laser surgeons. Aggressive treatments often result in rebound melasma or post-inflammatory pigmentary alteration. Recent reports suggest melasma pathogenesis may have a vascular component. Spectrocolorimetry can detect subtle or sub-clinical telangiectatic erythema within melasma lesions. For certain patients identified by spectrocolorimetry, effective melasma treatment may include vascular-targeted therapy together with pigment-specific treatment modalities. Such combined therapies may reduce the likelihood of melasma recurrence. To evaluate the efficacy of treating melasma lesions exhibiting subtle or sub-clinical telangiectatic erythema with the 595-nm pulsed dye laser (PDL) combined with the 1927-nm fractional low-powered diode laser (FDL). A retrospective review was performed over a 2-year period as follows. Evaluated patients (n = 11) include 10 women and 1 man, average age of 38.7 years, and Fitzpatrick skin types II-IV. Each patient exhibited melasma lesions with subtle or sub-clinical telangiectatic erythema identified by spectrocolorimetry. Each underwent a series of treatments (average of four) at approximate 4-6 week intervals of the PDL followed by the FDL. Treatments were performed same-day, sequentially, with 10-15 minute interim time allowance for skin cooling. The following PDL parameters were utilized: 10 mm spot, 10-20 ms pulse duration, 7.5-8.5 J/cm 2 fluence, 30/30 DCD. Eight passes with the FDL (Clear + Brilliant ® Permea™, Solta Medical, Hayward, CA) were then performed utilizing a "low" treatment level. Clinical endpoint was mild erythema and edema. Patients were encouraged to practice strict photoprotection and apply topical skin lightening agents, but compliance was not measured. An independent physician evaluated photographs taken at baseline and at follow-up after last treatment session (average follow-up of 96 days). A quartile improvement score was used to grade the

Mechanisms of multiple production processes

International Nuclear Information System (INIS)

Dremin, I.M.

1977-01-01

Theoretical approaches to multiple production processes are discussed. A large number of models proceeds from the notion about common excited system produced by colliding hadrons. This class of models includes the hydrodynamical, statistical, thermodynamical and statistical bootstrap models. Sometimes the production process is due to excitation and decay of two colliding particles. The fragmentation bremsstrahlung and inelastic diffraction models belong to this group. The largest group of models describes the multiple production process as a result of formation of many excited centers. The typical example is the multiperipheral model. An interesting direction is given by the attempts to interrelate the mechanism of multiple production with internal structure of particles that is with their constituents (C-group)'-quarks, gluons, etc. Besides the models there are phenomenological (p group) attempts to connect different features of multiple production. Experimental data indicate the existence of leading and pionization particles thus giving an evidence for applications of different models. The data about increase of total and inclusive cross sections, the behaviour of the mean multiplicity and correlations at high energies provide a clue for further development of multiple production theory

Multiplicative properties of quantum channels

Science.gov (United States)

Rahaman, Mizanur

2017-08-01

In this paper, we study the multiplicative behaviour of quantum channels, mathematically described by trace preserving, completely positive maps on matrix algebras. It turns out that the multiplicative domain of a unital quantum channel has a close connection to its spectral properties. A structure theorem (theorem 2.5), which reveals the automorphic property of an arbitrary unital quantum channel on a subalgebra, is presented. Various classes of quantum channels (irreducible, primitive, etc) are then analysed in terms of this stabilising subalgebra. The notion of the multiplicative index of a unital quantum channel is introduced, which measures the number of times a unital channel needs to be composed with itself for the multiplicative algebra to stabilise. We show that the maps that have trivial multiplicative domains are dense in completely bounded norm topology in the set of all unital completely positive maps. Some applications in quantum information theory are discussed.

Optimized simultaneous inversion of primary and multiple reflections; Inversion linearisee simultanee des reflexions primaires et des reflexions multiples

Energy Technology Data Exchange (ETDEWEB)

Pelle, L.

2003-12-01

The removal of multiple reflections remains a real problem in seismic imaging. Many preprocessing methods have been developed to attenuate multiples in seismic data but none of them is satisfactory in 3D. The objective of this thesis is to develop a new method to remove multiples, extensible in 3D. Contrary to the existing methods, our approach is not a preprocessing step: we directly include the multiple removal in the imaging process by means of a simultaneous inversion of primaries and multiples. We then propose to improve the standard linearized inversion so as to make it insensitive to the presence of multiples in the data. We exploit kinematics differences between primaries and multiples. We propose to pick in the data the kinematics of the multiples we want to remove. The wave field is decomposed into primaries and multiples. Primaries are modeled by the Ray+Born operator from perturbations of the logarithm of impedance, given the velocity field. Multiples are modeled by the Transport operator from an initial trace, given the picking. The inverse problem simultaneously fits primaries and multiples to the data. To solve this problem with two unknowns, we take advantage of the isometric nature of the Transport operator, which allows to drastically reduce the CPU time: this simultaneous inversion is this almost as fast as the standard linearized inversion. This gain of time opens the way to different applications to multiple removal and in particular, allows to foresee the straightforward 3D extension. (author)

Multiple sclerosis and organic solvents

DEFF Research Database (Denmark)

Mortensen, J T; Brønnum-Hansen, Henrik; Rasmussen, K

1998-01-01

We investigated a possible causal relation between exposure to organic solvents in Danish workers (housepainters, typographers/printers, carpenters/cabinetmakers) and onset of multiple sclerosis. Data on men included in the Danish Multiple Sclerosis Register (3,241 men) were linked with data from......, and butchers. Over a follow-up period of 20 years, we observed no increase in the incidence of multiple sclerosis among men presumed to be exposed to organic solvents. It was not possible to obtain data on potential confounders, and the study design has some potential for selection bias. Nevertheless......, the study does not support existing hypotheses regarding an association between occupational exposure to organic solvents and multiple sclerosis....

Nipple adenoma in a female patient presenting with persistent erythema of the right nipple skin: case report, review of the literature, clinical implications, and relevancy to health care providers who evaluate and treat patients with dermatologic conditions of the breast skin.

Science.gov (United States)

Spohn, Gina P; Trotter, Shannon C; Tozbikian, Gary; Povoski, Stephen P

2016-05-20

Nipple adenoma is a very uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, it often presents as a palpable nipple nodule, a visible nipple skin erosive lesion, and/or with discharge from the surface of the nipple skin, and is primarily seen in middle-aged women. Resultantly, nipple adenoma can clinically mimic the presentation of mammary Paget's disease of the nipple. The purpose of our current case report is to present a comprehensive review of the available data on nipple adenoma, as well as provide useful information to health care providers (including dermatologists, breast health specialists, and other health care providers) who evaluate patients with dermatologic conditions of the breast skin for appropriately clinically recognizing, diagnosing, and treating patients with nipple adenoma. Fifty-three year old Caucasian female presented with a one year history of erythema and induration of the skin of the inferior aspect of the right nipple/areolar region. Skin punch biopsies showed subareolar duct papillomatosis. The patient elected to undergo complete surgical excision with right central breast resection. Final histopathologic evaluation confirmed nipple adenoma. The patient is doing well 31 months after her definitive surgical therapy. Since nipple adenoma represents a benign proliferative process of the nipple, complete surgical excision is curative. However, the coexistence of nipple adenoma and ipsilateral or contralateral breast cancer is well reported in the literature. The potential for a direct causal link or association of nipple adenoma and breast cancer cannot be fully excluded.

Human Supervision of Multiple Autonomous Vehicles

Science.gov (United States)

2013-03-22

AFRL-RH-WP-TR-2013-0143 HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES Heath A. Ruff Ball...REPORT TYPE Interim 3. DATES COVERED (From – To) 09-16-08 – 03-22-13 4. TITLE AND SUBTITLE HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES 5a...Supervision of Multiple Autonomous Vehicles To support the vision of a system that enables a single operator to control multiple next-generation

Multicentric malignant transformation of multiple exostoses

International Nuclear Information System (INIS)

Ozaki, T.; Hillmann, A.; Winkelmann, W.; Blasius, S.; Link, T.

1998-01-01

We treated a patient with large multiple chondrosarcomas derived from multiple cartilaginous exostoses. One sarcoma originated in the left pubic bone and the other sarcoma in the posterior aspect of the greater trochanter of the left femur. Thirty months after hindquarter amputation, the patient is alive without relapse. This is the first report of a patient with synchronous multiple malignant transformation of multiple cartilaginous exostoses. (orig.)

Toxocariasis masquerading as liver and lung metastatic nodules in patents with gastrointestinal cancer: clinicopathologic study of five cases.

Science.gov (United States)

Park, Sanghui; Kim, Yun Soo; Kim, Yu Jin; Kyung, Sun Young; Park, Jeong-Woong; Jeong, Sung Hwan; Lee, Sang Pyo

2012-01-01

There are sporadic reports in the literature in which radiologic liver and lung lesions found incidentally during follow-up metastatic surveillance were shown to be caused by toxocariasis. The objective of the work discussed in this report was to identify common clinical and histopathological features of toxocariasis resembling metastatic nodules in five patients with gastrointestinal cancer. We retrospectively analyzed clinical features of five gastrointestinal cancer patients with liver or lung nodules mimicking metastasis. Serologic tests for parasitic infestations and pathologic examinations were performed. All five patients were males and three patients had gastric cancer and two had colorectal cancer. All the cases of toxocariasis were confirmed serologically. On follow-up imaging, the lesions improved or resolved, suggestive of the phenomenon of visceral larva migrans. In two patients, liver biopsy was performed and showed eosinophilic abscess. Serologic tests and liver or lung biopsy should be performed aggressively to exclude toxocariasis when patients with underlying gastrointestinal cancer present with hepatic or pulmonary nodules associated with eosinophilia, particularly if the patients have a clinical history of raw animal liver ingestion. Curative surgical intervention should not be excluded just because of multiple nodules in the liver or the lungs.

Prevalence of Toxocara infection in schoolchildren from the Butantã region, São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Jussara MS Alderete

2003-07-01

Full Text Available Visceral larva migrans syndrome by Toxocara affects mainly children between 2 and 5 years of age, it is generally asymptomatic, and the seroprevalence varies from 3 to 86% in different countries. A total of 399 schoolchildren from 14 public schools of the Butantã region, São Paulo city, Brazil, were evaluated by Toxocara serology (enzyme-linked immunosorbent assay. Epidemiological data to the Toxocara infection obtained from a protocol were submitted to multiple logistic regression analysis for a risk profile definition. Blood was collected on filter paper by finger puncture, with all samples tested in duplicate. Considering titers > 1/160 as positive, the seroprevalence obtained was 38.8%. Among infected children, the mean age was 9.4 years, with a similar distribution between genders. A significant association was observed with the presence of onychophagia, residence with a dirty backyard, living in a slum, previous wheezing episodes, school attended, and family income (p 5 minimum salaries represented a protective factor, although of low relevance. Toxocara eggs were found in at least one of the soil samples obtained from five schools, with high prevalence of Toxocara infections, indicating the frequent soil contamination by this agent.

Teaching Individuals with Profound Multiple Disabilities to Access Preferred Stimuli with Multiple Microswitches

Science.gov (United States)

Tam, Gee May; Phillips, Katrina J.; Mudford, Oliver C.

2011-01-01

We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate…

Multiple group membership and well-being

DEFF Research Database (Denmark)

Sønderlund, Anders L.; Morton, Thomas A.; Ryan, Michelle K.

2017-01-01

multiple group membership and well-being, but only for individuals high in SIC. This effect was mediated by perceived identity expression and access to social support. Study 2 (N = 104) also found that multiple group memberships indirectly contributed to well-being via perceived identity expression......A growing body of research points to the value of multiple group memberships for individual well-being. However, much of this work considers group memberships very broadly and in terms of number alone. We conducted two correlational studies exploring how the relationship between multiple group...... and social support, as well as identity compatibility and perceived social inclusion. But, in this study the relationship between multiple group memberships and well-being outcomes was moderated by the perceived value and visibility of group memberships to others. Specifically, possessing multiple, devalued...

Multiple-source multiple-harmonic active vibration control of variable section cylindrical structures: A numerical study

Science.gov (United States)

Liu, Jinxin; Chen, Xuefeng; Gao, Jiawei; Zhang, Xingwu

2016-12-01

Air vehicles, space vehicles and underwater vehicles, the cabins of which can be viewed as variable section cylindrical structures, have multiple rotational vibration sources (e.g., engines, propellers, compressors and motors), making the spectrum of noise multiple-harmonic. The suppression of such noise has been a focus of interests in the field of active vibration control (AVC). In this paper, a multiple-source multiple-harmonic (MSMH) active vibration suppression algorithm with feed-forward structure is proposed based on reference amplitude rectification and conjugate gradient method (CGM). An AVC simulation scheme called finite element model in-loop simulation (FEMILS) is also proposed for rapid algorithm verification. Numerical studies of AVC are conducted on a variable section cylindrical structure based on the proposed MSMH algorithm and FEMILS scheme. It can be seen from the numerical studies that: (1) the proposed MSMH algorithm can individually suppress each component of the multiple-harmonic noise with an unified and improved convergence rate; (2) the FEMILS scheme is convenient and straightforward for multiple-source simulations with an acceptable loop time. Moreover, the simulations have similar procedure to real-life control and can be easily extended to physical model platform.

Multiple Stars Across the H-R Diagram

CERN Document Server

Hubrig, Swetlana; Tokovinin, Andrei; Proceedings of the ESO Workshop held in Garching, Germany, 12-15 July 2005

2008-01-01

Stars show a marked tendency to be in systems of different multiplicity, ranging from simple binaries and triples to globular clusters with several 10,000's of stars. The formation and evolution of multiple systems remains a challenging part of astrophysics, and the contributions in this book report on the significant progress that had been made in this research field in the last years. The reader will find a variety of research topics addressed, such as the dynamical evolution in multiple stars, the effects of the environment on multiple system parameters, stellar evolution within multiple stars, multiplicity of massive stars, pre-main sequence and intermediate mass stars, multiplicity of low-mass stars from embedded protostars to open clusters, and brown dwarfs and extrasolar planets in multiples. This book presents the proceedings of the ESO Workshop on Multiple Stars across the H-R Diagram held in the summer of 2005.

Assessing Children's Multiplicative Thinking

Science.gov (United States)

Hurst, Chris; Hurrell, Derek

2016-01-01

Multiplicative thinking is a "big idea" of mathematics that underpins much of the mathematics learned beyond the early primary school years. This paper reports on a current study that utilises an interview tool and a written quiz to gather data about children's multiplicative thinking. The development of the tools and some of the…

Eosinophilic meningoencephalitis associated with rat lungworm (Angiostrongylus cantonensis) migration in two nine-banded armadillos (Dasypus novemcinctus) and an opossum (Didelphis virginiana) in the southeastern United States.

Science.gov (United States)

Dalton, Martha F; Fenton, Heather; Cleveland, Christopher A; Elsmo, Elizabeth J; Yabsley, Michael J

2017-08-01

Angiostrongylus cantonensis , the rat lungworm, was the cause of neural larval migrans in two nine-banded armadillos ( Dasypus novemcinctus ) and one Virginia opossum ( Didelphis virginiana ) from the southeastern United States. Histologic findings in all three cases included eosinophilic meningoencephalitis with variable numbers of nematode larvae in the meninges or the neuroparenchyma. In two of the three cases, nematodes were extracted from brain tissue via a "squash prep" method. Identification of the nematodes was confirmed by amplification and sequence analysis of the partial cytochrome c oxidase subunit I gene from all three cases. Sequences (704bp) from the two cases from Louisiana were identical and 99.7% similar to nematodes detected in the armadillo from Florida. As A. cantonensis is now considered endemic in the southern United States, it should be considered as an important differential for any wild or domestic animal or human patient with neurological signs and eosinophilic meningitis. Many wildlife species frequently consume snails and slugs and could serve as sentinels for the detection of this parasite in regions where the presence of this parasite has not been confirmed. To the authors' knowledge, this is the first report of neural larval migrans due to A. cantonensis in an armadillo and provides additional documentation that this nematode can cause disease in wildlife species in the southeastern United States.

Eosinophilic meningoencephalitis associated with rat lungworm (Angiostrongylus cantonensis migration in two nine-banded armadillos (Dasypus novemcinctus and an opossum (Didelphis virginiana in the southeastern United States

Directory of Open Access Journals (Sweden)

Martha F. Dalton

2017-08-01

Full Text Available Angiostrongylus cantonensis, the rat lungworm, was the cause of neural larval migrans in two nine-banded armadillos (Dasypus novemcinctus and one Virginia opossum (Didelphis virginiana from the southeastern United States. Histologic findings in all three cases included eosinophilic meningoencephalitis with variable numbers of nematode larvae in the meninges or the neuroparenchyma. In two of the three cases, nematodes were extracted from brain tissue via a “squash prep” method. Identification of the nematodes was confirmed by amplification and sequence analysis of the partial cytochrome c oxidase subunit I gene from all three cases. Sequences (704bp from the two cases from Louisiana were identical and 99.7% similar to nematodes detected in the armadillo from Florida. As A. cantonensis is now considered endemic in the southern United States, it should be considered as an important differential for any wild or domestic animal or human patient with neurological signs and eosinophilic meningitis. Many wildlife species frequently consume snails and slugs and could serve as sentinels for the detection of this parasite in regions where the presence of this parasite has not been confirmed. To the authors’ knowledge, this is the first report of neural larval migrans due to A. cantonensis in an armadillo and provides additional documentation that this nematode can cause disease in wildlife species in the southeastern United States.

Retinal injury from a welding arc

International Nuclear Information System (INIS)

Naidoff, M.A.; Sliney, D.H.

1974-01-01

An 18-year-old man stared at a welding arc for approximately ten minutes, sustaining moderate facial erythema, keratoconjunctivitis, marked visual loss, a pupillary abnormality, and a retinal injury accompanied by a dense central scotoma and peripheral field constriction. A residual, partially pigmented foveal lesion remained after 16 months, with normal visual acuity. Since the degree of keratoconjunctivitis and facial erythema was known, we substantiated the duration of exposure to the arc by weighting the known action spectrum of moderate ultraviolet erythema with the ultraviolet spectral irradiance measurements of the arc. From the radiometric measurements of the visible brightness and visible and near infrared spectrum of the arc and from knowledge of pupil size, we calculated the retinal exposure dose rate, which was less than normally considered necessary to produce a chorioretinal burn. This case may provide a clinical example of photic maculopathy recently reported in experimental investigations

Restoration of γ-ray multiplicity distributions from experiments with low efficiency multiplicity filters

International Nuclear Information System (INIS)

Bellia, G.; Del Zoppo, A.; Migneco, E.; Russo, G.; Istituto Nazionale di Fisica Nucleare, Catania

1984-01-01

The restoration of γ-ray multiplicity distributions from experimental p-fold coincidence distributions is discussed. It is shown that the restoration of the multiplicity from measurements with low total detection efficiency is an 'incorrectly posed problem'. While in the literature the analysis of the experimental data has been attempted only in terms of the lowest central moments of the multiplicity distribution, in this paper an unfolding method based on the minimization of the directioned discrepancies in the probability space is used. The method is found to work very well even if the total efficiency Ω <= 0.1. Realistic tests and a comparison with the usual method of analysis are presented. (orig.)

Comparison of three techniques for evaluating skin erythemal response for determination of sun protection factors of sunscreens: high resolution laser Doppler imaging, colorimetry and visual scoring.

Science.gov (United States)

Wilhelm, K P; Kaspar, K; Funkel, O

2001-04-01

Sun protection factor (SPF) measurement is based on the determination of the minimal erythema dose (MED). The ratio of doses required to induce a minimal erythema between product-treated and untreated skin is defined as SPF. The aim of this study was to validate the conventionally used visual scoring with two non-invasive methods: high resolution laser Doppler imaging (HR-LDI) and colorimetry. Another goal was to check whether suberythemal reactions could be detected by means of HR-LDI measurements. Four sunscreens were selected. The measurements were made on the back of 10 subjects. A solar simulator SU 5000 (m.u.t., Wedel, Germany) served as radiation source. For the visual assessment, the erythema was defined according to COLIPA as the first perceptible, clearly defined unambiguous redness of the skin. For the colorimetric determination of the erythema, a Chromameter CR 300 (Minolta, Osaka, Japan) was used. The threshold for the colorimetry was chosen according to the COLIPA recommendation as an increase of the redness parameter delta a* = 2.5. For the non-contact perfusion measurements of skin blood flow, a two-dimensional high resolution laser Doppler imager (HR-LDI) (Lisca, Linköping, Sweden) was used. For the HR-LDI measurements, an optimal threshold perfusion needed to be established. For the HR-LDI measurements basal perfusion +1 standard deviation of all basal measurements was found to be a reliable threshold perfusion corresponding to the minimal erythema. Smaller thresholds, which would be necessary for detection of suberythemal responses, did not provide unambiguous data. All three methods, visual scoring, colorimetry and HR-LDI, produced similar SPFs for the test products with a variability of colorimetry are suitable, reliable and observer-independent methods for MED determination. However, they do not provide greater sensitivity and thus do not result in lower UV dose requirements for testing.

Surfactant-induced skin irritation and skin repair. Evaluation of the acute human irritation model by noninvasive techniques.

Science.gov (United States)

Wilhelm, K P; Freitag, G; Wolff, H H

1994-06-01

Although the induction of irritant dermatitis by surfactants has been extensively studied in recent years, our understanding of the repair phase of irritant dermatitis is limited. We investigated qualitative and quantitative differences in surfactant-induced irritant skin reactions from short-term exposure to three structurally different surfactants. Sodium lauryl sulfate (SLS), dodecyl trimethyl ammonium bromide (DTAB), and potassium soap were the model irritants. Surfactant solutions (0.5%) were applied for 24 hours to the volar aspect of the forearm of 11 volunteers. Irritant reactions were assessed until complete healing was indicated by visual assessment and by various aspects of skin function, that is, transepidermal water loss (TEWL), erythema (skin color reflectance), and stratum that is, transepidermal water loss (TEWL), erythema (skin color reflectance), and stratum corneum hydration (electrical capacitance). SLS and DTAB induced similar degrees of erythema, whereas SLS induced significantly higher TEWL increase. Although both erythema and TEWL were highest 1 hour after exposure to surfactants, skin dryness was a symptom with delayed onset, justifying the long observation period in this study. Minimum hydration values were measured as late as 7 days after surfactant exposure. Dryness was significantly more pronounced in areas exposed to SLS than in areas exposed to DTAB. Complete repair of the irritant reaction induced by either SLS or DTAB was achieved 17 days after surfactant exposure. Stratum corneum hydration was the last feature to return to baseline values. Potassium soap did not significantly influence any skin function. We emphasize the importance of extended periods needed before a patient with irritant contact dermatitis can be reexposed to irritant substances. The evaluation of the irritation potential of diverse surfactants depended significantly on the feature (erythema vs hydration and TEWL) measured.

Does vagotomy protect against multiple sclerosis?

Science.gov (United States)

Sundbøll, Jens; Horváth-Puhó, Erzsébet; Adelborg, Kasper; Svensson, Elisabeth

2017-07-01

To examine the association between vagotomy and multiple sclerosis. We conducted a matched cohort study of all patients who underwent truncal or super-selective vagotomy and a comparison cohort, by linking Danish population-based medical registries (1977-1995). Hazard ratios (HRs) for multiple sclerosis, adjusting for potential confounders were computed by means of Cox regression analysis. Median age of multiple sclerosis onset corresponded to late onset multiple sclerosis. No association with multiple sclerosis was observed for truncal vagotomy (0-37 year adjusted HR=0.91, 95% confidence interval [CI]: 0.48-1.74) or super-selective vagotomy (0-37 year adjusted HR=1.28, 95% CI: 0.79-2.09) compared with the general population. We found no association between vagotomy and later risk of late onset multiple sclerosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Interferon Treatment of Multiple Sclerosis

OpenAIRE

Alajbegovic, Azra; Deljo, Dervis; Alajbegovic, Salem; Djelilovic-Vranic, Jasminka; Todorovic, Ljubica; Tiric-Campara, Merita

2012-01-01

Introduction: In the treatment of Multiple Sclerosis (MS) differ: treatment of relapse, treatment slow the progression of the disease (immunomodulators and immunosuppression), and symptomatic treatment. The aim: The aim of this study is to analyze the application of interferon therapy in the treatment of MS-E: Process the disease, patients with multiple sclerosis who have passed the commission for multiple sclerosis at the Neurology Clinic of Clinical Center of Sarajevo University as a refere...

Immunomodulation of multiple myeloma.

Science.gov (United States)

Tohnya, Tanyifor M; Figg, William D

2004-11-01

Multiple myeloma is a multi-process disease, and these different processes are responsible for the reduced sensitivity to chemotherapy and radiotherapy, hence the relapse and refractory nature of multiple myeloma. Emphasis is now placed on the hypothesis that myeloma cell growth, inhibition of apoptosis and drug resistance are dependent on immunomodulatory cytokines such as IL-6 and pro-angiogenic factors such as VEGF. In addition to its anti-angiogenic effects, the immunomodulatory properties of thalidomide make it a possible therapy for patients with advanced multiple myeloma. This has lead to the clinical development of a number of immunomodulatory thalidomide analogues (IMiDs) which are more potent and have less side effects than the parent drug, thalidomide. In the August 15(th) issue of Journal of Clinical Oncology, Schey SA et al. suggested that an IMiD (CC-4047) maybe efficacious due to T-cell co-stimulation, and safe in patients with relapsed or refractory multiple myeloma. This article demonstrates a supporting role for IMiDs as immunomodulatory adjuvant therapy.

Sudden multiple fractures in a patient with sarcoidosis in multiple organs.

Science.gov (United States)

Sada, Mitsuru; Saraya, Takeshi; Ishii, Haruyuki; Goto, Hajime

2014-04-07

A 30-year-old man who incidentally fractured his right olecranon and other multiple phalanges was admitted to our hospital. He had a 2-year history of uveitis and bilateral hilar lymphadenopathy (BHL), and pulmonary sarcoidosis was diagnosed from transbronchial lung biopsy. Right elbow arthrodesis was performed, and biopsied specimens showed non-caseating epithelioid cell granuloma, suggesting osseous sarcoidosis. He was discharged uneventfully without further treatment, but BHL had progressed with the appearance of lung parenchymal lesions 3 months later. At that time, involvement of other organs was also noted on Gallium-67 scintigraphy, showing accumulations in BHL, axillary and inguinal lymph nodes, enlarged liver and spleen and subcutaneous areas. After initiation of steroid therapy, multiple organ involvement improved, and no further bone involvement has been recognised to date. Osseous sarcoidosis complicated by bone fracture is an extremely rare presentation, but should be considered in patients with sarcoidosis, especially when multiple organs are involved.

Multiple myeloma.

LENUS (Irish Health Repository)

Collins, Conor D

2012-02-01

Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.

Multiple Sclerosis

Science.gov (United States)

Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down ...

Multiple relay selection for delay-limited applications

KAUST Repository

Alsharoa, Ahmad M.; Abediseid, Walid; Alouini, Mohamed-Slim

2013-01-01

A multiple relay selection system model that implements the decode-and-forward mode is investigated. All communication nodes are assumed to be equipped by multiple antennas. Furthermore, lattices space-time coded multiple-input multiple-output half

Hadron multiplicities at COMPASS

Energy Technology Data Exchange (ETDEWEB)

Du Fresne von Hohenesche, Nicolas [Institut fuer Kernphysik, Universitaet Mainz, Johann-Joachim-Becher-Weg 45, 55128 Mainz (Germany); Collaboration: COMPASS Collaboration

2014-07-01

Quark fragmentation functions (FF) D{sub q}{sup h}(z,Q{sup 2}) describe final-state hadronization of quarks q into hadrons h. The FFs can be extracted from hadron multiplicities produced in semi-inclusive deep inelastic scattering. The COMPASS collaboration has recently measured charged hadron multiplicities for identified pions and kaons using a 160 GeV/c muon beam impinging on an iso-scalar target. The data cover a large kinematical range and provide an important input for global QCD analyses of world data at NLO, aiming at the determination of FFs in particular in the strange quark sector. The newest results from COMPASS on pion and kaon multiplicities will be presented.

Multiple giant cell lesions in a patient with Noonan syndrome with multiple lentigines

NARCIS (Netherlands)

van den Berg, Henk; Schreuder, Willem Hans; Jongmans, Marjolijn; van Bommel-Slee, Danielle; Witsenburg, Bart; de Lange, Jan

2016-01-01

A patient with Noonan syndrome with multiple lentigines (NSML) and multiple giant cell lesions (MGCL) in mandibles and maxillae is described. A mutation p.Thr468Met in the PTPN11-gene was found. This is the second reported NSML patient with MGCL. Our case adds to the assumption that, despite a

Sentencing Multiple Crimes

DEFF Research Database (Denmark)

Most people assume that criminal offenders have only been convicted of a single crime. However, in reality almost half of offenders stand to be sentenced for more than one crime.The high proportion of multiple crime offenders poses a number of practical and theoretical challenges for the criminal......, and psychology offer their perspectives to the volume. A comprehensive examination of the dynamics involved with sentencing multiple offenders has the potential to be a powerful tool for legal scholars and professionals, particularly given the practical importance of the topic and the relative dearth of research...

Closed-Loop Surface Related Multiple Estimation

NARCIS (Netherlands)

Lopez Angarita, G.A.

2016-01-01

Surface-related multiple elimination (SRME) is one of the most commonly used methods for suppressing surface multiples. However, in order to obtain an accurate surface multiple estimation, dense source and receiver sampling is required. The traditional approach to this problem is performing data

Toric Codes, Multiplicative Structure and Decoding

DEFF Research Database (Denmark)

Hansen, Johan Peder

2017-01-01

Long linear codes constructed from toric varieties over finite fields, their multiplicative structure and decoding. The main theme is the inherent multiplicative structure on toric codes. The multiplicative structure allows for \\emph{decoding}, resembling the decoding of Reed-Solomon codes and al...

Generation of multiple excitons in Ag2S quantum dots: Single high-energy versus multiple-photon excitation

KAUST Repository

Sun, Jingya; Yu, Weili; Usman, Anwar; Isimjan, Tayirjan T.; Del Gobbo, Silvano; Alarousu, Erkki; Takanabe, Kazuhiro; Mohammed, Omar F.

2014-01-01

We explored biexciton generation via carrier multiplication (or multiple-exciton generation) by high-energy photons and by multiple-photon absorption in Ag2S quantum dots (QDs) using femtosecond broad-band transient absorption spectroscopy. Irrespective of the size of the QDs and how the multiple excitons are generated in the Ag2S QDs, two distinct characteristic time constants of 9.6-10.2 and 135-175 ps are obtained for the nonradiative Auger recombination of the multiple excitons, indicating the existence of two binding excitons, namely, tightly bound and weakly bound excitons. More importantly, the lifetimes of multiple excitons in Ag 2S QDs were about 1 and 2 orders of magnitude longer than those of comparable size PbS QDs and single-walled carbon nanotubes, respectively. This result is significant because it suggests that by utilizing an appropriate electron acceptor, there is a higher possibility to extract multiple electron-hole pairs in Ag2S QDs, which should improve the performance of QD-based solar cell devices. © 2014 American Chemical Society.

Generation of multiple excitons in Ag2S quantum dots: Single high-energy versus multiple-photon excitation

KAUST Repository

Sun, Jingya

2014-02-20

We explored biexciton generation via carrier multiplication (or multiple-exciton generation) by high-energy photons and by multiple-photon absorption in Ag2S quantum dots (QDs) using femtosecond broad-band transient absorption spectroscopy. Irrespective of the size of the QDs and how the multiple excitons are generated in the Ag2S QDs, two distinct characteristic time constants of 9.6-10.2 and 135-175 ps are obtained for the nonradiative Auger recombination of the multiple excitons, indicating the existence of two binding excitons, namely, tightly bound and weakly bound excitons. More importantly, the lifetimes of multiple excitons in Ag 2S QDs were about 1 and 2 orders of magnitude longer than those of comparable size PbS QDs and single-walled carbon nanotubes, respectively. This result is significant because it suggests that by utilizing an appropriate electron acceptor, there is a higher possibility to extract multiple electron-hole pairs in Ag2S QDs, which should improve the performance of QD-based solar cell devices. © 2014 American Chemical Society.

The human sunburn reaction: histologic and biochemical studies

International Nuclear Information System (INIS)

Gilchrest, B.A.; Soter, N.A.; Stoff, J.S.; Mihm, M.C. Jr.

1981-01-01

The ultraviolet-induced erythema reaction was investigated histologically and biochemically in four subjects, utilizing suction blister aspirates, analyzed for histamine and prostaglandin E2 (PGE2), and Epon-embedded 1-mu skin biopsy sections from control skin and from irradiated skin at intervals for 72 hours after exposure to a Hanovia lamp. Major histologic alterations in the epidermis included dyskeratotic and vacuolated keratinocytes (sunburn cells), and disappearance of Langerhans cells. In the dermis the major changes were vascular, involving both the superficial and deep venular plexuses. Endothelial cell enlargement was first apparent within 30 minutes of irradiation, peaked at 24 hours, and persisted throughout the 72-hour study period. Mast cell degranulation and associated perivenular edema were first apparent at 1 hour and striking at the onset of erythema, 3 to 4 hours postirradiation; edema was absent and mast cells were again normal in number and granule content at 24 hours. Histamine levels rose approximately fourfold above control values immediately after the onset of erythema and returned to baseline within 24 hours. PGE2 levels were statistically elevated even before the onset of erythema and reached approximately 150% of the control value at 24 hours. These data provide the first evidence that histamine may mediate the early phase of the human sunburn reaction and increase our understanding of its complex histologic and biochemical sequelae

Deep convolutional neural network based antenna selection in multiple-input multiple-output system

Science.gov (United States)

Cai, Jiaxin; Li, Yan; Hu, Ying

2018-03-01

Antenna selection of wireless communication system has attracted increasing attention due to the challenge of keeping a balance between communication performance and computational complexity in large-scale Multiple-Input MultipleOutput antenna systems. Recently, deep learning based methods have achieved promising performance for large-scale data processing and analysis in many application fields. This paper is the first attempt to introduce the deep learning technique into the field of Multiple-Input Multiple-Output antenna selection in wireless communications. First, the label of attenuation coefficients channel matrix is generated by minimizing the key performance indicator of training antenna systems. Then, a deep convolutional neural network that explicitly exploits the massive latent cues of attenuation coefficients is learned on the training antenna systems. Finally, we use the adopted deep convolutional neural network to classify the channel matrix labels of test antennas and select the optimal antenna subset. Simulation experimental results demonstrate that our method can achieve better performance than the state-of-the-art baselines for data-driven based wireless antenna selection.

Molecular cloning and characterization of arginine kinase gene of Toxocara canis

OpenAIRE

Sahu, Shivani; Samanta, S.; Harish, D. R.; Sudhakar, N. R.; Raina, O. K.; Shantaveer, S. B.; Madhu, D. N.; Kumar, Ashok

2013-01-01

Toxocara canis is an important gastrointestinal nematode of dogs and also a causative agent of visceral larva migrans in humans. Arginine kinase (AK) gene is one of the important biomolecule of phosphagen kinase of T. canis which is emerging as an exciting novel diagnostic target in toxocarosis. The present study was carried out to clone and characterize AK gene of T. canis for future utilization as a diagnostic molecule. Total RNA was extracted from intact adult worms and reverse transcripti...

“The guys told us crying that they saw how they were killing her and they could not do anything”: Psychosocial explorations of migrant journeys to the U.S.+

OpenAIRE

Sládková, Jana

2014-01-01

In this article I examine undocumented migrant experiences on their journeys to the U.S. Tens of thousands of Honduran migrants leave their homes in hopes to provide better for their families from afar. In in-depth interviews, 21 migrants from Honduras share the events they endure as they cross Guatemala, Mexico and the borders that divide them. I conducted narrative analyses and specifically used the analytical tools of high points and poises to locate the most salient experiences the migran...

Functional Multiple-Set Canonical Correlation Analysis

Science.gov (United States)

Hwang, Heungsun; Jung, Kwanghee; Takane, Yoshio; Woodward, Todd S.

2012-01-01

We propose functional multiple-set canonical correlation analysis for exploring associations among multiple sets of functions. The proposed method includes functional canonical correlation analysis as a special case when only two sets of functions are considered. As in classical multiple-set canonical correlation analysis, computationally, the…

Model Pembelajaran Berbasis Penstimulasian Multiple Intelligences Siswa

Directory of Open Access Journals (Sweden)

Edy Legowo

2017-03-01

Full Text Available Tulisan ini membahas mengenai penerapan teori multiple intelligences dalam pembelajaran di sekolah. Pembahasan diawali dengan menguraikan perkembangan konsep inteligensi dan multiple intelligences. Diikuti dengan menjelaskan dampak teori multiple intelligences dalam bidang pendidikan dan pembelajaran di sekolah. Bagian selanjutnya menguraikan tentang implementasi teori multiple intelligences dalam praktik pembelajaran di kelas yaitu bagaimana pemberian pengalaman belajar siswa yang difasilitasi guru dapat menstimulasi multiple intelligences siswa. Evaluasi hasil belajar siswa dari pandangan penerapan teori multiple intelligences seharusnya dilakukan menggunakan authentic assessment dan portofolio yang lebih memfasilitasi para siswa mengungkapkan atau mengaktualisasikan hasil belajarnya melalui berbagai cara sesuai dengan kekuatan jenis inteligensinya.

The INEL beryllium multiplication experiment

International Nuclear Information System (INIS)

Smith, J.R.; King, J.J.

1991-03-01

The experiment to measure the multiplication of 14-MeV neutrons in bulk beryllium has been completed. The experiment consists of determining the ratio of 56 Mn activities induced in a large manganese bath by a central 14-MeV neutron source, with and without a beryllium sample surrounding the source. In the manganese bath method a neutron source is placed at the center of a totally-absorbing aqueous solution of MnSo 4 . The capture of neutrons by Mn produces a 56 Mn activity proportional to the emission rate of the source. As applied to the measurement of the multiplication of 14- MeV neutrons in bulk beryllium, the neutron source is a tritium target placed at the end of the drift tube of a small deuteron accelerator. Surrounding the source is a sample chamber. When the sample chamber is empty, the neutrons go directly to the surrounding MnSO 4 solution, and produce a 56 Mn activity proportional to the neutron emission rate. When the chamber contains a beryllium sample, the neutrons first enter the beryllium and multiply through the (n,2n) process. Neutrons escaping from the beryllium enter the bath and produce a 56 Mn activity proportional to the neutron emission rate multiplied by the effective value of the multiplication in bulk beryllium. The ratio of the activities with and without the sample present is proportional to the multiplication value. Detailed calculations of the multiplication and all the systematic effects were made with the Monte Carlo program MCNP, utilizing both the Young and Stewart and the ENDF/B-VI evaluations for beryllium. Both data sets produce multiplication values that are in excellent agreement with the measurements for both raw and corrected values of the multiplication. We conclude that there is not real discrepancy between experimental and calculated values for the multiplication of neutrons in bulk beryllium. 12 figs., 11 tabs., 18 refs

Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts

DEFF Research Database (Denmark)

Vilhelmsen, Troels Norvin; Ferre, Ty Paul

2017-01-01

. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific...... measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when...

Multiple mononeuropathy

Science.gov (United States)

... with multiple mononeuropathy are prone to new nerve injuries at pressure points such as the knees and elbows. They should avoid putting pressure on these areas, for example, by not leaning on the elbows, crossing the knees, ...

Multiple Sclerosis After Infectious Mononucleosis

DEFF Research Database (Denmark)

Nielsen, Trine Rasmussen; Rostgaard, Klaus; Nielsen, Nete Munk

2007-01-01

BACKGROUND: Infectious mononucleosis caused by the Epstein-Barr virus has been associated with increased risk of multiple sclerosis. However, little is known about the characteristics of this association. OBJECTIVE: To assess the significance of sex, age at and time since infectious mononucleosis......, and attained age to the risk of developing multiple sclerosis after infectious mononucleosis. DESIGN: Cohort study using persons tested serologically for infectious mononucleosis at Statens Serum Institut, the Danish Civil Registration System, the Danish National Hospital Discharge Register, and the Danish...... Multiple Sclerosis Registry. SETTING: Statens Serum Institut. PATIENTS: A cohort of 25 234 Danish patients with mononucleosis was followed up for the occurrence of multiple sclerosis beginning on April 1, 1968, or January 1 of the year after the diagnosis of mononucleosis or after a negative Paul...

Multiple Thymoma with Myasthenia Gravis

Directory of Open Access Journals (Sweden)

Dong Hyun Seo

2017-02-01

Full Text Available The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. A well-encapsulated multinodular cystic mass, measuring 57 mm×50 mm×22 mm in the right lobe of the thymus, and a well-encapsulated mass, measuring 32 mm×15 mm×14 mm in the left lobe, were found. Both tumors were type B2 thymoma. Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis.

On Utmost Multiplicity of Hierarchical Stellar Systems

Directory of Open Access Journals (Sweden)

Gebrehiwot Y. M.

2016-12-01

Full Text Available According to theoretical considerations, multiplicity of hierarchical stellar systems can reach, depending on masses and orbital parameters, several hundred, while observational data confirm the existence of at most septuple (seven-component systems. In this study, we cross-match the stellar systems of very high multiplicity (six and more components in modern catalogues of visual double and multiple stars to find among them the candidates to hierarchical systems. After cross-matching the catalogues of closer binaries (eclipsing, spectroscopic, etc., some of their components were found to be binary/multiple themselves, what increases the system's degree of multiplicity. Optical pairs, known from literature or filtered by the authors, were flagged and excluded from the statistics. We compiled a list of hierarchical systems with potentially very high multiplicity that contains ten objects. Their multiplicity does not exceed 12, and we discuss a number of ways to explain the lack of extremely high multiplicity systems.

Multiple Sclerosis and Vitamin D

Science.gov (United States)

... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT ... caused by improper immune responses (autoimmune diseases), including multiple sclerosis (MS). A recent Patient Page in Neurology provided ...

Multiple Hierarchies and Organizational Control

Science.gov (United States)

Evans, Peter B.

1975-01-01

Uses a control-loss model to explore the effects of multiple channels in formal organizations, and presents an argument for the superior control properties of dual hierarchies. Two variant forms of multiple hierarchies are considered. (Author)

Multiple Intelligences: Current Trends in Assessment

Science.gov (United States)

Harman, Marsha J.; Kordinak, S. Thomas; Bruce, A. Jerry

2009-01-01

With his theory of multiple intelligences, Howard Gardner challenged the presumption that intelligence is a single innate entity. He maintained that multiple intelligences exist and are related to specific brain areas and symbol systems. Each of the intelligences has its merits and limits, but by using a multiple intelligences approach, more…

High-multiplicity processes

International Nuclear Information System (INIS)

Shelkov, G.; Sisakyan, A.; Mandzhavidze, I.

1999-01-01

We wish to demonstrate that investigation of asymptotically high multiplicity (AHM) hadron reactions may solve, or at least clear up, a number of problems unsolvable by other ways. We would lean upon the idea: (i) the reactions final state entropy is proportional to multiplicity and, by this reason, just in the AHM domain one may expect the equilibrium final state and (ii) the AHM final state is cold because of the energy-momentum conservation laws. This means that the collective phenomena may become important in the AHM domain. The possibility of hard processes dominance is considered also

Realization of a gamma multiplicity filter and gamma multiplicity measurements

International Nuclear Information System (INIS)

Azgui, F.

1981-12-01

A gamma multiplicity filter for the study of reaction mechanism has been realised. It's composed of six NaI(Tl) counters. The flexibility of the geometry allows many configurations. This set up has been tested with gamma radioactive sources and with the 252 Cf source to resolve problems of gamma-efficiency of the NaI(Tl) counters and the contamination of neutrons in these detectors. A logical electronic unit (Encodeur) has been constructed and the around electronic has been developped. This gamma multiplicity filter has been coupled with a detector of high resolution Ge(Li), and used in two reactions: 12 C + 55 Mn at E( 12 C) = 54 MeV; α + 63 Cu at E(α) = 52 MeV. The dominant process is the fusion-evaporation. The compound nucleus 67 Ga, is formed at the same excitation energy. The values of multiplicities Msub(γ) have been extracted using a program based on the formalism of W.J. Ockels. The fractionalization of the angular momentum is well observed for some residual nuclei ( 63 Zn, 64 Zn, 65 Zn), and for each residual nucleus, the average gamma multiplicity is lower with projectile α than that with projectile 12 C. For the most strongly output channel p2n, an entry point for the 64 Zn has been determined in the reactions. All these observations are in good agreement with those published, in the same region (f-p shell) of nuclei. This set up can be coupled with different central detector as, ''X'', neutrons charged particles detectors, and will be used with the new machine SARA to make a systematic study of transfer of angular momentum to the fragments at 30 MeV/A [fr

Genetic variants and multiple myeloma risk

DEFF Research Database (Denmark)

Martino, Alessandro; Campa, Daniele; Jurczyszyn, Artur

2014-01-01

BACKGROUND: Genetic background plays a role in multiple myeloma susceptibility. Several single-nucleotide polymorphisms (SNP) associated with genetic susceptibility to multiple myeloma were identified in the last years, but only a few of them were validated in independent studies. METHODS...... with multiple myeloma risk (P value range, 0.055-0.981), possibly with the exception of the SNP rs2227667 (SERPINE1) in women. CONCLUSIONS: We can exclude that the selected polymorphisms are major multiple myeloma risk factors. IMPACT: Independent validation studies are crucial to identify true genetic risk...

Piercing and Tattoos - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Piercing and Tattoos URL of this page: https://medlineplus. ... V W XYZ List of All Topics All Piercing and Tattoos - Multiple Languages To use the sharing ...

Multiple-valued logic design based on the multiple-peak BiCMOS-NDR circuits

Directory of Open Access Journals (Sweden)

Kwang-Jow Gan

2016-06-01

Full Text Available Three different multiple-valued logic (MVL designs using the multiple-peak negative-differential-resistance (NDR circuits are investigated. The basic NDR element, which is made of several Si-based metal-oxide-semiconductor field-effect-transistor (MOS and SiGe-based heterojunction-bipolar-transistor (HBT devices, can be implemented by using a standard BiCMOS process. These MVL circuits are designed based on the triggering-pulse control, saw-tooth input signal, and peak-control methods, respectively. However, there are some transient states existing between the multiple stable levels for the first two methods. These states might affect the circuit function in practical application. As a result, our proposed peak-control method for the MVL design can be used to overcome these transient states.

The Multiple Control of Verbal Behavior

Science.gov (United States)

Michael, Jack; Palmer, David C.; Sundberg, Mark L.

2011-01-01

Amid the novel terms and original analyses in Skinner's "Verbal Behavior", the importance of his discussion of multiple control is easily missed, but multiple control of verbal responses is the rule rather than the exception. In this paper we summarize and illustrate Skinner's analysis of multiple control and introduce the terms "convergent…

Multiplicity in Early Stellar Evolution

Science.gov (United States)

Reipurth, B.; Clarke, C. J.; Boss, A. P.; Goodwin, S. P.; Rodríguez, L. F.; Stassun, K. G.; Tokovinin, A.; Zinnecker, H.

Observations from optical to centimeter wavelengths have demonstrated that multiple systems of two or more bodies is the norm at all stellar evolutionary stages. Multiple systems are widely agreed to result from the collapse and fragmentation of cloud cores, despite the inhibiting influence of magnetic fields. Surveys of class 0 protostars with millimeter interferometers have revealed a very high multiplicity frequency of about 2/3, even though there are observational difficulties in resolving close protobinaries, thus supporting the possibility that all stars could be born in multiple systems. Near-infrared adaptive optics observations of class I protostars show a lower binary frequency relative to the class 0 phase, a declining trend that continues through the class II/III stages to the field population. This loss of companions is a natural consequence of dynamical interplay in small multiple systems, leading to ejection of members. We discuss observational consequences of this dynamical evolution, and its influence on circumstellar disks, and we review the evolution of circumbinary disks and their role in defining binary mass ratios. Special attention is paid to eclipsing PMS binaries, which allow for observational tests of evolutionary models of early stellar evolution. Many stars are born in clusters and small groups, and we discuss how interactions in dense stellar environments can significantly alter the distribution of binary separations through dissolution of wider binaries. The binaries and multiples we find in the field are the survivors of these internal and external destructive processes, and we provide a detailed overview of the multiplicity statistics of the field, which form a boundary condition for all models of binary evolution. Finally, we discuss various formation mechanisms for massive binaries, and the properties of massive trapezia.

Phytochemical and Botanical Therapies for Rosacea: A Systematic Review.

Science.gov (United States)

Fisk, Whitney A; Lev-Tov, Hadar A; Clark, Ashley K; Sivamani, Raja K

2015-10-01

Botanical and cosmeceutical therapies are commonly used to treat symptoms of rosacea such as facial erythema, papules/pustule counts, and telangiectasia. These products may contain plant extracts, phytochemicals, and herbal formulations. The objective of this study was to review clinical studies evaluating the use of botanical agents for the treatment of rosacea. MEDLINE and Embase databases were searched for clinical studies evaluating botanical therapies for rosacea. Major results were summarized, and study methodology was analyzed. Several botanical therapies may be promising for rosacea symptoms, but few studies are methodologically rigorous. Several plant extract and phytochemicals effectively improved facial erythema and papule/pustule counts caused by rosacea. Many studies are not methodologically rigorous. Further research is critical, as many botanicals have been evaluated in only one study. Botanical agents may reduce facial erythema and effectively improve papule/pustule counts associated with rosacea. Although promising, further research in the area is imperative. Copyright © 2015 John Wiley & Sons, Ltd.

Caso para diagnóstico Case for diagnosis

Directory of Open Access Journals (Sweden)

Vanessa Martins Ferreira de Albuquerque

2008-04-01

Full Text Available Relata-se caso de erythema gyratum repens em paciente do sexo masculino, de 40 anos, com eritema disseminado, pruriginoso, bizarro, figurado, com fina descamação nas bordas. Na primeira consulta, os exames laboratoriais e a radiografia do tórax foram normais. Durante acompanhamento clínico foi diagnosticado câncer de pulmão por tomografia computadorizada de tórax, tendo a imuno-histoquímica da biópsia da linfonodomegalia inguinal confirmado o pulmão como sítio primário.A case of erythema gyratum repens is described in a 40-year-old man with a generalized, bizarre, figurated and pruritic erythema with fine scaling borders. Laboratorial exams and radiography of the thorax were normal in the first visit. A tomographic study of the thorax showed a lobulated pulmonary nodule and the immunohistochemistry on the biopsy of an inguinal lymph node confirmed the lung cancer as the primary site of the neoplasia.

Rough multiple objective decision making

CERN Document Server

Xu, Jiuping

2011-01-01

Rough Set TheoryBasic concepts and properties of rough sets Rough Membership Rough Intervals Rough FunctionApplications of Rough SetsMultiple Objective Rough Decision Making Reverse Logistics Problem with Rough Interval Parameters MODM based Rough Approximation for Feasible RegionEVRMCCRMDCRM Reverse Logistics Network Design Problem of Suji Renewable Resource MarketBilevel Multiple Objective Rough Decision Making Hierarchical Supply Chain Planning Problem with Rough Interval Parameters Bilevel Decision Making ModelBL-EVRM BL-CCRMBL-DCRMApplication to Supply Chain Planning of Mianyang Co., LtdStochastic Multiple Objective Rough Decision Multi-Objective Resource-Constrained Project Scheduling UnderRough Random EnvironmentRandom Variable Stochastic EVRM Stochastic CCRM Stochastic DCRM Multi-Objective rc-PSP/mM/Ro-Ra for Longtan Hydropower StationFuzzy Multiple Objective Rough Decision Making Allocation Problem under Fuzzy Environment Fuzzy Variable Fu-EVRM Fu-CCRM Fu-DCRM Earth-Rock Work Allocation Problem.

[Future challenges in multiple sclerosis].

Science.gov (United States)

Fernández, Óscar

2014-12-01

Multiple sclerosis occurs in genetically susceptible individuals, in whom an unknown environmental factor triggers an immune response, giving rise to a chronic and disabling autoimmune disease. Currently, significant progress is being made in our knowledge of the frequency and distribution of multiple sclerosis and its risk factors, genetics, pathology, pathogenesis, diagnostic and prognostic markers, and treatment. This has radically changed patients' and clinicians' expectations of multiple sclerosis and has raised hope that there will soon be a way to control the disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Asian American Health - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Asian American Health URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Asian American Health - Multiple Languages To use the sharing features ...

Rotator Cuff Injuries - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Rotator Cuff Injuries URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotator Cuff Injuries - Multiple Languages To use the sharing features ...

Multiple-Symbol Detection Of Multiple-Trellis-Coded MDPSK

Science.gov (United States)

Divsalar, Dariush; Simon, Marvin K.; Shahshahani, Mehrdad M.

1991-01-01

In proposed scheme for detection and decoding of multiple-trellis-coded multilevel differential-phase-shift-keyed (MDPSK) radio signals, observation time for differential detection extended from conventional 2 to larger number of symbol periods. Decreases rate of error in differential detection of uncoded MDPSK by increasing number of symbol periods.

Dermatologic symptoms associated with gastrointestinal neoplasia

Directory of Open Access Journals (Sweden)

Beata Młynarczyk-Bonikowska

2017-03-01

Full Text Available Gastrointestinal tumors are among the most common neoplastic causes of death worldwide. Presence of characteristic skin lesions can allow faster diagnosis and therapy and this way can increase the probability of a cure. In the paper we present the most important paraneoplastic syndromes that can coexist with gastrointestinal malignancy including colon, gastric, esophagus and pancreatic cancers. We take into account genetic syndromes such as Cowden syndrome, familial atypical multiple mole melanoma syndrome (FAMMM (melanoma/pancreatic cancer, Clarke Howel-Evans, Peutz-Jeghers, Muir-Torre, Gardner syndromes and acquired syndromes such as acantosis nigricans maligna, tripe palms, Leser-Trelat, Bazex, hypertrichosis languinosa, erythema gyratum repens , carcinoid and glucagonoma syndrome. We also include cutaneous metastases and coexistence of neoplasia in some cases of dermatomyositis.

Yersinia enterocolitica-associated generalized microinfarctions of bone and spleen in a child

International Nuclear Information System (INIS)

Reiss-Zimmermann, Martin; Sorge, Ina; Hirsch, Wolfgang; Schille, Regine; Beer, Joerg

2007-01-01

We report a case of unusual extraintestinal yersiniosis in a 16-year-old girl with generalized microinfarctions of the bone and spleen. For the past 2 years she had been repeatedly admitted to our hospital with reactive arthritis, erythema nodosum and iridocyclitis of unknown aetiology. Ultrasound showed multiple round hypoechoic lesions in the spleen that were shown to have low T2 signal on MRI. MRI also showed disseminated nodular lesions of the skeleton that were low T1 and high T2 signal and demonstrated inhomogeneous contrast enhancement. The patient is currently in good health on low-dose nonsteroidal immunosuppressive therapy. This is a unique case of microinfarctions of the skeleton and spleen caused by a severe postinfectious autoimmune reaction following extraintestinal Yersinia enterocolitica infection. (orig.)

Yersinia enterocolitica-associated generalized microinfarctions of bone and spleen in a child

Energy Technology Data Exchange (ETDEWEB)

Reiss-Zimmermann, Martin; Sorge, Ina; Hirsch, Wolfgang [University Hospital Leipzig, Paediatric Radiology, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Schille, Regine [University Hospital Leipzig, Paediatric Department, Leipzig (Germany); Beer, Joerg [University of Leipzig, Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig (Germany)

2007-12-15

We report a case of unusual extraintestinal yersiniosis in a 16-year-old girl with generalized microinfarctions of the bone and spleen. For the past 2 years she had been repeatedly admitted to our hospital with reactive arthritis, erythema nodosum and iridocyclitis of unknown aetiology. Ultrasound showed multiple round hypoechoic lesions in the spleen that were shown to have low T2 signal on MRI. MRI also showed disseminated nodular lesions of the skeleton that were low T1 and high T2 signal and demonstrated inhomogeneous contrast enhancement. The patient is currently in good health on low-dose nonsteroidal immunosuppressive therapy. This is a unique case of microinfarctions of the skeleton and spleen caused by a severe postinfectious autoimmune reaction following extraintestinal Yersinia enterocolitica infection. (orig.)

Model Pembelajaran Berbasis Penstimulasian Multiple Intelligences Siswa

OpenAIRE

Edy Legowo

2017-01-01

Tulisan ini membahas mengenai penerapan teori multiple intelligences dalam pembelajaran di sekolah. Pembahasan diawali dengan menguraikan perkembangan konsep inteligensi dan multiple intelligences. Diikuti dengan menjelaskan dampak teori multiple intelligences dalam bidang pendidikan dan pembelajaran di sekolah. Bagian selanjutnya menguraikan tentang implementasi teori multiple intelligences dalam praktik pembelajaran di kelas yaitu bagaimana pemberian pengalaman belajar siswa yang difasilita...

Novel applications of multitask learning and multiple output regression to multiple genetic trait prediction.

Science.gov (United States)

He, Dan; Kuhn, David; Parida, Laxmi

2016-06-15

Given a set of biallelic molecular markers, such as SNPs, with genotype values encoded numerically on a collection of plant, animal or human samples, the goal of genetic trait prediction is to predict the quantitative trait values by simultaneously modeling all marker effects. Genetic trait prediction is usually represented as linear regression models. In many cases, for the same set of samples and markers, multiple traits are observed. Some of these traits might be correlated with each other. Therefore, modeling all the multiple traits together may improve the prediction accuracy. In this work, we view the multitrait prediction problem from a machine learning angle: as either a multitask learning problem or a multiple output regression problem, depending on whether different traits share the same genotype matrix or not. We then adapted multitask learning algorithms and multiple output regression algorithms to solve the multitrait prediction problem. We proposed a few strategies to improve the least square error of the prediction from these algorithms. Our experiments show that modeling multiple traits together could improve the prediction accuracy for correlated traits. The programs we used are either public or directly from the referred authors, such as MALSAR (http://www.public.asu.edu/~jye02/Software/MALSAR/) package. The Avocado data set has not been published yet and is available upon request. dhe@us.ibm.com. © The Author 2016. Published by Oxford University Press.

Multiples waveform inversion

KAUST Repository

Zhang, Dongliang

2013-01-01

To increase the illumination of the subsurface and to eliminate the dependency of FWI on the source wavelet, we propose multiples waveform inversion (MWI) that transforms each hydrophone into a virtual point source with a time history equal to that of the recorded data. These virtual sources are used to numerically generate downgoing wavefields that are correlated with the backprojected surface-related multiples to give the migration image. Since the recorded data are treated as the virtual sources, knowledge of the source wavelet is not required, and the subsurface illumination is greatly enhanced because the entire free surface acts as an extended source compared to the radiation pattern of a traditional point source. Numerical tests on the Marmousi2 model show that the convergence rate and the spatial resolution of MWI is, respectively, faster and more accurate then FWI. The potential pitfall with this method is that the multiples undergo more than one roundtrip to the surface, which increases attenuation and reduces spatial resolution. This can lead to less resolved tomograms compared to conventional FWI. The possible solution is to combine both FWI and MWI in inverting for the subsurface velocity distribution.

Treatment of Cognitive Impairment in Multiple Sclerosis

Science.gov (United States)

Pierson, Susan H.; Griffith, Nathan

2006-01-01

Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the cognitive impairment of multiple sclerosis are reviewed including the effects of disease modifying therapies and the use of physical and cognitive interventions. PMID:16720960

Humanizing Outgroups Through Multiple Categorization

Science.gov (United States)

Prati, Francesca; Crisp, Richard J.; Meleady, Rose; Rubini, Monica

2016-01-01

In three studies, we examined the impact of multiple categorization on intergroup dehumanization. Study 1 showed that perceiving members of a rival university along multiple versus simple categorical dimensions enhanced the tendency to attribute human traits to this group. Study 2 showed that multiple versus simple categorization of immigrants increased the attribution of uniquely human emotions to them. This effect was explained by the sequential mediation of increased individuation of the outgroup and reduced outgroup threat. Study 3 replicated this sequential mediation model and introduced a novel way of measuring humanization in which participants generated attributes corresponding to the outgroup in a free response format. Participants generated more uniquely human traits in the multiple versus simple categorization conditions. We discuss the theoretical implications of these findings and consider their role in informing and improving efforts to ameliorate contemporary forms of intergroup discrimination. PMID:26984016

[Delivery in multiple pregnancies].

Science.gov (United States)

Colla, F; D'Addato, F; Grio, R

2001-04-01

A knowledge of clinical physiognomy in pathologies related to multiple births is indispensable for improving maternal and feto-neonatal prognosis. This study is a contribution to the solution of this problem. A meta-analysis of data for multiple births at Department B of the Gynecology and Obstetrics Clinic at the University of Turi during the decade 1989-1998 was carried out, focusing on the arrangement and presentation of fetuses, the various types of birth, the gestational age at which birth occurred, the weight of neonates, neonatal mortality and maternal morbidity. Out of 11,523 births, there were a total of 194 (1.68%) multiple births, including 190 sets of twins and 4 triplets. 154 (79.38%) premature births were reported; 20 occurred 1500 g). The perinatal mortality rate was 3.82%. Maternal complications mainly occurred during the placental state, in the immediate postpartum and in puerperio. The authors feel that a more careful medical and social assistance, preventive hospitalisation, early recognition of the risk, constant monitoring for the optimal timing of birth, and lastly, qualified medical assistance during labour (expert gynecologist, trained obstetric staff) with other medical personnel (anesthetist, neonatal specialist) represent winning strategies to solve the problems arising during multiple pregnancies.

Application of neutron multiplicity counting to waste assay

Energy Technology Data Exchange (ETDEWEB)

Pickrell, M.M.; Ensslin, N. [Los Alamos National Lab., NM (United States); Sharpe, T.J. [North Carolina State Univ., Raleigh, NC (United States)

1997-11-01

This paper describes the use of a new figure of merit code that calculates both bias and precision for coincidence and multiplicity counting, and determines the optimum regions for each in waste assay applications. A {open_quotes}tunable multiplicity{close_quotes} approach is developed that uses a combination of coincidence and multiplicity counting to minimize the total assay error. An example is shown where multiplicity analysis is used to solve for mass, alpha, and multiplication and tunable multiplicity is shown to work well. The approach provides a method for selecting coincidence, multiplicity, or tunable multiplicity counting to give the best assay with the lowest total error over a broad spectrum of assay conditions. 9 refs., 6 figs.

Phototoxicity and antipsoriatic effect of a topical methoxypsoralen solution in relation to the application time

DEFF Research Database (Denmark)

Meffert, H; Andersen, Klaus Ejner; Sönnichsen, N

1984-01-01

The phototoxicity and antipsoriatic activity of a topically applied 0.075% methoxypsoralen alcohol-glycerol solution was investigated in relation to the interval between drug application and irradiation. On healthy skin, maximum UVA sensitivity for erythema development appeared 40 to 60 min after...... the application of the methoxypsoralen solution, but in psoriatic plaques the antipsoriatic UVA sensitization reached its maximum after 10 to 20 min. This difference between induction of antipsoriatic effect and erythema sensitivity may be explained by rapid penetration of methoxypsoralen in psoriatic lesions...

Multiple sclerosis

DEFF Research Database (Denmark)

Stenager, E; Knudsen, L; Jensen, K

1991-01-01

In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled...

Multiple sclerosis

DEFF Research Database (Denmark)

Stenager, E; Jensen, K

1990-01-01

An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison...