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1

Les manifestations rhumatologiques de la borréliose de Lyme  

Microsoft Academic Search

Purpose. – Lyme borreliosis is a multisystemic infection caused by the spirochaete Borrelia burgdorferi. In European endemic areas like northeast France, articular manifestations are, after neuroborreliosis, the most frequent extra-cutaneous features observed. Among the pathogenic species of Borrelia, Borrelia burgdorferi sensu stricto is the most frequently identified during Lyme arthritis, but others species also seem to be involved.Current knowledge and key

J. Sibilia; B. Jaulhac; F. X. Limbach

2002-01-01

2

[Horton's disease: facial manifestations].  

PubMed

Facial manifestations due to giant cell arteritis are analysed about 102 cases. The whole facial vascular territories are involved, so we have many manifestations. Diagnosis depends on artery biopsy with Doppler aid. PMID:9036519

Lample, G D; Benateau, H; Agron, L; Letellier, P; Compere, J F

1996-12-01

3

Thermodynamics in 'Manifest Reality'  

SciTech Connect

D'Espagnat's proof that the universe is not a 'strongly objective reality' demands that all physical processes are reconsidered in that light. D'Espagnat suggests a 'Veiled Reality' as a suitable alternative. The most economical way to achieve that is to demand that 'information production' at a quantum level creates the basis for self-consistent perception of a world of macroscopic, 'manifest' entities, as opposed to self-existent objects. Such a 'manifest reality' fulfils both Wheeler's attempt at an 'IT-from-BIT' programme, and Zeilinger's suggestion that 'information is primary'.

Hankey, Alex [Meru Research Institute, Bucks, 1985 (United Kingdom)

2010-12-22

4

Cutaneous Manifestations of ESRD  

PubMed Central

Summary A broad range of skin diseases occurs in patients with ESRD: from the benign and asymptomatic to the physically disabling and life-threatening. Many of them negatively impact on quality of life. Their early recognition and treatment are essential in reducing morbidity and mortality. The cutaneous manifestations can be divided into two main categories: nonspecific and specific. The nonspecific manifestations are commonly seen and include skin color changes, xerosis, half-and-half nails, and pruritus. The specific disorders include acquired perforating dermatosis, bullous dermatoses, metastatic calcification, and nephrogenic systemic fibrosis. This review article describes these conditions and considers the underlying pathophysiology, clinical presentations, diagnosis, and treatment options. PMID:24115194

Cronin, Antonia J.; Leslie, Kieron S.

2014-01-01

5

Destiny - Not So Manifest.  

ERIC Educational Resources Information Center

Higher education in the United States is facing a period of uncertainty, confusion, conflict, and potential change, and it has little to guide it in its past experiences. For most of its three and one-third century history, it has had a manifest destiny and through the period from 1820-1870 was marked by rapid change and some student unrest. Two…

Kerr, Clark

6

Cutaneous Manifestations of Hyperthyroidism  

Microsoft Academic Search

\\u000a The key to diagnosing hyperthyroidism from a dermatologic perspective is based on having a high index of suspicion that excess\\u000a thyroid hormone is responsible for the patient's signs and symptoms. As there are no definitive cutaneous manifestations of\\u000a hyperthyroidism, a careful review of systems may yield important clinical clues to the diagnosis: Is the patient intolerant\\u000a of heat? Has there

Clara-Dina Cokonis; Carrie W. Cobb; Warren R. Heymann; Chad M. Hivnor

7

Radiological manifestations of melioidosis.  

PubMed

Melioidosis is a serious infection that is associated with high mortality. It is due to a Gram-negative bacterium, Burkholderia pseudomallei which is an environmental saprophyte found in wet soils. Melioidosis is endemic to northern Australia and the Southeast Asia. However, there is now increasing number of reports of imported cases to regions where this infection has not been previously encountered. Almost any organ can be affected. Like many other conditions, radiological imaging is an integral part of the diagnostic workup of melioidosis. Awareness of the various radiological manifestations can help direct appropriate investigations to achieve early diagnosis and the initiation of appropriate treatment. Generally, there are no known characteristic features on imaging that can specifically differentiate melioidosis from other infections. However, the "honeycomb" appearance has been described to be characteristic for large melioidosis liver abscesses. Simultaneous involvement of various organs is also characteristics. To date, there are few data available on the radiological manifestations of melioidosis. The present pictorial essay describes melioidosis affecting the various organs. PMID:20103424

Lim, K S; Chong, V H

2010-01-01

8

Rheumatic manifestations of malignancy.  

PubMed

The rheumatic associations of cancer therapy are highlighted in this review. Interleukin-2, interferon alfa, and Calmette-Guérin bacillus immunotherapies are related to an inflammatory arthritis, and septic arthritis can complicate breast-cancer therapy. In a large retrospective study, an increased incidence of cancer in systemic sclerosis was confirmed, especially lung and breast cancers. Lymphoproliferative associations of Sjögren's syndrome were explored in a study of non-Hodgkin's lymphoma patients in which clinical and histologic criteria were used to diagnose Sjögren's syndrome. B- and T-cell lymphomas continue to be reported with rheumatologic manifestations such as seronegative polyarthritis and sacroiliitis. Malignant angioendotheliomatosis, which mimics central nervous system vasculitis diseases, has been reported. Paraneoplastic associations of lung, ovarian, and renal-cell carcinomas are discussed. PMID:8031673

Conaghan, P G; Brooks, P M

1994-01-01

9

Eosinophilic granuloma: MRI manifestations.  

PubMed

The appearance on magnetic resonance imaging (MRI) of 16 cases of pathologically proven eosinophilic granuloma were reviewed retrospectively and correlated with the radiographic appearance of the lesion. The most common MR appearance (ten cases) was a focal lesion, surrounded by an extensive, ill-defined bone marrow and soft tissue reaction with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, considered to represent bone marrow and soft tissue edema (the flare phenomenon). The MRI manifestations of eosinophilic granuloma, especially during the early stages, are nonspecific, and may stimulate an aggressive lesion such as osteomyelitis or Ewings sarcoma, or other benign bone tumors such as osteoid osteoma or chondroblastoma. PMID:8480200

Beltran, J; Aparisi, F; Bonmati, L M; Rosenberg, Z S; Present, D; Steiner, G C

1993-01-01

10

Manifesting the Quantum World  

NASA Astrophysics Data System (ADS)

In resisting attempts to explain the unity of a whole in terms of a multiplicity of interacting parts, quantum mechanics calls for an explanatory concept that proceeds in the opposite direction: from unity to multiplicity. Being part of the Scientific Image of the world, the theory concerns the process by which (the physical aspect of) what Sellars called the Manifest Image of the world comes into being. This process consists in the progressive differentiation of an intrinsically undifferentiated entity. By entering into reflexive spatial relations, this entity gives rise to (i) what looks like a multiplicity of relata if the reflexive quality of the relations is not taken into account, and (ii) what looks like a substantial expanse if the spatial quality of the relations is reified. If there is a distinctly quantum domain, it is a non-spatial and non-temporal dimension across which the transition from the unity of this entity to the multiplicity of the world takes place. Instead of being constituents of the physical world, subatomic particles, atoms, and molecules are instrumental in its manifestation. These conclusions are based on the following interpretive principle and its more direct consequences: whenever the calculation of probabilities calls for the addition of amplitudes, the distinctions we make between the alternatives lack objective reality. Applied to alternatives involving distinctions between regions of space, this principle implies that, owing to the indefiniteness of positions, the spatiotemporal differentiation of the physical world is incomplete: the existence of a real-valued spatiotemporal background is an unrealistic idealization. This guarantees the existence of observables whose values are real per se, as against "real by virtue of being indicated by the values of observables that are real per se." Applied to alternatives involving distinctions between things, it implies that, intrinsically, all fundamental particles are numerically identical and thus identifiable with the aforementioned undifferentiated entity.

Mohrhoff, Ulrich

2014-06-01

11

Oral Manifestations of Vitiligo  

PubMed Central

Background: Vitiligo is one of the disorder that has social impact. Both skin and mucous membrane show depigmentation in vitiligo. Depigmentation in oral cavity can be more easily observed and the patient can be given awareness regarding the condition if they are unaware of vitiligo elsewhere in their body and can be guided for treatment. Aim and objectives: The aim of this study is to determine the frequency of occurrence of oral mucosal vitiligo in vitiligo patients and to determine the most commonly involved oral mucosal site. Materials and methods: The study sample included 100 vitiligo patients. The patients of all age groups and both genders were included. Vitiligo patients associated with systemic conditions such as thyroid disorders, juvenile diabetes mellitus, pernicious anemia, Addison's disease were excluded in this study. Results: Out of 100 vitiligo patients 44 % male and 56% were female. The oral presentation of vitiligo in this study showed depigmentation of buccal mucosa in 5% of patients, labial mucosa in 5% of patients, palate in 8% of patients, gingiva in 2% of patients and alveolar mucosa 1%. Depigmentation of lip was seen in 42% of patients. Lip involvement refers to depigmentation of both the lips or either lip. Also vermilion border involvement was noted in majority of cases. In some cases, the depigmentation of lip extended to the facial skin also. Conclusion: In this study 55 patients out of 100 patients showed depigmentation in the oral cavity. Lip involvement was most common in this study showing about 42% of patients. Intraoral mucosal involvement was found in 21% of patients. Among intraoral mucosal site palate was common followed by buccal and labial mucosa, gingiva. Two patients had lip pigmentation as the only manifestation without any depigmentation in the skin.

Nagarajan, Anitha; Masthan, Mahaboob Kader; Sankar, Leena Sankari; Narayanasamy, Aravindha Babu; Elumalai, Rajesh

2015-01-01

12

40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.  

Code of Federal Regulations, 2012 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest...Page 2: “Designated facility to generator State (if required)”. (iii) Page 3: “Designated facility to generator”. (iv) Page 4:...

2012-07-01

13

40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest...Page 2: “Designated facility to generator State (if required)”. (iii) Page 3: “Designated facility to generator”. (iv) Page 4:...

2013-07-01

14

40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.  

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest...Page 2: “Designated facility to generator State (if required)”. (iii) Page 3: “Designated facility to generator”. (iv) Page 4:...

2014-07-01

15

Cutaneous manifestations in celiac disease  

PubMed Central

Celiac disease (CD) is an autoimmune gluten-dependent enteropathy characterized by atrophy of intestinal villi that improves after gluten-free diet (GFD). CD is often associated with extra-intestinal manifestations; among them, several skin diseases are described in CD patients. The present review reports all CD-associated skin manifestations described in the literature and tries to analyze the possible mechanisms involved in this association. The opportunity to evaluate the possible presence of CD in patients affected by skin disorders is discussed. PMID:16521210

Abenavoli, L; Proietti, I; Leggio, L; Ferrulli, A; Vonghia, L; Capizzi, R; Rotoli, M; Amerio, PL; Gasbarrini, G; Addolorato, G

2006-01-01

16

Oral manifestations of gastrointestinal diseases  

PubMed Central

The present paper offers a detailed review of the oral manifestations of various gastrointestional diseases or conditions, with suggestions on how they may be relevant to the practice of gastroenterology. The review includes Crohn’s disease, ulcerative colitis, Gardner syndrome, Peutz-Jeghers syndrome, malabsorption conditions related to hematopoiesis, gastrointestinal malignancy metastatic to the jaws, jaundice and gastric reflux diseases. PMID:17431513

Daley, Tom D; Armstrong, Jerrold E

2007-01-01

17

Gastrointestinal manifestations of chagas' disease  

Microsoft Academic Search

Chagas' disease is an infectious disease that affects millions of people in Latin America and is increasingly seen outside endemic areas. A substantial number of patients develop gastrointestinal disorders secondary to lesions of the enteric nervous system. The purpose of this article is to review the current knowledge about gastrointestinal manifestations of Chagas' disease, including disorders other than the well-known

Ricardo Brandt de Oliveira; LuizErnesto A. Troncon; Roberto Oliveira Dantas; Ulysses G. Meneghelli

1998-01-01

18

Esophageal Manifestations of Multisystem Diseases  

PubMed Central

The esophagus may be involved directly or indirectly by numerous disease conditions. On occasion, the esophageal process may be the key to the diagnosis. In some situations, the esophageal manifestation of a disease may be more immediately life-threatening than the primary process. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:7310903

Mapp, Esmond

1980-01-01

19

Psychiatric manifestations in cerebrotendinous xanthomatosis  

PubMed Central

Cerebrotendinous xanthomatosis (CTX) is a rare and severe, but treatable, inborn disorder of bile acid biosynthesis and sterol storage with autosomal recessive inheritance and variable clinical presentation. CTX treatment consists of chenodeoxycholic acid and must be started as early as possible to prevent permanent disability. Psychiatric manifestations are rare and non-specific, and often lead to significant diagnostic and treatment delay. Therefore, better recognition of the gamut of psychiatric manifestations in CTX can diminish the risk of misdiagnosis and irreversible neurological deterioration. We hereby describe the psychiatric features in CTX. A complete review of all published cases of CTX in the medical literature was undertaken and the case reports with psychiatric presentation were collected and analyzed. We also describe the psychiatric features in relation to the neurological semeiology in six patients with CTX diagnosed at the La Salpêtrière Hospital. We conclude that psychiatric manifestations in CTX follow a bimodal/bitemporal pattern, appearing early in the disease course in the form of a behavioral/personality disorder associated with learning difficulties or mental retardation, or manifesting in advanced disease in the setting of dementia as rich neuropsychiatric syndromes, such as frontal, orbitofrontal or frontotemporal syndromes of cortico-subcortical dementia encompassing behavioral/personality disturbance, affective/mood disorders or psychotic disorders. Behavioral/personality disturbance in childhood or adolescence, especially when accompanied by learning difficulties, should therefore lead to further investigation to exclude CTX, as early diagnosis and treatment is critical for prognosis. PMID:24002088

Fraidakis, M J

2013-01-01

20

78 FR 11877 - Announcement of Requirements Gathering Meetings for the Electronic Manifest (e-Manifest) System  

Federal Register 2010, 2011, 2012, 2013

...Gathering Meetings for the Electronic Manifest (e-Manifest) System AGENCY: Environmental...stakeholders on a national electronic manifest (``e-Manifest'') system to capture information...the agency begins the planning stage of the e-Manifest system development process....

2013-02-20

21

[Digestive manifestations in systemic sclerosis].  

PubMed

Gastrointestinal involvement occurs in most patients with systemic sclerosis. Pathology is characterized by vasculopathy, resulting in tissue ischemia, progressive dysfunction and fibrosis. In its diffuse and visceral pattern, digestive manifestations may involve most of the intestinal tract and are the most frequent before renal, cardiac and pulmonary involvement. Whatever the visceral extension, about 80% of patients have digestive manifestations including gastroesophageal reflux, abnormalities of intestinal motility leading to chronic intestinal pseudo-obstruction and small bowel bacterial overgrowth and malnutrition. Long-term treatment of reflux with high-dose proton pump inhibitors appears safe and effective for symptom relief and may prevent recurrence of esophagitis and stricture. Prokinetic agents effective in pseudoobstruction include metoclopramide, domperidone, octreotide, and erythromycin. PMID:12218892

Attar, Alain

2002-06-01

22

Porphyria and its neurologic manifestations.  

PubMed

Porphyrias are rare disorders resulting from a defect in the heme biosynthetic pathway. They can produce significant disease of both the peripheral and central nervous systems, in addition to other organ systems, with acute intermittent porphyria, hereditary coproporphyria, and variegate porphyria as the subtypes associated with neurologic manifestations. The presence of a motor-predominant peripheral neuropathy (axonal predominant), accompanied by gastrointestinal distress and neuropsychiatric manifestations, should be a strong clue to the diagnosis of porphyria. Clinical confirmation can be made through evaluation of urine porphyrins during an exacerbation of disease. While hematin is helpful for acute treatment, long-term effective management requires avoidance of overstimulation of the cytochrome P450 pathway, as well as other risk factor control. PMID:24365356

Tracy, Jennifer A; Dyck, P James B

2014-01-01

23

Multisystem manifestations of mitochondrial disorders  

Microsoft Academic Search

Mitochondria are cytoplasmic organelles in eukaryotic cells that accomplish several distinct vital functions, including oxidative\\u000a phosphorylation, metabolic anaplerotic and degradative pathways, and integration of signaling for apoptosis. Impaired oxidative\\u000a phosphorylation, the common final pathway of mitochondrial metabolism, results in a variety of clinical manifestations, and\\u000a the term mitochondrial disorders is currently ascribed to (mostly) genetic diseases of the respiratory chain

Stefano Di Donato

2009-01-01

24

Clinical Manifestations of Portal Hypertension  

PubMed Central

The portal hypertension is responsible for many of the manifestations of liver cirrhosis. Some of these complications are the direct consequences of portal hypertension, such as gastrointestinal bleeding from ruptured gastroesophageal varices and from portal hypertensive gastropathy and colopathy, ascites and hepatorenal syndrome, and hypersplenism. In other complications, portal hypertension plays a key role, although it is not the only pathophysiological factor in their development. These include spontaneous bacterial peritonitis, hepatic encephalopathy, cirrhotic cardiomyopathy, hepatopulmonary syndrome, and portopulmonary hypertension. PMID:23024865

Al-Busafi, Said A.; McNabb-Baltar, Julia; Farag, Amanda; Hilzenrat, Nir

2012-01-01

25

MUCOCUTANEOUS MANIFESTATIONS OF DENGUE FEVER  

PubMed Central

Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition. Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue. The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash. PMID:20418984

Thomas, Emy Abi; John, Mary; Kanish, Bimal

2010-01-01

26

Manifestations cutanées des syndromes myélodysplasiques  

Microsoft Academic Search

Purpose. – Our purpose was to describe cutaneous manifestations associated with myelodysplastic syndromes.Methods. – Data from seven patients with cutaneous vasculitis (four cases), neutrophilic dermatosis (one case), relapsing polychondritis (one case), and possible erythema elevatum diutinum (one case) in association with myelodysplastic syndrome (refractory anaemia RA, RA with excess of blasts – RAEB-, RAEB in transformation RAEBt, chronic myelomonocytic leukaemia – CMML-), and analysis of the

J. J Morand; E Lightburn; M. A Richard; S Hesse-Bonerandi; F Carsuzaa; J. J Grob

2001-01-01

27

Gastrointestinal manifestations in APECED syndrome.  

PubMed

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) (or autoimmune polyendocrine syndrome type 1) is a rare autosomal recessive disorder caused by mutations in the autoimmune regulator gene. It causes a loss in central immune tolerance, failure to eliminate autoreactive T cells in the thymus, and their escape to the periphery. APECED patients are susceptible to mucocutaneous candidiasis and multiple endocrine and nonendocrine autoimmune diseases. Although it depends on the series, approximately 25% of APECED patients are affected by gastrointestinal (GI) manifestations, mainly autoimmune-related disorders like autoimmune hepatitis, atrophic gastritis with or without pernicious anemia (Biermer disease), intestinal infections, and malabsorption. In contrast to the major organ-specific autoimmune symptoms of APECED, the GI symptoms and their underlying pathogenesis are poorly understood. Yet isolated case reports and small series depict severe intestinal involvement in children, leading to malabsorption, multiple deficiencies, growth impairment, and possible death. Moreover, very few systematic studies of GI function with intestinal biopsies have been performed. GI symptoms may be the first manifestation of APECED, yet they may have various causes; effective treatment will therefore vary. We provide here an updated review of GI manifestations in APECED, including principles of diagnosis and therapy. PMID:23314667

Kluger, Nicolas; Jokinen, Martta; Krohn, Kai; Ranki, Annamari

2013-02-01

28

Cardiac manifestations in systemic sclerosis  

PubMed Central

Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis (SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography (especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome. PMID:25276300

Lambova, Sevdalina

2014-01-01

29

Gaucher disease and bone manifestations.  

PubMed

Gaucher disease is a relatively rare metabolic disease caused by the inherited deficiency of the lysosomal enzyme glucocerebrosidase. Gaucher disease affects multiple organs, among which is the skeleton. Bone involvement occurs frequently in Gaucher disease, and is one of its most debilitating features, reducing the quality of life of patients. Bone status is an important consideration for treatment to ameliorate symptoms and reduce the risk of irreversible complications. We have conducted a systematic review of all the various aspects of Gaucher disease, focusing on different skeletal manifestations, pathophysiology of bone alterations, clinical symptoms, and current diagnostic and therapeutic approaches. PMID:25377906

Marcucci, Gemma; Zimran, Ari; Bembi, Bruno; Kanis, John; Reginster, Jean-Yves; Rizzoli, Renè; Cooper, Cyrus; Brandi, Maria Luisa

2014-12-01

30

Clinical manifestations of central neurocytoma.  

PubMed

Central neurocytomas (CNs) are rare central nervous system tumors that occur in the lateral ventricles. They are prevalent in young adults and are typically benign with excellent prognosis following surgical resection. Because of the rarity of the disease and its similar features with more common tumors, misdiagnosis becomes an issue. Optimal treatment is achieved only when the correct tumor types are distinguished. Typical clinical manifestations include symptoms of increased intracranial pressure, although no clinical feature is pathognomonic to CN. Radiologic imaging, histology, magnetic resonance spectroscopy, and immunohistochemistry must be used to elucidate tumor characteristics and properly diagnose CN. PMID:25432178

Yang, Isaac; Ung, Nolan; Chung, Lawrance K; Nagasawa, Daniel T; Thill, Kimberly; Park, Junmook; Tenn, Stephen

2015-01-01

31

Cardiovascular manifestations of ankylosing spondylitis  

Microsoft Academic Search

Summary  In a retrospective study, 40 patients with ankylosing spondylitis were assessed for extraspinal manifestations. Cardiovascular\\u000a complications were found in 17 patients (42.5%)?5(12.5%) had aortic insufficiency, 3 (7.5%) had atrioventricular block and\\u000a 5 (12.5%) had bundle branch block. Wolff-Parkinson-White syndrome was diagnosed in one case and short PR syndrome in another.\\u000a Cardiovascular complications were more common in patients with longer disease

S. Sukenik; A. Pras; D. Buskila; A. Katz; Y. Snir; J. Horowitz

1987-01-01

32

Coronal manifestations of preflare activity  

NASA Technical Reports Server (NTRS)

A variety of coronal manifestations of precursors or preheating for flares are discussed. Researchers found that almost everyone with a telescope sees something before flares. Whether an all-encompassing scenario will ever be developed is not at all clear at present. The clearest example of preflare activity appears to be activated filaments and their manifestations, which presumably are signatures of a changing magnetic field. But researchers have seen two similar eruptions, one without any evidence of emerging flux (Kundu et al., 1985) and the other with colliding poles (Simon et al., 1984). While the reconnection of flux is generally agreed to be required to energize a flare, the emergence of flux from below (at least on short timescales and in compact regions) does not appear to be a necessary condition. In some cases the cancelling of magnetic flux (Martin, 1984) by horizontal motions instead may provide the trigger (Priest, 1985) Researchers found similarities and some differences between these and previous observations. The similarities, besides the frequent involvement of filaments, include compact, multiple precursors which can occur both at and near (not at) the flare site, and the association between coronal sources and activity lower in the atmosphere (i.e., transition zone and chromosphere).

Schmahl, E. J.; Webb, D. F.; Woodgate, B.; Waggett, P.; Bentley, R.; Hurford, G.; Schadee, A.; Schrijver, J.; Harrison, R.; Martens, P.

1986-01-01

33

Skin manifestations in diabetes mellitus.  

PubMed

Background: Diabetes mellitus affects all systems of the body. Skin is also frequently involved. The aim of the study was to assess the frequency of various skin manifestations in patients with diabetes mellitus. Methods: This descriptive study was conducted at the out-patient diabetic clinics at Aga Khan University Hospital, Karachi. One hundred consecutive patients, both male and female suffering from either type-1 or type-2 diabetes mellitus were included. Results: Out of hundred patients, skin changes were present in 84% of patients. The most frequent finding was skin infections present in 29.7% of patients and the second most common finding was diabetic dermopathy found in 28.5% of patients. Other finding were: Acanthosis Nigricans in 19%, sweating complications in 14.2%, nail involvement in 10.7%, oral involvenient in 5.9%, diabetic foot in 5.9%, xanthelasma in 4.7%, yellow skin in 1.1%, generalized Pruritus in 1.1%, limited joint mobility in 1.1%. Conclusion: The cutaneous manifestations are very common in our diabetic patients (84%) and it is important that they are identified and appropriately treated in diabetes follow up clinics. PMID:25358216

Furqan, Saira; Kamani, Lubna; Jabbar, Abdul

2014-01-01

34

Neurodevelopmental Manifestations of Mitochondrial Disease  

PubMed Central

Mitochondrial disease is an increasingly recognized but widely heterogeneous group of multi-systemic disorders that commonly involve severe neurodevelopmental manifestations in childhood. This article will review the presentation, genetic basis, and diagnostic evaluation of primary mitochondrial disease. Emphasis will be placed on neurodevelopmental findings that may be encountered by a Developmental Pediatrician that should provoke consideration of a mitochondrial disorder. The inheritance patterns and mechanisms by which mutations in genes located in either the nuclear or mitochondrial genomes can cause mitochondrial diseases will be discussed. A general overview of the current diagnostic evaluation that can be readily initiated by the Developmental Pediatrician will be provided, along with a summary of currently available treatment options. PMID:20814259

Falk, Marni J.

2014-01-01

35

Pulmonary manifestations of ankylosing spondylitis.  

PubMed

Ankylosing spondylitis, a chronic multisystem inflammatory disorder, can present with articular and extra-articular features. It can affect the tracheobronchial tree and the lung parenchyma, and respiratory complications include chest wall restriction, apical fibrobullous disease with or without secondary pulmonary superinfection, spontaneous pneumothorax, and obstructive sleep apnea. Ankylosing spondylitis is a common cause of pulmonary apical fibrocystic disease; early involvement may be unilateral or asymmetrical, but most cases eventually consist of bilateral apical fibrobullous lesions, many of which are progressive with coalescence of the nodules, formation of cysts and cavities, fibrosis, and bronchiectasis. Mycobacterial or fungal superinfection of the upper lobe cysts and cavities occurs commonly. Aspergillus fumigatus is the most common pathogen isolated, followed by various species of mycobacteria. Prognosis of patients with fibrobullous apical lesions is mainly determined by the presence, extent, and severity of superinfection. Pulmonary function test results are nonspecific and generally parallel the severity of parenchymal involvement. A restrictive ventilatory impairment can develop in patients with ankylosing spondylitis because of either fusion of the costovertebral joints and ankylosis of the thoracic spine or anterior chest wall involvement. Chest radiographic findings may mirror the severity of clinical involvement. Pulmonary parenchymal disease is typically progressive, and cyst formation, cavitation, and fibrosis are seen in advanced cases. No treatment has been shown to alter the clinical course of apical fibrobullous disease. Although several antiinflammatory agents, such as infliximab, etanercept, and adalimumab, are being used to treat ankylosing spondylitis, their effects on pulmonary manifestations are unclear. PMID:20692546

Kanathur, Naveen; Lee-Chiong, Teofilo

2010-09-01

36

Gastrointestinal manifestations in cystic fibrosis.  

PubMed

CFTR, or cystic fibrosis transmembrane conductance regulator, the gene product that is defective in cystic fibrosis, is present in the apical membrane of the epithelial cells from the stomach to the colon. In the foregut, the clinical manifestations are not directly related to the primary defect of the CFTR chloride channel. The most troublesome complaints and symptoms originate from the oesophagus as peptic oesophagitis or oesophageal varices. In the small intestinal wall, the clinical expression of CF depends largely on the decreased secretion of fluid and chloride ions, the increased permeability of the paracellular space between adjacent enterocytes and the sticky mucous cover over the enterocytes. As a rule, the brush border enzyme activities are normal and there is some enhanced active transport as shown for glucose and alanine. The results of continuous enteral feeding of CF patients clearly show that the small intestinal mucosa, in the daily situation, is not functioning at maximal capacity. Although CFTR expression in the colon is lower, the large intestine may be the site of several serious complications such as rectal prolapse, meconium ileus equivalent, intussusception, volvulus and silent appendicitis. In recent years colonic strictures, after the use of high-dose pancreatic enzymes, are being increasingly reported; the condition has recently been called CF fibrosing colonopathy. The CF gastrointestinal content itself differs mainly from the normal condition by the lower acidity in the foregut and the accretion of mucins and proteins, eventually resulting in intestinal obstruction, in the ileum and colon. Better understanding of the CF gastrointestinal phenotype may contribute to improvement of the overall wellbeing of these patients. PMID:8864667

Eggermont, E

1996-08-01

37

Endocrine manifestations of celiac disease  

PubMed Central

Background: Celiac disease can have extra gastrointestinal tract (GIT) presentations, most of which are endocrine. The aim of this study was to present patients diagnosed to have celiac disease from an endocrine department and to study the prevalence of endocrinopathies in celiac disease. Materials and Methods: A total of 36 patients from the endocrinology department (LLRM Medical College, Meerut) between January 2011 and July 2012 and who were diagnosed to have celiac disease were included in the study. Results: Short stature was the commonest presentation (25%), other presentations included short stature and delayed puberty (20%), delayed puberty (11%), screening for celiac disease in type-1 DM patients (17%), rickets (6%), anemia not responding to oral therapy (6%), type-1 DM with recurrent hypoglycaemia (6%), and osteomalacia (3%). The endocrine manifestations include (after complete evaluation) short stature (58%), delayed puberty (31%), elevated alkaline phospahatase (67%), low calcium (22%), X-rays suggestive of osteomalacia or rickets (8%), capopedal spasm (6%), and night blindness (6%). Anti-TPO antibody positivity was found in 53%, hypothyroidism in 28%, subclinical hypothyroidism in 17%, and type-1 DM in 25% of the patients. A total of 14% patients had no GI symptoms. Conclusion: Celiac disease is an endocrine disrupter as well as the great masquerader having varied presentations including short stature, delayed puberty, and rickets. Some patients who have celiac disease may not have any GI symptoms, making the diagnosis all the more difficult. Also, there is significant incidence of celiac disease with hypothyroidism and type-1 DM, making screening for it important in these diseases. PMID:23565481

Philip, R.; Patidar, PP; Saran, S.; Agarwal, P.; Arya, TVS; Gupta, KK

2012-01-01

38

Paraneoplastic cutaneous manifestations: concepts and updates*  

PubMed Central

The skin often signals systemic changes. Some neoplastic diseases that affect internal organs may trigger several cutaneous manifestations. Although these dermatoses are relatively unusual, the recognition of some typical paraneoplastic dermatoses may lead to the early diagnosis of a neoplasm and determine a better prognosis. In this review article, we discuss the paraneoplastic cutaneous manifestations strongly associated with neoplasms, which include acanthosis nigricans maligna, tripe palms, erythema gyratum repens, Bazex syndrome, acquired hypertrichosis lanuginosa, necrolytic migratory erythema, Leser-Trélat sign and paraneoplastic pemphigus. We also review the clinical manifestations of each condition and include updated knowledge on disease pathogenesis. PMID:23538999

da Silva, Josenilson Antônio; Mesquita, Kleyton de Carvalho; Igreja, Ana Carolina de Souza Machado; Lucas, Isabella Cristina Rodrigues Naves; Freitas, Aline Ferreira; de Oliveira, Sandra Maximiano; Costa, Izelda Maria Carvalho; Campbell, Iphis Tenfuss

2013-01-01

39

Genetic alterations in syndromes with oral manifestations.  

PubMed

Ever since Gregor Johan Mendel proposed the law of inheritance, genetics has transcended the field of health and has entered all walks of life in its application. Thus, the gene is the pivoting factor for all happenings revolving around it. Knowledge of gene mapping in various diseases would be a valuable tool in prenatally diagnosing the condition and averting the future disability and stigma for the posterity. This article includes an array of genetically determined conditions in patients seen at our college out-patient department with complete manifestation, partial manifestation and array of manifestations not fitting into a particular syndrome. PMID:24379857

Anuthama, Krishnamurthy; Prasad, Harikrishnan; Ramani, Pratibha; Premkumar, Priya; Natesan, Anuja; Sherlin, Herald J

2013-11-01

40

Endocrine disorders and the neurologic manifestations  

PubMed Central

The nervous system and the endocrine system are closely interrelated and both involved intimately in maintaining homeostasis. Endocrine dysfunctions may lead to various neurologic manifestations such as headache, myopathy, and acute encephalopathy including coma. It is important to recognize the neurologic signs and symptoms caused by the endocrine disorders while managing endocrine disorders. This article provides an overview of the neurologic manifestations found in various endocrine disorders that affect pediatric patients. It is valuable to think about 'endocrine disorder' as a cause of the neurologic manifestations. Early diagnosis and treatment of hormonal imbalance can rapidly relieve the neurologic symptoms. Better understanding of the interaction between the endocrine system and the nervous system, combined with the knowledge about the pathophysiology of the neurologic manifestations presented in the endocrine disorders might allow earlier diagnosis and better treatment of the endocrine disorders. PMID:25654063

2014-01-01

41

Metabolic and hormonal signatures in pre-manifest and manifest Huntington's disease patients  

PubMed Central

Huntington's disease (HD) is an inherited neurodegenerative disorder typified by involuntary body movements, and psychiatric and cognitive abnormalities. Many HD patients also exhibit metabolic changes including progressive weight loss and appetite dysfunction. Here we have investigated metabolic function in pre-manifest and manifest HD subjects to establish an HD subject metabolic hormonal plasma signature. Individuals at risk for HD who have had predictive genetic testing showing the cytosine-adenine-guanine (CAG) expansion causative of HD, but who do not yet present signs and symptoms sufficient for the diagnosis of manifest HD are said to be “pre-manifest.” Pre-manifest and manifest HD patients, as well as both familial and non-familial controls, were evaluated for multiple peripheral metabolism signals including circulating levels of hormones, growth factors, lipids, and cytokines. Both pre-manifest and manifest HD subjects exhibited significantly reduced levels of circulating growth factors, including growth hormone and prolactin. HD-related changes in the levels of metabolic hormones such as ghrelin, glucagon, and amylin were also observed. Total cholesterol, HDL-C, and LDL-C were significantly decreased in HD subjects. C-reactive protein was significantly elevated in pre-manifest HD subjects. The observation of metabolic alterations, even in subjects considered to be in the pre-manifest stage of HD, suggests that in addition, and prior, to overt neuronal damage, HD affects metabolic hormone secretion and energy regulation, which may shed light on pathogenesis, and provide opportunities for biomarker development. PMID:25002850

Wang, Rui; Ross, Christopher A.; Cai, Huan; Cong, Wei-Na; Daimon, Caitlin M.; Carlson, Olga D.; Egan, Josephine M.; Siddiqui, Sana; Maudsley, Stuart; Martin, Bronwen

2014-01-01

42

Neurological manifestations of the oculodentodigital dysplasia syndrome  

Microsoft Academic Search

Oculodentodigital dysplasia (ODDD) (MIM 164200) is a rare autosomal dominant inherited disorder affecting the development\\u000a of the face, eyes, limbs and dentition. Neurological complications are thought to be occasional manifestations of the disorder.\\u000a This report illustrates the neurological manifestations by a pedigree of two ODDD patients with spastic paraparesis, cerebral\\u000a white matter hyperintensity and basal ganglia hypointensity. A systematic review

Tobias Loddenkemper; Kerstin Grote; Stefan Evers; Michael Oelerich; Florian Stögbauer

2002-01-01

43

Skeletal scintigraphy manifestations of hematologic disorders.  

PubMed

Skeletal manifestations are common in hematologic disorders. Benign entities such as Sickle cell disease develop microvascular embolization causing skeletal crisis. Leukemia, acute myeloblastic or lymphoblastic may develop bone marrow infarcts. Compromised immunity makes them susceptible to secondary infection leading to osteomyelitis or septic arthritis. Exposure to steroids may lead to osteonecrosis in these cases. Presented here is an atlas of various scintigraphic skeletal manifestations encountered over the past 10 years, in hematologic disorders. PMID:23599605

Solav, Shrikant V; Bhandari, Ritu; Solav, Pallavi

2012-01-01

44

19 CFR 122.116 - Identification of manifest sheets.  

Code of Federal Regulations, 2010 CFR

... false Identification of manifest sheets. 122.116 Section 122.116 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...Transit Air Cargo Manifest (TACM) Procedures § 122.116 Identification of manifest sheets. When the...

2010-04-01

45

40 CFR 262.23 - Use of the manifest.  

Code of Federal Regulations, 2010 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification...with § 262.40(a). (b) The generator must give the transporter the...

2010-07-01

46

40 CFR 262.23 - Use of the manifest.  

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification...with § 262.40(a). (b) The generator must give the transporter the...

2014-07-01

47

40 CFR 262.23 - Use of the manifest.  

Code of Federal Regulations, 2012 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification...with § 262.40(a). (b) The generator must give the transporter the...

2012-07-01

48

40 CFR 262.23 - Use of the manifest.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification...with § 262.40(a). (b) The generator must give the transporter the...

2013-07-01

49

40 CFR 262.23 - Use of the manifest.  

Code of Federal Regulations, 2011 CFR

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification...with § 262.40(a). (b) The generator must give the transporter the...

2011-07-01

50

40 CFR 262.24 - Use of the electronic manifest.  

...CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest ...requirement in these regulations for a generator to keep or retain a copy of each manifest...of a signed electronic manifest in the generator's account on the national...

2014-07-01

51

40 CFR 761.208 - Use of the manifest.  

Code of Federal Regulations, 2010 CFR

...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...manifest. (a)(1) The generator of PCB waste shall: (i) Sign the manifest...manifest that will accompany the shipment of PCB waste. (2) For bulk...

2010-07-01

52

Cutaneous Manifestations of Systemic Lupus Erythematosus  

PubMed Central

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. The skin is one of the target organs most variably affected by the disease. The American College of Rheumatology (ACR) established 11 criteria as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individuals and do not do well in that capacity. Cutaneous lesions account for four of these 11 revised criteria of SLE. Skin lesions in patients with lupus may be specific or nonspecific. This paper covers the SLE-specific cutaneous changes: malar rash, discoid rash, photosensitivity, and oral mucosal lesions as well as SLE nonspecific skin manifestations, their pathophysiology, and management. A deeper thorough understanding of the cutaneous manifestations of SLE is essential for diagnosis, prognosis, and efficient management. Thus, dermatologists should cooperate with other specialties to provide optimal care of SLE patient. PMID:22888407

Uva, Luís; Miguel, Diana; Pinheiro, Catarina; Freitas, João Pedro; Marques Gomes, Manuel; Filipe, Paulo

2012-01-01

53

[Dermatologic manifestations of the antiphospholipid syndrome].  

PubMed

A wide variety of dermatologic manifestations has been described in the antiphospholipid syndrome (APS). The most frequent skin lesion is livedo reticularis, present not only on the limbs but also on the trunk, with a fine irregular pattern. It belongs to the arterial subset of APS. Circumscribed ulcerations, resembling livedoid vasculitis, may be the first manifestation of APS. Ulcerations may also occur as a late complication of recurrent venous thrombosis. Extensive skin necrosis is a classic manifestation of catastrophic APS. Pseudo-vasculitis lesions are misdiagnosed if a skin biopsy is not performed, especially in the context of systemic lupus erythematosus. In systemic lupus erythematosus, primary anetoderma is always associated with antiphospholipid antibodies. PMID:22078802

Francès, C; Barete, S; Soria, A

2012-04-01

54

Neurological Manifestation of Methyl Bromide Intoxication  

Microsoft Academic Search

Methyl bromide is a highly toxic gas with poor olfactory warning properties. It is widely used as insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor , convulsion, un- consciousness

Kammant Phanthumchinda

55

Osteoarticular manifestations in sickle-cell disorders  

Microsoft Academic Search

Summary  The osteoarticular manifestations of the main sickling disorders (homozygous sickle cell-HbSS anaemia-, double heterozygous-HbS- thalassaemia, double heterozygous HbS-C disease and sickle cell-trait) are reviewed; They may be grouped into 3 main categories: vaso-occlusive, infective and metabolic. The pathophysiology and pathogenesis as well as the treatment are discussed.

Phaedon Kaklamanis

1984-01-01

56

Pulmonary manifestations of Crohn’s disease  

PubMed Central

Crohn’s disease (CD) is a systemic illness with a constellation of extraintestinal manifestations affecting various organs. Of these extraintestinal manifestations of CD, those involving the lung are relatively rare. However, there is a wide array of lung manifestations, ranging from subclinical alterations, airway diseases and lung parenchymal diseases to pleural diseases and drug-related diseases. The most frequent manifestation is bronchial inflammation and suppuration with or without bronchiectasis. Bronchoalveolar lavage findings show an increased percentage of neutrophils. Drug-related pulmonary abnormalities include disorders which are directly induced by sulfasalazine, mesalamine and methotrexate, and opportunistic lung infections due to immunosuppressive treatment. In most patients, the development of pulmonary disease parallels that of intestinal disease activity. Although infrequent, clinicians dealing with CD must be aware of these, sometimes life-threatening, conditions to avoid further impairment of health status and to alleviate patient symptoms by prompt recognition and treatment. The treatment of CD-related respiratory disorders depends on the specific pattern of involvement, and in most patients, steroids are required in the initial management. PMID:24415866

Lu, De-Gan; Ji, Xiao-Qing; Liu, Xun; Li, Hong-Jia; Zhang, Cai-Qing

2014-01-01

57

Gastrointestinal Manifestations of AIDS in Children  

Microsoft Academic Search

The gastrointestinal manifestations of AIDS in children are related to opportunistic infections, lymphoproliferative disease, and cancer. The infections that affect the gastrointestinal tract at different sites also occur in patients without AIDS. However, in children with AIDS, the infections are more severe, often relapse, and are harder to eradicate. Candidiasis is the most common infection in the esophagus, but infections

Harris L. Cohen

58

40 CFR 761.210 - Manifest discrepancies.  

Code of Federal Regulations, 2010 CFR

...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...differences between the quantity or type of PCB waste designated on the manifest or shipping paper and the quantity or type of PCB waste actually delivered to and...

2010-07-01

59

Oropharyngeal Dysphagia: neurogenic etiology and manifestation.  

PubMed

To determine the type, severity and manifestation of dysphagia in patients with neurogenic etiology. Clinical documentation was done on the different etiologies, its manifestation, assessment findings and management strategies taken for patients with neurogenic oropharyngeal dysphagia who were referred for assessment and management of dysphagia over a period of three months in a tertiary care teaching hospital. Flexible endoscopic examination was done in all the patients. The severity of dysphagia in these patients were graded based on Gugging Swallowing Screen (GUSS). A total of 53 patients with neurogenic oropharyngeal dysphagia were evaluated by an otolaryngologist and a speech language pathologist over a period of three months. The grading of severity based on GUSS for these patients were done. There were 30 patients with recurrent laryngeal nerve injury due to various etiologies, one patient with Neurofibroma-vestibular schwanoma who underwent surgical excision, 16 patients with stroke, two patients with traumatic brain injury, two patients with Parkinsonism and two patients with myasthenia gravis. The manifestation of dysphagia was mainly in the form of prolonged masticatory time, oral transit time, and increased number of swallows required for each bolus, cricopharyngeal spasms and aspiration. Among the dysphagia patients with neurogenic etiology, dysphagia is manifested with a gradual onset and is found to have a progressive course in degenerative disorders. Morbidity and mortality may be reduced with early identification and management of neurogenic dysphagia. PMID:25621266

Sebastian, Swapna; Nair, Prem G; Thomas, Philip; Tyagi, Amit Kumar

2015-03-01

60

Real-Life Contextual Manifestations of Wisdom  

ERIC Educational Resources Information Center

Wisdom pertains to managing human affairs, and it arises in highly contextualized situations. The present study aims to investigate manifestations of wisdom in real-life contexts through semi-structured interviews with 66 individuals nominated as wise persons. All nominees were ethnic Chinese from Taiwan, an East Asian country which has…

Yang, Shih-Ying

2008-01-01

61

Manifest Anxiety and School Achievement of Adolescents  

ERIC Educational Resources Information Center

This study investigated the nature of relationships between manifest anxiety and school achievement of 700 Indian adolescents. The conclusions were: (1) the relationship between these two variables is curvilinear supporting the inverted U hypothesis; and (2) this relationship holds for both males and females. (Author)

Sharma, Sagar

1970-01-01

62

Propylthiouracil induced leukocytoclastic vasculitis: A rare manifestation.  

PubMed

Propylthiouracil (PTU) is a common drug used in patients with hyperthyroidism. It may cause perinuclearantineutrophil cytoplasmic antibodies (p-ANCA) in few patients with Graves' disease. This antibody has been associated with different forms of vasculitis. We report a patient who presented with cutaneous manifestations of leukocytoclasticvasculitis with simultaneous development of p-ANCAs during PTU therapy for Graves' disease. PMID:23776917

Ayturk, Semra; Demir, Mustafa Volkan; Yaylac?, Selçuk; Tamer, Ali

2013-03-01

63

Proteus syndrome: emphasis on the pulmonary manifestations  

Microsoft Academic Search

Published articles on the radiologic aspects of Proteus syndrome are sparse. This report highlights the features of this disease with specific attention to the serious pulmonary manifestations that may occur at an early age. Two cases of Proteus syndrome and severe lung disease are presented, with complete autopsy in one case and correlative surgical pathologic data in the other. Multiple

B. Newman; A. H. Urbach; D. Orenstein; P. S. Dickman

1994-01-01

64

Neurological manifestations of Erdheim-Chester disease  

Microsoft Academic Search

Erdheim-Chester disease is a rare sporadic systemic histiocytic disease of unknown aetiology that affects multiple organ systems. The case records of all patients with Erdheim-Chester disease who had been seen at the Mayo Clinic between 1975 and 1996 were reviewed to assess the neurological manifestations of the disease. Two of 10 patients had neurological involvement. A 42 year old woman

R Alan Wright; Robert C Hermann; Joseph E Parisi

1999-01-01

65

Testicular Manifestation of a Transformed Mycosis Fungoides  

PubMed Central

Testicular neoplasms occur in more than 90% of cases, due to primary testicular germ cell tumors. Other entities are non germ cell tumors of the testis, testicular manifestation of lymphomas or metastases. International and interdisciplinary co-operation has led to the development of urological guidelines and to good therapeutic success for testicular neoplasms. The gold standard for treatment of a testicular neoplasm is the radical orchiectomy. However, for individual cases with suspected lymphoma, a treatment decision differing from the guidelines may be reasonable. We present the case of a 38-year-old man with testicular manifestation of a transformed mycosis fungoides, which is the most common form of cutaneous T-cell lymphoma. PMID:24711905

Borgmann, Hendrik; Vallo, Stefan; Ruf, Christian; Schmidt, Anke; Thon, Walter Ferdinand

2014-01-01

66

Testicular manifestation of a transformed mycosis fungoides.  

PubMed

Testicular neoplasms occur in more than 90% of cases, due to primary testicular germ cell tumors. Other entities are non germ cell tumors of the testis, testicular manifestation of lymphomas or metastases. International and interdisciplinary co-operation has led to the development of urological guidelines and to good therapeutic success for testicular neoplasms. The gold standard for treatment of a testicular neoplasm is the radical orchiectomy. However, for individual cases with suspected lymphoma, a treatment decision differing from the guidelines may be reasonable. We present the case of a 38-year-old man with testicular manifestation of a transformed mycosis fungoides, which is the most common form of cutaneous T-cell lymphoma. PMID:24711905

Borgmann, Hendrik; Vallo, Stefan; Ruf, Christian; Schmidt, Anke; Thon, Walter Ferdinand

2014-01-23

67

Ocular manifestations of hepatitis C virus infection.  

PubMed

Approximately 3.6 million persons in the United States are infected with the hepatitis C virus (HCV), a condition with both hepatic and extrahepatic sequelae. Although no pathognomonic manifestation of HCV infection in the eye has been demonstrated, associations between HCV infection and various ocular syndromes have been reported in small case series and individual patients. At this time, the ocular manifestations of HCV infections best supported by the literature include a dry eye syndrome similar to Sjögren syndrome, and ischemic retinopathy caused by either an HCV-induced vasculitis or treatment with interferon. Patients with diabetes seem to be more susceptible to interferon retinopathy and to subsequent permanent visual loss. There have been no cases of HCV transmission via corneal transplantation, suggesting that current cadaveric screening protocols are effective in preventing this route of transmission. Screening for HCV should be considered in patients with risk factors for HCV infection who suffer from unexplained ischemic retinopathy or dry eyes. PMID:12441848

Zegans, Michael E; Anninger, William; Chapman, Christopher; Gordon, Stuart R

2002-12-01

68

Imaging lung manifestations of HIV/AIDS  

PubMed Central

Advances in our understanding of human immunodeficiency virus (HIV) infection have led to improved care and incremental increases in survival. However, the pulmonary manifestations of HIV/acquired immunodeficiency syndrome (AIDS) remain a major cause of morbidity and mortality. Respiratory complaints are not infrequent in patients who are HIV positive. The great majority of lung complications of HIV/AIDS are of infectious etiology but neoplasm, interstitial pneumonias, Kaposi sarcoma and lymphomas add significantly to patient morbidity and mortality. Imaging plays a vital role in the diagnosis and management of lung of complications associated with HIV. Accurate diagnosis is based on an understanding of the pathogenesis of the processes involved and their imaging findings. Imaging also plays an important role in selection of the most appropriate site for tissue sampling, staging of disease and follow-ups. We present images of lung manifestations of HIV/AIDS, describing the salient features and the differential diagnosis. PMID:20981180

Allen, Carolyn M.; AL-Jahdali, Hamdan H.; Irion, Klaus L.; Al Ghanem, Sarah; Gouda, Alaa; Khan, Ali Nawaz

2010-01-01

69

Cutaneous human papillomavirus infection: manifestations and diagnosis.  

PubMed

Keratinocytes react to human papillomavirus (HPV) infection by proliferation resulting in different clinical manifestations ranging from flat warts to common warts and cauliflower-like or filiform warts. The clinical presentation may vary according to the HPV type and anatomical site. Although warts are usually a self-limiting disease, some HPV subtypes may induce malignant changes. Bowenoid papulosis is characterized by multiple flat macules or patches in the genital area that may or may not be pigmented. Rarely other forms of superficial squamous cell carcinomas may be induced by HPV infections, for example periungual Bowen's disease. Dermatoscopy is a noninvasive diagnostic technique that facilitates the diagnosis of skin manifestations induced by HPV. PMID:24643180

Tschandl, Philipp; Rosendahl, Cliff; Kittler, Harald

2014-01-01

70

[Cerebrotendinous xanthomatosis: physiopathology, clinical manifestations and genetics].  

PubMed

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease, caused by genetic deficiency of the 27-hydroxylase enzyme (encoded by CYP27A1). It plays a key role in cholesterol metabolism, especially in bile acid synthesis and in the 25-hydroxylation of vitamin D3 in the liver. Its deficiency causes reduced bile acid synthesis and tissue accumulation of cholestanol. Clinical manifestations are related to the presence of cholestanol deposits and include tendon xanthomas, premature cataracts, chronic diarrhea, progressive neurologic impairment and less frequently coronary heart disease, early onset osteoporosis and abnormalities in the optic disk and retina. An early diagnosis and treatment with quenodeoxycholic acid may prevent further complications, mainly neurological manifestations. This review summarizes cholesterol metabolism related to bile acid synthesis, physiopathology, biochemistry and treatment of cerebrotendinous xanthomatosis. PMID:25427019

Preiss, Yudith; Santos, José L; Smalley, Susan V; Maiz, Alberto

2014-05-01

71

Skin and mucosal manifestations in vitamin deficiency.  

PubMed

The skin and mucosal changes in vitamin deficiency are described. Pellagra, which is the oldest known cutaneous manifestation among vitamin deficiencies, is reviewed. Cutaneous alterations caused by deficiency of the water-soluble vitamins B6, C, B1 and biotin, B12, folic acid, and riboflavin result in more mucosal alterations and are discussed. Alterations caused by fat-soluble vitamin deficiencies (vitamins A and K) are also considered. PMID:2948974

Barthelemy, H; Chouvet, B; Cambazard, F

1986-12-01

72

Pulmonary tuberculosis with atypical histopathological manifestations  

Microsoft Academic Search

This report presents a case of pulmonary tuberculosis with atypical histopathological manifestations in an immunocompetent\\u000a patient. A 37-year-old Japanese man was admitted due to multiple small nodules on chest computed tomography (CT). He was diagnosed\\u000a with pulmonary tuberculosis following a culture of acid-fast bacterium from suction sputum specimens obtained by bronchoscopy.\\u000a The histopathological findings from video-assisted thoracoscopy revealed small, sporadically

Hirokazu Taniguchi; Akio Uchiyama; Hideki Shinno; Hitoshi Abo; Saburo Izumi

2010-01-01

73

MANIFESTATION JOURNEE EUROPE INFORMATIONS PROGRAMME HORIZON 2020  

E-print Network

MANIFESTATION JOURNEE EUROPE ­ INFORMATIONS PROGRAMME HORIZON 2020 ET EUROPAID 16 décembre 2013 9, Zoraïda MARTINEZ 16 décembre 2013 10 :00 Matin JOURNEE D'INFORMATION HORIZON 2020 / EUROPAID CESBIO- Salle de conférence - Présentation générale d'HORIZON 2020 et son intérêt pour l'IRD - Les nouveautés et

Dintrans, Boris

74

Skin Manifestations of Inflammatory Bowel Disease  

PubMed Central

Inflammatory bowel disease (IBD) is a disease that affects the intestinal tract via an inflammatory process. Patients who suffer from IBD often have diseases that affect multiple other organ systems as well. These are called extraintestinal manifestations and can be just as, if not more debilitating than the intestinal inflammation itself. The skin is one of the most commonly affected organ systems in patients who suffer from IBD. The scientific literature suggests that a disturbance of the equilibrium between host defense and tolerance, and the subsequent over-activity of certain immune pathways are responsible for the cutaneous disorders seen so frequently in IBD patients. The purpose of this review article is to give an overview of the types of skin diseases that are typically seen with IBD and their respective pathogenesis, proposed mechanisms, and treatments. These cutaneous disorders can manifest as metastatic lesions, reactive processes to the intestinal inflammation, complications of IBD itself, or side effects from IBD treatments; these can be associated with IBD via genetic linkage, common autoimmune processes, or other mechanisms that will be discussed in this article. Ultimately, it is important for healthcare providers to understand that skin manifestations should always be checked and evaluated for in patients with IBD. Furthermore, skin disorders can predate gastrointestinal symptoms and thus may serve as important clinical indicators leading physicians to earlier diagnosis of IBD. PMID:22347192

Huang, Brian L.; Chandra, Stephanie; Shih, David Quan

2012-01-01

75

Manifestly covariant Jüttner distribution and equipartition theorem.  

PubMed

The relativistic equilibrium velocity distribution plays a key role in describing several high-energy and astrophysical effects. Recently, computer simulations favored Jüttner's as the relativistic generalization of Maxwell's distribution for d=1,2,3 spatial dimensions and pointed to an invariant temperature. In this work, we argue an invariant temperature naturally follows from manifest covariance. We present a derivation of the manifestly covariant Jüttner's distribution and equipartition theorem. The standard procedure to get the equilibrium distribution as a solution of the relativistic Boltzmann's equation, which holds for dilute gases, is here adopted. However, contrary to previous analysis, we use Cartesian coordinates in d+1 momentum space, with d spatial components. The use of the multiplication theorem of Bessel functions turns crucial to regain the known invariant form of Jüttner's distribution. Since equilibrium kinetic-theory results should agree with thermodynamics in the comoving frame to the gas the covariant pseudonorm of a vector entering the distribution can be identified with the reciprocal of temperature in such comoving frame. Then by combining the covariant statistical moments of Jüttner's distribution a form of the equipartition theorem is advanced which also accommodates the invariant comoving temperature and it contains, as a particular case, a previous not manifestly covariant form. PMID:20365549

Chacón-Acosta, Guillermo; Dagdug, Leonardo; Morales-Técotl, Hugo A

2010-02-01

76

[Chronic polyarthritis as isolated manifestation of toxocariasis.  

PubMed

Human toxocariasis is a parasitic zoonosis mainly caused by Toxocara canis or T. cati and is acquired by ingestion of the parasite's embryonated eggs. Arthralgia and/or arthritis were reported in up to 17% of cases, generally with acute duration (less than 6 weeks). However, to our knowledge, chronic polyarthritis, as the isolated presentation of Toxocara infection, was not reported. One of 5,809 patients that was followed up at our service (0.017%) had chronic polyarthritis as the single manifestation of toxocariasis and was described herein. A 3-year-old girl was referred to our service with severe painful chronic polyarthritis for a period longer than 10 weeks and morning stiffness of 30minutes. Dog contact exposure history in the recreational areas of neighborhood was reported. Her exams showed high levels of eosinophils in peripheral blood (29%), bone marrow aspirate revealed marked eosinophilia (32%) and Toxocara enzyme-linked immunosorbent assay (Elisa) was positive (1:1,280). She was treated with paracetamol (40 mg/kg/day) and thiabendazole (25 mg/kg/day) for 10 days, and all manifestations reduced. After eight months of follow-up, she was on clinical and laboratorial remission. In conclusion, we described a case of chronic polyarthritis, as isolated manifestation of toxocariasis, mimicking juvenile idiopathic arthritis and leukemia. Importantly, this zoonosis should be considered in patients with arthritis and eosinophilia. PMID:25435169

Viola, Gabriela R; Giacomin, Maria Fernanda A; França, Camila M P; Sallum, Adriana M E; Jacob, Cristina M A; Silva, Clovis A

2014-10-16

77

Extraintestinal manifestations of Edwardsiella tarda infection.  

PubMed

Summary Edwardsiella tarda, a member of the family Enterobacteriaceae, is a rare human pathogen. Gastroenteritis is the most frequently reported manifestation of E. tarda infection. In contrast, extraintestinal infection with E. tarda has rarely been reported. This study made a retrospective case and microbiological data review of patients with extraintestinal E. tarda infections to further understand this disease. This study retrospectively reviewed the charts of all isolates of E. tarda cultures from clinical specimens other than faeces at Chang Gung Memorial Hospital, Taoyuan, Taiwan from October 1998 through December 2001. Edwardsiella tarda was isolated from 22 clinical specimens from 22 hospitalised patients (13 females and nine males). The extraintestinal manifestations of E. tarda infection included biliary tract infection, bacteraemia, skin and soft tissue infection, liver abscess, peritonitis, intra-abdominal abscess, and tubo-ovarian abscess. The major underlying diseases predisposing to E. tarda extraintestinal infection were hepatobiliary diseases, malignancy and diabetes mellitus. The overall mortality rate of E. tarda extraintestinal infection in the present series was 22.7% (5/22), and four (40%) of 10 patients with bacteraemia expired. Although rare, human E. tarda extraintestinal infections can have diverse clinical manifestations and moreover may cause severe and life-threatening infections. Consequently, E. tarda should be considered a potentially important pathogen. PMID:16033613

Wang, I-K; Kuo, H-L; Chen, Y-M; Lin, C-L; Chang, H-Y; Chuang, F-R; Lee, M-H

2005-08-01

78

76 FR 36480 - Hazardous Waste Manifest Printing Specifications Correction Rule  

Federal Register 2010, 2011, 2012, 2013

...FRL-9321-7] Hazardous Waste Manifest Printing Specifications Correction Rule AGENCY...action proposes to amend the current printing specification regulation to indicate...the Federal hazardous waste manifest printing specifications. DATES: Written...

2011-06-22

79

49 CFR 172.205 - Hazardous waste manifest.  

...2014-10-01 2014-10-01 false Hazardous waste manifest. 172.205 Section...Shipping Papers § 172.205 Hazardous waste manifest. (a) No person...transport, transfer, or deliver a hazardous waste (waste) unless an EPA...

2014-10-01

80

49 CFR 172.205 - Hazardous waste manifest.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false Hazardous waste manifest. 172.205 Section...Shipping Papers § 172.205 Hazardous waste manifest. (a) No person...transport, transfer, or deliver a hazardous waste (waste) unless an EPA...

2012-10-01

81

49 CFR 172.205 - Hazardous waste manifest.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Hazardous waste manifest. 172.205 Section...Shipping Papers § 172.205 Hazardous waste manifest. (a) No person...transport, transfer, or deliver a hazardous waste (waste) unless an EPA...

2010-10-01

82

49 CFR 172.205 - Hazardous waste manifest.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Hazardous waste manifest. 172.205 Section...Shipping Papers § 172.205 Hazardous waste manifest. (a) No person...transport, transfer, or deliver a hazardous waste (waste) unless an EPA...

2013-10-01

83

49 CFR 172.205 - Hazardous waste manifest.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 2011-10-01 false Hazardous waste manifest. 172.205 Section...Shipping Papers § 172.205 Hazardous waste manifest. (a) No person...transport, transfer, or deliver a hazardous waste (waste) unless an EPA...

2011-10-01

84

77 FR 54863 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations  

Federal Register 2010, 2011, 2012, 2013

...sections of the Polychlorinated Biphenyl (PCB) regulations associated with the manifesting...Federal Regulations (CFR) part 761 of the PCB regulations. In the ``Rules and Regulations...the existing regulations for manifesting PCB wastes to match the existing Uniform...

2012-09-06

85

10 CFR 20.2006 - Transfer for disposal and manifests.  

Code of Federal Regulations, 2010 CFR

...false Transfer for disposal and manifests. 20.2006 Section 20.2006 Energy NUCLEAR REGULATORY COMMISSION STANDARDS...PROTECTION AGAINST RADIATION Waste Disposal § 20.2006 Transfer for disposal and manifests. (a)...

2010-01-01

86

Manifestation of optical activity in different materials  

NASA Astrophysics Data System (ADS)

Various manifestations of optical activity (OA) in crystals and organic materials are considered. Examples of optically active enantiomorphic and nonenantiomorphic crystals of 18 symmetry classes are presented. The OA of enantiomorphic organic materials as components of living nature (amino acids, sugars, and proteins) is analyzed. Questions related to the origin of life on earth are considered. Examples of differences in the enantiomers of drugs are shown. The consequences of replacing conventional left-handed amino acids with additionally right-handed amino acids for living organisms are indicated.

Konstantinova, A. F.; Golovina, T. G.; Konstantinov, K. K.

2014-07-01

87

[Fournier gangrene (manifestation of anogenital necrotizing fasciitis)].  

PubMed

In connection with a typical case, clinical features of genitaly extended Fournier gangrene--its pathogenic factors and the standpoints of treatment--are demonstrated. This infection of foudroyant nature, going on with significant mortality is held to be a characteristic form of necrotizing fasciitis, constituting main manifestation of toxic shock-like syndrome. Attention is drawn to the fact, that in case of internal diseases, predisposing factors respectively-even by adequate therapy-outcome of the infection may be lethal nowadays as well. PMID:8992439

Török, L; Ficsor, E

1996-10-27

88

Oral Manifestations and Complications of Diabetes Mellitus  

PubMed Central

Diabetes mellitus is a chronic disease affecting all age groups. It is one of the leading causes of mortality and morbidity worldwide. Many chronic macrovascular and microvascular complications of diabetes have been reported in the literature with few reports about oral complications. This article aims to review and increase the awareness of oral manifestations and complications of diabetes mellitus and to stimulate research on the subject. It treats in depth some of the complications such as periodontal disease, fungal infection and salivary dysfunction while other complications are mentioned briefly. PMID:21969888

Al-Maskari, Awatif Y.; Al-Maskari, Masoud Y.; Al-Sudairy, Salem

2011-01-01

89

Paraneoplastic dermatological manifestation of gastrointestinal malignancies  

PubMed Central

Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI) tract. Such cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic carcinomas. The recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy, timely administration of therapy, and ultimately, better prognosis. In this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers. PMID:19764087

Dourmishev, Lyubomir A; Draganov, Peter V

2009-01-01

90

Dermatologic manifestations of diabetes mellitus: a review.  

PubMed

Diabetes mellitus affects every organ of the body including the skin. Certain skin manifestations of diabetes are considered cutaneous markers of the disease, whereas others are nonspecific conditions that occur more frequently among individuals with diabetes compared with the general population. Diabetic patients have an increased susceptibility to some bacterial and fungal skin infections, which account, in part, for poor healing. Skin complications of diabetes provide clues to current and past metabolic status. Recognition of cutaneous markers may slow disease progression and ultimately improve the overall prognosis by enabling earlier diagnosis and treatment. PMID:24286954

Murphy-Chutorian, Blair; Han, George; Cohen, Steven R

2013-12-01

91

Neuromyelitis optica: clinical manifestations and neuroimaging features.  

PubMed

Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system with distinguishing features from multiple sclerosis. Understanding of clinical presentation, immunopathology, and imaging features has changed during the last decade. The identification of NMO immunoglobulin G and aquaporin 4 as the target antigen in this disease helped to define the NMO spectrum of disorders and showed that NMO is an autoimmune channelopathy of the central nervous system. Several types of brain involvement have been described in patients with NMO. This article discusses the epidemiology, clinical manifestations, and immunopathogenesis of the disease with an emphasis on neuroimaging. PMID:23186898

Sahraian, Mohammad Ali; Radue, Ernst-Wilhelm; Minagar, Alireza

2013-02-01

92

Cutaneous manifestations of category A bioweapons.  

PubMed

The 2001 anthrax attacks on the United States brought bioterrorism to the forefront of the medical community. Because many bioterrorist agents produce cutaneous disease, dermatologists will likely be first responders during a future attack. Despite this, many dermatologists are not adequately prepared to deal with a bioterrorism attack. It is critical that all first responders be able to recognize symptoms of bioterrorism-related disease and prepared to respond to a bioterrorist attack to minimize threats to public health. This article reviews the diagnosis and treatment of diseases caused by potential biowarfare agents that produce cutaneous manifestations, and also provides information regarding reporting and containment of possible bioterrorism-related diseases. PMID:21777993

Aquino, Lisa L; Wu, Jashin J

2011-12-01

93

Osteo-articular manifestations of amyloidosis.  

PubMed

Whether it is overload disease or mispleated proteins, amyloid is a great pretender. This is especially true for all of the osteo-articular manifestations of amyloid light chain (AL) amyloidosis, which may mimic rheumatoid arthritis, polymyalgia rheumatica, a myeloma or a bone tumour. To improve the prognosis, AL amyloidosis must be considered in front of atypical osteo-articular manifestations. Amyloidosis Ab2M of chronic haemodialysis (members' arthropathy and destructive spondylitis) is a specific entity that needs to be differentiated from other osteoarthropathies of chronic renal failure. It has become exceptional since the progress of haemodialysis. Finally transthyretin amyloidosis(ATTR) can be responsible for carpal tunnel syndrome(CTS) in its genetic and senile form. Although amyloidosis is rare, it represents one of the aetiologies of CSC, regardless of its type. In the specific context of haemodialysis, this poses no difficulty for the clinician. Yet AL amyloidosis must be considered more often, as must senile amyloidosis ATTR in the elderly. It seems obvious that the anatomo-pathologic analysis with specific staining with Congo red - see typing - should be systematically performed in the case of surgical neurolysis. Amyloidosis is defined by the extracellular deposit of proteins which share common tinctorial affinities, a fibril aspect under electron microscopy and spatial conformation called beta pleated. Once regarded as a mere overload disease, it is currently considered as a disease of misfolded proteins. Indeed, it is certain that abnormalities of spatial pattern play an essential role in the responsibility for the pathology of many proteins whose amyloid fibre is the final common way. They involve both changes in the conformation of proteins and other major in vivo interactions between amyloid protein and the extracellular matrix. In most cases, amyloidosis represents the bulk of histopathological lesions and its pathogenic role is certain. In other cases, it is only one elementary lesion of the disease and its role is controversial. The amyloidosis responsible for osteo-articular manifestations are the AL immunoglobulin amyloidosis, the beta2-microglobulin amyloidosis in patients under haemodialysis and finally the amyloidosis of transthyretin (genetic and senile). Rheumatological manifestations of immunoglobulin amyloidosis are numerous and often indicative of the disease. Deposits affect joint and periarticular structures. The most common presentation is a progressively developing bilateral symmetric polyarthritis with negative immunology and absent specific structural abnormalities. Carpal tunnel syndrome (CTS) is very common and should suggest the aetiology. Other clinical representations are rarer as an isolated bone tumour (amyloidoma) or integrating systemic AL amyloidosis. ? 2-Microglobulin amyloidosis occurs in patients under chronic haemodialysis. It is responsible for CTS, arthralgia and above all a specific destructive spondyloarthropathy. The transthyretin amyloidosis also causes CTS. PMID:23040361

M'bappé, Pauline; Grateau, Gilles

2012-08-01

94

19 CFR 123.22 - In-transit manifest.  

...2014-04-01 2014-04-01 false In-transit manifest. 123.22 Section 123.22...RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required....

2014-04-01

95

19 CFR 123.22 - In-transit manifest.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false In-transit manifest. 123.22 Section 123.22...RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required....

2013-04-01

96

19 CFR 123.22 - In-transit manifest.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false In-transit manifest. 123.22 Section 123.22...RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required....

2010-04-01

97

19 CFR 123.22 - In-transit manifest.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false In-transit manifest. 123.22 Section 123.22...RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required....

2011-04-01

98

19 CFR 123.22 - In-transit manifest.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false In-transit manifest. 123.22 Section 123.22...RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required....

2012-04-01

99

Cutaneous manifestations of gastrointestinal disease: part I.  

PubMed

Cutaneous findings are not uncommonly a concomitant finding in patients afflicted with gastrointestinal (GI) diseases. The dermatologic manifestations may precede clinically evident GI disease. Part I of this 2-part CME review focuses on dermatologic findings as they relate to hereditary and nonhereditary polyposis disorders and paraneoplastic disorders. A number of hereditary GI disorders have an increased risk of colorectal carcinomas. These disorders include familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Each disease has its own cutaneous signature that aids dermatologists in the early diagnosis and detection of hereditary GI malignancy. These disease processes are associated with particular gene mutations that can be used in screening and to guide additional genetic counseling. In addition, there is a group of hamartomatous syndromes, some of which are associated with phosphatase and tensin homolog (PTEN) gene mutations, which present with concurrent skin findings. These include Cowden syndrome, Bannayan-Riley-Ruvalcaba syndrome, and Cronkhite-Canada syndrome. Finally, paraneoplastic disorders are another subcategory of GI diseases associated with cutaneous manifestations, including malignant acanthosis nigricans, Leser-Trélat sign, tylosis, Plummer-Vinson syndrome, necrolytic migratory erythema, perianal extramammary Paget disease, carcinoid syndrome, paraneoplastic dermatomyositis, and paraneoplastic pemphigus. Each of these disease processes have been shown to be associated with an increased risk of GI malignancy. This underscores the important role of dermatologists in the diagnosis, detection, monitoring, and treatment of these disorders while consulting and interacting with their GI colleagues. PMID:23317980

Shah, Kejal R; Boland, C Richard; Patel, Mahir; Thrash, Breck; Menter, Alan

2013-02-01

100

Pulmonary manifestations of gastroesophageal reflux disease  

PubMed Central

Gastroesophageal reflux disease (GERD) may cause, trigger or exacerbate many pulmonary diseases. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients may present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, nose and throat disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/ pneumonia. This clinical review examines the potential pathophysiological mechanisms of pulmonary manifestations of GERD. It also reviews relevant clinical information concerning GERD-related chronic cough and asthma. Finally, a potential management strategy for GERD in pulmonary patients is discussed. PMID:19641641

Gaude, Gajanan S.

2009-01-01

101

Otolaryngologic manifestations of diffuse idiopathic skeletal hyperostosis.  

PubMed

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by formation of large cervical osteophytes that may compress the posterior wall of the aerodigestive tract. It is a rare cause of dysphagia in the elderly. The aim of this study was to investigate the various otolaryngologic manifestations of DISH. Eleven elderly patients with DISH were included in the study. All patients presented with dysphagia that was graded on the swallowing screening tool (EAT-10), and the diagnosis of DISH was based on computed tomographic criteria. The patients were subjected to otolaryngologic examination and flexible laryngoscopy. Polysomnography was used for patients with excessive daytime sleepiness for detection of obstructive sleep apnea (OSA). In addition to dysphagia of varying severity, OSA was found in nine patients, change of voice in six, globus sensation in seven, aspiration in three, and cervical pain in seven. Flexible laryngoscopy showed bulging of the posterior pharyngeal wall in all patients. DISH may be an unrecognized contributory factor to both dysphagia and OSA in the elderly. Change of voice, aspiration, globus sensation, and cervical pain are other otolaryngologic manifestations that may be encountered symptoms of the disease. An otolaryngologist should be aware of the disease that may be overlooked, and computed tomography is a confirmatory diagnostic method. PMID:24264765

Abdel-Aziz, Mosaad; Azab, Noha A; Rashed, Mohammed; Talaat, Ahmed

2014-06-01

102

Rheumatic manifestations of parvovirus B19 infection.  

PubMed

Human parvovirus B19 is an emerging DNA virus. B19 infection is common and widespread. Major manifestations of B19 infection are transient aplastic crisis, erythema infectiosum, hydrops fetalis, acute and chronic rheumatoid-like arthropathy, and, in the immunocompromised host, chronic or recurrent bone marrow suppression. A number of less common manifestations of B19 infection include various rash illnesses, neuropathies, and acute fulminant liver failure. Of rheumatologic interest, B19 infection must be differentiated from early presentation of more classic erosive rheumatoid arthritis and, in some cases, systemic lupus erythematosus. It is unlikely that B19 plays a role in classic erosive rheumatoid arthritis, but understanding pathogenesis of B19 arthropathy may provide insights into the mechanisms by which rheumatoid arthritis develops. Evidence for persistence of B19 infection suggests that human parvovirus B19 infection may serve as a model for the study of virus-host interactions and the role of viruses in the pathogenesis of rheumatic diseases. PMID:9606764

Naides, S J

1998-05-01

103

Neurologic manifestations of chronic methamphetamine abuse  

PubMed Central

Summary Chronic methamphetamine abuse has devastating effects on the central nervous system. The degree to which addicts will tolerate the dysfunction in the way they think, feel, move, and even look, is a powerful testimony to the addictive properties of this drug. While the mechanisms behind these disorders are complex, at their heart they involve the recurring increase in the concentrations of central monoamines with subsequent dysfunction in dopaminergic neurotransmission. The mainstay of treatment for the problems associated with chronic methamphetamine abuse is abstinence. However, by recognizing the manifestations of chronic abuse, clinicians will be better able to help their patients get treatment for their addiction and to deal with the neurologic complications related to chronic abuse. PMID:21803215

Rusyniak, Daniel E.

2011-01-01

104

Epidemiology and clinical manifestations of mucormycosis.  

PubMed

Mucormycosis is an emerging angioinvasive infection caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. Mucormycosis has emerged as the third most common invasive mycosis in order of importance after candidiasis and aspergillosis in patients with hematological and allogeneic stem cell transplantation. Mucormycosis also remains a threat in patients with diabetes mellitus in the Western world. Furthermore, this disease is increasingly recognized in recently developed countries, such as India, mainly in patients with uncontrolled diabetes or trauma. Epidemiological data on this type of mycosis are scant. Therefore, our ability to determine the burden of disease is limited. Based on anatomic localization, mucormycosis can be classified as one of 6 forms: (1) rhinocerebral, (2) pulmonary, (3) cutaneous, (4) gastrointestinal, (5) disseminated, and (6) uncommon presentations. The underlying conditions can influence clinical presentation and outcome. This review describes the emerging epidemiology and the clinical manifestations of mucormycosis. PMID:22247442

Petrikkos, George; Skiada, Anna; Lortholary, Olivier; Roilides, Emmanuel; Walsh, Thomas J; Kontoyiannis, Dimitrios P

2012-02-01

105

Neurologic manifestations of gastrointestinal and liver diseases.  

PubMed

Hepatic and gastrointestinal disorders can produce a wide spectrum of neurologic complications both affecting the central nervous system (CNS) and the peripheral nervous system. These manifestations range in severity from coma in acute liver failure and acute pancreatitis, to minor cognitive changes in chronic portosystemic encephalopathy and hepatitis C. Cerebrovascular diseases can complicate hepatitis C infection and inflammatory bowel disease. Demyelinating disorders may co-exist with inflammatory bowel disease. Anti-tumor necrosis factor alpha drugs may induce demyelination. Ataxia may occur in malabsorption syndromes and in gluten related disorders. Characteristic movement disorders are key features of acquired hepatocerebral degeneration and of Whipple disease. Multiple types of neuropathy can be found in association with hepatitis, inflammatory bowel disease and gluten related disorders. PMID:25171900

Ferro, José M; Oliveira, Sofia

2014-10-01

106

[Radiological manifestations of Baastrup's disease in children].  

PubMed

Baastrup's disease is not usually considered among the possible causes of low back pain in children. Classically, Baastrup's disease is characterized by degenerative phenomena secondary to friction between adjacent spinous processes, with sclerosis of the margins and decrease in the interspinous space. Baastrup's disease becomes more prevalent with age and is usually accompanied by degenerative changes in the vertebral column, such as lumbar facet hypertrophy or disc disease. Certain activities like dance or gymnastics can make Baastrup's disease more likely to appear at an earlier age. In children, Baastrup's disease can manifest in a different way, with increased interspinous spaces and bone remodeling. In this article, we present the cases of two patients with low back pain who were diagnosed with Baastrup's disease. PMID:21958726

Arias Fernández, J; Broncano Cabrero, J; Bondía Gracia, J M; Aquerreta Beola, J D

2013-09-01

107

Neurologic manifestations of pediatric chikungunya infection.  

PubMed

Chikungunya virus, a mosquito-borne arbovirus, was responsible for a massive epidemic in La Réunion Island during 2005 to 2006. The disease is usually benign, but neurologic involvement, with sometimes fatal outcome, has been described. We report a retrospective hospital-based pediatric series of 30 children (23 boys and 7 girls) who presented neurologic manifestations of chikungunya such as encephalitis (n = 12), febrile seizures (n = 10), meningeal syndrome (n = 4), and acute encephalopathy (n = 4). Cerebrospinal fluid biological and cytological analyses (n = 23) were unremarkable except for 1 case of acute disseminated encephalomyelitis. The presence of viral genome in cerebrospinal fluid was inconstantly positive. Brain magnetic resonance imaging (MRI) scans (n = 14) were abnormal in 5 cases. Electroencephalography was nonspecific. Two patients died. At discharge and 6 months later, 5 children had neurologic sequelae. Patients with initial severe neurologic presentation and having pathological brain MRI had more sequelae or fatal disease. PMID:18287573

Robin, Stéphanie; Ramful, Duksha; Le Seach', Florence; Jaffar-Bandjee, Marie-Christine; Rigou, Gérald; Alessandri, Jean-Luc

2008-09-01

108

Ocular manifestations after upper dorsal sympathectomy.  

PubMed

Fifty patients underwent ophthalmologic examination before and after bilateral upper dorsal sympathectomy performed for palmar hyperhidrosis. Postoperative examination was done during the first week, at 3 to 4 weeks and at 6 to 12 months after the operation. Immediately after surgery there were 18 patients with ptosis (6 severe) and 23 with miosis (12 severe). There were 19 patients with excessive lacrimation and some degree of congestion of conjunctival blood vessels was present in almost all patients. Uniocular decrease in tears was present in 2 patients. Most of these manifestations decreased with passage of time. At one year there remained only 3 patients with severe ptosis and 4 with severe miosis. The results suggest that the classical anatomic explanation of Horner's syndrome may require some modification. PMID:485002

Romano, A; Kurchin, A; Rudich, R; Adar, R

1979-07-01

109

Cutaneous manifestations of disease in athletes.  

PubMed

Various means of skin injury in athletes are examined, supplementing those discussed in Cutaneous Manifestations of Disease Part 1 (November/ December). Skin injury due to mechanical means such as corns, calluses, talon noir (calcaneal petechiae), tennis toe, joggers nipples, and piezogenic pedal papules will be discussed followed by a thorough discussion of environmental means of skin injury. There are a variety of ways that the environment may affect athletes both during competition and years after the competition is finished. The discussion will conclude with a look at performance-enhancing drugs and their effect on an athletes skin, and how the practitioner can better appreciate and perhaps prevent the long-term sequelae of drug abuse. PMID:14673322

Bender, Thomas W

2003-01-01

110

Brucella arteritis: clinical manifestations, treatment, and prognosis.  

PubMed

Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp, and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thromboses. We report a case of brucellosis presenting as bacteraemia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampicin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen. PMID:24480149

Herrick, Jesica A; Lederman, Robert J; Sullivan, Brigit; Powers, John H; Palmore, Tara N

2014-06-01

111

Ocular manifestations in porphyria cutanea tarda.  

PubMed

A 24-year-old man presented with pain, sticky discharge and loss of vision in the right eye. He has had typical skin manifestations of porphyria cutanea tarda (PCT) since 6 years and ophthalmological symptom for 6 weeks. On ophthalmological examination, visual acuity was light perception in the right eye and 6/12 in the left. There were bilateral, symmetrical temporal scleromalacia along with temporal corneal melting in both eyes and perforation in the right eye. Ultrasonography B-scan (USG B-scan) revealed a retinal detachment in the right eye. Artificial tear instillation was started every hour along with topical antibiotic coverage in both eyes. Additionally, ultraviolet protective sunglasses and hat for photo-protection was advised. The vision in the right eye improved to 5/60 along with subsidence of retinal detachment on repeat USG B-scan after 3 weeks. PMID:24811555

Gogri, Pratik Yeshwant; Misra, Neeta Somen; Misra, Somen

2014-01-01

112

Coronary artery manifestations of fibromuscular dysplasia.  

PubMed

Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic "string of beads" that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies. PMID:25190240

Michelis, Katherine C; Olin, Jeffrey W; Kadian-Dodov, Daniella; d'Escamard, Valentina; Kovacic, Jason C

2014-09-01

113

Ophthalmic manifestations of inherited neurodegenerative disorders.  

PubMed

Ophthalmic findings are common features of neurodegenerative disorders and, in addition to being clinically important, have emerged as potentially useful biomarkers of disease progression in several conditions. Clinically, these visual system abnormalities can be a clue to diagnosis, as well as being a prominent cause of disability in affected patients. In this Review, we describe the various afferent visual system and other ophthalmic features of inherited neurodegenerative disorders, including the muscular dystrophies, Friedreich ataxia, the spinocerebellar ataxias, hereditary spastic paraplegia, Charcot-Marie-Tooth disease, and other conditions. We focus on the expanding role of optical coherence tomography in diagnostic imaging of the retina and optic nerve head, and the possible use of ophthalmic findings as biomarkers of disease severity in hereditary neurodegenerative disorders. In addition, we discuss the ophthalmic manifestations and treatment implications of mitochondrial dysfunction, which is a feature of many inherited neurodegenerative diseases. PMID:24840976

Kersten, Hannah M; Roxburgh, Richard H; Danesh-Meyer, Helen V

2014-06-01

114

Neuromuscular and Central Nervous System Manifestations of Clostridium perfringens Infections  

Microsoft Academic Search

Infections with Clostridium perfringens usually manifest locally or spread to sepsis with multiorgan involvement, hemolysis or septic shock. Central nervous system\\u000a (CNS) manifestations are rare and most frequently comprise meningitis with or without pneumencephalon, encephalitis, plexitis,\\u000a cerebral abscess, or subdural empyema. The course of CNS affections is usually foudroyant and the outcome fatal. Neuromuscular\\u000a manifestations of C. perfringens infections are

J. Finsterer; B. Hess

2007-01-01

115

Neurologic Manifestations of Chronic Methamphetamine Abuse  

PubMed Central

COMMENTARY ON METHAMPHETAMINE ABUSE FOR PSYCHIATRIC PRACTICE Every decade seems to have its own unique drug problem. The 1970s had hallucinogens, the 1980s had crack cocaine, the 1990s had designer drugs, the 2000s had methamphetamine (Meth), and in the 2010s we are dealing with the scourge of prescription drug abuse. While each of these drug epidemics has distinctive problems and history, the one with perhaps the greatest impact on the practice of Psychiatry is Meth. By increasing the extracellular concentrations of dopamine while slowly damaging the dopaminergic neurotransmission, Meth is a powerfully addictive drug whose chronic use preferentially causes psychiatric complications. Chronic Meth users have deficits in memory and executive functioning as well as higher rates of anxiety, depression, and most notably psychosis. It is because of addiction and chronic psychosis from Meth abuse that the Meth user is most likely to come to the attention of the practicing Psychiatrist/Psychologist. Understanding the chronic neurologic manifestations of Meth abuse will better arm practitioners with the diagnostic and therapeutic tools needed to make the Meth epidemic one of historical interest only. PMID:23688691

Rusyniak, Daniel E.

2013-01-01

116

Neuro-ophthalmic manifestations of prematurity  

PubMed Central

Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children. PMID:25449932

Chhablani, Preeti Patil; Kekunnaya, Ramesh

2014-01-01

117

Unusual manifestations of a common gastrointestinal disorder.  

PubMed

We present an instructive case of a 13-year old male who presented with bilateral scrotal redness, swelling and tenderness, but with a normal testicular exam. His scrotal swelling persisted despite treatment with intravenous antibiotics, and on further history he reported 2 years of intermittent upper lip swelling. After a referral to a dermatologist, a lip biopsy showed granulomatous changes and he was referred to the gastroenterology department. A gastroscopy and colonoscopy was performed and histology confirmed non-caseating granulomas consistent with Crohn's disease (CD). Eighteen months after the diagnosis of CD he developed perianal disease with a fistula and distal anal stricture. He was successfully treated with insertion of a seton and escalation of therapy to azathioprine and infliximab. CD is a phenotypically diverse chronic inflammatory condition with an increasing incidence in Australia and other Western countries. Non-typical presentations, such as perianal manifestations or orofacial granulomatosis, can be the only presenting symptom in CD, and this highlights the importance for a high degree of clinical suspicion. Genital involvement is rare, but reported. PMID:23662656

Rajah, Karthik; Oliver, Mark R; McLeod, Liz; Orchard, David; Leal, Marcelo

2014-02-01

118

[Uncommon clinical manifestations of cutaneous leishmaniasis].  

PubMed

Cutaneous leishmaniasis is one of the most common dermatoses of the tropics. A major focus of this disease is the Syrian city of Aleppo, after which it was named in many textbooks ("Aleppo boil"). The first cases of cutaneous leishmaniasis were reported from Aleppo particularly more than 100 years ago. Syria is one of the most affected countries worldwide. This disease used to be well documented until the onset of the war in Syria in 2012, which is also supported by the numbers of the World Health Organisation (WHO), and Aleppo used to be the most affected Syrian city. Since 2012, the documentation of cutaneous leishmaniasis in Syria is no longer possible. An outbreak of cutaneous leishmaniasis has been detected especially in the besieged regions due to missing prevention measures against the sandflies and a lack of medical care. A short summary of the epidemiologic situation in Syria as well as outstanding and uncommon clinical manifestations of cutaneous leishmaniasis in Aleppo are presented. PMID:25115981

Hayani, K; Dandashli, A; Weisshaar, E

2014-10-01

119

Observational Manifestation of Chaos in Astrophysical Objects  

NASA Astrophysics Data System (ADS)

This book addresses a broad range of problems related to observed manifestations of chaotic motions in galactic and stellar objects, by invoking basic theory, numerical modeling, and observational evidence. For the first time, methods of stochastic dynamics are applied to actually observed astronomical objects, e.g. the gaseous disc of the spiral galaxy NGC 3631. In the latter case, the existence of chaotic trajectories in the boundary of giant vortices was recently found by the calculation of the Lyapunov characteristic number of these trajectories. The reader will find research results on the peculiarities of chaotic system behaviour; a study of the integrals of motion in self-consistent systems; numerical modeling results of the evolution process of disk systems involving resonance excitation of the density waves in spiral galaxies; a review of specific formations in stars and high-energy sources demonstrating their stochastic nature; a discussion of the peculiarities of the precessional motion of the accretion disk and relativistic jets in the double system SS 433; etc. This book stands out as the first one that deals with the problem of chaos in real astrophysical objects. It is intended for graduate and post-graduate students in the fields of non-linear dynamics, astrophysics, planetary and space physics; specifically for those dealing with computer modeling of the relevant processes. Link: http://www.wkap.nl/prod/b/1-4020-0935-6

Fridman, A.; Marov, M.; Miller, R.

2002-12-01

120

[Respiratory manifestations in hereditary angioneurotic edema].  

PubMed

Hereditary angioneurotic oedema is an autosomal dominant state associated with a quantitative, and sometimes purely functional, deficiency of C1 esterase inhibitor (C1 INH). The clinical manifestations may begin during adulthood or childhood; they are periodical and of varying severity. Beside oedema of the skin and digestive disorders, respiratory disorders are bound to attract attention. They consist of laryngeal oedema, which may end in lethal asphyxia if tracheotomy is not performed, or, exceptionally, of pulmonary oedema requiring assisted ventilation, as in the case reported here. The diagnosis, suspected in the presence of a decrease in CH50 and C4, is confirmed by a quantitative assay of C1 INH, which is low, and/or by the Fong and Good's functional tests. The physiopathological mechanisms are complex. They involve complement activation through the classical route, and activation of the coagulation system contact phase. Patients with severe attacks now benefit from treatment with preparations of C1 INH in high concentrations. The best treatment, however, is prophylactic, using testosterone derivatives, danazol and stanozolol, which can be prescribed for long periods taking into account their usually moderate side-effects. PMID:4081477

Legendre, M; Chiche, J F; Molina, C; Grouffal, C; Betail, G

1985-01-01

121

Oral manifestations of hepatitis C virus infection  

PubMed Central

Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV. PMID:24976694

Carrozzo, Marco; Scally, Kara

2014-01-01

122

Clinical manifestations of taeniasis in Taiwan aborigines.  

PubMed

From 1974 to 1989, a total of 24,500 aborigines at 67 villages in ten mountainous districts/towns in Taiwan were examined for the Taiwan Taenia infection and 12% were found to be infected. In order to define the clinical manifestations of taeniasis caused by the Taiwan Taenia, 1661 aborigines in ten mountainous districts were surveyed. The overall clinical rate was 76%. The clinical rate was highest among Atayal aborigines (81%), followed by Bunun (66%) and Yami (61%) aborgines and lowest among Ami aborigines (40%). Among 1153 infected people, 10% had passed gravid segments in the faeces for less than 1 year, 24% for 1-3 years, 17% for 4-5 years, 23% for 6-10 years, 16% for 11-20 years, 7% for 21-30 years, and 3% over 30 years. Twenty-six occurrences of gastrointestinal and neurological symptoms were reported by 1258 infected persons. Passing proglottides in the faeces (95%) was the most frequent sign, followed by pruritus ani (77%), nausea (46%), abdominal pain (45%), dizziness (42%), increased appetite (30%), headache (26%), etc. PMID:1640085

Fan, P C; Chung, W C; Lin, C Y; Chan, C H

1992-06-01

123

Neurological manifestations of dengue infection: a review.  

PubMed

Dengue is a common arboviral infection in tropical and sub-tropical areas of the world transmitted by Aedes mosquitoes and caused by infection with one of the 4 serotypes of dengue virus. Neurologic manifestations are increasingly recognised but the exact incidence is unknown. Dengue infection has a wide spectrum of neurological complications such as encephalitis, myositis, myelitis, Guillain-Barré syndrome (GBS) and mononeuropathies. Encephalopathy is the most common reported complication. In endemic regions, dengue infection should be considered as one of the aetiologies of encephalitis. Even for other neurological syndromes like myelitis, myositis, GBS etc., dengue infection should be kept in differential diagnosis and should be ruled out especially so in endemic countries during dengue outbreaks and in cases where the aetiology is uncertain. A high degree of suspicion in endemic areas can help in picking up more cases thereby helping in understanding the true extent of neurological complications in dengue fever. Also knowledge regarding the various neurological complications helps in looking for the warning signs and early diagnosis thereby improving patient outcome. PMID:25220113

Verma, Rajesh; Sahu, Ritesh; Holla, Vikram

2014-11-15

124

Hypersensitivity manifestations to the fruit mango.  

PubMed

The objectives of this study are 1) To review the published data and document the current knowledge on allergic manifestations to the fruit mango 2) To highlight the two distinct clinical presentations of hypersensitivity reactions caused by mango 3) To discuss the role of cross-reactivity 4) To increase awareness of potentially life threatening complications that can be caused by allergy to mango. An extensive search of the literature was performed in Medline/PubMed with the key terms "mango", "anaphylaxis", "contact dermatitis", "cross-reactivity", "food hypersensitivity", "oral allergy syndrome" and "urticaria". The bibliographies of all papers thus located were searched for further relevant articles. A total of 17 reports describing 22 patients were documented, including ten patients with immediate hypersensitivity reaction and twelve patients with delayed hypersensitivity reaction to mango. Ten of these patients (four with immediate reaction; six with delayed reaction) were from geographical areas cultivating mango, whereas twelve patients (six with immediate reaction; six with delayed reaction) were from the countries where large scale mango cultivation does not occur. The clinical features, pathogenesis and diagnostic modalities of both these presentations are highlighted. The fruit mango can cause immediate and delayed hypersensitivity reactions, as also "oral allergy syndrome". Although rare, it can even result in a life threatening event. Reactions may even occur in individuals without prior exposure to mango, owing to cross reactivity. It is imperative to recognize such a phenomenon early so as to avoid potentially severe clinical reactions in susceptible patients. PMID:22053296

Sareen, Richa; Shah, Ashok

2011-04-01

125

Neurotologic manifestations of the fibromyalgia syndrome.  

PubMed

The purpose was to assess otologic symptoms, and audiologic and vestibular findings in fibromyalgia (FM) syndrome. Twenty-four female patients with FM syndrome (FMS) were included in the study. The assessments were based on history, physical examination, audiometry, bithermal caloric testing and auditory brainstem response (ABR) testing. Dizziness was the most common complaint of the patients, and was followed by tinnitus, hearing loss and vertigo. Almost 50% of the patients had some sort of otologic symptoms.Dix-Halpike maneuver proved positional rotary vertigo in 5 (20.8%) patients. The audiometry results of 23 patients were normal. None of the patients had abnormal bithermal caloric testing. Although there were a variety of ABR abnormalities, the ABR results of the patients with and without cochleovestibular symptoms were not significantly different (p<0.05). In conclusion, FM patients can complain otologic symptoms even though they do not have any clinically or audiologically detectable ear disease. A neural disintegration or some other events related to neural mediators may be the mechanisms involved in the pathogenesis of otoneurologic as well as systemic manifestations of the disease that possibly leads to abnormal perception of the stimuli coming from internal or external environment. PMID:11959160

Bayazit, Yildirim A; Gürsoy, Sava?; Ozer, Enver; Karakurum, Günhan; Madenci, Ercan

2002-04-15

126

Neuro-ophthalmic manifestations of prematurity.  

PubMed

Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children. PMID:25449932

Chhablani, Preeti Patil; Kekunnaya, Ramesh

2014-10-01

127

Association of oral manifestations with ulcerative colitis  

PubMed Central

Aim The study aims to document the oral lesions in patients with UC. Background Inflammatory bowel disease (IBD) is comprised of two chronic, tissue-destructive and clinical entities including Crohn's disease (CD) and ulcerative colitis (UC), both of which are immunologically based. Patients and methods The population of the study includes fifty patients with UC, as the experimental group, and fifty patients without gastrointestinal disease as the control group. All patients had an oral examination and completed the relevant questionnaire. Results There was a significant statistical relationship among tongue coating (<0.0001), halitosis (<0.0001), and oral ulceration (0.001) in patients suffering from severe UC compared to the control group. Also there was a higher prevalence of oral manifestations in patients with moderate UC compared to that of control group; but taste change (0.001) was the only significant factor. Acidic taste and taste change were among the symptoms more commonly found in patients suffering from pancolitis (40% each). Conclusion The results of the present study show that patients with UC had more oral signs and symptoms than the patients in the normal group. Further researches on oral lesions in UC are also recommended so that these diseases can be better understood. PMID:24834217

Elahi, Maryam; Samadi, Vahid; Vakili, Hadi

2012-01-01

128

Neuromuscular Manifestations of West Nile Virus Infection  

PubMed Central

The most common neuromuscular manifestation of West Nile virus (WNV) infection is a poliomyelitis syndrome with asymmetric paralysis variably involving one (monoparesis) to four limbs (quadriparesis), with or without brainstem involvement and respiratory failure. This syndrome of acute flaccid paralysis may occur without overt fever or meningoencephalitis. Although involvement of anterior horn cells in the spinal cord and motor neurons in the brainstem are the major sites of pathology responsible for neuromuscular signs, inflammation also may involve skeletal or cardiac muscle (myositis, myocarditis), motor axons (polyradiculitis), and peripheral nerves [Guillain–Barré syndrome (GBS), brachial plexopathy]. In addition, involvement of spinal sympathetic neurons and ganglia provides an explanation for autonomic instability seen in some patients. Many patients also experience prolonged subjective generalized weakness and disabling fatigue. Despite recent evidence that WNV may persist long-term in the central nervous system or periphery in animals, the evidence in humans is controversial. WNV persistence would be of great concern in immunosuppressed patients or in those with prolonged or recurrent symptoms. Support for the contention that WNV can lead to autoimmune disease arises from reports of patients presenting with various neuromuscular diseases that presumably involve autoimmune mechanisms (GBS, other demyelinating neuropathies, myasthenia gravis, brachial plexopathies, stiff-person syndrome, and delayed or recurrent symptoms). Although there is no specific treatment or vaccine currently approved in humans, and the standard remains supportive care, drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful (high-dose corticosteroids, interferon preparations, and intravenous immune globulin containing WNV-specific antibodies). Human experience with these agents seems promising based on anecdotal reports. PMID:22461779

Leis, A. Arturo; Stokic, Dobrivoje S.

2012-01-01

129

19 CFR 123.3 - Inward foreign manifest required.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Inward foreign manifest required. 123.3 Section 123.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.3 Inward foreign manifest required. (a)...

2010-04-01

130

19 CFR 123.3 - Inward foreign manifest required.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Inward foreign manifest required. 123.3 Section 123.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.3 Inward foreign manifest required. (a)...

2011-04-01

131

A Review of the Latent and Manifest Benefits (LAMB) Scale  

ERIC Educational Resources Information Center

The latent and manifest benefits (LAMB) scale (Muller, Creed, Waters & Machin, 2005) was designed to measure the latent and manifest benefits of employment and provide a single scale to test Jahoda's (1981) and Fryer's (1986) theories of unemployment. Since its publication in 2005 there have been 13 studies that have used the scale with 5692…

Muller, Juanita; Waters, Lea

2012-01-01

132

Orofacial manifestations of hematological disorders: anemia and hemostatic disorders.  

PubMed

The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases, with particular reference to anemias and disorders of hemostasis. A computerized literature search using MEDLINE was conducted for published articles on orofacial manifestations of hematological diseases, with emphasis on anemia. Mesh phrases used in the search were: oral diseases AND anaemia; orofacial diseases AND anaemia; orofacial lesions AND anaemia; orofacial manifestations AND disorders of haemostasis. The Boolean operator "AND" was used to combine and narrow the searches. Anemic disorders associated with orofacial signs and symptoms include iron deficiency anemia, Plummer-Vinson syndrome, megaloblastic anemia, sickle cell anemia, thalassaemia and aplastic anemia. The manifestations include conjunctiva and facial pallor, atrophic glossitis, angular stomatitis, dysphagia, magenta tongue, midfacial overgrowth, osteoclerosis, osteomyelitis and paraesthesia/anesthesia of the mental nerve. Orofacial petechiae, conjunctivae hemorrhage, nose-bleeding, spontaneous and post-traumatic gingival hemorrhage and prolonged post-extraction bleeding are common orofacial manifestations of inherited hemostatic disorders such as von Willebrand's disease and hemophilia. A wide array of anemic and hemostatic disorders encountered in internal medicine has manifestations in the oral cavity and the facial region. Most of these manifestations are non-specific, but should alert the hematologist and the dental surgeon to the possibilities of a concurrent disease of hemopoiesis or hemostasis or a latent one that may subsequently manifest itself. PMID:22048588

Adeyemo, Titilope A; Adeyemo, Wasiu L; Adediran, Adewumi; Akinbami, Abd Jaleel A; Akanmu, Alani S

2011-01-01

133

Gastrointestinal Manifestations of Patients with Chronic Granulomatous Disease  

Microsoft Academic Search

Chronic Granulomatous Disease (CGD) represents a group of inherited disorders of phagocytic system, manifesting recurrent infections at different sites. The present study was accomplished in order to determine the gastrointestinal manifestations of CGD patients. Fifty-seven patients (38 males and 19 females) with CGD, who had been referred to three immunodeficiency referral centers in Iran, were studied during a 24-year period

Masoud Movahedi; Asghar Aghamohammadi; Nima Rezaei; Abolhasan Farhoudi; Mostafa Moin; Mohammad Gharagozlou; Davoud Mansouri; Saba Arshi; Lida Atarod; Bahram MirSaeid Ghazi; Nikrad Shahnavaz; Ali Babaei Jandaghi; Kamran Abolmaali; Maryam Mahmoudi; Nasrin Bazargan; Akefeh Ahmadi Afshar; Mohammad Nabavi

134

40 CFR 761.209 - Retention of manifest records.  

Code of Federal Regulations, 2010 CFR

...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...manifest records. (a) A generator of PCB waste shall keep a copy of each manifest...storage or disposal facility which received the PCB waste. The copy signed by the...

2010-07-01

135

Dermatologic manifestation of hyperandrogenism: a retrospective chart review.  

PubMed

Several studies have described a wide spectrum of hyperandrogenism diseases, many of which are difficult to distinguish from each other. In order to better understand diseases of hyperandrogenism, the authors performed a retrospective study of the cutaneous features and metabolic findings in women with hyperandrogenism. A retrospective chart analysis compiled by three dermatologists in both academic and private settings was performed, including patients presenting with > or = 2 manifestations of hyperandrogenism. Relevant dermatologic and associated manifestations and laboratory and imaging study findings were reviewed. Moderate to severe acne was the most common manifestation. Other common manifestations that patients first presented with include hirsutism, acanthosis nigricans, androgenic alopecia, and skin tags. Oligomenorrhea was the most common systemic presenting sign. Statistical analysis of various clinical markers revealed correlations with hyperandrogenemia. Acanthosis nigricans and hirsutism were found to be useful clinical markers for hyperandrogenism, whereas androgenic alopecia was not. This study provides some insights into the presentation and diverse manifestations seen in hyperandrogenism. PMID:24933845

Clark, Charlotte M; Rudolph, Jennifer; Gerber, Donald A; Glick, Sharon; Shalita, Alan R; Lowenstein, Eve J

2014-01-01

136

Diagnosis and treatment of HIV-associated manifestations in otolaryngology.  

PubMed

Almost 30 years after its first description, HIV still remains a global pandemic. The present paper aims to review the current knowledge on the ear, nose and throat (ENT) manifestations of HIV infection, and present the available diagnostic and treatment options. A literature review was conducted in Medline and other available database sources. Information from related books was also included in the data analysis. It is well acknowledged that up to 80% of HIV-infected patients eventually develop ENT manifestations; among which, oral disease appears to be the most common. Oro-pharyngeal manifestations include candidiasis, periodontal and gingival disease, HSV and HPV infection, oral hairy leucoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma. ENT manifestations in the neck can present as cervical lymphadenopathy or parotid gland enlargement. Respective nasal manifestations include sinusitis (often due to atypical bacteria), and allergic rhinitis. Finally, otological manifestations include otitis (externa, or media), inner ear involvement (sensorineural hearing loss, disequilibrium), and facial nerve palsy (up to 100 times more frequently compared to the general population). Although ENT symptoms are not diagnostic of the disease, they might be suggestive of HIV infection, or related to its progression and the respective treatment failure. ENT doctors should be aware of the ENT manifestations associated with HIV disease, and the respective diagnosis and treatment. A multi-disciplinary approach may be required to provide the appropriate level of care to HIV patients. PMID:24470939

Lacovou, Emily; Vlastarakos, Petros V; Papacharalampous, George; Kampessis, George; Nikolopoulos, Thomas P

2012-01-01

137

Clinical and Pathological Manifestations with Differential Diagnosis in Behçet's Disease  

PubMed Central

Behçet's disease is a multisystemic inflammatory disease of unknown etiology which usually occurs as a trait of symptoms: aphthous stomatitis, genital ulcerations, and ocular disease. At the beginning of the disease the diagnosis is uncertain because of various clinical manifestations and a long period up to the full clinical picture manifestation. Since neither the laboratory data nor the histopathological signs are truly pathognomonic in Behçet's disease, the differential diagnosis depends on a careful evaluation of the medical history and meticulous physical examination to detect concomitant systemic manifestations. Sometimes, some laboratory test may help establish the diagnosis. Subspecialty referral to ophthalmology, rheumatology, neurology, and gastroenterology should be considered when indicated. PMID:22191082

Kokturk, Aysin

2012-01-01

138

76 FR 36363 - Hazardous Waste Manifest Printing Specifications Correction Rule  

Federal Register 2010, 2011, 2012, 2013

...FRL-9321-8] Hazardous Waste Manifest Printing Specifications Correction Rule AGENCY...in accordance with EPA's Federal printing specifications. Specifically, this action amends the current printing specification regulation to...

2011-06-22

139

Neuropsychiatric manifestations of Fahr's disease pathogenesis and potential for treatment.  

PubMed

Fahr's disease (FD) is a rare neuropsychiatric disease consisting of bilateral basal ganglia calcification with neurological, cognitive, and psychiatric manifestations. We report here a sporadic case of FDs with its neuropsychology. PMID:25013318

Mushtaq, Raheel; Shoib, Sheikh; Raju, M S V K; Naphade, Nilesh; Shah, Tabindah; Pawar, Alka

2013-07-01

140

Neuropsychiatric manifestations of Fahr's disease pathogenesis and potential for treatment  

PubMed Central

Fahr's disease (FD) is a rare neuropsychiatric disease consisting of bilateral basal ganglia calcification with neurological, cognitive, and psychiatric manifestations. We report here a sporadic case of FDs with its neuropsychology. PMID:25013318

Mushtaq, Raheel; Shoib, Sheikh; Raju, M. S. V. K.; Naphade, Nilesh; Shah, Tabindah; Pawar, Alka

2013-01-01

141

Dust Acoustic Mode Manifestations in Earth's Dusty Ionosphere  

SciTech Connect

Dust acoustic mode manifestations in the dusty ionosphere are studied. The reason for an appearance of the low-frequency radio noises associated with such meteor fluxes as Perseids, Orionids, Leonids, and Gemenids is determined.

Kopnin, S.I.; Popel, S.I. [Institute for Dynamics of Geospheres RAS, Leninsky pr. 38, bld. 1, 119334 Moscow (Russian Federation)

2005-10-31

142

Matrix Methods for Optimal Manifesting of Multinode Space Exploration Systems  

E-print Network

This paper presents matrix-based methods for determining optimal cargo manifests for space exploration. An exploration system is defined as a sequence of in-space and on-surface transports between multiple nodes coupled ...

Grogan, Paul Thomas

143

Unstable angina as initial manifestation of Wegener granulomatosis: case report.  

PubMed

Wegener granulomatosis (WG) is a necrotizing vasculitis that usually affects the respiratory tract, in association with kidney disease. Cardiac involvement is rare and silent in most cases, only becoming evident in necropsy studies. The authors report the case of a patient with WG, whose unstable angina was the first clinical manifestation, although the patient had suffered a previous unrecognized myocardial infarction. In most cases cardiovascular disease is clinically silent, but there may be symptoms indicating involvement of the coronary arteries, pericardium, myocardium, endocardium, cardiac valves, conduction system or thoracic great vessels. In most cases cardiac manifestations appear late in the natural history of GW. In the case reported, cardiac symptoms appeared as the first manifestation of the disease, a situation which we were unable to find described in the literature. The authors review the literature on cardiac manifestations of WG, together with recommendations for diagnosis and follow-up of this disease. PMID:19227813

Marques, Nuno; Mimoso, Jorge; Bohorquez, Rafael; Lázaro, Mário; Brito, Helena; Pereira, Maria Augusta; Valente, Isabel; Mendonça, Idálio; Gomes, Veloso

2008-11-01

144

Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study.  

PubMed

Hypoparathyroidism is a disorder of calcium and phosphorus metabolism due to decreased secretion of parathyroid hormone. Hypoparathyroidism can be hereditary and acquired. Acquired hypoparathyroidism usually occurs following neck surgery (thyroid surgery or parathyroid surgery). Along with systemic manifestations, hypoparathyroidism produces some skin manifestations. Lack of study regarding mucocutaneous manifestations of acquired hypoparathyroidism prompted us to undertake this study. To evaluate the mucocutaneous manifestations of acquired hypoparathyroidism. An observational study done in a tertiary care hospital of Kolkata by comprehensive history taking, through clinical examination and relevant laboratory investigations. Twenty-one patients were included in the study. The commonest form of acquired hypoparathyroidism was neck surgery (thyroidectomy and parathyroidectomy operation). Mucocutaneous manifestations were present in 76.19% of patients. The most frequent mucocutaneous manifestation was found in the hairs like the loss of axillary hair (61.9%), loss of pubic hair (52.38%), coarsening of body hair (47.62%), and alopecia areata (9.52%). The nail changes noted were brittle and ridged nail, followed by onycholysis, onychosezia, and onychomedesis. The most common skin features were xerotic skin in 11 patients (52.38%), followed by pellagra-like skin pigmentation, pustular psoriasis and acne form eruption, bullous impetigo, etc. Mucosa was normal in all the cases excepting the one which showed oral candidiasis. PMID:23087872

Sarkar, Somenath; Mondal, Modhuchanda; Das, Kapildev; Shrimal, Arpit

2012-09-01

145

19 CFR 122.113 - Form for transit air cargo manifest procedures.  

...2014-04-01 2014-04-01 false Form for transit air cargo manifest procedures. 122...TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures....

2014-04-01

146

19 CFR 122.113 - Form for transit air cargo manifest procedures.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Form for transit air cargo manifest procedures. 122...TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures....

2012-04-01

147

19 CFR 122.113 - Form for transit air cargo manifest procedures.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Form for transit air cargo manifest procedures. 122...TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures....

2011-04-01

148

19 CFR 122.113 - Form for transit air cargo manifest procedures.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Form for transit air cargo manifest procedures. 122...TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures....

2010-04-01

149

19 CFR 122.113 - Form for transit air cargo manifest procedures.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Form for transit air cargo manifest procedures. 122...TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures....

2013-04-01

150

Ocular Manifestations of Acquired Immunodeficiency Syndrome in Korea  

PubMed Central

The clinical features of HIV/AIDS-related ocular manifestations in Korean patients were investigated in this study. Data on 200 consecutive Korean patients diagnosed with AIDS who visited the Seoul National University Hospital from January 2003 to June 2008 were reviewed. Fifty-seven patients (28.5%) had ocular manifestations, and they showed significantly lower CD4+ T cell count than patients without ocular manifestations. Among them, 23 (40.3%) patients showed retinal microvasculopathy, and 22 (38.5%) patients showed cytomegalovirus (CMV) retinitis. Other manifestations included retinal vein occlusion (n = 4), herpes zoster ophthalmicus (n = 4), syphilitic uveitis (n = 2), acute retinal necrosis (n = 1), and progressive outer retinal necrosis (n = 1). The mean CD4+ lymphocyte counts of the patients with retinal microvasculopathy and cytomegalovirus retinitis were 108.5 cells/µL and 69.4 cells/µL, respectively. In conclusion, ocular manifestations including CMV retinitis are common complications in Korean patients with AIDS even in the era of highly active anti-retroviral therapy. Compared to previous reports in western countries, prevalence of CMV retinitis is relatively low and CD4+ lymphocytes count at the time of diagnosis is relatively high. PMID:22563221

Kim, Sang Jin; Park, Sang Jun; Kim, Nam Joong; Jang, Hee-Chang; Oh, Myoung-don

2012-01-01

151

Gastrointestinal and Hepatic Manifestations of Primary Immune Deficiency Diseases  

PubMed Central

Primary immune deficiency diseases (PIDs) are a heterogeneous group of inherited diseases characterized by variable genetic immune defects, conferring susceptibility to recurrent infections. They have a vast array of manifestations some of which involve the gastrointestinal and hepatobiliary systems. These complications can be the consequence of five different factors, namely, infection, autoimmune process, unregulated inflammation, malignancies and complications of therapeutic intervention. They may precede the PID diagnosis and, once developed, they pose high risk of morbidity. Untrained clinicians may treat these manifestations only at the level of their presentation, leaving the PIDs dangerously undiagnosed. In fact, early diagnosis of PIDs and accompanied gastrointestinal and hepatic complications clearly require appropriate treatment, and in-turn lead to an improved quality of life for the patient. To improve the awareness of gastroenterologists and related health care providers about these diseases, we have reviewed herein the complications of different PIDs focusing on gastrointestinal and hepatic manifestation. PMID:20339173

Al-Muhsen, Saleh Z.

2010-01-01

152

Extraintestinal manifestations of Helicobacter pylori: A concise review  

PubMed Central

Helicobacter pylori (H. pylori) infection has been clearly linked to peptic ulcer disease and some gastrointestinal malignancies. Increasing evidence demonstrates possible associations to disease states in other organ systems, known as the extraintestinal manifestations of H. pylori. Different conditions associated with H. pylori infection include those from hematologic, cardiopulmonary, metabolic, neurologic, and dermatologic systems. The aim of this article is to provide a concise review of the evidence that supports or refutes the associations of H. pylori and its proposed extraintestinal manifestations. Based on data from the literature, PUD, mucosal associated lymphoid tumors lymphoma, and gastric adenocarcinoma has well-established links. Current evidence most supports extraintestinal manifestations with H. pylori in immune thrombocytopenic purpura, iron deficiency anemia, urticaria, Parkinson’s, migraines and rosacea; however, there is still plausible link with other diseases that requires further research. PMID:25232230

Wong, Frank; Rayner-Hartley, Erin; Byrne, Michael F

2014-01-01

153

Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations.  

PubMed

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis that can lead to decreased health-related quality of life and permanent joint damage leading to functional decline. In addition to joint and skin manifestations, both psoriasis and PsA are associated with numerous comorbidities and extraarticular/cutaneous manifestations, which may influence the physician's choice of therapy. The objectives of this review are (1) to identify comorbidities in patients with PsA based on the available evidence; (2) to examine the effects of these comorbidities or extraarticular/cutaneous manifestation on the management of patients with PsA as well as the selection of therapy; and (3) to highlight research needs around comorbidities and treatment paradigms. This review is part of a treatment recommendations update initiated by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). PMID:25362717

Ogdie, Alexis; Schwartzman, Sergio; Eder, Lihi; Maharaj, Ajesh B; Zisman, Devy; Raychaudhuri, Siba P; Reddy, Soumya M; Husni, Elaine

2014-11-01

154

Extraintestinal manifestations of Helicobacter pylori: a concise review.  

PubMed

Helicobacter pylori (H. pylori) infection has been clearly linked to peptic ulcer disease and some gastrointestinal malignancies. Increasing evidence demonstrates possible associations to disease states in other organ systems, known as the extraintestinal manifestations of H. pylori. Different conditions associated with H. pylori infection include those from hematologic, cardiopulmonary, metabolic, neurologic, and dermatologic systems. The aim of this article is to provide a concise review of the evidence that supports or refutes the associations of H. pylori and its proposed extraintestinal manifestations. Based on data from the literature, PUD, mucosal associated lymphoid tumors lymphoma, and gastric adenocarcinoma has well-established links. Current evidence most supports extraintestinal manifestations with H. pylori in immune thrombocytopenic purpura, iron deficiency anemia, urticaria, Parkinson's, migraines and rosacea; however, there is still plausible link with other diseases that requires further research. PMID:25232230

Wong, Frank; Rayner-Hartley, Erin; Byrne, Michael F

2014-09-14

155

Large cerebellar mass lesion: A rare intracranial manifestation of blastomycosis  

PubMed Central

Background: Blastomyces dermatitidis is a dimorphic fungus found endemically in the Mississippi and Ohio River basins and in the Midwestern and Canadian provinces that border the Great Lakes. Unlike other fungal infections, it most commonly affects immunocompetent hosts. Blastomycosis typically manifests as pulmonary infection, but may affect nearly any organ, including the skin, bone, and genitourinary system. Central nervous system (CNS) blastomycosis is rare, but potentially fatal manifestation of this disease. When it does occur, it most commonly presents as acute or chronic meningitis. Case Description: We present a case of a patient who suffered intractable nausea and vomiting for several months before discovery of a large cerebellar blastomycoma causing mass effect and obstructive hydrocephalus. The enhancing lesion with unusual peripheral cystic structures is a unique radiographic appearance of CNS blastomycosis. Conclusion: We review this patient's purely intraparenchymal manifestation of CNS blastomycosis and describe the unique imaging characteristics encountered. PMID:24231945

Munich, Stephan A.; Johnson, Andrew K.; Ahuja, Sumeet K.; Venizelos, Alexander; Byrne, Richard W.

2013-01-01

156

Skin gangrene as an extraintestinal manifestation of inflammatory bowel disease.  

PubMed

Inflammatory bowel diseases can commonly present many cutaneous lesions which can contribute to the diagnosis of the disease or its activity. The most frequent cutaneous or mucocutaneous manifestations suggesting ulcerative rectocolitis activity are erythema nodosum (3-10%), pyoderma gangrenosum (5-12%) and aphthous stomatitis (4%). Other reactive skin manifestations related to immunological mechanisms associated with the inflammatory bowel disease are: Sweet's syndrome, arthritis-dermatitis syndrome associated with inflammatory bowel disease and leukocytoclastic vasculitis. We describe the case of a young man with diagnosis of ulcerative rectocolitis, which presented an extensive cutaneous gangrene secondary to microvascular thrombosis. The case represents a dermatologic rarity and should be recognized as a cutaneous manifestation related to the hypercoagulability state observed in the disease's activity. PMID:25387503

Komatsu, Yumi Cristina; Capareli, Gabriela Cunha; Boin, Maria Fernanda Feitosa de Camargo; Lellis, Rute; Freitas, Thaís Helena Proença de; Simone, Karine

2014-01-01

157

Cutaneous Manifestations of Lightning Injury: A Case Report  

PubMed Central

Background: Lightning injuries are relatively uncommon and have been a subject of awe since primitive times. It most significantly affects the cardiorespiratory, nervous, and integumentary systems. Surprisingly, cutaneous burn injuries caused by lightning are usually superficial. Objective: To present the cutaneous manifestations of lightning injuries and the sequelae of improper management. Case report: A 22-year-old woman presented with cutaneous manifestations of lightning-induced burns and bilateral upper limb gangrene after 2 months of improper treatment. She refused amputation after counseling and left the hospital. Conclusion: This is a rare case of burns with cutaneous manifestations peculiar to lightning injury. These features serve as evidence of lightning injury, when in doubt, especially in societies where superstition is rife. Education concerning the nature of lightning and proper management would improve outcome. PMID:18923641

Asuquo, M. E.; Ikpeme, I. A.; Abang, I.

2008-01-01

158

Can Quantum Gravitational Effects Manifest themselves at Large Distances?  

E-print Network

Consider a proposed model of the universe with $\\hbar$ much greater than its well-known value of $10^{-34} Js$. In this model universe, very large objects can show quantum behaviors. In a scenario with large extra dimensions, $\\hbar$ can attains very large values depending on the dimensionality of spacetime. In this letter, we show that although conventional thinking indicates that quantum gravitational effects should manifest themselves only at very small scales, in actuality quantum gravitational effects can manifest themselves at large scales too. We use the generalized uncertainty principle with a non-zero minimal uncertainty in momentum as our primary input to construct a mathematical framework for our proposal.

Kourosh Nozari; Behnaz Fazlpour

2006-07-02

159

Ocular manifestations of the potentially lethal rheumatologic and vasculitic disorders.  

PubMed

Vision threatening ocular inflammation may occur in patients with any of the acquired connective tissue disorders and vasculitic diseases. Additionally, the ocular inflammation may be the presenting manifestation of the disease, which leads the patient to seek medical care. Other manifestations of the potentially lethal disease may be subtle or absent, presenting the thoughtful ophthalmologist with the opportunity to make life saving discoveries. Necrotizing scleritis, peripheral ulcerative keratitis, and retinal vasculitis are the ocular findings which should prompt the ophthalmologist to initiate very aggressive measures aimed at discovering any evidence of extra-ocular abnormalities, laboratory or otherwise. Appropriate therapy will be sight saving and may be life saving. PMID:23688612

Foster, C Stephen

2013-06-01

160

FRAGILE X SYNDROME: PSYCHIATRIC MANIFESTATIONS, ASSESSMENT AND EMERGING THERAPIES  

PubMed Central

Fragile X Syndrome (FXS), the most common inherited cause of intellectual disabilities, is an X-linked dominant disorder caused by the amplification of a CGG repeat in the 5? untranslated region of the fragile X mental retardation gene 1 (FMR1). Prevalence estimates of the disorder are approximately 1/3600. Psychiatric manifestations of the disorder include anxiety, attention deficit hyperactivity disorder, autism, mood instability and aggression. In this article we review the above psychiatric manifestations and challenges to accurate assessment. We also discuss how the neurobiological underpinnings of these symptoms are beginning to be understood and can help guide treatment.

Wadell, Paula M.; Hagerman, Randi J.; Hessl, David R.

2015-01-01

161

Self-Organization in the Manifestations of Youth Extremism  

ERIC Educational Resources Information Center

The analysis of the nature of youth extremism has shown that there is a connection between the extremist tendency ["ekstremal'nost'"] that is an essential property of young people, on the one hand, and extremist manifestations that come about in that community under certain conditions. These conditions include external ones (the economic,…

Zubok, Iu. A.; Chuprov, V. I.

2011-01-01

162

Life as a manifestation of the second law of thermodynamics  

Microsoft Academic Search

We examine the thermodynamic evolution of various evolving systems, from primitivephysical systems to complex living systems, and conclude that they involve similar processeswhich are phenomenological manifestations of the second law of thermodynamics. We take thereformulated second law of thermodynamics of Hatsopoulos and Keenan and Kestin and extendit to nonequilibrium regions, where nonequilibrium is described in terms of gradientsmaintaining systems at

Eric D. Schneider; James J. Kay

1994-01-01

163

40 CFR 264.71 - Use of manifest system.  

...purposes of data entry and processing. In lieu of mailing...to the EPA system an image file of Page 1 of the...submitted in data file and image file formats that are...for the origination or processing of each electronic manifest...for the collection and processing of paper...

2014-07-01

164

40 CFR 265.71 - Use of manifest system.  

...purposes of data entry and processing. In lieu of mailing...the system operator an image file of Page 1 of the...submitted in data file and image file formats that are...for the origination or processing of each electronic manifest...for the collection and processing of paper...

2014-07-01

165

Mild Cutaneous Manifestation in Two Young Women with Extraordinary Hyperandrogenemia  

Microsoft Academic Search

Hyperandrogenism with hyperandrogenemia should be considered in those with severe acne of sudden onset or conspicuous male-pattern baldness with hairline recession, although the majority of female patients with acne or androgenetic alopecia possess no endocrine disorder. Herein we describe on the contrary 2 young women with primary amenorrhea displaying prominent hyperandrogenemia but subtle cutaneous manifestation. The first one presenting vertical

WenChieh Chen; Guan-Yu Chen; Shaw-Jenq Tsai; Pei-Wen Wang; Hamm-Ming Sheu; Yen-Sheng Shen; Fen-Fen Chen

2005-01-01

166

Ocular flutter in suspected multiple sclerosis: a presenting paroxysmal manifestation  

Microsoft Academic Search

A patient with suspected multiple sclerosis is described who presented with attacks of blurring of vision and ocular flutter. This has not previously been reported as an isolated paroxysmal manifestation of brain stem demyelination. As with other paroxysmal disturbances ocular flutter may present as the first sign of the disease.

D. A. Francis; J. R. Heron

1985-01-01

167

Bleeding Ectopic Varices as the First Manifestation of Portal Hypertension  

PubMed Central

Ectopic varices are defined as dilated portosystemic collateral veins in locations other than the gastroesophageal region. We present a case of recurrent upper gastrointestinal bleeding as the first manifestation of portal hypertension. We diagnosed ectopic duodenal varices without gastroesophageal varices on upper GI endoscopy and extrahepatic portal venous obstruction (EHPVO) on CT angiography and managed this case. PMID:25374725

Sharma, Brij; Raina, Sujeet; Sharma, Rajesh

2014-01-01

168

Analysis of Manifests for Containerized Commodities Imported through US Ports  

Microsoft Academic Search

Special nuclear material (SNM) hidden in sea-going cargo containers has been identified as a significant threat at US ports, consequently several SNM detection schemes based on imaging and active interrogation techniques are being developed. Since it has proven difficult to establish what standard cargos should be, we analyzed shipping manifests for US imports shipped through North American ports collected on

Marie-Anne Descalle; Doug Manatt; Dennis Slaughter

2006-01-01

169

Achondroplasia: Craniofacial manifestations and considerations in dental management  

Microsoft Academic Search

Achondroplasia is the most common form of skeletal dysplasia dwarfism that manifests with stunted stature and disproportionate limb shortening. Achondroplasia is of dental interest because of its characteristic craniofacial features which include relative macrocephaly, depressed nasal bridge and maxillary hypoplasia. Presence of large head, implanted shunt, airway obstruction and difficulty in head control require special precautions during dental management. Craniofacial

Afnan Al-Saleem; Asma Al-Jobair

2010-01-01

170

19 CFR 123.3 - Inward foreign manifest required.  

Code of Federal Regulations, 2012 CFR

...HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CBP RELATIONS WITH CANADA AND MEXICO General Provisions § 123.3 Inward foreign...vessel of less than 5 net tons arriving otherwise than by sea from Canada or Mexico shall be listed on a manifest as prescribed...

2012-04-01

171

19 CFR 123.3 - Inward foreign manifest required.  

...HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CBP RELATIONS WITH CANADA AND MEXICO General Provisions § 123.3 Inward foreign...vessel of less than 5 net tons arriving otherwise than by sea from Canada or Mexico shall be listed on a manifest as prescribed...

2014-04-01

172

Manifest Need Satisfaction in Male and Female Counselors.  

ERIC Educational Resources Information Center

Examined manifest needs of achievement, dominance, autonomy, and affiliation of counselors. Results indicated similarities in male and female counselors regarding achievement, dominance, and autonomy and that there was a consistent trend for the male counselors to have higher needs for affiliation than female counselors on the job. (Author/PAS)

Harvey, Brian; France, Honore

1982-01-01

173

Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis  

PubMed Central

Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83%) out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%). Visual loss was the presenting clinical manifestation in 17 patients (50%) and was the most common ocular symptom (70%). Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%). Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms. PMID:24223306

Basilico, Paola; Trezzi, Ilaria; Borellini, Linda; Franco, Giulia; Civelli, Vittorio; Bresolin, Nereo; Baron, Pierluigi

2013-01-01

174

Cardiac tamponade presenting as early manifestation in dengue fever.  

PubMed

Dengue fever (DF) is an outbreak prone viral disease transmitted by aedes mosquitoes. It is often associated with evidence of plasma leakage due to increased vascular permeability manifested by pleural effusion, ascites, hypoproteinaemia and pericardial effusion. Cases of small pericardial effusion have been reported in association with dengue fever, largely with dengue haemorrhagic fever (DHF) during epidemic outbreaks. Dengue may rarely present with cardiac tamponade as early manifestation and urgent pericardiocentesis is life saving. A 34 year old male presented with low grade fever, headache, myalgia and breathlessness. Echocardiography revealed large pericardial effusion with right ventricular diagnostic collapse requiring urgent drainage. Subsequently patient improved. Dengue serology (both IgM and IgG) was reported as markedly elevated supporting a diagnosis of classic dengue fever. PMID:25327070

Bendwal, Suresh; Malviya, Kavita; Jatav, O P; Malviya, Kapil

2014-03-01

175

Papilledema as the presenting manifestation of spinal schwannoma.  

PubMed

A 63-year-old woman with headache, blurred vision, bilateral optic disc edema, and normal cranial magnetic resonance imaging scan underwent lumbar puncture that revealed an elevated opening pressure (290 mm water), a protein level of 114 mg/dl, and mild pleocytosis. Spinal magnetic resonance imaging later demonstrated a sacral tumor, which proved to be a schwannoma with sarcoid-like features. After surgical removal of the tumor, the patient's manifestations resolved. This case emphasizes that low spinal cord tumors can cause elevated intracranial pressure without causing markedly elevated cerebrospinal fluid protein or cells, or any myelopathic manifestations, perhaps by obstructing sacral cerebrospinal drainage. Comprehensive spine imaging should be a part of the evaluation of a patient with papilledema who has normal brain imaging but abnormal spinal fluid constituents. PMID:12352582

Costello, Fiona; Kardon, Randy H; Wall, Michael; Kirby, Patricia; Ryken, Timothy; Lee, Andrew G

2002-09-01

176

Extradigestive manifestation of Helicobacter pylori infection in children and adolescents.  

PubMed

Helicobacter pylori infection fulfills each of Koch's postulates as a human pathogen causing chronic active gastritis. Disease consequences that develop in a subset of infected subjects include peptic ulcerations, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. More recently, multiple publications have advocated a role for H. pylori infection in causing a variety of extraintestinal manifestations. Many of these reports suffer from being case reports or case series without adequate controls. As a result, purported manifestations may simply be coincidental in nature. On the other hand, increasing evidence supports H. pylori infection as a cause of sideropenic (refractory iron deficiency) anemia. Moderate evidence supports H. pylori gastric infection as a cause of some cases of immune thrombocytopenic purpura due to molecular mimicry. Guidelines should be adjusted in accordance with advancing knowledge in the field. PMID:16010304

Sherman, Philip M; Lin, Frank Y H

2005-07-01

177

Secondary glaucoma as initial manifestation of uveal melanoma  

PubMed Central

Purpose Secondary glaucoma can be induced by a variety of local ocular problems. Intraocular tumors may initially present as secondary glaucoma. Methods 8 consecutive patients with secondary glaucoma were found to have uveal melanoma. Thorough examination included detailed history, fundus examination with scleral depression, B scan ultrasonography, and CT/MRI scanning techniques. Results A single case presented with spontaneous hyphema, two patients presented with secondary glaucoma, extraocular melanoma and metastases, a single case was found to have angle block by an iridociliary ring melanoma and 4 cases presented with neovascular glaucoma. Enucleation was necessary in all 8 cases. Conclusions General ophthalmologists should be aware of these rare initial manifestations of intraocular tumors as secondary glaucoma. Enucleation would be recommended in most cases of intraocular malignancy manifesting as secondary glaucoma. One should be extremely cautious in doing a penetrating surgery in such cases. PMID:24227987

Othman, Ihab Saad; Assem, Maher; Zaki, Iman M.A.

2013-01-01

178

Extra-Renal Manifestations of Complement-Mediated Thrombotic Microangiopathies  

PubMed Central

Thrombotic microangiopathies (TMA) are rare but severe disorders, characterized by endothelial cell activation and thrombus formation leading to hemolytic anemia, thrombocytopenia, and organ failure. Complement over activation in combination with defects in its regulation is described in an increasing number of TMA and if primary for the disease denominated as atypical hemolytic-uremic syndrome. Although TMA predominantly affects the renal microvasculature, extra-renal manifestations are observed in 20% of patients including involvement of the central nerve system, cardiovascular system, lungs, skin, skeletal muscle, and gastrointestinal tract. Prompt diagnosis and treatment initiation are therefore crucial for the prognosis of disease acute phase and the long-term outcome. This review summarizes the available evidence on extra-renal TMA manifestations and discusses the role of acute and chronic complement activation by highlighting its complex interaction with inflammation, coagulation, and endothelial homeostasis. PMID:25250305

Hofer, Johannes; Rosales, Alejandra; Fischer, Caroline; Giner, Thomas

2014-01-01

179

What type of different clinical manifestations can cardiac sarcoidosis present?  

PubMed

Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45 %. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement. PMID:25429793

Sentürk, Ay?egül; Mara?, Yüksel; Argüder, Emine; Karalezli, Ay?egül; Hasano?lu, H Canan; O?üt, Tuba; Ba?tu?, Serdal; Karabekir, Ercan

2014-11-28

180

Extraintestinal manifestations and complications in inflammatory bowel diseases  

PubMed Central

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; i.e. thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system. PMID:16937463

Rothfuss, Katja S; Stange, Eduard F; Herrlinger, Klaus R

2006-01-01

181

Acute pancreatitis: Manifestation of acute HIV infection in an adolescent  

PubMed Central

Summary Background: Pancreatitis in the pediatric age group is not as common as in adults. Etiologies are various and differ from those in adults. Although infectious etiology accounts for a significant number of cases of pancreatitis, acute infection with Human Immunodeficiency Virus (HIV) was rarely reported as a possible etiology for acute pancreatitis in adults. Acute pancreatitis has never been reported as a presenting manifestation of acute HIV infection in children. Case Report: We describe a pediatric patient who presented with acute pancreatitis that revealed acute HIV infection. Conclusions: Acute pancreatitis as a primary manifestation of HIV infection is very rare. It may represent an uncommon aspect of primary HIV infection. We suggest that acute HIV infection should be considered in the differential diagnosis of acute pancreatitis at all ages. PMID:23569476

Bitar, Anas; Altaf, Muhammad; Sferra, Thomas J.

2012-01-01

182

A Rare Presentation of Hepatitis A Infection with Extrahepatic Manifestations  

PubMed Central

Hepatitis A has a variety of associated extrahepatic manifestations that clinicians should be aware of for early diagnosis and treatment. We report a unique case of hepatitis A presenting with multiple extrahepatic manifestations not previously described in a single patient. A 34-year-old male presented with sudden onset of left sided facial pain, swelling, and skin rash, with diffuse body pains and muscle weakness, and was found to be positive for hepatitis A immunoglobulin M (IgM). He was initially started on antibiotics for concerns of bacterial parotitis but did not show any improvement. A punch biopsy of his mandibular rash and swelling was done which showed lymphohistiocytic infiltration with a few eosinophils. A trial of prednisone resulted in improvement of his symptoms. Clinicians should be aware to look for hepatitis A infection in a patient with atypical clinical picture causing a widespread systemic inflammatory response. Treatment with prednisone may result in resolution. PMID:25295197

Bhatt, Geetika; Sandhu, Varrinder S.; Mitchell, Charlene K.

2014-01-01

183

Hashimoto's thyroiditis with clinical manifestations resembling dermatomyositis: a case report.  

PubMed

We report on a 59-year-old man with a 1-year history of forearm erythema, bilateral limb arthralgia, and muscle weakness. During the initial examination we observed infiltrative erythema of the forearm and muscle weakness and atrophy of the limbs. Blood tests revealed marked increases in myogenic enzymes. Because histopathological studies showed lymphocytic infiltration around the small blood vessels in the dermis and mucin deposition, we made a tentative diagnosis of dermatomyositis. However, the specific cutaneous manifestations of dermatomyositis, including heliotrope erythema and Gottron's sign, were absent, and the findings of electromyography were normal. A subsequent detailed examination revealed hypothyroidism and high titers of antithyroglobulin and antimicrosome antibodies, and we made a definitive diagnosis of Hashimoto's thyroiditis. The thyroid function and skin manifestations both improved after treatment with levothyroxine sodium. Dermatomyositis and Hashimoto's thyroiditis can exhibit similar characteristics, and caution is required because of the possibility of misdiagnosis. PMID:24805098

Matayoshi, Takemitsu; Omi, Tokuya; Mayumi, Nobuko; Kawana, Seiji

2014-01-01

184

A rare presentation of hepatitis a infection with extrahepatic manifestations.  

PubMed

Hepatitis A has a variety of associated extrahepatic manifestations that clinicians should be aware of for early diagnosis and treatment. We report a unique case of hepatitis A presenting with multiple extrahepatic manifestations not previously described in a single patient. A 34-year-old male presented with sudden onset of left sided facial pain, swelling, and skin rash, with diffuse body pains and muscle weakness, and was found to be positive for hepatitis A immunoglobulin M (IgM). He was initially started on antibiotics for concerns of bacterial parotitis but did not show any improvement. A punch biopsy of his mandibular rash and swelling was done which showed lymphohistiocytic infiltration with a few eosinophils. A trial of prednisone resulted in improvement of his symptoms. Clinicians should be aware to look for hepatitis A infection in a patient with atypical clinical picture causing a widespread systemic inflammatory response. Treatment with prednisone may result in resolution. PMID:25295197

Bhatt, Geetika; Sandhu, Varrinder S; Mitchell, Charlene K

2014-01-01

185

[Otomastoiditis as an initial clinical manifestation of Wegener's granulomatosis].  

PubMed

Wegener's granulomatosis (WG) forms part of a group of primary vasculitis of the small and medium-sized blood vessels, associated with antineutrophil cytoplasmic antibodies (ANCA). This disease may affect any body organ, especially the upper and lower airways and the kidneys. Hardly ever is otomastoiditis the first and only clinical manifestation of generalized Wegener's granulomatosis. We present the case of a patient whose disease started with the inflammation of the middle ear, which was unresponsive to the usual treatment. Later he developed nasal, pulmonary and renal compromise. The determination of ANCA and a transbronchial biopsy confirmed the diagnosis of WG. We report this case to express the view that otomastoiditis in adults, which is refractory to the usual treatment, may seldom be the first and only clinical manifestation of WG. PMID:21296720

De All, Jorge; Koutnouyan, Gabriel; Herrando, Sergio; Diez, Eduardo; Olmedo, Gloria; Gnocchi, Cesar

2011-01-01

186

Oral manifestations associated with systemic complications of prune belly syndrome.  

PubMed

Prune belly syndrome (PBS) is a rare congenital malformation of unknown etiology characterized by congenital abnormalities including abdominal wall flaccidity, urinary tract alterations, and bilateral cryptorchidism. The incidence of the syndrome is between 1/35000 and 1/50000 live births and there is little information about the oral findings. The present case describes the oral manifestations of a 15-year-old boy diagnosed with PBS. The findings include enamel hypoplasia associated with generalized hypocalcemic dental lines. In the radiographic exam, pronounced demineralization of the trabecular bone of the jaws, loss of lamina dura in all the teeth, and discontinuity of the mandibular cortical bone were observed. Prune belly syndrome is a rare disease, whose clinical dental aspects are not pathognomonic of the syndrome. The comprehension of the systemic mechanism of PBS and its comorbidities enable an understanding of the systemic etiologic factors associated with oral manifestations. PMID:22901648

Pessoa, Larissa; Galvão, Virgilio

2013-01-01

187

Ocular Manifestations of Late-Onset Behçet Disease  

Microsoft Academic Search

Purpose: To describe the demographic characteristics and ocular manifestations of patients with late-onset Behçet disease (BD). Patients and Methods: The patients for this retrospective study were selected using the data obtained from the medical records of 16 patients with late-onset BD between January 2000 and May 2008. Results: Twelve (75%) of the cases were male and 4 (25%) were female.

Mehmet Citirik; Nilufer Berker; Murat Serkan Songur; Seyhan Sonar Ozkan; Orhan Zilelioglu

2011-01-01

188

Manifest diabetes and keratoconus: A retrospective case-control study  

Microsoft Academic Search

Purpose: To assess the influence of diabetes on the development of keratoconus to show whether biomechanical effects are also reflected\\u000a in epidemiology. The two diseases have opposite impact on the biomechanics of the corneal stroma: manifest diabetes stiffens\\u000a the cornea, whereas keratectasia weakens the tensile strength of the stroma. Methods: The retrospective case-control study included files of 1142 patients, with

Theo Seiler; Sabine Huhle; Eberhard Spoerl; Hildebrand Kunath

2000-01-01

189

Ball Lightning: Manifestation of Cosmic Little Black Holes  

Microsoft Academic Search

A case is made that in encounters with the earth's atmosphere, astrophysical little black holes (LBH) can manifest themselves\\u000a as the core energy source of ball lightning (BL). Relating the LBH incidence rate on earth to BL occurrence has the potential\\u000a of shedding light on the distribution of LBH in the universe, and their velocities relative to the earth. Most

Mario Rabinowitz

2001-01-01

190

Ball Lightning: Manifestation of Cosmic Little Black Holes  

Microsoft Academic Search

A case is made that in encounters with the earth's atmosphere, astrophysical\\u000alittle black holes (LBH) can manifest themselves as the core energy source of\\u000aballlightning (BL). Relating the LBH incidence rate on earth to BL occurrence\\u000ahas the potential of shedding light on the distribution of LBH in the universe,\\u000aand their velocities relative to the earth. Most BL

Mario Rabinowitz

2001-01-01

191

Premature centromere division: A possible manifestation of chromosome instability  

SciTech Connect

Retrospective analysis of {open_quotes}routine{close_quotes} chromosome preparations from 2 patients with Fanconi anemia and 2 others with ataxia-teleangiectasia showed increased chromosome breakage and a tendency to premature centromere division (PCD) with special reference to early separation of the large acrocentric (13-15) chromosomes. The findings suggest that PCD may be a manifestation of chromosome instability related to potential malignancy. 28 refs., 1 fig., 1 tab.

Mehes, K. [Univ. Medical School, Pecs (Hungary); Buehler, E.M. [Univ. of Children`s Hospital, Basle (Switzerland)

1995-03-13

192

Geographic Manifestation of Spanish Moss Physiology Across The Americas  

E-print Network

Geographic Manifestation of Spanish Moss Physiology Across The Americas Narayani Barve Ecology and evolutionary biology University of Kansas GIS Day, November 16, 2011 Problem • Ecological niche models use known occurrences... geography taking into account its physiological limits. Spanish Moss (Tillandsia Usneoides) • South?eastern United States to South America • Large geographical area • Heterogeneous landscape • Varied climatic conditions • CAM plant, no roots Var 1 Var 3 Var 2 Data, Schema & Parameters • ERA...

Barve, Narayani

2011-11-16

193

Contributions to the treatment of dermatologic manifestations of Lyme borreliosis.  

PubMed

Lyme borreliosis was identified in Czechoslovakia for the first time in 1985. Since then, more cases have gradually been identified. Since 1989, about 1,500 patients per ten million inhabitants have been reported every year. Having summarized the results of the therapy of 371 patients with dermatologic manifestations of lyme borreliosis (erythema migrans in 315, borrelial lymphocytoma in fifteen, and acrodermatitis chronica atrophicans in forty-one) we present the antibiotic regimens used by Czechoslovak dermatologists in clinical practice. PMID:1628507

Hercogová, J; Tománková, M; Barták, P

1992-06-01

194

Pulmonary necrobiotic nodules: a rare extraintestinal manifestation of Crohn's disease.  

PubMed

The present article reports the case of a 22-yr-old female with new onset Crohn's colitis, anterior uveitis and multiple pulmonary nodules which, on histological examination, were necrobiotic nodules. This is a rare but recognised pulmonary extraintestinal manifestation of Crohn's disease and only the fourth reported case. The present case report is followed by a brief review of the relevant literature. PMID:20956123

Warwick, G; Leecy, T; Silverstone, E; Rainer, S; Feller, R; Yates, D H

2009-03-01

195

Brachial plexopathy as a rare presenting manifestation of scorpion envenomation.  

PubMed

We report a patient who experienced a rare manifestation of an acute, severe brachial plexopathy as the initial complication of scorpion (presumed Hemiscorpius lepturus species) envenomation. Features suggesting conduction block, due to either proximal demyelination or ion channel dysfunction, along with axonal loss were seen on serial electrophysiological studies. Possible mechanisms of the brachial plexopathy include direct compression from tissue edema or a toxic effect on the membrane channels along the nerve. PMID:21674527

Rubin, Devon I; Vavra, Michael

2011-07-01

196

Atypical Clinical Manifestations of Graves' Disease: An Analysis in Depth  

PubMed Central

Over the past few decades, there has been an increase in the number of reports about newly recognized (atypical or unusual) manifestations of Graves' disease (GD), that are related to various body systems. One of these manifestations is sometimes the main presenting feature of GD. Some of the atypical manifestations are specifically related to GD, while others are also similarly seen in patients with other forms of hyperthyroidism. Lack of knowledge of the association between these findings and GD may lead to delay in diagnosis, misdiagnosis, or unnecessary investigations. The atypical clinical presentations of GD include anemia, vomiting, jaundice, and right heart failure. There is one type of anemia that is not explained by any of the known etiological factors and responds well to hyperthyroidism treatment. This type of anemia resembles anemia of chronic disease and may be termed GD anemia. Other forms of anemia that are associated with GD include pernicious anemia, iron deficiency anemia of celiac disease, and autoimmune hemolytic anemia. Vomiting has been reported as a presenting feature of Graves' disease. Some cases had the typical findings of hyperthyroidism initially masked, and the vomiting did not improve until hyperthyroidism has been detected and treated. Hyperthyroidism may present with jaundice, and on the other hand, deep jaundice may develop with the onset of overt hyperthyroidism in previously compensated chronic liver disease patients. Pulmonary hypertension is reported to be associated with GD and to respond to its treatment. GD-related pulmonary hypertension may be so severe to produce isolated right-sided heart failure that is occasionally found as the presenting manifestation of GD. PMID:22132347

Hegazi, Mohamed Osama; Ahmed, Sherif

2012-01-01

197

[Apropos of 1 case of ophthalmologic manifestation of bilharziasis].  

PubMed

We present an ocular manifestation of schistosomiasis. We observed the case of a 10 year old young girl living near a flooding canal of the Niger river. She presented a tumor of the left lid associated with an important ptosis. This tumor resulted from numerous polyps of the conjunctiva. The histological analysis of a biopsy of the conjunctiva made the diagnostic. It was confirmed by the analysis of urine and by the important amelioration of inflammation resulting from a specific therapy. PMID:8219789

Kabo, A M; Warter, A

1993-01-01

198

Medical Management of Extrathyroidal Manifestation of Graves Disease.  

PubMed

Objective: To review preventive measures and current medical management of extrathyroidal manifestation of Graves disease and to provide an overview of potential immune therapies of the future.Methods: Literature review of investigative trials of treatment methods for Graves disease and its extrathyroidal manifestations.Results: With recent knowledge of the stages of the autoimmune cascade responsible for development of these extrathyroidal manifestations, the possibility has been raised of undertaking randomized trials of agents of benefit in other immune conditions. Two randomized trials on the efficacy of rituximab in moderate-to-severe Graves ophthalmopathy have shown conflicting results.Conclusion: Additional studies of rituximab and other agents are needed before they become routinely used in treating Graves disease. Meanwhile, standard medical therapy for moderate-to-severe ophthalmopathy is intravenous or oral corticosteroids and, for dermopathy, local corticosteroid application with occlusive dressing. Since major adverse effects such as life-threatening hepatic failure can occur with very high doses of intravenous prednisolone, the cumulative total dose should not exceed 8 g. PMID:25370325

Fatourechi, Vahab

2014-11-01

199

19 CFR 123.5 - Certification and filing of inward foreign manifest.  

... U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CBP RELATIONS WITH CANADA AND MEXICO General Provisions § 123.5 Certification and filing of inward foreign manifest. The manifest...

2014-04-01

200

19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.  

Code of Federal Regulations, 2011 CFR

... Penalties for failure to manifest narcotic drugs or marihuana. 162.65 Section...AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a)...

2011-04-01

201

19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.  

... Penalties for failure to manifest narcotic drugs or marihuana. 162.65 Section...AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a)...

2014-04-01

202

19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.  

Code of Federal Regulations, 2012 CFR

... Penalties for failure to manifest narcotic drugs or marihuana. 162.65 Section...AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a)...

2012-04-01

203

19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.  

Code of Federal Regulations, 2013 CFR

... Penalties for failure to manifest narcotic drugs or marihuana. 162.65 Section...AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a)...

2013-04-01

204

19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.  

Code of Federal Regulations, 2010 CFR

... Penalties for failure to manifest narcotic drugs or marihuana. 162.65 Section...AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a)...

2010-04-01

205

Cutaneous manifestations of endocrine disorders: a guide for dermatologists.  

PubMed

Dermatologists may commonly see skin lesions that reflect an underlying endocrine disorder. Identifying the endocrinopathy is very important, so that patients can receive corrective rather than symptomatic treatment. Skin diseases with underlying endocrine pathology include: thyrotoxicosis; hypothyroidism; Cushing syndrome; Addison disease; acromegaly; hyperandrogenism; hypopituitarism; primary hyperparathyroidism; hypoparathyroidism; pseudohypoparathyroidism and manifestations of diabetes mellitus. Thyrotoxicosis may lead to multiple cutaneous manifestations, including hair loss, pretibial myxedema, onycholysis and acropachy. In patients with hypothyroidism, there is hair loss, the skin is cold and pale, with myxedematous changes, mainly in the hands and in the periorbital region. The striking features of Cushing syndrome are centripetal obesity, moon facies, buffalo hump, supraclavicular fat pads, and abdominal striae. In Addison disease, the skin is hyperpigmented, mostly on the face, neck and back of the hands. Virtually all patients with acromegaly have acral and soft tissue overgrowth, with characteristic findings, like macrognathia and enlarged hands and feet. The skin is thickened, and facial features are coarser. Conditions leading to hyperandrogenism in females present as acne, hirsutism and signs of virilization (temporal balding, clitoromegaly).A prominent feature of hypopituitarism is a pallor of the skin with a yellowish tinge. The skin is also thinner, resulting in fine wrinkling around the eyes and mouth, making the patient look older. Primary hyperparathyroidism is rarely associated with pruritus and chronic urticaria. In hypoparathyroidism, the skin is dry, scaly and puffy. Nails become brittle and hair is coarse and sparse. Pseudohypoparathyroidism may have a special somatic phenotype known as Albright osteodystrophy. This consists of short stature, short neck, brachydactyly and subcutaneous calcifications. Some of the cutaneous manifestations of diabetes mellitus include necrobiosis lipoidica diabeticorum, diabetic dermopathy, scleredema adultorum and acanthosis nigricans. PMID:12688837

Jabbour, Serge A

2003-01-01

206

Automated Detection of Anomalous Shipping Manifests to Identify Illicit Trade  

SciTech Connect

We describe an approach to analyzing trade data which uses clustering to detect similarities across shipping manifest records, classification to evaluate clustering results and categorize new unseen shipping data records, and visual analytics to provide to support situation awareness in dynamic decision making to monitor and warn against the movement of radiological threat materials through search, analysis and forecasting capabilities. The evaluation of clustering results through classification and systematic inspection of the clusters show the clusters have strong semantic cohesion and offer novel ways to detect transactions related to nuclear smuggling.

Sanfilippo, Antonio P.; Chikkagoudar, Satish

2013-11-12

207

["Baboon syndrome". A particular manifestation of hematogenous contact reaction].  

PubMed

We report on a 52-year-old patient with a typical manifestation of a haematogenous contact reaction. The characteristic distribution of light-red erythema predominantly located in the major flexural areas of the extremities and on the buttocks was consistent with the diagnosis of "baboon syndrome." The term derives from the skin lesions, which are compared to the red gluteal region of the baboon. An allergic type-IV reaction to systemically administered allergens probably underlies lesions of this type. In our case the baboon syndrome had been induced by amoxicillin. So far, mercury, nickel, ampicillin, and heparin have been reported as causes of baboon syndrome. PMID:8365882

Herfs, H; Schirren, C G; Przybilla, B; Plewig, G

1993-07-01

208

Lithium carbonate toxicity. Acneform eruption and other manifestation.  

PubMed

Manifestations of lithium carbonate toxicity include acneform eruptions, sinus node dysfunction, hyperparathyroidism, hypothyroidism, thyrotoxicosis, extrapyramidal side effects, and renal toxicity, which may present as nephrogenous diabetes insipidus. This report concerns a patient with a toxic reaction to lithium carbonate. The patient initially had acneform lesions, hypoglycemia, hypothyroidism, and nephrogenous diabetes insipidus. Features of lithium carbonate-induced acneform eruptions are emphasized. Renal toxicity from a lithium carbonate overdose is common, and the hazards of prescribing potentially nephrotoxic drugs to such a patient are stressed. PMID:6461296

Heng, M C

1982-04-01

209

Atypical giant haemangioma of liver with systemic inflammatory manifestations  

PubMed Central

Haemangioma is the most common benign tumour of the liver. Most of them are small in size (less than 4?cm) and are often asymptomatic and discovered incidentally on modern diagnostic imaging. Lesions with a diameter larger than 4?cm are called giant haemangiomas, and these are usually located in the right hepatic lobe. Although haemangioma is the most frequent benign tumour of the liver, ‘giant’ haemangiomas are rare. Such lesions may give rise to symptoms requiring treatment. In this case report, we describe the case of a 50-year-old Indian man who presented with giant liver haemangioma and systemic inflammatory manifestations. PMID:23355558

Khalid, Mohd; Ahmad, Mehtab; Jain, Amit; Rizvi, Imran

2013-01-01

210

Dermatological Manifestations of Stress in Normal and Psychiatric Populations.  

PubMed

This article explores the way stress affects the skin, both at the molecular level, where the skin has an intricate connection to the neurocutaneous and immune systems, and at the clinical level. The concept of psychodermatology is reviewed with regard to the way skin reacts to stress, how stress is a trigger for several common skin diseases, and how neuropsychiatric disorders may have skin manifestations. The article is directed at making the dermatologist, the psychiatrist, the psychologist, and the primary physician familiar with the brain-skin mechanisms involved in stress and the resultant clinical expressions on the skin. PMID:25455069

Rodriguez-Vallecillo, Edgardo; Woodbury-Fariña, Michel A

2014-12-01

211

A rare vulvar manifestation of neurofibromatosis 1 in a teen.  

PubMed

Neurofibromatosis 1 is an autosomal dominant disorder with cutaneous findings that include multiple café-au-lait spots, axillary/inguinal freckling, dermal, and plexiform neurofibromas. Skin manifestations, including involvement of the vulva, are often the most troubling physical finding to patients. Hormonal and growth factor changes during puberty have been implicated in neurofibroma growth. In the case presented here, an exceedingly rare isolated vulvar neurofibroma without clitoral involvement became enlarged and symptomatic, requiring excisional surgery after puberty. The diffuse involvement of these tumors makes complete resection very difficult and recurrence is common. PMID:21715194

Skorupski, Josh C; Hafener, Hope K; Smith, Yolanda R; Quint, Elisabeth H

2011-10-01

212

Spastic foot-drop as an isolated manifestation of neurocysticercosis.  

PubMed

Foot-drop is a rare but important manifestation of intracranial pathologies ranging from space-occupying lesions to cerebrovascular accidents. Being most commonly associated with peripheral nerve lesions or radicular compressions, it remains an underappreciated feature of central-structural abnormalities. We describe an interesting case of a 14-year-old boy who had presented with acute onset right-sided foot-drop due to a left-sided parasagittal neurocysticercus lesion, without seizures and discuss the location of the lesion in the precentral area in reference to Penfield's motor homunculus. PMID:23008377

Sahu, Ritesh; Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Lalla, Rakesh

2012-01-01

213

Spontaneous perforation of the esophagus as a manifestation of dermatomyositis.  

PubMed

Spontaneous perforation of the esophagus evolving into a retropharyngeal abscess in a child with severe dermatomyositis is reported. Clinical presentation and successful management are discussed. Aggressive surgical debridement with extensive drainage, multiple antibiotic coverage, and careful steroid management are advocated. The histopathology and clinical presentation of dermatomyositis as a type of polymyositis are discussed as pertinent to the otolaryngologic clinician. The literature is reviewed and results of a retrospective analysis of head and neck manifestations are reported in 50 children with dermatomyositis treated at Children's Hospital, Los Angeles, over the past 20 years. PMID:6497240

Thompson, J W

1984-01-01

214

Chromosomal and Multifactorial Genetic Disorders with Oral Manifestations  

PubMed Central

The chromosomal disorders are individually rare, but collectively they are common whereas the multifactorial disorders are the most common form of genetic disorders. The chromosomal anomalies typically arise from alterations in the DNA containing chromosomal regions and can be reliably detected by karyotype analysis, whereas the multifactorial disorders demonstrate multi-gene as well as environmental interactions. Both the chromosomal and multifactorial disorders may manifest signs and symptoms such as a combination of birth defects, physical disabilities, challenging behavior and certain craniofacial defects as well, the knowledge of which can aid in a better patient management in everyday practice of dentistry. PMID:25395808

Patil, Shankargouda; Rao, Roopa S; Majumdar, Barnali

2014-01-01

215

The acute encephalitic phase of neurocysticercosis: computed tomographic manifestations.  

PubMed

Brain infestation by Cysticercus cellulosae, the larval form of Taenia solium, is a common disorder in Mexico and other Latin American countries, Asia, Africa, and some Eastern European countries. Recent immigration has caused an increase in the number of cases of neurocysticercosis in the United States. This work describes the acute encephalitic form of neurocysticercosis in 26 cases. The clinicopathologic and neuroradiologic manifestations are discussed with particular emphasis on the use of computed tomography as a main diagnosis modality which demonstrates multiple diffuse (85%) or localized (15%) enhancing nodules associated with severe edema. PMID:6402903

Rodriguez-Carbajal, J; Salgado, P; Gutierrez-Alvarado, R; Escobar-Izquierdo, A; Aruffo, C; Palacios, E

1983-01-01

216

Hydrops fetalis: manifestation in lysosomal storage diseases including Farber disease  

Microsoft Academic Search

The authors describe a case of disseminated lipogranulomatosis (Farber disease) presenting as nonimmune hydrops fetalis. This\\u000a is the tenth lysosomal storage disease which can show this clinical manifestation. The literature is reviewed for all hydrops\\u000a cases associated with lysosomal storage diseases.\\u000a \\u000a \\u000a Conclusion Although rare, the lysosomal storage diseases collectively are significant causes of non-immune hydrops and appropriate investigations\\u000a are required

Evelyn Kattner; A. Schäfer; K. Harzer

1997-01-01

217

Dermatologic manifestations and neuropathic symptoms in women with Fabry disease.  

PubMed

Fabry disease (angiokeratoma corporis diffusum universale) is a rare, progressive, X-linked lysosomal storage disease. Deficiency of the ?-galactosidase A (?-gal A) enzyme leads to accumulation of neutral glycosphingolipids within vascular endothelial lysosomes of various organs, including skin, kidneys, heart, and brain.1. We herein describe the case of a 30-year-old female presenting two classic signs of Fabry disease, angiokeratomas and episodic acroparesthesias, in the absence of other clinical manifestations. An haplotype corresponding to the combination of three different nucleotide polymorphic variants (g. 7192-7198del5+ g. 10115A>G + g. 10956 C>T) at the heterozygous state, was identified.2. PMID:24897976

Melpignano, Andrea; Mandurino-Mirizzi, Alessandro; Besagni, Francesca; Leri, Annarosa

2014-01-01

218

Organising pneumonia as the first manifestation of rheumatoid arthritis  

PubMed Central

Organising pneumonia (OP) is an inflammatory lung disease with distinctive clinicopathological features. OP can be evident during the course of rheumatoid arthritis (RA) with increased disease activity. The authors report an OP associated with RA case in which pulmonary symptoms preceded the onset of joint symptoms. An OP patient with elevated serum anticyclic citrullinated peptide antibody is likely to manifest RA in the near future, reflecting its high disease activity. Thus, an early rheumatologic consultation should be taken into consideration to make an early decision to initiate disease-modifying antirheumatic drugs therapy. PMID:22699479

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

219

Organising pneumonia as the first manifestation of rheumatoid arthritis.  

PubMed

Organising pneumonia (OP) is an inflammatory lung disease with distinctive clinicopathological features. OP can be evident during the course of rheumatoid arthritis (RA) with increased disease activity. The authors report an OP associated with RA case in which pulmonary symptoms preceded the onset of joint symptoms. An OP patient with elevated serum anticyclic citrullinated peptide antibody is likely to manifest RA in the near future, reflecting its high disease activity. Thus, an early rheumatologic consultation should be taken into consideration to make an early decision to initiate disease-modifying antirheumatic drugs therapy. PMID:22699479

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

220

Mood Disorder as the Presenting Manifestation of Demyelination  

PubMed Central

Objective To report an unusual presenting manifestation of multiple sclerosis in a teenager. Case Report We report the case of a 16-year-old male who was diagnosed with schizoaffective disorder a year prior to his neurological consultation. Neurological examination showed evidence of mild lower extremity spasticity with ataxia and dysarthria. Imaging revealed lesions suggestive of multiple sclerosis. Conclusion An organic basis for psychiatric disorders is often overlooked. Children presenting with symptoms suggestive of a mood disorder, decline in cognition or psychosis deserve a detailed neurological examination and appropriate imaging if indicated, before starting them on antidepressant or neuroleptic medication. PMID:23741225

Tapos, D.; Sivaswamy, L.

2013-01-01

221

Pycnodysostosis: A bone dysplasia with unusual oral manifestation  

PubMed Central

Pycnodysostosis, a sclerosing bone dysplasia, is a rare autosomal recessive disorder with an estimated prevalence rate of one in one million. Patients with pycnodyostosis usually have normal intelligence, sexual development and life span. This condition is characterized by increased bone density and fragility along with oral manifestations like malposition teeth, hypoplastic maxilla, receded chin and delayed eruption of permanent teeth with discharging sinuses in the jaws because of poor blood supply. This is one such rare case report of a 47-year-old patient presenting with a complaint of fractured jaw and reviewing the clinical and radiographic characteristics of pycnodysostosis. PMID:25565757

Balaji, M S Anandi; Sundaram, R Kanmani Shanmuga; Karthik, Poornima; Asokan, Kannan

2014-01-01

222

Pulmonary Nodules as an Initial Manifestation of Behçet's Disease.  

PubMed

Behçet's disease (BD) is a systemic vasculopathy, characterized by recurrent oral aphthae, genital ulcers, uveitis, and skin lesions. Although vascular involvement, including venous and arteries of any size, is a usual manifestation, cases with pulmonary thrombosis as the initial symptom are not common in the absence of pulmonary artery aneurysm (PAA). This report describes a 36-year-old man with recurrent fever, nonmassive hemoptysis, and persistent cough with lung nodules in CT scan who had undergone open lung biopsy. On the basis of morphological findings, BD was suggested and more precise evaluation confirmed the diagnosis. PMID:25436168

Malekmohammad, M; Emamifar, A

2014-01-01

223

Case report: bipolar disorder as the first manifestation of CADASIL  

PubMed Central

Background Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease, clinically characterized by variable manifestations of migraine, recurrent transient ischemic attack or lacunar strokes, cognitive decline, and mood disturbances. However, manic episodes have rarely been documented as an initial symptom of CADASIL and bipolar disorder presenting as the first manifestation in CADASIL has not been reported previously from evaluations by psychiatrists or psychological testing by psychologists. Case presentation A 53 year old woman developed symptoms of mania in her 50s leading to a personality change involving a continuously labile mood and irritability over a number of years. Neuropsychological testing revealed an intact memory, but impairment in attention and executive function. In the Rorschach test, she showed a high level of cognitive rigidity. Magnetic resonance imaging findings were very consistent with a diagnosis of CADASIL, which was confirmed by genetic testing for NOTCH3 mutations. Atypical antipsychotics proved to be helpful in treating her manic symptoms and for behavior control. Conclusion We present a novel case of CADASIL that first presented as bipolar disorder. We contend that when patients show a late onset personality change or chronically irritable mood that deteriorates over many years, an organic cause such as CADASIL must be considered. Further studies are needed to better understand the exact impacts of cerebral tissue lesions and psychiatric symptoms in CADASIL patients. PMID:24929957

2014-01-01

224

Clinical Manifestations and Distribution of Cutaneous Leishmaniasis in Pakistan  

PubMed Central

Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL. PMID:22174721

Afghan, Abaseen Khan; Kassi, Masoom; Kasi, Pashtoon Murtaza; Ayub, Adil; Kakar, Niamatullah; Marri, Shah Muhammad

2011-01-01

225

Clinical manifestations of food protein-induced enterocolitis syndrome  

PubMed Central

Purpose of review To raise awareness among healthcare providers about the clinical and laboratory findings in acute and chronic food protein-induced enterocolitis syndrome (FPIES). Recent findings FPIES can be caused by trivial exposure or rare foods. Summary FPIES is a non-IgE-mediated reaction that usually presents with acute severe repetitive vomiting and diarrhea associated with lethargy, pallor, dehydration, and even hypovolemic shock. Manifestations resolve usually within 24–48?h of elimination of the causative food. In chronic cases, symptoms may include persistent diarrhea, poor weight gain, failure to thrive, and improvement may take several days after the food elimination. In the acute cases, laboratory evaluation may reveal thrombocytosis and neutrophilia, peaking about 6?h postingestion. Depending on the severity, metabolic acidosis and methemoglobinemia may occur. In chronic cases, anemia, hypoalbuminemia and eosinophilia may be seen. Radiologic evaluation or other procedures, such as endoscopy and gastric juice analysis may show nonspecific abnormal findings. The diagnosis is based on clinical manifestations. Further studies looking at the phenotypes of FPIES are needed to identify clinical subtypes, and to understand the predisposing factors for developing FPIES compared with immediate-type, IgE-mediated gastroenteropathies. PMID:24651279

Mane, Shikha K.; Bahna, Sami L.

2014-01-01

226

Analysis of clinical manifestations of symptomatic acquired jejunoileal diverticular disease  

PubMed Central

AIM: To analyze systematically our experience over 22 years with symptomatic acquired diverticular disease of the jejunum and ileum, exploring the clinical manifestations and diagnosis of this rare but life-threatening disease. METHODS: The medical records of patients with surgically confirmed symptomatic jejunoileal diverticular disease were retrospectively reviewed. Data collected included demographic data, laboratory results, clinical course (acute or chronic), preoperative diagnosis, and operative findings. Inclusion criteria were as follows: (1) surgical confirmation of jejunoileal diverticular disease and (2) exclusion of congenital diverticula (e.g. Meckel’s diverticulum). RESULTS: From January 1982 to July 2004, 28 patients with a total of 29 operations met the study criteria. The male:female ratio was 14:14, and the mean age was 62.6±3.5 years. The most common manifestation was abdominal pain. In nearly half of the patients, the symptoms were chronic. Two patients died after surgery. Only four cases were correctly diagnosed prior to surgery, three by small bowel series. CONCLUSION: Symptomatic acquired small bowel diverticular disease is difficult to diagnose. It should be considered in older patients with unexplained chronic abdominal symptoms. A small bowel series may be helpful in diagnosing this potentially life-threatening disease. PMID:16222755

Liu, Chia-Yuan; Chang, Wen-Hsiung; Lin, Shee-Chan; Chu, Cheng-Hsin; Wang, Tsang-En; Shih, Shou-Chuan

2005-01-01

227

Lupus anticoagulant and cardiac manifestations in systemic lupus erythematosus.  

PubMed

The occurrence of cardiac manifestations and their relationship with the lupus anticoagulant (LA) in SLE was studied in 74 patients who were followed up for 22 years (median), of which 16 years were after the initial LA testing. Pericarditis was the most common cardiac event occurring in 16 (22%) patients but it did not correlate with LA. Valvular heart disease, coronary artery disease, left ventricular failure and/or cor pulmonale were observed in 16 (22%) patients. Taken together, their occurrence was associated with a history of leg ulcers (odds 3.8, P = 0.028) but not with LA or other common clinical manifestations of the antiphospholipid syndrome. Valvular heart disease in five patients was significantly associated with LA (P = 0.05). Cor pulmonale due to chronic pulmonary embolism was present in two patients with LA. Myocardial infarctions in five patients occurred late in the course of disease but in relatively young patients (mean 43 years). Fatal myocardial infarction in the absence of atherosclerosis in two LA-positive patients supports a pathogenetic role for LA in these cases. In conclusion, of the various cardiac complications in SLE, valvular heart disease and cor pulmonale appear to be connected with the antiphospholipid syndrome. Both conditions should be actively sought in patients with LA to decrease possible adverse events (arterial emboli and right ventricular failure) affecting the patients' prognosis. PMID:7951302

Jouhikainen, T; Pohjola-Sintonen, S; Stephansson, E

1994-06-01

228

Extrahepatic manifestations of chronic hepatitis C virus infection.  

PubMed

Hepatitis C virus (HCV) infected patients are known to be at risk of developing liver complications i.e. cirrhosis and liver cancer. However, the risks of morbidity and mortality are underestimated because they do not take into account non-liver consequences of chronic hepatitis C virus infection. Numerous extrahepatic manifestations have been reported in up to 74% of patients, from perceived to disabling conditions. The majority of data concern hepatitis C virus-related autoimmune and/or lymphoproliferative disorders, from mixed cryoglobulinaemia vasculitis to frank lymphomas. More recently, other hepatitis C virus-associated disorders have been reported including cardiovascular, renal, metabolic, and central nervous system diseases. This review aims to outline most of the extrahepatic manifestations that are currently being investigated, including some of autoimmune and/or lymphoproliferative nature, and others in which the role of immune mechanisms appears less clear. Beyond the liver, hepatitis C virus chronic infection should be analyzed as a multifaceted systemic disease leading to heavy direct and indirect costs. The accurate consideration of extrahepatic consequences of such a systemic infection significantly increases the weight of its pathological burden. The need for effective viral eradication measures is underlined. PMID:25458776

Cacoub, Patrice; Gragnani, Laura; Comarmond, Cloe; Zignego, Anna Linda

2014-12-15

229

Neural Manifestations of Implicit Self-Esteem: An ERP Study  

PubMed Central

Behavioral research has established that humans implicitly tend to hold a positive view toward themselves. In this study, we employed the event-related potential (ERP) technique to explore neural manifestations of positive implicit self-esteem using the Go/Nogo association task (GNAT). Participants generated a response (Go) or withheld a response (Nogo) to self or others words and good or bad attributes. Behavioral data showed that participants responded faster to the self paired with good than the self paired with bad, whereas the opposite proved true for others, reflecting the positive nature of implicit self-esteem. ERP results showed an augmented N200 over the frontal areas in Nogo responses relative to Go responses. Moreover, the positive implicit self-positivity bias delayed the onset time of the N200 wave difference between Nogo and Go trials, suggesting that positive implicit self-esteem is manifested on neural activity about 270 ms after the presentation of self-relevant stimuli. These findings provide neural evidence for the positivity and automaticity of implicit self-esteem. PMID:25006966

Wu, Lili; Cai, Huajian; Gu, Ruolei; Luo, Yu L. L.; Zhang, Jianxin; Yang, Jing; Shi, Yuanyuan; Ding, Lei

2014-01-01

230

Analysis of Recent Manifests for Goods Imported through US Ports  

SciTech Connect

Several active interrogation techniques are being developed to detect shielded special nuclear materials (SNM) hidden in cargo containers loaded on container ships arriving at US ports. It raises the questions of the types of cargos in which SNM could be hidden, and their impact on detected signatures. Since the definition of a set of ''typical'' or standard cargos has proven to be difficult, we analyzed shipping manifests for US imports shipped through North American ports collected on 14 days distributed over 12 months. From these data, we generated several distribution functions such as commodity categories, average densities, and packaging types that could be of interest to the cargo scanning community. One of the cargo scanning techniques currently under development at LLNL is based on neutron active interrogation, and relies on the unique signature of beta-delayed gammas emitted by fission products in the 3 to 7 MeV energy range. {sup 19}F(n,a){sup 16}N, has been identified as the main potential interference for 7 and 9 MeV neutron beams. Estimates of cargo compositions based on manifests identified as containing fluorine are presented.

Descalle, M; Manatt, D; Slaughter, D

2006-09-27

231

Cistoid macular edema as first manifestation of sarcoidosis.  

PubMed

The purpose of this study is to report a case of cystoid macular edema (CME) as a rare first manifestation of ocular sarcoidosis after cataract surgery. A 60-year-old male developed a CME following uneventful phacoemulsification cataract extraction on his left eye. It resolved with conventional medical therapy. One year later the patient was diagnosed with bilateral CME. Oral corticosteroid therapy produced a significant regression. His medical and ocular histories were unremarkable and all tests for etiological diagnosis were negative. There were inflammation recurrences in his left eye, which were also treated with steroids. Optical coherence tomography showed complete resolution of foveal thickening without improvement in vision. Four years later, the patient presented with CME in both eyes. The laboratory tests included high angiotensin-converting enzyme levels and a gallium scan which were also consistent with sarcoidosis. Azathioprine was needed for management of ocular involvement, but it was withheld due to side-effects. At the present time, the CME is controlled with low-dose corticoids. Ocular involvement in sarcoidosis occurs in 20-50 % of patients. CME is not often the initial manifestation of the disease, but ocular sarcoidosis may present with a wide variety of ocular symptoms in all parts of the eye. Therefore, sarcoidosis should be kept in mind when evaluating a patient with ocular inflammation. PMID:24322273

Cabrillo-Estevez, Lucia; de Juan-Marcos, Lourdes; Kyriakou, Danai; Hernández-Galilea, Emiliano

2014-08-01

232

Manifestations of paediatric Leishmania infantum infections in Malta  

PubMed Central

Summary Leishmania infantum is endemic in the Maltese archipelago, a group of islands in the Mediterranean which are visited frequently by tourists from Northern European countries. The burden of leishmaniasis is highest in children who may present with cutaneous or visceral manifestations. We describe systematically the manifestations, diagnosis and management of leishmaniasis in children <14 years of age, who had a histopathological diagnosis of leishmaniasis in Malta, from 2004 to 2008. Eleven children were diagnosed with leishmaniasis; 8 children (15–44 months of age) had visceral disease and three (aged 9–13 years) suffered cutaneous infections. Prolonged high grade fever, pallor, hepatosplenomegaly, and pancytopenia were common presenting features of visceralisation. Diagnosis was based on the visualisation of amastigotes from bone marrow aspirates. Pentavalent antimonials were associated with treatment failure in two children, whilst liposomal amphotericin B was curative in all. Children with cutaneous leishmaniasis had dry crusted ulcero-nodular lesions on exposed areas which responded to intra-lesional instillation of sodium stibogluconate or to cryotherapy. Leishmaniasis should be included in the differential diagnosis of fever and hepatosplenomegaly or chronic cutaneous lesions in children who travel to Malta. PMID:21212024

Pace, David; Williams, Thomas N.; Grochowska, Alicja; Betts, Alexandra; Attard-Montalto, Simon; Boffa, Michael J.; Vella, Cecil

2011-01-01

233

Symptomatic brain involvement as the initial manifestation of neuromyelitis optica.  

PubMed

Neuromyelitis optica (NMO) is an inflammatory demyelinating disorder that predominantly affects the optic nerve and spinal cord; however, symptomatic brain involvement is not rare and is sometimes an initial manifestation in NMO. In this study, we investigated the characteristic features of patients with NMO with symptomatic brain involvement as the initial manifestation of disease (NMO(brain)) compared with patients with NMO who presented initially with optic neuritis or myelitis (NMO(ON/myelitis)). We retrospectively reviewed 27 consecutive Korean patients with NMO with aquaporin-4 antibodies. Patients with NMO(brain) (n=9) initially presented with intractable hiccup/nausea/vomiting and/or encephalopathy at a younger age than the patients with NMO(ON/myelitis) (n=18) (p<0.01). During the disease course, the patients with NMO(brain) continued to show more frequent symptomatic involvement of the brain than the 18 patients with NMO(ON/myelitis) (p<0.05). At the final visit, the mean age was also significantly lower in patients with NMO(brain) than in patients with NMO(ON/myelitis) (p<0.01); however, the Expanded Disability Status Scale scores, used to evaluate disease progression, were not different between the two groups. Our study suggests that patients with NMO who present initially with symptomatic brain involvement may have earlier disease onset and become disabled at a younger age compared to patients with typical NMO. Additional large scale prospective studies are warranted. PMID:23673142

Min, Ju-Hong; Waters, Patrick; Vincent, Angela; Kang, Eun-Suk; Lee, Sujin; Lee, Dong Kyoo; Lee, Kwang Ho; Kim, Byoung Joon

2013-07-01

234

Skin and Systemic Manifestations of Jellyfish Stings in Iraqi Fishermen  

PubMed Central

Background: Jellyfish stings are common worldwide with an estimated 150 million cases annually, and their stings cause a wide range of clinical manifestations from skin inflammation to cardiovascular and respiratory collapse. No studies on jellyfish stings have been carried out in Basra, Iraq. Objectives: To describe the immediate and delayed skin reactions to White Jellyfish (Rhizostoma sp.) stings and the types of local treatment used by fishermen. Methods and Materials: 150 fishermen were enrolled at three Marine stations in Basra, Iraq. Demographic data, types of skin reactions, systemic manifestations and kinds of treatments were collected. Results: Overall, 79% of fishermen in all three Marine stations gave a history of having been stung. The common sites of sings were the hands and arms followed by the legs. Most fishermen claimed that stings led to skin reactions within 5 minutes. The presenting complaints were itching, burning sensation, and erythematic wheals. A few days after the sting, new groups of painless and itchy erythematous monomorphic papular rashes developed at the site of the sting in 62% of cases as a delayed type of skin reaction that resolved spontaneously. The local remedies commonly used by the fishermen were seawater, tap water and ice. A few fishermen considered stings as insignificant and did not think there was a need to seek medical help. Conclusions: We conclude that jellyfish causes many stings among fishermen in the Basra region. Their stings lead to immediate and delayed skin reactions. Self-treatment by topical remedies is common. PMID:21483513

Al-Rubiay, KK; Al-Musaoi, HA; Alrubaiy, L; Al-Freje, MG

2009-01-01

235

Radiologic Manifestations of Senile Lymph Nodes in the Popliteal Fossa.  

PubMed

Abstract Purpose: To determine the radiologic manifestations of senile lymph nodes in the popliteal fossa for radiologic and clinical application. Methods: A total of six lower extremities from four unembalmed human cadavers were studied. Under a surgical microscope, 6% hydrogen peroxide was used to detect the lymphatic vessels commencing from the foot and leg. A 30-gauge needle was inserted into the vessels and injected with a radio-opaque lead oxide mixture. The specimens were radiographed and photographed to demonstrate the lymph nodes in the popliteal fossa. The final results were transferred to the computer for image analysis. Results: An average of two lymph nodes (range 1 to 3) were found in the popliteal fossa of the lower extremity. They were divided into superficial and deep popliteal groups. The superficial group was located in the superficial layer of the popliteal fossa around the small saphenous vein (SSV). The deep group was close to the popliteal surface of the femur and always located next to the popliteal vein. All lymph nodes were transparent in appearance and contained coiled lymphatic tubules. The size and density of the tubules varied. Conclusion: The radiologic manifestations of senile lymph nodes in the popliteal fossa have been presented and discussed to upgrade our radiologic and anatomical knowledge. This will be of benefit for radiologic and clinical applications. PMID:25121708

Pan, Wei-Ren; Levy, Sidney M; Wang, De-Guang; Chen, Yuan

2014-08-14

236

Clinical manifestations of Q fever in adults and children.  

PubMed

Q fever is a common zoonosis with almost a worldwide distribution caused by Coxiella burnetii. Farm animals and pets are the main reservoirs of infection and transmission to humans is usually via inhalation of contaminated aerosols, which may be carried by the wind far from the original source of infection. Occupational groups with close association with farm or wild animals are most at risk, however travellers occasionally become infected. The disease is associated with a wide spectrum of clinical manifestations and symptoms, ranging from asymptomatic infection to fatal disease. Awareness of the disease and newer diagnostic methods led to increase of recognition and detection in cases with various or multiple symptoms in adults and children. However, children seem to be less frequently symptomatic and may have milder disease. This review of Q fever cases examines clinical manifestations and symptoms of Q fever in both adults and children and shows that certain symptoms and their severity have altered presentation in children with acute and chronic Q fever when compared to adults. PMID:17448942

Terheggen, Ulrich; Leggat, Peter A

2007-05-01

237

Oral Crohn’s disease without intestinal manifestations  

PubMed Central

Crohn?s disease is a granulomatous inflammatory bowel disease and was described in 1932 as a chronic granulomatous disorder of the terminal ileum and is now considered a distinct member of the inflammatory bowel disease family. It may affect any part of the gastrointestinal tract. Oral Crohn?s disease has been reported frequently in the last three decades with or without intestinal manifestations. In the latter case, it is considered as one of the orofacial granulomatosis. There has been much doubt whether intestinal manifestations of Crohn?s disease will eventually develop in the orofacial granulomatosis. We present a female patient aged 22 years with prominent clinical findings such as persistent swelling of lower and upper lip with fissuring and angular cheilitis, granulomatous gingival enlargement, and cobblestone or corrugated appearance of labial mucosa, which are suggestive of Crohn?s disease, but with no evidence of other gastrointestinal involvement. The patient underwent surgical treatment with external gingivectomy procedure. A 6-month follow-up showed minimal recurrence. PMID:23066305

Harikishan, Gingisetty; Reddy, Nagate Raghavendra; Prasad, Harikrishnan; Anitha, Subappa

2012-01-01

238

What we know about ocular manifestations of Ebola  

PubMed Central

Ebola hemorrhagic fever is a deadly disease caused by several species of ebolavirus. The current outbreak of 2014 is unique in that it has affected a greater number of people than ever before. It also has an unusual geographic distribution. Nonspecific findings such as fever and generalized weakness have traditionally been very common early in the acute phase. Ophthalmic manifestations have also been reported in significant numbers. Conjunctival injection has been identified in both the acute and late phases. Subconjunctival hemorrhage and excessive lacrimation have also been reported. Various forms of uveitis have been associated with the convalescent phase of the disease. When identified in conjunction with other signs such as fever, acute findings such as conjunctivitis may contribute to the diagnosis of Ebola hemorrhagic fever. Ideally, serologic testing should be performed prior to isolation and treatment of these individuals. Considering the prevalence of the current outbreak and the threat of transcontinental spread, ophthalmic health professionals need to be aware of the ocular manifestations of Ebola hemorrhagic fever as well as the associated signs and symptoms in order to prevent further spread. PMID:25473261

Moshirfar, Majid; Fenzl, Carlton R; Li, Zhan

2014-01-01

239

Environmental influences on skin aging and ethnic-specific manifestations  

PubMed Central

Skin aging does not only occur by passing time alone but also by the exposure to different environmental factors. The skin aging process, which is induced by environmental factors, is named premature or extrinsic skin aging process and can be distinguished from the chronologically (intrinsic) skin aging process by characteristic skin aging signs. Well known environmental factors leading to extrinsic skin aging are sun exposure and smoking. Recently, an epidemiological study could further discover an association between air pollution and skin aging. First of all the skin aging inducing effect of sun exposure was discovered and an own term (photoaging) was given to this special field of extrinsic skin aging. Mechanistic studies have further increased our knowledge about the molecular pathways by which environmental factors contribute to extrinsic skin aging. In this regard, profound knowledge how sun exposure leads to extrinsic skin aging were gained in the last years, and additionally there are also indications how smoking and air pollution might contribute to this process. Moreover it was realized that extrinsic skin aging manifests differently between different populations. Thus, in this review we summarize the influence of the different environmental factors: sun exposure, smoking and air pollution on skin aging and further present ethnic-specific manifestations of extrinsic skin aging. PMID:23467702

Vierkötter, Andrea; Krutmann, Jean

2012-01-01

240

19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...  

Code of Federal Regulations, 2010 CFR

...false Electronic manifest requirement for all individuals onboard private aircraft arriving...22 Electronic manifest requirement for all individuals onboard private aircraft arriving...b) Electronic manifest requirement for all individuals onboard private aircraft...

2010-04-01

241

15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...  

...export shipping instructions, manifest, train consist, or other commercial loading...transporting goods shall file a car manifest or train consist with CBP Port Director at the border...export shipping instructions, manifest, train consist, or other commercial...

2014-01-01

242

An atlas of the morphological manifestations of hidradenitis suppurativa.  

PubMed

This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. circinate, linear, arcuate), scarring folliculitis of the buttocks (from mild to cigarette-like scarring), condyloma like lesions in intertrigous areas, fishmouth scars, acne inversa, honey-comb scarring, cribiform scarring, tombstone comedones, and morphia-like plaques. HS can co-exist with other follicular diseases such as pilonidal cysts, dissecting cellulitis, acne conglobata, pyoderma gangrenosum, and acanthosis nigricans. In sum, the variety of presentations of HS as shown by these images supports the supposition that HS is a reaction pattern.HS is a follicular based diseased and its manifestations involve a multitude of follicular pathologies [1,2]. It is also known as acne inversa (AI) because of one manifestation that involves the formation of open comedones on areas besides the face. It is as yet unclear why HS is so protean in its manifestations. HS severity is assessed using the Hurley Staging System (Table 1). It also remains unclear why hidradentitis may remain limited to Hurley Stage 1, evolve to the more confluent (Hurley Stage 2), or progress even further to the fully confluent (Hurley Stage 3).In addition, HS can be associated with other follicular based diseases such as pilonidal cysts (PCs) of the sacrum and buttocks, dissecting cellulitis (DC), and acne conglobata (AC), which usually involves the face, chest, When HS occurs with PCs, DC, and/or AC it is referred to as the follicular occlusion triad or tetrad [2]. HS can more rarely be associated with pyoderma gagrenosum (PG) or Crohn disease (CD), other inflammatory diseases of the skin that are not follicular. The reason for this is unclear [2]. What AC, DC, HS, CD, and PG share is that they occur in bacterially rich environments. HS probably occurs with acanthosis nigricans because many HS patients are obese [2]. This concurrence seems under reported. PMID:24746309

Scheinfeld, Noah

2014-01-01

243

Asymmetric graves ophthalmopathy as a sole manifestation of autoimmune hypothyroidism  

PubMed Central

Graves ophthalmopathy (GO) is commonly associated with hyperthyroidism, however its coexistence with hypothyroidism is seen uncommonly in 5% of cases. The ophthalmic signs in GO are usually bilaterally symmetrical, however in 10–15% of cases patients may present asymmetrically. The ophthalmic signs in GO are commonly seen with other systemic features of thyroid disease, however when a patient present with asymmetric ophthalmic signs in the absence of other thyroid manifestations, it is difficult to consider the possibility of thyroid disorder, which may result in delayed diagnosis and further progression of disease. Here, we report a case of 22-year-old man who presented with progressive painless bulging of right eye without other features of thyroid disease which on workup was diagnosed as a case of autoimmune hypothyroidism. PMID:23291813

Verma, Sudhir Kumar; Jain, Nirdesh; Saraf, Sameer; Singh, Shailesh Kumar

2013-01-01

244

Higher derivative corrections to manifestly supersymmetric nonlinear realizations  

NASA Astrophysics Data System (ADS)

When global symmetries are spontaneously broken in supersymmetric vacua, there appear quasi-Nambu-Goldstone (NG) fermions as superpartners of NG bosons. In addition to these, there can appear quasi-NG bosons in general. The quasi-NG bosons and fermions together with the NG bosons are organized into chiral multiplets. Kähler potentials of low-energy effective theories were constructed some years ago as supersymmetric nonlinear realizations. It is known that higher-derivative terms in the superfield formalism often encounter the auxiliary field problem; the auxiliary fields that accompanied with space-time derivatives and cannot be eliminated. In this paper, we construct higher-derivative corrections to supersymmetric nonlinear realizations in the off-shell superfield formalism free from the auxiliary field problem. As an example, we present the manifestly supersymmetric chiral Lagrangian.

Nitta, Muneto; Sasaki, Shin

2014-11-01

245

Right putamen hemorrhage manifesting as apraxia of eyelid opening  

PubMed Central

Purpose The purpose of this report is to demonstrate a rare clinical manifestation of apraxia eyelid opening related to a basal ganglia lesion. Case report In this study, we report a 91-year-old woman suffering from difficulty in eyelid opening after being treated for myocardial ischemia with dual antiplatelet medications. She could open her eyelid with fingers touching her forehead. Brain computed tomography revealed a right putamen hemorrhage. Surface electromyography revealed persistent frontalis muscle contraction during relaxation of orbicularis oculi muscles. Apraxia of eyelid opening was diagnosed. Her eyelid symptom resolved 2 months later. Conclusion Apraxia of eyelid opening may be caused by subcortical hemorrhage of the basal ganglia. In addition to the primary motor cortex and supplemental motor area, the basal ganglia may also play a role in eyelid opening. PMID:24109186

Lin, Yi-Hui; Liou, Li-Min; Lai, Chiou-Lian; Chang, Yang-Pei

2013-01-01

246

Physicochemical Properties of Nanomaterials: Implication in Associated Toxic Manifestations  

PubMed Central

Nanotechnology has emerged as one of the leading fields of the science having tremendous application in diverse disciplines. As nanomaterials are increasingly becoming part of everyday consumer products, it is imperative to assess their impact on living organisms and on the environment. Physicochemical characteristics of nanoparticles and engineered nanomaterials including size, shape, chemical composition, physiochemical stability, crystal structure, surface area, surface energy, and surface roughness generally influence the toxic manifestations of these nanomaterials. This compels the research fraternity to evaluate the role of these properties in determining associated toxicity issues. Reckoning with this fact, in this paper, issues pertaining to the physicochemical properties of nanomaterials as it relates to the toxicity of the nanomaterials are discussed. PMID:25165707

Gatoo, Manzoor Ahmad; Naseem, Sufia; Arfat, Mir Yasir; Mahmood Dar, Ayaz; Qasim, Khusro

2014-01-01

247

Extragastric manifestations of Helicobacter pylori infection -- other Helicobacters.  

PubMed

Today there is evidence that Helicobacter pylori has a critical role in different extragastric diseases. The discovery of a number of other novel Helicobacter species has stimulated the research in different extragastric diseases, in which an infectious hypothesis is plausible. Enterohepatic Helicobacter species have been hypothesized to play a role in different disorders, including hepatocellular carcinoma, gallstones formation and cholangiocellular carcinoma, as well as enteric diseases and inflammatory bowel diseases. Concerning the extragastric manifestations of H. pylori infection, idiopathic thrombocytopenic purpura, and sideropenic anemia represent, based on the current data, the diseases in which the pathogenic link appears to be strongest. There is also an increasing evidence for a possible association of H. pylori with cardiovascular disease. PMID:17727460

Bohr, Ulrich R M; Annibale, Bruno; Franceschi, Francesco; Roccarina, Davide; Gasbarrini, Antonio

2007-10-01

248

[Serrapeptase-induced lung injury manifesting as acute eosiniphilic pneumonia].  

PubMed

An 84-year-old man was referred to our hospital because of fever, cough, and hemoptysis. The patient had acute respiratory failure (PaO2 < 40 mmHg) on admission, with diffuse interstitial infiltration and bilateral pleural effusion. The bronchoalveolar lavage fluid was bloody, and contained a high percentage of eosinophils (32%). A diagnosis of acute eosinophilic pneumonia was established, and the patient made a rapid recovery after corticosteroids were administered. When the DLST (drug lymphocyte stimulation test) was performed after the corticosteroid therapy was stopped, it was positive for serrapeptase, which had been prescribed for chronic cystitis for 3 months before the onset of the pneumonia. This was a case of drug (serrapeptase)-induced pneumonitis manifesting as acute eosinophilic pneumonia. PMID:11019569

Sasaki, S; Kawanami, R; Motizuki, Y; Nakahara, Y; Kawamura, T; Tanaka, A; Watanabe, S

2000-07-01

249

Ball Lightning Manifestation of Cosmic Little Black Holes  

E-print Network

A case is made that in encounters with the earth's atmosphere, astrophysical little black holes (LBH) can manifest themselves as the core energy source of balllightning (BL). Relating the LBH incidence rate on earth to BL occurrence has the potential of shedding light on the distribution of LBH in the universe, and their velocities relative to the earth. Most BL features can be explained by a testable LBH model. Analyses are presented to support this model. LBH produce complex and many-faceted interactions in air directly and via their exhaust, resulting in excitation, ionization, and radiation due to processes such as gravitational and electrostatic tidal force, bremsstrahlung, pair production and annihilation, orbital electron near-capture by interaction with a charged LBH. Gravitational interaction of atmospheric atoms with LBH can result in an enhanced cross-section for polarization and ionization. An estimate for the power radiated by BL ~ Watts is in agreement with observation. An upper limit is found f...

Rabinowitz, M

2001-01-01

250

Recurrent abdominal pain and fever as clinical manifestations: epiploic appendagitis.  

PubMed

Epiploic appendagitis is a relatively rare disease which includes primary and secondary types. Typical manifestations of Primary Epiploic Appendagitis (PEA) are similar to appendicitis except that it is not usually accompanied with fever or leucocytosis, thus misdiagnosis of diverticulitis or appendicitis in clinical settings is common. In this study, we presented a case study of a patient diagnosed with PEA and recurrent abdominal pain and fever for four months The patient experienced persistent dull abdominal pain since four months age and after tolerating a recent episode of pain for two days, and developed a fewer of up to 39°C accompanied with chills. Clinical analysis and computed tomography (CT) were conducted to better understand PEA. PMID:25550980

Li, Lin; Shen, Zhe; Xu, Lei; Guo, Ganhua; Qin, Yu'e

2014-01-01

251

Cardiac tamponade as manifestation of advanced thymic carcinoma.  

PubMed

Thymic carcinoma, a malignant thymoma, is rare in the anterior mediastinum. Typically it occurs after age 40 years, presents as an asymptomatic disorder for prolonged periods of time, and is incidentally detected by chest radiograph. Symptomatic patients often complain of a dull ache or chest pain. Cardiac tamponade as the first manifestation of these advanced thymomas is unusual. We now report the case of a 47-year-old man who experienced sudden onset syncope because of cardiac tamponade and massive pleural and pericardial effusions resulting from a huge thymic tumor. Emergency pericardiocentesis and thoracentesis terminated the life-threatening episode. The tumor and lung lesion were resected. Pathologic examination showed a moderately differentiated squamous cell carcinoma. Postoperative radiotherapy and chemotherapy were introduced. The patient has subsequently done well for the past 10 months. PMID:15761459

Cheng, Ming-Fang; Tsai, Chien-Sung; Chiang, Pei-Chun; Lee, Herng-Sheng

2005-01-01

252

Oral manifestations of epidermolysis bullosa dystrophica: a rare genetic disease  

PubMed Central

Epidermolysis bullosa (EB) constitutes a group of phenotypically diverse genodermatoses, which manifests with blistering and erosions of the skin and mucous membranes as the unifying diagnostic feature. It is an acquired disease or inherited as either autosomal-dominant or recessive with an incidence of 1/50?000. The prominent clinical characteristic of the disease is the development of bullae or vesicles in mucosa or skin in response to minor trauma. It is a chronic mechanobullous disease characterised by auto antibodies against Type VII collagen. This paper documents a case of a man diagnosed with dominant dystrophic EB; describing the measures that dentists and healthcare providers should adopt in order to provide a safe and effective dental treatment. Early prevention protocols for these patients have also been discussed. PMID:23349175

Parushetti, Anita Dundappa; Agrawal, Jiwanasha Manish; Nanjannawar, Lalita Girish; Agrawal, Manish Suresh

2013-01-01

253

Clinical Manifestations and Management of Dengue/DHF/DSS.  

PubMed

Dengue is one of the most important mosquito-borne viral illnesses. The first DHF outbreak was reported from the Philippines in 1953. Initially it was endemic only in Southeast Asia and the Western Pacific regions. After about 50 years from the first outbreak, it spread globally to almost every continent including North and South America, Australia and Africa. The majority of cases during the 50s to 80s were children, but today the disease affects both children and adults of all age groups. The disease is caused by dengue viruses that have four serotypes: dengue 1, dengue 2, dengue 3 and dengue 4. Primary infection usually results in milder illness, while more severe disease occurs in cases of repeated infection with different serotypes. In this paper clinical manifestations and management of dengue/DHF/DSS are summarized. PMID:22500140

Kalayanarooj, Siripen

2011-12-01

254

Clinical Manifestations and Management of Dengue/DHF/DSS  

PubMed Central

Dengue is one of the most important mosquito-borne viral illnesses. The first DHF outbreak was reported from the Philippines in 1953. Initially it was endemic only in Southeast Asia and the Western Pacific regions. After about 50 years from the first outbreak, it spread globally to almost every continent including North and South America, Australia and Africa. The majority of cases during the 50s to 80s were children, but today the disease affects both children and adults of all age groups. The disease is caused by dengue viruses that have four serotypes: dengue 1, dengue 2, dengue 3 and dengue 4. Primary infection usually results in milder illness, while more severe disease occurs in cases of repeated infection with different serotypes. In this paper clinical manifestations and management of dengue/DHF/DSS are summarized. PMID:22500140

Kalayanarooj, Siripen

2011-01-01

255

Cervical mass as the presenting manifestation of hepatocellular carcinoma  

PubMed Central

Background: Hepatocellular carcinoma is one of the most common cancers in the world due to its association with chronic hepatitis infections. Amongst the most usual metastasis of hepatocellular carcinoma are the lymph nodes, the lungs and the bones. Soft tissue metastases are extremely rare. Case presentation: Herein, we report the case of a 73-years-old male patient who presented with cervical and upper extremities muscle pain along with paresthesias and a palpable mass on the cervical region. Conclusion: This unusual clinical manifestation along with the above-described rare presentations of hepatocellular carcinoma must be taken into account, especially among patients with chronic hepatitis infections. Hippokratia 2014; 18 (3): 285-287.

Vallianou, NG; Gounari, P; Skourtis, A; Vourlakou, C

2014-01-01

256

Pictorial review of intrathoracic manifestations of progressive systemic sclerosis  

PubMed Central

Intra-thoracic manifestations of progressive systemic sclerosis (PSS) are not well known particularly the imaging features, which forms the basis of accurate and timely diagnosis. The aim of this study is to familiarize the physicians and radiologists with these features. The diagnosis can remain elusive because of the non-specific nature of symptoms which mimic many common conditions. Thus, the diagnosis of PSS can be missed leading to continuous morbidity if the correct imaging is not pursued. The authors examined the records of rheumatology patient referrals of over a 5 year period. A hundred and seventy patients with systemic sclerosis and mixed connective tissue disorders were chosen for detailed study of the imaging available, which form the basis of this review. The images included conventional chest radiographs, digital radiographs computed radiography (CT) and high resolution computed tomography (HRCT). Where applicable computed pulmonary angiography (CTPA) and radionuclide scans were also interrogated. PMID:25276237

AL-Jahdali, Hamdan; Rajiah, Prabhakar; Allen, Carolyn; Koteyar, Shyam Sunder; Khan, Ali Nawaz

2014-01-01

257

Trypanosoma cruzi infection: a review with emphasis on cutaneous manifestations  

PubMed Central

Chagas disease, an infection caused by the protozoan Trypanosoma cruzi and transmitted by the Reduuvid insect vector, remains a major cause of morbidity in Central and South America over a century after its discovery in 1909. Though major advances in preventing the spread of this disease have been made in recent decades, millions of individuals remain chronically infected due to prior exposure to T. cruzi and are at risk for future complications from the disease. Dermatologic manifestations of acute infection may include localized swelling at the site of inoculation (chagoma), conjunctivitis (Romaña’s sign), and a generalized morbilliform eruption (schizotrypanides). Reactivation of quiescent infection in immunocompromised hosts due to the acquired immunodeficiency syndrome or organ transplantation can present with fever and skin lesions including panniculitis. The wide-spread emigration of chronic carriers of T. cruzi to North America, Europe, and Australia makes it imperative that dermatologists worldwide be familiar with this entity to ensure proper diagnosis and treatment. PMID:22515575

Hemmige, Vagish; Tanowitz, Herbert; Sethi, Aisha

2013-01-01

258

Oral manifestations of Ellis-van Creveld syndrome  

PubMed Central

Ellis-van Creveld syndrome is a rare autosomal-recessive disorder characterized by short limbs, post-axial polydactyly, ectodermal dysplasia, edentulous mandibular incisor region, absence of mucobuccal fold, congenitally missing teeth, slight serrations of the alveolar ridge and multiple small alveolar notches. The clinical report not only describes the classical oral and dental manifestations of Ellis-van Creveld syndrome but also presents unusual findings such as single-rooted and funnel-shaped primary first molars, single conical roots of primary second molars and taurodontisum, which must be considered in the differential diagnostic criteria to avoid misdiagnosis of syndromes. The article also discusses the differential diagnosis and preventive and therapeutic oral health care for these patients. The management of Ellis-van Creveld syndrome is multidisciplinary and, therefore, the oral health care provider should get updated with latest knowledge for timely referral to prevent the patient from further complications of heart defect and bony deformity. PMID:22629068

Kalaskar, Ritesh; Kalaskar, Ashita R.

2012-01-01

259

Cutaneous manifestation of ??-antitrypsin deficiency: panniculitis absent on biopsy.  

PubMed

Patients with ??-antitrypsin (AAT) deficiency may develop cutaneous manifestations of the disorder that histologically appear as panniculitis. Algorithms consistently emphasize measuring AAT levels when both clinical and histological features of deficiency are present; however, the patient's medical history and a physical examination alone can be extremely helpful in guiding the physician to the diagnosis of AAT deficiency. We describe a patient who presented with the classic clinical findings of AAT deficiency-associated panniculitis with surprising absence of panniculitis on repeated deep incisional biopsies. We propose a triad of classic findings that should alert the clinician to check the patient's serum AAT levels, even in the absence of panniculitis on histologic evaluation. Consideration of this clinical triad may prevent delays in the diagnosis of AAT deficiency, as early lesions may not yet demonstrate subcutaneous fat involvement. PMID:24999642

Streicher, Jenna L; Sheehan, Michael P; Armstrong, Andrew B; Mousdicas, Nico

2014-06-01

260

Cutaneous manifestations of injectable drug use: hidden secrets.  

PubMed

Abscesses related to drug use are the most common cutaneous manifestations among injection drug users, often occurring when the veins become less accessible. In these cases, other techniques may be used to administer drugs, such as skin popping (subcutaneous injection) or muscle popping (intramuscular injection). The main risk factors for abscess formation include skin popping, use of unsterilized needles, and injection of speedball (a mixture of cocaine and heroin). We present a case of recurrent abscesses accompanied by fever, hypersomnia alternating with insomnia, diaphoresis, fatigue, recent weight loss, and agitation following subcutaneous injection of a tramadol, opipramol, and clonazepam mixture. Differential diagnoses included pyoderma gangrenosum on the basis of hepatitis C virus, skin lesions connected with human immunodeficiency virus infection, vasculitis, endocarditis, and serotonin syndrome. The patient was treated with oral antibiotics, surgical incision, and drainage of the abscesses, with consequent improvement. PMID:24818177

Bara?ska-Rybak, Wioletta; B?a?ewicz, Izabela; K?kol, Monika; Roter, Miros?aw; Nowicki, Roman

2014-04-01

261

The gastrointestinal manifestations of scleroderma: pathogenesis and management.  

PubMed

This case exemplifies the severe gastrointestinal manifestations of scleroderma. Esophageal, gastric, small intestinal, and colonic motility disorders were present. The patient was unable to survive on oral feedings or tube feedings. He was clinically resistant to the pharmacologic stimulation of gastrointestinal motility. After considerable discussion the patient was begun on intravenous hyperalimentation to be performed at home. Approximately 1 hr later, he has done remarkably well. He has maintained his weight and has had only one brief hospitalized for a sepsis most likely related to the intravenous feedings. He is still unable to take oral feedings. Other organs have remained clinically uninvolved, and the skin and joint disease have remained stable. It is our feeling that intravenous home alimentation has provided a useful adjunct to management in this patient with severe gastrointestinal involvement of scleroderma. It is hoped that the newer therapeutic modalities described by Dr. Jimenez may be effective in patients with this disease who can now be nourished parenterally. PMID:6769749

Cohen, S

1980-07-01

262

The neuropsychiatric manifestations of Huntington's disease-like 2.  

PubMed

Huntington's disease-like 2 (HDL2) is a rare neuropsychiatric disorder that resembles HD but results from a distinct mutation. The authors present a patient with HDL2, hospitalized for psychiatric management, and they review the neuropsychiatric manifestations of this disorder. Depression, irritability/aggression, and frontal lobe personality changes are common presentations of HDL2 and are comparable to classic HD. Patients with HDL2 may differ from those with HD in having a lower incidence of obsessive-compulsive acts, known suicides, antisocial acts, and changes in sexuality. Clinicians should be aware of the psychiatric presentations of this disorder, when to obtain genetic testing, and how to manage problematic behaviors. PMID:23224457

Fischer, Christopher A; Licht, Eliot A; Mendez, Mario F

2012-01-01

263

Quantum manifestation of a synchronization transition in optomechanical systems  

NASA Astrophysics Data System (ADS)

Recent years have witnessed significant interest in nanoscale physical systems, such as nanoelectromechanical and optomechanical systems, which can exhibit distinct collective dynamical behaviors, such as synchronization. As a parameter of the system changes, transition from one type of emerging collective behavior to another can occur. But what are the quantum manifestations of such a transition? We investigate a system of two optically coupled optomechanical cavities and uncover the phenomenon of transition from in-phase to antiphase synchronization. Quantum mechanically, we find that, associated with the classical transition, the entanglement measures between the various optical and mechanical degrees of freedom in the two cavities exhibit a change characteristic of second-order phase transition. These phenomena can be tested experimentally.

Ying, Lei; Lai, Ying-Cheng; Grebogi, Celso

2014-11-01

264

Clinical Manifestations and Diagnostic Challenges in Acute Porphyrias  

PubMed Central

The porphyrias are a group of disorders characterized by an enzyme deficiency in the heme biosynthetic pathway. These can be classified into either erythropoietic or hepatic forms depending on the site of the major enzyme deficiency. The diagnosis of acute porphyrias, however, can be very challenging due to overlapping features amongst the various types. Initial suspicion is based on a myriad of clinical manifestations, which then are confirmed by laboratory testing where available. Genetic testing is now also available for the different types of porphyrias, aiding in the definitive diagnosis. Here, we present a challenging case of porphyria in a patient with end-stage renal disease and present the diagnostic challenges associated with the case and the ways forward. PMID:23476835

Trier, Henry; Krishnasamy, Vikram P.; Kasi, Pashtoon Murtaza

2013-01-01

265

Star copolymers in porous environments: scaling and its manifestations  

E-print Network

We consider star polymers, consisting of two different polymer species, in a solvent subject to quenched correlated structural obstacles. We assume that the disorder is correlated with a power-law decay of the pair correlation function g(x)\\sim x^{-a}. Applying the field-theoretical renormalization group approach in d dimensions, we analyze different scenarios of scaling behavior working to first order of a double \\epsilon=4-d, \\delta=4-a expansion. We discuss the influence of the correlated disorder on the resulting scaling laws and possible manifestations such as diffusion controlled reactions in the vicinity of absorbing traps placed on polymers as well as the effective short-distance interaction between star copolymers.

Viktoria Blavatska; Christian von Ferber; Yurij Holovatch

2010-10-11

266

Recurrent abdominal pain and fever as clinical manifestations: epiploic appendagitis  

PubMed Central

Epiploic appendagitis is a relatively rare disease which includes primary and secondary types. Typical manifestations of Primary Epiploic Appendagitis (PEA) are similar to appendicitis except that it is not usually accompanied with fever or leucocytosis, thus misdiagnosis of diverticulitis or appendicitis in clinical settings is common. In this study, we presented a case study of a patient diagnosed with PEA and recurrent abdominal pain and fever for four months The patient experienced persistent dull abdominal pain since four months age and after tolerating a recent episode of pain for two days, and developed a fewer of up to 39°C accompanied with chills. Clinical analysis and computed tomography (CT) were conducted to better understand PEA.

Li, Lin; Shen, Zhe; Xu, Lei; Guo, Ganhua; Qin, Yu’e

2014-01-01

267

Aspergillus Osteomyelitis: Epidemiology, Clinical Manifestations, Management, and Outcome  

PubMed Central

Background The epidemiology, pathogenesis, diagnosis, and management of Aspergillus osteomyelitis are not well understood. Methods Protocol-defined cases of Aspergillus osteomyelitis published in the English literature were reviewed for comorbidities, microbiology, mechanisms of infection, clinical manifestations, radiological findings, inflammatory biomarkers, antifungal therapy, and outcome. Results Among 180 evaluable patients, 127 (71%) were males. Possible predisposing medical conditions in 103 (57%) included pharmacological immunosuppression, primary immunodeficiency, and neutropenia. Seventy-three others (41%) had prior open fracture, trauma or surgery. Eighty (44%) followed a hematogenous mechanism, 58 (32%) contiguous infections, and 42 (23%) direct inoculation. Aspergillus osteomyelitis was the first manifestation of aspergillosis in 77%. Pain and tenderness were present in 80%. The most frequently infected sites were vertebrae (46%), cranium (23%), ribs (16%), and long bones (13%). Patients with vertebral Aspergillus osteomyelitis had more previous orthopedic surgery (19% vs 0%; P=0.02), while those with cranial osteomyelitis had more diabetes mellitus (32% vs 8%; P=0.002) and prior head/neck surgery (12% vs 0%; P=0.02). Radiologic findings included osteolysis, soft-tissue extension, and uptake on T2-weighted images. Vertebral body Aspergillus osteomyelitis was complicated by spinal-cord compression in 47% and neurological deficits in 41%. Forty-four patients (24%) received only antifungal therapy, while 121(67%) were managed with surgery and antifungal therapy. Overall mortality was 25%. Median duration of therapy was 90 days (range, 10–772 days). There were fewer relapses in patients managed with surgery plus antifungal therapy in comparison to those managed with antifungal therapy alone (8% vs 30%; P=0.006). Conclusions Aspergillus osteomyelitis is a debilitating infection affecting both immunocompromised and immunocompetent patients. The most common sites are vertebrae, ribs, and cranium. Based upon this comprehensive review, management of Aspergillus osteomyelitis optimally includes antifungal therapy and selective surgery to avoid relapse and to achieve a complete response. PMID:24378282

Gamaletsou, Maria N.; Rammaert, Blandine; Bueno, Marimelle A.; Moriyama, Brad; Sipsas, Nikolaos V.; Kontoyiannis, Dimitrios P.; Roilides, Emmanuel; Zeller, Valerie; Prinapori, Roberta; Tajaldeen, Saad Jaber; Brause, Barry; Lortholary, Olivier; Walsh, Thomas J.

2014-01-01

268

Pseudoexfoliation syndrome, a systemic disorder with ocular manifestations  

PubMed Central

Pseudoexfoliation syndrome (PXS) is a systemic condition with eye manifestations. In the eye, pseudoexfoliation material deposits on various structures of the anterior segment. The nature of this material is mostly fibrillar with fibers made up of microfibrils and coated with amorphous material. The composition of these fibrils is diverse and includes basement membrane components as well as enzymes involved in extracellular matrix maintenance. Pseudoexfoliation is the most common cause of secondary open-angle glaucoma (pseudoexfoliation glaucoma, PXG) worldwide. The goal of this review is to summarize our knowledge on the genetics of this systemic disorder and its resultant ocular manifestations. PXS familial aggregation suggests genetic inheritance. PXS has been strongly associated with single nucleotide polymorphisms (SNPs) of the lysyl oxidase-like 1 (LOXL1) gene on chromosome 15q24.1. Two of these SNPs confer a higher than 99% population attributable risk for PXS and PXG in the Nordic population; however, they carry different risks in different populations. The high risk haplotypes also vary among different populations. LOXL1 is one of group of the enzymes involved in the cross-linking of collagen and elastin in the extracellular matrix. Its function in connective tissue maintenance has been confirmed in mice; however, its actual role in PXS remains unclear. Contactin-associated protein-like 2 also has a strong genetic association with PXS in a German cohort and is an attractive candidate molecule. It encodes for a protein involved in potassium channel trafficking. Other candidate genes linked to PXS include lysosomal trafficking regulator, clusterin, adenosine receptors, matrix metalloproteinase-1 (MMP1), and glutathione transferase. These genes may be modifying genes for development of PXS and PXG. PMID:23157966

2012-01-01

269

Non-cardiac manifestations of neonatal lupus erythematosus.  

PubMed

Neonatal lupus erythematosus (NLE) is characterized by the transplacental passage of maternal anti-Ro and/or anti-La antibodies and characteristic illnesses in the foetus/neonate. Most attention has focused on the most serious complication- cardiac involvement. This article will focus on non-cardiac involvement. Skin involvement (cutaneous NLE) is present in 15-25% of children with NLE. The rash of NLE tends to be photosensitive but may be present at birth or in non-sun exposed areas. It is most frequently seen around the eyes, not in the malar area, but also occurs in other parts of the body. The pathology resembles the rash of subacute cutaneous lupus erythematosus. Anti-Ro antibodies are present in >95% with the remaining mothers having anti-U1RNP antibodies only. Asymptomatic elevation of liver function tests, which may be associated with evidence of cholestasis, is seen in 10-25% of cases of NLE. Mild hepatomegaly and less commonly splenomegaly may be present. Liver involvement seen in isolation or associated with other features. The pathology resembles idiopathic neonatal giant cell hepatitis. Any haematological lineage, neutropenia and thrombocytopenia most commonly, may be affected by NLE. Haematological involvement is almost always asymptomatic. There are protean manifestations of neurologic involvement in NLE: hydrocephalus, non-specific white matter changes, calcification of the basal ganglia and a 'vasculopathy'. The most unusual feature of NLE is the radiographic finding of stippling of the epiphyses (chondrodysplasia punctata). Overall, non-cardiac involvement of NLE is more common than cardiac. The study of these manifestations may lead to new insight into how autoantibodies lead to disease. PMID:20696019

Silverman, E; Jaeggi, E

2010-09-01

270

Cryopyrin-Associated Periodic Syndromes: Otolaryngologic and Audiologic Manifestations  

PubMed Central

Objective Cryopyrin-associated periodic syndromes (CAPS) represent a spectrum of CIAS1 gene-mediated autoinflammatory diseases characterized by recurrent systemic inflammation. The clinical spectrum of CAPS varies from mild to severe and includes the syndromes historically described as familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (NOMID). This article presents the largest cohort of patients with CAPS. The objective is to describe the pathogenesis, otolaryngologic, and audiologic manifestations of CAPS. Study Design Prospective (2003–2009). Setting National Institutes of Health. Subjects and Methods Fifty-seven patients with a diagnosis of CAPS were identified (31 NOMID, 11 NOMID/MWS, 9 MWS, and 6 FCAS). Comprehensive data regarding clinical manifestations, audiologic phenotype, and fluid attenuation inversion recovery MRI (FLAIR-MRI) of the brain and inner ear were obtained. Results Complete audiologic data obtained on 70% of ears revealed conductive hearing loss in 4 (11%) NOMID ears and mixed hearing loss in 5 (13%) NOMID and 2 (14%) NOMID/MWS ears. Sensorineural hearing loss (SNHL), worse in higher frequencies, was the most common type of hearing loss and was present in 23 (61%) NOMID, 10 (71%) NOMID/MWS, and 4 (33%) MWS ears. All of the patients with FCAS had normal hearing except 2, who had SNHL from 4 to 8 kHz. On FLAIR-MRI sequence, cochlear enhancement was noted in 26 of 29 (90%) NOMID, 6 of 11 (55%) NOMID/MWS, 3 of 9 (33%) MWS, and 1 of 6 (17%) FCAS patients and was significantly associated with the presence of hearing loss. Maxillary sinus hypoplasia and mucosal thickening were found in 39% and 86% of the cohort, respectively. Conclusion CIAS1 pathway–mediated CAPS is associated with unregulated autoinflammation mediated by interleukin-1 in the cochlea and hearing loss. Timely diagnosis is crucial to initiate early treatment with interleukin-1 receptor antagonists. PMID:21493283

Ahmadi, Neda; Brewer, Carmen C.; Zalewski, Christopher; King, Kelly A.; Butman, John A.; Plass, Nicole; Henderson, Cailin; Goldbach-Mansky, Raphaela; Kim, H. Jeffrey

2012-01-01

271

Clinical Manifestations among Children with Chronic Functional Constipation  

PubMed Central

BACKGROUND Constipation is one of the most frequent cause of patient visits to pediatric gastroenterology clinics. Early diagnosis and treatment is important. There are few studies about clinical manifestations of constipation in children. We aimed to find the relative frequency of gastrointestinal manifestations of constipation among constipated children. METHODS This cross-sectional study was carried out on children aged < 18 years old with chronic functional constipation referred to Imam Reza Clinic of Shiraz University of Medical Sciences. Children with organic causes of chronic constipation were excluded from study. Rome III criteria were used for defining constipation. The duration of study was 1 year starting from September 2010. Abdominal pain, fecal mass, rectal bleeding, anorexia, fecal soiling, retentive posture, withholding behavior, anal fissure, and peri-anal erythema were recorded for each case based on history and physical examination. Data were analyzed using SPSS software, version 13.0 (Chicago, IL, USA). RESULTS Of 222 children with functional constipation, 124(55.9%) were girls and 98 (44.1%) were boys with a mean ± SD age of 5±3.12 years. The mean ± SD duration of constipation was 2.2±1.9 years. Large and hard stool was present in 93.7% of the patients. Painful defecation and withholding behavior were seen in 92.3% and 91.9% of the patients, respectively. Fecal impaction was more frequent among boys compared with girls (p<0.01). Fecal soiling was present in 40.8% of the boys and 28.2% of the girls (p=0.04). CONCLUSION Large and hard stool, painful defecation and withholding behavior were the most frequent signs or symptoms among children with chronic functional constipation. Fresh rectal bleeding and anal fissure were the least frequent signs and symptoms in this group. PMID:25628851

Dehghani, Seyed Mohsen; Kulouee, Niloofar; Honar, Naser; Imanieh, Mohammad-Hadi; Haghighat, Mahmood; Javaherizadeh, Hazhir

2015-01-01

272

Cutaneous Manifestations in HTLV-I Positive Blood Donors  

PubMed Central

Objective(s): Infection with the human T-cell lymphotrophic virus type-I (HTLV-I) is endemic in Mashhad, Iran. In our research we evaluated the relation between exposure to this infection and the occurrence of dermatologic manifestations. Materials and Methods: 100 blood donors, who were seropositive but asymptomatic for infection with HTLV-I, were selected as case group. They were identified by the Blood Transfusion Organization Mashhad via the ELISA test and documented by PCR. Another 100 blood donors, that were seronegative for HTLV-I via the ELISA test and who were matched to the case group for age, gender, and existence of systemic diseases, were considered as the controls. Dermatologic evaluations and skin biopsies were performed if deemed necessary, and the results were statistically analyzed. Results: 73% of the case and control groups were male, while 27% in each of these groups were female. The mean age in both groups was 40.96±11.94 years. The examination indicated that 58% of the case group and 37% of the control group had cutaneous manifestations (P<0.01). The most common diseases found in the case group were aphthous stomatitis, herpes labialis, and non-genital warts, while common diseases found in the control group were herpes labialis, aphthous stomatitis, and skin tag. The frequency of aphthous stomatitis, eczema, and non-genital warts in the case group were significantly more than the control group (P<0.05). Conclusion : Cutaneous diseases can be found more frequent in asymptomatic carriers of HTLV-I than those who are HTLV-I seronegative. The aphthous stomatitis, eczema, and non-genital warts are more prevalent in those infected by HTLV-I. PMID:24470876

Yazdanpanah, Mohammad Javad; Maleki, Masoud; Joneidi, Nasaibe; Khalighi, Amir Reza; Azarpazhooh, Mahmoud Reza; Khajedaluee, Mohammad; Tehranian, Farahnaz; Shahabi, Majid; Esmaeil Khayami, Mohammad; Livani, Fatemeh

2013-01-01

273

Age and manifestation related symptoms in familial adenomatous polyposis  

PubMed Central

Background To identify early symptoms of familial adenomatous polyposis with a view to improve early diagnosis and treatment. Diagnosis on the basis of genetic testing is usually limited to where there is a known family history, so FAP is more usually diagnosed on clinical grounds. Except for those identified via FAP registers, the majority of patients are symptomatic at the time of diagnosis. Methods We undertook a retrospective study of 143 FAP patients treated at the Department of Surgery, University of Erlangen between 1971 and 2000. We identified patterns of symptoms, endoscopic findings and extracolonic manifestations in three age groups. Results FAP was diagnosed clinically on the basis of symptoms in 84% (120/143) of these patients. Most presented with intestinal symptoms such as colonic bleeding (68%) and diarrhea (42%). All but one of the patients between 20 and 40 years old had rectal polyps (98.7%, 75/76), whereas in those over 40 years old the prevalence was 76% (35/46). Non-specific symptoms such as abdominal pain, fatigue and bloating were less frequent and were mainly reported by patients older than 40. Conclusion The commonest presenting features of FAP are alteration of bowel habit and rectal bleeding, but both are found in many other conditions. Patients with these findings need immediate endoscopy to allow prompt diagnosis and prophylactic surgery. PMID:15740631

Croner, Roland S; Brueckl, Wolfgang M; Reingruber, Bertram; Hohenberger, Werner; Guenther, Klaus

2005-01-01

274

Pulmonary manifestations of immunoglobulin G4-related sclerosing disease.  

PubMed

Immunoglobulin (Ig)G4-related sclerosing disease (ISD) (also called IgG4-related systemic disease, IgG4-related disease or hyper-IgG4 disease) is a recently described systemic fibroinflammatory disease associated with elevated circulating levels of IgG4. Although initial descriptions of this disorder focused on its pancreatic presentation (autoimmune pancreatitis), it has become apparent that ISD is a systemic disease with many facets. The lesion of ISD is characterised by lymphoplasmacytic inflammation, fibrosis, phlebitis and increased numbers of IgG4-positive plasma cells. The disease can either be localised to one or two organs, or be present with diffuse multi-organ disease. Furthermore, lesions in different organs can present simultaneously or metachronously. In the thorax, lesions associated with ISD have been described in the lung parenchyma, airways and pleura, as well as the mediastinum. Data published to date suggest that ISD may account for a portion of various fibroinflammatory conditions of unknown cause encountered in the chest, including inflammatory pseudotumours, idiopathic interstitial pneumonias, fibrosing mediastinitis, inflammatory pleural lesions and, occasionally, airway disease. Some aspects of pulmonary manifestations attributed to ISD remain controversial and additional studies are needed to clarify the relationship along with the increasing relevance of this disorder to pulmonary medicine. PMID:21719489

Ryu, J H; Sekiguchi, H; Yi, E S

2012-01-01

275

Fraser Syndrome-Oral Manifestations and a Dental Care Protocol  

PubMed Central

Fraser syndrome is a rare genetic malformation with an autosomal recessive pattern of inheritance and an incidence of consanguinity ranging from 15% to 25%. A 5-year-old male patient who is a carrier of Fraser syndrome initiated treatment in the pediatric dentistry sector. The patient was fed parenterally since birth, experienced recurring bouts of chronic lung disease, and was referred to the pediatric dentistry sector by the medical team. Radiographic examination revealed the presence of all permanent teeth. Supragingival dental calculus, halitosis, and gingival inflammation were also observed. Dental calculus was removed by manual scraping, and chemotherapeutic agents were used, chlorhexidine 0,12%, chlorhexidine gel 2%, and PVP-I, to control the bacterial flora. The patient is still being monitored after an 8-year follow-up period, the complications associated with periodontal disease decreased, and since the initiation of treatment, the patient has not needed to be hospitalized because of chronic lung disease. This study reports the case of a patient diagnosed with Fraser syndrome and describes the clinical manifestations (general and oral). PMID:25587460

de Oliveira, Talita Lopes; de Sant'Anna, Giselle Rodrigues

2014-01-01

276

Superwarfarin intoxication: hematuria is a major clinical manifestation.  

PubMed

Since superwarfarin is popular and readily available in stores, it may cause intoxication or overexposure, which can result in coagulopathy or abnormal bleeding in humans and, thus, is an important public health problem. We report our clinical experience with superwarfarin intoxication. Nine patients, including eight patients who had histories of ingesting superwarfarin, were studied. Of the patients, hematuria occurred in eight. Laboratory tests among the nine patients showed extremely prolonged prothrombin times and activated partial thromboplastin times, which could be corrected to normal by mixing 1:1 with normal pooled plasma; they also had very low functional levels of factor II, VII, IX, X, and proteins C and S, but normal functional levels of factors V, VIII, fibrinogen, and anti-thrombin III. Large doses of vitamin K1 were needed for 3 months or more to treat and correct the coagulopathy among the patients. The majority of the patients presented with gross hematuria, suggesting that hematuria is probably a major clinical manifestation of superwarfarin intoxication. Prolonged use of large doses of vitamin K1 is needed for the treatment of superwarfarin intoxication. PMID:19588218

Wu, Yi-Feng; Chang, Cheng-Shyong; Chung, Chih-Yuan; Lin, Hsuan-Yu; Wang, Chuan-Cheng; Shen, Ming-Ching

2009-09-01

277

Ocular manifestations of graft-versus-host disease  

PubMed Central

Allogeneic hematopoietic stem cell transplantation (HSCT) has evolved over the past two decades to become the standard of care for hematologic and lymphoid malignancies. Major ocular complications after allogeneic HSCT have been increasing in number and severity. Graft-versus-host disease (GVHD) remains a major cause of ocular morbidity after allogeneic HSCT. The main objective of this review is to elucidate the ocular complications in patients developing GVHD following HSCT. Ocular complications secondary to GVHD are common and include dry eye syndrome, acquisition of ocular allergy from donors with allergic disorders. Eyelid changes may occur in GVHD leading to scleroderma-like changes. Patients may develop poliosis, madarosis, vitiligo, lagophthalmos, and entropion. The cornea may show filamentary keratitis, superficial punctate keratitis, corneal ulcers, and peripheral corneal melting which may lead to perforation in severe cases. Scleritis may also occur which can be anterior or posterior. Keratoconjunctivis sicca appears to be the most common presentation of GVHD. The lacrimal glands may be involved with mononuclear cell infiltration of both the major and accessory lacrimal glands and decrease in tear production. Severe dry eye syndrome in patients with GVHD may develop conjunctival scarring, keratinization, and cicatrization of the conjunctiva. Therapy of GVHD includes systemic immunosuppression and local therapy. Surgical treatment in refractory cases includes surgical intervention to improve the manifestation of GVHD of the eye. This may include tarsorrhapy, prose lenses, punctal occlusions and corneal transplantation. PMID:24227989

Nassar, Amr; Tabbara, Khalid F.; Aljurf, Mahmoud

2013-01-01

278

Astrophysical manifestations of clumps of cold dark matter  

SciTech Connect

Small-scale structures (clumps) of dark matter may manifest themselves owing to the annihilation of dark-matter particles in them as pointlike gamma-ray sources. In view of this, investigation into respective effects on the basis of data on unidentified pointlike gamma-ray sources is of importance. It is shown that the existing uncertainties in the description of physical properties of dark-matter particles (their annihilation cross section) and in the distribution of their density in the clumps are of crucial importance; therefore, an analysis of data from the observation of pointlike gamma-ray sources makes it possible to impose constraints on the values of respective uncertain parameters (that is, to single out preferable ones). It is considered that the rate of annihilation of dark-matter particles in the clumps may be enhanced both owing to a higher density and owing to the growth of the cross section at low relative velocities of dark-matter particles in the clumps. In particular, dark-matter particles may have self-interaction of the Coulomb type, and this leads to the enhancement of the annihilation rate because of the Sommerfeld-Sakharov effect. It is shown that the heavy-neutrino model featuring an extra interaction can explain partly Fermi and EGRET data on unidentified pointlike gamma-ray sources. It is indicated that the motion of gamma-ray sources over the celestial sphere can be noticed for several clumps within several years of observations.

Belotsky, K. M., E-mail: k-belotsky@yandex.ru; Kirillov, A. A., E-mail: kirillov-aa@yandex.ru; Khlopov, M. Yu., E-mail: khlopov@apc.univ-paris7.fr [National Research Nuclear University MEPhI (Russian Federation)

2013-04-15

279

Ball Lightning: Manifestation of Cosmic Little Black Holes  

E-print Network

A case is made that in encounters with the earth's atmosphere, astrophysical little black holes (LBH) can manifest themselves as the core energy source of balllightning (BL). Relating the LBH incidence rate on earth to BL occurrence has the potential of shedding light on the distribution of LBH in the universe, and their velocities relative to the earth. Most BL features can be explained by a testable LBH model. Analyses are presented to support this model. LBH produce complex and many-faceted interactions in air directly and via their exhaust, resulting in excitation, ionization, and radiation due to processes such as gravitational and electrostatic tidal force, bremsstrahlung, pair production and annihilation, orbital electron near-capture by interaction with a charged LBH. Gravitational interaction of atmospheric atoms with LBH can result in an enhanced cross-section for polarization and ionization. An estimate for the power radiated by BL ~ Watts is in agreement with observation. An upper limit is found for the largest masses that can produce ionization and polarization excitation. It is shown that the LBH high power exhaust radiation is not prominent and its effects are consistent with observations.

Mario Rabinowitz

2001-04-03

280

Microthrombotic/microangiopathic manifestations of the antiphospholipid syndrome.  

PubMed

The paper presents an overview of clinical manifestations and histopathologic findings in different organs in microvascular thrombotic and microangiopathic antiphospholipid syndrome (MAPS). Subsets of antiphospholipid syndrome (APS) are presented and defined. Clinico-pathologic correlations seem insufficient so far, because of a lack of detailed systematic studies of the histopathology in different organs. Based on their own autopsy and biopsy studies, the authors propose a novel categorization of histopathologic lesions that occur in patients with classic and catastrophic APS. In addition to the already accepted category of a microvascular thrombotic type of lesions, microangiopathic lesions consistent with thrombotic microangiopathy are proposed to be included in new revised classification criteria for definite APS. Microvascular thrombotic and so far underestimated microangiopathic histopathologic lesions have been shown to appear in various combinations and of different ages in patients with both classic and catastrophic APS, which fits into the concept of MAPS. These preliminary findings of our studies are also in line with the most recent hypothesis of two main mechanisms in the pathogenesis of APS, emphasizing a key role of endothelial cell affection induced by aPL on the one hand and interference with coagulation cascade on the other side. PMID:19067253

Praprotnik, Sonja; Ferluga, Dusan; Vizjak, Alenka; Hvala, Anastazija; Avcin, Tadej; Rozman, Blaz

2009-06-01

281

Melasma and other skin manifestations or oral contraceptives.  

PubMed

Pigmentary anomalies are among the least serious but most frequent skin changes resulting from oral contraceptive use. A pseudo "mask of pregnancy" called chloasma or melasma may be produced. It is a blotchy hyperpigmentation of the face which can be a disfiguring cosmetic and emotional problem. Melasma most often appears 1-4 months after taking the pill. Of 13 such patients closely studied, melasma of pregnancy had previously been present in 10. Only minimal improvement was noted in 7 even up to 4 years after stopping the drug. Histological examination of 10 biopsy specimens showed normal appearing epidermis with pigment in the basal cell layer of the skin. Of 199 patients taking oral contraceptives in one study, 24% had melasma; of 212 patients in a second study, 29% developed this problem. A history of temporary melasma during pregnancy is an important predictor. Reduced exposure to sunlight is recommended. Use of a hydroquinone cream as a bleaching agent results in only slight improvement. Changing the type of pill has had little effect but reducing the amount of progesterone may help. Other skin manifestations with oral contraceptives include: 1) acne vulgaris, which may be improved or aggravated; 2) alopecia or diffuse thinning of the entire scalp hair, which may be reversible; 3) treatment of aphthous stomatitis, which is controlled by estrogen therapy; and 4) erythema nodosum, which subsides when oral contraceptives are stopped. Urticarial reactions represent an allergic response to special drugs. PMID:5620604

Resnik, S S

1967-01-01

282

Spectrum of neurological manifestations of idiopathic hypoparathyroidism and pseudohypoparathyroidism.  

PubMed

We describe clinical, biochemical, radiological profile, and treatment outcome in 97 patients with idiopathic hypoparathyroidism seen over a period of 18 years. Of the 97 patients, 78 (80%) had idiopathic hypoparathyroidism and 19 (20%) had pseudohypoparathyroidism. The mean age±standard deviation (SD) at presentation was 28.7±14.1 years. There were 52 males, the mean lag time from first reported symptom to diagnosis was 5.9±5.2 years and the mean (±SD) follow-up was 1.8±0.4 years. The most common presenting manifestation was carpopedal spasm in 68 (70%) patients, followed by paresthesia and seizures in 52 (54%) patients. The mean (±SD) serum calcium and inorganic phosphate concentrations were 6.1±1.5 mg/dl and 6.3±1.5 mg/dl, respectively. The most common imaging abnormality noted was basal ganglia calcification followed by cerebral cortex and cerebellum calcification. More than one-third of patients were on various antiepileptic drugs including phenytoin. In addition to oral calcium and active vitamin D (calcitriol), twenty-six patients (27%) also required hydrochlorothiazide. The important finding in our study was long lag time from the first reported symptom to diagnosis. Phenytoin was the drug in almost one- third of our patients with seizures. Practicing clinicians should have high index of suspicion of diagnosis hypoparathyroidism in the appropriate clinical states to avoid the morbidity associated with hypoparathyroidism. Phenytoin should be avoided in patients with hypoparathyroidism and seizures. PMID:21891938

Bhadada, Sanjay Kumar; Bhansali, Anil; Upreti, Vimal; Subbiah, Sridhar; Khandelwal, Niranjan

2011-01-01

283

Could Dark Energy be a Manifestation of Gravity?  

E-print Network

It is shown that so-called dark energy could possible be a manifestation of the gravitational vortex producing the 'gravitomagnetic' (GM) force field: associated with cosmic matter rotation and inertial spacetime frame dragging. The general relativistic Godel-Obukhov spacetime metric which incorporates expansion and rotation of the Universe is used to evaluate this force. This metric is expressed here in spherical comoving coordinates. Through a cosmic time-scale evolution, it is shown that cosmic acceleration is expected when the magnitude of the radial repulsive GM force exceeds that of the usual attractive gravitational 'gravitoelectric' (GE) force: associated with just cosmic matter and spacetime warping. In general, this phenomenon of cosmic accelerated expansion appears to have occurred twice in the history of the Universe: the inflationary phase and the present-day acceleration phase. It is suggested in this model that the two phases may or may not be related. The cosmological model presented here is described in the context of Einstein's Theory of General Relativity in Riemann-Cartan spacetime, which includes cosmic rotation, its effects, and it being considered as an intrinsic part of spacetime. Also, a derived analytical expression for the cosmic primordial magnetic field is presented; and how it might relate to the GM field through the spin density of the cosmic matter is discussed.

Reva Kay Williams

2011-09-26

284

The manifestation of oxygen contamination in ErD2.  

SciTech Connect

Erbium dihydride Er(H,D,T){sub 2} is a fluorite structure rare-earth dihydride useful for the storage of hydrogen isotopes in the solid state. However, thermodynamic predictions indicate that erbium oxide formation will proceed readily during processing, which may detrimentally contaminate Er(H,D,T){sub 2} films. In this work, transmission electron microscopy (TEM) techniques including energy-dispersive x-ray spectroscopy, energy-filtered TEM, selected area electron diffraction, and high-resolution TEM are used to examine the manifestation of oxygen contamination in ErD{sub 2} thin films. An oxide layer {approx}30-130 nm thick was found on top of the underlying ErD{sub 2} film, and showed a cube-on-cube epitaxial orientation to the underlying ErD{sub 2}. Electron diffraction confirmed the oxide layer to be Er{sub 2}O{sub 3}. While the majority of the film was observed to have the expected fluorite structure for ErD{sub 2}, secondary diffraction spots suggested the possibility of either nanoscale oxide inclusions or hydrogen ordering. In situ heating experiments combined with electron diffraction ruled out the possibility of hydrogen ordering, so epitaxial oxide nanoinclusions within the ErD{sub 2} matrix are hypothesized. TEM techniques were applied to examine this oxide nanoinclusion hypothesis.

Snow, Clark Sheldon; Parish, Chad Michael; Brewer, Luke N.

2008-10-01

285

[Lower costovertebral arthritis in rheumatic pelvispondylitis. Pseudourologic manifestation].  

PubMed

Costo-vertebral and costo-transverse joints are often involved during rheumatoid pelvispondylitis. Their involvement may lead to thoracic ankylosis and decreased respiratory capabilities. These arthritis may also cause intercostal or pseudo-visceral pains. The authors report three cases of lower costo-vertebral arthritis, revealed by pseudo-urological, acute or subacute pains. The diagnosis was made on clinical findings (especially mobilization of the lower ribs) and confirmed by X-Rays (especially tomodensitometry). One of the cases presents an image of unilateral pedicle opacity secondary to costovertebral arthritis. The pseudo-urological manifestation of the pain is likely explained by the anatomical relationship between costo-vertebral joints and the sympathetic communicating rami. This close anatomical relationship was confirmed by dissection. Through the communicating rami, the costo-vertebral joints are thus in relation with the sympathetic system, which is responsible for the sensory innervation of the renal space. The pseudo-urological revelation of this arthritis should be compared to that of costal sprains. PMID:3589451

Benhamou, C L; Roux, C; Benhamou-Mayoux, A; Gauvain, J B; Corlieu, P; Viala, J F; Amor, B

1987-03-01

286

MHC associations with clinical and autoantibody manifestations in European SLE.  

PubMed

Systemic lupus erythematosus (SLE) is a clinically heterogeneous disease affecting multiple organ systems and characterized by autoantibody formation to nuclear components. Although genetic variation within the major histocompatibility complex (MHC) is associated with SLE, its role in the development of clinical manifestations and autoantibody production is not well defined. We conducted a meta-analysis of four independent European SLE case collections for associations between SLE sub-phenotypes and MHC single-nucleotide polymorphism genotypes, human leukocyte antigen (HLA) alleles and variant HLA amino acids. Of the 11 American College of Rheumatology criteria and 7 autoantibody sub-phenotypes examined, anti-Ro/SSA and anti-La/SSB antibody subsets exhibited the highest number and most statistically significant associations. HLA-DRB1*03:01 was significantly associated with both sub-phenotypes. We found evidence of associations independent of MHC class II variants in the anti-Ro subset alone. Conditional analyses showed that anti-Ro and anti-La subsets are independently associated with HLA-DRB1*0301, and that the HLA-DRB1*03:01 association with SLE is largely but not completely driven by the association of this allele with these sub-phenotypes. Our results provide strong evidence for a multilevel risk model for HLA-DRB1*03:01 in SLE, where the association with anti-Ro and anti-La antibody-positive SLE is much stronger than SLE without these autoantibodies. PMID:24598797

Morris, D L; Fernando, M M A; Taylor, K E; Chung, S A; Nititham, J; Alarcón-Riquelme, M E; Barcellos, L F; Behrens, T W; Cotsapas, C; Gaffney, P M; Graham, R R; Pons-Estel, B A; Gregersen, P K; Harley, J B; Hauser, S L; Hom, G; Langefeld, C D; Noble, J A; Rioux, J D; Seldin, M F; Vyse, T J; Criswell, L A

2014-04-01

287

Severe Abdominal Pain as the First Manifestation of Rabies  

PubMed Central

Introduction: Rabies is an acute fatal viral disease that is generally transmitted from animals to humans following wild and domestic animal bites. The rabies virus enters the body from the area where the individual is bitten, and then the virus moves towards the brain and involves the nerves. Case Presentation: During the years 2001-2011, there have been 73 reported rabies cases. About 50,000 reported human deaths are annually due to rabies. The actual number of human deaths due to rabies in Asia especially India, Pakistan and Bangladesh are more than these numbers, since there is no advanced surveillance system for disease control to determine the actual number of infected and fatal human cases. According to the World Health Organization (WHO) reports, more than 10 million people who are bitten by animals are annually treated by prophylactic treatment regimens for rabies, worldwide. Conclusions: This paper reports on a case of human rabies with the first disease manifestation (severe abdominal pain). The patient reported extensive biting on his left leg by a dog. He had a slight fever of 38.1°C. It has been recommended that a careful history should be taken from patients for diagnosis of rabies disease. A complete history should be taken from patients for diagnosis of disease, because rabies could be wrong with various diseases with atypical symptoms. because various diseases with atypical symptoms or long incubation periods can visit. PMID:25485053

Ayatollahi, Jamshid; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

2014-01-01

288

Para-dichlorobenzene toxicity – a review of potential neurotoxic manifestations  

PubMed Central

Background: Para-dichlorobenzene (PDCB) is an active ingredient of mothballs, deodorizers and fumigants. Due to the easy availability of this chemical, there is a considerable risk for accidental or intentional toxic exposure. Recently, multiple cases of PDCB toxicity due to mothball ingestion were reported. PDCB toxicity can affect multiple organ systems including liver, kidneys, skin, lung and the central nervous system (CNS). CNS toxicity often results in leukoencephalopathy and heterogeneous neurological manifestations. Objectives: The objective of this study was to illustrate the clinical presentation, imaging findings, diagnosis and management of PDCB toxicity. Methods: We carried out a literature review of the pharmacological and toxicological properties of PDCB. Conclusions: PDCB and other aromatic hydrocarbons are capable of CNS tissue damage and in promoting functional neurological decline. While very little is currently known about prevalence of PDCB addiction, it cannot be ruled out that its illicit use among young people is under-recognized. The number of cases of PDCB toxicity might also rise due to the increasing industrial and domestic use of this chemical. PMID:24790648

Dubey, Divyanshu; Sharma, Vibhash D.; Pass, Steven E.; Sawhney, Anshudha

2014-01-01

289

Cutaneous manifestations of primary immunodeficiency diseases in children.  

PubMed

Primary immunodeficiency diseases (PIDs) are rare but include severe conditions found predominantly in children, Most PIDs have cutaneous manifestations that may be important as early diagnostic features. The purpose of this study was to determine the frequency and nature of cutaneous alterations associated with PIDs. This article is a cross-sectional study at the department of allergy and clinical immunology of children's medical center conducted between December 5, 2001 and April 20, 2002. The subjects included pediatric patients with a diagnosis of PID and dermatological diagnoses were made by a dermatologist. Two hundred and ten patients were studied They consisted of 68 cases of humoral deficiency, 22 cases of cellular and combined deficiencies, 57 cases of phagocytic defects and 63 cases of other PIDs. In 67 cases (31.8%) the cutaneous alterations preceded and were the basis for clinical immunological diagnosis. Overall cutaneous alterations were infections in 99 cases and eczematous dermatitis in 27 cases. Our findings support the results of other studies that most PIDs have cutaneous features which being their typical aspects are highly suggestive for the diagnosis of PIDs. PMID:17237563

Moin, Athar; Farhoudi, Abolhassan; Moin, Mostafa; Pourpak, Zahra; Bazargan, Nasrin

2006-09-01

290

Renal manifestations of patients with MYH9-related disorders.  

PubMed

MYH9-related disorders are a group of autosomal, dominantly inherited disorders caused by mutations of the MYH9 gene, which encodes the non-muscle myosin heavy chain IIA (NMMHC-IIA). May-Hegglin anomaly and Sebastian, Fechtner, and Epstein syndromes belong to this group. Macrothrombocytopenia is a common characteristic associated with MYH9-related disorders, and basophilic cytoplasmic inclusion bodies in leukocytes (Döhle-like bodies), deafness, cataracts, and glomerulopathy are also found in some patients. In this study, renal manifestations of 7 unrelated Korean patients with MYH9-related disorders were analyzed. Of a total of 7 patients, 4 had disease-related family histories. One familial case had a mutation in the tail domain of NMMHC-IIA and showed milder renal involvement with preserved renal function by his 30s. Among the 3 familial cases without renal involvement, 2 had mutations in the tail domain of NMMHC-IIA and 1 had a mutation in the motor domain. The remaining 3 sporadic cases had severe renal involvement with rapid progression to end-stage renal disease and mutations located in the motor domain. In summary, mutations in the motor domain of NMMHC-IIA and negative family history were associated with severe renal involvement in patients with MYH9-related disorders. These results are in agreement with those of previous reports. PMID:21210153

Han, Kyoung Hee; Lee, HyunKyung; Kang, Hee Gyung; Moon, Kyung Chul; Lee, Joo Hoon; Park, Young Seo; Ha, Il Soo; Ahn, Hyo Seop; Choi, Yong; Cheong, Hae Il

2011-04-01

291

Astronomical Factors Manifestation on Climate Parameters in a Tropical Region  

NASA Astrophysics Data System (ADS)

The variations of the temperature values for the last 20 000 years, measured in the cave Dos Anas (Sierra del Rosario, Cuba) are studied in comparison with the values of the hydrogen isotopes concentration obtained in the coral reef of the Barbados Island in the Caribbean region. They are compared as well, with the abundance of Be10 measured in the permanent layers of ice of Central Greenland, representative of the global temperature for the same period. The obtained results show good correlation between the temperature and these parameters. The manifestation of the solar activity is evidenced in the temperatures measured in a stalagmite of the cave Dos Anas, when being proven that an increment of the temperatures belongs together with a decrease of the production of isotopes. This behavior is consequence of a smallest quantity in cosmic rays arriving to the Earth as result of an increment in the solar activity. The 2000 years interval, of temperature reduction observed in the curves, can be interpreted like a stage of low solar activity alike it has been observed in other Sun type stars. The scale of variation of the influence in climate due to the orbital dynamics of the Earth in that interval is not significant. An analysis of the behavior of the mean surface air temperature for the last century at a tropical location, in relationship with the solar activity, is also presented.

Alvarez, O.; Doval, J. P.; Pajón, J. M.

292

[Clinical manifestations and hazards of brucellosis in the Netherlands].  

PubMed

Brucellosis, a zoonotic infection characterised by undulant fever, has a low incidence in the Netherlands and is therefore rarely considered. We describe 3 patients aged 26, 47 and 56 years old; each presented with long-standing fever as predominant symptom after having travelled to an endemic area, Iraq or Turkey, 1 week to 4 months prior to manifestation of illness. They had similar symptoms: fever, weight loss, chills, night sweats and dry cough. Blood cultures of all patients became positive for gram-negative rods after 3-4 days of incubation. One patient had imported and consumed sheep-milk cheese from which a genetically indistinguishable Brucella strain was cultured. In another patient, identification of the bacterium proved difficult, resulting in delayed prescription of adequate antibiotic treatment. Serologic testing confirmed the diagnosis in this case. In the laboratory, there is a considerable risk of airborne transmission of the disease necessitating clear notification of the suspicion of brucellosis when material for culturing is submitted. PMID:22436527

Kaan, Jan A; Frakking, Florine N J; Arents, Nicolaas L A; Anten, Sander; Roest, Hendrik I J; Rothbarth, Ph H Flip

2012-01-01

293

Endocrine manifestations related to inherited metabolic diseases in adults  

PubMed Central

Most inborn errors of metabolism (IEM) are recessive, genetically transmitted diseases and are classified into 3 main groups according to their mechanisms: cellular intoxication, energy deficiency, and defects of complex molecules. They can be associated with endocrine manifestations, which may be complications from a previously diagnosed IEM of childhood onset. More rarely, endocrinopathies can signal an IEM in adulthood, which should be suspected when an endocrine disorder is associated with multisystemic involvement (neurological, muscular, hepatic features, etc.). IEM can affect all glands, but diabetes mellitus, thyroid dysfunction and hypogonadism are the most frequent disorders. A single IEM can present with multiple endocrine dysfunctions, especially those involving energy deficiency (respiratory chain defects), and metal (hemochromatosis) and storage disorders (cystinosis). Non-autoimmune diabetes mellitus, thyroid dysfunction and/or goiter and sometimes hypoparathyroidism should steer the diagnosis towards a respiratory chain defect. Hypogonadotropic hypogonadism is frequent in haemochromatosis (often associated with diabetes), whereas primary hypogonadism is reported in Alström disease and cystinosis (both associated with diabetes, the latter also with thyroid dysfunction) and galactosemia. Hypogonadism is also frequent in X-linked adrenoleukodystrophy (with adrenal failure), congenital disorders of glycosylation, and Fabry and glycogen storage diseases (along with thyroid dysfunction in the first 3 and diabetes in the last). This is a new and growing field and is not yet very well recognized in adulthood despite its consequences on growth, bone metabolism and fertility. For this reason, physicians managing adult patients should be aware of these diagnoses. PMID:22284844

2012-01-01

294

An unusual ultrasonographic manifestation of a fetal Ebstein anomaly  

PubMed Central

An Ebstein anomaly is a rare congenital heart defect defined by an inferior displacement of the septal and posterior leaflets of the tricuspid valve from the tricuspid annulus. This anomaly shows various ultrasonographic manifestations, thus making the prenatal diagnosis sometimes difficult. We here report a rare case of an Ebstein anomaly which was prenatally suspected as the absence of the tricuspid valve with functional pulmonary atresia because of non-visible tricuspid leaflets on an echocardiograph at 24 weeks of gestation. An emergency cesarean section was performed at 35 weeks of gestation as fetal hydrops were seen on a follow-up scan. Postnatal surgery confirmed Ebstein anomaly type-D which demonstrates an almost complete atrialization of the right ventricle with the exception of a small and infundibular component. Because of its rarity, prenatal findings of a type-D Ebstein anomaly have not been reported previously. We suggest from this first such case report that this anomaly should be considered as a possible diagnosis when the tricuspid leaflets are not well visualized. PMID:25469344

Cha, Min-Young; Lee, Mi-Young; Woo, Kyung-Hee; Shim, Jae-Yoon

2014-01-01

295

Gastrointestinal and hepatic manifestations of systemic lupus erythematosus.  

PubMed

In this review of the gastrointestinal (GI) and hepatic manifestations of systemic lupus erythematosus (SLE), 180 articles from the English literature, found using a medline search from January 1965 to December 2010, were examined. Vasculitis may cause ulcerations, bleeding, stricture formation, and perforation from ischemia and infarction. Otherwise, GI symptoms, occurring in about 50% of patients, are usually mild. Esophageal dysmotility may result in heartburn, regurgitation, and dysphagia. Occasionally, pneumatosis cystoides intestinalis may develop, sometimes associated with benign pneumoperitoneum. Patients are prone to salmonella bacteremia, presenting more commonly with fever and abdominal pain than with diarrhea. Intestinal pseudoobstruction usually is found with active lupus serology, preferentially involving small rather than the large bowel. Protein-losing enteropathy, characterized by diarrhea, edema, and hypoalbuminemia, can be the initial presentation of SLE. Malabsorption with a prevalence of 9.5% is occasionally associated with celiac disease. Pancreatitis, with an annual incidence of 0.4 to 1/1000, has an overall mortality of 27% that is decreased with corticosteroid therapy. Acute and chronic ascites may be due to lupus peritonitis or to associated diseases, such as pancreatitis, nephrotic syndrome, heart failure, or infections. Abnormal liver function tests may be due to steatosis from lupus or from corticosteroid therapy. Only about 10% of patients with autoimmune hepatitis have lupus. Up to 4.7% of patients with SLE have chronic active hepatitis correlating strongly with the presence of antibody to ribosomal P protein. SLE can involve the entire GI tract and the liver. Treatment with corticosteroids, cytotoxic agents, and/or immunosuppressants is often successful. PMID:21422947

Ebert, Ellen C; Hagspiel, Klaus D

2011-01-01

296

Changes in the clinical manifestations of primary aldosteronism  

PubMed Central

Background/Aims Primary aldosteronism (PA) is now widely recognized to have a higher prevalence than was once thought. In view of its increasing prevalence, we compared chronological changes in clinical manifestations of PA according to different times of diagnosis. Methods In total, 85 patients diagnosed with PA from January 1986 through March 2012 were reviewed retrospectively, based on their medical records. During two periods-1986 to 2005 and 2006 to 2012-41 and 44 patients, respectively, were diagnosed with PA. We compared the clinical and biological characteristics of PA between these periods. Results The results demonstrate an increasing trend in the prevalence of idiopathic hyperaldosteronism (IHA; p = 0.19). In the 2006 to 2012 period, patients with PA presented with higher serum potassium levels at the time of diagnosis than in the 1986 to 2005 period (p < 0.0002). Adrenal vein sampling (AVS) was performed mostly in the latter period (82.3%) and the diagnostic accuracy of adrenal computed tomography, compared with AVS, was only 56.2%. About 78.0% versus 86.3% of patients had at least one target organ damage (TOD) in the 1986 to 2005 and 2006 to 2012 periods, respectively (p = 0.39). However, patients with TOD were older and had longer durations of hypertension than patients without, in both periods. Conclusions PA is becoming more prevalent. There was an increasing tendency for IHA, and more PA patients presented with normokalemia than in the earlier period. Early and accurate diagnosis of PA with AVS and proper treatment should have substantial prognostic value. PMID:24648805

Kim, Sun Hwa; Ahn, Jae Hee; Hong, Ho Cheol; Choi, Hae Yoon; Kim, Yoon Jung; Kim, Nam Hoon; Yoo, Hye Jin; Kim, Hee Young; Seo, Ji A; Kim, Nan Hee; Kim, Sin Gon; Choi, Kyung Mook; Baik, Sei Hyun

2014-01-01

297

First report of HIV-related oral manifestations in Mali  

PubMed Central

Introduction In 2004, the sudden availability of free antiretroviral therapy (ART in Mali, within the context of an already overburdened health care system created gaps in individual patient quality of care. The objective of this study was to determine the prevalence of HIV-related oral manifestations (OM) during the first month of ART therapy in a Malian health facility. Methods Medical records of adult patients who initiated ART regimens at the Gabriel Touré Hospital, Mali (2001 to 2008) were randomly identified. Multiple logistic regression models were used to evaluate the relationship between the presence of OM during the first month of ART and selected variables, including CD4 counts and WHO clinical staging at ART initiation. Results Out of 205 patients on ART (mean age 39 ± 10 years), 71.0% were females and 36.1% had no formal education. 40.6% were in WHO clinical stage III. OM prevalence during the first month of HIV care was 31.4%, being oral candidiasis the commonest lesion. 73.2% and 82.5% of the patients with OM had CD4 count < 200 cells/mm3 and were classified as WHO clinical stage III or IV. WHO clinical stage III and VI patients had 5.4-fold increased odds of having any OM (both p< 0.01) when controlling for age, ethnicity, gender, marital status, and CD4 counts. Conclusion OM detected in people with low CD4 count and WHO clinical stage III and IV at ART initiation suggested that they were very immune-compromised when initiating HIV care. Early identification of OM could improve the quality of care and guarantee the benefits of ART. PMID:22368761

Tamí-Maury, Irene; Coulibaly, Yaya Ibrahim; Cissoko, Souare Salimata; Dao, Sounkalo; Kristensen, Sibylle

2012-01-01

298

Clinical manifestations of CNS infections caused by enterovirus type 71  

PubMed Central

Purpose Enterovirus 71, one of the enteroviruses that are responsible for both hand-foot-and-mouth disease and herpangina, can cause neural injury. During periods of endemic spread of hand-foot-andmouth disease caused by enterovirus 71, CNS infections are also frequently diagnosed and may lead to increased complications from neural injury, as well as death. We present the results of our epidemiologic research on the clinical manifestations of children with CNS infections caused by enterovirus 71. Methods The study group consisted of 42 patients admitted for CNS infection by enterovirus 71 between April 2009 and October 2009 at the Department of Pediatrics of 5 major hospitals affiliated with the Catholic University of Korea. We retrospectively reviewed initial symptoms and laboratory findings on admission, the specimen from which enterovirus 71 was isolated, fever duration, admission period, treatment and progress, and complications. We compared aseptic meningitis patients with encephalitis patients. Results Of the 42 patients (23 men, 19 women), hand-foot-and-mouth disease was most prevalent (n=39), followed by herpangina (n=3), upon initial clinical diagnosis. Among the 42 patients, 15 (35.7%) were classified as severe, while 27 (64.3%) were classified as mild. Factors such as age, fever duration, presence of seizure, and use of intravenous immunoglobulin (IVIG) were statistically different between the 2 groups. Conclusion Our results indicate that patients with severe infection caused by enterovirus 71 tended to be less than 3 years old, presented with at least 3 days of fever as well as seizure activity, and received IVIG treatment. PMID:21359055

Choi, Cheol Soon; Choi, Yun Jung; Choi, Ui Yoon; Han, Ji Whan; Jeong, Dae Chul; Kim, Hyun Hee; Kim, Jong Hyun

2011-01-01

299

A Unique Manifestation of Pupillary Fatigue in Autoimmune Autonomic Ganglionopathy  

PubMed Central

Objective To demonstrate a unique abnormality of the pupillary light reflex in patients with Autoimmune Autonomic Ganglionopathy (AAG). Design Case series Setting Autonomic clinics at two university hospitals (University of Texas Southwestern Medical Center and Beth Israel Deaconess Medical Center) Participants Seven patients with antibody positive AAG. Intervention All patients with AAG underwent either monocular or binocular infrared pupillometry using a standard 2 second light stimulus at a defined intensity. Findings were compared to healthy controls and patients with other autonomic disorders. The light stimulus used in this study was selected to eliminate the normal phenomenon of pupil escape. Main Outcome measure The time to onset of redilation was the main outcome measure. Other indices of pupillary constriction to light stimulus were also measured. Results Patients with AAG exhibited premature pupillary redilation (1.02 ±0.20 seconds) compared to healthy control subjects (2.24±0.10 seconds) and other patients with autonomic disorders (2.3±0.12 seconds; P<0.0001). In healthy control subjects and patients with other autonomic disorders pupillary redilation always followed the termination of the light stimulus while in AAG patients redilation consistently occurred during the light stimulus. In one patient, serial repetitive light stimulation further decreased the time to onset of redilation. Conclusion Premature redilation of the pupil is a unique physiological feature seen only in patients with AAG. This phenomenon appears to be a manifestation of pupillary fatigue, a clinical correlate of defective synaptic transmission at the level of autonomic ganglia in antibody positive AAG. PMID:22232207

Muppidi, Srikanth; Scribner, Maggie; Gibbons, Christopher H.; Adams-Huet, Beverley; Spaeth, Elaine B.; Vernino, Steven

2012-01-01

300

Diverse Manifestations of Convective Upwelling Beneath the North Atlantic Ocean  

NASA Astrophysics Data System (ADS)

The Icelandic Plume dominates the North Atlantic Ocean. Residual depth anomalies of oceanic lithosphere, long wavelength gravity anomalies, and seismic tomographic models show that this large upwelling reaches from Baffin Bay to Western Norway, and from offshore Newfoundland to Spitzbergen. At continental margins, there is excellent evidence for present-day dynamic support of crust beneath Scotland and Western Norway. It is generally agreed that the Icelandic Plume started at 62 Ma. In recent years, a quantitative understanding of the temporal evolution of this upwelling has begun to emerge. The best evidence occurs in the oceanic basins north and south of Iceland. Since the mid-oceanic ridge straddles the plume, it acts as a linear sampler of transient activity over the last 40-50 Ma. A pair of seismic reflection flowlines acquired in 2010 have enabled us to determine the detailed history of transient activity. The implications of this history are profound. Waxing and waning of convective upwelling beneath this important oceanic gateway appears to have modulated the overflow of the ancient precursor to North Atlantic Deep Water (NADW). The growth of contourite drifts which plaster deep-water margins can also be directly linked to changing vertical motions at this gateway. Finally, there is increasing evidence that the otherwise uniform thermal subsidence of sedimentary basins, which fringe both sides of the North Atlantic Ocean, has been periodically interrupted by transient uplift events which generated ephemeral landscapes. These geologic manifestations of convective activity should lead to improved insights into the fluid dynamics of the mantle.

White, Nicky; Parnell-Turner, Ross

2013-04-01

301

[Osteoarticular pains as early manifestation of malignancies in children].  

PubMed

Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. Findings reported in the literature and own observations indicate that these complaints correlate with: lower white cell counts, lower percentage of blast cells in the peripheral blood and lower incidence of organomegaly - that may delay the decision of bone marrow aspiration. In our study we have also presented 4 cases of other malignancies in children, who were complaining of the osteoarticular pains, that limited they activity, long time before the beginning of treatment in Department of Oncology and Pediatric Hematology of University's Pediatric Hospital in Cracow. Long-lasting and intensive osteoarticular complains, that restraint normal activity and do not resolve during rest, spinal compression symptoms, coexisting adenopathy, hepatosplenomegaly, weight loss, change of behaviour, unexplicained fever must be recognized as specific "red flags". Oncologic vigilance must be inspired by discreet hematological abnormalites (like increased anemia, lower white cell counts with lymphocytosis, mild thrombocytopenia) -that indicate bone marrow infiltration, as well as high erythrocyte sedimentation rate, accompanied by moderately elevated C-reactive protein - characteristic for malignancy. Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints. PMID:19485254

Cwikli?ska, Magdalena; Balwierz, Walentyna

2009-01-01

302

Intraocular inflammation as the main manifestation of Rickettsia conorii infection  

PubMed Central

Objective To report the clinical features and management of seven cases of intraocular inflammation caused by Rickettsia infection and review published literature. Methods Rickettsia conorii or Rickettsia spp. infection was diagnosed based on the following criteria: (1) positive serology according to the European Guidelines, (2) titer normalization after specific treatment, and (3) complete resolution of ophthalmic disease and accompanying symptoms after antibiotic therapy. Results Seven patients were referred for uveitis of unknown etiology. All came from regions where Mediterranean spotted fever is prevalent. One patient met the European guidelines criteria for Rickettsia spp. infection, while the other six cases met the criteria for R. conorii infection. The main symptoms were visual loss, floaters, eye redness, photophobia, and ocular pain. Predominant ophthalmic signs included vasculitis, choroiditis, vitritis, and macular edema. All patients required antibiotic treatment that resulted in the remission of the infection. Doxycycline was the first choice and the only antibiotic used to treat four patients. One patient needed ciprofloxacin as a second antibiotic after not responding to doxycycline. Two patients had doxycycline as a second antibiotic after not responding primarily to sulfonamides (which had been given after 2–3 days of doxycycline gastric intolerance); one of these patients needed ciprofloxacin as a third antibiotic. Conclusion Intraocular inflammation can occur as the main manifestation of Rickettsia conorii or Rickettsia spp. infection. It should be considered as a differential diagnosis for uveitis especially for patients living in countries where this infection is endemic in the world. Antibiotic treatment remains effective in the management of Rickettsia infection. PMID:22034560

Agahan, Archimedes LD; Torres, Jenice; Fuentes-Páez, Graciana; Martínez-Osorio, Hernan; Orduña, Antonio; Calonge, Margarita

2011-01-01

303

The Eye as a Common Site for the Early Clinical Manifestation of Sarcoidosis  

Microsoft Academic Search

Aims: Our purpose was to detect the rate of initial manifestation of sarcoidosis in the eye. Material and Methods: We conducted a retrospective chart review in a sarcoidosis clinic in Germany. Ophthalmological data were obtained by using a standardized protocol, including the medical history, any comorbidity, onset and type of ocular manifestation that was evaluated by slit lamp, tonometry and

Arnd Heiligenhaus; Dirk Wefelmeyer; Elfa Wefelmeyer; Martin Rösel; Mathias Schrenk

2011-01-01

304

19 CFR 123.4 - Inward foreign manifest forms to be used.  

Code of Federal Regulations, 2011 CFR

... false Inward foreign manifest forms to be used. 123.4 Section 123.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.4 Inward foreign manifest forms to be used....

2011-04-01

305

19 CFR 123.9 - Explanation of a discrepancy in a manifest.  

Code of Federal Regulations, 2011 CFR

...false Explanation of a discrepancy in a manifest. 123.9 Section 123.9 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.9 Explanation of a discrepancy in a manifest....

2011-04-01

306

19 CFR 123.4 - Inward foreign manifest forms to be used.  

Code of Federal Regulations, 2010 CFR

... false Inward foreign manifest forms to be used. 123.4 Section 123.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.4 Inward foreign manifest forms to be used....

2010-04-01

307

19 CFR 123.9 - Explanation of a discrepancy in a manifest.  

Code of Federal Regulations, 2010 CFR

...false Explanation of a discrepancy in a manifest. 123.9 Section 123.9 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...RELATIONS WITH CANADA AND MEXICO General Provisions § 123.9 Explanation of a discrepancy in a manifest....

2010-04-01

308

Low-dose weekly methotrexate for progressive neuropsychiatric manifestations in Behcet's disease  

Microsoft Academic Search

The most serious central nervous system (CNS) manifestation in Behcet's disease is a slowly progressive dementia (progressive NB), which may ultimately lead to the deterioration of the personality of patients. An open trial was designed to investigate the efficacy of low dose weekly methotrexate (MTX) therapy for progressive NB. Six patients with Behcet's disease, whose neuropsychiatric manifestations were judged to

Shunsei Hirohata; Hiroko Suda; Takashi Hashimoto

1998-01-01

309

Polyarteritis Nodosa and Extrahepatic Manifestations of HBV Infection: The Case Against Autoimmune Intervention in Pathogenesis  

Microsoft Academic Search

Numerous extrahepatic manifestations have been reported in patients with both acute and chronic hepatitis B (arthralgias or arthritis, skin rashes, glomerulonephritis and neuritis), all of which are present in polyarteritis nodosa (PAN) which is the most unique and spectacular extrahepatic manifestation. In the 1970s, the frequency of PAN due to the hepatitis B (HBV) reached 30%. Immunization programs explain the

Christian Trepo

2001-01-01

310

Musculoskeletal manifestations and autoantibody profilein 90 hepatitis C virus infected israeli patients  

Microsoft Academic Search

Objectives:Recent interest has been expressed in rheumatic manifestations inhepatitis C virus (HCV)-infected populations. The aim of this study was to determine the prevalence and characteristics of the musculoskeletal manifestations and serological markers of autoirnmunity in HCV-infected patients in Israel.

Dan Buskila; Alla Shnaider; Lily Neumann; Margalit Lorber; Doron Zilberman; Nir Hilzenrat; Oded J. Kuperman; Emanuel Sikuler

1998-01-01

311

Chronic primary central nervous system histoplasmosis in a healthy child with intermittent neurological manifestations.  

PubMed

Meningitis is an unusual clinical manifestation of Histoplasma capsulatum infection in nonimmunosuppressed children. We report a previously healthy 6-year-old boy with primary, chronic histoplasma meningitis and magnetic resonance imaging findings consistent with demyelinating disease presenting with brief, intermittent neurological manifestations for 7 months before diagnosis. PMID:23838780

Schuster, Jennifer E; Wushensky, Curtis A; Di Pentima, M Cecilia

2013-07-01

312

Relationship between allergic manifestations and Toxocara seropositivity: a cross-sectional study among elementary school children  

Microsoft Academic Search

Toxocara (the cause of visceral larva migrans in humans) and aller- gy have in common both elevated immunoglobulin E (IgE) levels and eosinophilia. In the present study, we investigated: 1) associations between Toxocara seroposi- tivity and allergic manifestations; 2) risk factors for Toxocara infection; and 3) differences in Toxocara seroprevalence, allergic manifestations and the associa- tions between these two, in

J. Buijs; G. Borsboom; M. Renting; W. J. A. Hilgersom; J. C. van Wieringen; G. Jansen; J. Neijens

1997-01-01

313

Neuro-ophthalmologic manifestations of systemic lupus erythematosus: a systematic review.  

PubMed

Herein we summarize the clinical presentation, treatment and outcome of neuro-ophthalmologic manifestations in patients with systemic lupus erythematosus (SLE). We performed a systematic review of the neuro-ophthalmologic manifestations of SLE reported in the English literature from 1970 to 2010 by a Medline search. The prevalence of neuro-ophthalmologic manifestations is 3.6% in adult and 1.6% in childhood SLE patients. Neuro-ophthalmologic manifestations of SLE are highly variable, with the commonest presentation being optic neuritis, followed by myasthenia gravis, visual field defects and pseudotumor cerebri. The underlying pathology was thought to be either SLE activity or its vascular complications. Most neuro-ophthalmologic manifestations of SLE are responsive to high-dose glucocorticoids. Anticoagulation is indicated when there is concomitant antiphospholipid syndrome. SLE-related neuromyelitis optica is often refractory to treatment and 92% of patients require multiple immunosuppressive protocols. Neuro-ophthalmologic manifestations of SLE are uncommon but heterogeneous. The prognosis of neuro-ophthalmologic manifestations in SLE is generally good because of their rapid response to glucocorticoids. Relapses of these manifestations may be reduced by the use of maintenance immunosuppression. Cyclophosphamide, azathioprine, plasmapheresis, intravenous immunoglobulin and rituximab can be considered in glucocorticoid-dependent or refractory cases. Anticoagulation is indicated when there is concomitant antiphospholipid syndrome. PMID:24673755

Man, Bik Ling; Mok, Chi Chiu; Fu, Yat Pang

2014-06-01

314

Smoking increases the risk of extraintestinal manifestations in Crohn's disease  

PubMed Central

AIM: To demonstrate a high prevalence of extraintestinal manifestations (EIMs) in a prospective population-based cohort of inflammatory bowel disease (IBD) patients at first diagnosis as well as during the early course of the disease. METHODS: EIMs are common in patients with IBD. Data on the frequency of EIMs have mostly been assessed in patients from tertiary centers; however, data about the prevalence of EIMs at first diagnosis as well as factors influencing their incidence during the early course of disease from prospective population-based cohorts are scarce. We present data of patients of our population-based “Oberpfalz cohort” (Bavaria, Germany) from first diagnosis (up to 3 mo after first diagnosis) as well as during the early course of the disease. Possible risk factors were assessed by calculating the relative risk (RR) as well as using logistic regression analysis. RESULTS: In total, data of 257 newly diagnosed patients with IBD were evaluated [161 Crohn’s disease (CD), 96 ulcerative colitis (UC)]. Median duration of follow-up was 50 mo after first diagnosis. In 63.4% of all patients (n = 163), an EIM was diagnosed at any point during the observation period. At first diagnosis, patients with CD had a significantly increased risk of an EIM [n = 69 (42.9%)] compared with UC patients [n = 21 (21.9%); P < 0.001; RR = 1.96; 95%CI: 1.30-2.98]. Active smoking increased the risk of CD patients developing an EIM during the early course of the disease, but notably not of UC patients (P = 0.046; RR = 1.96; 95%CI: 1.01-3.79). In addition, using logistic regression analysis, the need for IBD-related surgery and a young age at first diagnosis were identified as risk factors for the development of an EIM in CD patients. No association with EIMs was found for the factors sex, localization of the disease and positive family history of IBD. In contrast, no key factors which increased the risk of development of an EIM could be identified in UC patients. CONCLUSION: We found a high prevalence of EIM in this cohort at first diagnosis and during the early course of the disease. In patients with CD, smoking, need for surgery and younger age at first diagnosis were risk factors for the development of an EIM. PMID:25232261

Ott, Claudia; Takses, Angela; Obermeier, Florian; Schnoy, Elisabeth; Müller, Martina

2014-01-01

315

Early Clinical Manifestations Associated with Death from Visceral Leishmaniasis  

PubMed Central

Background In Brazil, lethality from visceral leishmaniasis (VL) is high and few studies have addressed prognostic factors. This historical cohort study was designed to investigate the prognostic factors for death from VL in Belo Horizonte (Brazil). Methodology The analysis was based on data of the Reportable Disease Information System-SINAN (Brazilian Ministry of Health) relating to the clinical manifestations of the disease. During the study period (2002–2009), the SINAN changed platform from a Windows to a Net-version that differed with respect to some of the parameters collected. Multivariate logistic regression models were performed to identify variables associated with death from VL, and these were included in prognostic score. Principal Findings Model 1 (period 2002–2009; 111 deaths from VL and 777 cured patients) included the variables present in both SINAN versions, whereas Model 2 (period 2007–2009; 49 deaths from VL and 327 cured patients) included variables common to both SINAN versions plus the additional variables included in the Net version. In Model 1, the variables significantly associated with a greater risk of death from VL were weakness (OR 2.9; 95%CI 1.3–6.4), Leishmania-HIV co-infection (OR 2.4; 95%CI 1.2–4.8) and age ?60 years (OR 2.5; 95%CI 1.5–4.3). In Model 2, the variables were bleeding (OR 3.5; 95%CI 1.2–10.3), other associated infections (OR 3.2; 95%CI 1.3–7.8), jaundice (OR 10.1; 95%CI 3.7–27.2) and age ?60 years (OR 3.1; 95%CI 1.4–7.1). The prognosis score was developed using the variables associated with death from VL of the latest version of the SINAN (Model 2). The predictive performance of which was evaluated by sensitivity (71.4%), specificity (73.7%), positive and negative predictive values (28.9% and 94.5%) and area under the receiver operating characteristic curve (75.6%). Conclusions Knowledge regarding the factors associated with death from VL may improve clinical management of patients and contribute to lower mortality. PMID:22347514

de Araújo, Valdelaine Etelvina Miranda; Morais, Maria Helena Franco; Reis, Ilka Afonso; Rabello, Ana; Carneiro, Mariângela

2012-01-01

316

[Spanish adaptation of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM)].  

PubMed

The aim of the present study was to translate into Spanish and to describe the psychometric properties of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM), developed by Fimian, Fastenau, Tashner and Cross to identify the main manifestations of stress in adolescents. The scale was applied to a sample of 1,002 pupils from years one and two of Secondary Education. The paper reports the factor structure, an item analysis, the internal consistency, differences by sex and academic year, external evidence of validity, and norms for scoring the scale. The results reveal a factor structure based on three first-order factors (emotional manifestations, physiological manifestations and behavioural manifestations) and one second-order factor (indicative of stress manifestations). In terms of external validity, there was a positive association with measures of perceived stress, aggressiveness, internalized/externalized symptoms, and a negative association with life satisfaction. The results show that the scale is an adequate tool for evaluating stress manifestations in adolescents. PMID:21774903

Escobar Espejo, Milagros; Blanca, María J; Fernández-Baena, F Javier; Trianes Torres, María Victoria

2011-08-01

317

Prediction of clinical manifestations of transurethral resection syndrome by preoperative ultrasonographic estimation of prostate weight  

PubMed Central

Background This study aimed to investigate the relationship between preoperative estimated prostate weight on ultrasonography and clinical manifestations of transurethral resection (TUR) syndrome. Methods The records of patients who underwent TUR of the prostate under regional anesthesia over a 6-year period were retrospectively reviewed. TUR syndrome is usually defined as a serum sodium level of?manifestations. This study focused on the clinical manifestations only, and recorded specific central nervous system and cardiovascular abnormalities according to the checklist proposed by Hahn. Patients with and without clinical manifestations of TUR syndrome were compared to determine the factors associated with TUR syndrome. Receiver operating characteristic curve analysis was used to determine the optimal cutoff value of estimated prostate weight for the prediction of clinical manifestations of TUR syndrome. Results This study included 167 patients, of which 42 developed clinical manifestations of TUR syndrome. There were significant differences in preoperative estimated prostate weight, operation time, resected prostate weight, intravenous fluid infusion volume, blood transfusion volume, and drainage of the suprapubic irrigation fluid between patients with and without clinical manifestations of TUR syndrome. The preoperative estimated prostate weight was correlated with the resected prostate weight (Spearman’s correlation coefficient, 0.749). Receiver operator characteristic curve analysis showed that the optimal cutoff value of estimated prostate weight for the prediction of clinical manifestations of TUR syndrome was 75 g (sensitivity, 0.70; specificity, 0.69; area under the curve, 0.73). Conclusions Preoperative estimation of prostate weight by ultrasonography can predict the development of clinical manifestations of TUR syndrome. Particular care should be taken when the estimated prostate weight is?>?75 g. PMID:25128188

2014-01-01

318

19 CFR 103.31 - Information on vessel manifests and summary statistical reports.  

Code of Federal Regulations, 2010 CFR

...1 2010-04-01 2010-04-01 false Information on vessel manifests and summary statistical reports...DEPARTMENT OF THE TREASURY AVAILABILITY OF INFORMATION Other Information Subject to Restricted Access § 103.31...

2010-04-01

319

19 CFR 4.7a - Inward manifest; information required; alternative forms.  

Code of Federal Regulations, 2010 CFR

...lading for delivery or contact purposes, the carrier...party's identity and contact information (address) in the...sheet of the passenger list under the caption “Unaccompanied...to provide manifest information;...

2010-04-01

320

The great imitator revisited: the spectrum of atypical cutaneous manifestations of secondary syphilis.  

PubMed

Syphilis is a well-known sexually transmitted infection infamous for its protean cutaneous manifestations. Over the last decade, the rate of infection in the USA has risen, particularly among human immunodeficiency virus (HIV)-infected individuals and certain ethnic groups. Although the primary chancre developing at the site of inoculation usually has typical and well-characterized features, cutaneous manifestations of secondary syphilis span a wide spectrum and mimic those of other dermatoses. This may be particularly evident in patients with HIV. Such deviations from the expected typical papulosquamous eruption may present a diagnostic challenge and delay diagnosis and therapy. Given the increasing incidence of syphilis among the immunosuppressed patient population, recognition of atypical cutaneous manifestations is critical for adequate management. We review a range of cutaneous manifestations of secondary syphilis and the skin diseases it may mimic. PMID:25312512

Balagula, Yevgeniy; Mattei, Peter L; Wisco, Oliver J; Erdag, Gulsun; Chien, Anna L

2014-12-01

321

19 CFR 4.64 - Electronic passenger and crew member departure manifests.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Electronic passenger and crew member departure...TRADES Foreign Clearances § 4.64 Electronic passenger and crew member departure...for purposes of this section. (b) Electronic departure manifest —(1)...

2010-04-01

322

76 FR 76983 - Agency Information Collection Activities: Entry and Manifest of Merchandise Free of Duty, Carrier...  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Agency Information...Manifest of Merchandise Free of Duty, Carrier's Certificate and Release AGENCY: U.S. Customs and Border Protection, Department of...

2011-12-09

323

76 FR 62086 - Agency Information Collection Activities: Entry and Manifest of Merchandise Free of Duty, Carrier...  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Agency Information...Manifest of Merchandise Free of Duty, Carrier's Certificate and Release AGENCY: U.S. Customs and Border Protection (CBP),...

2011-10-06

324

78 FR 76153 - Agency Information Collection Activities: Entry and Manifest of Merchandise Free of Duty, Carrier...  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Agency Information...Manifest of Merchandise Free of Duty, Carrier's Certificate and Release AGENCY: U.S. Customs and Border Protection, Department of...

2013-12-16

325

Investigating Factorial Invariance of Latent Variables Across Populations When Manifest Variables Are Missing Completely  

PubMed Central

Difficulties arise in multiple-group evaluations of factorial invariance if particular manifest variables are missing completely in certain groups. Ad hoc analytic alternatives can be used in such situations (e.g., deleting manifest variables), but some common approaches, such as multiple imputation, are not viable. At least 3 solutions to this problem are viable: analyzing differing sets of variables across groups, using pattern mixture approaches, and a new method using random number generation. The latter solution, proposed in this article, is to generate pseudo-random normal deviates for all observations for manifest variables that are missing completely in a given sample and then to specify multiple-group models in a way that respects the random nature of these values. An empirical example is presented in detail comparing the 3 approaches. The proposed solution can enable quantitative comparisons at the latent variable level between groups using programs that require the same number of manifest variables in each group. PMID:24019738

Widaman, Keith F.; Grimm, Kevin J.; Early, Dawnté R.; Robins, Richard W.; Conger, Rand D.

2013-01-01

326

Impact of parental BMI on the manifestation of overweight 5–7 year old children  

Microsoft Academic Search

Summary  \\u000a Background There is an increase in the prevalence of overweight and obese children. Genetic and environmental factors are contributing\\u000a factors but the influence of parental nutritional state on early manifestation of overweight is not well characterised. Aim of the study To systematically investigate the impact of parental BMI on the manifestation of overweight in 5 to 7 year old

Sandra Danielzik; Kristina Langnäse; Mareike Mast; Carina Spethmann; Manfred J. Müller

2002-01-01

327

Atypical Manifestations of Dengue Fever (DF) – Where Do We Stand Today?  

PubMed Central

Background and Objectives: Dengue fever (DF) is transmitted by Aedes aegypti mosquitoes. With growing population, rapid urbanization and lack of appropriate sanitary measures, proliferation of mosquitoes and subsequent dengue infections have increased rampantly with an estimated 30-fold increase in incidence over last five decades. With rising disease burden, atypical manifestations have increased as well, which are missed most often due to lack of awareness. Our aim was to look for the atypical manifestations of dengue fever. Materials and Methods: A prospective hospital based observational study was conducted at hospitals of Kasturba Medical College in Mangalore over a period of two years (June–2010 to May–2012). One-hundred fifty ELISA confirmed IgM-dengue sero-positive cases satisfying WHO criteria were examined clinically and laboratory data assessed till they got discharged from hospital after ruling out other causes of fever. Atypical manifestations in dengue fever were noted and analyzed. Results: Most common symptoms noticed were myalgia, headache, rash, arthralgia, pain in abdomen and nausea. More than half of the study group had one or the other atypical manifestation. Liver function test derangement was most often seen. Most common atypical manifestation was hepatitis found in 40.6% patients. Febrile diarrhea, renal failure, Acalculous cholecystitis and conduction abnormalities of heart were among other common manifestations. Three patients died of multi-organ dysfunction, disseminated intravascular coagulation and shock. Platelet count did not correlate well with severity of bleeding. Overall recovery rate was good. Conclusion: Some of the atypical manifestations of dengue fever are no more a rare entity. Clinical vigilance for these manifestations is important for timely detection and management as some of them could be fatal. PMID:24596727

Nimmagadda, Satya Sudhish; Mahabala, Chakrapani; Boloor, Archith; Raghuram, Pavan Manibettu; Nayak U., Akshatha

2014-01-01

328

[A single metastasis in the carpal bones as the first clinical manifestation of a hepatocellular carcinoma].  

PubMed

Hepatocellular carcinoma is the most common primary tumor of the liver. Spreading outside the liver usually takes place in advanced stages of the disease, and bone is the third most common site of metastases. We present a case of hepatocellular carcinoma in which the first clinical manifestation was a single metastasis to the carpal bones. The interest of this case lies in the way this hepatocellular carcinoma manifested as well as in the unusual site of the metastasis. PMID:23092693

Corrales Pinzón, R; Alonso Sánchez, J M; de la Mano González, S; El Karzazi Tarazona, K

2014-01-01

329

Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C  

PubMed Central

Sensory or motor peripheral neuropathy may be observed in a significant proportion of hepatitis C virus (HCV)-infected patients. However, central nervous system (CNS) involvement is uncommon, especially in cryoglobulin-negative subjects. We describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without cryoglobulinemia. Significant improvement was observed after antiviral therapy. We discuss the spectrum of neurological manifestations of HCV infection and review the literature. PMID:22253526

Carvalho-Filho, Roberto J; Narciso-Schiavon, Janaína Luz; Tolentino, Luciano HL; Schiavon, Leonardo L; Ferraz, Maria Lucia G; Silva, Antonio Eduardo B

2012-01-01

330

What i think and feel: A revised measure of children's manifest anxiety  

Microsoft Academic Search

The 1956 adaptation for children of Taylor's Manifest Anxiety Scale, the Children's Manifest Anxiety Scale, was revised to meet current psychometric standards. A 73-item revision draft was administered to 329 school children from grades 1 to 12. Based on item-analysis criteria for rbis=.4 and .30=p=.70, 28 anxiety items were retained along with 9 of the original 11 Lie scale items.

Cecil R. Reynolds; Bert O. Richmond

1978-01-01

331

Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation  

PubMed Central

It is rare that amyotrophic lateral sclerosis (ALS) presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness. PMID:25232334

Tateno, Fuyuki; Sakakibara, Ryuji; Kawashima, Kengo; Kishi, Masahiko; Tsuyusaki, Yohei; Aiba, Yosuke; Ogata, Tsuyoshi

2014-01-01

332

An Unusual Case of Multiple Intraoral Manifestations of Neurofibromatosis Type 1: Case Report with Literature Review  

PubMed Central

The various oral manifestations of neurofibromatosis in dentulous patients have been documented in literature. Although most of the previous documents have discussed on common findings like a prominent lingual papillae, or solitary overgrowth of gingival soft tissue, this article focuses on a relatively rare occurrence of multiple nodular manifestations of Neurofibromatosis–1 on an edentulous alveolar ridge, tongue, palate and lips of an elderly female patient.

M, Sheejith; Joseph, Benny; Sheejith, Bhavya

2014-01-01

333

Do evolutionary constraints on thermal performance manifest at different organizational scales?  

PubMed

The two foremost hypotheses on the evolutionary constraints on an organism's thermal sensitivity - the hotter-is-better expectation, and the specialist-generalist trade-off - have received mixed support from empirical studies testing for their existence. Could these conflicting results reflect confusion regarding the organizational level (i.e. species > population > individual) at which these constraints should manifest? We propose that these evolutionary constraints should manifest at different organizational levels because of differences in their underlying causes and requirements. The hotter-is-better expectation should only manifest across separate evolutionary units (e.g. species, populations), and not within populations. The specialist-generalist trade-off, by contrast, should manifest within as well as between separate evolutionary units. We measured the thermal sensitivity of sprint performance for 440 rainforest sun skinks (Lampropholis coggeri) representing 10 populations, and used the resulting performance curves to test for evidence for the hypothesized constraints at two organizational levels: (i) across populations and (ii) within populations. As predicted, the hotter-is-better expectation was evident only at the across-population level, whereas the specialist-generalist trade-off was evident within, as well as across, populations. Our results suggest that, depending on the processes that drive them, evolutionary constraints can manifest at different organizational levels. Consideration of these underlying processes, and the organizational level at which a constraint should manifest, may help resolve conflicting empirical results. PMID:25403471

Phillips, B L; Llewelyn, J; Hatcher, A; Macdonald, S; Moritz, C

2014-12-01

334

Revisiting the Molecular Mechanism of Neurological Manifestations in Antiphospholipid Syndrome: Beyond Vascular Damage  

PubMed Central

Antiphospholipid syndrome (APS) is a multiorgan disease often affecting the central nervous system (CNS). Typically, neurological manifestations of APS include thrombosis of cerebral vessels leading to stroke and requiring prompt initiation of treatment with antiplatelet drugs or anticoagulant therapy. In these cases, alterations of the coagulation system at various levels caused by multiple effects of antiphospholipid antibodies (aPL) have been postulated to explain the vascular damage to the CNS in APS. However, several nonvascular neurological manifestations of APS have progressively emerged over the past years. Nonthrombotic, immune-mediated mechanisms altering physiological basal ganglia function have been recently suggested to play a central role in the pathogenesis of these manifestations that include, among others, movement disorders such as chorea and behavioral and cognitive alterations. Similar clinical manifestations have been described in other autoimmune CNS diseases such as anti-NMDAR and anti-VGCK encephalitis, suggesting that the spectrum of immune-mediated basal ganglia disorders is expanding, possibly sharing some pathophysiological mechanisms. In this review, we will focus on thrombotic and nonthrombotic neurological manifestations of APS with particular attention to immune-mediated actions of aPL on the vascular system and the basal ganglia. PMID:24741580

Carecchio, M.; Cantello, R.; Comi, C.

2014-01-01

335

Epidemiological Features and Clinical Manifestations of Lyme Borreliosis in Korea, 2005-2012.  

PubMed

Lyme borreliosis is one of the most common tick-borne infections in the northern hemisphere. However, the epidemiological features and clinical manifestations of Lyme borreliosis in Korea are unknown. This is the first study to investigate the characteristics of Lyme borreliosis in Korea. We traced suspected cases of Lyme borreliosis between 2005 and 2012. Of the 16 Lyme borreliosis patients identified, 11 patients had acquired autochthonous infection in Korea and 5 patients were infected outside Korea. Past exposure histories were investigated in 8 of the 11 patients with autochthonous infection. Five of 8 patients (62.5%) were suspected to be infected in northeastern alpine region. Clinically, 6 of 11 patients (54.5%) with autochthonous infection had early skin manifestations, 4 patients (36.4%) had neurologic manifestations, and one patient had acrodermatitis chronica atrophicans. In conclusion, Lyme borreliosis could be endemic in the northeastern alpine region of Korea, and neurological manifestations as well as early skin manifestations could be the major clinical characteristics of autochthonous Lyme borreliosis in Korea. PMID:25420645

Moon, Shinje; Hong, Yeongseon; Hwang, Kyu-Jam; Kim, Suyeon; Eom, Jihye; Kwon, Donghyok; Park, Ji-Hyuk; Youn, Seung-Ki; Sohn, Aeree

2014-11-25

336

Ocular Manifestations of Systemic Lupus Erythematosus: A Review of the Literature  

PubMed Central

About one-third of patients suffering from systemic lupus erythematosus have ocular manifestations. The most common manifestation is keratoconjunctivitis sicca. The most vision threatening are retinal vasculitis and optic neuritis/neuropathy. Prompt diagnosis and treatment of eye disease is paramount as they are often associated with high levels of systemic inflammation and end-organ damage. Initial management with high-dose oral or IV corticosteroids is often necessary. Multiple “steroid-sparing” treatment options exist with the most recently studied being biologic agents. PMID:22811887

Palejwala, Neal V.; Walia, Harpreet S.; Yeh, Steven

2012-01-01

337

Immunology and Clinical Manifestations of Non-Clonal Mast Cell Activation Syndrome  

PubMed Central

There is a spectrum of disorders that clinically manifest as a result of mast cell activation. A non-clonal form has emerged in the literature where many of the clinical features of systemic mastocytosis are shared despite having a distinct mast cell biology. In this review, we summarize key features of the science behind mast cell activation relevant to what is now known as non-clonal mast cell activation syndrome (nc-MCAS). We highlight the clinical manifestations of nc-MCAS with a focus on diagnosis and treatment. PMID:23212667

Cardet, Juan-Carlos; Castells, Maria C.; Hamilton, Matthew J.

2012-01-01

338

B-cell markers in malignant B-cell lymphoma with scleroderma-like manifestation.  

PubMed

A case is described of malignant B-cell lymphoma with scleroderma-like manifestation. Using different monoclonals as B-cell markers the tumor appeared to be positive for surface immunoglobulins (SmIg) and for B2-antigen, but negative for intracytoplasmic immunoglobulin (CIg), BA2- and FMC7-antigens. Therefore, the tumor could be determined as a highly differentiated Sm-positive early B-cell type of B-cell lymphoma. In this clinically rare manifestation of cutaneous B-cell lymphoma aspects of the cell morphology and of cellular mediated immunity are briefly discussed. PMID:6335153

Van Joost, T; Stolz, E; Blog, F B; Van der Kwast, T H; Vuzevski, V D; Van Dongen, J M

1984-12-01

339

Rare manifestations of sarcoidosis in modern era of new diagnostic tools  

PubMed Central

Background & objectives: Growing body of literature on sarcoidosis in India has led to an increased awareness of the disease. With the advent of better imaging tools hitherto under-recognized manifestations of sarcoidosis are likely to be better recognized. We sought to study the rare clinical and radiological manifestations (<5%) in patients with sarcoidosis. Methods: Retrospective review of records of 164 patients with histopathologically proven sarcoidosis seen over six years in a tertiary care centre in north India, was done. Results: Fifty four rare manifestations were observed in 164 patients. Acute presentation in the form of Lofgren syndrome was seen in eight (4.9%) and Heerfordt's syndrome in two (1.2%) patients. Musculoskeletal manifestations included chronic sarcoid arthritis in three (1.8%), deforming arthritis and bone erosion in one (0.6%) each. Rare initial presentation with dilated cardiomyopathy in one (0.6%), complete heart block in two (1.2%), bilateral sequential facial nerve palsy in two (1.2%), and pyrexia of unknown origin was seen in one (0.6%) patient. Other rare manifestations included chronic respiratory failure in one (0.6%), dysphagia in one (0.6%), sicca syndrome in five (3%), massive splenomegaly in one (0.6%), portal hypertension in two (1.2%), hypersplenism, gastric sarcoidosis, ninth and tenth cranial nerve palsies, moderate pericardial effusion and nephrocalcinosis in one (0.6%) each, and pulmonary artery hypertension in two (1.2%) patients. Rare radiological manifestations included moderate pleural effusion in two (1.2%), pleural thickening in five (3%), calcification of intrathoracic lymph nodes in four (2.4%), alveolar (nodular) sarcoidosis in three (1.8%), and myocardial uptake of 18F-fluorodeoxyglucose (F-18 FDG) in two (1.2%) patients. Fourteen patients had airways obstruction and behaved typically like seasonal bronchial asthma with excellent response to corticosteroids. Interpretation & conclusions: Increased awareness of rare manifestations will facilitate better management of these patients. With increasing use of modern diagnostic tools, manifestations hitherto considered rare, are likely to be recognized more frequently in the future. PMID:22771590

Sharma, Surendra K; Soneja, Manish; Sharma, Abhishek; Sharma, Mehar C.; Hari, Smriti

2012-01-01

340

Initial manifestation of primary hyperoxaluria type I in adults-- recognition, diagnosis, and management.  

PubMed Central

Primary hyperoxaluria type I may initially manifest as urolithiasis, renal insufficiency, or symptoms of systemic oxalosis. This hereditary disorder was fatal until effective therapies evolved during the past two decades. Difficulty in recognizing and diagnosing this disorder in adults is illustrated in a report of a patient eventually restored to good health by high-flux dialysis and combined renal and hepatic transplantation. I explore the molecular processes of the genetic defect and discuss clinical indicators of primary hyperoxaluria type I, manifestations of oxalosis, the pathogenesis of chronic oxalate nephropathy, and the diagnosis and management of this disease. Images Figure 2. Figure 3. Figure 4. PMID:8779202

Kuiper, J J

1996-01-01

341

Immunology and clinical manifestations of non-clonal mast cell activation syndrome.  

PubMed

There is a spectrum of disorders that clinically manifest as a result of mast cell activation. A non-clonal form has emerged in the literature where many of the clinical features of systemic mastocytosis are shared despite having a distinct mast cell biology. In this review, we summarize key features of the science behind mast cell activation relevant to what is now known as non-clonal mast cell activation syndrome (nc-MCAS). We highlight the clinical manifestations of nc-MCAS with a focus on diagnosis and treatment. PMID:23212667

Cardet, Juan-Carlos; Castells, Mariana C; Hamilton, Matthew J

2013-02-01

342

Rosai-Dorfman disease presenting with extensive cutaneous manifestation - case report.  

PubMed

Rosai-Dorfman disease is a benign, self-limited, idiopathic proliferative histiocytic disorder. It was first described in 1969 by Rosai and Dorfman. In its typical form the disease is characterized by extensive cervical lymphadenopathy associated with fever, polyclonal gammopathy and leukocytosis with neutrophilia. The skin is the most common site affected. Extranodal manifestations have been reported in 43% of cases. In this study, we report an atypical case of Rosai-Dorfman disease in a female with massive cutaneous manifestation on the thigh, associated with a minimal lymphadenopathy limited to the regional inguinal lymph nodes. PMID:23739703

Leal, Paula Azevedo Borges; Adriano, Adrilena Lopes; Breckenfeld, Marcelle Parente; Costa, Igor Santos; de Sousa, Antônio Renê Diógenes; Gonçalves, Heitor de Sá

2013-01-01

343

Rosai-Dorfman disease presenting with extensive cutaneous manifestation - Case report*  

PubMed Central

Rosai-Dorfman disease is a benign, self-limited, idiopathic proliferative histiocytic disorder. It was first described in 1969 by Rosai and Dorfman. In its typical form the disease is characterized by extensive cervical lymphadenopathy associated with fever, polyclonal gammopathy and leukocytosis with neutrophilia. The skin is the most common site affected. Extranodal manifestations have been reported in 43% of cases. In this study, we report an atypical case of Rosai-Dorfman disease in a female with massive cutaneous manifestation on the thigh, associated with a minimal lymphadenopathy limited to the regional inguinal lymph nodes. PMID:23739703

Leal, Paula Azevedo Borges; Adriano, Adrilena Lopes; Breckenfeld, Marcelle Parente; Costa, Igor Santos; de Sousa, Antônio Renê Diógenes; Gonçalves, Heitor de Sá

2013-01-01

344

Zangfu zheng (patterns) are associated with clinical manifestations of zang shang (target-organ damage) in arterial hypertension  

Microsoft Academic Search

Background: Hypertension is a clinical condition that manifests target-organ damage (TOD) with symptoms. This study investigates the association between Zangfu patterns and symptomatic manifestations of TOD. Methods: Datasets with manifestations of Zangfu patterns (Liver-fire blazing upwards; Kidney-yin deficiency and Liver-yang rising; obstruction of phlegm and dampness of Heart\\/Liver\\/Gallbladder; qi and blood deficiency leading to Liver-yang rising; Kidney-yin\\/yang deficiency) and TODs

Alexandre Bastos Luiz; Ivan Cordovil; José Barbosa Filho; Arthur Sá Ferreira

2011-01-01

345

Spiral-type terahertz antennas and the manifestation of the Mushiake principle  

E-print Network

Spiral-type terahertz antennas and the manifestation of the Mushiake principle Ranjan Singh1 on the experimental and theoretical study of the resonant eigenmodes of spiral-type terahertz antennas. The analysis reflection and transmission coefficient. This property makes the spiral-type terahertz antenna not only

Oklahoma State University

346

Age and Gender Differences in Motivational Manifestations of the Big Five from Age 16 to 60  

ERIC Educational Resources Information Center

The present cross-sectional study investigated age and gender differences in motivational manifestations of the Big Five in a large German-speaking Internet sample (N = 19,022). Participants ranging in age from 16 to 60 years completed the Five Individual Reaction Norms Inventory (FIRNI; Denissen & Penke, 2008a), and two traditional Big Five…

Lehmann, Regula; Denissen, Jaap J. A.; Allemand, Mathias; Penke, Lars

2013-01-01

347

Imaging manifestations of a dreaded obstetric complication in the immediate postpartum period.  

PubMed

HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome is a dreaded complication that may develop during pregnancy or in the immediate postpartum period. Rarely this syndrome manifests itself with imaging findings. We report a case of HELLP syndrome in which the diagnosis was reaffirmed via imaging findings. PMID:24688204

Levine, Harold; Zarghouni, Mehrzad; Cannon, Walter

2014-04-01

348

78 FR 52958 - Announcement of Test Concerning Manifesting and Entry of Residue Found in Instruments of...  

Federal Register 2010, 2011, 2012, 2013

...also ensuring the safety and security of CBP Officers and the transportation...off the manifest through an indicator that identifies it as a Residue...Chief, Cargo Conveyance & Security, Office of Field Operations...Section 321 release without the Food and Drug...

2013-08-27

349

Primary brain tumours manifesting during pregnancy: presentation of six cases and a review of the literature  

Microsoft Academic Search

We review six cases of primary brain tumours with an initial manifestation of symptoms during pregnancy. Three patients presented with epileptic seizures, two with progressive motor disturbance, and one with visual disturbance. Three patients were diagnosed as harbouring brain tumours at 20–25 weeks of pregnancy, while the remaining three were diagnosed at 36–38 weeks of pregnancy. The tumours consisted of

Shunji Nishio; Takato Morioka; Satoshi Suzuki; Iwao Takeshita; Kiyonobu Ikezaki; Masashi Fukui; Hitoo Nakano

1996-01-01

350

Subscales to the Taylor Manifest Anxiety Scale in Three Chronically Ill Populations.  

ERIC Educational Resources Information Center

Examines factors of anxiety in the Taylor Manifest Anxiety Scale in 150 asthma, tuberculosis, and chronic pain patients. Key cluster analysis revealed five clusters: restlessness, embarrassment, sensitivity, physiological anxiety, and self-confidence. Embarrassment is fairly dependent on the other factors. (JAC)

Moore, Peter N.; And Others

1984-01-01

351

Neurological manifestations of gastrointestinal disorders, with particular reference to the differential diagnosis of multiple sclerosis  

Microsoft Academic Search

. Neurological manifestations of gastrointestinal disorders are described, with particular reference to those resembling multiple sclerosis (MS) on clinical or MRI grounds. Patients with celiac disease can present cerebellar ataxia, progressive myoclonic ataxia, myelopathy, or cerebral, brainstem and peripheral nerve involvement. Antigliadin antibodies can be found in subjects with neurological dysfunction of unknown cause, particularly in sporadic cerebellar ataxia (\\

A. Ghezzi; M. Zaffaroni

2001-01-01

352

Bedrock displacements in Greenland manifest ice mass variations, climate cycles and climate change  

E-print Network

Bedrock displacements in Greenland manifest ice mass variations, climate cycles and climate change anomaly. climate change climate cycles elasticity crustal motion geodesy The Greenland GPS Network a new means to measure the impact of climate cycles and climate change on ice mass balance in the world

Howat, Ian M.

353

Clinical manifestations of allergy related to breast and cows' milk feeding  

Microsoft Academic Search

The frequency of allergic manifestations in the first year of life was studied. The prevalence of allergic signs affecting the skin and respiratory tract in infants who had been started on breast feeding was compared with the prevalence of such signs in infants started on cows' milk formulae. The relationship of allergy to family history was investigated. Eczema and rhinitis

D W Hide; B M Guyer

1981-01-01

354

Hydrothorax as the sole manifestation of ovarian hyperstimulation syndrome: unusual case and literature review.  

PubMed

An unusual case of a unilateral massive hydrothorax after IVF treatment is reported in a 41-year-old patient, which developed as the only manifestation of ovarian hyperstimulation syndrome. The literature on such rare presentation is also reviewed to highlight its diagnostic features and prognosis. PMID:17579985

Khairy, Mohamed; El-Toukhy, Tarek; Emovon, Emanuel; Khalaf, Yacoub

2007-06-01

355

Manifesting Destiny: A Land Education Analysis of Settler Colonialism in Jamestown, Virginia, USA  

ERIC Educational Resources Information Center

Globally, colonization has been and continues to be enacted in the take-over of Indigenous land and the subsequent conversion of agriculture from diverse food and useful crops to large-scale monoculture and cash crops. This article uses a land education analysis to map the rise of the ideology and practices of Manifest Destiny in Virginia.…

McCoy, Kate

2014-01-01

356

One-loop /N-point superstring amplitudes with manifest /d=4 supersymmetry  

NASA Astrophysics Data System (ADS)

The hybrid formalism for the superstring is used to compute one-loop amplitudes with an arbitrary number of external d=4 supergravity states. These one-loop N-point amplitudes are expressed as Koba-Nielsen-like formulas with manifest d=4 supersymmetry.

Berkovits, Nathan; Carlini Vallilo, Brenno

2002-03-01

357

Local peritonitis as the first manifestation of Crohn's disease in a child  

PubMed Central

Crohn's disease (CD) can occur anywhere in the gastrointestinal tract from the mouth to the anus and sometimes it presents in a nonspecific manner. Herein we describe a case of local peritonitis as the first manifestation of CD in an 11-year-old girl, and the subsequent method of treatment. PMID:24741214

Kambouri, Katerina; Gardikis, Stefanos; Agelidou, Maria; Vaos, George

2014-01-01

358

Human-computer interaction in information retrieval: nature and manifestations of feedback  

Microsoft Academic Search

This study develops a theoretical framework for expressing the nature of feedback as a critical process in interactive information retrieval (IR). Feedback concepts from cybernetics and social sciences perspectives are used to develop a concept of informational feedback applicable to IR. Models from human-computer interaction and interactive IR are then adapted as a framework for studying the manifestations of feedback

Amanda Spink; Tefko Saracevic

1998-01-01

359

Overview of common, rare and atypical manifestations of cutaneous lupus erythematosus and histopathological correlates.  

PubMed

The skin is the second most frequently affected organ system in lupus erythematosus. Although only very rarely life threatening--an example is lupus erythematosus-associated toxic epidermal necrolysis--skin disease contributes disproportionally to disease burden in terms of personal and psychosocial wellbeing, vocational disability, and hence in medical and social costs. Since several manifestations are closely associated with the presence and activity of systemic lupus erythematosus, prompt and accurate diagnosis of cutaneous lupus erythematosus is essential. This review aims to cover common, rare, and atypical manifestations of lupus erythematosus-associated skin disease with a detailed discussion of histopathological correlates. Cutaneous lupus erythematosus covers a wide morphological spectrum well beyond acute, subacute and chronic cutaneous lupus erythematosus, which are commonly classified as lupus-specific skin disease. Other uncommon or less well-known manifestations include lupus erythematosus tumidus, lupus profundus, chilblain lupus, mucosal lupus erythematosus, and bullous lupus erythematosus. Vascular manifestations include leukocytoclastic and urticarial vasculitis, livedoid vasculopathy and livedo reticularis/ racemosa. Finally, we discuss rare presentations such as lupus erythematosus-related erythema exsudativum multiforme (Rowell syndrome), Kikuchi-Fujimoto disease, extravascular necrotizing palisaded granulomatous dermatitis (Winkelmann granuloma), and neutrophilic urticarial dermatosis. PMID:20693199

Obermoser, G; Sontheimer, R D; Zelger, B

2010-08-01

360

Psychopathological Manifestations of Children with Intellectual Disabilities According to Their Cognitive and Adaptive Behavior Profile  

ERIC Educational Resources Information Center

Children with intellectual disabilities show deficits in cognitive abilities and adaptive behavior which increase the risk of psychopathological disorders. This exploratory study aims at delineating profiles of children based on their cognitive functioning and adaptive behaviors, and to compare them on psychopathological manifestations. A…

Tremblay, Karine N.; Richer, Louis; Lachance, Lise; Cote, Alain

2010-01-01

361

Manifestations of Greek-Cypriot Teachers' Discomfort toward a Peace Education Initiative: Engaging with Discomfort Pedagogically  

ERIC Educational Resources Information Center

This study sought to understand how teachers' discomforting emotions were manifest in a teacher education setting and how teacher educators might engage with discomfort pedagogically. A qualitative perspective was used with a group of teachers who participated in a series of peace education workshops in Cyprus. All of the workshops were audio- and…

Zembylas, Michalinos; Charalambous, Panayiota; Charalambous, Constadina

2012-01-01

362

Manifest and Latent Components in Methadone Maintenance: The Methadone Maintenance Game  

ERIC Educational Resources Information Center

This paper discusses various difficulties which arise when the staff of a methadone maintenance clinic must come to grips with the manifest and latent issues in service delivery. A solution is suggested which involves severing the tie between methadone and the behaviors which are reinforced by its use. (Author)

King, Charles H.

1975-01-01

363

Vertigo as Manifestation of Vertebral Artery Dissection after Chiropractic Neck Manipulations  

Microsoft Academic Search

We recently observed a case of vertebral artery (VA) dissection following chiropractic neck manipulations. The first manifestation was unusual; in the form of vertigo. Therefore, the patient was referred to the otoneurologist. A VA dissection should be suspected in a case of vertigo following chiropractic neck manipulations, and vestibular tests should be done carefully, avoiding Rose’s positions. In our case,

Dominique Vibert; Josette Rohr-Le Floch; Gèrard Gauthier

1993-01-01

364

Manifest: A computer program for 2-D flow modeling in Stirling machines  

NASA Technical Reports Server (NTRS)

A computer program named Manifest is discussed. Manifest is a program one might want to use to model the fluid dynamics in the manifolds commonly found between the heat exchangers and regenerators of Stirling machines; but not just in the manifolds - in the regenerators as well. And in all sorts of other places too, such as: in heaters or coolers, or perhaps even in cylinder spaces. There are probably nonStirling uses for Manifest also. In broad strokes, Manifest will: (1) model oscillating internal compressible laminar fluid flow in a wide range of two-dimensional regions, either filled with porous materials or empty; (2) present a graphics-based user-friendly interface, allowing easy selection and modification of region shape and boundary condition specification; (3) run on a personal computer, or optionally (in the case of its number-crunching module) on a supercomputer; and (4) allow interactive examination of the solution output so the user can view vector plots of flow velocity, contour plots of pressure and temperature at various locations and tabulate energy-related integrals of interest.

Gedeon, David

1989-01-01

365

Antiphospholipid syndrome in 2014: more clinical manifestations, novel pathogenic players and emerging biomarkers  

PubMed Central

The clinical spectrum of the anti-phospholipid syndrome (APS) is not limited to vascular thrombosis or miscarriages but includes additional manifestations that cannot be explained solely by a thrombophilic state. Anti-cardiolipin, anti-beta2 glycoprotein I (anti-?2GPI) and lupus anticoagulant (LA) assays are not only the formal diagnostic and classification laboratory tools but also parameters to stratify the risk to develop the clinical manifestations of the syndrome. In particular, anti-?2GPI antibodies reacting with an immunodominant epitope on domain I of the molecule were reported as the prevalent specificity in APS patients, correlating with a more aggressive clinical picture. Several laboratory assays to improve the diagnostic and predictive power of the standard tests have been proposed. Plates coated with the phosphatidylserine-prothrombin complex for detecting antibodies represent a promising laboratory tool correlating with LA and with clinical manifestations. Anti-phospholipid antibodies can be found in patients with full-blown APS, in those with thrombotic events or obstetric complications only or in asymptomatic carriers. An inflammatory second hit is required to increase the presence of ?2GPI in vascular tissues, eventually triggering thrombosis. Post-transcriptional modifications of circulating ?2GPI, different epitope specificities or diverse anti-?2GPI antibody-induced cell signaling have all been suggested to affect the clinical manifestations and/or to modulate their occurrence. PMID:25166960

2014-01-01

366

Making Induction Manifest in Modular ACL2 Carl Eastlund Matthias Felleisen  

E-print Network

Making Induction Manifest in Modular ACL2 Carl Eastlund Matthias Felleisen Northeastern University Boston, Massachusetts, U.S.A. {cce,matthias}@ccs.neu.edu Abstract ACL2, a Common Lisp-based language such as a module system. In previous work, we equipped ACL2 with modules, interfaces, and explicit linking

367

Longitudinal Change in Gait and Motor Function in Pre-manifest Huntington's Disease  

E-print Network

increased (p=0.0001) from baseline to year five. Step length difference (p (HD). We examined ten pre-manifest subjects at baseline, one and five years. Quantitative gait data, step length, cadence), asymmetry (step length difference), dynamic balance (percent time in double

368

Manifestations of Neoliberal Discourses within a Local Job-Training Program  

ERIC Educational Resources Information Center

The purpose of conducting this study was to understand how neoliberal discourses manifest within the local context of a short-term, job-training program offered at a two-year college in the USA. Ethnographic data were collected at the local site through interviews, observations and document analysis. We then situated these data within a global…

Ayers, David Franklin; Carlone, David

2007-01-01

369

Managerial Power Bases and Subordinates' Manifest Needs as Influences on Psychological Climate  

Microsoft Academic Search

This study investigated the-relative and interactive effects of manifest needs and managerial power bases as explanatory variables of psychological climate. Previously validated measures of the constructs were completed by 420 full-time employees in the United States of America. Using the dimensions of psychological climate as the dependent variables denoting managerial effectiveness, stepwise multiple regression analyses with the managerial power bases

Edward A. Ward

1998-01-01

370

ERP Manifestations of Processing Printed Words at Different Psycholinguistic Levels: Time Course and Scalp Distribution  

Microsoft Academic Search

The aim of the present study was to examine the time course and scalp distribution of electrophysiological manifestations of the visual word recognition mechanism. Event-related potentials (ERPs) elicited by visually presented lists of words were recorded while subjects were involved in a series of oddball tasks. The distinction between the designated target and nontarget stimuli was manipulated to induce a

S. Bentin; Y. Mouchetant-Rostaing; M. H. Giard; J. F. Echallier; J. Pernier

1999-01-01

371

Attitudes and InactionA Case Study of the Manifest Demographics of Urban Water Conservation  

Microsoft Academic Search

The public’s disposition with respect to conservation is predominantly ascertained by surveys. Rarely are these attitudes contrasted directly against manifested behavior from an independent source. This article analyzes the response to a residential urban water conservation program by using municipal water consumption data at the census tract level in San Antonio, Texas. A selection of demographic variables (i.e., income, education,

Miguel De Oliver

1999-01-01

372

Exploring the Manifestations of Anxiety in Children with Autism Spectrum Disorders  

ERIC Educational Resources Information Center

This study explores the manifestation and measurement of anxiety symptoms in 415 children with ASDs on a 20-item, parent-rated, DSM-IV referenced anxiety scale. In both high and low-functioning children (IQ above vs. below 70), commonly endorsed items assessed restlessness, tension and sleep difficulties. Items requiring verbal expression of worry…

Hallett, Victoria; Lecavalier, Luc; Sukhodolsky, Denis G.; Cipriano, Noreen; Aman, Michael G.; McCracken, James T.; McDougle, Christopher J.; Tierney, Elaine; King, Bryan H.; Hollander, Eric; Sikich, Linmarie; Bregman, Joel; Anagnostou, Evdokia; Donnelly, Craig; Katsovich, Lily; Dukes, Kimberly; Vitiello, Benedetto; Gadow, Kenneth; Scahill, Lawrence

2013-01-01

373

Change in the Manifestation of Overt Aggression during Early Adolescence: Gender and Ethnicity  

ERIC Educational Resources Information Center

This study examined how the manifestation of overt aggression changes during early adolescence using Hierarchical Linear Modeling. The distinct courses of physical and verbal aggression identified in this study provide support for developmental transformations in overt aggression, which would have been obscured unless aggression had been defined…

Kim, Sangwon; Kamphaus, Randy W.; Orpinas, Pamela; Kelder, Steve H.

2010-01-01

374

Association between different clinical manifestations of Lyme disease and different species of Borrelia burgdorferi sensu lato  

Microsoft Academic Search

Borrelia burgdorferi sensu lato, the aetiological agent of Lyme disease, has been sub-divided into three species: B. burgdorferi sensu stricto, B. garinii and B. afzelii. We and other authors have hypothesized an association between the three species of B. burgdorferi sensu lato and some of the different clinical manifestations of Lyme disease. In order to demonstrate this hypothesis, we analysed

T Balmelli; J.-C Piffaretti

1995-01-01

375

~omtnentarylDuss:Sex diHerences The Innate versus the manifest: How  

E-print Network

~omtnentarylDuss:Sex diHerences The Innate versus the manifest: How universal does universal have of the frequent accr~sationthat the major evolutionary hyputl~eses (inclusive! fitness theory. sexual selection ethnocentrism projectedontotheanimal and non-Western world (Sahlins 1976). But how universal does a universal

Cosmides, Leda

376

Isolated mandibular condylar metastases: an uncommon manifestation of recurrent cervical cancer.  

PubMed

Bone metastases from recurrent cervical cancer is a rare scenario, with commonly involved sites being lumbar spine and pelvic bones report an extremely rare manifestation of cervical cancer recurrence presenting as a painful jaw swelling due to metastasis to the mandibular condyle. PMID:23575087

Puranik, Ameya D; Purandare, Nilendu C; Dua, Sumeet; Deodhar, Kedar; Shah, Sneha; Agrawal, Archi; Rangarajan, Venkatesh

2013-01-01

377

Systemic Lupus Erythematosus: Old and New Susceptibility Genes versus Clinical Manifestations  

PubMed Central

Systemic Lupus Erythematosus (SLE) is one of the most relevant world-wide autoimmune disorders. The formation of autoantibodies and the deposition of antibody-containing immune complexes in blood vessels throughout the body is the main pathogenic mechanism of SLE leading to heterogeneous clinical manifestations and target tissue damage. The complexity of etiology and pathogenesis in SLE, enclosing genetic and environmental factors, apparently is one of the greatest challenges for both researchers and clinicians. Strong indications for a genetic background in SLE come from studies in families as well as in monozygotic and dizygotic twins, discovering several SLE-associated loci and genes (e.g. IRF5, PTPN22, CTLA4, STAT4 and BANK1). As SLE has a complex genetic background, none of these genes is likely to be entirely responsible for triggering autoimmune response in SLE even if they disclosure a potentially novel molecular mechanisms in the pathogenesis' disease. The clinical manifestations and disease severity varies greatly among patients, thus several studies try to associate clinical heterogeneity and prognosis with specific genetic polymorphisms in SLE associated genes. The continue effort to describe new predisposing or modulating genes in SLE is justified by the limited knowledge about the pathogenesis, assorted clinical manifestation and the possible prevention strategies. In this review we describe newly discovered, as well as the most studied genes associated to SLE susceptibility, and relate them to clinical manifestations of the disease. PMID:24653663

J, De Azevêdo Silva; C, Addobbati; P, Sandrin-Garcia; S, Crovella

2014-01-01

378

Exercise intolerance and systemic manifestations of pulmonary emphysema in a mouse model  

Microsoft Academic Search

BACKGROUND: Systemic effects of chronic obstructive pulmonary disease (COPD) significantly contribute to severity and mortality of the disease. We aimed to develop a COPD\\/emphysema model exhibiting systemic manifestations of the disease. METHODS: Female NMRI mice were treated 5 times intratracheally with porcine pancreatic elastase (emphysema) or phosphate-buffered saline (control). Emphysema severity was quantified histologically by mean linear intercept, exercise tolerance

Lars Lüthje; Tobias Raupach; Hellmuth Michels; Bernhard Unsöld; Gerd Hasenfuss; Harald Kögler; Stefan Andreas

2009-01-01

379

Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis  

PubMed Central

Background Although health care providers utilize classically described signs and symptoms to diagnose tension pneumothorax, available literature sources differ in their descriptions of its clinical manifestations. Moreover, while the clinical manifestations of tension pneumothorax have been suggested to differ among subjects of varying respiratory status, it remains unknown if these differences are supported by clinical evidence. Thus, the primary objective of this study is to systematically describe and contrast the clinical manifestations of tension pneumothorax among patients receiving positive pressure ventilation versus those who are breathing unassisted. Methods/Design We will search electronic bibliographic databases (MEDLINE, PubMed, EMBASE, and the Cochrane Database of Systematic Reviews) and clinical trial registries from their first available date as well as personal files, identified review articles, and included article bibliographies. Two investigators will independently screen identified article titles and abstracts and select observational (cohort, case–control, and cross-sectional) studies and case reports and series that report original data on clinical manifestations of tension pneumothorax. These investigators will also independently assess risk of bias and extract data. Identified data on the clinical manifestations of tension pneumothorax will be stratified according to whether adult or pediatric study patients were receiving positive pressure ventilation or were breathing unassisted, as well as whether the two investigators independently agreed that the clinical condition of the study patient(s) aligned with a previously published tension pneumothorax working definition. These data will then be summarized using a formal narrative synthesis alongside a meta-analysis of observational studies and then case reports and series where possible. Pooled or combined estimates of the occurrence rate of clinical manifestations will be calculated using random effects models (for observational studies) and generalized estimating equations adjusted for reported potential confounding factors (for case reports and series). Discussion This study will compile the world literature on tension pneumothorax and provide the first systematic description of the clinical manifestations of the disorder according to presenting patient respiratory status. It will also demonstrate a series of methods that may be used to address difficulties likely to be encountered during the conduct of a meta-analysis of data contained in published case reports and series. PROSPERO registration number: CRD42013005826. PMID:24387082

2014-01-01

380

Reliability measures in item response theory: Manifest versus latent correlation functions.  

PubMed

For item response theory (IRT) models, which belong to the class of generalized linear or non-linear mixed models, reliability at the scale of observed scores (i.e., manifest correlation) is more difficult to calculate than latent correlation based reliability, but usually of greater scientific interest. This is not least because it cannot be calculated explicitly when the logit link is used in conjunction with normal random effects. As such, approximations such as Fisher's information coefficient, Cronbach's ?, or the latent correlation are calculated, allegedly because it is easy to do so. Cronbach's ? has well-known and serious drawbacks, Fisher's information is not meaningful under certain circumstances, and there is an important but often overlooked difference between latent and manifest correlations. Here, manifest correlation refers to correlation between observed scores, while latent correlation refers to correlation between scores at the latent (e.g., logit or probit) scale. Thus, using one in place of the other can lead to erroneous conclusions. Taylor series based reliability measures, which are based on manifest correlation functions, are derived and a careful comparison of reliability measures based on latent correlations, Fisher's information, and exact reliability is carried out. The latent correlations are virtually always considerably higher than their manifest counterparts, Fisher's information measure shows no coherent behaviour (it is even negative in some cases), while the newly introduced Taylor series based approximations reflect the exact reliability very closely. Comparisons among the various types of correlations, for various IRT models, are made using algebraic expressions, Monte Carlo simulations, and data analysis. Given the light computational burden and the performance of Taylor series based reliability measures, their use is recommended. PMID:24484622

Milanzi, Elasma; Molenberghs, Geert; Alonso, Ariel; Verbeke, Geert; De Boeck, Paul

2015-02-01

381

Mucocutaneous manifestations and nail changes in patients with end-stage renal disease on hemodialysis.  

PubMed

Mucocutaneous manifestations are common among patients on hemodialysis (HD). This study was undertaken to determine the prevalence of mucocutaneous manifestations in patients with end-stage renal disease (ESRD) who are on HD. In this cross-sectional, descriptive and analytic study conducted in 2009, 100 patients on HD at the Five Azar Hospital in Gorgan city were randomly selected. All the patients underwent detailed examination by a dermatologist to look for lesions in the skin, hair, nail and mucous membranes; if felt necessary, biopsy was obtained from the lesions. The findings were statistically analyzed using SPSS-13 software. For evaluation of normality of distribution, Kolmogorov-Smirnov was used, for quantitative variables Mann-Whitney and T-test (abnormal distribution) were used and for qualitative variables, Chi-2 and Fisher were used. In this study, P-value less than 0.05 was considered significant. Fifty-one males and 49 females were enrolled. The mean age was 49 ± 12 years. Diabetes was the most common cause of ESRD. In 95% of the patients, at least one mucocutaneous manifestation was present. Xerosis (78.3%) was the most common lesion, followed by pruritus (39.1%), lentigo (34.8%), skin discoloration (32.6%), leukonychia (32%) and thinning of the nail bed (24%). Xerosis, scaling, lentigo, folliculitis, idiopathic guttate hypopigmentation, leukonychia and half and half nail were associated with age. A significant relationship was seen between duration on dialysis and skin discoloration and leukonychia. Clubbing had a significant association with calcium-phosphorus product (Ca × P). There was a significant association between serum ferritin level and pruritus and tinea versicolor lesions. Our study shows that mucocutaneous manifestations are common among patients with ESRD. Identification of these manifestations and their association with causative factors are useful for preventing the lesions. PMID:23354189

Tajbakhsh, Ramin; Dehghan, Mohammad; Azarhoosh, Ramin; Haghighi, Ali Nobakht; Sadani, Somayeh; Zadeh, Soheila Samad; Kabootari, Maryam; Qorbani, Mostafa

2013-01-01

382

Evaluation of respiratory manifestations in systemic lupus erythematosus with special reference to pulmonary interstitial involvement.  

PubMed

Different respiratory manifestations in systemic lupus erythematosus (SLE) are not uncommon. We lack sufficient Indian data in this regard. Forty diagnosed cases of SLE were evaluated, to find out the prevalence of respiratory manifestations in SLE, as also to correlate the findings as observed by different diagnostic methods. It was a single centre cross-sectional observational study conducted at rheumatology clinic, IPGME&R, Kolkata. Patients suffering from chronic airways obstruction, upper airway diseases, left ventricular failure and lung cancer were all excluded from the study. After clinical evaluation and routine testing of organ specific parameters, patients underwent spirometry and chest x-ray in all cases and pleural fluid study, pleural biopsy and high resolution CT scan of thorax selectively as required. Mean age at presentation was 26.8 years and female to male ratio was 39:1. Commonest respiratory symptom was dyspnoea and commonest respiratory manifestation was pleural effusion. Pleural effusion was bilateral in 80% of cases. Interstitial lung disease (ILD) was found in 10% of cases presented either subacutely or chronically. High resonance CT was found to be more sensitive to diagnose ILD, as in 50% of ILDs diagnosed by scan, chest x-rays were normal. Pleuropulmonary infections (7.5%) were next most common manifestation and tuberculosis was found to be the commonest cause. Lupus pneumonitis was found in one only (2.5%). Screening lung function test as done by spirometry, could pick up some abnormality in 50% cases and restrictive change was the major abnormality (47%). None showed evidence of bronchial hyper-responsiveness. No case was detected to have neuromuscular disease, acute respiratory distress syndrome or pulmonary thrombo-embolism. All the respiratory manifestations as noted appeared in variable period after the onset of SLE. PMID:23029844

Ghosh, Asutosh; Das, Tapas; Ghosh, Alokendu; Karmakar, Parthasarathi; Pal, Jyotirmoy

2012-02-01

383

Solar Wind: Manifestations of Solar Activity E N CYC LO PE D IA O F AS T R O N O MY AN D AS T R O PHYS I C S Solar Wind: Manifestations of Solar  

E-print Network

Solar Wind: Manifestations of Solar Activity E N CYC LO PE D IA O F AS T R O N O MY AN D AS T R O PHYS I C S Solar Wind: Manifestations of Solar Activity The Sun's outer atmosphere, the corona, is continually heated and expands to create the solar wind. Solar activity waxes and wanes with the 11 yr cycle

Webb, David F.

384

A Learning and Memory Area in the Octopus Brain Manifests a Vertebrate-Like Long-Term Potentiation  

E-print Network

A Learning and Memory Area in the Octopus Brain Manifests a Vertebrate- Like Long-Term Potentiation in the octopus brain manifests a vertebrate-like long-term potentiation. J Neurophysiol 90: 3547­3554, 2003 and memory were investigated in the octopus using a brain slice prepara- tion of the vertical lobe, an area

Hochner, Binyamin

385

High prevalence of vitamin D deficiency and insufficiency in patients with manifest Huntington disease  

PubMed Central

Vitamin D deficiency and insufficiency are common in older institutionalized people and known to be associated with muscle weakness, impaired balance and increased fall risk. Falls and balance problems are common in people with Huntington disease (HD). Despite this, the prevalence of vitamin D deficiency in patients with manifest HD has never been investigated. Serum 25(OH)D levels were measured in routinely drawn blood samples from 28 Dutch institutionalized patients with manifest Huntington disease. Mean serum 25(OH)D level was 33 nmol/l (SD 15). Twenty-five subjects (89%) were vitamin D deficient or insufficient (25(OH)D < 50 nmol/L). A positive association was found between serum 25(OH)D levels and Functional Ambulation Classification (FAC) scores (p = 0.023). PMID:24516688

Chel, Victor GM; Ooms, Marcel E; van der Bent, Jessie; Veldkamp, Fleur; Roos, Raymund AC; Achterberg, Wilco P; Lips, Paul

2013-01-01

386

Celiac Disease and Dermatologic Manifestations: Many Skin Clue to Unfold Gluten-Sensitive Enteropathy  

PubMed Central

Cutaneous manifestations of intestinal diseases are increasingly reported both in the adult and in the children, and this association cannot longer be considered a simple random. Besides the well-known association between celiac disease (CD) and dermatitis herpetiformis (DH), considered as the cutaneous manifestation of gluten-dependent enteropathy, is more frequently reported also the association with other mucocutaneous diseases. Among these there are both autoimmune, allergic, and inflammatory diseases, but also a more heterogeneous group called miscellaneous. The knowledge about pathogenic, epidemiological, clinical, and diagnostic aspects of CD is increasing in recent years as well as those about DH, but some aspects still remain to be defined, in particular the possible pathogenetic mechanisms involved in the association between both CD and DH and CD and other immunological skin diseases. The aim of this paper is to describe the skin diseases frequently associated with CD, distinguishing them from those which have a relationship probably just coincidental. PMID:22693492

Caproni, Marzia; Bonciolini, Veronica; D'Errico, Antonietta; Antiga, Emiliano; Fabbri, Paolo

2012-01-01

387

Childhood onset of left ventricular dysfunction in a female manifesting carrier of muscular dystrophy.  

PubMed

Duchenne muscular dystrophy and Becker muscular dystrophy are X-linked disorders that result from a mutation in the dystrophin gene that reduces the production or effectiveness of the protein dystrophin. These disorders are clinically characterized by progressive muscle degeneration. Manifesting female carriers are generally not identified as such until after puberty, when symptoms such as muscle weakness may arise. This clinical report describes a female manifesting carrier who started to show deterioration of left ventricular systolic function, but no marked skeletal muscle weakness, at the age of 10 years. The patient's cardiac function improved significantly after dual drug therapy with an ACE inhibitor (enalapril) and a beta-blocker (carvedilol). Our case adds to the existing evidence that left ventricular myocardial dysfunction may occur during childhood in female carriers of dystrophinopathies. PMID:22052614

Martinez, Hugo R; Pignatelli, Ricardo; Belmont, John W; Craigen, William J; Jefferies, John L

2011-12-01

388

A Case of Hemophagocytic Syndrome due to Tuberculosis: Uncommon Manifestation of a Common Disease  

PubMed Central

Hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis (HLH), is the manifestation of immune dysregulation. It is associated with ineffective but exaggerated immune response and infiltration of active lymphocytes and histiocytes in various organs. This devastating clinical condition has myriad of clinical and biochemical manifestations such as fever, splenomegaly, pancytopenia, hypertrygliceridemia, and hyperferritinemia. It can be either primary or secondary. Primary HLH usually presents in childhood. Secondary HLH occurs due to infection mostly viruses but other aetiologies are also important as early detection and treatment may improve survival. Hemophagocytosis due to tuberculosis is uncommon. Only handful of cases have been reported mostly in immunocompromised patients. We report a case of hemophagocytic syndrome associated with disseminated tuberculosis in an immunocompetent women highlighting early diagnosis and treatment is a demanding need in this devastating disease. PMID:25404945

Singha, Arijit; Mukherjee, Adreesh; Dasgupta, Riddhi; Das, Tapas

2014-01-01

389

Manifestation of a nonclassical Berry phase of an electromagnetic field in atomic Ramsey interference  

E-print Network

The Berry phase acquired by an electromagnetic field undergoing an adiabatic and cyclic evolution in phase space is a purely quantum-mechanical effect of the field. However, this phase is usually accompanied by a dynamical contribution and cannot be manifested in any light-beam interference experiment because it is independent of the field state. We here show that such a phase can be produced using an atom coupled to a quantized field and driven by a slowly changing classical field, and it is manifested in atomic Ramsey interference oscillations. We also show how this effect may be applied to one-step implementation of multiqubit geometric phase gates, which is impossible by previous geometric methods. The effects of dissipation and fluctuations in the parameters of the pump field on the Berry phase and visibility of the Ramsey interference fringes are analyzed.

Shi-Biao Zheng

2012-03-02

390

Musician's cramp as manifestation of maladaptive brain plasticity: arguments from instrumental differences.  

PubMed

Musician's cramp is a task-specific movement disorder that presents itself as muscular incoordination or loss of voluntary motor control of extensively trained movements while a musician is playing the instrument. It is characterized by task specificity and gender bias, affecting significantly more males than females. The etiology is multifaceted: a combination of a genetic predisposition, termed endophenotype, and behavioral triggering factors being the leading features for the manifestation of the disorder. We present epidemiological data from 591 musician patients from our outpatient clinic demonstrating an influence of fine-motor requirements on the manifestation of dystonia. Brass, guitar, and woodwind players were at greater risk than other instrumentalists. High temporospatial precision of movement patterns, synchronous demands on tonic and phasic muscular activation, in combination with fine-motor burdens of using the dominant hand in daily life activities, constitute as triggering factors for the disorder and may explain why different body parts are affected. PMID:22524368

Altenmüller, Eckart; Baur, Volker; Hofmann, Aurélie; Lim, Vanessa K; Jabusch, Hans-Christian

2012-04-01

391

Nonbacterial thrombotic endocarditis as the sole manifestation of stage IV gastric cancer: a case report  

PubMed Central

Introduction Nonbacterial thrombotic endocarditis is a very rare complication of malignancy and other hypercoagulable states. It describes the deposition of small sterile smooth or verrucoid vegetations on the valve leaflets, causing a clinical picture similar to that of bacterial endocarditis. The authors reported this case because this is a rare and unusual first manifestation of malignancy generally and of gastric cancer particularly, with only a few reports present in the literature. Case presentation The authors present a case of a 36-year-old Caucasian male with occult gastric cancer whose first and only manifestation was nonbacterial thrombotic endocarditis causing extensive multi-organ infarctions. Conclusions An endocarditis not responsive to antibiotics should raise the suspicion of an occult malignancy. Differentiating between an infective endocarditis and a nonbacterial thrombotic endocarditis will cause a radical change in the management which will eventually affect the patient’s prognosis. PMID:25091999

2014-01-01

392

[Primary cutane manifestation of a precursor-B-lymphoblastic lymphoma in the external ear].  

PubMed

A Non-Hodgkin Lymphoma (NHL) represents nearly three percent of all malignant tumors. Thirty to fourty percent of the lymphomas are located extra-nodal. Within the head and neck region they might occur in the tonsils, tongue base or the sinuses, the larynx and the pharynx. A cutaneous manifestation is rare. We report on an extranodal B-cell-lymphoma of the ear in a young woman. She reported on a piercing of the pinna months before with a subsequent infection. This infection led to the development of a massive ear tumor. Histologic examination resulted in the final diagnosis. In spite of the considerable extent of the lymphoma there was no systemic manifestation and a total remission was induced by chemotherapy before adjuvant radiation. PMID:18633860

Greve, J; Bas, M; Schipper, J; Hoffmann, T K

2008-10-01

393

Laryngotracheal stenosis requiring emergency tracheostomy as the first manifestation of childhood-relapsing polychondritis.  

PubMed

Relapsing polychondritis is a rare childhood disorder of unknown etiology, characterized by inflammatory, recurrent and destructive cartilage lesions. The chondritis could be widespread and involves generally laryngeal and auricular hyaline cartilages. We described a 9 years and 4 months old girl, who presented recurrent acute laryngotracheitis and laryngotracheal stenosis, which were the first manifestations of relapsing polychondritis, and was submitted to emergency tracheostomy. She also had ear condritis and arthritis, being treated with prednisolone and methotrexate. In conclusion, we reported a rare case of relapsing polychondritis that presented a life-threatening laryngo-tracheo-bronchial disorder requiring tracheostomy. We suggest that the diagnosis of relapsing polychondritis should be considered for patients who present recurrent acute laryngotracheitis with other types of condritis, as well as musculoskeletal manifestations. PMID:24149019

Buscatti, Izabel M; Giacomin, Maria Fernanda A; Silva, Marco Felipe C; Campos, Lúcia M A; Sallum, Adriana M E; Silva, Clovis A

2013-01-01

394

Intrathoracic extramedullary haematopoiesis manifested as a neoplastic lesion within anterior mediastinum.  

PubMed

Intrathoracic extramedullary hematopoiesis (EMH), the formation of apparently normal blood cells outside the confines of the bone marrow, is an uncommon but well-defined entity. It is usually associated with hematologic disorders and located in the lower paravertebral sulci or rarely in the pleura. We report a case of EMH, which presented in a patient without hematologic disorders and was manifested as an anterior mediastinal mass. The first interesting aspect of our case was that EMH occurred in a patient with normal laboratory findings and no past medical history of anemia. The second remarkable characteristic was that EMH manifested as an anterior mediastinal mass, mimicking a neoplastic lesion. Definitive diagnosis of EMH was established by a video-assisted thoracoscopic surgical biopsy. In light of this diagnosis, no further surgical procedure was carried out. PMID:19932276

Santini, Mario; Fiorelli, Alfonso; Vicidomini, Giovanni; Napolitano, Filomena

2009-12-01

395

Onset of obsessive compulsive disorder in pregnancy with pica as the sole manifestation.  

PubMed

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after puerperium, but persisted in the last one. Probably physical stress of limb edema during the third pregnancy was reason for the persistence. She responded to fluoxetine 40 mg / day after three months of treatment, without behavioral therapy. We conclude that pica may either be only a manifestation of obsessive compulsive disorder during pregnancy or it is an obsessive compulsive spectrum disorder. PMID:23440014

Upadhyaya, Suneet Kumar; Sharma, Archana

2012-07-01

396

Onset of Obsessive Compulsive Disorder in Pregnancy with Pica as the Sole Manifestation  

PubMed Central

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after puerperium, but persisted in the last one. Probably physical stress of limb edema during the third pregnancy was reason for the persistence. She responded to fluoxetine 40 mg / day after three months of treatment, without behavioral therapy. We conclude that pica may either be only a manifestation of obsessive compulsive disorder during pregnancy or it is an obsessive compulsive spectrum disorder. PMID:23440014

Upadhyaya, Suneet Kumar; Sharma, Archana

2012-01-01

397

Severe iron deficiency anaemia as a manifestation of silent coeliac disease: case report and literature review.  

PubMed

Coeliac disease (CD) occurs in individuals sensitive to gluten protein contained in wheat products. It affects at least 1:100 children and may present with extra-intestinal manifestations such as iron deficiency anaemia, short stature and delay in puberty. A case of severe iron deficiency anaemia as a manifestation of CD is described here. There is a need to raise awareness among health professionals about CD and its extra-intestinal presentations. Suspicion of CD should lead to antibody screening tests and positive results should be followed by an intestinal biopsy for a definitive diagnosis. Involvement of a paediatric dietitian is vital in the management of CD and lifelong adherence to a gluten-free diet is necessary. We hope this article leaves the reader with a heightened awareness about CD and will lead to appropriate early referral to the paediatric services. PMID:20518373

Paul, Siba P; Taylor, T M; Barnard, Penny

2010-01-01

398

Differences in Clinical Manifestations of Imported versus Autochthonous Leptospirosis in Austria and Germany  

PubMed Central

Leptospirosis, a zoonosis occurring worldwide, has a broad spectrum of clinical manifestations. Recently, various countries observed an increase of severe anicteric cases. In Austria and Germany, growing numbers of imported cases are notified in addition to autochthonous infections. The aim of this study was to assess whether imported and autochthonous cases differ in clinical manifestations and outcome. We retrospectively analyzed 24 imported and 35 autochthonous cases treated in six infectious disease units between 1998 and 2008. To compare disease severity, patients were classified according to established independent risk factors for fatal outcome. Although severe leptospirosis (i.e., presence of ? 1 independent risk factors for death) occurred in similar proportions of imported (67%) and autochthonous (86%) infections (P = 0.1), imported cases were significantly fewer icteric (13% versus 69%; P < 0.0001). In conclusion, an increasing incidence of severe anicteric imported cases of leptospirosis should be anticipated with rising global travel activities. PMID:20682876

Hoffmeister, Bodo; Peyerl-Hoffmann, Gabriele; Pischke, Sven; Zollner-Schwetz, Ines; Krause, Robert; Müller, Matthias C.; Graf, Angelika; Kluge, Stefan; Burchard, Gerd D.; Kern, Winfried V.; Suttorp, Norbert; Cramer, Jakob P.

2010-01-01

399

Abrupt changes in alpha-decay systematics as a manifestation of collective nuclear modes  

SciTech Connect

An abrupt change in alpha-decay systematics around the N=126 neutron shell closure is discussed. It is explained as a sudden hindrance of the clustering of the nucleons that eventually form the alpha particle. This is because the clustering induced by the pairing mode acting upon the four nucleons is inhibited if the configuration space does not allow a proper manifestation of the pairing collectivity.

Qi, C.; Liotta, R. J.; Wyss, R. A. [KTH, Alba Nova University Center, SE-10691 Stockholm (Sweden); Andreyev, A. N. [Instituut voor Kern-en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven (Belgium); School of Engineering and Science, University of the West of Scotland, Paisley PA1 2BE (United Kingdom); Huyse, M.; Van Duppen, P. [Instituut voor Kern-en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven (Belgium)

2010-06-15

400

The association between patellar alignment on magnetic resonance imaging and radiographic manifestations of knee osteoarthritis  

Microsoft Academic Search

The aim of our study was to evaluate the association between patellar alignment by using magnetic resonance imaging images\\u000a and radiographic manifestations of patello-femoral osteoarthritis (OA). Subjects were recruited to participate in a natural\\u000a history study of symptomatic knee OA. We examined the relation of patellar alignment in the sagittal plane (patellar length\\u000a ratio (PLR)) and the transverse plane (sulcus

Leonid Kalichman; Yuqing Zhang; Jingbo Niu; Joyce Goggins; Daniel Gale; Yanyan Zhu; David T Felson; David J Hunter

2007-01-01

401

Manifestations of the Indian Ocean tsunami of 2004 in satellite nadir-viewing radar backscatter variations  

Microsoft Academic Search

This paper reports on the first experimental evidence for space?observed manifestations of the open ocean tsunami in the microwave radar backscatter (in the C and Ku bands; electromagnetic wavelengths of 6 and 2 cm, respectively). Significant (a few dB) variations of the radar cross section synchronous with the sea level anomaly were found in the geophysical data record of the altimetry

Y. I. Troitskaya; S. A. Ermakov

2008-01-01

402

Manifestations of the Indian Ocean tsunami of 2004 in satellite nadir-viewing radar backscatter variations  

Microsoft Academic Search

The paper reports on the first experimental evidence for space-observed manifestation of the open ocean tsunami in the microwave radar backscatter (in C- and Ku-bands; electromagnetic wave lengths 6cm and 2 cm respectively). Significant (a few dB) variations of the radar cross section synchronous with the sea level anomaly were found in the geophysical data record of the altimetry satellite

Yuliya I. Troitskaya; Stanislav A. Ermakov

2006-01-01

403

Diagnostic clues and manifesting carriers in fukutin-related protein (FKRP) limb-girdle muscular dystrophy.  

PubMed

Mutations in the fukutin-related protein (FKRP) gene are a known cause of autosomal recessive limb-girdle muscular dystrophy. Clinically, patients resemble Becker's muscular dystrophy and generally present in the first two decades of life with a mild, progressive phenotype. Cardiac involvement is variable. Heterozygous carriers are usually clinically unaffected. We report a patient presenting later in life with life-threatening cardiac failure and we describe for the first time clinically manifesting carriers in the family. PMID:25560911

Schottlaender, Lucia V; Petzold, Axel; Wood, Nicholas; Houlden, Henry

2015-01-15

404

Differential response to corticosteroid therapy of MRI findings and clinical manifestations in spinal cord sarcoidosis  

Microsoft Academic Search

Spinal cord sarcoidosis is a rare disorder whose natural history and therapeutic outcome are not fully known. We examined\\u000a four patients with spinal cord sarcoidosis both clinically and radiologically, particularly in relation to corticosteroid\\u000a treatment. The initial manifestation was cervical myelopathy in three and uveitis in one. All four patients progressed slowly\\u000a until corticosteroid therapy was initiated. The cervial spine

Haruki Koike; Ken-ichiro Misu; Keizo Yasui; Takashi Kameyama; Tetsuo Ando; Tsutomu Yanagi; Gen Sobue

2000-01-01

405

Gender differences in manifestations of antisocial personality disorder among residential drug abuse treatment clients  

Microsoft Academic Search

We examined gender differences in manifestations of DSM-III-R antisocial personality disorder in 106 male and 34 female drug abusers enrolled in residential relapse prevention\\/health education treatment. In childhood, compared to males, females had more often run away but less often used weapons in fights, been cruel to animals, and set fires. Females also reported less vandalism. In adulthood, women had

Risë B. Goldstein; Sally I. Powers; Jane McCusker; Kenneth A. Mundt; Benjamin F. Lewis; Carol Bigelow

1996-01-01

406

Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus)  

Microsoft Academic Search

Objective—The efficacy of nifedipine and prazosin in combination or alone in the management of cardiovascular manifestations caused to Mesobuthus tamulus poisoning was investigated.Design—Observation and study.Setting—Hospital at Mahad, Maharashtra, India.Subjects—62 patients who had been stung by a red scorpion were admitted from January to December 1990: 18 with hypertension, 15 with supraventricular tachycardia, 11 with pulmonary oedema, and 18 with local

H S Bawaskar; P H Bawaskar

1992-01-01

407

Clinical and Imaging Manifestations of Hemorrhagic Pulmonary Leptospirosis: A State-of-the-Art Review  

Microsoft Academic Search

Leptospirosis, a spirochetal zoonosis, is frequently unrecognized due to its manifestation as an undifferentiated fever. It\\u000a is an emerging infectious disease that has changed from an occupational disease of veterinarians, farmers, butchers, and other\\u000a animal handlers to a cause of epidemics in poor and decayed urban communities in developing countries. Humans are infected\\u000a when mucous membranes or abraded skin come

Edson Marchiori; Sílvia Lourenço; Sérgio Setúbal; Gláucia Zanetti; Taisa Davaus Gasparetto; Bruno Hochhegger

2011-01-01

408

Oral Manifestations Compatible with Chronic Graft-versus-Host Disease in Patients with Fanconi Anemia.  

PubMed

Fanconi anemia (FA) is a genetic disease that is characterized by several congenital abnormalities and progressive bone marrow failure and is associated with an increased susceptibility to malignant disorders. Currently, the only potential cure for hematological disorders is hematopoietic stem cell transplantation (HSCT). However, 1 of the most common complications after HSCT is the development of oral chronic graft-versus-host disease (cGVHD), which is also a risk factor for the development of cancer, particularly oral squamous cell carcinoma. Therefore, the purpose of this study was to describe the prevalence and characteristics of oral manifestations compatible with cGVHD in patients diagnosed with FA according to the National Institutes of Health (NIH) consensus criteria. A total of 96 patients (51 females, 45 males; median age, 16 years) with FA, who were in medical follow-up after HSCT at the outpatient clinic of the bone marrow transplantation unit (Hospital de Clínicas from the Universidade Federal do Paraná) underwent an oral evaluation between January 2013 and December 2013. Post-HSCT periods varied from 1 to 261 months and were divided into 3 periods: immediate post-HSCT period; intermediate post-HSC period, and late post-HSCT period. Among the evaluated patients, 40 of 96 (42%) presented with oral manifestations of cGVHD, with 29 of 40 (73%) of these patients in the late post-HSCT period. NIH scale scores varied from 0 to 10, and lichenoid and hyperkeratotic lesions were the abnormalities most frequently observed (100%). Overall, a high prevalence of oral manifestations was observed for cGVHD patients with FA. These data highlight the importance of monitoring oral manifestations compatible with cGVHD to identify and treat individuals with a higher risk of developing oral cancer. PMID:25316110

Grein Cavalcanti, Laura; Fuentes Araújo, Renata L; Bonfim, Carmem; Torres-Pereira, Cassius C

2015-02-01

409

Designing criteria suites to identify discrete and networked sites of high value across manifestations of biodiversity  

Microsoft Academic Search

Suites of criteria specifying ecological, biological, social, economic, and governance properties enable the systematic identification\\u000a of sites and networks of high biodiversity value, and can support balancing ecological and socioeconomic objectives of biodiversity\\u000a conservation in terrestrial and marine spatial planning. We describe designs of suites of ecological, governance and socioeconomic\\u000a criteria to comprehensively cover manifestations of biodiversity, from genotypes to

Eric Gilman; Daniel Dunn; Andrew Read; K. David Hyrenbach; Robin Warner

410

Sleep-Disordered Breathing as Presenting Manifestation of Chiari Type I Malformation: A Case Report  

PubMed Central

Chiari Type I malformation (CM-I) is a rare disorder with displaced cerebellar tonsils through foramen magnum. Here we present a 30-year-old man with severe central and obstructive sleep apneas as presenting manifestations of CM-I. The patient underwent neurosurgery and the follow-up polysomnography revealed the resolution of central apnea while obstructive apnea remained unchanged. Central sleep apnea (CSA) could be associated with an underlying pathology; thus, further investigation is recommended in affected subjects. PMID:25506375

Adimi, Parisa; Bakhshayesh-Karam, Mehrdad; Kiapour, Nazanin

2014-01-01

411

Acute renal failure as an initial manifestation of multiple endocrine neoplasia (MEN) type 1.  

PubMed

Multiple endocrine neoplasia (MEN) is a group of heritable syndromes characterized by aberrant growth of benign or malignant tumors in a subset of endocrine tissues. There are three major syndromes: MEN1, 2A and 2B. We describe a 60-year-old woman who initially manifested acute renal failure due to hypercalcemia and dehydration and, finally, was diagnosed as a sporadic MEN1 case. PMID:22237232

Afshar, Reza; Sanavi, Suzan; Taheri, Hamid-Reza

2012-01-01

412

Atlantic multidecadal oscillation and its manifestations in the Atlantic-European region  

Microsoft Academic Search

We present a brief survey of the works devoted to the investigation of the Atlantic Multidecadal Oscillation, i.e., of the\\u000a quasiperiodic variations of sea-surface temperature in the North Atlantic with typical time scales of 50–100 yr. This oscillation\\u000a is a manifestation of the natural variability in the ocean-atmosphere system. The characteristic scale of the Atlantic Multidecadal\\u000a Oscillation is determined by

A. B. Polonskii

2008-01-01

413

Catalogue of the main gas manifestation of Greece: Geochemical characterisation and preliminary gas hazard assessment  

NASA Astrophysics Data System (ADS)

Like other geodynamically active areas, the Hellenic territory is also affected by a large number of geogenic gas manifestations. These occur either in form of point sources (fumaroles, mofettes, bubbling gases) or as diffuse soil gas emanations. The present work produced a first catalogue of the geogenic gas manifestations of the whole Hellenic territory also considering a few literature data. All collected samples were analysed for their chemical composition (He, Ne, Ar, O2, N2, H2, H2S, CO, CH4 and CO2) and isotopic composition (He, CO2-C, CH4-C, N2-N). Geogenic sources release huge amounts of gases, which, apart from having important influences on the global climate, could have strong impact on human health. Gases have both acute and chronic effects. Carbon Dioxide and Hydrogen Sulphide are the main gases responsible for acute mortality due to their asphyxiating and/or toxic properties. Methane instead represents a risk for its explosive properties. Gas hazard is often disregarded because in fatal episodes connected to geogenic gases the death cause is often not correctly attributed. Due to the fact that geodynamic active areas can release geogenic gases for million years over wide areas, it is important not to underestimate potential risks. A preliminary estimation of the gas hazard has been made for the time period of the last 20 years considering the whole population of Greece. In this period at least two fatal episodes with a total of three victims could be certainly attributed to geogenic gases (specifically CO2). This would give a risk of 1.3×10-8 fatality from geogenic gas manifestations per annum. Such value, although probably underestimated, is much lower than most other natural or anthropogenic risks. Nevertheless this risk, being unevenly distributed along the whole territory, should not be overlooked especially in areas with high density of gas manifestations and high soil gas fluxes.

D'Alessandro, Walter; Kyriakopoulos, Konstantinos; Calabrese, Sergio

2014-05-01

414

Myoelectric manifestations of jaw elevator muscle fatigue and recovery in healthy and TMD subjects.  

PubMed

The effects of muscle pain and fatigue on the control of jaw elevator muscles are not well known. Furthermore, the myoelectric manifestations of fatigue and recovery from fatigue in the masticatory muscles are not reported in literature. The main aims of this study were (i) to evaluate the possible use of surface electromyography (sEMG) as an objective measure of fatigue of the jaw elevator muscles, (ii) to compare the myoelectric manifestations of fatigue in the temporalis anterior and masseter muscles bilaterally, (iii) to assess recovery of the investigated muscles after an endurance test and (iv) to compare fatigue and recovery of the jaw elevator muscles in healthy subjects and patients with muscle-related temporomandibular disorders (TMD). The study was performed on twenty healthy volunteers and eighteen patients with muscle-related TMD. An intra-oral compressive-force sensor was used to measure the voluntary contraction forces close to the intercuspal position and to provide visual feedback of submaximal forces to the subject. Surface EMG signals were recorded with linear electrode arrays during isometric contractions at 20%, 40%, 60% and 80% of the maximum voluntary contraction force, during an endurance test and during the recovery phase. The results showed that (i) the slope of the mean power spectral frequency (MNF) and the initial average rectified value (ARV) could be used to monitor fatigue of the jaw elevators, (ii) the temporalis anterior and masseter muscle show the same myoelectric manifestations of fatigue and recovery and (iii) the initial values of MNF and ARV were lower in patients with muscle-related TMD. The assessment of myoelectric manifestations of fatigue in the masticatory muscles may assist in the clinical assessment of TMDs. PMID:22490056

Castroflorio, T; Falla, D; Tartaglia, G M; Sforza, C; Deregibus, A

2012-09-01

415

The short-wing gene in Drosophila melanogaster , and the effect of temperature on its manifestation  

Microsoft Academic Search

Summary  A new recessive gene inDrosophila melanogaster is described which affects the eyes and wings in various characteristic ways, the degree of its manifestation in the population\\u000a depending upon temperature. At high temperature (31°) it acts as a lethal; with successively lower temperatures its viability\\u000a increases, and its expression decreases from nearly 100 per cent. at 27·5° to 0 at 14°.

Reidar Eker

1935-01-01

416

Polychondritis presenting with oculomotor and abducens nerve palsies as the initial manifestation.  

PubMed

We treated a patient with relapsing polychondritis (RP) who presented with intermittent oculomotor and abducens nerve palsies as the first manifestation. Ear swelling and laryngeal edema emerged 7 months later, which led us to diagnose him with RP. Moderate doses of glucocorticoid resolved all symptoms. Our experience with RP accompanied by oculomotor nerve palsy suggests that RP should be considered in patients with cranial nerve palsies so that they may be promptly diagnosed and treated. PMID:24884407

Akiyama, Mitsuhiro; Kaneko, Yuko; Hanaoka, Hironari; Kuwana, Masataka; Takeuchi, Tsutomu

2014-06-01

417

Musculoskeletal manifestations of brucellosis: A study of 90 cases in Israel  

Microsoft Academic Search

Rheumatological manifestations are frequently reported in patients with brucellosis.In a retrospective study of 90 patients diagnosed with brucellosis over a period of 18 years, 83 (92%) patients were Bedouins, 55 of whom (61%) reported ingestion of unpasteurized goat milk and goat milk products. The male\\/female ratio was 1:1, and the adult to child ratio was 3:2. The mean age of

Nurit Zaks; Shaul Sukenik; Michael Alkan; Daniel Flusser; Lily Neumann; Dan Buskila

1995-01-01

418

Effect of gender, biochemical parameters & parathyroid surgery on gastrointestinal manifestations of symptomatic primary hyperparathyroidism  

PubMed Central

Background & objectives: Information on gastrointestinal manifestations and then response after curative parathyroid surgery is scarce in symptomatic primary hyperparathyroidism (PHPT). This study was carried out to analyse gastrointestinal manifestations in patients with PHPT and their associations with biochemical parameters. Methods: This retrospective study included 153 patients with symptomatic primary hyperparathyroidism (PHPT). The signs and symptoms pertaining to gastrointestinal system were analyzed. The difference of symptoms between men and women and difference in biochemical parameters in presence of different symptoms were evaluated. The relationship between serum calcium, phosphate and parathyroid hormone (PTH) levels with presence of gallstone and pancreatitis was also studied. Result: Of the 153 patients, 46 (30%) were men. The mean age was 39.2 ± 13.9 yr. Nearly 80 per cent of PHPT patients had at least one symptom/ sign related to gastrointestinal system. The most common gastrointestinal manifestations were abdominal pain 66 (43%), constipation 55 (36%), and nausea/or vomiting 46 (30%). Nearly one-fourth 34 (22%) of patients had a history of either gallstone disease or cholecystectomy or both. The prevalence of gallstone disease was higher in women (P<0.05). Imaging and biochemical evidence of pancreatitis was found in 27 (18%) patients. Pancreatitis was more common in men compared to women (P<0.05) despite the higher prevalence of gallstones in women. Serum calcium, phosphate or PTH levels were not associated with high risk for gallstone disease, however, serum calcium (P<0.05) was associated with 1.3 times higher risk of developing pancreatitis. In majority of patients, gastrointestinal manifestations resolved within three months of curative parathyroidectomy. Except two patients, none had recurrence of pancreatitis. Interpretation & conclusions: The study revealed that the gastrointestinal symptoms were common in patients with symptomatic PHPT. There was not much gender difference in gastrointestinal symptoms except higher occurrence of gallstones in women and pancreatitis in men. There was no difference in biochemical profile between those who had and did not have gastrointestinal symptoms. PMID:24718404

Shah, Viral N.; Bhadada, Sanjay Kumar; Bhansali, Anil; Behera, A.; Bhattacharya, Anish; Nahar, Uma; Bhasin, Deepak; Vadera, Bhavin

2014-01-01

419

Manifestations of the North - South Asymmetry in the Photosphere and in the Green Line Corona  

NASA Astrophysics Data System (ADS)

The north - south asymmetries (NSA) of three solar activity indices are derived and mutually compared over a period of more than five solar cycles (1945 - 2001). A catalogue of the hemispheric sunspot numbers, the data set of the coronal green line brightness developed by us, and the magnetic flux derived from the NSO/KP data (1975 - 2001) are treated separately within the discrete low- and mid-latitude zones (5° - 30°, 35° - 60°). The calculated autocorrelations, cross-correlations, and regressions between the long-term NSA data sets reveal regularities in the solar activity phenomenon. Namely, the appearance of a distinct quasi-biennial oscillation (QBO) is evident in all selected activity indices. Nevertheless, a smooth behavior of QBO is derived only when sufficient temporal averaging is performed over solar cycles. The variation in the significance and periodicity of QBO allows us to conclude that the QBO is not persistent over the whole solar cycle. A similarity in the photospheric and coronal manifestations of the NSA implies that their mutual relation will also show the QBO. A roughly two-year periodicity is actually obtained, but again only after significant averaging over solar cycles. The derived cross-correlations are in fact variable in degree of correlation as well as in changing periodicity. A clear and significant temporal shift of 1 - 2 months in the coronal manifestation of the magnetic flux asymmetry relative to the photospheric manifestation is revealed as a main property of their mutual correlation. This shift can be explained by the delayed large-scale coronal manifestation in responding to the emergence of the magnetic flux in the photosphere. The reliability of the derived results was confirmed by numerical tests performed by selecting different numerical values of the used parameters.

Sýkora, J.; Rybák, J.

2010-02-01

420

Modest reversal of metabolic syndrome manifestations with vitamin D status correction: a 12-month prospective study  

Microsoft Academic Search

Numerous cross-sectional studies have noted significant negative associations between circulating levels of 25-hydroxyvitamin D and cardiometabolic risk factors, highlighting potential extraskeletal functions of this sterol hormone. Prospective studies, however, have been limited; and hence, no cause-and-effect relations can be inferred. This study aims to determine whether vitamin D status correction can reverse already established manifestations of the metabolic syndrome (MetS).

Nasser M. Al-Daghri; Khalid M. Alkharfy; Yousef Al-Saleh; Omar S. Al-Attas; Majed S. Alokail; Abdulaziz Al-Othman; Osama Moharram; Emad El-Kholie; Shaun Sabico; Sudhesh Kumar; George P. Chrousos

421

Adjuvant induced autoimmune/inflammatory syndrome presenting as joint and lung manifestations.  

PubMed

A 59 year-old female with a history of injection of an oily material in the buttocks 11 years ago. She developed symmetric aditive polyarthritis as well as superior and inferior airways involvement. There was no evidence of granulomatosis with polyangiitis (Wegener). She had several serum autoantibodies and a skin biopsy showed a foreign body granuloma. The diagnosis of adjuvant induced autoimmune/inflammatory syndrome was made. The pulmonary involvement was an atypical manifestation at the onset of disease. PMID:24685295

Flores Padilla, Guillermo; Mora Mendoza, Benjamín; Pedraza Montenegro, Axel

422

The Mucocutaneous Manifestations and Pathergy Reaction in Behçet’s Disease  

Microsoft Academic Search

\\u000a The diagnosis of Behçet’s disease is based on clinical features. There is no specific diagnostic test. Skin-mucosa lesions\\u000a like recurrent aphtous stomatitis, genital ulcers, and various cutaneous lesions are its foremost manifestations. The presence\\u000a of erythema nodosum-like lesions, pseudofolliculitis, papulopustular lesions, acneiform nodules, subcutaneous thrombophlebitis,\\u000a and cutaneous hyperreactivity (pathergy) are included in the criteria of the International Study Group for

M. Cem Mat; Dongsik Bang; Melike Meliko?lu

423

[Multiple erythema migrans and facial nerve paralysis: clinical manifestations of early disseminated Lyme borreliosis].  

PubMed

Lyme borreliosis is a common vector-borne disease in Europe. The infection follows different stages with a broad variability of clinical symptoms and manifestations in different organs. A 49-year-old man presented with flu-like symptoms, facial nerve paralysis and multiple erythematous macular on his trunk and extremities. We diagnosed Lyme disease (stage II) with facial nerve paralysis and multiple erythema migrans. Intravenous ceftriaxone led to complete healing of hissymptoms within 2 weeks. PMID:24700023

Braun, S A; Baran, A M; Boettcher, C; Kieseier, B C; Reifenberger, J

2014-04-01

424

ENSO Regime Change since the Late 1970s as Manifested by Two Types of ENSO  

NASA Astrophysics Data System (ADS)

During the late 1970s, El Niño-Southern Oscillation (ENSO) has experienced a notable regime change, which was manifested by several properties; i.e., a change in amplitude, dominant period and sea surface temperature anomaly (SSTA) propagation characteristics. The present study shows that these features of ENSO regime change are associated with property changes of the canonical ENSO, i.e., Cold-Tongue (CT) type ENSO. Another signature of the ENSO regime change is manifested by the frequent occurrence of Warm-Pool (WP) type ENSO that accompanies SSTAs centered over the central Pacific near the WP edge and exhibits characteristics differing from those of CT ENSO. The distinct manifestations of the two types of ENSO in this ENSO regime change are identified clearly by removing the strong background decadal signal. Since the late 1970s, the WP ENSO features a weak eastward (westward) propagation of SSTA center in developing (decaying) phase, which makes no net contribution to the observed eastward propagation, and features a 2-3-yr period compared to the 4-5-yr period of the CT ENSO. Observations strongly suggest that WP and CT ENSO are independent quasi-biennial and quasi-quadrennial modes of the tropical Pacific climate variability, respectively, and that these two ENSO modes have coexisted actively since the late 1970s when either El Niño or La Niña can be separated into the two types.

Ren, H.; Jin, F.; Stuecker, M. F.; Xie, R.

2013-12-01

425

Clinical Manifestation and Prognosis of Vestibular Migraine According to the Vestibular Function Test Results  

PubMed Central

Background and Objectives According to previous reports, patients with vestibular migraine (VM) display variable results from vestibular function tests (VFT): central, peripheral, or normal. The aim of this study was to classify the VM patients into the three groups according to interictal VFT findings (central, peripheral or normal) and to clarify the relationship between VFT results and the clinical manifestations and prognosis in each group. Subjects and Methods We reviewed the medical records of 81 patients diagnosed as VM using the criteria of Neuhauser, et al. between December 2004 and June 2009. Patients were divided into three groups according to the results of VFT. We compared the clinical manifestations and prognosis between groups. Characteristics including dizziness, the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time were analyzed. Results The number of patients with central, peripheral vestibular dysfunction and normal finding in VFT were 15, 28, and 38 respectively. There were no significant differences in the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time. A small difference was observed in the mean age and characteristics of dizziness, but these were not significant. Conclusions In patients with VM, classification according to the type of vestibular dysfunction was not helpful in the prediction of prognosis and clinical manifestations. PMID:24653898

Lee, Jae-Wook; Jung, Jae Yun; Chung, You Sun

2013-01-01

426

A Clinical Study of the Cutaneous Manifestations of Hypothyroidism in Kashmir Valley  

PubMed Central

Background: Thyroid disorders are known to involve all the organ systems of the body, the skin being no exception. The association of thyroid disorders with cutaneous manifestations is complex. Both hypothyroidism and hyperthyroidism are known to cause these changes. Aims: The present study was designed to ascertain the varied cutaneous manifestations of hypothyroidism. Materials and Methods: This study was a hospital based clinical study conducted in collaboration with the Endocrinology Division (Department of Medicine) of SMHS Hospital (associated teaching hospital of Government Medical College Srinagar), over a period of one year, from May 2010 to May 2011. Four hundred and sixty consecutive diagnosed cases of hypothyroidism constituted the subject material for the study and were evaluated for the presence of any cutaneous manifestation. Results: In our study group of 460 patients, there were 416 females and 44 male patients. The predominant cutaneous symptom in our hypothyroid patients was dry coarse skin (65.22%), followed by hair loss (42.6%) and puffy edema (38.48%). The most common cutaneous sign observed in hypothyroid patients was xerosis (57.17%), followed by diffuse hair loss (46.09%), altered skin texture (31.74%), coarse scalp hair (29.35%) and puffy face (28.69%). Conclusions: The interaction between thyroid gland and skin is of profound clinical importance in dermatological practice. So, dermatologists need to be cognizant of the ways in which these two organs interact. PMID:23919021

Keen, Mohammad Abid; Hassan, Iffat; Bhat, Mohammad Hayat

2013-01-01

427

Cutaneous Manifestations in Patients with Chronic Kidney Disease on Maintenance Hemodialysis  

PubMed Central

Cutaneous disorders can precede or follow the initiation of hemodialysis treatment. We evaluated the prevalence of various dermatological manifestations in patients undergoing hemodialysis at least twice a week for minimum of three months at our center. Patients were excluded if they were undergoing hemodialysis less than twice a week or on hemodialysis secondary to ESRD following graft dysfunction. One hundred and forty-three patients were evaluated. Among them, there were 113 male and 30 females. Among the skin changes, pruritus accounted for 56%, Xerosis was observed in 52%, Diffuse blackish hyper pigmentation was seen in 40%. Skin infections was seen in 53% of patients, of these fungal, bacterial and viral infections were 27.2%, 14.6%, and 11.2%, respectively. Kyrle's disease was observed only in 6.9%. Other skin manifestations include eczema 4.8%, psoriasis 2.7%, and drug rash 2.1%. Nail changes were observed in 46 patients of whom 27 patients had onychomycosis. Other changes include discoloration, onycholysis, and splinter hemorrhages. Hair changes were observed in 21.7%. Mucosal changes were seen in 27.3%. In our study, pruritus, xerosis, and pigmentation were higher among skin changes. Recognition and management of some of these dermatological manifestations vastly reduce the morbidity and improve the quality of life. PMID:22830039

Kolla, Praveen Kumar; Desai, Madhav; Pathapati, Ram Mohan; Mastan Valli, B.; Pentyala, Suneetha; Madhusudhan Reddy, G.; Vijaya Mohan Rao, A.

2012-01-01

428

Cutaneous manifestations in patients with chronic kidney disease on maintenance hemodialysis.  

PubMed

Cutaneous disorders can precede or follow the initiation of hemodialysis treatment. We evaluated the prevalence of various dermatological manifestations in patients undergoing hemodialysis at least twice a week for minimum of three months at our center. Patients were excluded if they were undergoing hemodialysis less than twice a week or on hemodialysis secondary to ESRD following graft dysfunction. One hundred and forty-three patients were evaluated. Among them, there were 113 male and 30 females. Among the skin changes, pruritus accounted for 56%, Xerosis was observed in 52%, Diffuse blackish hyper pigmentation was seen in 40%. Skin infections was seen in 53% of patients, of these fungal, bacterial and viral infections were 27.2%, 14.6%, and 11.2%, respectively. Kyrle's disease was observed only in 6.9%. Other skin manifestations include eczema 4.8%, psoriasis 2.7%, and drug rash 2.1%. Nail changes were observed in 46 patients of whom 27 patients had onychomycosis. Other changes include discoloration, onycholysis, and splinter hemorrhages. Hair changes were observed in 21.7%. Mucosal changes were seen in 27.3%. In our study, pruritus, xerosis, and pigmentation were higher among skin changes. Recognition and management of some of these dermatological manifestations vastly reduce the morbidity and improve the quality of life. PMID:22830039

Kolla, Praveen Kumar; Desai, Madhav; Pathapati, Ram Mohan; Mastan Valli, B; Pentyala, Suneetha; Madhusudhan Reddy, G; Vijaya Mohan Rao, A

2012-01-01

429

[Cervicogenic proprioceptive vertigo: etiopathogenesis, clinical manifestations, diagnosis and therapy with special emphasis on manual therapy].  

PubMed

Cervical proprioceptive system (CPS) consisting of mechanoreceptors of cervical intervertebral joints, mechanoreceptors of neck muscles and ligament's insertions, muscle spindles located in deep short muscles of cervical spine and sensitive fibers connecting neck's proprioceptors with neurons of cornu posteriori of spinal cord, plays an essential part in maintaining bodily balance. CPS, via tractus spinovestibularis, is connected to vestibular nuclei. Clinical and neurophysiological studies have shown that functional disorders and/or organic lesions of CPS cause identical symptoms as vestibular diseases: vertigo, nystagmus and balance disorders. Dysfunction (functional blockade) of craniocervical joints is the most frequent cause of cervicogenic proprioceptive vertigo (CPV). The constant tension of the capsule of a blocked joint irritates mechanoreceptors protecting the joint's capsules. The increased activity of mechanoreceptors results in confusion of vestibular system. That is, the impulses from the blocked craniocervical joints do not correspond to the impulses from the vestibular organ and other sensory systems that take part in maintaining bodily balance. The disharmony of impulses results in an inadequate vestibulo-spinal and vestibulo-ocular reaction manifesting as vertigo and nystagmus. Hyperactivity of craniocervical mechanoreceptors also causes disturbances in reflex regulation of postural muscle tonus manifesting as "general instability". Knowledge of CPV as a separate clinical entity is important from diagnostical and therapeutical aspect. As it concerns a peripheral vestibular disorder still unknown to a wider circle of physicians, the article describes etiopathogenesis, clinical manifestations, diagnosis and therapy of CPV with special emphasis on manual therapy. PMID:17128668

Grgi?, Vjekoslav

2006-01-01

430

doi: 10.3389/fphys.2012.00013 Skin manifestations of inflammatory bowel disease  

E-print Network

Inflammatory bowel disease (IBD) is a disease that affects the intestinal tract via an inflammatory process. Patients who suffer from IBD often have diseases that affect multiple other organ systems as well. These are called extraintestinal manifestations and can be just as, if not more debilitating than the intestinal inflammation itself. The skin is one of the most commonly affected organ systems in patients who suffer from IBD.The scientific literature suggests that a disturbance of the equilibrium between host defense and tolerance, and the subsequent over-activity of certain immune pathways are responsible for the cutaneous disorders seen so frequently in IBD patients. The purpose of this review article is to give an overview of the types of skin diseases that are typically seen with IBD and their respective pathogenesis, proposed mechanisms, and treatments. These cutaneous disorders can manifest as metastatic lesions, reactive processes to the intestinal inflammation, complications of IBD itself, or side effects from IBD treatments; these can be associated with IBD via genetic linkage, common autoimmune processes, or other mechanisms that will be discussed in this article. Ultimately, it is important for healthcare providers to understand that skin manifestations should always be checked and evaluated for in patients with IBD. Furthermore, skin disorders can predate gastrointestinal symptoms and thus may serve as important clinical indicators leading physicians to earlier diagnosis of IBD. Keywords: inflammatory bowel disease, skin disorders, Crohn’s disease, ulcerative colitis

Brian L. Huang; Stephanie Ch; David Quan Shih; Simon Beaven; David Quan Shih

2012-01-01

431

Dietary Fish Oil Blocks the Microcirculatory Manifestations of Ischemia- Reperfusion Injury in Striated Muscle in Hamsters  

NASA Astrophysics Data System (ADS)

Epidemiologic observations and experimental studies have demonstrated a protective effect of dietary fish oil on the clinical manifestations of ischemia-reperfusion injury. To investigate the underlying mechanisms, we used the dorsal skinfold chamber model for intravital fluorescence microscopy of the microcirculation in striated muscle of awake hamsters. In control hamsters (n = 7), reperfusion after a 4-hr pressure-induced ischemia to the muscle tissue elicited the adhesion of fluorescently stained leukocytes to the endothelium of postcapillary venules, capillary obstruction, and the breakdown of endothelial integrity. These microvascular manifestations of ischemia-reperfusion injury were significantly attenuated in animals (n = 7) when fed with a fish oil-enriched diet for 4 weeks prior to the experiments. In leukocyte total lipids, the fish oil diet resulted in a substantial displacement of arachidonic acid, the precursor of the potent adhesionpromoting leukotriene (LT) B_4, by fish oil-derived eicosapentaenoic acid, the precursor of biologically less potent LTB_5, emphasizing the mediator role of LTB_4 in ischemia-reperfusion injury. These results suggest that the preservation of microvascular perfusion by dietary fish oil contributes to its protective effects on the clinical manifestations of ischemia-reperfusion injury.

Lehr, Hans-Anton; Hubner, Christoph; Nolte, Dirk; Kohlschutter, Alfried; Messmer, Konrad

1991-08-01

432

Lichen planus-like lesions as the first manifestation of adult T-cell leukaemia/lymphoma.  

PubMed

Cutaneous involvement is frequent in adult T-cell leukaemia/lymphoma (ATLL), a peripheral T-cell neoplasm caused by human T-cell lymphotropic virus type I (HTLV-I). Patients with ATLL manifest different types of skin lesions, including nodules, plaques, ulcers, erythroderma and purpura. It has been reported that this type of skin eruption is an independent prognostic factor for ATLL. We report here a rare case of a 62-year-old Japanese woman with smouldering-type ATLL, first manifested by lichen planus-like skin lesions on the lower leg. This case report highlights the multiplicity of skin manifestations in ATLL. PMID:23224072

Sumida, Hayakazu; Sugaya, Makoto; Kamata, Masahiro; Suga, Hiraku; Miyagaki, Tomomitsu; Ohmatsu, Hanako; Fujita, Hideki; Sato, Shinichi

2013-07-01

433

Towards building a disease-phenotype knowledge base: extracting disease-manifestation relationship from literature  

PubMed Central

Motivation: Systems approaches to studying phenotypic relationships among diseases are emerging as an active area of research for both novel disease gene discovery and drug repurposing. Currently, systematic study of disease phenotypic relationships on a phenome-wide scale is limited because large-scale machine-understandable disease–phenotype relationship knowledge bases are often unavailable. Here, we present an automatic approach to extract disease–manifestation (D-M) pairs (one specific type of disease–phenotype relationship) from the wide body of published biomedical literature. Data and Methods: Our method leverages external knowledge and limits the amount of human effort required. For the text corpus, we used 119 085 682 MEDLINE sentences (21 354 075 citations). First, we used D-M pairs from existing biomedical ontologies as prior knowledge to automatically discover D-M–specific syntactic patterns. We then extracted additional pairs from MEDLINE using the learned patterns. Finally, we analysed correlations between disease manifestations and disease-associated genes and drugs to demonstrate the potential of this newly created knowledge base in disease gene discovery and drug repurposing. Results: In total, we extracted 121 359 unique D-M pairs with a high precision of 0.924. Among the extracted pairs, 120 419 (99.2%) have not been captured in existing structured knowledge sources. We have shown that disease manifestations correlate positively with both disease-associated genes and drug treatments. Conclusions: The main contribution of our study is the creation of a large-scale and accurate D-M phenotype relationship knowledge base. This unique knowledge base, when combined with existing phenotypic, genetic and proteomic datasets, can have profound implications in our deeper understanding of disease etiology and in rapid drug repurposing. Availability: http://nlp.case.edu/public/data/DMPatternUMLS/ Contact: rxx@case.edu PMID:23828786

Xu, Rong; Li, Li; Wang, QuanQiu

2013-01-01

434

Clinical, morphological, and molecular aspects of sialic acid storage disease manifesting in utero  

PubMed Central

Background: Sialic acid storage diseases (SASDs) are caused by the defective transport of free sialic acid outside the lysosome. Apart from the Salla presentation in Finland, SASD is a very rare form of lysosomal storage disease (LSD) with approximately 35 cases, all diagnosed after birth, having been reported worldwide. We report a series of 12 French patients with very early manifestations, including eight fetuses diagnosed in utero. Results: Ultrasound examination, fetal autopsy, or clinical examination showed prominent ascites, rarely progressing to complete hydrops, and highlighted the early severity of bone disease. Dramatic increase of free sialic acid in various biological samples confirmed the diagnosis in all cases. Storage staining affinities and storage distribution in placenta and fetal organs allowed differential diagnosis from other LSDs but cannot differentiate between SASD, sialidosis, and galactosialidosis. Fourteen different mutations were identified, showing the molecular heterogeneity of SASD in the French population. We found that the previously described p.Y306X mutation generated two different transcripts, and we identified seven novel mutations: three deletions (del exon 7, del exons10+11 and c.1296delT), one splice site mutation (c.1350+1G?T) one nonsense mutation (p.W339X), and two missense mutations (p.R57C and p.G127E). Conclusions: The severity of our patients' genotypes is in agreement with their phenotypes but not with the importance and early appearance of the very frequent in utero manifestations. Minimal fetal disease in some patients and a reported case of heterogeneity of fetal involvement within a family suggest that factors other than the genotype influence fetal manifestations. PMID:15805149

Froissart, R; Cheillan, D; Bouvier, R; Tourret, S; Bonnet, V; Piraud, M; Maire, I

2005-01-01

435

Subtle Abnormalities in Contractile Function Are an Early Manifestation of Sarcomere Mutations in Dilated Cardiomyopathy  

PubMed Central

Background Sarcomere mutations cause both dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM); however, the steps leading from mutation to disease are not well described. By studying mutation carriers before a clinical diagnosis develops, we characterize the early manifestations of sarcomere mutations in DCM and investigate how these manifestations differ from sarcomere mutations associated with HCM. Methods and Results Sixty-two genotyped individuals in families with sarcomeric DCM underwent clinical evaluation including strain echocardiography. The group included 12 subclinical DCM mutation carriers with normal cardiac dimensions and left ventricular ejection fraction (LVEF ?55%), 21 overt DCM subjects, and 29 related mutation (?) normal controls. Results were compared with a previously characterized cohort of 60 subclinical HCM subjects (sarcomere mutation carriers without left ventricular hypertrophy). Systolic myocardial tissue velocity, longitudinal, circumferential, and radial strain, and longitudinal and radial strain rate were reduced by 10%–23% in subclinical DCM mutation carriers compared with controls (P<0.001 for all comparisons), after adjusting for age and family relations. No significant differences in diastolic parameters were identified comparing the subclinical and control cohorts. The opposite pattern of contractile abnormalities with reduced diastolic but preserved systolic function was seen in subclinical HCM. Conclusions Subtle abnormalities in systolic function are present in subclinical DCM mutation carriers, despite normal left ventricular size and ejection fraction. In contrast, impaired relaxation and preserved systolic function appear to be the predominant early manifestations of sarcomere mutations that lead to HCM. These findings support the theory that the mutation’s intrinsic impact on sarcomere function influences whether a dilated or hypertrophic phenotype develops PMID:22949430

Lakdawala, Neal K.; Thune, Jens J.; Colan, Steven D.; Cirino, Allison L.; Farrohi, Faranak; Rivero, Jose; McDonough, Barbara; Sparks, Elizabeth; Orav, E. J.; Seidman, J. G.; Seidman, Christine E.; Ho, Carolyn Y.

2013-01-01

436

Systemic Sclerosis: Current Concepts in Pathogenesis and Therapeutic Aspects of Dermatological Manifestations  

PubMed Central

Systemic sclerosis (SSc) is a chronic, multisystem connective tissue disease with protean clinical manifestations. Recent advances in understanding the pathogenic mechanisms have led to development of target-oriented and vasomodulatory drugs which play a pivotal role in treating various dermatological manifestations. An exhaustive literature search was done using Medline, Embase, and Cochrane library to review the recent concepts regarding pathogenesis and evidence-based treatment of salient dermatological manifestations. The concept of shared genetic risk factors for the development of autoimmune diseases is seen in SSc. It is divided into fibroproliferative and inflammatory groups based on genome-wide molecular profiling. Genetic, infectious, and environmental factors play a key role; vascular injury, fibrosis, and immune activation are the chief pathogenic factors. Vitamin D deficiency has been documented in SSc and correlates with the severity of skin involvement. Skin sclerosis, Raynaud's phenomenon (RP) with digital vasculopathies, pigmentation, calcinosis, and leg ulcers affect the patient's quality of life. Immunosuppressives, biologicals, and hematopoietic stem cell transplantation are efficacious in skin sclerosis. Endothelin A receptor antagonists, calcium-channel blockers, angiotensin receptor inhibitors, prostacyclin analogs, and phosphodiesterase type 5 (PDE-5) inhibitors are the mainstay in RP and digital vasculopathies. Pigmentation in SSc has been attributed to melanogenic potential of endothelin-1 (ET-1); the role of ET 1 antagonists and vitamin D analogs needs to be investigated. Sexual dysfunction in both male and female patients has been attributed to vasculopathy and fibrosis, wherein PDE-5 inhibitors are found to be useful. The future concepts of treating SSc may be based on the gene expression signature. PMID:23918994

Viswanath, Vishalakshi; Phiske, Meghana M; Gopalani, Vinay V

2013-01-01

437

Clinical Manifestations of Human Brucellosis: A Systematic Review and Meta-Analysis  

PubMed Central

Background The objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of specifying a disability weight for a DALY calculation. Methods/Principal Findings Thirty three databases were searched, with 2,385 articles published between January 1990–June 2010 identified as relating to human brucellosis. Fifty-seven studies were of sufficient quality for data extraction. Pooled proportions of cases with specific clinical manifestations were stratified by age category and sex and analysed using generalized linear mixed models. Data relating to duration of illness and risk factors were also extracted. Severe complications of brucellosis infection were not rare, with 1 case of endocarditis and 4 neurological cases per 100 patients. One in 10 men suffered from epididymo-orchitis. Debilitating conditions such as arthralgia, myalgia and back pain affected around half of the patients (65%, 47% and 45%, respectively). Given that 78% patients had fever, brucellosis poses a diagnostic challenge in malaria-endemic areas. Significant delays in appropriate diagnosis and treatment were the result of health service inadequacies and socioeconomic factors. Based on disability weights from the 2004 Global Burden of Disease Study, a disability weight of 0.150 is proposed as the first informed estimate for chronic, localised brucellosis and 0.190 for acute brucellosis. Conclusions This systematic review adds to the understanding of the global burden of brucellosis, one of the most common zoonoses worldwide. The severe, debilitating, and chronic impact of brucellosis is highlighted. Well designed epidemiological studies from regions lacking in data would allow a more complete understanding of the clinical manifestations of disease and exposure risks, and provide further evidence for policy-makers. As this is the first informed estimate of a disability weight for brucellosis, there is a need for further debate amongst brucellosis experts and a consensus to be reached. PMID:23236528

Dean, Anna S.; Crump, Lisa; Greter, Helena; Hattendorf, Jan; Schelling, Esther; Zinsstag, Jakob

2012-01-01

438

EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC  

PubMed Central

Chikungunya fever, caused by “Chikungunya virus,” is an arbovirus disease transmitted by the bite of infected mosquitoes belonging to the genus Aedes. Chikungunya fever epidemics have been reported from several countries around the world. The disease that was silent for nearly 32 years re-emerged in the October 2005 outbreak in India that is still ongoing. The incubation period ranges from 3 to 12 days. The onset is usually abrupt and the acute stage is characterized by sudden onset with high-grade fever, severe arthralgias, myalgias, and skin rash. Swollen tender joints and crippling arthritis are usually evident. In the chronic stage, relapses that include sensation of fever, asthenia, exacerbation of arthralgias, inflammatory polyarthritis, and stiffness may be evident. Neurological, ocular, and mucocutaneous manifestations have also been described. Chronic arthritis may develop in about 15% of the patients. Viral culture is the gold standard for the diagnosis of Chikungunya fever. Reverse transcription polymerase chain reaction and real-time loop-mediated isothermal amplification have also been found to be useful. Serodiagnostic methods for the detection of immunoglobulin M and immunoglobulin G antibodies against Chikungunya virus are more frequently used. Chikungunya is a self-limiting disease; however, severe manifestations such as meningoencephalitis, fulminant hepatitis, and bleeding manifestations may sometimes be life-threatening. Treatment is symptomatic and supportive. Prevention by educating the community and public health officials, vector control measures appear to be the best approach at controlling Chikungunya fever as no commercially available vaccine is available for public use in India for this condition presently. PMID:20418981

Mohan, Alladi; Kiran, DHN; Manohar, I Chiranjeevi; Kumar, D Prabath

2010-01-01

439

Outcomes in patients with high-degree atrioventricular block as the initial manifestation of cardiac sarcoidosis.  

PubMed

Although high-degree atrioventricular block (AVB) is a common initial manifestation of cardiac sarcoidosis, little is known about the outcomes. The aim of this study was to assess outcomes in patients with AVB as an initial manifestation of cardiac sarcoidosis compared with those in patients with ventricular tachyarrhythmia (VT) and/or heart failure (HF). Fifty-three consecutive patients with cardiac sarcoidosis, who had high-degree AVB (n = 22) or VT and/or HF (n = 31), were enrolled. The end point was defined as major adverse cardiac events, including cardiac death, ventricular fibrillation, sustained VT, and hospitalization for HF. Over a median follow-up period of 34 months, the outcomes of major adverse cardiac events were better in patients with high-degree AVB than in those with VT and/or HF (log-rank test, p = 0.046). However, this difference was due mainly to HF hospitalization. The outcomes of fatal cardiac events, including cardiac death, ventricular fibrillation, and sustained VT, were comparable between the 2 groups (log-rank test, p = 0.877). The fatal cardiac events in patients with high-degree AVB were not associated with the initiation of steroid treatment or left ventricular dysfunction. In conclusion, the outcomes of major adverse cardiac events are better in patients with high-degree AVB than in those with VT and/or HF. However, patients with high-degree AVB have a high rate of fatal cardiac events, similar to those with VT and/or HF. An indication for an implantable cardioverter-defibrillator, but not a pacemaker system, can be considered in patients with cardiac sarcoidosis manifested by high-degree AVB. PMID:25529542

Takaya, Yoichi; Kusano, Kengo Fukushima; Nakamura, Kazufumi; Ito, Hiroshi

2015-02-15

440

Elevated Levels of Somatic Mutation in a Manifesting BRCA1 Mutation Carrier  

PubMed Central

Homozygous loss of activity at the breast cancer-predisposing genes BRCA1 and BRCA2 (FANCD1) confers increased susceptibility to DNA double strand breaks, but this genotype occurs only in the tumor itself, following loss of heterozygosity at one of these loci. Thus, if these genes play a role in tumor etiology as opposed to tumor progression, they must manifest a heterozygous phenotype at the cellular level. To investigate the potential consequences of somatic heterozygosity for a BRCA1 mutation demonstrably associated with breast carcinogenesis on background somatic mutational burden, we applied the two standard assays of in vivo human somatic mutation to blood samples from a manifesting carrier of the Q1200X mutation in BRCA1 whose tumor was uniquely ascertained through an MRI screening study. The patient had an allele-loss mutation frequency of 19.4 × 10?6 at the autosomal GPA locus in erythrocytes and 17.1 × 10?6 at the X-linked HPRT locus in lymphocytes. Both of these mutation frequencies are significantly higher than expected from age-matched disease-free controls (P < 0.05). Mutation at the HPRT locus was similarly elevated in lymphoblastoid cell lines established from three other BRCA1 mutation carriers with breast cancer. Our patient’s GPA mutation frequency is below the level established for diagnosis of homozygous Fanconi anemia patients, but consistent with data from obligate heterozygotes. The increased HPRT mutation frequency is more reminiscent of data from patients with xeroderma pigmentosum, a disease characterized by UV sensitivity and deficiency in the nucleotide excision pathway of DNA repair. Therefore, this BRCA1-associated breast cancer patient manifests a unique phenotype of increased background mutagenesis that likely contributed to the development of her disease independent of loss of heterozygosity at the susceptibility locus. PMID:18158561

GRANT, Stephen G.; DAS, Rubina; CERCEO, Christina M.; RUBINSTEIN, Wendy S.; LATIMER, Jean J.

2015-01-01

441

Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis.  

PubMed Central

Although the etiology of pouchitis after ileal pouch-anal anastomosis (IPAA) is unknown, its manifestations resemble those of nonspecific inflammatory bowel disease, including, anecdotally, the apparent ability to evoke extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD). Our aim was to determine in what manner pouchitis and EIMs were associated. The computerized records of 819 consecutive patients who underwent IPAA between January 1981 and December 1988 were reviewed. Eighty-five patients were excluded (because of incomplete follow-up, death, or permanent ileostomy). Follow-up of the remaining 734 patients was complete (mean, 41 months). The mean age was 32 years and the ratio of men to women was 1:1. Ileal pouch-anal anastomosis was performed for chronic ulcerative colitis in 91% of patients and for familial adenomatous polyposis in 9%. Pouchitis occurred in 31% of chronic ulcerative colitis patients and 6% of familial adenomatous polyposis patients (p less than 0.01). The mean time to first occurrence was 17 months. Pouchitis recurred in 61% of patients at risk. Patients with preoperative and postoperative EIMs had significantly higher rates of pouchitis than did patients without EIMs (39% preoperative EIMs versus 26% with no EIMs, p less than 0.001; 53% postoperative EIMs versus 25% with no EIMs, p less than 0.001). Of patients with pouchitis in whom EIMs resolved after IPAA but then recurred (n = 12), EIMs recurred when pouchitis occurred and abated when pouchitis was treated in seven patients. We concluded that pouchitis occurred frequently after IPAA and that patients with EIMs were at higher risk of developing pouchitis than were patients who never had EIMs. Furthermore some patients experienced a temporal relationship between flares of EIMs and pouchitis. These results imply that pouchitis may be a novel manifestation of inflammatory bowel disease persisting after operation. PMID:2339922

Lohmuller, J L; Pemberton, J H; Dozois, R R; Ilstrup, D; van Heerden, J

1990-01-01

442

Validation of the Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2) Scores for Children with Specific Learning Disabilities  

E-print Network

Specific learning disabilities are one of the most common and debilitating disorders experienced by children and adolescents, and students with specific learning disabilities may be particularly vulnerable to anxiety. The Revised Children's Manifest...

Raad, Jennifer Marie

2013-08-31

443

Unusual manifestations of ectodermal dysplasia-syndactyly syndrome type I in two Yemeni siblings.  

PubMed

Ectodermal dysplasias (EDs) are a group of genodermatoses characterized by malformations of tissues derived from the ectoderm, including the skin, its appendages (hair, nails, sweat glands), teeth, and the breasts. Ectodermal dysplasia syndactyly syndrome (EDSS) is a rare, newly described type of ED involving syndactyly. We report 2 Yemeni siblings with typical EDSS manifestations, including bilateral, partial cutaneous syndactyly of the fingers and toes; sparse, coarse, brittle scalp hair, eyebrows, and eyelashes; and conical, widely spaced teeth with enamel notches. In addition, the siblings presented with other features hitherto not described for this syndrome, such as adermatoglyphia, onychogryphosis, hypoplastic widely spaced nipples, hypoplastic thumbs, and red scalp hair. PMID:25612123

Mohammad, Alshami

2015-01-01

444

Neurological manifestations, diagnosis, and treatment of celiac disease: A comprehensive review.  

PubMed

Celiac disease or gluten sensitivity may initially present as one or more neurological signs and/or symptoms. On the other hand, it may be associated with or complicated by neurological manifestations. Neurological presentations are rare in children but as many as 36% of adult patients present with neurological changes. With severe malnutrition after progression of celiac disease, different vitamin deficiencies may develop. Such problems can in turn overlap with previous neurological abnormalities including ataxia, epilepsy, neuropathy, dementia, and cognitive disorders. In this study, we aimed to review the neurological aspects of celiac disease. Early diagnosis and treatment could prevent related disability in patients with celiac disease. PMID:24250863

Nikpour, Shahriar

2012-01-01

445

Pericardial tamponade and coexisting pulmonary embolism as first manifestation of non-advanced lung adenocarcinoma  

PubMed Central

Pericardial effusion and pulmonary embolism are relatively common complications of malignancy and are uncommon as its initial manifestation. This report describes a case of a patient, who presented with this association, due to an underlying pulmonary adenocarcinoma. When a major pericardial effusion is associated with pulmonary hypertension, some echocardiographic signs may redress the diagnosis. This case emphasizes a challenge diagnostic which may be guided by high right ventricular pressure and on the other hand the importance of keeping both these conditions in mind when dealing with context of malignancy. PMID:25360199

Akhbour, Salwa; Khennine, Brahim Amine; Oukerraj, Latifa; Zarzur, Jamila; Cherti, Mohamed

2014-01-01

446

Manifestations of Drag Reduction by Polymer Additives in Decaying, Homogeneous, Isotropic Turbulence  

E-print Network

The existence of drag reduction by polymer additives, well established for wall-bounded turbulent flows, is controversial in homogeneous, isotropic turbulence. To settle this controversy we carry out a high-resolution direct numerical simulation (DNS) of decaying, homogeneous, isotropic turbulence with polymer additives. Our study reveals clear manifestations of drag-reduction-type phenomena: On the addition of polymers to the turbulent fluid we obtain a reduction in the energy dissipation rate, a significant modification of the fluid energy spectrum especially in the deep-dissipation range, a suppression of small-scale intermittency, and a decrease in small-scale vorticity filaments.

Prasad Perlekar; Dhrubaditya Mitra; Rahul Pandit

2006-09-27

447

Widespread Intracranial Calcification, Seizures and Extrapyramidal Manifestations in a Case of Hypoparathyroidism  

PubMed Central

Hypoparathyroidism can present with neurological complaints like seizures, parasthesias, depression, psychosis, extrapyramidal manifestations and features of raised intracranial pressure. Hypoparathyroidism and pseudohypoparathyroidism are the most common causes of pathological basal ganglia calcification. A 50 year male presented with generalized seizures and extrapyramidal features like tremors and rigidity. Investigations revealed that he had hypocalcemia, hyperphosphatemia and very low PTH levels, CT scan of head showed calcification of bilateral basal ganglia, cerebellum and subcortical white matter of frontal and parietal lobes. He showed remarkable recovery on restoration of normal serum calcium levels. Hypoparathyroidism should be kept in the differential diagnosis of patients presenting with seizures and extrapyramidal features. PMID:22912949

Rizvi, Imran; Ansari, Noor Alam; Beg, Mujahid; Shamim, Md. Dilawez

2012-01-01

448

An Update on the Treatment of the Cutaneous Manifestations of Systemic Sclerosis  

PubMed Central

Systemic sclerosis is a connective tissue disorder that affects multiple organs. Although the initial symptoms of the disease are vascular, skin involvement is almost universally present in patients with systemic sclerosis. The presence of Raynaud's phenomenon, progressive thickening of the skin, digital ulcers, and calcinosis all correlate proportionally with disease severity. Since no treatment is available to completely prevent the natural course of the disease, emphasis is often placed on managing symptoms and complications. In this review, the authors focus on the management of each one of the skin manifestations seen in systemic sclerosis, as the dermatologist may facilitate the early recognition and treatment of these complications. PMID:22798974

Vitiello, Magalys; Abuchar, Adriana; Santana, Néstor; Dehesa, Luis

2012-01-01

449

Unusual late clinical manifestation of Bland-White-Garland syndrome as sudden cardiac death survival.  

PubMed

In this report, we present an extremely late clinical manifestation of Bland-White-Garland syndrome in a 53-year old woman who was ttransferred to our hospital after successful cardiopulmonary resuscitation. Coronary angiography revealed a dilated right coronary artery giving rise to multiple dominant septal collaterals to the left coronary artery (LCA) which arose from the pulmonary trunk (left to right shunt 0.15). Cardiac computed tomography identified a retropulmonary course of the LCA. The patient underwent cardiac surgery with LCA occlusion and triple coronary bypass grafting. PMID:25412599

Plank, Fabian; Feuchtner, Gudrun; Chevtchik, Orest; Mair, Johannes

2014-11-21

450

Ocular manifestation of vitamin A deficiency among Orang asli (Aborigine) children in Malaysia.  

PubMed

This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine) children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot's spot in 2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with the standard diagnosis procedure using luxometer readings. PMID:12074186

Ngah, Nor F; Moktar, Norhayati; Isa, Noor H M; Selvara, S; Yusof, Md Shahrom; Sani, Halimah A; Hasan, Zainal A A; Kadir, Rohani A

2002-01-01

451

Neuralgic amyotrophy manifested by severe axillary mononeuropathy limited only to the anterior branch.  

PubMed

Introduction: This case demonstrates clinical, radiographic, electrophysiologic, and surgical evidence of a restricted but severe anterior branch axillary nerve mononeuropathy due to neuralgic amyotrophy (NA). Methods: On each of the diagnostic modalities there was severe involvement of the anterior and lateral deltoid muscle with sparing of the posterior deltoid muscle, the teres minor, and the cutaneous innervation to the skin overlying the lateral shoulder. Results: No structural etiologies were discovered during surgical exploration. Discussion: This case provides another unique manifestation of NA, and augments the theory of selective fascicular vulnerability. This article is protected by copyright. All rights reserved. PMID:25418351

Landau, Mark E; Faillace, Walter J; Nesti, Leon J; Grimes, Jamie B

2014-11-22

452

Unusual occurrence of dentoalveolar manifestations in a case with beta thalassemia trait.  

PubMed

A case of thalassemia minor with dentoalveolar manifestations in a 22-year-old Iranian male is presented. On the basis of patient complaint of upper incisors mobility, radiographic examination was performed which revealed enlarged medullary space, thin lamina dura, prominent antegonial notch, spiky and short roots of upper incisors and a generalized root resorption. This is the second report of dentoalveolar changes in regard to a minor hemoglubinopathy disorder. In this case treatment was carried out with 1 mg per day oral folic acid for 2 months which relived patient complaint as well as some radiographic changes. PMID:24984659

Alireza, Farhad; Maryam, Allameh

2014-06-01

453

Monarthritis of the ankle as manifestation of a calcaneal metastasis of bronchogenic carcinoma.  

PubMed

We report a case of bronchiogenic carcinoma metastasizing to the calcaneus and clinically manifesting itself as a therapy-refractory monarthritis in the right ankle. There is a wide spectrum of possible diagnoses of acute ankle monarthritis including different forms of inflammatory rheumatic diseases, sarcoidosis, osteoarthritis, or septic arthritis. Primary or metastatic malignancies of the hand or foot bones are considered to be rare. Persistent monarthritis as a sole symptom of a calcaneal metastasis has never been reported. This case demonstrates possible difficulties in the early differential diagnosis of acute monarthritis, and will be discussed with respect to the few reports on foot acrometastases. PMID:11846057

Kaufmann, J; Schulze, E; Hein, G

2001-01-01

454

Kimura Disease Manifesting as Synchronous Bilateral Parotid Swelling in a Young Middle-Eastern Patient  

PubMed Central

Kimura disease is a rare, benign, chronic inflammatory swelling of the subcutaneous tissue, lymph nodes, and glandular tissue. Characteristic features of the disease include, but not limited to, painless subcutaneous head and neck swelling, blood and tissue eosinophilia, and markedly elevated immunoglobulin E (IgE) levels. Herein, we report a rare case of Kimura disease manifesting as synchronous bilateral parotid swelling of 12 years duration in a 33-year-old Middle-Eastern man. To our knowledge only few cases have been reported in the literature involving bilateral parotid glands, and this is the first case to be reported in the Middle East. PMID:25544928

Abo-Alhassan, Fawaz; Al-Sebeih, Khalid

2014-01-01

455

Chronic kidney disease-mineral bone disorder: an update on the pathology and cranial manifestations.  

PubMed

Chronic kidney disease-mineral bone disorder (CKD-MBD) is a syndrome encompassing skeletal and extra skeletal changes associated with chronic kidney disease. It progresses silently until an advanced clinical stage when complications impact on the quality of life and survival rates of patients. The maxillofacial manifestations are unique and may play an important role in the early identification of changes which could influence the management of these patients. The goal of this review is to highlight the maxillofacial features, pathology, and principles of management of CKD-MBD. PMID:24646006

Raubenheimer, Erich J; Noffke, Claudia E E; Hendrik, Hilde D

2014-03-20

456

Pulmonary Necrobiotic Nodules in Crohn's Disease: A Rare Extra-intestinal Manifestation.  

PubMed

Pulmonary necrobiotic nodules represent a rare extra-intestinal manifestation of Crohn's disease. Histologically, they are composed of sterile aggregates of inflammatory cells with necrosis. The differential diagnosis is broad, and exclusion of infectious etiologies is mandatory before starting immunosuppressive therapy. Here, we present the fifth reported case of pulmonary necrobiotic nodules in Crohn's disease. Our patient had new-onset Crohn's disease associated with both cavitating and non-cavitating lung nodules that were confirmed to be necrobiotic nodules by biopsy. The patient was started on mesalamine and prednisone, with subsequent improvement of his gastrointestinal symptoms and regression of the necrobiotic nodules. PMID:25233391

El-Kersh, Karim; Fraig, Mostafa; Cavallazzi, Rodrigo; Saad, Mohamed; Perez, Rafael L

2014-12-01

457

[Multifocal, bone manifestation of decompression sickness in a professional pilot: a case report].  

PubMed

Decompression sickness is a group of pathological processes occurring in the body, following its exposure to an excessive drop in atmospheric pressure. The paper presents a case of a 62-year-old patient with no substantial disease history, a long-standing professional military pilot who was diagnosed with multifocal, bone manifestation of decompression sickness during the diagnosis of right knee joint injury following a torsion injury. The case was presented to draw attention to the usefulness of occupational history in the process of diagnosing osteoarticular system diseases. PMID:23829071

Ku?mierska, Anna; Ga?, Pawe?; Szyma?ski, Marcin; Bienias, Mariusz; Pluci?ska, Irena; Wodzis?awski, Wojciech; Ja?wiec, Przemys?aw

2013-01-01

458

Pulmonary arterial hypertension as the first manifestation in a patient with hereditary hemorrhagic telangiectasia.  

PubMed

A 17-year-old Japanese girl visited our hospital for an evaluation of exertional dyspnea. A diagnosis of pulmonary arterial hypertension (PAH) was confirmed based on the findings of right heart catheterization. Detailed questioning revealed a family history of hereditary hemorrhagic telangiectasia (HHT), and a genetic mutation analysis disclosed a mutation in the activin receptor-like kinase 1 gene (ACVRL1). The patient was finally diagnosed with HHT according to the Curaçao diagnostic criteria eight years after the diagnosis of PAH. This case supports previous reports indicating that signs of PAH can be the first manifestation of disease in ACVRL1 mutation carriers. PMID:25318803

Ishiwata, Tsukasa; Terada, Jiro; Tanabe, Nobuhiro; Abe, Mitsuhiro; Sugiura, Toshihiko; Tsushima, Kenji; Tada, Yuji; Sakao, Seiichiro; Kasahara, Yasunori; Nakanishi, Norifumi; Morisaki, Hiroko; Tatsumi, Koichiro

2014-01-01

459

[Spontaneous Achilles tendon rupture as early manifestation of systemic lupus erythematosus].  

PubMed

Spontaneous tendon rupture is rare in the course of systemic lupus erythematosus (SLE). Its incidence rate remains unknown. The pathogenesis of this manifestation is complex and poorly understood. We report a 39-year-old woman who presented with a spontaneous Achilles tendon rupture as the presenting presentation of SLE, before any corticosteroid therapy. All the patients previously published were receiving corticosteroids and reported in some an associated traumatism. Risk factors are prolonged disease duration, chronic therapy with corticosteroids, deforming arthropathy of the hands, and inactive disease. PMID:22318210

Benjilali, L; Benhima, H; Zahlane, M; Essaadouni, L

2012-08-01

460

Hemoptysis as the presenting manifestation of thyroid carcinoma. A case report  

SciTech Connect

An unusual case of a 61-year-old man who had hemoptysis as the major presenting manifestation of radiation-induced thyroid carcinoma is reported. The diagnosis was made by bronchoscopic removal of a polypoid lesion that was a direct extension of tumor through the trachea. Bronchoscopy is an effective and reliable means of establishing the diagnosis in this unusual subset of patients with thyroid carcinoma invading the trachea, and should be considered as the first diagnostic procedure in a patient with a thyroid mass and hemoptysis.

Weiland, J.E.; de los Santos, E.T.; Mazzaferri, E.L.; Schuller, D.E.; Oertel, J.E.

1989-07-01

461

Polycystic ovary syndrome: A review for dermatologists: Part I. Diagnosis and manifestations.  

PubMed

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women who are of reproductive age. The pathogenesis involves several associated hormonal pathways that culminate in metabolic, reproductive, and cardiovascular effects. The hallmark features of hyperandrogenism and hyperinsulinemia have systemic long-term implications. Dermatologists frequently evaluate and manage the cutaneous manifestations of PCOS (ie, acanthosis nigricans, hirsutism, acne, and alopecia), and therefore play a key role in its diagnosis and management. In part I of this continuing medical education article, we review the definition, etiology, pathogenesis, and clinical features of PCOS. PMID:25437977

Housman, Elizabeth; Reynolds, Rachel V

2014-11-01

462

Environmental dermatology: skin manifestations of injuries caused by invertebrate aquatic animals*  

PubMed Central

Contact between humans and coastal areas has increased in recent decades, which has led to an increase in injuries from aquatic animals. The majority of these present dermatological manifestations, and some of them show typical lesions. The highest percentages of injuries that occur in marine environments are associated with invertebrates such as sea urchins, jellyfish and Portuguese men-of-war (echinoderms and cnidarians). In this review, we discuss the clinical, therapeutic and preventive aspects of injuries caused by marine and freshwater invertebrates, focusing on first aid measures and diagnosis for dermatologists and professionals in coastal areas. PMID:24068119

Haddad Junior, Vidal

2013-01-01

463

Brain abscess as the first manifestation of pulmonary arteriovenous malformation: A case report  

PubMed Central

Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, right to left shunt produced by PAVM, could result in easy access of septic or non-septic emboli to systemic circulation, end to serious central nervous system (CNS) complication. Here we report a case of brain abscess in a young man. Its source was initially unknown but multiple arteriovenous malformations were detected incidentally in his thoracic CT, which was performed for ruling out embolism. Although the cases of brain abscesses associated with PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PMID:24592375

Moradi, Maryam; Adeli, Maryam

2014-01-01

464

Anterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome  

PubMed Central

Ocular complications are known to occur as a result of human immunodeficiency virus (HIV) disease. They can be severe leading to ocular morbidity and visual handicap. Cytomegalovirus (CMV) retinitis is the commonest ocular opportunistic infection seen in acquired immune deficiency syndrome (AIDS). Though posterior segment lesions can be more vision-threatening, there are varied anterior segment manifestations which can also lead to ocular morbidity and more so can affect the quality of life of a HIV-positive person. Effective antiretroviral therapy and improved prophylaxis and treatment of opportunistic infections have led to an increase in the survival of an individual afflicted with AIDS. This in turn has led to an increase in the prevalence of anterior segment and adnexal disorders. Common lesions include relatively benign conditions such as blepharitis and dry eye, to infections such as herpes zoster ophthalmicus and molluscum contagiosum and malignancies such as squamous cell carcinoma and Kaposi?s sarcoma. With the advent of highly active antiretroviral therapy, a new phenomenon known as immune recovery uveitis which presents with increased inflammation, has been noted to be on the rise. Several drugs used in the management of AIDS such as nevirapine or indinavir can themselves lead to severe inflammation in the anterior segment and adnexa of the eye. This article is a comprehensive update of the important anterior segment and adnexal manifestations in HIV-positive patients with special reference to their prevalence in the Indian population. PMID:18711264

Sudharshan, S

2008-01-01

465

A Self-inactivating ?-Retroviral Vector Reduces Manifestations of Mucopolysaccharidosis I in Mice  

PubMed Central

Mucopolysaccharidosis I (MPS I) is a lysosomal storage disease due to deficiency in ?-L-iduronidase (IDUA) that results in accumulation of glycosaminoglycans (GAGs) throughout the body, causing numerous clinical defects. Intravenous administration of a ?-retroviral vector (?-RV) with an intact long terminal repeat (LTR) reduced the clinical manifestations of MPS I, but could cause insertional mutagenesis. Although self-inactivating (SIN) ?-RVs in which the enhancer and promoter elements in the viral LTR are absent after transduction reduces this risk, such vectors could be less effective. This report demonstrates that intravenous (i.v.) injection of a SIN ?-RV expressing canine IDUA from the liver-specific human ?1-antitrypsin promoter into adult or newborn MPS I mice completely prevents biochemical abnormalities in several organs, and improved bone disease, vision, hearing, and aorta to a similar extent as was seen with administration of the LTR-intact vector to adults. Improvements were less profound than when using an LTR-intact ?-RV in newborns, which likely reflects a lower level of transduction and expression for the SIN vector-transduced mice, and might be overcome by using a higher dose of SIN vector. A SIN ?-RV vector ameliorates clinical manifestations of MPS I in mice and should be safer than an LTR-intact ?-RV. PMID:19844196

Metcalf, Jason A; Ma, Xiucui; Linders, Bruce; Wu, Susan; Schambach, Axel; Ohlemiller, Kevin K; Kovacs, Attila; Bigg, Mark; He, Li; Tollefsen, Douglas M; Ponder, Katherine P

2009-01-01

466

Manifestation of Chaos in Real Complex Systems: Case of Parkinson's Disease  

E-print Network

In this chapter we present a new approach to the study of manifestations of chaos in real complex system. Recently we have achieved the following result. In real complex systems the informational measure of chaotic chatacter (IMC) can serve as a reliable quantitative estimation of the state of a complex system and help to estimate the deviation of this state from its normal condition. As the IMC we suggest the statistical spectrum of the non-Markovity parameter (NMP) and its frequency behavior. Our preliminary studies of real complex systems in cardiology, neurophysiology and seismology have shown that the NMP has diverse frequency dependence. It testifies to the competition between Markovian and non-Markovian, random and regular processes and makes a crossover from one relaxation scenario to the other possible. On this basis we can formulate the new concept in the study of the manifestation of chaoticity. We suggest the statistical theory of discrete non-Markov stochastic processes to calculate the NMP and t...

Yulmetyev, R M; Hänggi, P; Yulmetyev, Renat M.; Demin, Sergey A.; H\\"{a}nggi, Peter

2006-01-01

467

Gender and Ocular Manifestations of Connective Tissue Diseases and Systemic Vasculitides  

PubMed Central

Ocular manifestations are present in many connective tissue diseases which are characterized by an immune system that is directed against self. In this paper, we review the ocular findings in various connective tissue diseases and systemic vasculitides and highlight gender differences in each disease. In rheumatoid arthritis, we find that dry eyes affect women nine times more than men. The other extra-articular manifestations of rheumatoid arthritis affect women three times more commonly than men. Systemic lupus erythematosus can involve all ocular structures and women are nine times more affected than men. Systemic sclerosis is a rare disease but, again, it is more common in women with a female to male ratio of 8?:?1. Polymyositis and dermatomyositis also affect women more commonly than men but no gender differences have been found in the incidence or disease course in the systemic vasculitides associated with antineutrophil cytoplasmic antibody such as granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis). Finally, Behcet's disease is more common in males, and male gender is a risk factor for Behcet's disease. There is a slight female preponderance in sarcoidosis with female gender carrying a worse prognosis in the outcome of ocular disease. PMID:24757559

Choudhary, Maria M.; Hajj-Ali, Rula A.; Lowder, Careen Y.

2014-01-01

468

Nelson's syndrome: a review of the clinical manifestations, pathophysiology, and treatment strategies.  

PubMed

Nelson's syndrome is a rare clinical manifestation that occurs in 8%-47% of patients as a complication of bilateral adrenalectomy, a procedure that is used to control hypercortisolism in patients with Cushing's disease. First described in 1958 by Dr. Don Nelson, the disease has since become associated with a clinical triad of hyperpigmentation, excessive adrenocorticotropin secretion, and a corticotroph adenoma. Even so, for the past several years the diagnostic criteria and management of Nelson's syndrome have been inadequately studied. The primary treatment for Nelson's syndrome is transsphenoidal surgery. Other stand-alone therapies, which in many cases have been used as adjuvant treatments with surgery, include radiotherapy, radiosurgery, and pharmacotherapy. Prophylactic radiotherapy at the time of bilateral adrenalectomy can prevent Nelson's syndrome (protective effect). The most promising pharmacological agents are temozolomide, octreotide, and pasireotide, but these agents are often administered after transsphenoidal surgery. In murine models, rosiglitazone has shown some efficacy, but these results have not yet been found in human studies. In this article, the authors review the clinical manifestations, pathophysiology, diagnostic criteria, and efficacy of multimodal treatment strategies for Nelson's syndrome. PMID:25639316

Patel, Jimmy; Eloy, Jean Anderson; Liu, James K

2015-02-01

469

McCune-Albright syndrome and the extraskeletal manifestations of fibrous dysplasia  

PubMed Central

Fibrous dysplasia (FD) is sometimes accompanied by extraskeletal manifestations that can include any combination of café-au-lait macules, hyperfunctioning endocrinopathies, such as gonadotropin-independent precocious puberty, hyperthyroidism, growth hormone excess, FGF23-mediated renal phosphate wasting, and/or Cushing syndrome, as well as other less common features. The combination of any of these findings, with or without FD, is known as McCune-Albright syndrome (MAS). The broad spectrum of involved tissues and the unpredictable combination of findings owe to the fact that molecular defect is due to dominant activating mutations in the widely expressed signaling protein, Gs?, and the fact these mutations arises sporadically, often times early in development, prior to gastrulation, and can distribute across many or few tissues. The complexity can be mastered by a systematic screening of potentially involved tissues and cognizance that the pattern of involved tissues is established, to some degree, in utero. Thorough testing allows the clinician to establish, often times at presentation, the full extent of the disease, and importantly as well what tissues are unaffected. Treatment and follow-up can then be focused on affected systems and a meaningful prognosis can be offered to the patient and family. The authors outline screening and treatment strategies that allow for effective management of the extraskeletal manifestations of FD. PMID:22640971

2012-01-01

470

Hepatobiliary manifestations of ulcerative colitis: an example of gut–liver crosstalk  

PubMed Central

The interaction between inflammatory bowel disease (IBD) and hepatobiliary manifestations represents a classic example of liver–gut crosstalk. The importance of liver–gut crosstalk in IBD is demonstrated in the pathogenesis and outcome of primary sclerosing cholangitis (PSC) in IBD patients. Immunoglobulin G4-associated cholangitis (IAC), which has recently been described in UC patients, may also illustrate the significance of gut–liver interaction in these patients. Presence of these hepatobiliary manifestations influences the outcome of associated IBD, in particular ulcerative colitis (UC), and vice versa. The pathogenesis of PSC is postulated to be related to gut inflammation in IBD that results in inflammation in the portal tracts (the ‘leaky gut’). Enterohepatic circulation of lymphocytes from the gut to the liver is also of potential relevance to PSC pathogenesis and outcomes. The presence of PSC and gut inflammation in IBD influences the course and outcomes of both diseases. Further research is required, to understand the mutual effect of liver–gut crosstalk in the outcomes of UC patients, and highlights the importance of an interdisciplinary approach—involving gastroenterologists, hepatologists, advanced endoscopists and liver transplant surgeons—in the management of these patients. PMID:24951514

Navaneethan, Udayakumar

2014-01-01

471

Hepatobiliary manifestations of ulcerative colitis: an example of gut-liver crosstalk.  

PubMed

The interaction between inflammatory bowel disease (IBD) and hepatobiliary manifestations represents a classic example of liver-gut crosstalk. The importance of liver-gut crosstalk in IBD is demonstrated in the pathogenesis and outcome of primary sclerosing cholangitis (PSC) in IBD patients. Immunoglobulin G4-associated cholangitis (IAC), which has recently been described in UC patients, may also illustrate the significance of gut-liver interaction in these patients. Presence of these hepatobiliary manifestations influences the outcome of associated IBD, in particular ulcerative colitis (UC), and vice versa. The pathogenesis of PSC is postulated to be related to gut inflammation in IBD that results in inflammation in the portal tracts (the 'leaky gut'). Enterohepatic circulation of lymphocytes from the gut to the liver is also of potential relevance to PSC pathogenesis and outcomes. The presence of PSC and