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Sample records for manifestations rhumatologiques revelatrices

  1. Rheumatic manifestations of scurvy.

    PubMed

    Ferrari, Claudia; Possemato, Niccolò; Pipitone, Nicolò; Manger, Bernhard; Salvarani, Carlo

    2015-04-01

    This paper reviews the rheumatological manifestations of scurvy, based on articles published in English from 1965 until October 2014, with a particular focus on rheumatological manifestations. Scurvy is a rare, uncommon disease in developed countries. Due to its clinical heterogeneity, the disease can easily mimic rheumatologic conditions leading to a delay in diagnosis and treatment. PMID:25854491

  2. Haematological manifestations of lupus

    PubMed Central

    Fayyaz, Anum; Igoe, Ann; Kurien, Biji T; Danda, Debashish; James, Judith A; Stafford, Haraldine A; Scofield, R Hal

    2015-01-01

    Our purpose was to compile information on the haematological manifestations of systemic lupus erythematosus (SLE), namely leucopenia, lymphopenia, thrombocytopenia, autoimmune haemolytic anaemia (AIHA), thrombotic thrombocytopenic purpura (TTP) and myelofibrosis. During our search of the English-language MEDLINE sources, we did not place a date-of-publication constraint. Hence, we have reviewed previous as well as most recent studies with the subject heading SLE in combination with each manifestation. Neutropenia can lead to morbidity and mortality from increased susceptibility to infection. Severe neutropenia can be successfully treated with granulocyte colony-stimulating factor. While related to disease activity, there is no specific therapy for lymphopenia. Severe lymphopenia may require the use of prophylactic therapy to prevent select opportunistic infections. Isolated idiopathic thrombocytopenic purpura maybe the first manifestation of SLE by months or even years. Some manifestations of lupus occur more frequently in association with low platelet count in these patients, for example, neuropsychiatric manifestation, haemolytic anaemia, the antiphospholipid syndrome and renal disease. Thrombocytopenia can be regarded as an important prognostic indicator of survival in patients with SLE. Medical, surgical and biological treatment modalities are reviewed for this manifestation. First-line therapy remains glucocorticoids. Through our review, we conclude glucocorticoids do produce a response in majority of patients initially, but sustained response to therapy is unlikely. Glucocorticoids are used as first-line therapy in patients with SLE with AIHA, but there is no conclusive evidence to guide second-line therapy. Rituximab is promising in refractory and non-responding AIHA. TTP is not recognised as a criteria for classification of SLE, but there is a considerable overlap between the presenting features of TTP and SLE, and a few patients with SLE have concurrent TTP. Myelofibrosis is an uncommon yet well-documented manifestation of SLE. We have compiled the cases that were reported in MEDLINE sources. PMID:25861458

  3. Thermodynamics in 'Manifest Reality'

    SciTech Connect

    Hankey, Alex

    2010-12-22

    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'.

  4. Thermodynamics in `Manifest Reality'

    NASA Astrophysics Data System (ADS)

    Hankey, Alex

    2010-12-01

    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'.

  5. Cutaneous Manifestations of ESRD

    PubMed Central

    Cronin, Antonia J.; Leslie, Kieron S.

    2014-01-01

    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

  6. Lymphatic manifestations of lymphangioleiomyomatosis.

    PubMed

    Gupta, R; Kitaichi, M; Inoue, Y; Kotloff, R; McCormack, F X

    2014-09-01

    Lymphangioleiomyomatosis (LAM) is a slowly progressive, low grade, metastasizing neoplasm, associated with cellular invasion and cystic destruction of the pulmonary parenchyma. Although the source of LAM cells that infiltrate the lung is unknown, available evidence indicates that the disease spreads primarily through lymphatic channels, often involving abdominal, axial, and retroperitoneal nodes, suggestive of an origin in the pelvis. LAM cells harbor mutations in tuberous sclerosis genes and produce lymphangiogenic growth factors, which facilitate access to and movement through the lymphatic system and likely play an important role in destructive tissue remodeling in the lung. Lymphatic manifestations of LAM include thoracic duct wall invasion, lymphangioleiomyoma formation, chylous fluid collections in the peritoneal, pleural, and pericardial spaces, chyloptysis, chylocolporrheal chylometrorrhea, chyle leak from the umbilicus, chylous pulmonary congestion, and lower extremity lymphedema. LAM lesions express lymphangiogenic growth factors VEGF-C and VEGF-D; growth factor receptors, VEGFR-2 and VEGFR-3; and markers LYVE-1 and podoplanin, and are laced with chaotic lymphatic channels. Serum VEGF-D is elevated in 70% of patients with LAM and is a clinically useful diagnostic and prognostic biomarker. Molecular targeted therapy with sirolimus stabilizes lung function, is anti-lymphangiogenic, and is highly effective for the lymphatic and chylous complications of LAM. Future trials in patients with LAM who have lymphatic manifestations or elevated serum VEGF-D will likely focus on the VEGF-C/VEGF-D/VEGFR-3 axis. PMID:25507287

  7. Lymphatic manifestations of lymphangioleiomyomatosis.

    PubMed

    Gupta, R; Kitaichi, M; Inoue, Y; Kotloff, R; McCormack, F X

    2014-09-01

    Lymphangioleiomyomatosis (LAM) is a slowly progressive, low grade, metastasizing neoplasm, associated with cellular invasion and cystic destruction of the pulmonary parenchyma. Although the source of LAM cells that infiltrate the lung is unknown, available evidence indicates that the disease spreads primarily through lymphatic channels, often involving abdominal, axial, and retroperitoneal nodes, suggestive of an origin in the pelvis. LAM cells harbor mutations in tuberous sclerosis genes and produce lymphangiogenic growth factors, which facilitate access to and movement through the lymphatic system and likely play an important role in destructive tissue remodeling in the lung. Lymphatic manifestations of LAM include thoracic duct wall invasion, lymphangioleiomyoma formation, chylous fluid collections in the peritoneal, pleural, and pericardial spaces, chyloptysis, chylocolporrheal chylometrorrhea, chyle leak from the umbilicus, chylous pulmonary congestion, and lower extremity lymphedema. LAM lesions express lymphangiogenic growth factors VEGF-C and VEGF-D; growth factor receptors, VEGFR-2 and VEGFR-3; and markers LYVE-1 and podoplanin, and are laced with chaotic lymphatic channels. Serum VEGF-D is elevated in 70% of patients with LAM and is a clinically useful diagnostic and prognostic biomarker. Molecular targeted therapy with sirolimus stabilizes lung function, is anti-lymphangiogenic, and is highly effective for the lymphatic and chylous complications of LAM. Future trials in patients with LAM who have lymphatic manifestations or elevated serum VEGF-D will likely focus on the VEGF-C/VEGF-D/VEGFR-3 axis. PMID:25420303

  8. Ophthalmic manifestations postlightning strike.

    PubMed

    Dhillon, Permesh Singh; Gupta, Mohit

    2015-01-01

    Various ophthalmic complications affecting the anterior and posterior segments have been identified due to lightning strike. We report the first case of an indirect lightning-induced full thickness macular hole formation in the UK as evidenced by slit lamp examination and optical coherence tomography (OCT) scan in a 77-year-old woman presenting with sudden visual loss in her right eye and thermal skin injury affecting her scalp. Her best corrected visual acuities were LogMAR 0.46 and 0.12 in the right and left eyes, respectively. There were no other ocular manifestations observed in either eye. She was initially managed conservatively with non-steroidal anti-inflammatory drug eye drops but surgery was later advised due to minimal changes in the visual acuity and macular hole on follow-up. OCT scanning is important in diagnosing macular holes, which usually warrant surgical intervention. PMID:25827914

  9. Oral Manifestations of Vitiligo

    PubMed Central

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

    2015-01-01

    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. PMID:25657420

  10. [Skin manifestations of monoclonal gammopathies].

    PubMed

    Hello, M; Barbarot, S; Néel, A; Connault, J; Graveleau, J; Durant, C; Decaux, O; Hamidou, M

    2014-01-01

    Whatever their aetiology, monoclonal gammopathies can be associated to several clinical features. Mechanisms are various and sometimes unknown. Skin is frequently involved and may represent a challenging diagnosis. Indeed, skin manifestations are either the presenting features and isolated, or at the background of a systemic syndrome. Our objective was to review the various skin manifestations that have been associated with monoclonal gammopathies. PMID:24070793

  11. Cutaneous Manifestations of Crohn Disease.

    PubMed

    Hagen, Joshua W; Swoger, Jason M; Grandinetti, Lisa M

    2015-07-01

    Awareness of the extraintestinal manifestations of Crohn disease is increasing in dermatology and gastroenterology, with enhanced identification of entities that range from granulomatous diseases recapitulating the underlying inflammatory bowel disease to reactive conditions and associated dermatoses. In this review, the underlying etiopathology of Crohn disease is discussed, and how this mirrors certain skin manifestations that present in a subset of patients is explored. The array of extraintestinal manifestations that do not share a similar pathology, but which are often seen in association with inflammatory bowel disease, is also discussed. Treatment and pathogenetic mechanisms, where available, are discussed. PMID:26143422

  12. Ocular manifestations of Behcet's disease.

    PubMed

    A, Sam Ebenezer; Moses, Prabhakar D; George, Renu

    2005-09-01

    Behcets disease is a systemic inflammatory vascular disorder characterized by recurrent oral and genital ulcers, eye lesion, arthritis and skin lesions. We report a case of Behcets disease with ocular manifestation in an 8 year old boy. PMID:16208057

  13. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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:...

  14. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...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:...

  15. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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:...

  16. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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:...

  17. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...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:...

  18. Neuropsychiatric manifestations in rheumatoid arthritis.

    PubMed

    Joaquim, Andrei F; Appenzeller, Simone

    2015-12-01

    Rheumatoid arthritis (RA) is a chronic disease characterized by persistent synovitis, systemic inflammation, and the presence of autoantibodies. Neuropsychiatric manifestations are quite common in RA, including depression, cognitive dysfunction, behavior changes, spinal cord compression and peripheral nerve involvement. Potential causes include systemic inflammatory process, neural compression due to bone and joint destruction, side effects of medications and copying difficulties due to the chronicity of the disease. A high level of suspicious is required for an adequate diagnosis and treatment. In this review, we will discuss topographically the main neuropsychiatric manifestations described in RA patients, in an attempt to help in the management of these complex and multifaceted disease. PMID:26238502

  19. [Neurological manifestations of Behçet's disease].

    PubMed

    Noel, N; Drier, A; Wechsler, B; Piette, J-C; De Paz, R; Dormont, D; Cacoub, P; Saadoun, D

    2014-02-01

    Neurological manifestations of Behçet's disease (BD) occur in 5.3 to more than 50% of patients. They are divided into two major forms: "parenchymal" lesions, which include mainly meningoencephalitis as opposed to "extra-parenchymal" lesions (i.e. cerebral venous thrombosis and arterial aneurysms). Myelitis or peripheral neuropathy is exceptional. The neuro-Behçet syndrome (NBS) should be considered in the setting of neurological manifestations, particularly headache and pyramidal signs, in a young man diagnosed with BD. However, its recognition may be difficult when neurological manifestations are the presenting features of BD (one third of cases), and requires a thorough knowledge of clinical manifestations and morphological lesions. Thus, parenchymal NB lesions classically exhibit inflammatory characteristics on MRI and are located at the meso-diencephalic junction and in the brainstem, rarely with a supratentorial extension. Meningitis is not systematically associated, and may be absent in about 30% of cases. The pathogenesis of these lesions is incompletely understood, but inflammatory infiltrates include mainly neutrophils and activated T cells (mainly Th17). Differential diagnoses include infectious diseases (herpes, listeria, tuberculosis), and inflammatory diseases (i.e. multiple sclerosis and sarcoidosis). A prompt recognition of NBS should lead to initiate adequate therapies in order to limit the risk of sequelae, relapses or death. PMID:24290030

  20. Psychiatric manifestations in cerebrotendinous xanthomatosis

    PubMed Central

    Fraidakis, M J

    2013-01-01

    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

  1. Unusual manifestations of osteoarticular tuberculosis.

    PubMed

    Babhulkar, Sudhir S; Pande, Sonali K

    2002-05-01

    Unusual manifestations of osteoarticular tuberculosis, especially tubercular osteomyelitis, are described. Diagnostic problems may arise and lead to delay in treatment if these conditions are not considered in the differential diagnosis. The importance of bacteriologic and histopathologic confirmation of the disease is stressed. PMID:11964639

  2. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... instructions in the appendix to 40 CFR part 262 must appear legibly on the back of the copies of the manifest... application must also indicate how the printer will pre-print a unique number on each form (e.g., crash or... this section. A registered source may be a: (i) State agency; (ii) Commercial printer; (iii)...

  3. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... instructions in the appendix to 40 CFR part 262 must appear legibly on the back of the copies of the manifest... application must also indicate how the printer will pre-print a unique number on each form (e.g., crash or... this section. A registered source may be a: (i) State agency; (ii) Commercial printer; (iii)...

  4. Manifest requirements. RCRA Information Brief

    SciTech Connect

    Not Available

    1994-04-01

    Specific pretransport regulatory requirements must be met by DOE prior to shipment of hazardous waste, low-level wastes (LLW), and radioactive mixed wastes (RMW). The pretransport requirements are intended to help reduce the risk of loss or leakage of, or exposure to, hazardous wastes, LLW, and RMW during shipment; and to communicate information on potential hazards to shippers, carriers, or receivers of waste shipments, and emergency response personnel in the event of an accident, spill, or leak. These goals are accomplished through tracking of shipments, correct packaging and labeling, and communication of potential hazards. Specific requirements include manifesting, packaging, marking and labeling of waste packages, placarding of vehicles, and selecting appropriate waste transporters and shipment destinations. This Information Brief focuses on the manifesting requirements associated with domestic transport of hazardous wastes, LLW, and RMW.

  5. Laryngeal Manifestations of Rheumatoid Arthritis

    PubMed Central

    Hamdan, A. L.; Sarieddine, D.

    2013-01-01

    Rheumatoid arthritis is a destructive autoimmune disease that affects 3% of the adult population. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints. There are ubiquitous reports on the head and neck manifestations of RA with emphasis on the larynx. The laryngeal presenting features of this systemic disease may mimic a plethora of medical conditions, inflammatory and neoplastic. The main phonatory and respiratory symptoms are often subtle and misleading. This paper represents a literature review of the laryngeal manifestations of RA with emphasis on the clinical symptoms, laryngeal findings, diagnosis, and treatment. An early diagnosis of laryngeal involvement may prevent drastic complications. PMID:23864939

  6. [Neuropsychiatric manifestations ushering pernicious anemia].

    PubMed

    Mrabet, S; Ellouze, F; Ellini, S; Mrad, M F

    2015-12-01

    Biermer disease or pernicious anemia is an autoimmune atrophic gastritis characterized by the lack of secretion of gastric intrinsic factor. This leads to an insufficient absorption of vitamin B12 in the ileum. Clinical manifestations are mainly hematologic. Neuropsychiatric manifestations are known but are less frequent especially early in the disease. Inaugural neuropsychiatric arrays are rare and various thus making diagnosis difficult. In this article, we report through two clinical cases different neuropsychiatric manifestations revealing pernicious anemia. Mrs. C.O., aged 56, presented after surgery for gallstones, an acute psychiatric array associated with gait disorders. She had no history of neurological or psychiatric problems. The psychiatric interview revealed delirious syndrome, depressive symptoms and anxiety. Neurological examination noted a flaccid paraplegia with peripheral neuropathic syndrome and myoclonus in the upper limbs. At the full blood count, a macrocytosis (VGM: 112.2fl) without anemia was found. The level of vitamin B12 in the blood was low. Cerebro-spinal MRI was suggestive of a neuro-Biermer and showed hypersignal in the cervical cord on T2-weighted sagittal section. In axial section, hypersignal appears at the posterior columns in the form of V. There were no brain abnormalities. A sensorimotor axonal polyneuropathy was diagnosed. The patient received vitamin B12 intramuscularly for ten days associated with neuroleptic treatment. Mrs. R.M., aged 40, was brought to the psychiatry consultation for acute behavioral disorders progressively worsening over a month. An anxiety syndrome, depressive syndrome and delirious syndrome were identified. Neurological examination showed a posterior cordonal syndrome with quadripyramidal syndrome. Full blood count showed a macrocytic anemia. Serum B12 level was collapsed. Cerebro-spinal MRI was normal. She received vitamin B12 with clinical and biological improvement. Features of pernicious anemia vary according to studies and age range. Digestive and hematological manifestations are well known. Neurological and psychiatric manifestations of pernicious anemia were also described in the early literature. They can be the initial symptoms or the only ones. However, inaugural neuropsychiatric features are often unrecognized. The most common psychiatric symptoms were depression, mania, psychotic symptoms, cognitive impairment and obsessive compulsive disorder. Neurological involvement includes mainly combined spinal sclerosis, peripheral neuropathy and dementia. Cerebellar ataxia and movement disorders are reported less often. Severity of neuropsychiatric features and therapeutic efficacy depends on the duration of signs and level of B12 deficiency. Macrocytic anemia may lack. Neuropsychiatric manifestations could be isolated or be the first manifestation of vitamin deficiency and occur without any hematological or gastrointestinal context. Pernicious anemia and serum B12 assay should be discussed in all patients with organic mental disorders, atypical psychiatric symptoms and fluctuation of symptomatology. Nevertheless, B12 level could be normal in genuine pernicious anemia diseases and macrocytic anemia may lack. Substitutive vitaminotherapy is required when diagnosis is strongly suspected and etiologic assessment is negative. PMID:26345354

  7. 19 CFR 122.75 - Complete manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.75 Complete manifest. (a) Contents. A...

  8. 19 CFR 122.75 - Complete manifest.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.75 Complete manifest. (a) Contents. A...

  9. 19 CFR 122.75 - Complete manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.75 Complete manifest. (a) Contents. A...

  10. 19 CFR 122.75 - Complete manifest.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.75 Complete manifest. (a) Contents. A...

  11. 19 CFR 122.75 - Complete manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.75 Complete manifest. (a) Contents. A...

  12. Clinical manifestations of sleep apnea

    PubMed Central

    2015-01-01

    Obstructive sleep apnea (OSA) may manifest in a number of ways from subtle intrusion into daily life to profound sleepiness, snoring, witnessed apneas and other classic symptoms. Although there is increasing evidence suggesting OSA can adversely affect health in a variety of ways, this disorder remains underdiagnosed. The most well-escribed health consequences of OSA relate to the cardiovascular system. Hypertension and arrhythmias have a strong association with OSA, and evidence suggests that treatment of OSA in patients with refractory hypertension and in patients planning cardioversion for atrial fibrillation may be of particularly importance. Significant associations between heart failure and OSA as well as complex sleep apnea have also been well-described. Cerebrovascular insult, impaired neurocognition, and poorly controlled mood disorder are also associated with in OSA. Therapy for OSA may ameliorate atherosclerotic progression and improve outcomes post-cerebrovascular accident (CVA). OSA should be considered in patients complaining of poor concentration at work, actual or near-miss motor vehicle accidents, and patients with severe sleepiness as a component of their co-morbid mood disorders. The metabolic impact of OSA has also been studied, particularly in relation to glucose homeostasis. Also of interest is the potential impact OSA has on lipid metabolism. The adverse effect untreated OSA has on glucose tolerance and lipid levels has led to the suggestion that OSA is yet another constituent of the metabolic syndrome. Some of these metabolic derangements may be related to the adverse effects untreated OSA has on hepatic health. The cardiovascular, neurocognitive, and metabolic manifestations of OSA can have a significant impact on patient health and quality of life. In many instances, evidence exists that therapy not only improves outcomes in general, but also modifies the severity of co-morbid disease. To mitigate the long-term sequela of this disease, providers should be aware of the subtle manifestations of OSA and order appropriate testing as necessary. PMID:26543619

  13. Cardiac manifestations in systemic sclerosis

    PubMed Central

    Lambova, Sevdalina

    2014-01-01

    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

  14. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  15. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  16. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  17. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  18. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  19. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  20. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  1. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  2. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  3. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...the manifest or shipping paper, and the quantity and...waste, any variation in piece count, such as a...the manifest or shipping paper. (c) Upon discovering...the manifest or shipping paper at issue. (d...delivery of the waste to the first transporter...

  4. Coronal manifestations of preflare activity

    NASA Technical Reports Server (NTRS)

    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

    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).

  5. 78 FR 11877 - Announcement of Requirements Gathering Meetings for the Electronic Manifest (e-Manifest) System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ...Gathering Meetings for the Electronic Manifest (e-Manifest...EPA's Office of Resource Conservation and Recovery...stakeholders on a national electronic manifest (``e-Manifest...in hard copy at the Resource Conservation and Recovery...greater advantage of electronic information...

  6. Oropharyngeal dysphagia: manifestations and diagnosis.

    PubMed

    Rommel, Nathalie; Hamdy, Shaheen

    2016-01-01

    Swallowing disorders (dysphagia) have been recognized by the WHO as a medical disability associated with increased morbidity, mortality and costs of care. With increasing survival rates and ageing of the population, swallowing disorders and their role in causing pulmonary and nutritional pathologies are becoming exceedingly important. Over the past two decades, the study of oropharyngeal dysphagia has been approached from various disciplines with considerable progress in understanding its pathophysiology. This Review describes the most frequent manifestations of oropharyngeal dysphagia and the clinical as well as instrumental techniques that are available to diagnose patients with dysphagia. However, the clinical value of these diagnostic tests and their sensitivity to predict outcomes is limited. Despite considerable clinical research efforts, conventional diagnostic methods for oropharyngeal dysphagia have limited proven accuracy in predicting aspiration and respiratory disease. We contend that incorporation of measurable objective assessments into clinical diagnosis is needed and might be key in developing novel therapeutic strategies. PMID:26627547

  7. Musculoskeletal manifestations of diabetes mellitus.

    PubMed

    Merashli, M; Chowdhury, T A; Jawad, A S M

    2015-11-01

    The prevalence of Type 1 and Type 2 diabetes are increasing significantly worldwide. Whilst vascular complications of diabetes are well recognized, and account for principle mortality and morbidity from the condition, musculoskeletal manifestations of diabetes are common and whilst not life threatening, are an important cause of morbidity, pain and disability. Joints affected by diabetes include peripheral joints and the axial skeleton. Charcot neuroarthropathy is an important cause of deformity and amputation associated with peripheral neuropathy. A number of fibrosing conditions of the hands and shoulder are recognized, including carpal tunnel syndrome, adhesive capsulitis, tenosynovitis and limited joint mobility. People with diabetes are more prone to gout and osteoporosis. Management of these conditions requires early recognition and close liaison between diabetes and rheumatology specialists. PMID:26025688

  8. Oral manifestations in transplant patients

    PubMed Central

    Nappalli, Deepika; Lingappa, Ashok

    2015-01-01

    Organ transplantation is a widely undertaken procedure and has become an important alternative for the treatment of different end-stage organ diseases that previously had a poor prognosis. The field of organ transplant and hematopoietic stem cell transplant is developing rapidly. The increase in the number of transplant recipients also has an impact on oral and dental services. Most of the oral problems develop as a direct consequence of drug-induced immunosuppression or the procedure itself. These patients may present with oral complaints due to infections or mucosal lesions. Such lesions should be identified, diagnosed, and treated. New treatment strategies permit continuous adaptation of oral care regimens to the changing scope of oral complications. The aim of this review is to analyze those oral manifestations and to discuss the related literature. PMID:26005458

  9. MUCOCUTANEOUS MANIFESTATIONS OF CHIKUNGUNYA FEVER

    PubMed Central

    Bandyopadhyay, Debabrata; Ghosh, Sudip Kumar

    2010-01-01

    Chikungunya fever (CF) is an arboviral acute febrile illness transmitted by the bite of infected Aedes mosquitoes. After a quiescence of more than three decades, CF has recently re-emerged as a major public health problem of global scale. CF is characterized by an acute onset of high fever associated with a severe disabling arthritis often accompanied by prominent mucocutaneous manifestations. The disease is usually self-limiting, but the joint symptoms and some of the cutaneous features may persist after the defervescence. A wide range of mucocutaneous changes has been described to occur in association with CF during the current epidemic. Besides a morbilliform erythema, hyperpigmentation, xerosis, excoriated papules, aphthous-like ulcers, vesiculobullous and lichenoid eruptions, and exacerbation of pre-existing or quiescent dermatoses had been observed frequently. These unusual features may help in the clinical differential diagnosis of acute viral exanthems mimicking CF. PMID:20418982

  10. Cardiac manifestations in Behcet's disease

    PubMed Central

    Demirelli, Selami; Degirmenci, Husnu; Inci, Sinan; Arisoy, Arif

    2015-01-01

    Summary Behcet's disease (BD) is a chronic inflammatory disorder, with vasculitis underlying the pathophysiology of its multisystemic effects. Venous pathology and thrombotic complications are hallmarks of BD. However, it has been increasingly recognised that cardiac involvement and arterial complications are also important aspects of the course of the disease. Cardiac lesions include pericarditis, endocarditis, intracardiac thrombosis, myocardial infarction, endomyocardial fibrosis, and myocardial aneurysm. Treatment of cardiovascular involvement in BD is largely empirical, and is aimed towards suppressing the vasculitis. The most challenging aspect seems to be the treatment of arterial aneurysms and thromboses due to the associated risk of bleeding. When the prognosis of cardiac involvement in BD is not good, recovery can be achieved through oral anticoagulation, immunosuppressive therapy, and colchicine use. In this review, we summarise the cardiovascular involvement, different manifestations, and treatment of BD. PMID:25984424

  11. Ocular Manifestations of Acquired Immunodeficiency Syndrome

    PubMed Central

    Kim, Young Shin; Sun, Hae Jung; Kim, Tae Hyong; Kang, Kui Dong

    2015-01-01

    Purpose To investigate the patterns and risk factors of the ocular manifestations of acquired immunodeficiency syndrome (AIDS) and their correlation with CD4+ count in the era of highly active antiretroviral therapy (HAART). Methods This retrospective study examined 127 AIDS patients who presented to Soonchunhyang University Hospital. Data were collected from patient interviews, clinical examinations, and laboratory investigations. Ophthalmologic examinations included the best-corrected visual acuity, intraocular pressure, anterior segment and adnexal examination, and dilated fundus examination. Results Of the 127 patients with AIDS, 118 were on HAART and 9 were not. The mean CD4+ count was 266.7 ± 209.1 cells/µL. There were ocular manifestations in 61 patients (48.0%). The incidence of anterior segment manifestations was higher than posterior segment manifestations at 28.3% and 19.7%, respectively. The mean CD4+ count was significantly (p < 0.05) lower in the patients with posterior versus anterior segment ocular manifestations. The most common ocular manifestation was retinal microvasculopathy (15.0%), followed by keratoconjunctivitis sicca (14.2%), conjunctival microvasculopathy (9.4%), cytomegalovirus retinitis (3.1%), herpes zoster ophthalmicus (2.4%), and blepharitis (1.6%). Retinal microvasculopathy and cytomegalovirus retinitis were common in patients with CD4+ counts <200 cells/µL, while keratoconjunctivitis sicca and conjunctival microvasculopathy were common in patients with CD4+ counts of 200 to 499 cells/µL. There was a significant (p < 0.05) association between ocular manifestation and CD4+ count or age. Conclusions The introduction of HAART has changed the landscape of ocular presentations in patients with AIDS. In this study, anterior segment and external ocular manifestations occurred more frequently than posterior segment manifestations. Also, the mean CD4+ count was significantly lower in patients with posterior segment ocular manifestations versus anterior segment ocular manifestations. We found that CD4+ count and age >35 years were independent risk factors for developing ocular manifestations. PMID:26240508

  12. Skin manifestations of drug allergy.

    PubMed

    Ardern-Jones, Michael R; Friedmann, Peter S

    2011-05-01

    Cutaneous adverse drug reactions range from mild to severe and from those localized only to skin to those associated with systemic disease. It is important to distinguish features of cutaneous drug reactions which help classify the underlying mechanism and likely prognosis as both of these influence management decisions, some of which necessarily have to be taken rapidly. Severe cutaneous reactions are generally T cell-mediated, yet this immunological process is frequently poorly understood and principles for identification of the culprit drug are different to those of IgE mediated allergic reactions. Furthermore, intervention in severe skin manifestations of drug allergy is frequently necessary. However, a substantial literature reports on success or otherwise of glucocorticoids, cyclophsphamide, ciclosporin, intravenous immunoglobulin and anti-tumour necrosis factor therapy for the treatment of toxic epidermal necrolysis without clear consensus. As well as reviewing the recommended supportive measures and evidence base for interventions, this review aims to provide a mechanistic overview relating to a proposed clinical classification to assist the assessment and management of these complex patients. PMID:21480947

  13. Neurologic manifestations of Angelman syndrome.

    PubMed

    Thibert, Ronald L; Larson, Anna M; Hsieh, David T; Raby, Annabel R; Thiele, Elizabeth A

    2013-04-01

    Angelman syndrome is a neurogenetic disorder characterized by the loss or reduction of the ubiquitin-protein ligase E3A enzyme. Angelman syndrome results from a deletion or mutation of the maternally inherited 15q11.2-13.1 region, paternal uniparental disomy of chromosome 15, or an imprinting error. Epilepsy is common and may present with multiple seizure types, including nonconvulsive status epilepticus. Seizures are often intractable and typically require broad-spectrum antiepileptic medications. Dietary therapy has also proved successful in Angelman syndrome. Electroencephalographic patterns include notched ? and rhythmic ? activity and epileptiform discharges. Sleep disorders are also common, often characterized by abnormal sleep-wake cycles. Movement disorders are nearly universal in Angelman syndrome, most frequently presenting with ataxia and tremor. Neurocognitive impairment is always present to varying degrees, and expressive speech is typically severely affected. Individuals with Angelman syndrome often manifest psychiatric comorbidities including hyperactivity, anxiety, and challenging behaviors such as aggression and self-injury. We focus on a comprehensive whole-child approach to the diagnosis and long-term clinical care of individuals with Angelman syndrome. PMID:23498559

  14. Ocular manifestations of frontonasal dysplasia.

    PubMed

    Roarty, J D; Pron, G E; Siegel-Bartelt, J; Posnick, J C; Buncic, J R

    1994-01-01

    The ophthalmologic findings associated with frontonasal dysplasia have not been defined previously in a large series of untreated children. We reviewed the ophthalmic manifestations of a series of patients with frontonasal dysplasia who were seen as part of their craniofacial evaluation. All had undergone a complete ophthalmologic examination before any manipulation of either the orbits or the soft tissues of the orbital contents. From 1986 to 1991, 23 patients with frontonasal dysplasia were seen; ophthalmologic abnormalities were found in 20 (87 percent). Abnormalities included significant refractive errors, strabismus, nystagmus, and eyelid ptosis. Three patients had amblyopia, a treatable cause of visual loss, from strabismus or anisometropia. Ten eyes in seven patients (30 percent) had severe structural anomalies, such as optic nerve hypoplasia, optic nerve colobomas, microphthalmia, cataract, corneal dermoid, or inflammatory retinopathy, that resulted in an acuity of 20/100 or worse. The high incidence of ocular abnormalities indicates that early assessment by an ophthalmologist should be part of the initial evaluation of patients with frontonasal dysplasia to detect treatable visual or ocular problems. PMID:8278482

  15. Gastrointestinal manifestations of Behcet's disease.

    PubMed

    Bayraktar, Y; Ozaslan, E; Van Thiel, D H

    2000-03-01

    Behcet's disease (BD) is a multisystem, chronic, relapsing vasculitis of unknown origin that affects nearly all organs and systems. While recurrent oral ulcerations are a "sine qua non" of BD, the frequency of extra-oral parts of the gastrointestinal involvement varies widely in different countries. The most frequent extra-oral sites of gastrointestinal involvement are the ileocecal region and the colon. The liver (except with Budd-Chiari syndrome), pancreas, and spleen are rarely involved. The symptoms associated with these extra-oral manifestations of BD are abdominal pain, nausea, vomiting, diarrhea with or without blood, and constipation. The lesions typically are resistant to medical treatment and frequently recur with surgical treatment. We review the literature regarding the gastrointestinal and hepatobiliary systems in BD. Also, we present a patient who had BD complicated with radiologically-proven hepatic veins involvement (Budd-Chiari syndrome) and complete occlusion of hepatic portion of inferior vena cava and who had a good response to colchicine and penicillin treatment. PMID:10730919

  16. Skin manifestations in autoinflammatory syndromes.

    PubMed

    Braun-Falco, Markus; Ruzicka, Thomas

    2011-03-01

    Autoinflammatory diseases encompass a group of inflammatory diseases that are non-infectious, non-allergic, non-autoimmune and non-immunodeficient. The term was initially coined for a small group of familial periodic fever syndromes of which familial Mediterranean fever (FMF) is the most common and best known. Genetic and molecular analyses demonstrated for the majority of these diseases an impairment of inflammasomes to cause an increased activity of an interleukin-1-dependent inflammatory response. Over the last years an increasing number of either rare hereditary syndromes or acquired common diseases could be summarized under the designation of autoinflammatory disease, thus creating an emerging new rubric of inflammatory diseases. Many of them display cutaneous manifestations as both concomitant or more rarely main symptoms. To name some of them like erysipelas-like erythema in FMF; urticaria-like rashes in tumor necrosis factor receptor 1- or cryopyrin-associated periodic syndromes (TRAPS, CAPS), hyperimmunoglobulin D syndrome (HIDS) or Schnitzler syndrome; pyoderma gangrenosum and acne in PAPA syndrome; or behçetoid aphthous ulcerations in HIDS and PFAPA syndrome. Based on the new insights into pathogenesis one increasingly realizes the good response of these diseases to IL-1 antagonist therapies. PMID:21176105

  17. Protean Manifestations of Neonatal Hyperinsulinism

    PubMed Central

    Mayer, Thom; Matlak, Michael E.; Lowry, Stephen F.; Gooch, W. Manford; Johnson, Dale G.

    1981-01-01

    Endogenous hyperinsulinism is the leading cause of persistent hypoglycemia in children under one year of age. Classically, the symptoms of neonatal hypoglycemia have been referable to central nervous system dysfunction, with seizures described in nearly all patients. Our experience with eight neonates emphasizes the protean manifestations of this disease. One patient presented with a maternal history of diuretic use, and developed asymptomatic hyperinsulinism documented by provocative testing. The hyperinsulinism cleared after two weeks of medical therapy. This transient hyperinsulinism may have been secondary to use of a thiazide-type diuretic. A second patient presented, as a neonate, with a large abdominal mass but no seizure activity. Exploratory laparotomy revealed an 11 x 5 x 3 cm pancreatic tumor, which required splenectomy, 60% gastrectomy and duodenectomy for removal. Histologic examination demonstrated an insulin-secreting hamartoma. A third patient died suddenly without prior symptoms, and was found to have striking nesidioblastosis on pathologic examination. One infant presented with absence of the abdominal musculature (prune belly syndrome) and features of the Beck-with-Wiedeman syndrome, as well as profound hypoglycemia. Only three patients had seizures, and an additional patient had jitteriness. Pathologic diagnoses were: nesidioblastosis (n = 2); islet cell hyperplasia (n = 1); adenoma (n = 1); hamartoma (n = 1); transient hyperinsulinism (n = 1). One patient's pancreas showed areas of nesidioblastosis, islet cell hyperplasia, and a discrete adenoma in the region of the common bile duct. Careful diagnostic testing is essential in these patients, inasmuch as hypoglycemia is poorly tolerated by neonates and infants. Using the diagnostic algorithm presented here, all patients' endogenous hyperinsulinism was documented quickly and efficiently. Recognition of the broad spectrum of symptoms with which these patients may present is essential if serious neurologic sequelae are to be avoided. PMID:7259339

  18. 40 CFR 761.215 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...on the manifest or shipping paper, and the quantity and type...batch waste, any variation in piece count, such as a discrepancy...of the manifest or shipping paper at issue. (d)(1...delivery of the waste to the first transporter designated on...

  19. 40 CFR 761.215 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...on the manifest or shipping paper, and the quantity and type...batch waste, any variation in piece count, such as a discrepancy...of the manifest or shipping paper at issue. (d)(1...delivery of the waste to the first transporter designated on...

  20. [Extra-digestive manifestations of food allergy].

    PubMed

    Vandenplas, Y; Loeb, H

    1994-01-01

    Intestinal manifestations are the predominant symptoms of food allergy. Nevertheless, it is generally accepted that dietary proteins can also induce intestinal manifestations such as systemic reactions or symptoms related to the skin, the respiratory tract, the central nervous system, the urinary tract, the vascular system, the joints. The cause-effect relationships between the contact with the dietary protein (e.g. it is unclear if direct skin contact is more relevant in patients with cutaneous manifestations than ingestion) and the symptoms if often difficult to prove. As a consequence, the number of "extra-intestinal" manifestations that are suggested to be related to food proteins is probably greater than the number of manifestations that are generally accepted as such. PMID:8087223

  1. 78 FR 11877 - Announcement of Requirements Gathering Meetings for the Electronic Manifest (e-Manifest) System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... inefficiencies associated with the use of paper manifest forms (66 FR 28240). Although comments generally... electronically completing and transmitting manifests through a national, centralized e-Manifest system (71 FR... from the time it leaves the generator facility where it was produced, until it reaches the...

  2. Paraneoplastic cutaneous manifestations: concepts and updates*

    PubMed Central

    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

    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

  3. Genetic alterations in syndromes with oral manifestations

    PubMed Central

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

    2013-01-01

    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

  4. Mucocutaneous manifestations of helminth infections: Nematodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Pino, Livia; Bravo, Francisco; Giglio, Patricia; Sethi, Aisha; Klaus, Sidney; Sangueza, Omar P; Fuller, Claire; Mendoza, Natalia; Ladizinski, Barry; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568337

  5. Endocrine disorders and the neurologic manifestations

    PubMed Central

    2014-01-01

    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

  6. 40 CFR 267.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...discrepancies in type are obvious differences which can be discovered by inspection or waste analysis, such as waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping paper. (b) Upon...

  7. 40 CFR 267.72 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...discrepancies in type are obvious differences which can be discovered by inspection or waste analysis, such as waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping paper. (b) Upon...

  8. 40 CFR 267.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...discrepancies in type are obvious differences which can be discovered by inspection or waste analysis, such as waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping paper. (b) Upon...

  9. 40 CFR 267.72 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...discrepancies in type are obvious differences which can be discovered by inspection or waste analysis, such as waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping paper. (b) Upon...

  10. 40 CFR 267.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...discrepancies in type are obvious differences which can be discovered by inspection or waste analysis, such as waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping paper. (b) Upon...

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

    PubMed Central

    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

    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

  12. Manifestation and Origin of the Isotope Effect

    E-print Network

    V. G. Plekhanov

    2009-07-12

    This article reviews from one point of view the current status of the manifestations of isotope effect in a nuclear, atomic and molecular as well as solid state physics. Although these manifestations vary, they have one common feature - they all depend on mass. At present time the Standard Model can't explain the origin of the mass of elementary particles and their hierarchy. The last one don't permit to find the origin of the isotope effect.

  13. Rheumatic Manifestations in Patients with Chikungunya Infection.

    PubMed

    Arroyo-Ávila, Mariangelí; Vilá, Luis M

    2015-06-01

    Chikungunya virus (CHIKV) infection is a common cause of febrile arthritis. The most common manifestations of acute infection are fever, symmetrical polyarthralgias or polyarthritis, myalgias, and maculopapular rash. Up to 80% of patients may develop musculoskeletal manifestations that persist longer than 3 months, causing impairment in their quality of life. The most common chronic manifestations are persistent or relapsing-remitting polyarthralgias, polyarthritis, and myalgias. Fingers, wrists, knees, ankles, and toes are the most frequently involved, but proximal joints and axial involvement can occur in the chronic stage. Chronic manifestations of CHIKV infection may resemble those of some autoimmune connective tissue diseases. Furthermore, CHIKV infection can cause cryoglobulinemia and may induce rheumatoid arthritis and seronegative spondyloarthropathies in genetically susceptible individuals. The Centers for Disease Control and Prevention recommend acetaminophen and non steroidal anti-inflammatory drugs for the acute rheumatic manifestations of CHIKV infection. However, some studies suggest that low-dose corticosteroids for about 1-2 months (depending on clinical course) are beneficial in relieving acute rheumatic symptoms. Conversely, hydroxychloroquine in combination with corticosteroids or other disease modifying anti-rheumatic drugs (DMARDs) has been successful in treating chronic rheumatic manifestations. Methotrexate and sulfasalazine (alone or in combination) have also been effective for chronic CHIKV arthritis. Patients with CHIKV infection should be closely monitored to identify those with chronic arthritis who would benefit from a rheumatologic evaluation and early treatment with DMARDs. PMID:26061056

  14. 40 CFR 263.21 - Compliance with the manifest.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...includes the facility's date and signature, and the Manifest Tracking Number of the new manifest that will accompany the shipment...discrepancy block of the manifest, and the name, address, phone number, and Identification Number for the alternate...

  15. 40 CFR 263.21 - Compliance with the manifest.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...includes the facility's date and signature, and the Manifest Tracking Number of the new manifest that will accompany the shipment...discrepancy block of the manifest, and the name, address, phone number, and Identification Number for the alternate...

  16. 40 CFR 263.21 - Compliance with the manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...includes the facility's date and signature, and the Manifest Tracking Number of the new manifest that will accompany the shipment...discrepancy block of the manifest, and the name, address, phone number, and Identification Number for the alternate...

  17. 40 CFR 263.21 - Compliance with the manifest.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...includes the facility's date and signature, and the Manifest Tracking Number of the new manifest that will accompany the shipment...discrepancy block of the manifest, and the name, address, phone number, and Identification Number for the alternate...

  18. 40 CFR 263.21 - Compliance with the manifest.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...includes the facility's date and signature, and the Manifest Tracking Number of the new manifest that will accompany the shipment...discrepancy block of the manifest, and the name, address, phone number, and Identification Number for the alternate...

  19. 40 CFR 761.208 - Use of the manifest.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

  20. 40 CFR 761.208 - Use of the manifest.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  1. 40 CFR 761.208 - Use of the manifest.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  2. 40 CFR 262.25 - Electronic manifest signatures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 2014-07-01 false Electronic manifest signatures. 262...AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS...APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.25 Electronic manifest signatures....

  3. 40 CFR 262.24 - Use of the electronic manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...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...

  4. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...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...

  5. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  6. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  7. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...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...

  8. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

  9. Pulmonary manifestations of renal cell carcinoma.

    PubMed

    Agrawal, Abhinav; Sahni, Sonu; Iftikhar, Asma; Talwar, Arunabh

    2015-12-01

    Renal cell carcinoma (RCC) accounts for majority of all primary renal neoplasms. Classic manifestations of RCC include the triad of flank pain, hematuria and a palpable renal mass. Patients with RCC can develop various extra renal manifestations including involvements of the lungs, inferior vena cava, liver and the bones. The pulmonary manifestations of renal cell carcinoma include metastatic disease including endobronchial, pleural, parenchymal or lymph node metastasis, pleural effusion or hemothorax. Pulmonary embolism and tumor embolism is another common manifestation of renal cell carcinoma. RCC is a highly vascular tumor and can cause pulmonary arterio-venous fistulas leading to high output failure. Rarely, RCC can also present with paraneoplastic presentations including cough or bilateral diaphragm paralysis. Drugs used to treat RCC have been associated with drug related pneumonitis and form an important differential diagnosis in patients with RCC on therapy presenting with shortness of breath. In this review we discuss the various pulmonary manifestations of RCC. A high index of suspicion with these presentations can lead to an early diagnosis and assist in instituting an appropriate intervention. PMID:26525375

  10. Ocular manifestations in systemic lupus erythematosus.

    PubMed

    Silpa-Archa, Sukhum; Lee, Joan J; Foster, C Stephen

    2016-01-01

    Systemic lupus erythematosus (SLE) can involve many parts of the eye, including the eyelid, ocular adnexa, sclera, cornea, uvea, retina and optic nerve. Ocular manifestations of SLE are common and may lead to permanent blindness from the underlying disease or therapeutic side effects. Keratoconjunctivitis sicca is the most common manifestation. However, vision loss may result from involvement of the retina, choroid and optic nerve. Ocular symptoms are correlated to systemic disease activity and can present as an initial manifestation of SLE. The established treatment includes prompt systemic corticosteroids, steroid-sparing immunosuppressive drugs and biological agents. Local ocular therapies are options with promising efficacy. The early recognition of disease and treatment provides reduction of visual morbidity and mortality. PMID:25904124

  11. Oral manifestations of hematologic and nutritional diseases.

    PubMed

    Schlosser, Bethanee J; Pirigyi, Megan; Mirowski, Ginat W

    2011-02-01

    Oral manifestations of hematologic and nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissues, salivary glands, and perioral skin. This article reviews common oral manifestations of hematologic conditions starting with disorders of the white blood cells including cyclic hematopoiesis (cyclic neutropenia), leukemias, lymphomas, plasma cell dyscrasias, and mast cell disorders; this is followed by a discussion of the impact of red blood cell disorders including anemias and less common red blood cell dyscrasias (sickle cell disease, hemochromatosis, and congenital erythropoietic porphyria) as well as thrombocytopenia. Several nutritional deficiencies exhibit oral manifestations. The authors specifically discuss the impact of water-soluble vitamins (B2, B3, B6, B9, B12, and C), fat-soluble vitamins (A, D, and K) and the eating disorders anorexia nervosa and bulimia nervosa on the oral mucosa. PMID:21093629

  12. Imaging Cardiovascular Manifestations of Genetic Syndromes.

    PubMed

    Shah, Soham; Ashwath, Ravi; Rajiah, Prabhakar

    2016-01-01

    Congenital structural cardiovascular defects are commonly associated and found concurrently with many different types of genetic diseases and syndromes. Understanding these cardiovascular manifestations is essential for diagnosing these genetic syndromes without delay and provides prompt attention and repair of life-threatening defects without complications. Computed tomography and magnetic resonance imaging are increasingly used in the evaluation of cardiovascular abnormalities, and it is imperative for radiologists to be cognizant of the syndromes associated with these abnormalities. In this article, we review the cardiovascular manifestations of the common genetic syndromes and illustrate the role of computed tomography and magnetic resonance imaging in the evaluation of these abnormalities. PMID:26163737

  13. [Paroxysmal neurological manifestations disclosing panic attacks].

    PubMed

    Petiau, C; Hirsch, E; Peretti, S; Sellal, F; Hammouti, A; Danion, J M; Marescaux, C

    1992-01-01

    Thirty-seven patients presented with paroxysmal neurological manifestations attributed to anxiety attacks. The manifestations included loss of consciousness, focal sensorimotor deficits, diffuse dysesthaesiae, visual disorders and tremor. They lasted 10 to 45 minutes and occurred once per day to once per week. Organic pathology was dismissed on the basis of normal examinations and atypical course. In all patients questioning revealed symptoms that were those of acute anxiety. The fact that these attacks took place in suggestive (circumstances e.g. in crowds and car driving), and that they could be induced by challenge tests hyperpnoea, infusion of lactate) suggested that these disorders were consecutive to panic attacks. PMID:1362998

  14. Bodily manifestations in the psychoanalytic process.

    PubMed

    Vartzopoulos, Ioannis; Beratis, Stavroula

    2012-07-01

    The broadening scope of psychoanalysis has brought to the fore patients whose unconscious conflicts tend to be literally played out on the stage of the body. In these cases, the body seems to be predominantly used in a concrete, not symbolic, way in order to express underlying conflicts. In a similar vein, transference and countertransference can be manifested via the body. The authors briefly discuss some of the literature on body-mind issues, and then present an extended case report to illustrate bodily manifestations in the psychoanalytic process. PMID:23038903

  15. 19 CFR 123.22 - In-transit manifest.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false In-transit manifest. 123.22 Section 123.22 Customs... CBP RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required. A manifest in duplicate covering the in-transit merchandise which is...

  16. 19 CFR 123.22 - In-transit manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false In-transit manifest. 123.22 Section 123.22 Customs... CBP RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required. A manifest in duplicate covering the in-transit merchandise which is...

  17. 19 CFR 123.22 - In-transit manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false In-transit manifest. 123.22 Section 123.22 Customs... CBP RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required. A manifest in duplicate covering the in-transit merchandise which is...

  18. 19 CFR 123.22 - In-transit manifest.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false In-transit manifest. 123.22 Section 123.22 Customs... CBP RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit manifest. (a) Manifest required. A manifest in duplicate covering the in-transit merchandise which is...

  19. 40 CFR 262.54 - Special manifest requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Exports of Hazardous Waste § 262.54 Special manifest requirements. A primary exporter must comply with the manifest requirements of 40 CFR 262.20... (as defined in 40 CFR 264.72(a)) between the manifest and the shipment. A copy of the manifest...

  20. 40 CFR 262.54 - Special manifest requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Exports of Hazardous Waste § 262.54 Special manifest requirements. A primary exporter must comply with the manifest requirements of 40 CFR 262.20... (as defined in 40 CFR 264.72(a)) between the manifest and the shipment. A copy of the manifest...

  1. 40 CFR 262.54 - Special manifest requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Exports of Hazardous Waste § 262.54 Special manifest requirements. A primary exporter must comply with the manifest requirements of 40 CFR 262.20... (as defined in 40 CFR 264.72(a)) between the manifest and the shipment. A copy of the manifest...

  2. 40 CFR 262.54 - Special manifest requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... manifest requirements. A primary exporter must comply with the manifest requirements of 40 CFR 262.20... (as defined in 40 CFR 264.72(a)) between the manifest and the shipment. A copy of the manifest signed.../or commercial forms printers). (f) The primary exporter must require the consignee to confirm...

  3. 40 CFR 262.54 - Special manifest requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... manifest requirements. A primary exporter must comply with the manifest requirements of 40 CFR 262.20... (as defined in 40 CFR 264.72(a)) between the manifest and the shipment. A copy of the manifest signed.../or commercial forms printers). (f) The primary exporter must require the consignee to confirm...

  4. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... limits for “empty” containers set forth in 40 CFR 261.7(b). (b) Significant differences in quantity are... exceeds the quantity limits for “empty” containers set forth in 40 CFR 261.7(b), the facility must consult... set forth in 40 CFR 261.7(b) after it has signed, dated, and returned a copy of the manifest to...

  5. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... limits for “empty” containers set forth in 40 CFR 261.7(b). (b) Significant differences in quantity are... exceeds the quantity limits for “empty” containers set forth in 40 CFR 261.7(b), the facility must consult... set forth in 40 CFR 261.7(b) after it has signed, dated, and returned a copy of the manifest to...

  6. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... limits for “empty” containers set forth in 40 CFR 261.7(b). (b) Significant differences in quantity are... exceeds the quantity limits for “empty” containers set forth in 40 CFR 261.7(b), the facility must consult... set forth in 40 CFR 261.7(b) after it has signed, dated, and returned a copy of the manifest to...

  7. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... limits for “empty” containers set forth in 40 CFR 261.7(b). (b) Significant differences in quantity are... exceeds the quantity limits for “empty” containers set forth in 40 CFR 261.7(b), the facility must consult... set forth in 40 CFR 261.7(b) after it has signed, dated, and returned a copy of the manifest to...

  8. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... limits for “empty” containers set forth in 40 CFR 261.7(b). (b) Significant differences in quantity are... exceeds the quantity limits for “empty” containers set forth in 40 CFR 261.7(b), the facility must consult... set forth in 40 CFR 261.7(b) after it has signed, dated, and returned a copy of the manifest to...

  9. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

  10. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  11. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  12. Behavioral Manifestations of Child Sexual Abuse: Response.

    ERIC Educational Resources Information Center

    Reece, Robert M.

    1998-01-01

    This response to a previous article on behavioral manifestations of child sexual abuse (EC 619 258) stresses the importance of empirical research and the avoidance of assumptions that incidents of sexual abuse are the sentinel events in the life of a child, when the child's dysfunctional milieu may provide far more traumatic events. (DB)

  13. Spectrum of Eosinophilic End-Organ Manifestations.

    PubMed

    Akuthota, Praveen; Weller, Peter F

    2015-08-01

    Eosinophil-associated disorders can affect practically all tissues and organs in the body, either individually or in combination. This article provides an overview of end-organ manifestations of eosinophilia and discusses selected organ systems, including the upper and lower respiratory, cardiovascular, gastrointestinal, nervous, dermatologic, and renal systems. Mechanisms by which eosinophilia leads to end-organ damage are also considered. PMID:26209892

  14. Other manifestations of mixed connective tissue disease.

    PubMed

    Pope, Janet E

    2005-08-01

    This article describes other manifestations of mixed connective tissue disease (MCTD). We focus on inflammatory arthritis, the gastrointestinal tract (the esophagus in particular), the kidney, skin, and hematologic changes such as thrombocytopenia. Due to the complexity of potential organ involvements in MCTD, vigilance with appropriate diagnosis and treatment is warranted. PMID:16084323

  15. VIOLATIONS OF RELATIVITY could be manifest in

    E-print Network

    Walsworth, Ronald L.

    - periments, and relativity is now a basic, everyday tool of experimental physics: particle colliders take ultimate unified theory, some physicists have been investigating the possibili- ty that relativityVIOLATIONS OF RELATIVITY could be manifest in the ticking rates of mirror-image, antimatter clocks

  16. Varied Clinical Manifestations of Amebic Colitis.

    PubMed

    Cooper, Chad J; Fleming, Rhonda; Boman, Darius A; Zuckerman, Marc J

    2015-11-01

    Invasive amebiasis is common worldwide, but infrequently observed in the United States. It is associated with considerable morbidity in patients residing in or traveling to endemic areas. We review the clinical and endoscopic manifestations of amebic colitis to alert physicians to the varied clinical manifestations of this potentially life-threatening disease. Copyright ©Most patients present with watery or bloody diarrhea. Less common presentations of amebic colitis include abdominal pain, overt gastrointestinal bleeding, exacerbation of inflammatory bowel disease, or the incidental association with colon cancer. Amebic liver abscesses are the most frequent complication. Rectosigmoid involvement may be found on colonoscopy; however, most case series have reported that the cecum is the most commonly involved site, followed by the ascending colon. Endoscopic evaluation should be used to assist in the diagnosis, with attention to the observation of colonic inflammation, ulceration, and amebic trophozoites on histopathological examination. PMID:26539949

  17. [Early Manifest Glaucoma Trial update 2004].

    PubMed

    Erb, C

    2005-03-01

    Elevated intraocular pressure (IOP) represents one of the most important risk factors for developing glaucomatous optic neuropathy. The "Early Manifest Glaucoma Trial" (EMGT) was initiated to answer the question of how immediate IOD-lowering therapy affects the progression of early manifest glaucoma and which clinically relevant factors are important. The study compares 129 patients undergoing treatment with 126 patients receiving no IOP-lowering therapy. IOP remained virtually constant in the untreated group, while a reduction of 25% was achieved in the treatment group. The results of the EMGT indicate that glaucoma progression is influenced by higher initial IOP, pseudoexfoliation or bilateral glaucoma, poorer MD value, higher age, and marginal papillary hemorrhage. No clear conclusions can be drawn regarding the significance of cardiovascular risk factors. PMID:15700191

  18. The Chronic Gastrointestinal Manifestations of Chagas Disease

    PubMed Central

    Matsuda, Nilce Mitiko; Miller, Steven M.; Evora, Paulo R. Barbosa

    2009-01-01

    Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer. PMID:20037711

  19. Autoimmune disorders: gastrointestinal manifestations and endoscopic findings.

    PubMed

    Schneider, Alison; Merikhi, Afkhamossadat; Frank, Barbara B

    2006-01-01

    The gastrointestinal tract can be involved in many autoimmune disorders, and women are affected more than men in most of the disease processes discussed. As this article outlines, gastrointestinal manifestations can be either part of the clinical presentation or complications of treatment. Depending on the disease process and the severity of symptoms, gastrointestinal evaluation and treatment can have an important role in the management of these diseases. PMID:16546029

  20. Peripheral Nervous System Manifestations of Infectious Diseases

    PubMed Central

    Brizzi, Kate T.

    2014-01-01

    Infectious causes of peripheral nervous system (PNS) disease are underrecognized but potentially treatable. Heightened awareness educed by advanced understanding of the presentations and management of these infections can aid diagnosis and facilitate treatment. In this review, we discuss the clinical manifestations, diagnosis, and treatment of common bacterial, viral, and parasitic infections that affect the PNS. We additionally detail PNS side effects of some frequently used antimicrobial agents. PMID:25360209

  1. Dermatologic Extrahepatic Manifestations of Hepatitis C

    PubMed Central

    Dedania, Bhavtosh; Wu, George Y.

    2015-01-01

    Hepatitis C virus (HCV) affects millions of people worldwide, and an estimated 3.2 million people in the United States. HCV is a hepatotropic and lymphotropic virus that causes not only liver disease, but also a significant number of extrahepatic manifestations (EHMs). Up to 74% of patients affected by HCV will have HCV-related EHMs of some severity in their lifetime. The EHMs vary from simple cutaneous palpable purpura to complex lymphoproliferative disorders, including lymphomas and immune-complex deposit diseases causing local and/or systemic complications. Mixed cryoglobulinemia (MC) is manifested by multiple systemic organ involvement, mainly skin, kidney, peripheral nerves, and salivary glands, and less frequently causes widespread vasculitis and malignant lymphoma. MC affects up to 3% of HCV-infected patients with cryoglobulinemia of clinical significance, i.e. >6%. Severe disease requires immunosuppressive or plasma exchange therapy. HCV prevalence in the United States in patients with porphyria cutanea tarda (PCT) was reported to be 66%, much higher than that in general population. Therefore, all patients with PCT should be screened for HCV. The skin rash of PCT varies from large blisters to small vesicles and/or milia on the hands. Skin manifestations due to PCT usually respond to anti?HCV treatment together with reducing skin sun exposure, avoiding triggers, having routine phlebotomy (especially for people with chronic iron overload states), and using chloroquine. Lichen planus (LP), which typically affects both the skin and oral mucosa is a chronic inflammatory disease of squamous cell origin affecting about 1% of the worldwide population. The prevalence of HCV in patients with LP varies based on geographic location. We review here the basic pathophysiology, clinical features, and management of dermatologic manifestations of HCV. PMID:26357639

  2. Cutaneous Manifestations of Common Liver Diseases

    PubMed Central

    Dogra, Sunil; Jindal, Rashmi

    2012-01-01

    Skin functions as a window to our overall health and a number of systemic diseases result in various cutaneous changes. Knowledge of these manifestations helps in suspecting an underlying systemic illness. Cutaneous abnormalities are quite common in patients with liver diseases and this article aims to focus on these dermatoses. Cutaneous manifestations seen in patients with liver disease though common are nonspecific. They can also be seen in patients without liver diseases and generally do not indicate about a specific underlying hepatic disorder. The presence of a constellation of signs and symptoms is more useful in pointing toward an underlying hepatobiliary condition. The commonest symptom in patients with liver disease is pruritus which is often protracted and disabling. Other common features include spider angiomas, palmar erythema, paper money skin, xanthelasmas, pigmentary changes, and nutritional deficiencies. In this article, first the common cutaneous manifestations that may be associated with liver disorders are discussed and then common liver diseases with their specific cutaneous findings are discussed. Cutaneous abnormalities may be the first clue to the underlying liver disease. Identifying them is crucial for early diagnosis and better management. PMID:25755383

  3. [Chronic polyarthritis as isolated manifestation of toxocariasis.

    PubMed

    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

    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

  4. 76 FR 36363 - Hazardous Waste Manifest Printing Specifications Correction Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... Transportation's Hazardous Materials transportation laws. The requirement for consistency and uniformity in the... materials transportation, Hazardous waste, Imports, Labeling, Packaging and containers, Reporting and... standardized manifest form during the promulgation of the March 4, 2005 Manifest Form Revisions Rule (70...

  5. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.74 Incomplete (pro forma) manifest. (a)...

  6. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.74 Incomplete (pro forma) manifest. (a)...

  7. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.74 Incomplete (pro forma) manifest. (a)...

  8. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.74 Incomplete (pro forma) manifest. (a)...

  9. 19 CFR 122.74 - Incomplete (pro forma) manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.74 Incomplete (pro forma) manifest. (a)...

  10. 77 FR 54863 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ...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...

  11. 40 CFR 263.25 - Electronic manifest signatures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Electronic manifest signatures. 263.25...PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE...and Recordkeeping § 263.25 Electronic manifest signatures. (a)...

  12. Gene Therapy for Neurologic Manifestations of Mucopolysaccharidoses

    PubMed Central

    Wolf, Daniel A.; Banerjee, Sharbani; Hackett, Perry B.; Whitley, Chester B.; McIvor, R. Scott; Low, Walter C.

    2015-01-01

    Introduction Mucopolysaccharidoses are a family of lysosomal disorders caused by mutations in genes that encode enzymes involved in the catabolism of glycoaminoglycans. These mutations affect multiple organ systems and can be particularly deleterious to the nervous system. At the present time, enzyme replacement therapy and hematopoietic stem-cell therapy are used to treat patients with different forms of these disorders. However, to a great extent the nervous system is not adequately responsive to current therapeutic approaches. Areas Covered Recent advances in gene therapy show great promise for treating mucopolysaccharidoses. This article reviews the current state of the art for routes of delivery in developing genetic therapies for treating the neurologic manifestations of mucopolysaccharidoses. Expert Opinion Gene therapy for treating neurological manifestations of mucopolysaccharidoses can be achieved by intraventricular, intrathecal, intranasal, and systemic administration. The intraventricular route of administration appears to provide the most wide-spread distribution of gene therapy vectors to the brain. The intrathecal route of delivery results in predominant distribution to the caudal areas of the brain while the intranasal route of delivery results in good distribution to the rostral areas of brain. The systemic route of delivery via intravenous delivery can also achieve wide spread delivery to the CNS, however, the distribution to the brain is greatly dependent on the vector system. Intravenous delivery using lentiviral vectors appear to be less effective than adeno-associated viral (AAV) vectors. Moreover, some subtypes of AAV vectors are more effective than others in crossing the blood-brain-barrier. In summary, the recent advances in gene vector technology and routes of delivery to the CNS will facilitate the clinical translation of gene therapy for the treatment of the neurological manifestations of mucopolysaccharidoses. PMID:25510418

  13. Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

    E-print Network

    Nizet, Victor

    Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus Mark J. Walker,a Timothy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267 Pharyngitis

  14. Manifestation of optical activity in different materials

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

    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.

  15. Sarcoidosis: Oral and extra-oral manifestation

    PubMed Central

    Gupta, Sanjay; Tripathi, Amitandra Kumar; Kumar, Vivek; Saimbi, Charanjit Singh

    2015-01-01

    Sarcoidosis is a multisystem granulomatous disease, which is usually associated with the formation of noncaseating granulomas in affected tissues and organs. It is mostly present with bilateral hilar lymphadenopathy, pulmonary infiltration, ocular, and cutaneous lesions. Oral manifestations of this disease are relatively rare. The present case report shows a 40-year-old male with lesions in the soft tissue of oral cavity (buccal mucosa, gingiva, and palate) and a diagnosis of sarcoidosis was established following hematological, biochemical and pulmonary function tests, chest radiograph, and histopathological investigation.

  16. Flight Manifesting Process for NASA Microgravity Payloads

    NASA Technical Reports Server (NTRS)

    Matisak, Brian; Boudreaux, Mark; Anderson, Sherwood; Ramage, William; Henderson, Robin N. (Technical Monitor)

    2001-01-01

    The objective of NASA's Microgravity Research Program is to utilize the low gravity environment of space to explore the nature of physical phenomena that contributes to progress in science and technology on Earth. Under the oversight of NASA Headquarters, the Microgravity Research Program Office (MRPO) at the Marshall Space Flight Center (MSFC) assumes all program management responsibilities associated with Microgravity Research and Space Product Development. One program management responsibility that plays a vital role to the success of the MRPO is the flight manifesting process for MRPO-sponsored payloads. In this paper, the authors will examine the various processes utilized by MRPO personnel in acquiring flight opportunities for MRPO-sponsored payloads.

  17. Skin manifestations of chronic kidney disease.

    PubMed

    Robles-Mendez, J C; Vazquez-Martinez, O; Ocampo-Candiani, J

    2015-10-01

    Skin manifestations associated with chronic kidney disease are very common. Most of these conditions present in the end stages and may affect the patient's quality of life. Knowledge of these entities can contribute to establishing an accurate diagnosis and prognosis. Severe renal pruritus is associated with increased mortality and a poor prognosis. Nail exploration can provide clues about albumin and urea levels. Nephrogenic systemic fibrosis is a preventable disease associated with gadolinium contrast. Comorbidities, such as diabetes mellitus and secondary hyperparathyroidism, can lead to acquired perforating dermatosis and calciphylaxis, respectively. Effective and innovative treatments are available for all of these conditions. PMID:26093993

  18. Extrahepatic Manifestations of Hepatitis C Virus.

    PubMed

    Viganò, Mauro; Colombo, Massimo

    2015-12-01

    Chronic infection with the hepatitis C virus (HCV) is a major cause of liver disease worldwide and is also responsible for extrahepatic manifestations (EHMs) involving the skin, kidneys, salivary glands, eyes, thyroid, and immune system. Mixed cryoglobulinemia is the prototype EHM related to HCV infection. Although these HCV-related EHMs may contribute to significant rates of morbidity affecting patient's quality of life and survival, most of these complications can reverse after HCV eradication by interferon therapy. This notwithstanding, individual patients may have an irreversible injury in various organs that is not reversed by a cure of the HCV infection. PMID:26600219

  19. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... returned to the generator by the designated facility (following the procedures of 40 CFR 264.72(f) or 265...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain the handwritten signature of...

  20. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... returned to the generator by the designated facility (following the procedures of 40 CFR 264.72(f) or 265...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain the handwritten signature of...

  1. 40 CFR 262.24 - Use of the electronic manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... compliance with 49 CFR 177.817, a generator originating an electronic manifest must also provide the initial... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.24 Use of the electronic... requirement in these regulations for a generator to keep or retain a copy of each manifest is satisfied...

  2. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... returned to the generator by the designated facility (following the procedures of 40 CFR 264.72(f) or 265...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain the handwritten signature of...

  3. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... returned to the generator by the designated facility (following the procedures of 40 CFR 264.72(f) or 265...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain the handwritten signature of...

  4. 40 CFR 262.23 - Use of the manifest.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... returned to the generator by the designated facility (following the procedures of 40 CFR 264.72(f) or 265...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.23 Use of the manifest. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain the handwritten signature of...

  5. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Air cargo manifest. 122.48 Section 122.48 Customs... AIR COMMERCE REGULATIONS Aircraft Entry and Entry Documents; Electronic Manifest Requirements for..., and Overflying the United States § 122.48 Air cargo manifest. (a) When required. Except as provided...

  6. 49 CFR 172.205 - Hazardous waste manifest.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) hazardous waste manifest (manifest) is prepared in accordance with 40 CFR 262.20 and is signed, carried, and... in accordance with 40 CFR 263.22. (5) Before accepting hazardous waste from a rail transporter, a non.... (h) A hazardous waste manifest required by 40 CFR part 262, containing all of the...

  7. 49 CFR 172.205 - Hazardous waste manifest.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) hazardous waste manifest (manifest) is prepared in accordance with 40 CFR 262.20 and is signed, carried, and... in accordance with 40 CFR 263.22. (5) Before accepting hazardous waste from a rail transporter, a non.... (h) A hazardous waste manifest required by 40 CFR part 262, containing all of the...

  8. 49 CFR 172.205 - Hazardous waste manifest.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) hazardous waste manifest (manifest) is prepared in accordance with 40 CFR 262.20 and is signed, carried, and... in accordance with 40 CFR 263.22. (5) Before accepting hazardous waste from a rail transporter, a non.... (h) A hazardous waste manifest required by 40 CFR part 262, containing all of the...

  9. 49 CFR 172.205 - Hazardous waste manifest.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) hazardous waste manifest (manifest) is prepared in accordance with 40 CFR 262.20 and is signed, carried, and... in accordance with 40 CFR 263.22. (5) Before accepting hazardous waste from a rail transporter, a non.... (h) A hazardous waste manifest required by 40 CFR part 262, containing all of the...

  10. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Air cargo manifest. 122.48 Section 122.48 Customs... AIR COMMERCE REGULATIONS Aircraft Entry and Entry Documents; Electronic Manifest Requirements for..., and Overflying the United States § 122.48 Air cargo manifest. (a) When required. Except as provided...

  11. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Air cargo manifest. 122.48 Section 122.48 Customs... AIR COMMERCE REGULATIONS Aircraft Entry and Entry Documents; Electronic Manifest Requirements for..., and Overflying the United States § 122.48 Air cargo manifest. (a) When required. Except as provided...

  12. Canine MPV17 truncation without clinical manifestations.

    PubMed

    Hänninen, Reetta L; Ahonen, Saija; Màrquez, Merce; Myöhänen, Maarit J; Hytönen, Marjo K; Lohi, Hannes

    2015-01-01

    Mitochondrial DNA depletion syndromes (MDS) are often serious autosomal recessively inherited disorders characterized by tissue-specific mtDNA copy number reduction. Many genes, including MPV17, are associated with the hepatocerebral form of MDS. MPV17 encodes for a mitochondrial inner membrane protein with a poorly characterized function. Several MPV17 mutations have been reported in association with a heterogeneous group of early-onset manifestations, including liver disease and neurological problems. Mpv17-deficient mice present renal and hearing defects. We describe here a MPV17 truncation mutation in dogs. We found a 1-bp insertion in exon 4 of the MPV17 gene, resulting in a frameshift and early truncation of the encoded protein. The mutation halves MPV17 expression in the lymphocytes of the homozygous dogs and the truncated protein is not translated in transfected cells. The insertion mutation is recurrent and exists in many unrelated breeds, although is highly enriched in the Boxer breed. Unexpectedly, despite the truncation of MPV17, we could not find any common phenotypes in the genetically affected dogs. The lack of observable phenotype could be due to a late onset, mild symptoms or potential tissue-specific compensatory mechanisms. This study suggests species-specific differences in the manifestation of the MPV17 defects and establishes a novel large animal model to further study MPV17 function and role in mitochondrial biology. PMID:26353863

  13. CANDLE SYNDROME: Orodfacial manifestations and dental implications.

    PubMed

    Roberts, T; Stephen, L; Scott, C; di Pasquale, T; Naser-Eldin, A; Chetty, M; Shaik, S; Lewandowski, L; Beighton, P

    2015-01-01

    A South African girl with CANDLE Syndrome is reported with emphasis on the orodental features and dental management. Clinical manifestations included short stature, wasting of the soft tissue of the arms and legs, erythematous skin eruptions and a prominent abdomen due to hepatosplenomegaly. Generalized microdontia, confirmed by tooth measurement and osteopenia of her jaws, confirmed by digitalized radiography, were previously undescribed syndromic components. Intellectual impairment posed problems during dental intervention. The carious dental lesions and poor oral hygiene were treated conservatively under local anaesthetic. Prophylactic antibiotics were administered an hour before all procedures.Due to the nature of her general condition, invasive dental procedures were minimal. Regular follow-ups were scheduled at six monthly intervals. During this period, her overall oral health status had improved markedly.The CANDLE syndrome is a rare condition with grave complications including immunosuppression and diabetes mellitus. As with many genetic disorders, the dental manifestations are often overshadowed by other more conspicuous and complex syndromic features. Recognition of both the clinical and oral changes that occur in the CANDLE syndrome facilitates accurate diagnosis and appropriate dental management of this potentially lethal condition. PMID:26711936

  14. Neurological manifestations in patients with antiphospholipid syndrome

    PubMed Central

    Etemadifar, Masoud; Tahani, Soheil; Toghianifar, Nafiseh; Rahaimi, Marzieh; Eskandari, Nahid

    2013-01-01

    Background Anti-phospholipids syndrome (APS) is considered a non inflammatory auto-immune disease with a significant thrombophilic risk with varied clinical manifestations. The purpose of the current study was to investigate the frequency of thrombotic and non-thrombotic events in patients with APS. Methods In this retrospective study, 102 definite APS subjects were recruited (2007-2011) at Alzahra Hospital, Isfahan, Iran. The patients were referred to Multiple Sclerosis Clinic with the diagnosis of definite APS according to 2006 Sydney's criteria. Disorders associated with APS such as pregnancy complication, vascular thrombosis and livedo reticularis (LR) were assessed. Neurological signs and symptoms such as cognitive dysfunction were recorded. Data analyses were performed using SPSS software and P < 0.05 were considered to be statistically significant. Results Our findings showed that majority of female gender, higher rate of ischemic thrombotic stroke and high miscarriage lied in a large number of APS patients. Conclusion Overall recurrent miscarriage is a common complication among (antiphospholidpid antibody) aPL patients. Furthermore, ischemic stroke is the second common neurological manifestations of APS patients. PMID:24250929

  15. Citing geospatial feature inventories with XML manifests

    NASA Astrophysics Data System (ADS)

    Bose, R.; McGarva, G.

    2006-12-01

    Today published scientific papers include a growing number of citations for online information sources that either complement or replace printed journals and books. We anticipate this same trend for cartographic citations used in the geosciences, following advances in web mapping and geographic feature-based services. Instead of using traditional libraries to resolve citations for print material, the geospatial citation life cycle will include requesting inventories of objects or geographic features from distributed geospatial data repositories. Using a case study from the UK Ordnance Survey MasterMap database, which is illustrative of geographic object-based products in general, we propose citing inventories of geographic objects using XML feature manifests. These manifests: (1) serve as a portable listing of sets of versioned features; (2) could be used as citations within the identification portion of an international geospatial metadata standard; (3) could be incorporated into geospatial data transfer formats such as GML; but (4) can be resolved only with comprehensive, curated repositories of current and historic data. This work has implications for any researcher who foresees the need to make or resolve references to online geospatial databases.

  16. Thoracic manifestations of collagen vascular diseases.

    PubMed

    Capobianco, Julia; Grimberg, Alexandre; Thompson, Bruna M; Antunes, Viviane B; Jasinowodolinski, Dany; Meirelles, Gustavo S P

    2012-01-01

    Collagen vascular diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. The collagen vascular diseases that most commonly involve the lung are rheumatoid arthritis, progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and dermatomyositis, mixed connective tissue disease, and Sjögren syndrome. Interstitial lung disease and pulmonary arterial hypertension are the main causes of mortality and morbidity among patients with collagen vascular diseases. Given the broad spectrum of possible thoracic manifestations and the varying frequency with which different interstitial lung diseases occur, the interpretation of thoracic images obtained in patients with collagen vascular diseases can be challenging. The task may be more difficult in the presence of treatment-related complications such as drug toxicity and infections, which are common in this group of patients. Although chest radiography is most often used for screening and monitoring of thoracic alterations, high-resolution computed tomography can provide additional information about lung involvement in collagen vascular diseases and may be especially helpful for differentiating specific disease patterns in the lung. General knowledge about the manifestations of thoracic involvement in collagen vascular diseases allows radiologists to provide better guidance for treatment and follow-up of these patients. PMID:22236892

  17. Thoracic manifestations of connective tissue diseases.

    PubMed

    Ruano, Carina A; Lucas, Rita N; Leal, Cecília I; Lourenço, João; Pinheiro, Sofia; Fernandes, Otília; Figueiredo, Luísa

    2015-01-01

    Connective tissue diseases (CTDs) comprise several immunologic systemic disorders, each of which associated with a particular set of clinical manifestations and autoimmune profile. CTDs may cause numerous thoracic abnormalities, which vary in frequency and pattern according to the underlying disorder. The CTDs that most commonly involve the respiratory system are progressive systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, polymyositis, dermatomyositis, and mixed connective tissue disease. Pulmonary abnormalities in this group of patients may result from CTD-related lung disease or treatment complications, namely drug toxicity and opportunistic infections. The most important thoracic manifestations of CTDs are interstitial lung disease and pulmonary arterial hypertension, with nonspecific interstitial pneumonia being the most common pattern of interstitial lung disease. High-resolution computed tomography is a valuable tool in the initial evaluation and follow-up of patients with CTDs. As such, general knowledge of the most common high-resolution computed tomographic features of CTD-related lung disease allows the radiologist to contribute to better patient management. PMID:25131613

  18. Managing IBD outside the gut: ocular manifestations.

    PubMed

    Calvo, P; Pablo, L

    2013-01-01

    Extraintestinal manifestations are common in inflammatory bowel disease (IBD), being reported in over 25% of patients. Ocular complications of IBD occur in around 10% of cases, but may precede systemic symptoms and are usually nonspecific. Complications of therapy, such as cataracts or glaucoma from steroid use or keratoconjunctivitis sicca related to 5-aminosalicylic acid medications, may also involve the eyes. The pathogenesis remains unclear, but factors such as the extent of intestinal disease, disease activity, and the presence of associated arthritis have been associated with ocular involvement. Conjunctivitis, episcleritis, scleritis and uveitis are by far the most common ophthalmic complications of IBD. However, posterior uveitis, intraretinal hemorrhages, vasculitis, choroiditis, optic neuropathy, and vaso-occlusive phenomena may also occur. The most frequent severe ocular manifestation is anterior uveitis (more common in women). It usually presents as a mild anterior nongranulomatous uveitis (60% of the cases). The inflammation in the eye and the inflammation in the gut are rarely correlated. Patients with uveitis, scleritis, and other anterior segment inflammation usually respond to steroids (topical, periocular or systemic). If the inflammation is resistant to steroids, or if appreciable steroid adverse effects are encountered, systemic immunosuppressive treatment should be considered; this is more likely in HLA-B27-positive patients with uveitis. Evaluation of the eye should be a routine component in the care of patients with IBD. PMID:24030231

  19. Hematologic manifestations of Helicobacter pylori infection

    PubMed Central

    Campuzano-Maya, Germán

    2014-01-01

    Helicobacter pylori (H. pylori) is the most common infection in humans, with a marked disparity between developed and developing countries. Although H. pylori infections are asymptomatic in most infected individuals, they are intimately related to malignant gastric conditions such as gastric cancer and gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to benign diseases such as gastritis and duodenal and gastric peptic ulcers. Since it was learned that bacteria could colonize the gastric mucosa, there have been reports in the medical literature of over 50 extragastric manifestations involving a variety medical areas of specialization. These areas include cardiology, dermatology, endocrinology, gynecology and obstetrics, hematology, pneumology, odontology, ophthalmology, otorhinolaryngology and pediatrics, and they encompass conditions with a range of clear evidence between the H. pylori infection and development of the disease. This literature review covers extragastric manifestations of H. pylori infection in the hematology field. It focuses on conditions that are included in international consensus and management guides for H. pylori infection, specifically iron deficiency, vitamin B12 (cobalamin) deficiency, immune thrombocytopenia, and MALT lymphoma. In addition, there is discussion of other conditions that are not included in international consensus and management guides on H. pylori, including auto-immune neutropenia, antiphospholipid syndrome, plasma cell dyscrasias, and other hematologic diseases. PMID:25278680

  20. Canine MPV17 truncation without clinical manifestations

    PubMed Central

    Hänninen, Reetta L.; Ahonen, Saija; Màrquez, Merce; Myöhänen, Maarit J.; Hytönen, Marjo K.; Lohi, Hannes

    2015-01-01

    ABSTRACT Mitochondrial DNA depletion syndromes (MDS) are often serious autosomal recessively inherited disorders characterized by tissue-specific mtDNA copy number reduction. Many genes, including MPV17, are associated with the hepatocerebral form of MDS. MPV17 encodes for a mitochondrial inner membrane protein with a poorly characterized function. Several MPV17 mutations have been reported in association with a heterogeneous group of early-onset manifestations, including liver disease and neurological problems. Mpv17-deficient mice present renal and hearing defects. We describe here a MPV17 truncation mutation in dogs. We found a 1-bp insertion in exon 4 of the MPV17 gene, resulting in a frameshift and early truncation of the encoded protein. The mutation halves MPV17 expression in the lymphocytes of the homozygous dogs and the truncated protein is not translated in transfected cells. The insertion mutation is recurrent and exists in many unrelated breeds, although is highly enriched in the Boxer breed. Unexpectedly, despite the truncation of MPV17, we could not find any common phenotypes in the genetically affected dogs. The lack of observable phenotype could be due to a late onset, mild symptoms or potential tissue-specific compensatory mechanisms. This study suggests species-specific differences in the manifestation of the MPV17 defects and establishes a novel large animal model to further study MPV17 function and role in mitochondrial biology. PMID:26353863

  1. [Dermato-mucosal manifestations of Behçet's disease].

    PubMed

    Francès, C

    1999-11-01

    Oral and genital aphthae are the main clinical dermatologic manifestations of Behçet's disease. They look like those that occur in other aphthosis. Cutaneous lesions include pseudofolliculitis, folliculitis, erythema nodosum-like lesions, Sweet's-like lesions and pyoderma gangrenosum-like lesions. Histologically, these lesions are frequently perivascular with proeminent infiltrates of neutrophils and/or lymphocytes. Hypersensibility to needle pricks is explored by the pathergy test which sensibility is highly variable depending on the countries. When there is no systemic lesions requiring oral corticosteroids or immunosuppressive therapy, colchicine, aspirine, or dapsone may be prescribed. Thalidomide is sometimes required if aphthosis is refractory to other treatments despite its neurotixic and teratogenic effects. PMID:10637669

  2. Brucella arteritis: clinical manifestations, treatment, and prognosis.

    PubMed

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

    2014-06-01

    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

  3. Secondary Syphilis: Uncommon Manifestations a Common Disease

    PubMed Central

    McPhee, Stephen J.

    1984-01-01

    Reports of cases of primary and secondary syphilis are increasing in the United States, particularly in urban areas and among homosexual men. While primary syphilis poses little diagnostic difficulty, many physicians are unfamiliar with the multisystem nature of secondary lues. Patients who have secondary syphilis commonly present with systemic signs, skin rash, mucous membrane lesions and generalized adenopathy. Less commonly, secondary syphilis may occur as acute meningitis, sensorineural hearing loss, iritis, anterior uveitis, optic neuritis, Bell's palsy, gastropathy, proctitis, hepatitis, pulmonary infiltration, nephrotic syndrome, glomerulonephritis, periostitis, tenosynovitis and polyarthritis. The diagnosis of secondary syphilis is easily confirmed. Its various manifestations are readily treated with penicillin and, if treated early, are entirely reversible. Two recent cases of secondary syphilis, one presenting as nephrotic syndrome and one as chorioretinitis and ptosis, illustrate the usual and unusual features of this common infection. Images PMID:6702190

  4. When does an illness begin: genetic discrimination and disease manifestation.

    PubMed

    Prince, Anya E R; Berkman, Benjamin E

    2012-01-01

    The Genetic Information Nondiscrimination Act of 2008 (GINA) was passed to encourage patients to seek genetic testing that could improve health outcomes and provide opportunities for preventive measures. GINA protects individuals from discrimination based upon genetic information, but not upon manifested diseases and conditions. Because the manifestation of a disease establishes a threshold of protection for individuals under GINA, the definition of manifestation is crucial to understanding the scope of the bill. This paper examines the range of possible legal definitions of disease manifestation and explores the historical struggle that courts have faced when trying to apply these different definitions. Specifically, the paper examines three frameworks that courts have used in the past to interpret the manifestation of a disease; "manifestation as apparent symptoms,"manifestation as patient action," and "manifestation as physician action." We argue that the "manifestation as physician action" is the best framework to utilize in this law generally, but that the definition of manifestation should be read in the light most favorable to a plaintiff in order to achieve the underlying goals of GINA. PMID:23061591

  5. Paradoxical Manifestation is Common in HIV-negative Tuberculous Meningitis.

    PubMed

    Tai, Mei-Ling Sharon; Nor, Hazman Mohd; Kadir, Khairul Azmi Abdul; Viswanathan, Shanthi; Rahmat, Kartini; Zain, Norzaini Rose Mohd; Ong, Kuo Ghee; Rafia, Mohd Hanip; Tan, Chong Tin

    2016-01-01

    Paradoxical manifestation is worsening of pre-existing tuberculous lesion or appearance of new lesions in patients whose condition initially improved with antituberculous treatment. Our hypothesis was that paradoxical manifestation in non-HIV tuberculous meningitis (TBM) patients was underestimated and this could contribute to patients' prognosis. This was the first systemic study of paradoxical manifestation in HIV-negative TBM patients.Between 2009 and 2014, TBM patients were studied prospectively in 2 hospitals. Clinical features, cerebrospinal fluid, and radiological findings were monitored. Paradoxical manifestation was divided into definite (4 weeks or more) and probable (between 14 and 27 d) after commencement of antituberculous treatment.Forty-one non-HIV TBM patients were recruited. Definite paradoxical manifestation occurred in 23/41 (56%) of the patients. Time to onset of paradoxical manifestation was between 28 days and 9 months, and majority was between 28 and 50 days.Neuroimaging manifestation in the brain (22/41 patients, 54%) and clinical manifestation (22/41 patients, 54%) were most commonly seen, followed by cerebrospinal fluid manifestation (7/41 patients, 17%). Neuroimaging changes most commonly seen were worsening of leptomeningeal enhancement, new infarcts, new tuberculomas, and enlargement of tuberculoma. Initial Computed Tomography Angiography/magnetic resonance angiography brain showed vasculitis in 14 patients, with 2 (12.5%) showing paradoxical vasculitis during follow-up.Recurrence of the paradoxical manifestation was seen in 7/23 (30%) of the patients. More than half (14/23, 61%) of the patients improved, 6 (26%) patients died, and 3 (13%) patients had persistent neurological deficit.Paradoxical manifestation was very common in non-HIV TBM patients. Neuroimaging paradoxical manifestation of 2-4 weeks may not be paradoxical manifestation but could be delayed treatment response. PMID:26735523

  6. Applying a presentation content manifest for signing clinical documents.

    PubMed

    Lien, Chung-Yueh; Hsiao, Chia-Hung; Huang, Lu-Chou; Kao, Tsair

    2010-04-01

    In this paper, we demonstrate how to digitally sign a content manifest of a presentable clinical document that contains multiple clinical data with presentations. Only one signature is needed for an entire clinical document with multiple data resources, which can reduce the computation time during signing and verifying processes. In the radiology field, a report may contain text descriptions, images, and annotations that are stored separately in different data resources. The manifest signature would be a proper means for integrity checking for all the clinical data within the manifest. The manifest signature can be extended with a trusted third party to add a digital time signature for long-term verifiability. The performance of the manifest signing compared with that of a traditional digital signing was evaluated. The new manifest signature can be used for signing different types of presentable clinical documents, such HL7 CDA documents and DICOM image reports. PMID:19290579

  7. Neuro-ophthalmic manifestations of prematurity.

    PubMed

    Chhablani, Preeti Patil; Kekunnaya, Ramesh

    2014-10-01

    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

  8. Radiation nephritis. Clinical manifestations and pathophysiologic mechanisms

    SciTech Connect

    Krochak, R.J.; Baker, D.G.

    1986-05-01

    Radiation nephritis is both volume and dose related. Clinical experience would indicate that a minimum of one third of the renal volume needs to be excluded from nephrotoxic doses which appears to have a threshold of 2,000 cGy. The site of damage leading to renal failure appears to be the microvasculature ultimately expressed as glomerulosclerosis. How much direct damage to the tubular system contributes to this process is unclear, but undoubtedly the resultant systemic physiologic effects potentiate the expression of damage in the irradiated kidney. The acute syndrome, with all the potential manifestations of renal failure, rarely presents sooner than six months and appears to have no clear prodrome, although it would seem reasonable that a subclinical syndrome consisting of abnormalities detectable by urinalysis may occur. Treatment of radiation-induced nephritis or hypertension is no different from treatment for nephritis from any other cause and should be aggressive with lifelong follow-up. Carcinogenesis is a rare late expression of radiation-induced kidney damage. 25 references.

  9. Endocrine manifestations of chronic HCV infection.

    PubMed

    Caviglia, G; Rosso, C; Fagoonee, S; Cisarò, F; Andrealli, A; Smedile, A; Pellicano, R

    2015-12-01

    Chronic hepatitis C virus (HCV) infection has been associated with a great number of extra-hepatic manifestations (EHMs), including several endocrine disorders. Currently available epidemiological, clinical and experimental data do not show a link between HCV and all EHMs. Thyroid disorders (TD) and type 2 diabetes, for example, are the most frequent endocrine alterations in patients with chronic HCV infection, but there are only weak evidences that HCV could be involved in hypothalamic-pituitary axis perturbation, bone metabolism alteration and sexual dysfunctions induction. Thus, this issue needs further investigation. Prospective studies have also shown that interferon (IFN)-based therapy for chronic HCV infection can induce or worsen EHMs. In particular, IFN has been associated with development of autoimmunity and/or TD in up to 40% of chronic HCV infected patients. Hence, a careful monitoring of thyroid function should be performed in such patients. The recent approval of direct-acting antiviral agents in IFN-free regimens for chronic hepatitis C treatment will dramatically reduce not only liver-related mortality but also morbidity due to EHMs. PMID:26350102

  10. Neurologic Manifestations of Chronic Methamphetamine Abuse

    PubMed Central

    Rusyniak, Daniel E.

    2013-01-01

    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

  11. Oral Manifestation in Mentally Challenged Children

    PubMed Central

    Rahul, V K; Mathew, Cinil; Jose, Sunil; Thomas, George; Noushad, M C; Feroz, T P Mohammed

    2015-01-01

    Background: In general, mentally challenged children have higher rates poor oral hygiene, gingivitis and periodontitis than the general population. An investigation was undertaken to assess the oral manifestations of mentally challenged children in Chennai, India. Materials and Methods: The study group consisted of 150 children (70 Down syndrome patients and 80 cerebral palsy patients). Of which, 93 patients were males and 57 were females. Results: Speech difficulty hindered the communication between the patient and the dentist. Mastication and swallowing difficulties were also present in few children. Profuse salivation was a cause for drooling of saliva down the cheeks, which was a constant finding in cerebral palsy children. The oral hygiene statuses of the patient were significantly poor. The prevalence of periodontitis was 35.7% in Down syndrome and 55.0% in cerebral palsy patients. Whereas, the prevalence of gingivitis was found to be 92.9% and 61.3% respectively. The prevalence of fractured maxillary anterior teeth was found to be more evident in cerebral palsy patients (62.9%) when compared to Down syndrome patients (0.0%). An increase in age shows an increase in the decayed-missing-filled teeth which is statistically significant. Conclusion: The prominent findings like flat nasal bridge (94.3%), hypertelorism (92.9%), high arched palate (78.6%) and fissured tongue (78.6%) in our study, suggest that they could be used as a reliable clinical markers to diagnose Down syndrome condition. PMID:25859105

  12. Extraintestinal Manifestations of Inflammatory Bowel Disease

    PubMed Central

    Schoepfer, Alain; Scharl, Michael; Lakatos, Peter L.; Navarini, Alexander; Rogler, Gerhard

    2015-01-01

    Abstract: Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are frequent and may occur before or after IBD diagnosis. EIM may impact the quality of life for patients with IBD significantly requiring specific treatment depending on the affected organ(s). They most frequently affect joints, skin, or eyes, but can also less frequently involve other organs such as liver, lungs, or pancreas. Certain EIM, such as peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum, are frequently associated with active intestinal inflammation and usually improve by treatment of the intestinal activity. Other EIM, such as uveitis or ankylosing spondylitis, usually occur independent of intestinal inflammatory activity. For other not so rare EIM, such as pyoderma gangrenosum and primary sclerosing cholangitis, the association with the activity of the underlying IBD is unclear. Successful therapy of EIM is essential for improving quality of life of patients with IBD. Besides other options, tumor necrosis factor antibody therapy is an important therapy for EIM in patients with IBD. PMID:26154136

  13. Sickle cell disease: renal manifestations and mechanisms.

    PubMed

    Nath, Karl A; Hebbel, Robert P

    2015-03-01

    Sickle cell disease (SCD) substantially alters renal structure and function, and causes various renal syndromes and diseases. Such diverse renal outcomes reflect the uniquely complex vascular pathobiology of SCD and the propensity of red blood cells to sickle in the renal medulla because of its hypoxic, acidotic, and hyperosmolar conditions. Renal complications and involvement in sickle cell nephropathy (SCN) include altered haemodynamics, hypertrophy, assorted glomerulopathies, chronic kidney disease, acute kidney injury, impaired urinary concentrating ability, distal nephron dysfunction, haematuria, and increased risks of urinary tract infections and renal medullary carcinoma. SCN largely reflects an underlying vasculopathy characterized by cortical hyperperfusion, medullary hypoperfusion, and an increased, stress-induced vasoconstrictive response. Renal involvement is usually more severe in homozygous disease (sickle cell anaemia, HbSS) than in compound heterozygous types of SCD (for example HbSC and HbS?(+)-thalassaemia), and is typically mild, albeit prevalent, in the heterozygous state (sickle cell trait, HbAS). Renal involvement contributes substantially to the diminished life expectancy of patients with SCD, accounting for 16-18% of mortality. As improved clinical care promotes survival into adulthood, SCN imposes a growing burden on both individual health and health system costs. This Review addresses the renal manifestations of SCD and focuses on their underlying mechanisms. PMID:25668001

  14. Clinical manifestations and management of Gaucher disease

    PubMed Central

    Linari, Silvia; Castaman, Giancarlo

    2015-01-01

    Summary Gaucher disease is a rare multi-systemic metabolic disorder caused by the inherited deficiency of the lysosomal enzyme ?-glucocerebrosidase, which leads to the accumulation of its normal substrate, glucocerebroside, in tissue macrophages with damage to haematological, visceral and bone systems. Anaemia, thrombocytopenia, enlargement of liver and/or spleen, skeletal abnormalities (osteopenia, lytic lesions, pathological fractures, chronic bone pain, bone crisis, bone infarcts, osteonecrosis and skeletal deformities) are typical manifestations of the most prevalent form of the disease, the so-called non-neuronopathic type 1. However, severity and coexistence of different symptoms are highly variable. The determination of deficient ?-glucocerebrosidase activity in leukocytes or fibroblasts by enzymatic assay is the gold standard for the diagnosis of Gaucher disease. Comprehensive and reproducible evaluation and monitoring of all clinically relevant aspects are fundamental for the effective management of Gaucher disease patients. Enzyme replacement therapy has been shown to be effective in reducing glucocerebroside storage burden and diminishing the deleterious effects caused by its accumulation. Tailored treatment plan for each patient should be directed to symptom relief, general improvement of quality of life, and prevention of irreversible damage. PMID:26604942

  15. Hematological manifestations and complications of Gaucher disease.

    PubMed

    Linari, Silvia; Castaman, Giancarlo

    2016-01-01

    Gaucher disease is a multisystemic metabolic disorder due to a genetic deficiency of the lysosomal enzyme glucocerebrosidase, which leads to the accumulation within the lysosomes of macrophages of its natural substrate, glucosylceramide and its deacylated product glucosylsphingosine. The most prevalent form of the disease is the so-called non-neuronopathic form (type 1) characterized by anemia, thrombocytopenia, enlargement of liver and/or spleen, skeletal abnormalities. Etiology of anemia and thrombocytopenia may be multifactorial and not necessarily predicted by the degree of splenomegaly. Bleeding diathesis may not always be related to absolute platelet count but may be influenced by abnormal platelet function or coagulation factor deficiencies. A significant increased risk of severe hematological co-morbidities, including multiple myeloma and B-cell lymphoma, has been reported. Accumulation of glucosylceramide and glucosylsphingosyne in macrophages and the resulting chronic inflammation with the secretion of cytokines leading to polyclonal and monoclonal B cell proliferation up to multiple myeloma, as a continuum clonal expansion, is a key pathophysiological mechanism. Enzyme replacement therapy has been shown to be effective in reducing glucosylceramide storage burden and the deleterious effects caused by its accumulation, including hematological manifestations. PMID:26565753

  16. Neuro-ophthalmic manifestations of prematurity

    PubMed Central

    Chhablani, Preeti Patil; Kekunnaya, Ramesh

    2014-01-01

    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

  17. Monogenic autoinflammatory diseases: concept and clinical manifestations.

    PubMed

    Almeida de Jesus, Adriana; Goldbach-Mansky, Raphaela

    2013-06-01

    The objective of this review is to describe the clinical manifestations of the growing spectrum of monogenic autoinflammatory diseases including recently described syndromes. The autoinflammatory diseases can be grouped based on clinical findings: 1. the three classic hereditary "periodic fever syndromes", familial Mediterranean Fever (FMF); TNF receptor associated periodic syndrome (TRAPS); and mevalonate kinase deficiency/hyperimmunoglobulinemia D and periodic fever syndrome (HIDS); 2. the cryopyrin associated periodic syndromes (CAPS), comprising familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID) or CINCA, and; 3. pediatric granulomatous arthritis (PGA); 4. disorders presenting with skin pustules, including deficiency of interleukin 1 receptor antagonist (DIRA); Majeed syndrome; pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome; deficiency of interleukin 36 receptor antagonist (DITRA); CARD14 mediated psoriasis (CAMPS), and early-onset inflammatory bowel diseases (EO-IBD); 5. inflammatory disorders caused by mutations in proteasome components, the proteasome associated autoinflammatory syndromes (PRAAS) and 6. very rare conditions presenting with autoinflammation and immunodeficiency. PMID:23711932

  18. Monogenic Autoinflammatory Diseases: Concept And Clinical Manifestations

    PubMed Central

    De Jesus, Adriana Almeida; Goldbach-Mansky, Raphaela

    2013-01-01

    The objectives of this review are to describe the clinical manifestations of the growing spectrum of monogenic autoinflammatory diseases including recently described syndromes. The autoinflammatory diseases can be grouped based on clinical findings: 1. the three classic hereditary “periodic fever syndromes”, familial Mediterranean Fever (FMF); TNF receptor associated periodic syndrome (TRAPS); and mevalonate kinase deficiency/hyperimmunoglobulinemia D and periodic fever syndrome (HIDS); 2. the cryopyrin associated periodic syndromes (CAPS), comprising familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID) or CINCA, and; 3. pediatric granulomatous arthritis (PGA); 4. disorders presenting with skin pustules, including deficiency of interleukin 1 receptor antagonist (DIRA); Majeed syndrome; pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome; deficiency of interleukin 36 receptor antagonist (DITRA); CARD14 mediated psoriasis (CAMPS), and early-onset inflammatory bowel diseases (EO-IBD); 5. inflammatory disorders caused by mutations in proteasome components, the proteasome associated autoinflammatory syndromes (PRAAS) 6. very rare conditions presenting with autoinflammation and immunodeficiency. PMID:23711932

  19. [Clinical manifestations caused by group A streptococci].

    PubMed

    Brandtzaeg, P; Gaustad, P; Vanberg, P J; Medbø, S; Ledaal, P; Reigstad, H

    1990-08-30

    We describe the symptomatology of different disease entities caused by group A beta-hemolytic streptococci (Streptococcus pyogenes, GAS). The case histories of four patients, two of whom died, emphasize the severity of certain clinical manifestations of GAS-infections. A 34 year-old woman was admitted to hospital four days after start of the symptoms. She presented a clinical picture very similar to that observed in fulminant meningococcal septicaemia; i.e. extensive skin haemorrhages, circulatory collapse, and multiple organ failure. She died within 12 hours of admission. GAS were isolated in blood culture. A seven day-old girl died before admission to hospital. GAS were isolated in blood cultures, cerebrospinal fluid and from her nose and throat. An eight year-old, psychomotoric retarded girl developed a severe left-sided pneumonia, empyema and scarlatina. GAS were detected in throat culture. She responded poorly to high doses of benzylpenicillin given intravenously. She recovered rapidly after thoracotomy and decortication of her left lung. Finally, we describe the case of an 11 year-old boy with rheumatic fever without cardiac involvement. The reported cases underline the need for careful diagnosis and penicillin treatment in cases of GAS-infections. PMID:2219027

  20. Oral mucosal manifestations of autoimmune skin diseases.

    PubMed

    Mustafa, Mayson B; Porter, Stephen R; Smoller, Bruce R; Sitaru, Cassian

    2015-10-01

    A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches. PMID:26117595

  1. Sickle cell disease: renal manifestations and mechanisms

    PubMed Central

    Nath, Karl A.; Hebbel, Robert P.

    2015-01-01

    Sickle cell disease (SCD) substantially alters renal structure and function, and causes various renal syndromes and diseases. Such diverse renal outcomes reflect the uniquely complex vascular pathobiology of SCD and the propensity of red blood cells to sickle in the renal medulla because of its hypoxic, acidotic, and hyperosmolar conditions. Renal complications and involvement in sickle cell nephropathy (SCN) include altered haemodynamics, hypertrophy, assorted glomerulopathies, chronic kidney disease, acute kidney injury, impaired urinary concentrating ability, distal nephron dysfunction, haematuria, and increased risks of urinary tract infections and renal medullary carcinoma. SCN largely reflects an underlying vasculopathy characterized by cortical hyperperfusion, medullary hypoperfusion, and an increased, stress-induced vasoconstrictive response. Renal involvement is usually more severe in homozygous disease (sickle cell anaemia, HbSS) than in compound heterozygous types of SCD (for example HbSC and HbS?+-thalassaemia), and is typically mild, albeit prevalent, in the heterozygous state (sickle cell trait, HbAS). Renal involvement contributes substantially to the diminished life expectancy of patients with SCD, accounting for 16–18% of mortality. As improved clinical care promotes survival into adulthood, SCN imposes a growing burden on both individual health and health system costs. This Review addresses the renal manifestations of SCD and focuses on their underlying mechanisms. PMID:25668001

  2. 40 CFR 262.25 - Electronic manifest signatures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Electronic manifest signatures. 262.25 Section 262.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.25 Electronic...

  3. 46 CFR 148.02-3 - Dangerous cargo manifest.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Dangerous cargo manifest. 148.02-3 Section 148.02-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DANGEROUS CARGOES CARRIAGE OF SOLID HAZARDOUS MATERIALS IN BULK Vessel Requirements § 148.02-3 Dangerous cargo manifest. (a) Each vessel, except for unmanned barges, transporting...

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

    ERIC Educational Resources Information Center

    Muller, Juanita; Waters, Lea

    2012-01-01

    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…

  5. 40 CFR 761.209 - Retention of manifest records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  6. 40 CFR 761.209 - Retention of manifest records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  7. 40 CFR 761.209 - Retention of manifest records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

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

    PubMed Central

    Kokturk, Aysin

    2012-01-01

    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

  9. Hepatic manifestations of non-steroidal inflammatory bowel disease therapy.

    PubMed

    Hirten, Robert; Sultan, Keith; Thomas, Ashby; Bernstein, David E

    2015-11-28

    Inflammatory bowel disease (IBD) is composed of Crohn's disease and ulcerative colitis and is manifested by both bowel-related and extraintestinal manifestations. Recently the number of therapeutic options available to treat IBD has dramatically increased, with each new medication having its own mechanism of action and side effect profile. A complete understanding of the hepatotoxicity of these medications is important in order to distinguish these complications from the hepatic manifestations of IBD. This review seeks to evaluate the hepatobiliary complications of non-steroid based IBD medications and aide providers in the recognition and management of these side-effects. PMID:26644815

  10. Hepatic manifestations of non-steroidal inflammatory bowel disease therapy

    PubMed Central

    Hirten, Robert; Sultan, Keith; Thomas, Ashby; Bernstein, David E

    2015-01-01

    Inflammatory bowel disease (IBD) is composed of Crohn’s disease and ulcerative colitis and is manifested by both bowel-related and extraintestinal manifestations. Recently the number of therapeutic options available to treat IBD has dramatically increased, with each new medication having its own mechanism of action and side effect profile. A complete understanding of the hepatotoxicity of these medications is important in order to distinguish these complications from the hepatic manifestations of IBD. This review seeks to evaluate the hepatobiliary complications of non-steroid based IBD medications and aide providers in the recognition and management of these side-effects. PMID:26644815

  11. 76 FR 36480 - Hazardous Waste Manifest Printing Specifications Correction Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... Subjects in 40 CFR Part 262 Environmental protection, Exports, Hazardous materials transportation... AGENCY 40 CFR Part 262 Hazardous Waste Manifest Printing Specifications Correction Rule AGENCY... proposing a minor change to the Resource Conservation and Recovery Act (RCRA) hazardous waste...

  12. 8 CFR 251.1 - Arrival manifests and lists.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...manifests and lists. (a) Vessels —(1) General. The master or agent of every vessel arriving in the...surname, given name, and middle initial of each alien crewman...citizen crewman serving on a vessel plying solely between...

  13. 19 CFR 123.22 - In-transit manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CUSTOMS RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.22 In-transit... cars or other overland carriers transiting Mexico a manifest on Customs Form 7512-B or 7533-C shall...

  14. Matrix Methods for Optimal Manifesting of Multinode Space Exploration Systems

    E-print Network

    Grogan, Paul Thomas

    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 ...

  15. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.48 Air cargo...

  16. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.48 Air cargo...

  17. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.48 Air cargo...

  18. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.48 Air cargo...

  19. 19 CFR 122.48 - Air cargo manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.48 Air cargo...

  20. Topical review-connective tissue diseases: orofacial manifestations including pain.

    PubMed

    Klasser, Gary D; Balasubramaniam, Ramesh; Epstein, Joel

    2007-01-01

    This topical review presents an overview of orofacial manifestations associated with the more common connective tissue diseases affecting multiple organs. The orofacial manifestations associated with these autoimmune disorders include oral mucosa alterations, salivary gland pathosis, sensory neuropathies, headaches, and temporomandibular disorders. Since many of these orofacial manifestations may be painful, the practitioner managing pain patients should be familiar with them. An understanding of the orofacial manifestations associated with these systemic diseases will enable the pain practitioner to establish an appropriate diagnosis within the context of the underlying systemic disease. This will allow the practitioner the opportunity to contribute and collaborate as a member of a multidisciplinary health-care team in the management of these systemic autoimmune diseases. PMID:17717956

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2013-07-01

    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

  3. Management of Musculoskeletal Manifestations in Inflammatory Bowel Disease

    PubMed Central

    Sheth, Tejas; Pitchumoni, C. S.; Das, Kiron M.

    2015-01-01

    Musculoskeletal manifestations are the most common extraintestinal manifestations in inflammatory bowel diseases. Some appendicular manifestations are independent of gut inflammation and are treated with standard anti-inflammatory strategies. On the other hand, axial involvement is linked to gut inflammatory activity; hence, there is a considerable amount of treatment overlap. Biological therapies have revolutionized management of inflammatory bowel diseases as well as of associated articular manifestations. Newer mechanisms driving gut associated arthropathy have surfaced in the past decade and have enhanced our interests in novel treatment targets. Introduction of biosimilar molecules is expected in the US market in the near future and will provide an opportunity for considerable cost savings on healthcare. A multidisciplinary approach involving a gastroenterologist, rheumatologist, and physical therapist is ideal for these patients. PMID:26170832

  4. 77 FR 54818 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ... regulations promulgated on March 4, 2005 (70 FR 10815), all of the States must use the same uniform manifest... private right-of-way within or along the border of contiguous property (codified under 62 FR 6651, Feb....

  5. Dust Acoustic Mode Manifestations in Earth's Dusty Ionosphere

    SciTech Connect

    Kopnin, S.I.; Popel, S.I.

    2005-10-31

    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.

  6. ESRD-associated cutaneous manifestations in a hemodialysis population.

    PubMed

    Headley, Carol M; Wall, Barry

    2002-12-01

    Cutaneous manifestations occurring in patients with end stage renal disease (ESRD) can indicate systemic problems that have significant morbidity and mortality risks. Skin changes are sometimes a consequence of the disease that caused the renal failure or may be an ESRD manifestation. Pruritus is the most prevalent ESRD cutaneous complaint, but its pathogenesis is not understood. The pathophysiology, presentation, and nursing implications of perforating dermatosis, metastatic calcification, polytetraflouroethylene graft infection, and lichen planus are discussed with corresponding case reports. PMID:12596603

  7. Onychomadesis with Lichen Planus: An Under-Recognized Manifestation.

    PubMed

    Grover, Chander; Vohra, Suruchi

    2015-01-01

    Onychomadesis or proximal separation of the nail pate usually results from severe, generalized dermatoses like bullous diseases, hand foot and mouth disease, varicella or severe cutaneous drug reactions. Although lichen planus (LP) produces varied nail manifestations (longitudinal onychorrhexis, onychoschizia, nail pigmentation, pterygium etc.), to the best of our knowledge, onychomadesis as a manifestation of nail LP is not recorded. This report presents two children with onychomadesis arising with generalized eruptive LP. PMID:26288428

  8. Ocular Manifestations of Acquired Immunodeficiency Syndrome in Korea

    PubMed Central

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

    2012-01-01

    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

  9. Extraintestinal manifestations of Helicobacter pylori: A concise review

    PubMed Central

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

    2014-01-01

    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

  10. Case report of Graves’ disease manifesting with odynophagia and heartburn

    PubMed Central

    Evsyutina, Yulia; Trukhmanov, Alexander; Ivashkin, Vladimir; Storonova, Olga; Godjello, Elina

    2015-01-01

    Graves’ disease is an autoimmune disease, which can manifest with a variety of extrathyroidal clinical syndromes like ophthalmopathy, pretibial myxedema (dermopathy), acropathy, cardiomyopathy, and encephalopathy. Though quite rare, this disease can also manifest with gastrointestinal symptoms such as dysphagia, heartburn, nausea, vomiting and diarrhea. We report a clinical case of Graves’ disease manifesting with dysfunction of the esophagus and heartburn in a 61-year-old man. In the muscular layer of the esophagus we found dystrophic changes led to its atony, which was documented by endoscopy and high-resolution manometry. The pathology features of esophageal symptoms were: focal proliferation of the basal cells, vascular distension, and dystrophy of the epithelial cells. Antithyroid treatment led to decrease of all clinical symptoms after 5 d of Thiamazole administration. Complete restoration of peristalsis in the esophagus, according to manometry, was observed in 1 mo after initiation of treatment.

  11. Isolated Tricuspid Regurgitation: Initial Manifestation of Cardiac Amyloidosis

    PubMed Central

    Yoon, Dong Woog; Park, Byung-Jo; Kim, In Sook; Jeong, Dong Seop

    2015-01-01

    Amyloid deposits in the heart are not exceptional in systemic amyloidosis. The clinical manifestations of cardiac amyloidosis may include restrictive cardiomyopathy, characterized by progressive diastolic and eventually systolic bi-ventricular dysfunction; arrhythmia; and conduction defects. To the best of our knowledge, no previous cases of isolated tricuspid regurgitation as the initial manifestation of cardiac amyloidosis have been reported. We describe a rare case of cardiac amyloidosis that initially presented with severe tricuspid regurgitation in a 42-year-old woman who was successfully treated with tricuspid valve replacement. Unusual surgical findings prompted additional evaluation that established a diagnosis of plasma cell myeloma. PMID:26665112

  12. Neuralgic Amyotrophy Manifesting as Mimicking Posterior Interosseous Nerve Palsy

    PubMed Central

    Yang, Jin Seo; Kang, Suk Hyung; Choi, Eun Hi

    2015-01-01

    The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies. PMID:26713154

  13. Advancements in Pharmacotherapy for Noncancerous Manifestations of HPV

    PubMed Central

    Kollipara, Ramya; Ekhlassi, Erfon; Downing, Christopher; Guidry, Jacqueline; Lee, Michael; Tyring, Stephen K.

    2015-01-01

    Human papillomavirus (HPV) is the most common sexually transmitted disease. Via infection of the basal epithelial cells, HPV causes numerous malignancies and noncancerous cutaneous manifestations. Noncancerous cutaneous manifestations of HPV, including common, plantar, plane, and anogenital warts, are among the most common reasons for an office visit. Although there are various therapies available, they are notoriously difficult to treat. HPV treatments can be grouped into destructive (cantharidin, salicylic acid), virucidal (cidofovir, interferon-?), antimitotic (bleomycin, podophyllotoxin, 5-fluorouracil), immunotherapy (Candida antigen, contact allergen immunotherapy, imiquimod) or miscellaneous (trichloroacetic acid, polyphenon E). The mechanism of action, recent efficacy data, safety profile and recommended regimen for each of these treatment modalities is discussed. PMID:26239450

  14. 19 CFR 122.113 - Form for transit air cargo manifest procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Form for transit air cargo manifest procedures... SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures. A manifest on Customs Form 7509 is...

  15. 19 CFR 122.113 - Form for transit air cargo manifest procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Form for transit air cargo manifest procedures... SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures. A manifest on Customs Form 7509 is...

  16. 19 CFR 122.113 - Form for transit air cargo manifest procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Form for transit air cargo manifest procedures... SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures. A manifest on Customs Form 7509 is...

  17. 19 CFR 122.113 - Form for transit air cargo manifest procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Form for transit air cargo manifest procedures... SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures. A manifest on Customs Form 7509 is...

  18. 19 CFR 122.113 - Form for transit air cargo manifest procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Form for transit air cargo manifest procedures... SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Transit Air Cargo Manifest (TACM) Procedures § 122.113 Form for transit air cargo manifest procedures. A manifest on Customs Form 7509 is...

  19. An Unusual Cutaneous Manifestation in a Patient with Murine Typhus.

    PubMed

    Blanton, Lucas S; Lea, Alfred S; Kelly, Brent C; Walker, David H

    2015-12-01

    Murine typhus is a flea-borne febrile illness caused by Rickettsia typhi. Although often accompanied by rash, an inoculation lesion has not been observed as it is with many tick- and mite-transmitted rickettsioses. We describe a patient with murine typhus and an unusual cutaneous manifestation at the site of rickettsial inoculation. PMID:26416115

  20. Perfectionism: Its Manifestations and Classroom-based Interventions.

    ERIC Educational Resources Information Center

    Nugent, Stephanie A.

    2000-01-01

    This article discusses perfectionism in gifted students, aspects of perfectionism, manifestations of perfectionism in the classroom, and classroom based interventions. Recommended interventions include creating a classroom that encourages sharing of self, active listening, and self-evaluation and metacognition, using bibliotherapy, and providing…

  1. Self-Organization in the Manifestations of Youth Extremism

    ERIC Educational Resources Information Center

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

    2011-01-01

    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,…

  2. 19 CFR 123.25 - Certification and disposition of manifests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...; DEPARTMENT OF THE TREASURY CUSTOMS RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.25 Certification and disposition of manifests. (a) Certification. Conveyances proceeding... required when the merchandise is to be transshipped in Canada or Mexico under Customs supervision shall...

  3. 40 CFR 263.20 - The manifest system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...manifest electronically and also sign with an ink signature the transporter acknowledgement...bearing the generator's and transporter's ink signatures shall also be presented by the...transporter to the designated facility to sign in ink to indicate the receipt of the waste...

  4. 40 CFR 264.71 - Use of manifest system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...signature method, then the owner or operator shall also sign with an ink signature the facility's certification of receipt or discrepancies...the manifest provided by the transporter. Upon executing its ink signature on this printed copy, the owner or operator...

  5. 40 CFR 265.71 - Use of manifest system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...signature method, then the owner or operator shall also sign with an ink signature the facility's certification of receipt or discrepancies...the manifest provided by the transporter. Upon executing its ink signature on this printed copy, the owner or operator...

  6. Chédiak-Higashi syndrome: brain MRI and MR spectroscopy manifestations.

    PubMed

    Lolli, Valentina; Soto Ares, Gustavo; Pruvo, Jean-Pierre; Abou Chahla, Wadih; Jissendi-Tchofo, Patrice

    2015-07-01

    Chédiak-Higashi syndrome is a rare inherited metabolic disorder characterized by partial oculocutaneous albinism, immunodeficiency, and neurological dysfunction. We present the brain magnetic resonance imaging (MRI) and MR spectroscopy (MRS) findings obtained during the accelerated phase of the disorder in an 8-year-old. The brain MRI manifestations at recurrences 15 months and 24 months later are reported as well. PMID:25875633

  7. The Development and Manifestation of Altruistic Caring: A Qualitative Inquiry

    ERIC Educational Resources Information Center

    Curry, Jennifer R.; Smith, Heather L.; Robinson, Edward H., III

    2009-01-01

    Qualitative, phenomenological research provides rich information about the constructive, life span perspectives of the manifestation and development of altruism. Using an interpretive phenomenological approach, this study investigated "altruism" as described by 34 older persons in a continuing care retirement community. The findings identified 13…

  8. 10 CFR 20.2006 - Transfer for disposal and manifests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 CFR part 20 are designed to— (1) Control transfers of low-level radioactive waste by any waste... appendix G to 10 CFR part 20. (c) Each shipment manifest must include a certification by the waste generator as specified in section II of appendix G to 10 CFR part 20. (d) Each person involved in...

  9. 40 CFR 761.207 - The manifest-general requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...who transports, or offers for transport PCB waste for commercial off-site storage...who offers for transport a rejected load of PCB waste, must prepare a manifest on...

  10. 40 CFR 761.207 - The manifest-general requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...who transports, or offers for transport PCB waste for commercial off-site storage...who offers for transport a rejected load of PCB waste, must prepare a manifest on...

  11. 77 FR 54818 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ...sections of the Polychlorinated Biphenyl (PCB) regulations associated with the manifesting...to 40 CFR Part 761 B. Revisions to the PCB Regulations under 40 CFR 761.207 (The...General Requirements) C. Revisions to the PCB Regulations under 40 CFR 761.208...

  12. Space Launch System Co-Manifested Payload Options for Habitation

    NASA Technical Reports Server (NTRS)

    Smitherman, David

    2015-01-01

    The Space Launch System (SLS) has a co-manifested payload capability that will grow over time as the launch vehicle matures and planned upgrades are implemented. The final configuration is planned to be capable of inserting a payload greater than 10 metric tons (mt) into a trans-lunar injection trajectory along with the crew in the Orion capsule and its service module. The co-manifested payload is located below the Orion and its service module in a 10 m high fairing similar to the way the Saturn launch vehicle carried the lunar lander below the Apollo command and service modules. Various approaches that utilize this comanifested payload capability to build up infrastructure in deep space have been explored in support of future asteroid, lunar, and Mars mission scenarios. This paper reports on the findings of the Advanced Concepts Office study team at NASA Marshall Space Flight Center (MSFC) working with the Advanced Exploration Systems Program on the Exploration Augmentation Module Project. It includes some of the possible options for habitation in the co-manifested payload volume of the SLS. Findings include a set of module designs that can be developed in 10 mt increments to support these co-manifested payload missions along with a comparison of this approach to a large-module payload flight configuration for the SLS.

  13. Manifestations of CP Violation in the MSSM Higgs Sector

    SciTech Connect

    Lee, Jae Sik

    2008-11-23

    We demonstrate how CP violation manifests itself in the Higgs sector of the minimal supersymmetric extension of the Standard Model (MSSM). Starting with a brief introduction to CP violation in the MSSM and its effects on the Higgs sector, we discuss some phenomenological aspects of the Higgs sector CP violation based on the two scenarios called CPX and Trimixing.

  14. Mykola Shopa Imaging and manifestation of plasmons on gold

    E-print Network

    Kisiel, Zbigniew

    Mykola Shopa Imaging and manifestation of plasmons on gold spherical nanoantennas in near and far absorption and scattering spectra for gold nanoparticle . . . . . . . . . . 24 4 Numerical modeling . . . . . . . . . . . . . . . . . . . . . . . . 26 4.1.1 Estimation of equilibrium free electron densities in gold nanosphere . 26 4.1.2 Homogeneity

  15. Biological therapy for dermatological manifestations of inflammatory bowel disease.

    PubMed

    Zippi, Maddalena; Pica, Roberta; De Nitto, Daniela; Paoluzi, Paolo

    2013-05-16

    Ulcerative colitis and Crohn's disease are the two forms of inflammatory bowel disease (IBD). The advent of biological drugs has significantly changed the management of these conditions. Skin manifestations are not uncommon in IBD. Among the reactive lesions (immune-mediated extraintestinal manifestations), erythema nodosum (EN) and pyoderma gangrenosum (PG) are the two major cutaneous ills associated with IBD, while psoriasis is the dermatological comorbidity disease observed more often. In particular, in the last few years, anti-tumor necrosis factor (TNF)-? agents have been successfully used to treat psoriasis, especially these kinds of lesions that may occur during the treatment with biological therapies. The entity of the paradoxical manifestations has been relatively under reported as most lesions are limited and a causal relationship with the treatment is often poorly understood. The reason for this apparent side-effect of the therapy still remains unclear. Although side effects may occur, their clinical benefits are undoubted. This article reviews the therapeutic effects of the two most widely used anti-TNF-? molecules, infliximab (a fusion protein dimer of the human TNF-? receptor) and adalimumab (a fully human monoclonal antibody to TNF-?), for the treatment of the major cutaneous manifestations associated with IBD (EN, PG and psoriasis). PMID:24303470

  16. Space Launch System Co-Manifested Payload Options for Habitation

    NASA Technical Reports Server (NTRS)

    Smitherman, David

    2015-01-01

    The Space Launch System (SLS) has a co-manifested payload capability that will grow over time as the rocket matures and planned upgrades are implemented. The final configuration is planned to be capable of inserting a payload greater than 10 metric tons (mt) into a trans-lunar injection trajectory along with the crew in the Orion capsule and the service module. The co-manifested payload is located below the Orion and its service module in a 10-meter high fairing similar to the way the Saturn launch vehicle carried the lunar lander below the Apollo command and service modules. A variety of approaches have been explored that utilizes this co-manifested payload capability to build up infrastructure in deep space in support of future asteroid, lunar, and Mars mission scenarios. This paper is a report on the findings from the Advanced Concepts Office study team at the NASA Marshall Space Flight Center, working with the Advanced Exploration Systems Program on the Exploration Augmentation Module Project. It includes some of the possible options for habitation in the co-manifested payload volume on SLS. Findings include module designs that can be developed in 10mt increments to support these missions, including overall conceptual layouts, mass properties, and approaches for integration into various scenarios for near-term support of deep space habitat research and technology development, support to asteroid exploration, and long range support for Mars transfer flights.

  17. Neurologic manifestations of inherited disorders of connective tissue.

    PubMed

    Debette, Stéphanie; Germain, Dominique P

    2014-01-01

    Inherited disorders of connective tissue are single gene disorders affecting structure or function of the connective tissue. Neurological manifestations are classic and potentially severe complications of many such disorders. The most common neurological manifestations are cerebrovascular. Ischemic stroke is a classic complication of vascular Ehlers-Danlos syndrome (type IV), homocystinuria, and arterial tortuosity syndrome, and may occasionally be seen in Marfan syndrome and pseudoxanthoma elasticum with distinct underlying mechanisms for each disease. Vascular Ehlers-Danlos syndrome can also lead to cervical artery dissection (with or without ischemic stroke), carotid-cavernous fistula, intracranial dissections and aneurysms potentially causing subarachnoid or intracerebral hemorrhage, and arterial rupture. Other neurological manifestations include nerve root compression and intracranial hypotension due to dural ectasia in Marfan and Loeys-Dietz syndrome, spinal cord compression in osteogenesis imperfecta, and mucopolysaccharidosis type I and VI, carpal tunnel syndrome in mucopolysaccharidosis type I, II, and VI. Impaired mental development can be observed in homocystinuria, mucopolysaccharidosis type II, and the severe form of mucopolysaccharidosis type I. For the neurologist, being aware of these complications and of the diagnostic criteria for inherited connective tissue disorders is important since neurological complications can be the first manifestation of the disease and because caution may be warranted for the management of these patients. PMID:24365320

  18. 77 FR 54863 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ... economic impacts of today's proposed rule on small entities, I certify that this action will not have a... Toxic Substances Control Act (TSCA). Today's changes are to match, as much as possible, the manifesting... promulgating today, we will not take further action on this proposed rule. If, however, we receive such...

  19. Mucocutaneous manifestations of helminth infections: Trematodes and cestodes.

    PubMed

    Lupi, Omar; Downing, Christopher; Lee, Michael; Bravo, Francisco; Giglio, Patricia; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased international travel for vacation, work, and medical missions and immigration into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. It has been estimated that 20% to 70% of international travelers suffer from some travel-related health problem. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on cutaneous diseases caused by helminth infections. Part I of the review focused on nematode infections; part II will focus on trematode and cestode infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568338

  20. Oral Manifestations and Dental Management of Epidermolysis Bullosa Simplex

    PubMed Central

    Scheidt, Lisa; Sanabe, Mariane Emi

    2015-01-01

    ABSTRACT Epidermolysis bullosa (EB) is a group of hereditary chronic disorders, characterized by fragility of the skin and mucous membranes in response to minor mechanical trauma. The objective of this study was to report the case of a young girl diagnosed with epidermolysis bullosa simplex (EBS), transmitted by an autosomal dominant gene. Cutaneous findings included blisters and dystrophy following minimal friction. Recurrent blisters and vesicle formation on the hard palate were the main oral findings. In conclusion, publications concerning the oral and clinical manifestations of EBS are important for providing knowledge and an early multidisciplinary approach that prevents blister formation and improves these patients’ quality of life, with the dentist playing an important role in oral health management. How to cite this article: Scheidt L, Sanabe ME, Diniz MB. Oral Manifestations and Dental Management of Epidermolysis Bullosa Simplex. Int J Clin Pediatr Dent 2015;8(3):239-241. PMID:26604545

  1. Extra-Renal Manifestations of Complement-Mediated Thrombotic Microangiopathies

    PubMed Central

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

    2014-01-01

    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

  2. [Spectrum of renal manifestations in sickle cell disease].

    PubMed

    Cazenave, Maud; Koehl, Bérengère; Nochy, Dominique; Tharaux, Pierre-Louis; Audard, Vincent

    2014-02-01

    Sickle cell disease (SCD), the most common hemoglobinopathy, is an increasing cause of chronic kidney disease. In the last decade, we have witnessed a better understanding in the characterization of clinical manifestations and pathogenesis of sickle cell nephropathy. The spectrum of renal diseases during SCD includes various renal manifestations such as impairment of urinary concentrating ability, defect in urine acidification, renal papillary necrosis and proteinuria related to glomerular injury leading to progressive end-stage renal disease. Endothelial dysfunction related to chronic hemolysis and the relative renal hypoxia caused by vaso-occlusive sickle red blood cells are probably two key factors for SCN development. Optimal therapeutic management (including the use of blockers of the renin-angiotensin system) of patients with proteinuria remains to be determined. Renal replacement therapy with dialysis is required in SCD patients with end-stage renal disease but these patients should probably undergo kidney transplantation that requires careful management. PMID:24113202

  3. Extraintestinal manifestations and complications in inflammatory bowel diseases

    PubMed Central

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

    2006-01-01

    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

  4. Neonatal lupus with atypical cardiac and cutaneous manifestation

    PubMed Central

    Morais, Sofia; Santos, Isabel Cristina; Pereira, Dolores Faria; Mimoso, Gabriela

    2013-01-01

    Neonatal lupus erythematosus is a rare, passively acquired autoimmune disease, caused by maternal autoantibodies. The most common manifestations are skin rash and congenital heart block. Cutaneous manifestations may be present at birth, but often develop within a few weeks after delivery. Congenital heart block may present as bradycardia in utero or during physical examination at birth. Approximately 40–60% of mothers are asymptomatic when the infants are diagnosed. We present a case of a child, born with erythematosus lesions in the face, scalp, trunk, limbs and nodules/papules on the palmar and plantar surfaces. He also had hepatosplenomegaly and thrombocytopenia. Echocardiography showed hyperechoic lesions on the anterior papilar muscle of the left ventricle and on the lateral cusp of the tricuspid valve. The mother had unexplained fever and vasculitic lesions in her hands and feet. Antinuclear antibodies, anti-SSa/Ro and anti-SSb/La were positive in the mother and child, making the diagnosis of neonatal lupus. PMID:23839605

  5. Current Perspectives on Ophthalmic Manifestations of Childhood Rheumatic Diseases

    PubMed Central

    Palejwala, Neal V.; Yeh, Steven; Angeles-Han, Sheila T.

    2013-01-01

    Inflammatory eye diseases are an important manifestation of many pediatric rheumatologic conditions. Early screening and diagnosis are imperative as these illnesses can not only result in significant visual morbidity but also be an indicator of systemic inflammation. Time to presentation of ocular inflammation varies significantly and can range from many years prior to the onset of systemic symptoms to well after the diagnosis of the rheumatologic disorder. Due to this variability in presentation, careful monitoring by an ophthalmologist is vital to preventing ocular complications and preserving vision. Both local and systemic immunosuppressive medications have been effective in the management of ocular disease. In this review, we will focus on the known ophthalmologic manifestations of common pediatric rheumatologic diseases and discuss recent advances in therapeutic considerations for these conditions. PMID:23686303

  6. Progressive outer retinal necrosis: manifestation of human immunodeficiency virus infection.

    PubMed

    Lo, Phey Feng; Lim, Rongxuan; Antonakis, Serafeim N; Almeida, Goncalo C

    2015-01-01

    We present the case of a 54-year-old man who developed progressive outer retinal necrosis (PORN) as an initial manifestation of HIV infection without any significant risk factors for infection with HIV. PORN is usually found as a manifestation of known AIDS late in the disease. Our patient presented with transient visual loss followed by decrease in visual acuity and facial rash. Subsequent investigation revealed anterior chamber tap positive for varicella zoster virus (VZV), as well as HIV positivity, with an initial CD4 count of 48 cells/µL. Systemic and intravitreal antivirals against VZV, and highly active antiretroviral therapy against HIV were started, which halted further progression of retinal necrosis. This case highlights the importance of suspecting PORN where there is a rapidly progressive retinitis, and also testing the patient for HIV, so appropriate treatment can be started. PMID:25948844

  7. Geographic Manifestation of Spanish Moss Physiology Across The Americas

    E-print Network

    Barve, Narayani

    2011-11-16

    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 and background climatic information... 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...

  8. Hypokalemic rhabdomyolysis: a rare manifestation of primary aldosteronism.

    PubMed

    Zavatto, A; Concistrè, A; Marinelli, C; Zingaretti, V; Umbro, I; Fiacco, F; Tinti, F; Petramala, L; Mitterhofer, A P; Letizia, C

    2015-10-01

    Rhabdomyolysis is a rare presentation of hypokalemia, although muscle weakness is a well-known manifestation of hypokalemia. Primary aldosteronism is characterized by hypertension, suppressed plasma renin activity, increased aldosterone excretion and hypokalemia with metabolic alkalosis. Rhabdomyolysis is not common in primary aldosteronism. We present here a 40-year-old woman presenting with rhabdomyolysis accompanied by severe hypokalemia as heralding symptom of primary aldosteronism. PMID:26531278

  9. Endocrine manifestations and management of Prader-Willi syndrome

    PubMed Central

    2013-01-01

    Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13. In infancy it is characterized by hypotonia with poor suck resulting in failure to thrive. As the child ages, other manifestations such as developmental delay, cognitive disability, and behavior problems become evident. Hypothalamic dysfunction has been implicated in many manifestations of this syndrome including hyperphagia, temperature instability, high pain threshold, sleep disordered breathing, and multiple endocrine abnormalities. These include growth hormone deficiency, central adrenal insufficiency, hypogonadism, hypothyroidism, and complications of obesity such as type 2 diabetes mellitus. This review summarizes the recent literature investigating optimal screening and treatment of endocrine abnormalities associated with PWS, and provides an update on nutrition and food-related behavioral intervention. The standard of care regarding growth hormone therapy and surveillance for potential side effects, the potential for central adrenal insufficiency, evaluation for and treatment of hypogonadism in males and females, and the prevalence and screening recommendations for hypothyroidism and diabetes are covered in detail. PWS is a genetic syndrome in which early diagnosis and careful attention to detail regarding all the potential endocrine and behavioral manifestations can lead to a significant improvement in health and developmental outcomes. Thus, the important role of the provider caring for the child with PWS cannot be overstated. PMID:23962041

  10. 19 CFR 122.73 - General declaration and air cargo manifest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.73 General declaration and air cargo manifest. (a)...

  11. 19 CFR 122.73 - General declaration and air cargo manifest.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.73 General declaration and air cargo manifest. (a)...

  12. 19 CFR 122.73 - General declaration and air cargo manifest.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.73 General declaration and air cargo manifest. (a)...

  13. 19 CFR 122.73 - General declaration and air cargo manifest.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.73 General declaration and air cargo manifest. (a)...

  14. 19 CFR 122.73 - General declaration and air cargo manifest.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...for Clearance and Permission To Depart; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the United States § 122.73 General declaration and air cargo manifest. (a)...

  15. 40 CFR 761.209 - Number of copies of a manifest.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...CONTROL ACT POLYCHLORINATED BIPHENYLS (PCBs) MANUFACTURING, PROCESSING, DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761.209 Number of copies of a manifest. The manifest consists of at...

  16. 40 CFR 761.209 - Number of copies of a manifest.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...CONTROL ACT POLYCHLORINATED BIPHENYLS (PCBs) MANUFACTURING, PROCESSING, DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761.209 Number of copies of a manifest. The manifest consists of at...

  17. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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)...

  18. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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)...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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)...

  20. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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)...

  1. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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)...

  2. Hazard Manifest.doc November 2007 The Hong Kong University of Science and Technology

    E-print Network

    Hazard Manifest.doc November 2007 The Hong Kong University of Science and Technology Health, Safety and Environment Office LAB EQUIPMENT / FURNITURE HAZARD MANIFEST ***************************************************************************************** Lab equipment / furniture used or is possibly contaminated with hazardous substances must be properly

  3. Abstract--Pathological manifestations of epilepsy are generally associated with a set of clinical events that

    E-print Network

    Slatton, Clint

    Abstract--Pathological manifestations of epilepsy are generally associated with a set of clinical It is widely suggested that certain clinical manifestations of epilepsy are directly reflected in the changes

  4. Pulmonary manifestations in Behçet disease: impaired natural killer cells activity

    PubMed Central

    2013-01-01

    Background Behçet’s disease (BD) is a systemic vasculitis with unknown aetiology, where, besides genetic predisposition, an immune dysregulation involving T and B lymphocytes and hyperactive neutrophils contribute to disease pathogenesis. The aim of this study was to determine the cytotoxicity of natural killer (NK) cells in bronchoalveolar lavage (BAL) from BD patients with pulmonary manifestations. Methods BAL was performed in 27 patients with BD and pulmonary manifestations, 14 patients with Rheumatoid Arthritis (RA) and 23 healthy controls (HC). Related orphan receptor C (RORC) and forkheadbox P3 (FOXP3) mRNA transcript were determined in BAL by reverse transcription–polymerase chain reaction (RT-PCR). NK cells, NK cell cytotoxicity, and lymphokine-activated killer (LAK) activity against K562 cells were measured by flow cytometry. Proportions of NK precursors and expression of genes for IL-2 receptor ? (IL-2R?; CD122), perforin, and granzyme in NK cells were measured by flow cytometry or RT-PCR. Results The analysis of transcription factors revealed an increase in the RORC/FOXP3 ratio (Th17/Treg cells) in BAL from BD patients. Percentages of NK were significantly lower in BD than in RA patients and healthy controls. Purified NK cells derived from BD patients were found to have lower cytotoxicity and LAK activity than those from controls. This defect of NK cells in BD patients was related to down-regulation of perforin and granzyme expression in NK cells. Conclusion In BD patients, the increased RORC/FOXP3 ratio indicated an inflammatory state of the lung. NK cells were decreased together with an impairment of their activity due to a defective expression of granzyme and perforin. These abnormalities possibly contribute to immune system dysregulation found in BAL of BD patients with pulmonary manifestations. PMID:23556512

  5. Ionospheric manifestations of earthquakes and tsunamis in a dynamic atmosphere

    NASA Astrophysics Data System (ADS)

    Godin, Oleg A.; Zabotin, Nikolay A.; Zabotina, Liudmila

    2015-04-01

    Observations of the ionosphere provide a new, promising modality for characterizing large-scale physical processes that occur on land and in the ocean. There is a large and rapidly growing body of evidence that a number of natural hazards, including large earthquakes, strong tsunamis, and powerful tornadoes, have pronounced ionospheric manifestations, which are reliably detected by ground-based and satellite-borne instruments. As the focus shifts from detecting the ionospheric features associated with the natural hazards to characterizing the hazards for the purposes of improving early warning systems and contributing to disaster recovery, it becomes imperative to relate quantitatively characteristics of the observed ionospheric disturbances and the underlying natural hazard. The relation between perturbations at the ground level and their ionospheric manifestations is strongly affected by parameters of the intervening atmosphere. In this paper, we employ the ray theory to model propagation of acoustic-gravity waves in three-dimensionally inhomogeneous atmosphere. Huygens' wavefront-tracing and Hamiltonian ray-tracing algorithms are used to simulate propagation of body waves from an earthquake hypocenter through the earth's crust and ocean to the upper atmosphere. We quantify the influence of temperature stratification and winds, including their seasonal variability, and air viscosity and thermal conductivity on the geometry and amplitude of ionospheric disturbances that are generated by seismic surface waves and tsunamis. Modeling results are verified by comparing observations of the velocity fluctuations at altitudes of 150-160 km by a coastal Dynasonde HF radar system with theoretical predictions of ionospheric manifestations of background infragravity waves in the ocean. Dynasonde radar systems are shown to be a promising means for monitoring acoustic-gravity wave activity and observing ionospheric perturbations due to earthquakes and tsunamis. We will discuss the effects of the background ionospheric disturbances and uncertainty in atmospheric parameters on the feasibility and accuracy of retrieval of the open-ocean tsunami heights from observations of the ionosphere.

  6. Osteoskeletal manifestations of scurvy: MRI and ultrasound findings.

    PubMed

    Polat, Ahmet Veysel; Bekci, Tumay; Say, Ferhat; Bolukbas, Emrah; Selcuk, Mustafa Bekir

    2015-08-01

    Scurvy has become very rare in the modern world. The incidence of scurvy in the pediatric population is extremely low. In the pediatric population, musculoskeletal manifestations are more common and multiple subperiosteal hematomas are an important indicator for the diagnosis of scurvy. Although magnetic resonance imaging findings of scurvy are well described in the literature, to our knowledge, ultrasound findings have not yet been described. In this article, we report a case of scurvy with associated magnetic resonance imaging and ultrasound findings. PMID:25597047

  7. Cutaneous manifestations of end-stage renal disease.

    PubMed

    Robinson-Bostom, L; DiGiovanna, J J

    2000-12-01

    Examination of the skin and nails can reveal many abnormalities in patients with end-stage renal disease that precede or follow initiation of dialysis treatment or kidney transplantation. This article focuses on specific and nonspecific cutaneous signs of end-stage renal disease, reviewing both banal and life-threatening conditions, including pruritus, perforating disorders, calcifying disorders, and bullous dermatoses. The pathogenesis, clinical findings, histologic findings, differential diagnosis, and treatment of these diseases are discussed. Cutaneous manifestations unique to kidney transplantation will not be covered. (J Am Acad Dermatol 2000;43:975-86.) PMID:11100013

  8. Automated Detection of Anomalous Shipping Manifests to Identify Illicit Trade

    SciTech Connect

    Sanfilippo, Antonio P.; Chikkagoudar, Satish

    2013-11-12

    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.

  9. Cardiac manifestation of the hypereosinophilic syndrome: new insights.

    PubMed

    Kleinfeldt, T; Nienaber, C A; Kische, S; Akin, I; Turan, R G; Körber, T; Schneider, H; Ince, H

    2010-07-01

    Cardiac manifestation is the major cause of morbidity in patients with hypereosinophilic syndrome (HES). Clinical features range from heart failure to arterial embolism, which are caused by thickening of the endocardium and mural left ventricular thrombosis. Modern magnetic resonance imaging and echocardiography are able to detect fibrosis, eosinophilic infiltrate and thrombi to stage the fibrotic evolution of the disease. Treatment of HES involves standard medication for heart failure, anticoagulant therapy, immunosuppressive therapy and potentially surgical resection. The outcome of HES depends on both the progression of endocardial fibrosis and associated complications and the 5-year mortality is estimated at 30%. PMID:20333409

  10. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation.

    PubMed

    Varol, Sefer; Ozdemir, Hasan Huseyin; Akil, Esref; Arslan, Demet; Aluclu, M Ufuk; Demir, Caner F; Yucel, Yavuz

    2015-12-01

    Objective Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff's brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin's Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation. PMID:26677119

  11. Peripheral Nervous System Manifestations in Systemic Autoimmune Diseases

    PubMed Central

    COJOCARU, Inimioara Mihaela; COJOCARU, Manole; SILOSI, Isabela; VRABIE, Camelia Doina

    2014-01-01

    The peripheral nervous system refers to parts of the nervous system outside the brain and spinal cord. Systemic autoimmune diseases can affect both the central and peripheral nervous systems in a myriad of ways and through a heterogeneous number of mechanisms leading to many different clinical manifestations. As a result, neurological complications of these disorders can result in significant morbidity and mortality. The most common complication of peripheral nervous system (PNS) involvement is peripheral neuropathy, with symptoms of numbness, sensory paresthesias, weakness, or gait imbalance. The neuropathy may be multifocal and asymmetric or, less frequently, distal and symmetric. PMID:25705295

  12. Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review.

    PubMed

    Mahale, Rohan R; Mehta, Anish; Rangasetty, Srinivasa

    2015-07-01

    Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options. PMID:26022457

  13. Hiccups, eructation, and other uncommon prodromal manifestations of herpes zoster.

    PubMed

    Berlin, Alexander L; Muhn, Channy Y; Billick, Robin C

    2003-12-01

    Although the most frequent presentation of herpes zoster involves sensory neurons, motor and autonomic symptomatology is also known to occur in this disease. An unusual symptom of hiccups is described here. Other infrequent manifestations of this common illness, including the Ramsay Hunt syndrome, herpes zoster ophthalmicus, urinary and fecal retention, sexual dysfunction, and zoster sine herpete, are reviewed. Greater awareness of unusual presentations of herpes zoster is necessary for proper diagnosis and timely management of complications that may otherwise lead to disability and serious long-term sequelae. PMID:14639397

  14. Beckwith-Wiedemann syndrome with overlapping Perlman syndrome manifestation.

    PubMed

    Ferianec, Vladimír; Bartova, Michaela

    2014-10-01

    Beckwith-Wiedemann syndrome (BWS) is an overgrowth syndrome known as exomphalos-macroglossia - gigantism syndrome. Prognosis is good, prenatal diagnosis is important for pregnancy management but might be difficult due to clinical overlap with other syndromes. Perlman syndrome is an overgrowth syndrome with high perinatal mortality, most frequent antenatal findings include polyhydramnios, macrosomia, visceromegaly, nephromegaly and foetal ascites. Authors present a case of prenatally diagnosed BWS with severe ascites as first antenatal finding and lethal course, signs more typical of Perlman syndrome. This combination of clinical signs has not been published yet and may contribute to specification of possible prenatal manifestation of BWS. PMID:24215131

  15. Orthopaedic manifestations of chronic graft-versus-host disease.

    PubMed

    Beredjiklian, P K; Drummond, D S; Dormans, J P; Davidson, R S; Brock, G T; August, C

    1998-01-01

    Chronic graft-versus-host disease (GVHD) is a well-recognized complication of allogeneic bone marrow transplantation (BMT). Musculoskeletal manifestations include joint contractures, polymyositis, polyserositis, and fasciitis. We present 14 patients with orthopaedic complications of chronic GVHD. Long-term conservative management of joint contractures with physical therapy and orthotics was generally successful in restoring patients' premorbid functional status. Surgical release of joint contractures yielded poor results and rendered the affected joints unresponsive to further conservative treatment. Surgical intervention in the treatment of joint contractures resulting from chronic GVHD does not appear qualitatively to improve functional status in patients affected with this disease process. PMID:9746402

  16. Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review

    PubMed Central

    Mehta, Anish; Rangasetty, Srinivasa

    2015-01-01

    Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options. PMID:26022457

  17. Manifest Predictors of Past Suicide Attempts in a Population of Icelandic Adolescents.

    ERIC Educational Resources Information Center

    Bjarnason, Thoroddur; Thorlindsson, Thorolfur

    1994-01-01

    Explores the use of manifest indicators to predict adolescents' suicide attempts. Manifest predictors in the categories of school, leisure, peer and parent relations, consumption, and contact with suicidal behavior identified those most at risk. Concludes that manifest predictors can complement psychiatric screenings by reducing the number to be…

  18. Pulmonary manifestations of Sjögren syndrome, systemic lupus erythematosus, and mixed connective tissue disease.

    PubMed

    Mira-Avendano, Isabel C; Abril, Andy

    2015-05-01

    Interstitial lung disease is a common and often life-threatening manifestation of different connective tissue disorders, often affecting its overall prognosis. Systemic lupus erythematosus, Sjögren syndrome, and mixed connective tissue disease, although all unique diseases, can have lung manifestations as an important part of these conditions. This article reviews the different pulmonary manifestations seen in these 3 systemic rheumatologic conditions. PMID:25836642

  19. 8 CFR 251.5 - Paper arrival and departure manifests for crew.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...2011-01-01 2011-01-01 false Paper arrival and departure manifests for crew...LISTS: SUPPORTING DOCUMENTS § 251.5 Paper arrival and departure manifests for crew...submit arrival and departure manifests in a paper format in accordance with §§...

  20. 78 FR 57405 - Agency Information Collection Activities: Transportation Entry and Manifest of Goods Subject to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-18

    ... and Manifest of Goods Subject to CBP Inspection and Permit AGENCY: U.S. Customs and Border Protection... requirement concerning the: Transportation Entry and Manifest of Goods Subject to CBP Inspection and Permit... concerning the following information collection: Title: Transportation Entry and Manifest of Goods Subject...

  1. Social Comparison Manifests in Event-related Potentials

    PubMed Central

    Luo, Yi; Feng, Chunliang; Wu, Tingting; Broster, Lucas S.; Cai, Huajian; Gu, Ruolei; Luo, Yue-jia

    2015-01-01

    Social comparison, a widespread phenomenon in human society, has been found to affect outcome evaluation. The need to belong to a social group may result in distinct neural responses to diverse social comparison outcomes. To extend previous studies by examining how social comparison with hierarchical characteristics is temporally processed, electroencephalography responses were recorded in the current study. Participants played a lottery game with two pseudo-players simultaneously and received both their own and the other two players’ outcomes. Results of three event-related potential components, including the P2, the feedback-related negativity (FRN), and the late positive component (LPC), indicate that social comparison manifests in three stages. First, outcomes indicating a different performance from others elicited a larger P2 than evenness. Second, the FRN showed hierarchical sensitivity to social comparison outcomes. This effect manifested asymmetrically. Finally, large difference between the participant’s outcome and the other two players’ evoked a larger LPC than the medium difference and the even condition. We suggest that during social comparison, people detect if there is any difference between self and others, and then evaluate the information of this difference hierarchically, and finally interpret the situations in which oneself deviates from the group as most motivationally salient. PMID:26183734

  2. Initial cutaneous manifestations of Hutchinson-Gilford progeria syndrome.

    PubMed

    Rork, Jillian F; Huang, Jennifer T; Gordon, Leslie B; Kleinman, Monica; Kieran, Mark W; Liang, Marilyn G

    2014-01-01

    Hutchinson-Gilford progeria syndrome (HGPS) is a rare, uniformly fatal, premature aging disease with distinct dermatologic features. We sought to identify and describe the initial skin and hair findings as potential diagnostic signs of the disease. We performed a chart review of the structured initial intake histories of 39 individuals with HGPS enrolled in clinical trials from 2007 to 2010 at Boston Children's Hospital, limited to cutaneous history from birth to 24 months. Medical photographs were provided through the clinical trials and the Progeria Research Foundation Medical and Research Database at Brown University Center for Gerontology and Healthcare Research. All 39 patients reported skin and hair abnormalities within the first 24 months of life. Pathologies included sclerodermoid change, prominent superficial veins, dyspigmentation, and alopecia. The mean age of presentation for each finding was <12 months. The most frequently reported skin feature was sclerodermoid change, which commonly involved the abdomen and bilateral lower extremities. Prominent superficial vasculature manifested as circumoral cyanosis and pronounced veins on the scalp and body. Hypo- and hyperpigmentation were observed over areas of sclerodermoid change. Scalp alopecia progressed in a distinct pattern, with preservation of the hair over the midscalp and vertex areas for the longest period of time. HGPS has distinct cutaneous manifestations during the first 2 years of life that may be the first signs of disease. Awareness of these findings could expedite diagnosis. PMID:24456199

  3. Neural correlates of impaired emotion processing in manifest Huntington's disease.

    PubMed

    Dogan, Imis; Saß, Christian; Mirzazade, Shahram; Kleiman, Alexandra; Werner, Cornelius J; Pohl, Anna; Schiefer, Johannes; Binkofski, Ferdinand; Schulz, Jörg B; Shah, N Jon; Reetz, Kathrin

    2014-05-01

    The complex phenotype of Huntington's disease (HD) encompasses motor, psychiatric and cognitive dysfunctions, including early impairments in emotion recognition. In this first functional magnetic resonance imaging study, we investigated emotion-processing deficits in 14 manifest HD patients and matched controls. An emotion recognition task comprised short video clips displaying one of six basic facial expressions (sadness, happiness, disgust, fear, anger and neutral). Structural changes between patients and controls were assessed by means of voxel-based morphometry. Along with deficient recognition of negative emotions, patients exhibited predominantly lower neural response to stimuli of negative valences in the amygdala, hippocampus, striatum, insula, cingulate and prefrontal cortices, as well as in sensorimotor, temporal and visual areas. Most of the observed reduced activity patterns could not be explained merely by regional volume loss. Reduced activity in the thalamus during fear correlated with lower thalamic volumes. During the processing of sadness, patients exhibited enhanced amygdala and hippocampal activity along with reduced recruitment of the medial prefrontal cortex. Higher amygdala activity was related to more pronounced amygdala atrophy and disease burden. Overall, the observed emotion-related dysfunctions in the context of structural neurodegeneration suggest both disruptions of striatal-thalamo-cortical loops and potential compensation mechanism with greater disease severity in manifest HD. PMID:23482620

  4. Ear-nose-throat manifestations of autoimmune rheumatic diseases.

    PubMed

    Papadimitraki, E D; Kyrmizakis, D E; Kritikos, I; Boumpas, D T

    2004-01-01

    Ear-nose-throat (ENT) manifestations of connective tissue disorders represent a diagnostic challenge for clinicians as they often constitute the initial sign of an otherwise asymptomatic autoimmune disease. Moreover, in patients with known autoimmune rheumatic diseases, ENT manifestations can be overlooked. Hearing disturbances may be seen in patients with systemic lupus erythematosus, Wegener's granulomatosis, relapsing polychondritis, polyarteritis nodosa, Cogan's syndrome, Sjögren's syndrome, and less frequently in Churg-Strauss syndrome and Adamantiades-Behçet's disease. Nose and paranasal sinuses are variably affected during the course of Wegener's granulomatosis, Churg-Strauss syndrome, relapsing polychondritis and sarcoidosis. Recurrent mucosal ulcerations are common in systemic lupus erythematosus and Adamantiades-Behçet's disease. Xerostomia is a common feature of primary and secondary Sjögren's syndrome; salivary gland enlargement may be also seen in these patients, as well as in patients with sarcoidosis. The cricoarytenoid joint can be involved during the course of rheumatoid arthritis, ankylosing spondylitis and gout; osteoarthritic changes have also been described. Motility disorders of the upper and/or the lower portions of the esophagus have been reported in patients with dermatomyositis/polymyositis, systemic sclerosis and systemic lupus erythematosus. Trigeminal nerve dysfunction may occur in patients with Sjögren's syndrome, systemic sclerosis, systemic lupus erythematosus and mixed connective tissue disease. Peripheral facial nerve palsy has been described to complicate the course of Sjögren's syndrome and sarcoidosis. PMID:15301251

  5. Initial Cutaneous Manifestations of Hutchinson-Gilford Progeria Syndrome

    PubMed Central

    Rork, Jillian F.; Huang, Jennifer T.; Gordon, Leslie B.; Kleinman, Monica; Kieran, Mark W.; Liang, Marilyn G.

    2014-01-01

    Hutchinson-Gilford progeria syndrome (HGPS) is a rare, uniformly fatal premature aging disease with distinct dermatologic features. We sought to identify and describe the initial skin and hair findings as potential diagnostic signs of the disease. We performed a chart review of the structured initial intake histories of 39 individuals with HGPS enrolled in clinical trials from 2007 to 2010 at Boston Children’s Hospital, limited to cutaneous history from birth to 24 months. Medical photographs were provided through the clinical trials and The Progeria Research Foundation Medical and Research Database at Brown University Center for Gerontology and Healthcare Research. All 39 patients reported skin and hair abnormalities within the first 24 months of life. Pathologies included sclerodermoid change, prominent superficial veins, dyspigmentation, and alopecia. The mean age of presentation for each finding was less than 12 months. The most frequently reported skin feature was sclerodermoid change, which commonly involved the abdomen and bilateral lower extremities. Prominent superficial vasculature manifested as circumoral cyanosis and pronounced veins on the scalp and body. Hypo- and hyperpigmentation were observed over areas of sclerodermoid change. Scalp alopecia progressed in a distinct pattern, with preservation of the hair over the midscalp and vertex areas for the longest period of time. HGPS has distinct cutaneous manifestations during the first 2 years of life that may be the first signs of disease. Awareness of these findings could expedite diagnosis. PMID:24456199

  6. Rare Bone Diseases and Their Dental, Oral, and Craniofacial Manifestations

    PubMed Central

    Foster, B.L.; Ramnitz, M.S.; Gafni, R.I.; Burke, A.B.; Boyce, A.M.; Lee, J.S.; Wright, J.T.; Akintoye, S.O.; Somerman, M.J.; Collins, M.T.

    2014-01-01

    Hereditary diseases affecting the skeleton are heterogeneous in etiology and severity. Though many of these conditions are individually rare, the total number of people affected is great. These disorders often include dental-oral-craniofacial (DOC) manifestations, but the combination of the rarity and lack of in-depth reporting often limit our understanding and ability to diagnose and treat affected individuals. In this review, we focus on dental, oral, and craniofacial manifestations of rare bone diseases. Discussed are defects in 4 key physiologic processes in bone/tooth formation that serve as models for the understanding of other diseases in the skeleton and DOC complex: progenitor cell differentiation (fibrous dysplasia), extracellular matrix production (osteogenesis imperfecta), mineralization (familial tumoral calcinosis/hyperostosis hyperphosphatemia syndrome, hypophosphatemic rickets, and hypophosphatasia), and bone resorption (Gorham-Stout disease). For each condition, we highlight causative mutations (when known), etiopathology in the skeleton and DOC complex, and treatments. By understanding how these 4 foci are subverted to cause disease, we aim to improve the identification of genetic, molecular, and/or biologic causes, diagnoses, and treatment of these and other rare bone conditions that may share underlying mechanisms of disease. PMID:24700690

  7. Cistoid macular edema as first manifestation of sarcoidosis.

    PubMed

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

    2014-08-01

    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

  8. Requirements for a Manifestly Covariant Quantum Field Theory

    NASA Astrophysics Data System (ADS)

    Walker, Stuart

    2015-04-01

    Quantum field theory has shown much success in defining manifestly covariant fields in Minkowski space-time. The general procedure for construction of QFT in terms of annihilation and creation operators acting through a simplectic form is outlined. It is demonstrated that this methodology fails to define a general covariant vector field in a space-time spanning a Riemannian manifold with Lorentz metric (M,guv) ; therefore, no appropriate outer product can be defined to produce a general 2nd rank tensor (i.e. stress-energy tensor). The QFT defined in flat space-time is expanded to include curvilinear coordinates. The manifestly covariant QFT in curved space-time is used to redefine the equations of motion in terms of the classical field theory. The resulting theory has the benefit of requiring an S-matrix defining unitarily equivalent quantum theories while providing an exact formulation for the quantized equations of motion in a gravitational field. The physical implications of this construction are discussed including the anisomorphic nature of the simplectic vector space in curvilinear coordinates. An example involving plane wave expansion is discussed.

  9. Rare bone diseases and their dental, oral, and craniofacial manifestations.

    PubMed

    Foster, B L; Ramnitz, M S; Gafni, R I; Burke, A B; Boyce, A M; Lee, J S; Wright, J T; Akintoye, S O; Somerman, M J; Collins, M T

    2014-07-01

    Hereditary diseases affecting the skeleton are heterogeneous in etiology and severity. Though many of these conditions are individually rare, the total number of people affected is great. These disorders often include dental-oral-craniofacial (DOC) manifestations, but the combination of the rarity and lack of in-depth reporting often limit our understanding and ability to diagnose and treat affected individuals. In this review, we focus on dental, oral, and craniofacial manifestations of rare bone diseases. Discussed are defects in 4 key physiologic processes in bone/tooth formation that serve as models for the understanding of other diseases in the skeleton and DOC complex: progenitor cell differentiation (fibrous dysplasia), extracellular matrix production (osteogenesis imperfecta), mineralization (familial tumoral calcinosis/hyperostosis hyperphosphatemia syndrome, hypophosphatemic rickets, and hypophosphatasia), and bone resorption (Gorham-Stout disease). For each condition, we highlight causative mutations (when known), etiopathology in the skeleton and DOC complex, and treatments. By understanding how these 4 foci are subverted to cause disease, we aim to improve the identification of genetic, molecular, and/or biologic causes, diagnoses, and treatment of these and other rare bone conditions that may share underlying mechanisms of disease. PMID:24700690

  10. Case report: bipolar disorder as the first manifestation of CADASIL

    PubMed Central

    2014-01-01

    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

  11. Neurologic and psychiatric manifestations of celiac disease and gluten sensitivity.

    PubMed

    Jackson, Jessica R; Eaton, William W; Cascella, Nicola G; Fasano, Alessio; Kelly, Deanna L

    2012-03-01

    Celiac Disease (CD) is an immune-mediated disease dependent on gluten (a protein present in wheat, rye or barley) that occurs in about 1% of the population and is generally characterized by gastrointestinal complaints. More recently the understanding and knowledge of gluten sensitivity (GS), has emerged as an illness distinct from celiac disease with an estimated prevalence 6 times that of CD. Gluten sensitive people do not have villous atrophy or antibodies that are present in celiac disease, but rather they can test positive for antibodies to gliadin. Both CD and GS may present with a variety of neurologic and psychiatric co-morbidities, however, extraintestinal symptoms may be the prime presentation in those with GS. However, gluten sensitivity remains undertreated and underrecognized as a contributing factor to psychiatric and neurologic manifestations. This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease, and summarizes the potential mechanisms related to this immune reaction. PMID:21877216

  12. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...manifest requirement for all individuals onboard private aircraft arriving in and departing...manifest requirement for all individuals onboard private aircraft arriving in and departing...manifest requirement for all individuals onboard private aircraft arriving in the...

  13. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...manifest requirement for all individuals onboard private aircraft arriving in and departing...manifest requirement for all individuals onboard private aircraft arriving in and departing...manifest requirement for all individuals onboard private aircraft arriving in the...

  14. Surface manifestations of internal waves investigated by a subsurface buoyant jet: 3. Surface manifestations of internal waves

    NASA Astrophysics Data System (ADS)

    Bondur, V. G.; Grebenyuk, Yu. V.; Ezhova, E. V.; Kazakov, V. I.; Sergeev, D. A.; Soustova, I. A.; Troitskaya, Yu. I.

    2010-08-01

    In a large test reservoir at the Institute of Applied Physics, Russian Academy of Sciences, a series of experiments were performed to investigate the surface manifestations of internal waves radiated by a subsurface buoyant jet. The field of currents on the water surface of the reservoir was studied through the distribution of temperature with shallow thermocline. Using Particle Tracking Velocimetry (PTV), the velocity field of surface currents was measured. A theoretical model was developed to calculate the rates of disturbances on the surface. A comparison with experimental data indicated that the calculated data of the surface rate value are overestimated. This discrepancy was explained by the presence of a film of surface-active substances (SASs) with experimentally obtained parameters. Using scale modeling coefficients, we estimated the parameters of internal waves radiated by the subsurface wastewater system and the values of their surface manifestations in field conditions. We estimated the hydrodynamic contrasts in the field of surface waves, which can be caused by these inhomogeneous currents on the surface. For a wind velocity of 5 m/s, the magnitude of the contrast in the field of short waves can reach up to 10-25%, which is detected with confidence by remote-sensing methods.

  15. MUCOCUTANEOUS MANIFESTATIONS OF CHIKUNGUNYA FEVER: A STUDY FROM AN EPIDEMIC IN COASTAL KARNATAKA

    PubMed Central

    Bhat, Ramesh M; Rai, Yashaswi; Ramesh, Amitha; Nandakishore, B; Sukumar, D; Martis, Jacintha; Kamath, Ganesh H

    2011-01-01

    Background: Chikungunya fever (CF) epidemic has recently re-emerged in India affecting large population. Mucocutaneous manifestations are an important clinical feature of the disease. We have reviewed mucocutaneous manifestations of the disease during a recent epidemic in coastal Karnataka. Patients and Methods Seventy-five “suspect cases” of CF with dermatological manifestations were examined. Results: We categorized the mucocutaneous manifestation into six groups: 1. skin rash, 2. apthae like ulcers, 3. pigmentary changes, 4. desquamation, 5. exacerbation of the existing dermatoses, 6. miscellaneous. Skin rashes were the most commonly observed skin changes followed by apthae like ulcers and pigmentary changes. Desquamation of the skin over the face is a new manifestation observed by us. Conclusion: wide spectrum of mucocutaneous manifestations is observed in CF. We have provided a classification for these manifestations, which may help in better recognition and uniform recording in future. PMID:21772590

  16. Effect of maternal transmissions on clinical manifestations of myotonic dystrophy

    SciTech Connect

    Eguchi, I.; Koike, R.; Onodera, O.

    1994-09-01

    The mutation of myotonic dystrophy (DM) has been identified as unstable expansions of trinucleotide CTG repeat, located on chromosome 19q13-3. Although previous investigations have emphasized the strong association of the sizes of the CTG repeat with ages of onset as well as the clinical manifestations, effects of the paternal or maternal transmissions other than CTG repeats on the clinical manifestations in DM have not been evaluated in detail. To investigate how parental transmission affect the DM phenotype, we analyzed 15 cases of paternal transmission and 25 cases of maternal transmission. We have classified DM patients into 4 clinical grades. As in accordance with previous reports, there is a good correlation on sizes of the CTG repeat with their clinical features. The sizes of the CTG repeat in congenital DM patients (4.13{plus_minus}0.221 kbp) (Mean {plus_minus}SEM), who inherited mutant genes from their mothers, were not significantly larger than those of non-congenital DM patients (3.65 {plus_minus}0.36 kbp). As it has been well established that congenital DM patients are born to affected mothers, we investigated to see if there are any parental bias on the clinical manifestations in non-congenital DM. We classified each case into 4 classes depending on the size ranges of the CTG repeat (0 to 1.5 kbp, 1.5 to 3.0 kbp, 3.0 to 4.5 kbp, 4.5 kbp<). In each group of the size ranges of the CTG repeat, the distribution of cases among grades I to III were compared between paternally and maternally transmitted cases. There were statistically significant differences in the distributions of cases among grades I to III for the size ranges of 3 to 4.5 kbp expansions (p<0.01) and over 4.5 kbp expansions (p<0.05) on {chi}{sup 2} test, respectively. The results revealed that maternally transmitted cases tend to show severe phenotypes compared to paternally transmitted ones even if they have similar sizes of CTG repeat.

  17. Topological manifestations of surface-roughening collapse in Langmuir monolayers

    NASA Astrophysics Data System (ADS)

    Hatta, E.; Nagao, J.

    2003-04-01

    A transition from surface-roughening collapse to a random network collapse has been investigated in fatty acid Langmuir monolayers. In contrast to the random network crack pattern, the surface-roughening crack pattern grows on a much longer time scale and on a much shorter length scale. A change in the isotherm from a surface pressure “spike” to a “plateau” occurs at the transition. In the surface-roughening regime, the pattern is manifested by the emergence of a three-dimensional (3D) disordered stripe phase with locally aligned, anisotropic stripe clusters. The individual stripes coalesce less with each other even at a late stage of the collapse process and there is a characteristic length for the stripe width and the nearest neighbor spacing. The pattern includes a high density of topological defects such as single open ends, twin open ends, branches, and loops. The effects of shear deformation on the observed patterns are discussed.

  18. Isolated facial hemihyperplasia: manifestation of Beckwith-Wiedemann syndrome.

    PubMed

    Sathienkijkanchai, Achara; Prucka, Sandra K; Grant, John H; Robin, Nathaniel H

    2008-01-01

    Facial asymmetry is a common finding in infants and can be the result of a number of distinctive conditions such as hemifacial microsomia, overgrowth syndromes, a soft tissue tumor, and a vascular malformation. However, overgrowth syndromes such as Beckwith-Wiedemann syndrome (BWS) typically manifest more extensive involvement; it rarely presents as isolated facial overgrowth.Here, we present a 7-year-old boy who presented with facial asymmetry. He was found to have isolated facial hemihyperplasia, involving his right cheek and teeth. No abnormalities were seen in the rest of his examination. The diagnosis of BWS was considered and was confirmed by detection of a methylation abnormality in H19 (DMR1). This case demonstrates that BWS should be considered, even with isolated facial involvement. This is important, as affected patients are predisposed to certain malignancies, especially in the first 5 to 8 years of life. Therefore, specialized surveillance is recommended as the part of management. PMID:18216702

  19. The Pion Velocity at Chiral Restoration and the Vector Manifestation

    E-print Network

    Masayasu Harada; Youngman Kim; Mannque Rho; Chihiro Sasaki

    2003-10-27

    We study the effects of Lorentz non-invariance on the physical pion velocity at the critical temperature $T_c$ in an effective theory of hidden local symmetry (HLS) with the "vector manifestation" fixed point. We match at a "matching scale" $\\Lambda_M$ the axial-vector current correlator in the HLS with the one in the operator product expansion for QCD, and present the matching condition to determine the bare pion velocity. We find that the physical pion velocity, which is found to be one at $T=T_c$ when starting from the Lorentz invariant bare HLS, remains close to one with the Lorentz non-invariance, $v_\\pi (T_c) = 0.83 - 0.99$. This result is quite similar to the pion velocity in dense matter.

  20. Pulmonary cystic disease associated with integumentary and renal manifestations

    PubMed Central

    Cayetano, Katherine S.; Albertson, Timothy E.; Chan, Andrew L.

    2013-01-01

    A 69-year-old man with multiple skin lesions on his face, neck and upper torso, which first appeared in the 3rd decade of his life, was admitted to our hospital. He had cystic changes in his lungs noted on chest computed tomography (CT) scanning, as well as a left kidney mass. This patient exhibited a rare complex of renal, cutaneous and pulmonary manifestations, eponymously named Birt-Hogg-Dube syndrome, with characteristic skin features (fibrofolliculomas, trichodiscomas and acrochordons). This syndrome is due to an autosomal dominant germ-line mutation of the folliculin (FLCN) gene located at chromosome 17p11.2. Diagnosis and differentiation from other disease complexes including the skin, kidneys and lungs are important in prognostication and management of potentially life-threatening complications such as renal cell carcinoma and pneumothoraces. PMID:24285950

  1. Pulmonary cystic disease associated with integumentary and renal manifestations.

    PubMed

    Cayetano, Katherine S; Albertson, Timothy E; Chan, Andrew L

    2013-11-01

    A 69-year-old man with multiple skin lesions on his face, neck and upper torso, which first appeared in the 3rd decade of his life, was admitted to our hospital. He had cystic changes in his lungs noted on chest computed tomography (CT) scanning, as well as a left kidney mass. This patient exhibited a rare complex of renal, cutaneous and pulmonary manifestations, eponymously named Birt-Hogg-Dube syndrome, with characteristic skin features (fibrofolliculomas, trichodiscomas and acrochordons). This syndrome is due to an autosomal dominant germ-line mutation of the folliculin (FLCN) gene located at chromosome 17p11.2. Diagnosis and differentiation from other disease complexes including the skin, kidneys and lungs are important in prognostication and management of potentially life-threatening complications such as renal cell carcinoma and pneumothoraces. PMID:24285950

  2. Manifestly Conformal Descriptions and Higher Symmetries of Bosonic Singletons

    E-print Network

    Xavier Bekaert; Maxim Grigoriev

    2011-08-03

    The usual ambient space approach to conformal fields is based on identifying the d-dimensional conformal space as the Dirac projective hypercone in a flat d+2-dimensional ambient space. In this work, we explicitly concentrate on singletons of any integer spin and propose an approach that allows one to have both locality and conformal symmetry manifest. This is achieved by using the ambient space representation in the fiber rather than in spacetime. This approach allows us to characterize a subalgebra of higher symmetries for any bosonic singleton, which is a candidate higher-spin algebra for mixed symmetry gauge fields on anti de Sitter spacetime. Furthermore, we argue that this algebra actually exhausts all higher symmetries.

  3. Manifestly conformal descriptions and higher symmetries of bosonic singletons

    E-print Network

    Bekaert, Xavier

    2009-01-01

    The usual ambient space approach to conformal fields is based on identifying the d dimensional conformal space as the Dirac projective hypercone in a flat d+2 dimensional ambient space. In this work, we explicitly concentrate on singletons of any integer spin and propose an approach that allows one to have both locality and conformal symmetry manifest. This is achieved by using the ambient space representation in the fiber rather than in spacetime. This approach allows us to characterize a subalgebra of higher symmetries for any bosonic singleton, which is a candidate higher-spin algebra for mixed symmetry gauge fields on anti de Sitter spacetime. Furthermore, we argue that this algebra actually exhausts all higher symmetries.

  4. Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency

    PubMed Central

    Farah, Julia de Lima; Lauand, Carolina Villar; Chequi, Lucas; Fortunato, Enrico; Pasqualino, Felipe; Bignotto, Luis Henrique; Batista, Rafael Loch; Aprahamian, Ivan

    2015-01-01

    We describe a case of severe psychotic disorder as the only manifestation of primary adrenal insufficiency. A 63-year-old man presented with psychotic symptoms without any prior psychiatric history. During the clinical and laboratorial investigation, exams revealed a normovolemic hyponatremia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency but displayed very high ACTH and low serum cortisol concentrations. Brain magnetic resonance imaging showed no significant changes, including the pituitary gland. The patient was initially treated with intravenous corticosteroids, resulting in rapid remission of the psychotic symptoms. The association between adrenal insufficiency and neuropsychiatric symptoms is rare but these symptoms can often be the first clinical presentation of the disease. PMID:25954562

  5. Dilative Arteriopathy and Leucencephalopathy as Manifestations of a Neurometabolic Disease

    PubMed Central

    Finsterer, Josef; Bastovansky, Adam

    2015-01-01

    Background: Dilative arteriopathy plus leucencephalopathy as a manifestation of a mitochondrial disorder (MID) is rare. Case report: In a 70yo Caucasian female, height 160cm, weight 62kg, with mild right-sided hemiparesis due to subacute ischemic stroke in the posterior leg of the left internal capsule, a megadolichobasilar artery and marked leucencephalopathy and gliosis of the pons were detected. In addition, microbleeds in a peripheral distribution at the cortical/subcortical border were noted. After the exclusion of various differentials, which could have explained her abnormalities, a MID was suspected. Conclusions: Dilative arteriopathy of the intra-cerebral arteries, in association with recurrent stroke and supra- and infratentorial leucencephalopathy, but the absence of neurofibromatosis or increased low-density lipoprotein values, is most likely attributable to a non-syndromic MID. PMID:26191091

  6. Infertility and miscarriage: common pathways in manifestation and management.

    PubMed

    Agenor, Angena; Bhattacharya, Sohinee

    2015-07-01

    The relationship between miscarriage and fertility is complex. While most healthcare settings treat miscarriage as a problem of subfertility in assisted reproduction units, others believe that miscarriage occurs in super-fertile women. Infertile women undergoing assisted reproduction are at a greater risk of having a miscarriage especially at an advanced age compared with women conceiving naturally. Aberrant expression of immunological factors and chromosomal abnormalities underlie both infertility and miscarriage. Common risk factors include increased maternal age, obesity, smoking, alcohol, pre-existing medical conditions and anatomical abnormalities of the reproductive system. Management pathways of both conditions may be similar with pre-implantation genetic testing and assisted reproductive technology used in both conditions. This paper discusses the synergies and differences between the two conditions in terms of their epidemiology, etiopathogenesis, risk factors and management strategies. The two conditions are related as degrees of severity of reproductive failure with common pathways in manifestation and management. PMID:26238301

  7. Pictorial review of intrathoracic manifestations of progressive systemic sclerosis

    PubMed Central

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

    2014-01-01

    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

  8. [Primary manifestation of Wegener's granulomatosis of the prostate].

    PubMed

    Mundinger, A; Pumpe, K; Grosser, G; Herbst, E W; Grotz, W; Kröpelin, T

    1989-07-01

    In approximately 2-7% of patients with Wegener's granulomatosis involvement of the prostate has been demonstrated histologically. This usually comes about quite late in the course of disease, after generalization of the granulomatous vasculitis from respiratory tract to kidneys and other organs. The patient we present had a highly atypical first manifestation of Wegener's granulomatosis in the prostate, generalized vasculitis not developing until later. When a biopsy shows unclear granulomatous changes in the prostate, a test for anticytoplasmatic antibodies should be performed in addition to the conventional serologic and cultural examinations. Anticytoplasmatic antibodies are highly specific for the diagnosis of active Wegener's granulomatosis. Early diagnosis and immediate initiation of immunosuppressive therapy with cyclophosphamide and corticosteroids can prevent or limit organ damage and improve the prognosis in Wegener's granulomatosis. PMID:2474881

  9. Neurobehavioral manifestations of developmental impairment of the brain

    PubMed Central

    Dubovický, Michal

    2010-01-01

    Individual characteristics of human nature (e.g. introversion, extroversion, mood, activity, adaptability, aggressiveness, social ability, anxiety) do not need to be primarily innate. They can be determined by the action of various influences and their interactions on functional development of the brain. There is ample epidemiological and experimental evidence that chemical and/or physical factors acting during sensitive time windows of the brain development can cause mental, behavioral, emotional and/or cognitive disorders. Environmental pollutants, addictive substances, drugs, malnutrition, excessive stress and/or hypoxia-ischemia were reported to induce functional maldevelopment of the brain with consequent neurobehavioral disorders. The article provides review on most significant neurobehavioral manifestations of developmental impairment of the brain during prenatal, perinatal and early postnatal period. The most known adverse factors causing developmental neurobehavioral dysfunctions in humans as well as in experimental animals are discussed. PMID:21217874

  10. Gastrointestinal manifestations of Behçet's disease: advances in evaluation and management.

    PubMed

    Vaiopoulos, Aristeidis G; Sfikakis, Petros P; Kanakis, Meletios A; Vaiopoulos, George; Kaklamanis, Phaedon G

    2014-01-01

    Behçet's disease is a chronic, recurrent, inflammatory disorder characterized by orogenital ulcers and skin lesions; serious manifestations also include ocular, large vessel, gastrointestinal and neurological involvement. Genetic and unknown environmental factors customise the wide clinical expression of the disease. Gastrointestinal involvement is not unusual, albeit with a highly variable frequency among different ethnic populations. However, given the fact that gastrointestinal symptoms such as reflux, bleeding, diarrhoea are common in the general population, their clinical significance needs to be carefully interpreted. Apart from mouth the ileocecal area is typically involved, but inflammatory and/or vasculitic lesions may affect any part of the gastrointestinal tract. Complications such as perforation carry high morbidity rates and even mortality. Herein, we review all available information pertinent to gastrointestinal involvement of Behçet's disease and discuss the published advances in evaluation and its empirical management, including anti-TNF biologic therapies. PMID:25268668

  11. Star copolymers in porous environments: scaling and its manifestations

    E-print Network

    Viktoria Blavatska; Christian von Ferber; Yurij Holovatch

    2010-10-11

    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.

  12. Quantum manifestation of a synchronization transition in optomechanical systems

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

    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.

  13. Oral manifestations of thyroid disorders and its management

    PubMed Central

    Chandna, Shalu; Bathla, Manish

    2011-01-01

    The thyroid is the major regulator of metabolism and affects all of the bodily functions. Thyroid dysfunction is the second most common glandular disorder of the endocrine system which may rear its head in any system in the body including the mouth. The oral cavity is adversely affected by either an excess or deficiency of these hormones. Before treating a patient who has thyroid disorder, the endocrinologist needs to be familiar with the oral manifestations of thyroid dysfunctions. The patient with a thyroid dysfunction, as well as the patient taking medications for it, requires proper risk management before considering dental treatment by the dentist. Thus, communication of dentist with endocrinologist must be bidirectional, to maintain patient's oral and thyroid health. PMID:21966646

  14. Oral manifestations of connective tissue disease and novel therapeutic approaches.

    PubMed

    Heath, Kenisha R; Rogers, Roy S; Fazel, Nasim

    2015-01-01

    Connective tissue diseases such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Sjögren syndrome (SS) have presented many difficulties both in their diagnosis and treatment. Known causes for this difficulty include uncertainty of disease etiology, the multitude of clinical presentations, the unpredictable disease course, and the variable cell types, soluble mediators, and tissue factors that are believed to play a role in the pathogenesis of connective tissue diseases. The characteristic oral findings seen with these specific connective tissue diseases may assist with more swift diagnostic capability. Additionally, the recent use of biologics may redefine the success rate in the treatment and management of the disease. In this review we describe the oral manifestations associated with SLE, SSc, and SS and review the novel biologic drugs used to treat these conditions. PMID:26632801

  15. Clinical Manifestations among Children with Chronic Functional Constipation

    PubMed Central

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

    2015-01-01

    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

  16. Castleman Disease: A Rare Condition with Endocrine Manifestations.

    PubMed

    Cervantes, Carmen E; Correa, Ricardo

    2015-01-01

    Castleman disease (CD) most commonly affects lymphoid tissues in the thorax, abdomen, pelvis, and neck. Extralymphatic tissues, such as lacrimal glands, lung, pancreas, larynx, parotid, meninges, and even muscles, have also been reported as sites. The etiology is unknown and its incidence has not been reported in the literature. Castleman disease can be classified clinically into a unicentric or multicentric form, depending on the number of lymph nodes involved, and histologically into a hyaline vascular variant, plasma cell, mixed cellular, or plasmablastic variant. The disease has a predominantly inflammatory background, reflected in high levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6). The role of cytokines in CD explains the clinical presentation. The clinical scenario varies widely, based mainly on the histologic type. Unicentric CD usually presents without symptomatology, whereas multicentric manifests with fatigue, abdominal or thoracic pain, cytopenias, and/or B- symptoms (10% weight loss in the last six months, nocturnal diaphoresis, and fever). The endocrinopathy has a wide range of manifestations, affecting either the pituitary or other target organs. Achieving the diagnosis is complicated and there is no laboratory or imaging pathognomonic for this disease. The gold standard is an excisional biopsy from an affected lymph node. The treatment depends on the type of CD. Unicentric CD has a good response to excisional surgery. However, in multicentric CD (MCD), surgery may provide transient relief of symptoms but with a rebound effect, so it is not considered a good method. The use of chemotherapy, monoclonal antibodies, glucocorticoids, and thalidomide has shown some improvement in MCD. PMID:26719823

  17. Castleman Disease: A Rare Condition with Endocrine Manifestations

    PubMed Central

    Correa, Ricardo

    2015-01-01

    Castleman disease (CD) most commonly affects lymphoid tissues in the thorax, abdomen, pelvis, and neck. Extralymphatic tissues, such as lacrimal glands, lung, pancreas, larynx, parotid, meninges, and even muscles, have also been reported as sites. The etiology is unknown and its incidence has not been reported in the literature. Castleman disease can be classified clinically into a unicentric or multicentric form, depending on the number of lymph nodes involved, and histologically into a hyaline vascular variant, plasma cell, mixed cellular, or plasmablastic variant. The disease has a predominantly inflammatory background, reflected in high levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6). The role of cytokines in CD explains the clinical presentation. The clinical scenario varies widely, based mainly on the histologic type. Unicentric CD usually presents without symptomatology, whereas multicentric manifests with fatigue, abdominal or thoracic pain, cytopenias, and/or B- symptoms (10% weight loss in the last six months, nocturnal diaphoresis, and fever). The endocrinopathy has a wide range of manifestations, affecting either the pituitary or other target organs. Achieving the diagnosis is complicated and there is no laboratory or imaging pathognomonic for this disease. The gold standard is an excisional biopsy from an affected lymph node. The treatment depends on the type of CD. Unicentric CD has a good response to excisional surgery. However, in multicentric CD (MCD), surgery may provide transient relief of symptoms but with a rebound effect, so it is not considered a good method. The use of chemotherapy, monoclonal antibodies, glucocorticoids, and thalidomide has shown some improvement in MCD.  PMID:26719823

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

    PubMed Central

    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

    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

  19. Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

    PubMed Central

    Kim, Dai Hyun; Seo, Soo Hong; Ahn, Hyo Hyun; Kye, Young Chul

    2015-01-01

    Background Pigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge. Objective The purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses. Methods Retrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012. Results Information on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schamberg's disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05). Conclusion Our overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05). PMID:26273156

  20. [A case of toxic epidermal necrolysis with severe intestinal manifestation].

    PubMed

    Otomi, Megumi; Yano, Mitsuyasu; Aoki, Hidetoshi; Takahashi, Kouji; Omoya, Toshihiro; Suzuki, Yasuhiro; Nakamoto, Jiro; Kataoka, Koichi; Yagi, Yoshiyuki; Yamamoto, Yosuke

    2008-09-01

    TEN is a severe dermatological disorder characterized by extended epidermal necrosis. Disseminated mucosal erosions have been occasionally reported to occur in the gastrointestinal tract. We report a case of toxic epidermal necrolysis (TEN) with severe intestinal manifestation. A 52-year-old woman was admitted with high fever, skin eruption and severe diarrhea. She was diagnosed as toxic epidermal necrolysis (TEN), which was most likely due to nonsteroidal anti-inflammatory drugs (NSAIDs). After skin lesion recovered, fever and bloody diarrhea went on. Colonoscopy and X-ray revealed lead-pipe like stenotic long loops which was caused by erosion and sublation of whole mucosa of large intestinum, and severe stenosis of ileum end. The ileo-cecal region was resected on the 216(th) hospital day. Pathological examination showed sublation of mucoepithelium and inflammatory change in the muco-submucosal layer, but muscular layers of mucosa remained intact. Pathologically, the intestinal lesion resemble the changes in the early skin lesions and seems to be part of the systemic lesion of TEN. PMID:18772576

  1. Para-dichlorobenzene toxicity – a review of potential neurotoxic manifestations

    PubMed Central

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

    2014-01-01

    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

  2. Fraser Syndrome-Oral Manifestations and a Dental Care Protocol

    PubMed Central

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

    2014-01-01

    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

  3. Mycobacterium haemophilum infection with prominent facial manifestation mimicking leprosy.

    PubMed

    Ishii, Kentaro; Ishii, Norihisa; Nakanaga, Kazue; Nakano, Kazuaki; Saito, Ikuo; Asahina, Akihiko

    2015-10-01

    Mycobacterium haemophilum is a slow-growing non-tuberculous mycobacterium that is rarely known to cause human skin infection, particularly in immunocompromised patients. We recently experienced a 69-year-old Japanese woman with this infection who had been under immunosuppressive treatment for recalcitrant rheumatoid arthritis. The patient showed disseminated erythematous plaques and subcutaneous nodules on the face and extremities, and interestingly, the face manifested with a striking "facies leontina" appearance. Biopsy revealed abscess and granulomatous dermatitis with the involvement of peripheral nerve bundles and the presence of innumerable acid-fast bacilli, thus necessitating differentiation from lepromatous leprosy. M. haemophilum was identified by molecular characterization as well as by successful culture with iron supplements. Although drug susceptibility testing indicated responsiveness to multiple antibiotics administrated simultaneously for the treatment, it took over 6 months to achieve significant improvement, and we also employed concurrent oral potassium iodide administration and repeated surgical excision. This case highlights the importance of continuous combination therapy for successful outcome in this rare infection. Furthermore, application of potassium iodide for mycobacterial infection warrants further evaluation by accumulating more cases. PMID:26017241

  4. Progeria: pathogenesis and oral manifestation--a review.

    PubMed

    Saigal, S; Bhargava, A

    2012-01-01

    Our life span is genetically programmed and it is possible that a defect in produced proteins encoded by the longevity gene is a cause of aging. Progeria which is a rare, fatal genetic condition which affects between one in four million and one in eight million children of both sexes equally and characterized by premature and accelerated aging. The appearance and physiology of these children resembles to elderly people but they typically have life span to their mid teens. It is also known as the Hutchinson-Gilford syndrome, which was initially reported by Johnathan Hutchinson in 1886 and further described by Hastings Gilford in 1904. It is an autosomal recessive disorder, which means an individual has inherited a mutated gene from both parents. It is added to the expanding catalogue of laminopathies, diseases caused by mutations affecting nuclear lamina proteins known as lamin A (LMNA). In oral manifestation primary finding is micrognathia with delayed tooth eruption and incomplete formation of root of permanent tooth. Presently there are no known cures for this abnormality. PMID:22971867

  5. Glomerulonephritis and cryoglobulinemia: first manifestation of visceral leishmaniasis.

    PubMed

    Ortiz, Milagros; Mon, Carmen; Herrero, Juan Carlos; Oliet, Aniana; Rodríguez, Isabel; Ortega, Olimpia; Gallar, Paloma; Hinostroza, Julie; Cobo, Gabriela; del Alamo, Manuel; Jiménez, Juana; Torres, Rafael; Digiogia, Cristina; San Martin, Juan; Vigil, Ana I; Blanco, Julia

    2015-06-01

    Visceral leishmaniasis due to Leishmania Infantum is an endemic parasitic infection in the Mediterranean area. Since 2009, Europe's largest outbreak of Leishmaniasis has been reported in the region of Madrid (Spain). Renal involvement is an unusual complication. Different forms of renal disease have been described: interstitial, glomerular, and vascular damage. Direct invasion of renal parenchyma by the parasite has been described as a mechanism of kidney damage, especially in the immunocompromised. Immune complex deposition and T cells adhesion molecules activation have demonstrated that a pathogenic role in glomerulonephritis related to visceral leishmaniasis. The association between mixed cryoglobulinemia and visceral leishmaniasis has been previously reported in six patients. Renal involvement is only described in one of them. From July 2009 to October 2012, 4 patients with membranoproliferative glomerulonephritis and mixed cryoglobulinemia with negative serology for hepatitis B and C were diagnosed in our hospital. Serology of Leishmania in serum bank samples was performed; it was positive in 3 patients. Leishmania parasite was confirmed by other tests. We present 3 patients with mixed cryoglobulinemia and membranoproliferative glomerulonephritis as first clinical manifestation of visceral leishmaniasis. PMID:25600859

  6. Severe Abdominal Pain as the First Manifestation of Rabies

    PubMed Central

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

    2014-01-01

    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

  7. New clinical trials for nonmotor manifestations of Parkinson's disease.

    PubMed

    Schrag, Anette; Sauerbier, Anna; Chaudhuri, Kallol Ray

    2015-09-15

    Nonmotor manifestations in Parkinson's disease (PD) encompass a range of clinical features, including neuropsychiatric problems, autonomic dysfunction, sleep disorders, fatigue, and pain. Despite their importance for patients' quality of life, the evidence base for their treatment is relatively sparse. Nevertheless, the last few years have seen a number of new trials starting that specifically address nonmotor features as an outcome measure in clinical trials. Large randomized, controlled trials in the last 3 years reported improvement of psychosis with the new selective serotonin 5-HT2A inverse agonist pimavanserin and of postural hypotension with the oral norepinephrine precursor droxidopa. Smaller new randomized, controlled trials support the effectiveness of Deep Brain Stimulation and opiates for pain, of rivastigmine for apathy and piribedil for apathy post-DBS, group cognitive behavioral therapy for depression and/or anxiety, continuous positive airway pressure for sleep apnea in PD and doxepin for insomnia, and of solifenacin succinate and transcutaneous tibial nerve stimulation for urinary symptoms. A number of new smaller or open trials as well as post-hoc analyses of randomized, controlled trials have suggested usefulness of other treatments, and new randomized, controlled trials are currently ongoing. PMID:26371623

  8. Astrophysical manifestations of clumps of cold dark matter

    SciTech Connect

    Belotsky, K. M. Kirillov, A. A. Khlopov, M. Yu.

    2013-04-15

    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.

  9. Astrophysical manifestations of clumps of cold dark matter

    NASA Astrophysics Data System (ADS)

    Belotsky, K. M.; Kirillov, A. A.; Khlopov, M. Yu.

    2013-04-01

    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.

  10. Thoracic roentgenologic manifestations in primary carcinoma of the liver.

    PubMed

    Tsai, G L; Liu, J D; Siauw, C P; Chen, P H

    1984-09-01

    The most common extrahepatic metastasis of primary carcinoma of the liver is pulmonary metastasis. The discrepancy in the incidence of metastasis between clinical and postmortem series is quite obvious. The rapidly fatal course of hepatoma, the limitations of the chest x-ray film in detecting the small implantation, and incomplete follow-up of patients lead to the lower incidence in clinical series. From January 1974 to December 1982, there were 470 cases of primary carcinoma of the liver at Taipei Municipal Jen-Ai Hospital. Among them, we found 439 cases of hepatocellular carcinoma and 31 cases of cholangiocellular carcinoma. We also found 50 cases (11 percent) of hepatocellular carcinoma with pulmonary metastasis and ten cases (2 percent) of hepatocellular carcinoma with bone metastasis. Seven of the ten cases of bone metastasis were intrathoracic. Additionally, we found that it was rare to have pulmonary metastasis in cholangiocellular carcinoma; it only occurred once. Hematogenous and lymphatic spread and direct invasion are the principal ways for metastasis in primary hepatoma. Multiple nodulation and pleural effusion are the main manifestations in the chest x-ray film. Additionally, we saw lymphangitic carcinomatosis and miliary lesions in some of our patients. The common characteristic of these metastases is that most of the lesions arise from or are prominent in the right lower pulmonary field. Osteolysis appears in the patients with bone metastasis. Most of the metastases form a big protruding mass of tumor. PMID:6088178

  11. An unusual ultrasonographic manifestation of a fetal Ebstein anomaly

    PubMed Central

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

    2014-01-01

    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

  12. Embolic Stroke as the Initial Manifestation of Systemic Lupus Erythematosus

    PubMed Central

    Khan, Reshma M.; Namas, Rajaie; Parikh, Sachin; Rubin, Bernard

    2015-01-01

    We present a case of a 21-year-old African-American female with no significant medical history, who presented to the emergency department with a one-week history of blurry and double vision. Ophthalmology evaluation revealed bilateral retinal artery occlusion. Further workup with imaging of the brain was consistent with an ischemic stroke. Hereditary hypercoagulable workup was unremarkable and initial testing for antiphospholipid syndrome was positive. She underwent transesophageal echocardiogram (TEE), which showed severe mitral regurgitation and thickening of mitral valve leaflets consistent with Libman-Sacks endocarditis. Autoimmune workup was positive for IF-ANA, anti-RNP, and anti-Smith antibody. She fulfilled 4/11 of the ACR criteria and met 5 of the SLICC (Systemic Lupus International Collaborating Clinics) criteria for lupus (nonscaring alopecia, thrombocytopenia, positive ANA, and positive anti-Smith and positive anti-phospholipid antibodies). This case highlights the importance of early recognition of underlying connective tissue diseases and timely management of these diseases in young patients with no previous manifestations of diseases. PMID:26266073

  13. Allergic Interstitial Nephritis Manifesting as a Striated Nephrogram

    PubMed Central

    Moinuddin, Irfan; Bracamonte, Erika; Thajudeen, Bijin; Sussman, Amy; Madhrira, Machaiah; Costello, James

    2015-01-01

    Allergic interstitial nephritis (AIN) is an underdiagnosed cause of acute kidney injury (AKI). Guidelines suggest that AIN should be suspected in a patient who presents with an elevated serum creatinine and a urinalysis that shows white cells, white cell casts, or eosinophiluria. Drug-induced AIN is suspected if AKI is temporally related to the initiation of a new drug. However, patients with bland sediment and normal urinalysis can also have AIN. Currently, a definitive diagnosis of AIN is made by renal biopsy which is invasive and fraught with risks such as bleeding, infection, and hematoma. Additionally, it is frequently unclear when a kidney biopsy should be undertaken. We describe a biopsy proven case of allergic interstitial nephritis which manifested on contrast enhanced Magnetic Resonance Imaging (MRI) as a striated nephrogram. Newer and more stable macrocyclic gadolinium contrast agents have a well-demonstrated safety profile. Additionally, in the presentation of AKI, gadolinium contrast agents are safe to administer in patients who demonstrate good urine output and a downtrending creatinine. We propose that the differential for a striated nephrogram may include AIN. In cases in which the suspicion for AIN is high, this diagnostic consideration may be further characterized by contrast enhanced MRI. PMID:26664405

  14. Ocular manifestations of graft-versus-host disease.

    PubMed

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

    2013-07-01

    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

  15. Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

    PubMed Central

    Hebbelstrup Jensen, Betina; Olsen, Katharina E. P.; Struve, Carsten; Petersen, Andreas Munk

    2014-01-01

    SUMMARY Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity. PMID:24982324

  16. Temporomandibular Joint Hypermobility Manifestation Based on Clinical Observations

    PubMed Central

    Nosouhian, Saeid; Haghighat, Abbas; Mohammadi, Iman; Shadmehr, Elham; Davoudi, Amin; Badrian, Hamid

    2015-01-01

    Background: Joint range of motion might affected by some factors like laxity and increase joint mobility. Generalized joint hypermobility and temporomandibular joint hypermobility (TMJH) are reported as risk factors for temporomandibular disorders. The aim of this study was to survey the etiological factors of TMJH and its relations to habitual status. Materials and Methods: In this cross-sectional descriptive study, 69 patients with TMJH were involved. After profiling personal information and medical history, the patients were divided into three groups based on their maximum mouth opening (MMO) as follow: (Light) MMO of 50-55 mm, (moderate): MMO between 55 and 65 mm, (severe) MMO >65 mm. For subjective observations, patients were asked to fill the prepared questionnaire. The objective evaluations conducted by a specialist. Finally, all the data subjected Chi-Square test by using SPSS software version 22 at a significant level of 0.05. Results: TMJH was more common in women (74.2%). The light group had significant differences with other groups in the discomfort of TMJ and TMJ sound (P < 0.05). Furthermore, sever group manifested highest percentage of masticatory pains, significantly (P < 0.05). Conclusion: It can be concluded that pain in TMJ would have a correlation with MMO. PMID:26464530

  17. Neurological Manifestations in Parry–Romberg Syndrome: 2 Case Reports

    PubMed Central

    Vix, Justine; Mathis, Stéphane; Lacoste, Mathieu; Guillevin, Rémy; Neau, Jean-Philippe

    2015-01-01

    Abstract Parry–Romberg syndrome (PRS) is a variant of morphea usually characterized by a slowly progressive course. Clinical and radiological involvement of the central nervous system may be observed in PRS. We describe 2 patients with PRS and neurological symptoms (one with trigeminal neuralgia associated with deafness, and the second with hemifacial pain associated with migraine without aura) in conjunction with abnormal cerebral MRI including white matter T2 hyperintensities and enhancement with gadolinium. Despite the absence of specific immunosuppressive treatments, both patients have presented stable imaging during follow-up without any clinical neurologic progression. We have performed a large review of the medical literature on patients with PRS and neurological involvement (total of 129 patients) Central nervous system involvement is frequent among PRS patients and is inconsistently associated with clinical abnormalities. These various neurological manifestations include seizures, headaches, movement disorders, neuropsychological symptoms, and focal symptoms. Cerebral MRI may reveal frequent abnormalities, which can be bilateral or more often homolateral to the skin lesions, localized or so widespread so as to involve the whole hemisphere: T2 hyperintensities, mostly in the subcortical white matter, gadolinium enhancement, brain atrophy, and calcifications. These radiological lesions do not usually progress over time. Steroids or immunosuppressive treatments are controversial since it remains unclear to what extent they are beneficial and there is often no neurological progression. PMID:26181554

  18. Oral Manifestations of Human Immunodeficiency Virus-Infected Patients

    PubMed Central

    Pakfetrat, Atessa; Falaki, Farnaz; Delavarian, Zahra; Dalirsani, Zohreh; Sanatkhani, Majid; Zabihi Marani, Mahsa

    2015-01-01

    Introduction: Oral lesions are among the earliest clinical manifestations of human immunodeficiency (HIV) infection and are important in early diagnosis and for monitoring the progression to acquired immunodeficiency syndrome (AIDS). The purpose of this study was to determine the prevalence of oral lesions and their relationship with a number of factors in HIV/AIDS patients attending an HIV center. Materials and Methods: A total of 110 HIV-positive patients were examined to investigate the prevalence of oral lesions according to the criteria established by the European Community Clearing House on Oral Problems Related to HIV Infection. An independent T-test was used for correlation of oral lesions with CD4+ count and a ?2 test was used for analysis of the relationship of co-infection with hepatitis B virus (HBV), sexual contact, route of transmission, history of drug abuse, and history of incarceration. Results: Most of the cases were male patients (82.7%). The mean age across all participants was 36.2±8.1 years. Rampant carries, severe periodontitis and oral candidiasis were the most notable oral lesions. Oral lesions were more prevalent in patients between 26–35 years of age. There was a significant difference between patients with and without pseudomembranous candidiasis and angular cheilitis according to mean level of CD4+. Conclusion: The most common oral presentations were severe periodontitis, pseudomembranous candidiasis and xerostomia. PMID:25745611

  19. Cytomegalovirus pneumonia as the first manifestation of severe combined immunodeficiency

    PubMed Central

    Jo?czyk-Potoczna, Katarzyna; Ossowska, Lidia; Br?borowicz, Anna; Bartkowska-?niatkowska, Alicja; Wachowiak, Jacek

    2014-01-01

    Severe combined immunodeficiency (SCID) is characterized by the absence of functional T lymphocytes and impairment of adaptive immunity. While heterogeneity of the genetic background in SCID leads to the variability of immune phenotypes, most of affected newborns appear healthy but within the first few months they develop life-threatening opportunistic respiratory or gastrointestinal tract infections. The objective of the study was to define the presenting features and etiology of infections in children with SCID. We retrospectively reviewed five children in whom the diagnosis of SCID had been established in our pediatric immunology clinic over the last 10-year period. A viral respiratory tract infection was the first manifestation of SCID in all the children studied. Cytomegalovirus (CMV) pneumonia was recognized in as many as 4 cases and coronavirus pulmonary infection was diagnosed in one case, whereas Pneumocystis jiroveci was identified as a co-pathogen in one CMV-infected patient. Severe combined immunodeficiency is a pediatric emergency condition and given the significant impact of pulmonary CMV infection in SCID children, establishing an accurate etiological diagnosis is of essential importance in instituting the specific treatment and improving the outcome. PMID:26155153

  20. Stability and its manifestation in the chemical and biological worlds.

    PubMed

    Pascal, Robert; Pross, Addy

    2015-10-29

    Bridging between the phenomenologically distinct biological and physical worlds has been a major scientific challenge since Boltzmann's probabilistic formulation of the second law of thermodynamics. In this review we summarize our recent theoretical attempts to bridge that divide through analysis of the thermodynamic-kinetic interplay in chemical processes and the manner in which that interplay impacts on material stability. Key findings are that the term 'stability' manifests two facets - time and energy - and that stability's time facet, expressed as persistence, is more general than its energy facet. That idea, together with the proposed existence of a logical law of nature, the persistence principle, leads to the mathematically-based insight that stability can come about through either Boltzmann's probabilistic considerations or Malthusian kinetics. Two mathematically-based forms of material persistence then lead directly to the physical likelihood of two material forms, animate and inanimate. Significantly, the incorporation of kinetic considerations into the stability concept appears to bring us closer to enabling two of the central theories in science - the second law of thermodynamics and Darwin's theory of evolution - to be reconciled within a single conceptual framework. PMID:26465292

  1. Ocular Manifestations in Infants Resulted from Assisted Reproductive Technology (ART)

    PubMed Central

    Jafarzadehpur, Ebrahim; Mohhamadi, Ali Reza; Nateghi, Mohammad Reza; Fazeli, Abolhasan Shahzade; Kashi, Khashayar Mehdizadeh

    2013-01-01

    Objective Nowadays, many infertile couples can have child by assistant reproductive technology (ART). Always the undesirable effects of these methods on newborn are considered and are evaluated. The aim of this study is to describe the impact of ART on ocular and visual performances of infants born by these methods. Materials and methods In a cross-sectional descriptive study, 479 infants aged three-nine months presented to an optometry clinic of Child Health and Development Research Department (CHDRD), Tehran, Iran. Static retinoscopy, qualitative fixation evaluation, Hirschberg test, red reflex assessment and external eye examination were carried out. Other information such as birth weight and maturity of the infants was recorded. Results It was possible to assess only 320 out of 479 infants due to general condition of some participants. Comparison of mean refractive error in infants’ right and left eyes did not show any significant difference. Our findings confirmed that 20.3% had poor fixation, while 2.9% revealed manifest strabismus. The results also revealed the prevalences of myopia, hyperopia and emmetropia are 2.9%, 87%, and 10.1%, respectively. Red reflex abnormalities were significantly found in boys and in preterm infants (p < 0.05). Failure of fixation control was seen more frequently with increasing refractive error, which significantly developed in preterm infants (p < 0.001). Conclusion These results reflect the necessity of more comprehensive assessments and further follow-up of infants born by ART, especially for premature male ART infants. These results also suggest the probability of fixation condition and visual deficiencies in these infants. It is recommended to pay close attention to this preliminary report about the refractive and fixation condition of the infants born after ART. PMID:24971123

  2. Extra-articular manifestations in psoriatic arthritis patients.

    PubMed

    Peluso, Rosario; Iervolino, Salvatore; Vitiello, Maria; Bruner, Vincenzo; Lupoli, Gelsy; Di Minno, Matteo Nicola Dario

    2015-04-01

    Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder, associated with skin and/or nail psoriasis. It has been included in the spondyloarthropathies (SpA) group, with which it shares clinical, radiologic, and serologic features and familial and genetic relationship. Inclusion of disease among SpA is also based on their striking points of similarity for extra-articular manifestations (EAMs). The aim of study was to describe the EAMs in patients with PsA, evaluating the prevalence and clinical features associated with established and early PsA. The study was a retrospective analysis of case records of 387 PsA patients. Data recorded were demographic data, disease properties, laboratory tests, drug use, and presence of EAMs. Of 387 PsA patients, 190 have shown EAMs: 33.16 % had bowel involvement, 32.63 % ocular, 28.42 % cardiovascular, 25.79 % urogenital, 8.42 % skin (excluding psoriasis), 1.05 % pulmonary, and 0.53 % renal. A higher prevalence of EAMs was found in axial subset (p?

  3. Anemia as the Main Manifestation of Myelodysplastic Syndromes.

    PubMed

    Santini, Valeria

    2015-10-01

    Myelodysplastic syndromes (MDS) are a constellation of different diseases sharing anemia in the great majority of cases, and this cytopenia defines these pathologies and their most dramatic clinical manifestations. Anemia in MDS is due to ineffective erythropoiesis, with a high degree of apoptosis of marrow erythroid progenitors. These progenitors show distinctive dysplastic features that consent diagnosis, and are recognizable and differentiated, although not easily, from other morphologic alterations present in other types of anemia. Reaching the diagnosis of MDS in a macrocytic anemia and alleviating the symptoms of anemia are therefore an essential objective of the treating physician. In this work, the signs and symptoms of anemia in MDS, as well as its peculiar pathophysiology, are discussed. Erythopoietic stimulating agents (ESAs) are providing the best treatment for anemic MDS patients, but their use is still not approved by health agencies. While still waiting for this waiver, their clinical use is widespread and their effectivness is well known, as well as the dismal prognosis of patients who do not respond to ESAs and require transfusions. MDS with del5q constitute a unique model of anemia whose complex pathophysiology has been clarified at least partially, defining its link to ribosomal alterations likewise what observed in hereditary anemias like Blackfan Diamond anemia. Lenalidomide is the agent that has shown striking and specific erythropoietic activity in del5q MDS, and the basis of this response is starting to be understood. Several new agents are under evaluation for ESA refractory/relapsed MDS patients, targeting different putative mechanisms of ineffective erythropoiesis, and are here reviewed. PMID:26404446

  4. On the Misuse of Manifest Variables in the Detection of Measurement Bias.

    ERIC Educational Resources Information Center

    Meredith, William; Millsap, Roger E.

    1992-01-01

    A unified treatment is presented for conditions that should allow detection of measurement bias using statistical procedures involving only observed or manifest variables. Computational results demonstrate that methods for studying bias that rely exclusively on manifest variables are not generally diagnostic of the presence or absence of…

  5. 40 CFR 761.210 - Use of the manifest-Generator requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Use of the manifest-Generator...—Generator requirements. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain...) Retain one copy, in accordance with § 761.214(a)(1). (b) The generator must give the transporter...

  6. 40 CFR 761.210 - Use of the manifest-Generator requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Use of the manifest-Generator...—Generator requirements. (a) The generator must: (1) Sign the manifest certification by hand; and (2) Obtain...) Retain one copy, in accordance with § 761.214(a)(1). (b) The generator must give the transporter...

  7. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Availability. Manifest data acquired from the Automated Manifest System (AMS) is available to interested... on the nationwide system within the last 24 hour period. Data for which parties have requested... mailed from the CBP Data Center, first class, on the next business day after compilation....

  8. Right Bundle Branch Block: An Uncommon Cardiotoxic Manifestation of Hair Dye Poisoning-A Case Report

    PubMed Central

    Balasubramanian, Deepak; Subramanian, Saravanan; Thangaraju, Pugazhenthan; Shanmugam, Kani

    2014-01-01

    Hair dye poisoning has been rising in incidence in the recent years. Apart from the commoner manifestations of upper airway edema, rhabdomyolysis and acute renal failure, cardiac toxicity, convulsions and sudden cardiac death are relatively rare complications. We discuss a case of hair dye poisoning manifesting as oropharyngeal edema along with cardiac complication. The patient survived. PMID:24596762

  9. 40 CFR 761.213 - Use of manifest-Commercial storage and disposal facility requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...commercial storage or disposal facility receives PCB waste accompanied by a manifest, the...2) of this section to certify that the PCB waste covered by the manifest was...

  10. 40 CFR 761.213 - Use of manifest-Commercial storage and disposal facility requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...commercial storage or disposal facility receives PCB waste accompanied by a manifest, the...2) of this section to certify that the PCB waste covered by the manifest was...

  11. Oral manifestations of HIV/AIDS in Asia: Systematic review and future research guidelines

    PubMed Central

    Oberoi, Sukhvinder-Singh; Vohra, Puneeta; Nagpal, Archna

    2015-01-01

    Objectives The authors have conducted a systematic review of oral manifestations of HIV from studies conducted in Asia to establish the characteristics and prevalence of individual oral manifestations in Asia, and to assess the direction of future research studies on oral manifestations of HIV in Asia. Material and Methods The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE], EBSCO, and EMBASE. The search was for limited articles published in English or with an English abstract and articles published during the period January 1995 to August 2014. The authors reached a final overall sample of 39 studies that were conducted in Asia. Results The median population size among all studies was 312.7 patients. Oral candidiasis [OC] was the most common oral manifestation [37.7%] in studies conducted in Asia. The overall prevalence of oral hairy leukoplakia and melanotic hyperpigmentation was computed to be 10.1% and 22.8% respectively. Thailand and India are primarily countries with maximum research on oral manifestations. Conclusions The research on oral manifestations of HIV in Asia has to upgrade to more interventional and therapeutic studies rather than the contemporary cross- sectional epidemiological descriptive studies. The authors have given suggestions and future directions for the implementation of clinical research of oral manifestations in HIV patients. Key words:Oral manifestations, HIV/AIDS, Asia, Systematic review. PMID:26330942

  12. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Penalties for failure to manifest narcotic drugs... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of...

  13. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Penalties for failure to manifest narcotic drugs... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of...

  14. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Penalties for failure to manifest narcotic drugs... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of...

  15. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 2 2014-04-01 2014-04-01 false Penalties for failure to manifest narcotic drugs... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of...

  16. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 2 2013-04-01 2013-04-01 false Penalties for failure to manifest narcotic drugs... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of...

  17. 78 FR 76152 - Agency Information Collection Activities: Transportation Entry and Manifest of Goods Subject to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Register (78 FR 57405) on September 18, 2013, allowing for a 60-day comment period. This notice allows for... and Manifest of Goods Subject to CBP Inspection and Permit AGENCY: U.S. Customs and Border Protection...: Transportation Entry and Manifest of Goods Subject to CBP Inspection and Permit. This is a proposed extension...

  18. 75 FR 60772 - Agency Information Collection Activities: Transportation Entry and Manifest of Goods Subject to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... published in the Federal Register (75 FR 43997) on July 27, 2010, allowing for a 60-day comment period. This... and Manifest of Goods Subject to CBP Inspection and Permit AGENCY: U.S. Customs and Border Protection...: Transportation Entry and Manifest of Goods Subject to CBP Inspection and Permit (CBP Form 7512). This is...

  19. 75 FR 43997 - Agency Information Collection Activities: Transportation Entry and Manifest of Goods Subject to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... and Manifest of Goods Subject to CBP Inspection and Permit AGENCY: U.S. Customs and Border Protection... collection requirement concerning the: Transportation Entry and Manifest of Goods Subject to CBP Inspection... of Goods Subject to CBP Inspection and Permit. OMB Number: 1651-0003. Form Numbers: CBP Forms...

  20. Manifestations of Heterosexism in Icelandic Upper Secondary Schools and the Responses of LGBT Students

    ERIC Educational Resources Information Center

    Kjaran, Jón Ingvar; Jóhannesson, Ingólfur Ásgeir

    2013-01-01

    How does institutionalized heterosexism manifest itself in Icelandic upper secondary schools and how do lesbian, gay, bisexual, and transgender (LGBT) students respond to these manifestations? In addressing these questions, interviews were conducted with six current and former LGBT upper secondary school students, using queer theory and thematic…

  1. Unusual Dermatological Manifestations of Gout: Review of Literature and a Case Report

    PubMed Central

    Ortega, Viviana Gómez; Gaona, Jennifer; Motta, Adriana; Medina Barragán, Oskar Javier

    2015-01-01

    Background: Gouty panniculitis is a rare clinical manifestation of gout, characterized by deposits of monosodium urate crystals in the hypodermis. Our aim was to describe atypical and rare clinical presentations of gouty tophi. Methods: We searched relevant English and Spanish literature of unusual gout manifestations using the following keywords: giant, gout, panniculitis, gouty panniculitis, gouty tophi, rare manifestations of gout, gouty, tophi, tophus, monosodium urate, uric acid, and unusual. Well-described case reports, case series, and review articles were evaluated and included in the literature review. Results: International literature has reported fewer than 10 cases of gouty panniculitis worldwide. In this case report, the patient presents a rare manifestation of gouty panniculitis, with typical joint injuries, gouty tophi in both lower and upper extremities, chronic gouty tophi in the nose, for which only 3 cases have been reported in literature, and great hypertrophy of adipose tissue in the lower back. Conclusions: Tophi can be found in atypical locations, which increase morbidities and deformities caused by the disease. We report an interesting case of gouty panniculitis associated with great hypertrophy of the adipose tissue, a rare manifestation of gout, and unusual locations of tophi. These clinical manifestations in our patient have not been recorded before, which leads us to think that we are in the presence of a new dermatological manifestation of gout. PMID:26301134

  2. Association of anti-cardiolipin antibodies with vascular thrombosis and neurological manifestation of Behçets disease.

    PubMed

    al-Dalaan, A N; al-Ballaa, S R; al-Janadi, M A; Bohlega, S; Bahabri, S

    1993-03-01

    We have studied 44 patients with Behçet's Disease (BD) to look for any correlation of arterial and venous thrombosis or central nervous system (CNS) manifestations with anti-cardiolipin antibodies (ACLA). Twenty patients were positive for ACLA by MELISA method. Ten patients had IgG antibody, four had IgM and six had both IgG and IgM. Of these patients, 11 had a history of vascular thrombosis and thrombophlebitis and nine had CNS manifestations. The association of ACLA with vascular thrombosis or CNS manifestation of Behçet's disease was statistically not significant. PMID:8467608

  3. 19 CFR 122.49a - Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the...

  4. 19 CFR 122.75a - Electronic manifest requirement for passengers onboard commercial aircraft departing from the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft departing from the...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the...Electronic manifest requirement for passengers onboard commercial aircraft departing from...

  5. 19 CFR 122.75a - Electronic manifest requirement for passengers onboard commercial aircraft departing from the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft departing from the...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the...Electronic manifest requirement for passengers onboard commercial aircraft departing from...

  6. 19 CFR 122.49a - Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the...

  7. 19 CFR 122.75a - Electronic manifest requirement for passengers onboard commercial aircraft departing from the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft departing from the...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the...Electronic manifest requirement for passengers onboard commercial aircraft departing from...

  8. 19 CFR 122.49a - Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the...

  9. 19 CFR 122.75a - Electronic manifest requirement for passengers onboard commercial aircraft departing from the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft departing from the...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the...Electronic manifest requirement for passengers onboard commercial aircraft departing from...

  10. 19 CFR 122.75a - Electronic manifest requirement for passengers onboard commercial aircraft departing from the...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft departing from the...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Departing From the...Electronic manifest requirement for passengers onboard commercial aircraft departing from...

  11. 19 CFR 122.49a - Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the...

  12. 19 CFR 122.49a - Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the United...Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing...Electronic manifest requirement for passengers onboard commercial aircraft arriving in the...

  13. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...the payrate for compensating occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...the payrate for compensating occupational disease claims which become manifest after...

  14. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...the payrate for compensating occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...the payrate for compensating occupational disease claims which become manifest after...

  15. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...amount of compensation for occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...amount of compensation for occupational disease claims which become manifest after...

  16. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...amount of compensation for occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...amount of compensation for occupational disease claims which become manifest after...

  17. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...amount of compensation for occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...amount of compensation for occupational disease claims which become manifest after...

  18. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...amount of compensation for occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...amount of compensation for occupational disease claims which become manifest after...

  19. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...the payrate for compensating occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...the payrate for compensating occupational disease claims which become manifest after...

  20. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...the payrate for compensating occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...the payrate for compensating occupational disease claims which become manifest after...

  1. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...the payrate for compensating occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...the payrate for compensating occupational disease claims which become manifest after...

  2. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...amount of compensation for occupational disease claims which become manifest after retirement...ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not Immediately Result in Death...amount of compensation for occupational disease claims which become manifest after...

  3. 19 CFR 122.49 - Correction of air cargo manifest or air waybill.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.49 Correction of air...

  4. 19 CFR 122.49 - Correction of air cargo manifest or air waybill.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.49 Correction of air...

  5. 19 CFR 122.49 - Correction of air cargo manifest or air waybill.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.49 Correction of air...

  6. 19 CFR 122.49 - Correction of air cargo manifest or air waybill.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.49 Correction of air...

  7. 19 CFR 122.49 - Correction of air cargo manifest or air waybill.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Aircraft Entry and Entry Documents; Electronic Manifest Requirements for Passengers, Crew Members, and Non-Crew Members Onboard Commercial Aircraft Arriving In, Continuing Within, and Overflying the United States § 122.49 Correction of air...

  8. Sexually Transmitted Pathogens, Depression, and Other Manifestations Associated with Premenstrual Syndrome.

    PubMed

    Doyle, Caroline; Swain, Walker A; Ewald, Holly A Swain; Cook, Christine L; Ewald, Paul W

    2015-09-01

    This study investigated whether sexually transmitted infections and lifestyle variables are associated with premenstrual syndrome (PMS) as well as particular manifestations commonly associated with PMS. Data were gathered from medical records of 500 regularly cycling women. The following infectious agents were investigated: human papillomavirus, Chlamydia trachomatis, Neisseria gonorrheae, Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis. Bivariate tests and multivariate logistic regressions were used to evaluate whether these pathogens were associated with headache, pain, nausea, and depression. Chlamydia trachomatis was significantly associated with premenstrual syndrome (PMS) and two common manifestations of PMS: depression and pain. Trichomonas vaginalis was significantly correlated with headache and Gardnerella vaginalis with nausea. None of the illness manifestations was significantly associated with the tested lifestyle variables: dietary calcium supplementation, alcohol and drug use, exercise, and smoking. These associations provide a basis for assessment of infectious causation of PMS and several manifestations of illness that are commonly associated with PMS. PMID:26272230

  9. 40 CFR 761.210 - Use of the manifest-Generator requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...the manifest. (c) For shipments of PCB waste within the United States solely...transporter. (d) For rail shipments of PCB waste within the United States which...

  10. 40 CFR 761.210 - Use of the manifest-Generator requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761...the manifest. (c) For shipments of PCB waste within the United States solely...transporter. (d) For rail shipments of PCB waste within the United States which...

  11. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... Republic of Cuba Czechoslovakia Estonia German Democratic Republic (Soviet Zone of Germany and Soviet...

  12. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... Republic of Cuba Czechoslovakia Estonia German Democratic Republic (Soviet Zone of Germany and Soviet...

  13. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... Republic of Cuba Czechoslovakia Estonia German Democratic Republic (Soviet Zone of Germany and Soviet...

  14. Metaphor and Manifestation-Cross-Reality with Ubiquitous Sensor/Actuator Networks

    E-print Network

    Paradiso, Joseph A.

    Looks at how MIT Media Lab's Responsive Environments Group is exploring ways to bridge networked electronic sensors and human perception through "cross reality" implementations that render and manifest phenomena between ...

  15. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... export declarations have been filed with the port director: Albania Bulgaria Cambodia China,...

  16. 78 FR 52958 - Announcement of Test Concerning Manifesting and Entry of Residue Found in Instruments of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ...Test Concerning Manifesting and Entry of Residue Found in Instruments of International...modified ruling, HQ H026715, requires that residue within containers be ``classified...new type of entry designed to capture residue in containers that will be cleaned...

  17. Clinical overview and treatment options for non-skeletal manifestations of mucopolysaccharidosis type IVA.

    PubMed

    Hendriksz, Christian J; Al-Jawad, Maisoon; Berger, Kenneth I; Hawley, Sara M; Lawrence, Rebecca; Mc Ardle, Ciarán; Summers, C Gail; Wright, Elizabeth; Braunlin, Elizabeth

    2013-03-01

    Mucopolysaccharidosis type IVA (MPS IVA) or Morquio syndrome is a multisystem disorder caused by galactosamine-6-sulfatase deficiency. Skeletal manifestations, including short stature, skeletal dysplasia, cervical instability, and joint destruction, are known to be associated with this condition. Due to the severity of these skeletal manifestations, the non-skeletal manifestations are frequently overlooked despite their significant contribution to disease progression and impact on quality of life. This review provides detailed information regarding the non-skeletal manifestations and suggests long-term assessment guidelines. The visual, auditory, digestive, cardiovascular, and respiratory systems are addressed and overall quality of life as measured by endurance and other functional abilities is discussed. Impairments such as corneal clouding, astigmatism, glaucoma, hearing loss, hernias, hepatomegaly, dental abnormalities, cardiac valve thickening and regurgitation, obstructive sleep apnea, tracheomalacia, restrictive and obstructive respiratory compromise, and muscular weakness are discussed. Increased awareness of these non-skeletal features is needed to improve patient care. PMID:22358740

  18. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... Republic of Cuba Czechoslovakia Estonia German Democratic Republic (Soviet Zone of Germany and Soviet...

  19. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... export declarations have been filed with the port director: Albania Bulgaria Cambodia China,...

  20. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... export declarations have been filed with the port director: Albania Bulgaria Cambodia China,...

  1. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... export declarations have been filed with the port director: Albania Bulgaria Cambodia China,...

  2. 19 CFR 4.75 - Incomplete manifest; incomplete export declarations; bond.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 15 CFR 30.24), the port director may accept in lieu thereof an incomplete manifest (referred to as a... export declarations have been filed with the port director: Albania Bulgaria Cambodia China,...

  3. Oral manifestations of Schimmelpenning syndrome: case report and review of literature.

    PubMed

    Murakami, A; Skovby, F; Andreasen, J O; Cohen, M M; Jensen, B L; Kreiborg, S

    1999-09-01

    Schimmelpenning syndrome (SS) is characterised by specific skin manifestations, skeletal defects, and central nervous system abnormalities. Here, the SS is briefly reviewed, and the oral and dental manifestations are described in a patient whose medical findings were previously published and included severe hypophosphatemic rickets. Significant oral and dental features included papillomatous lesions of the gingiva, hemihyperplasia (hemihypertrophy) of the tongue, bone cysts, aplasia of teeth, enlarged pulp chambers, hypoplastic or absent enamel, and an odontodysplasia-like permanent tooth. PMID:10597363

  4. Primary immunodeficiency update: Part II. Syndromes associated with mucocutaneous candidiasis and noninfectious cutaneous manifestations.

    PubMed

    Pichard, Dominique C; Freeman, Alexandra F; Cowen, Edward W

    2015-09-01

    Several primary immunodeficiencies (PIDs) have recently been described that confer an elevated risk of fungal infections and noninfectious cutaneous manifestations. In addition, immunologic advances have provided new insights into our understanding of the pathophysiology of fungal infections in established PIDs. We reviewed PIDs that present with an eczematous dermatitis in part I. In part II of this continuing medical education article we discuss updates on PIDs associated with fungal infections, their biologic basis in PIDs, and noninfectious cutaneous manifestations. PMID:26282795

  5. Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-12-01

    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

  7. Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

    PubMed Central

    Halsey, Eric S.; Marks, Morgan A.; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Methodology and Principal Findings Between the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Conclusions/Significance Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype. PMID:22563516

  8. Recurrent Fever, Anemia, Arthralgia, and Genu Varum as Late Manifestations of Congenital Syphilis.

    PubMed

    Quaresma, Liliana; Gonçalves, Juan; Estanqueiro, Paula; Salgado, Manuel

    2015-12-01

    We report an unusual case of recurrent fever, inflammatory knee pain, genu varum, persistent anemia, and high erythrocyte sedimentation rate in a 28-month-old boy as late manifestations of congenital syphilis (CS). Despite standard penicillin treatment at the end of the first month of life, it recurred later in life, more than once. In the first relapse, manifested by a likely gumma lesion, the prior penicillin treatment plus a negative venereal disease research laboratory result unduly led to exclusion of CS. A second treatment with penicillin led to complete clinical resolution. Although rare, bow legs, recurrent fever, anemia, and inflammatory arthralgias may be manifestations of late CS. Congenital syphilis should be considered throughout early childhood, especially if history of syphilis infection is present. A negative venereal disease research laboratory result does not exclude late syphilis, present in nearly 30% of these patients. The possibility of atypical symptoms of this "great masquerader" should always be borne in mind. PMID:26587855

  9. Novel Nut and Bolt Task Quantifies Motor Deficits in Premanifest and Manifest Huntington’s Disease

    PubMed Central

    Collins, Lucy M.; Begeti, Faye; Panin, Francesca; Lazar, Alpar S.; Cruickshank, Travis; Ziman, Mel; Mason, Sarah L.; Barker, Roger A.

    2015-01-01

    Background: We investigated the use of a simple novel nut and bolt task in premanifest and manifest Huntington’s disease (HD) patients to detect and quantify motor impairments at all stages of the disease. Methods: Premanifest HD (n=24), manifest HD (n=27) and control (n=32) participants were asked to screw a nut onto a bolt in one direction, using three different sized bolts with their left and right hand in turn. Results: We identified some impairments at all stages of HD and in the premanifest individuals, deficits in the non-dominant hand correlated with disease burden scores. Conclusion: This simple, cheap motor task was able to detect motor impairments in both premanifest and manifest HD and as such might be a useful quantifiable measure of motor function for use in clinical studies. PMID:26421223

  10. The Dermatological Manifestations of Postural Tachycardia Syndrome: A Review with Illustrated Cases.

    PubMed

    Huang, Hao; Hohler, Anna DePold

    2015-10-01

    Postural tachycardia syndrome (POTS) is a syndrome of excessive tachycardia with orthostatic challenge, and relief of such symptoms with recumbence. There are several proposed subtypes of the syndrome, each with unique pathophysiology. Numerous symptoms such as excessive tachycardia, lightheadedness, blurry vision, weakness, fatigue, palpitations, chest pain, and tremulousness are associated with orthostatic intolerance. Other co-morbid conditions associated with POTS are not clearly attributable to orthostatic intolerance. These include chronic headache, fibromyalgia, functional gastrointestinal or bladder disorders, cognitive impairment, and sleep disturbances. Dermatological manifestations of POTS are also common and wide ranging, from livedo reticularis to Raynaud's phenomenon, from cutaneous flushing to erythromelalgia. Here, we provide three illustrative cases of POTS with dermatological manifestations. We discuss the potential pathophysiology underlying such dermatological manifestations, and how such mechanisms could in turn help guide development of management. PMID:26242228

  11. Joint and fascia manifestations in chronic graft-versus-host disease and their assessment

    PubMed Central

    Inamoto, Yoshihiro; Pidala, Joseph; Chai, Xiaoyu; Kurland, Brenda F.; Weisdorf, Daniel; Flowers, Mary E.D.; Palmer, Jeanne; Arai, Sally; Jacobsohn, David; Cutler, Corey; Jagasia, Madan; Goldberg, Jenna D.; Martin, Paul J.; Pavletic, Steven Z.; Vogelsang, Georgia B.; Lee, Stephanie J.; Carpenter, Paul A.

    2014-01-01

    Objective Joint and fascia manifestations in patients with chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation need to be assessed reliably, simply and in a clinically meaningful way. Methods In a prospective, multicenter, longitudinal, observational cohort of patients with chronic GVHD (n=567), we evaluated 3 scales proposed for assessing joint status: National Institutes of Health (NIH) joint/fascia scale, Hopkins fascia scale and the Photographic Range of Motion (P-ROM) scale. Ten other scales were also tested for assessing symptoms, quality of life and physical functions. Results Joint and fascia manifestations were present at study enrollment in 164 (29%) patients. Limited range of motion was most frequent at wrists or fingers. Among the 3 joint scales, changes in the NIH scale correlated with both clinician and patient-perceived improvement of joint and fascia manifestations with higher sensitivity than the Hopkins fascia scale. Changes in all 3 scales correlated with clinician and patient-perceived worsening but the P-ROM scale was the most sensitive in this regard. Onset of joint and fascia manifestations was not associated with subsequent mortality. Conclusion Joint and fascia manifestations are common and should be assessed carefully in patients with chronic GVHD. Our results support the use of the NIH joint/fascia scale and P-ROM scale to assess joint and fascia manifestations. The NIH scale better captures improvement, while the P-ROM scale better captures worsening. The utility of these scales could also be tested in the rheumatic diseases. PMID:24757155

  12. Orthopedic manifestations in patients with mucopolysaccharidosis type II (Hunter syndrome) enrolled in the Hunter Outcome Survey

    PubMed Central

    Link, Bianca; de Camargo Pinto, Louise Lapagesse; Giugliani, Roberto; Wraith, James Edmond; Guffon, Nathalie; Eich, Elke; Beck, Michael

    2010-01-01

    Mucopolysaccharidosis type II (MPS II or Hunter syndrome) is a rare, inherited disorder caused by deficiency of the lysosomal enzyme iduronate-2-sulfatase. As a result of this deficiency, glycosaminoglycans accumulate in lysosomes in many tissues, leading to progressive multisystemic disease. The cardiopulmonary and neurological problems associated with MPS II have received considerable attention. Orthopedic manifestations are common but not as well characterized. This study aimed to characterize the prevalence and severity of orthopedic manifestations of MPS II and to determine the relationship of these signs and symptoms with cardiovascular, pulmonary and central nervous system involvement. Orthopedic manifestations of MPS II were studied using cross-sectional data from the Hunter Outcome Survey (HOS). The HOS is a global, physician-led, multicenter observational database that collects information on the natural history of MPS II and the long-term safety and effectiveness of enzyme replacement therapy. As of January 2009, the HOS contained baseline data on joint range of motion in 124 males with MPS II. In total, 79% of patients had skeletal manifestations (median onset, 3.5 years) and 25% had abnormal gait (median onset, 5.4 years). Joint range of motion was restricted for all joints assessed (elbow, shoulder, hip, knee and ankle). Extension was the most severely affected movement: the exception to this was the shoulder. Surgery for orthopedic problems was rare. The presence of orthopedic manifestations was associated with the presence of central nervous system and pulmonary involvement, but not so clearly with cardiovascular involvement. Orthopedic interventions should be considered on an individual-patient basis. Although some orthopedic manifestations associated with MPS II may be managed routinely, a good knowledge of other concurrent organ system involvement is essential. A multidisciplinary approach is required. PMID:21808707

  13. Two cases of erythema induratum of Bazin - a rare cutaneous manifestation of tuberculosis.

    PubMed

    von Huth, Sebastian; Øvrehus, Anne Lindebo; Lindahl, Kim Hein; Johansen, Isik Somuncu

    2015-09-01

    Tuberculosis remains a global disease burden, counting more than 9 million new cases per year. Tuberculosis is caused by infection with Mycobacterium tuberculosis-complex. Though most commonly affecting the lungs, any organ can become a site of tuberculous infection. Cutaneous tuberculosis is rare, representing 1-2% of all cases of tuberculosis. There are numerous different cutaneous manifestations of tuberculosis. We describe two cases of erythema induratum of Bazin, a so-called tuberculid manifestation of cutaneous TB. Both cases are patients from endemic areas. In the cases presented, there were no signs of other organs affected, and cutaneous lesions disappeared during anti-tuberculous treatment. PMID:26261059

  14. Endocrine Symptoms as the Initial Manifestation of Wilson’s Disease

    PubMed Central

    Krysiak, Robert; Handzlik-Orlik, Gabriela; Okopien, Boguslaw

    2012-01-01

    Wilson’s disease is a rare genetic disorder of copper metabolism. The difference in copper tissue accumulation is responsible for the various clinical manifestations of this disorder. If left untreated, Wilson’s disease progresses to hepatic failure, severe neurological disability, and even death. Due to the complex clinical picture of Wilson’s disease, its diagnosis relies on a high index of suspicion. In our paper, we present endocrine symptoms suggesting the presence of insulinoma and hyperprolactinemia as the initial clinical manifestation of Wilson’s disease in a young female. Zinc acetate treatment resulted in the disappearance of hypoglycemia, galactorrhea, and menstrual abnormalities. PMID:22737053

  15. Cutaneous manifestations of kwashiorkor: a case report of an adult man after abdominal surgery.

    PubMed

    Mann, Danielle; Presotto, Carolina; Queen, Stella Maria Facó; Oliveira, Elisa Fontenelle de; Gripp, Alexandre Carlos

    2011-01-01

    Kwashiorkor is a type of protein-energy malnutrition where diet protein deficit is found, in spite of appropriate caloric intake. Cutaneous manifestations include xerosis, with abnormally dry skin that has a flaking enamel paint aspect, a typical red to gray-white hair color, the "flag sign" and more evident edema in lower limbs and face, giving it a full moon appearance. This article reports a case of a male adult patient who had undergone Whipple surgery for treatment of chronic pancreatitis associated with pseudotumor of the pancreatic head that progressed to cutaneous manifestations of kwashiorkor after pulmonary tuberculosis. PMID:22281907

  16. Kocher Debre Semelaigne Syndrome: A Rare Case Report with Orofacial Manifestations

    PubMed Central

    Panat, Sunil R.; Jha, Prakash Chandra; Chinnannavar, Sangamesh N.; Chakarvarty, Ankkita; Aggarwal, Ashish

    2013-01-01

    Kocher Debre Semelaigne Syndrome is a rare syndrome with clinical manifestation of hypothyroidism associated with pseudomuscular hypertrophy. Very few cases have been reported on kocher-debre semelaigne syndrome in the literature with the incidence reported to be less than 10%. As per our knowledge; until now, only one case of oro-facial manifestations has been reported. Here we report one such case of Kocher debre semelaigne syndrome in an 11 year old boy, showing features of macroglossia, multiple impacted teeth, puffed lips and anterior open bite. PMID:23599883

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

    PubMed Central

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

    2012-01-01

    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

  18. Gyroscopic waves in the base of the solar corona: A model and possible observational manifestations

    NASA Technical Reports Server (NTRS)

    Pisanko, Y. V.; Tritakis, V. P.; Paliatsos, A. G.

    1997-01-01

    A linear model for gyroscopic waves in the base of the solar corona is proposed. The purpose was to point out possible observational manifestations of the phenomenon. According to the model, these waves move slowly around the sun along heliolatitude circles. The fact that the red line corona is fainter on the solar side facing the apex and north-south and east-west asymmetries of the red coronal emission line could be interpreted as a possible observational manifestation of the gyroscopic wave phenomenon in the coronal base.

  19. Depression is an early disease manifestation in lupus-prone MRL/lpr mice.

    PubMed

    Gao, Hua-Xin; Campbell, Sean R; Cui, Min-Hui; Zong, Pu; Hee-Hwang, Jong; Gulinello, Maria; Putterman, Chaim

    2009-02-15

    Many lupus patients develop neuropsychiatric manifestations, including cognitive dysfunction, depression, and anxiety. However, it is not clear if neuropsychiatric lupus is a primary disease manifestation, or is secondary to non-CNS disease. We found that MRL/lpr lupus-prone mice exhibited significant depression-like behavior already at 8 weeks of age, despite normal visual working memory, locomotor coordination and social preference. Moreover, depression was significantly correlated with titers of autoantibodies against DNA, NMDA receptors and cardiolipin. Our results indicate that lupus mice develop depression and CNS dysfunction very early in the course of disease, in the absence of substantial pathology involving other target organs. PMID:19121871

  20. Coricidin HBP abuse: patient characteristics and psychiatric manifestations as recorded in an inpatient psychiatric unit.

    PubMed

    Dickerson, Daniel L; Schaepper, Mary Ann; Peterson, Mark D; Ashworth, Michelle D

    2008-01-01

    Coricidin HBP, a cold medication containing dextromethorphan, has become a popular agent abused among adolescents. This retrospective chart review examines the potential psychiatric manifestations of Coricidin HBP misuse and patterns of use among patients treated in an inpatient child and adolescent psychiatric unit. Coricidin HBP use was documented in 47 patient. The data revealed that Coricidin HBP use was associated with: (a) predominantly depressive symptomatology; (b) transient substance-induced psychosis; (c) cardiac toxicity; and (d) greater quantities used per episode by Caucasians. Clinicians treating adolescents need to be aware of the abuse potential and psychiatric manifestations of this dextromethorphan-containing product. PMID:18551885

  1. Neurofibromatosis and fibrous dysplasia manifesting in the same patient: a rare case report.

    PubMed

    Sujatha, Sampangi; Jatti, Deepa

    2015-02-01

    Neurofibromatosis and fibrous dysplasia show the presence of café-au-lait spots, bone lesions, and endocrinopathies. There has been speculation whether neurofibromatosis and fibrous dysplasia are different manifestations of the same disease or if these conditions are in some way related. We provide a case of whether neurofibromatosis and fibrous dysplasia complicated by hyperparathyroidism and osteoporosis. PMID:24000123

  2. Manifestations of Metadata: From Alexandria to the Web--Old is New Again

    ERIC Educational Resources Information Center

    Kennedy, Patricia

    2008-01-01

    This paper is a discussion of the use of metadata, in its various manifestations, to access information. Information management standards are discussed. The connection between the ancient world and the modern world is highlighted. Individual perspectives are paramount in fulfilling information seeking. Metadata is interpreted and reflected upon in…

  3. Race Moves: Following Global Manifestations of New Racisms in Intimate Space

    ERIC Educational Resources Information Center

    Mishra Tarc, Aparna

    2013-01-01

    This article makes tentative links between abstract global forces and the affective and material reworking of race in intimate spaces of culture and community. Using postcolonial and psychoanalytic resources the article follows enduring manifestations of race as racism surfaces and is mobilized through global shifts of people, ideas and capital.…

  4. Exploring the Manifestations of Anxiety in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    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

    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…

  5. An Investigation of the Manifestation of Sexism in EFL/ESL Textbooks

    ERIC Educational Resources Information Center

    Ghorbani, Laya

    2009-01-01

    The present study, under the sponsorship of Islamic Azad University of Bandar Abbas, Iran, was designed to examine the manifestation of sexism in three EFL/ESL textbook series ("American Headway", "Interchange (3rd Ed.)", and "Person to Person") currently used in Iranian Language Institutes. A critical content analysis was conducted over the text…

  6. Susac's Syndrome: A Case with Unusual Cardiac Vestibular and Imaging Manifestations

    PubMed Central

    River, Yaron; Shupak, Avi; Tiosano, Beatrice; Danilov, Vika; Braverman, Itzhak

    2015-01-01

    Susac's syndrome (SS) is a disease of the microvasculature of the retina, brain, and inner ear. We describe a patient with unusual manifestations of SS with possible involvement of the brainstem, cardiac arrhythmia, and MRI findings lacking the characteristic lesions found in Susac's syndrome. PMID:26688762

  7. Cardiopulmonary manifestations of isolated pulmonary valve infective endocarditis demonstrated with cardiac CT.

    PubMed

    Passen, Edward; Feng, Zekun

    2015-01-01

    Right-sided infective endocarditis involving the pulmonary valve is rare. This pictorial essay discusses the use and findings of cardiac CT combined with delayed chest CT and noncontrast chest CT of pulmonary valve endocarditis. Cardiac CT is able to show the full spectrum of right-sided endocarditis cardiopulmonary features including manifestations that cannot be demonstrated by echocardiography. PMID:25977113

  8. Examination of the Psychometric Properties of the Adult Manifest Anxiety Scale-Elderly Version Scores

    ERIC Educational Resources Information Center

    Lowe, Patricia A.; Reynolds, Cecil R.

    2006-01-01

    The psychometric properties of the Adult Manifest Anxiety Scale-Elderly Version (AMAS-E) scores were evaluated in two studies. In Study 1, the temporal stability and construct validity of the AMAS-E test scores were examined in a group of 226 older adults, aged 60 years and older. Results indicated adequate to excellent temporal stability (2-week…

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

    ERIC Educational Resources Information Center

    Moore, Peter N.; And Others

    1984-01-01

    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)

  10. DETECTION AND ANALYSIS OF ABNORMAL SITUATIONS THROUGH FEAR-TYPE ACOUSTIC MANIFESTATIONS

    E-print Network

    DETECTION AND ANALYSIS OF ABNORMAL SITUATIONS THROUGH FEAR-TYPE ACOUSTIC MANIFESTATIONS C. Clavel1 in effective applications. The present research focuses on the development of a fear-type emotions recognition system to detect and analyze abnormal situa- tions for surveillance applications. The Fear vs. Neutral

  11. Epidemiological features and clinical manifestations of Lyme borreliosis in Korea during the period 2005-2012.

    PubMed

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

    2015-01-01

    Lyme borreliosis is one of the most common tick-borne infections in the northern hemisphere. However, the epidemiological features and clinical manifestations of this disease in Korea are unknown. The present study is the first to investigate the characteristics of Lyme borreliosis in Korea. We traced suspected cases of Lyme borreliosis during the period 2005-2012. Of the 16 identified patients with the disease, 11 had acquired autochthonous infection within Korea, while 5 patients were infected outside Korea. The history of past exposure was investigated in 8 of the 11 patients with autochthonous infection; 5 of these 8 patients (62.5%) were suspected to have acquired the infection in the northeastern alpine region. Clinically, of 11 patients with autochthonous infection, 6 (54.5%) showed early skin manifestations, 4 (36.4%) showed neurological manifestations, and 1 (9.1%) showed acrodermatitis chronica atrophicans. In conclusion, Lyme borreliosis could be endemic in the northeastern alpine region of Korea, and neurological and early skin manifestations are likely to be the major clinical characteristics of autochthonous Lyme borreliosis in Korea. PMID:25420645

  12. The NGO-ization of Community Colleges: One (More) Manifestation of Globalization

    ERIC Educational Resources Information Center

    Quint-Rapoport, Mia

    2006-01-01

    In this essay the author discusses the effects of globalization on Canadian community colleges. She applies contemporary social theories culled from the fields of feminism, geography and political science to understand one hidden manifestation of globalization in community colleges: involvement in global civil society via participation in…

  13. Manifesting Resilience in the Secondary School: An Investigation of the Relationship Dynamic in Visual Arts Classrooms

    ERIC Educational Resources Information Center

    Stride, Yvette; Cutcher, Alexandra

    2015-01-01

    Responding to the literature on positive adaptability, we investigated caring relationships as they manifest as protective processes in the Visual Arts classroom. Caring relationships between teachers and their students have been isolated as one of three protective factors which help promote resilience and thus positive adaptability. The Visual…

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

    NASA Technical Reports Server (NTRS)

    Gedeon, David

    1989-01-01

    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.

  15. Manifestation of the spin Hall effect through charge-transport in the mesoscopic regime 

    E-print Network

    Hankiewicz, EM; Molenkamp, LW; Jungwirth, T.; Sinova, Jairo.

    2004-01-01

    We study theoretically the manifestation of the spin Hall effect in a two-dimensional electronic system with Rashba spin-orbit coupling via dc-transport measurements in realistic mesoscopic H-shape structures. The Landauer-Buttiker formalism is used...

  16. 78 FR 76153 - Agency Information Collection Activities: Entry and Manifest of Merchandise Free of Duty, Carrier...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ...U.S. Customs and Border Protection (CBP) of the Department of Homeland Security will be submitting the following information collection request to the Office of Management and Budget (OMB) for review and approval in accordance with the Paperwork Reduction Act: Entry and Manifest of Merchandise Free of Duty, Carrier's Certificate and Release (CBP Form 7523). This is a proposed extension of an......

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

    PubMed Central

    Zarghouni, Mehrzad; Cannon, Walter

    2014-01-01

    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

  18. Manifestations of classical physics in the quantum evolution of correlated spin states in pulsed NMR experiments

    E-print Network

    Ligare, Martin

    " in an excellent review reconciling the quantum and classical points of view of single-spin NMR [1]. It is nowManifestations of classical physics in the quantum evolution of correlated spin states in pulsed to understand the quantum evolution of an ensemble of weakly-coupled spins in such experiments using some

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

    ERIC Educational Resources Information Center

    King, Charles H.

    1975-01-01

    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)

  20. arXiv:cond-mat/9903412v129Mar1999 Classical Chaos and its Quantum Manifestations

    E-print Network

    Shepelyansky, Dima

    ;Classical Chaos and its Quantum Manifestations Sputnik Conference of STATPHYS 20 In honor of Boris Chirikov/ Email: sylvia@irsamc2.ups-tlse.fr, dima@irsamc2.ups-tlse.fr #12;Boris Chirikov 6 June, 1998 #12;Sputnik of Chaos This special issue of Physica D represents selected proceedings of the Sputnik Conference

  1. Action with Manifest Duality for Maximally Supersymmetric Six-dimensional Supergravity

    E-print Network

    GianCarlo De Pol; Harvendra Singh; Mario Tonin

    2000-03-14

    We perform explicitly the toroidal compactification of eleven dimensional supergravity to six dimensions and present its action in a manifestly $SO(5,5)\\over SO(5)\\times SO(5)$ invariant form using the recently proposed covariant formulation of theories involving chiral fields.

  2. The Sources and Manifestations of Stress amongst School-Aged Dyslexics, Compared with Sibling Controls

    ERIC Educational Resources Information Center

    Alexander-Passe, Neil

    2008-01-01

    All school children experience stress at some point in their school careers. This study investigates whether dyslexic children, by way of their educational and social difficulties, experience higher levels of stress at school. The School Situation Survey was used to investigate both the sources and manifestations of stress amongst dyslexic…

  3. Susac's Syndrome: A Case with Unusual Cardiac Vestibular and Imaging Manifestations.

    PubMed

    River, Yaron; Shupak, Avi; Tiosano, Beatrice; Danilov, Vika; Braverman, Itzhak

    2015-01-01

    Susac's syndrome (SS) is a disease of the microvasculature of the retina, brain, and inner ear. We describe a patient with unusual manifestations of SS with possible involvement of the brainstem, cardiac arrhythmia, and MRI findings lacking the characteristic lesions found in Susac's syndrome. PMID:26688762

  4. Cutaneous Manifestations of Non-Celiac Gluten Sensitivity: Clinical Histological and Immunopathological Features

    PubMed Central

    Bonciolini, Veronica; Bianchi, Beatrice; Del Bianco, Elena; Verdelli, Alice; Caproni, Marzia

    2015-01-01

    Background: The dermatological manifestations associated with intestinal diseases are becoming more frequent, especially now when new clinical entities, such as Non-Celiac Gluten Sensitivity (NCGS), are identified. The existence of this new entity is still debated. However, many patients with diagnosed NCGS that present intestinal manifestations have skin lesions that need appropriate characterization. Methods: We involved 17 patients affected by NCGS with non-specific cutaneous manifestations who got much better after a gluten free diet. For a histopathological and immunopathological evaluation, two skin samples from each patient and their clinical data were collected. Results: The median age of the 17 enrolled patients affected by NCGS was 36 years and 76% of them were females. On the extensor surfaces of upper and lower limbs in particular, they all presented very itchy dermatological manifestations morphologically similar to eczema, psoriasis or dermatitis herpetiformis. This similarity was also confirmed histologically, but the immunopathological analysis showed the prevalence of deposits of C3 along the dermo-epidermal junction with a microgranular/granular pattern (82%). Conclusions: The exact characterization of new clinical entities such as Cutaneous Gluten Sensitivity and NCGS is an important objective both for diagnostic and therapeutic purposes, since these are patients who actually benefit from a GFD (Gluten Free Diet) and who do not adopt it only for fashion. PMID:26389946

  5. Oral manifestations of lipoid proteinosis: A case report and literature review

    PubMed Central

    Ravi Prakash, S.M.; Verma, Sankalp; Sumalatha, M.N.; Chattopadhyay, Sayan

    2013-01-01

    Lipoid proteinosis is an uncommon autosomal recessive metabolic disorder that presents in early life with hoarseness and pox-like acneiform scars involving the skin and mucous membranes. Previous studies have attributed the prevalence of lipoid proteinosis to consanguineous parents. This paper reports a classical case of lipoid proteinosis with oral manifestations but without a history of consanguinity. PMID:23960561

  6. ABNORMAL SITUATIONS DETECTION AND ANALYSIS THROUGH FEAR-TYPE ACOUSTIC MANIFESTATIONS

    E-print Network

    Richard, Gaël

    ABNORMAL SITUATIONS DETECTION AND ANALYSIS THROUGH FEAR-TYPE ACOUSTIC MANIFESTATIONS C. Clavel1 in effective applications. The present research focuses on the development of a fear-type emotions recognition system to detect and analyze abnormal situa- tions for surveillance applications. The Fear vs. Neutral

  7. Gender and Ethnicity Differences Manifested in Chemistry Achievement and Self-Regulated Learning

    ERIC Educational Resources Information Center

    Veloo, Arsaythamby; Hong, Lee Hooi; Lee, Seung Chun

    2015-01-01

    The aim of this study is to examine whether gender and ethnicity differences are manifested in chemistry achievement and self-regulated learning among a matriculation programme students in Malaysia. The result of students' midterm chemistry exam was used as the measure of chemistry achievement. The information of self-regulated learning was…

  8. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...such manifests or other papers filed in the customhouse...denied access to such papers. (e) Availability...issued monthly, with the first month's fee due in...the CBP Data Center, first class, on the next...party address. 1 19. Piece count. 20....

  9. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...such manifests or other papers filed in the customhouse...denied access to such papers. (e) Availability...issued monthly, with the first month's fee due in...Technology Support Center, first class, on the next...party address. 1 19. Piece count. 20....

  10. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...such manifests or other papers filed in the customhouse...denied access to such papers. (e) Availability...issued monthly, with the first month's fee due in...Technology Support Center, first class, on the next...party address. 1 19. Piece count. 20....

  11. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...such manifests or other papers filed in the customhouse...denied access to such papers. (e) Availability...issued monthly, with the first month's fee due in...Technology Support Center, first class, on the next...party address. 1 19. Piece count. 20....

  12. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...such manifests or other papers filed in the customhouse...denied access to such papers. (e) Availability...issued monthly, with the first month's fee due in...Technology Support Center, first class, on the next...party address. 1 19. Piece count. 20....

  13. [Cardiac Manifestations in Antiphospholipid Syndrome--A Brief Review of the Literature].

    PubMed

    Djokovi?, Aleksandra; Stojanovi?, Ljudmila

    2015-01-01

    Antiphospholipid syndrome (APS) or Hughes syndrome represents a systemic autoimmune disorder characterized by arterial and/or venous thrombosis, multiple and recurrent fetal losses, accompanied by persistently elevated levels of antiphospholipid antibodies (aPL). This syndrome is considered primary if unassociated with any other connective tissue disease, or secondary if it appears in association with other autoimmune disorders, mainly systemic lupus erythematosus. Cardiac manifestations in APS are integral part of the syndrome. aPL are involved in the pathogenesis of pseudoinfective endocarditis (Libman Sacks) and other valvular manifestations presented as their thickening and dysfunction. Intracardiac thrombi and myxomas, pulmonary hypertension and left ventricular dysfunction are also distinguishing features of APS. On the other hand, accelerated atherosclerosis, proven in APS and also aPL mediated, is accountable for the development of coronary and peripheral artery disease. This leads to higher cardiovascular mortality rate in the population of patients with low incidence of the traditional atherosclerosis risk factors. Furthermore, recent studies implied that presence of certain aPL could be a risk factor for a specific cardiac manifestation. Bearing all this in mind, early diagnosis of cardiac manifestations, control and abolition of traditional risk factors, as well as close cardiac follow-up of APS patients, are crucial in reducing their cardiovascular mortality. PMID:26259412

  14. Manifest Destiny and Competing Voices on the Eve of the Cherokee Removal

    ERIC Educational Resources Information Center

    Chandler, Prentice T.

    2011-01-01

    Manifest Destiny, the idea that Providence guided the conquest and settlement of North America, is one of the most contested ideas in American culture and history. One's opinion about this central aspect of American mythology depends heavily on one's point of view. Exploring westward expansion and the Cherokee Trail of Tears with primary sources…

  15. Sustained ventricular tachycardia as the first manifestation of hydatid cyst located in the interventricular septum.

    PubMed

    ?ahin, ?rfan; Özkaynak, Berk; Güngör, Bari?; Ayça, Burak; S??irci, Serhat; Mert, Bülent; Okuyan, Ertu?rul

    2015-07-01

    Echinococcus granulosus infection may manifest with cardiac involvement causing various symptoms. Here, we discuss a case of a young patient who presented with sustained ventricular tachycardia (VT) causing hemodynamic compromise. Diagnosis of cardiac hydatid cyst was established with echocardiography, computed tomography imaging, and serological examination. After surgical removal of the cyst VT did not recur. PMID:25586822

  16. Violence and Compassion: A Bioethical Insight into Their Cognitive Bases and Social Manifestations

    ERIC Educational Resources Information Center

    Mercadillo, Roberto E.; Arias, Nallely A.

    2010-01-01

    This article considers the social problem of violence and the alternative of resolution through cooperation and compassion from the perspective of cognitive neuroscience. Violence is a social problem, the manifestations of which have a biological basis reflected in the development of aggression and the neural mechanisms that regulate it.…

  17. Oral manifestations of Systemic Sclerosis and Correlation with anti-Topoisomerase I Antibodies (SCL-70)

    PubMed Central

    Bajraktari, Ismet H.; Kryeziu, Avni; Sherifi, Fadil; Bajraktari, Halit; Lahu, Ali; Bajraktari, Genc

    2015-01-01

    Introduction: Progressive systemic sclerosis (PSS) is a chronic autoimmune illness. Clinical oral manifestations in Scleroderma are very frequent. Aim: To explore the oral manifestations, frequent and rare, to investigate whether there are differences between gender and the observed correlation of changes in relation to Antibodies Anti-Topoisomerase I. Material and methods: in the study were included 75 patients (65 females and 10 males), their mean age was 45.2±10, duration of illness was around 5.1±12 years diagnosed according to the ACR criteria and treated in the period 2010-2013. Results: 98.7% of our patients were ANA positive, whereas 49.3% of them were Anti SCL-70 positive. Patients in 91% of cases had one or more oral manifestations of disease. The most frequent oral manifestations are: small mouth (n = 39), the lingua short frenulum (n = 21), Xerostomia (n = 24) and paradontopathia (n = 16), while more rare are: Telangiectasia (n = 14), decreased interincisal distance (n = 9), missing teeth (n = 9), absorption of dental alveoli (n = 5) and Neuralgia n. trigeminus (n = 3). Oral symptoms have been frequent in patients with Scleroderma, SCL -70 positive but not statistically significant difference. Conclusions: Oral changes have high frequency in patients with Scleroderma and these changes provide high discomfort of the mouth and lower quality of life. Oral health care to patients with Scleroderma is very important and it affects a lot in reducing the level of disease and increase the quality of life. PMID:26261381

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

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

    ERIC Educational Resources Information Center

    McCoy, Kate

    2014-01-01

    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.…

  1. Skin manifestation of methylmalonic acidemia: case report and review of the literature.

    PubMed

    Karamifar, H; Shakibazad, N; Saki, F; Saki, N; Kardeh, S

    2015-12-01

    Skin manifestations, including scalded skin, desquamation, and chronic periorificial dermatitis, are rare clinical signs in patients with methylmalonic acidemia. This condition may be due to enzyme deficiency or multi-nutrient deficiency because of nutritional restriction. Bullous skin lesion is very rare in these patients and consequently, this type of skin lesion can be the presenting sign of methylmalonic acidemia. PMID:25058035

  2. Hypokalemic periodic paralysis; two different genes responsible for similar clinical manifestations

    PubMed Central

    Kim, Hunmin; Hwang, Hee; Cheong, Hae Il

    2011-01-01

    Primary hypokalemic periodic paralysis (HOKPP) is an autosomal dominant disorder manifesting as recurrent periodic flaccid paralysis and concomitant hypokalemia. HOKPP is divided into type 1 and type 2 based on the causative gene. Although 2 different ion channels have been identified as the molecular genetic cause of HOKPP, the clinical manifestations between the 2 groups are similar. We report the cases of 2 patients with HOKPP who both presented with typical clinical manifestations, but with mutations in 2 different genes (CACNA1Sp.Arg528His and SCN4A p.Arg672His). Despite the similar clinical manifestations, there were differences in the response to acetazolamide treatment between certain genotypes of SCN4A mutations and CACNA1S mutations. We identified p.Arg672His in the SCN4A gene of patient 2 immediately after the first attack through a molecular genetic testing strategy. Molecular genetic diagnosis is important for genetic counseling and selecting preventive treatment. PMID:22253645

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

    PubMed Central

    2014-01-01

    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

  4. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India

    PubMed Central

    Koshy, Jacob; John, M Joseph; Thomas, Satish; Kaur, Gurvinder; Batra, Nitin; Xavier, Wilson J

    2015-01-01

    Context: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. Aims: This study evaluates the spectrum of ocular manifestations in acute and chronic leukemias presenting to a tertiary care center in India. Settings and Design: Subjects of leukemia presenting to a tertiary care center in India. Subjects and Methods: A prospective, cross-sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. Statistical Analysis Used: The collected data were analyzed using the Statistical Package for Social Sciences for Windows software, version 16 (SPSS Inc., Chicago, Illinois, USA). Results: The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ±22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (P = 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8.3%) subjects while secondary or indirect involvement due to anemia, thrombocytopenia, hyperviscosity, total body irradiation, and immunosuppression were seen in 42 (43.8%) subjects. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children (P = 0.09460). Twenty-eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (P = 0.2874). The ocular manifestations were significantly (P = 0.01158) more frequent in myeloid leukemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%). Conclusions: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. All the primary leukemic manifestations were seen in males. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular changes are often picked up in asymptomatic patients. PMID:26576524

  5. Mood disorder as a manifestation of primary hypoparathyroidism: a case report

    PubMed Central

    2014-01-01

    Introduction Primary hypoparathyroidism is a rare condition caused by parathyroid hormone deficiency and characterized by hypocalcemia. The clinical manifestations of primary hypoparathyroidism include tetany, seizures, paresthesias, dementia, and parkinsonism. Psychiatric manifestations such as mood disorders are unusual and may constitute a major diagnostic challenge, especially if the typical manifestations caused by hypocalcemia are absent. Case presentation The patient was a 22-year-old Caucasian man with a history of chronic omeprazole use and periodic seizures, who presented to the emergency department of a secondary hospital in Southern Brazil with symptoms of major depression (sadness, anhedonia, loss of appetite, insomnia, and fatigue) associated with paresthesias affecting his toes. The initial electrocardiogram revealed a prolonged QTc interval. A computed tomography scan of his brain revealed bilateral, nonenhancing hyperdense calcifications involving the putamen and caudate nucleus. An electroencephalogram showed generalized bursts of slow spikes. Blood laboratory study results indicated serum hypocalcemia, hypomagnesemia, and hyperphosphatemia associated with a low parathyroid hormone level. His serum levels of albumin, 25-hydroxyvitamin D, thyroid-stimulating hormone, T3 and T4 thyroid hormones, as well as the results of kidney function tests, were normal. The definitive diagnosis was primary hypoparathyroidism with psychiatric manifestations due to chronic hypomagnesemia induced by proton pump inhibitor use. Conclusions In some cases, to differentiate between a primary psychiatric disorder and primary hypoparathyroidism with neuropsychiatric symptoms may represent a challenge given that the classical manifestations of hypocalcemia, especially tetany, may be absent in the setting of chronic hypoparathyroidism. Clinicians and psychiatrists should consider primary hypoparathyroidism part of the differential diagnosis during the evaluation of patients with mood symptoms, especially in the context of atypical presentations associated with hypocalcemia. PMID:25280468

  6. 15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Vessel Transportation Module as provided in CBP Regulations, 19 CFR 4.63 and 4.76. (i) Bunker fuel. The...) Aircraft. Aircraft transporting goods shall file a complete manifest as required in CBP Regulations 19 CFR... export in accordance with 19 CFR 123. (4) Carriers not required to file manifests. Carriers exempted...

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

    E-print Network

    Hochner, Binyamin

    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

  8. Mixture Item Response Theory-MIMIC Model: Simultaneous Estimation of Differential Item Functioning for Manifest Groups and Latent Classes

    ERIC Educational Resources Information Center

    Bilir, Mustafa Kuzey

    2009-01-01

    This study uses a new psychometric model (mixture item response theory-MIMIC model) that simultaneously estimates differential item functioning (DIF) across manifest groups and latent classes. Current DIF detection methods investigate DIF from only one side, either across manifest groups (e.g., gender, ethnicity, etc.), or across latent classes…

  9. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... individuals onboard private aircraft arriving in and departing from the United States; notice of arrival and... Electronic manifest requirement for all individuals onboard private aircraft arriving in and departing from...) Electronic manifest requirement for all individuals onboard private aircraft arriving in the U.S.; notice...

  10. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... individuals onboard private aircraft arriving in and departing from the United States; notice of arrival and... Electronic manifest requirement for all individuals onboard private aircraft arriving in and departing from...) Electronic manifest requirement for all individuals onboard private aircraft arriving in the U.S.; notice...

  11. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... individuals onboard private aircraft arriving in and departing from the United States; notice of arrival and... Electronic manifest requirement for all individuals onboard private aircraft arriving in and departing from...) Electronic manifest requirement for all individuals onboard private aircraft arriving in the U.S.; notice...

  12. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... individuals onboard private aircraft arriving in and departing from the United States; notice of arrival and... Electronic manifest requirement for all individuals onboard private aircraft arriving in and departing from...) Electronic manifest requirement for all individuals onboard private aircraft arriving in the U.S.; notice...

  13. 19 CFR 122.22 - Electronic manifest requirement for all individuals onboard private aircraft arriving in and...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... individuals onboard private aircraft arriving in and departing from the United States; notice of arrival and... Electronic manifest requirement for all individuals onboard private aircraft arriving in and departing from...) Electronic manifest requirement for all individuals onboard private aircraft arriving in the U.S.; notice...

  14. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... occupational disease claims which become manifest after retirement. 702.604 Section 702.604 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the claim is for disability benefits and...

  15. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... occupational disease claims which become manifest after retirement. 702.603 Section 702.603 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the time of injury occurs within the...

  16. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... occupational disease claims which become manifest after retirement. 702.603 Section 702.603 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the time of injury occurs within the...

  17. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... occupational disease claims which become manifest after retirement. 702.604 Section 702.604 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the claim is for disability benefits and...

  18. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... occupational disease claims which become manifest after retirement. 702.604 Section 702.604 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the claim is for disability benefits and...

  19. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... occupational disease claims which become manifest after retirement. 702.603 Section 702.603 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the time of injury occurs within the...

  20. 20 CFR 702.604 - Determining the amount of compensation for occupational disease claims which become manifest...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... occupational disease claims which become manifest after retirement. 702.604 Section 702.604 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the claim is for disability benefits and...

  1. 20 CFR 702.603 - Determining the payrate for compensating occupational disease claims which become manifest after...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... occupational disease claims which become manifest after retirement. 702.603 Section 702.603 Employees' Benefits...' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Occupational Disease Which Does Not... disease claims which become manifest after retirement. (a) If the time of injury occurs within the...

  2. Transient global amnesia as a manifestation of acute myocardial infarction: a case of missed sudden cardiac death?

    PubMed

    Caramelli, Bruno; Dutra, Aurélio Pimenta; Calderaro, Daniela; Yu, Pai Ching; Gualandro, Danielle Menosi; Marques, André Coelho

    2009-07-24

    Acute myocardial infarction may lead to several clinical manifestations and many times this diagnosis is missed. Transient global amnesia (TGA) is a well-defined clinical syndrome of unknown etiology. Several mechanisms have been proposed but only trigger events have been clearly associated with the attack. We describe a case of acute myocardial infarction manifestated by TGA. PMID:18639945

  3. 15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Vessel Transportation Module as provided in CBP Regulations, 19 CFR 4.63 and 4.76. (i) Bunker fuel. The...) Aircraft. Aircraft transporting goods shall file a complete manifest as required in CBP Regulations 19 CFR... export in accordance with 19 CFR 123. (4) Carriers not required to file manifests. Carriers exempted...

  4. 15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Vessel Transportation Module as provided in CBP Regulations, 19 CFR 4.63 and 4.76. (i) Bunker fuel. The...) Aircraft. Aircraft transporting goods shall file a complete manifest as required in CBP Regulations 19 CFR... export in accordance with 19 CFR 123. (4) Carriers not required to file manifests. Carriers exempted...

  5. 15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Vessel Transportation Module as provided in CBP Regulations, 19 CFR 4.63 and 4.76. (i) Bunker fuel. The...) Aircraft. Aircraft transporting goods shall file a complete manifest as required in CBP Regulations 19 CFR... export in accordance with 19 CFR 123. (4) Carriers not required to file manifests. Carriers exempted...

  6. 15 CFR 30.45 - General statement of requirements for the filing of carrier manifests with proof of filing...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Vessel Transportation Module as provided in CBP Regulations, 19 CFR 4.63 and 4.76. (i) Bunker fuel. The...) Aircraft. Aircraft transporting goods shall file a complete manifest as required in CBP Regulations 19 CFR... export in accordance with 19 CFR 123. (4) Carriers not required to file manifests. Carriers exempted...

  7. Acute neuromuscular manifestations in a patient associated with ingesting octopus (Octopus sp.).

    PubMed

    Haddad, Vidal; Moura, Regina

    2007-01-01

    The authors report neuromuscular manifestations in a 45-year-old woman after consuming octopus meat (Octopus sp.). The patient presented malaise, paresthesias in perioral and extremity areas, intense muscular weakness and arterial hypotension, followed by severe itch and disseminated cutaneous rash. Gastrointestinal manifestations and fever were not observed, reducing the probability of alimentary poisoning. The presence of muscular and neurological symptoms suggests neurotoxin action, which could have been ingested by the victim from the octopus salivary glands or from an accumulation of toxins in the meat, or by an unknown mechanism. There is little known about toxins of the Octopus genus and this communication is important alert to the possibility of poisoning in humans that eat octopus and its differentiation from alimentary poisonings arising from incorrect conservation of seafood. PMID:17384822

  8. TAT assessment of sexually abused girls: an analysis of manifest content.

    PubMed

    Pistole, D R; Ornduff, S R

    1994-10-01

    Manifest content of Thematic Apperception Test (TAT; Murray, 1943) stories of 30 sexually abused female children and a clinical group of 30 female children with no documented history of abuse was examined using the Scoring Scheme for the TAT and Other Verbal Projective Techniques (Fine, 1955a). The two groups were similar demographically, and did not differ with regard to the overall frequency of negative feelings and outcomes. Significant group differences were found when specific negative feelings were investigated, with subjects in the abuse group having higher frequencies of stated sexual preoccupation than nonabused comparison subjects. In addition, higher frequencies of expressed guilt on the part of abuse subjects can be considered secondary to their overconcern with sexuality. Findings support the utility of the TAT in identifying victims of sexual abuse by the examination of manifest content. PMID:7965567

  9. Oral manifestations of neurofibromatosis type 1 in children with facial plexiform neurofibroma: report of three cases.

    PubMed

    Cunha, K S; Rozza-de-Menezes, R E; Andrade, R M; Almeida, Lms; Janini, Mer; Geller, M

    2015-01-01

    Neurofibromatosis type 1 (NF1) is a common autosomal genetic disorder with a prevalence of 1 in 3,000 births. NF1 is a complex syndrome characterized by many abnormalities and may affect all organ systems. Oral manifestations of NF1 occur frequently, but reports including NF1 children with facial plexiform neurofibromas and oral alterations are scant. Facial plexiform neurofibroma may cause asymmetry, disfigurement and usually arises from the trigeminal nerve. The aim of this paper is to to report three pediatric NF1 cases with facial plexiform neurofibroma presenting with oral manifestations, which were evaluated clinically and radiographically, and also to briefly review the literature. Patients presented with changes in the oral soft tissues, jaws, and teeth ipsilateral to the tumor. PMID:25823487

  10. [Ocular manifestations of Ebola virus disease: What we learned from the last epidemic].

    PubMed

    Rousseau, A; Labetoulle, M

    2015-10-01

    The Ebola virus disease (EVD) outbreak, which was declared as such in West Africa in March 2014, has become the largest EVD epidemic to date. It is the first time that EVD has been responsible for cases imported to the US as well as locally-acquired cases in Europe. Research on pathophysiology and treatment has been considerably accelerated, and more precise descriptions of various forms of ocular involvement have been obtained. Conjunctival hyperemia is often present during the acute phase, and it may contribute to the diagnosis of EVD in an epidemic context. During convalescence, ocular inflammatory manifestations may develop and can be caused by viral persistence in ocular tissue. Eye care providers need to be aware of the ophthalmic manifestations of EVD, sometimes several weeks after the acute infection, in order to recognize them and take appropriate safety precautions. PMID:26341021

  11. Nasal manifestations of IgG4-related disease: A report of two cases.

    PubMed

    Ohno, Keiko; Matsuda, Yoko; Arai, Tomio; Kimura, Yurika

    2015-12-01

    IgG4-related disease (IgG4-RD) is a recently recognized clinical disease entity characterized by elevated serum IgG4, tumefaction, tissue infiltration of IgG4-positive plasma cells and fibrosis. IgG4-RD may occur, either synchronously or metachronously, in a variety of organs throughout the body. We describe herein two representative cases of the nasal manifestations of IgG4-RD, characterized by diffuse, crusty, erosive lesions on nasal mucosa. Oral steroid administration was effective in treating these nasal manifestations. We report a decrease in IgG4 positive plasma cell infiltrates in nasal mucosa biopsy specimens after steroid therapy, demonstrating that infiltration of IgG4-positive cells is reversible. PMID:26060132

  12. IFN? kinoid vaccine-induced neutralizing antibodies prevent clinical manifestations in a lupus flare murine model

    PubMed Central

    Zagury, Daniel; Le Buanec, Hélène; Mathian, Alexis; Larcier, Patrick; Burnett, Roger; Amoura, Zahir; Emilie, Dominique; Peltre, Gabriel; Bensussan, Armand; Bizzini, Bernard; Gallo, Robert C.; Koutouzov, Sophie

    2009-01-01

    A major involvement of IFN? in the etiopathogenesis of systemic lupus erythematosus has been suggested by clinical observations, including the increase of serum levels of this cytokine in patients with active disease. Supporting this hypothesis, we have shown that expression of IFN? from a recombinant adenovirus (IFN? Adv) precipitates lupus manifestations in genetically susceptible New Zealand Black (NZB) × New Zealand White (NZW)F1 mice (NZB/W) but not in BALB/c mice. In the present investigation, we have prepared an IFN? immunogen, termed IFN? kinoid, which, appropriately adjuvanted, induces transient neutralizing antibodies (Abs) but no cellular immune response to the cytokine and without apparent side effects. Using this preparation, we also showed that, in kinoid-vaccinated NZB/W mice, lupus manifestations, including proteinuria, histological renal lesions, and death triggered by IFN? Adv challenge were delayed/prevented as long as an effective threshold of anti-IFN? inhibitory capacity was present in the serum. PMID:19279210

  13. Manifestly N = 2 supersymmetric regularization for N = 2 supersymmetric field theories

    NASA Astrophysics Data System (ADS)

    Buchbinder, I. L.; Pletnev, N. G.; Stepanyantz, K. V.

    2015-12-01

    We formulate the higher covariant derivative regularization for N = 2 supersymmetric gauge theories in N = 2 harmonic superspace. This regularization is constructed by adding the N = 2 supersymmetric higher derivative term to the classical action and inserting the N = 2 supersymmetric Pauli-Villars determinants into the generating functional for removing one-loop divergencies. Unlike all other regularization schemes in N = 2 supersymmetric quantum field theory, this regularization preserves by construction the manifest N = 2 supersymmetry at all steps of calculating loop corrections to the effective action. Together with N = 2 supersymmetric background field method this regularization allows to calculate quantum corrections without breaking the manifest gauge symmetry and N = 2 supersymmetry. Thus, we justify the assumption about existence of a regularization preserving N = 2 supersymmetry, which is a key element of the N = 2 non-renormalization theorem. As a result, we give the proof of the N = 2 non-renormalization theorem which does not require any additional assumptions.

  14. Differential Contributions of Polycystic Ovary Syndrome (PCOS) Manifestations to Psychological Symptoms.

    PubMed

    McCook, Judy G; Bailey, Beth A; Williams, Stacey L; Anand, Sheeba; Reame, Nancy E

    2015-07-01

    The purpose of this study was to investigate the relative contributions of previously identified Polycystic ovary syndrome (PCOS) manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Participants were 126 female endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of PCOS manifestations and psychological symptoms. Participants had significantly elevated scores on nine subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. After controlling for demographic factors, menstrual problems were the strongest predictor of psychological symptoms. Findings suggest features of excess body hair, obesity, and menstrual abnormalities carry unique risks for adverse psychologic symptoms, but menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS. PMID:24390359

  15. Oral Manifestations of Crohn's Disease: A Case Report and Review of the Literature

    PubMed Central

    Woo, Victoria L.

    2015-01-01

    Crohn's disease (CD) is an inflammatory disorder of the gastrointestinal tract that is likely caused by an inappropriate mucosal inflammatory response to intestinal bacteria in a genetically predisposed host. The lesions of CD can involve any region of the GI tract as well as extraintestinal sites such as the skin, joints, and eyes. The most common presenting symptoms are abdominal pain and prolonged diarrhea associated with fevers, fatigue, and malaise. Delayed growth and failure to thrive may also be observed in pediatric patients. Oral manifestations of CD are known as oral CD and may precede GI involvement, thus serving as early markers of this condition. We describe a 6-year-old male who presented with oral lesions as his initial manifestation of disease and review the current literature pertaining to oral CD. PMID:26240765

  16. Clinical manifestations of obstructive sleep apnoea in pregnancy: more than snoring and witnessed apnoeas.

    PubMed

    Bourjeily, G; Barbara, N; Larson, L; He, M

    2012-07-01

    Sleep disordered breathing and its symptoms have been associated with a multitude of fetal and maternal complications including gestational hypertensive disorders, gestational diabetes and possibly pre-term labour and other markers of alterations in fetal wellbeing. The disease remains underdiagnosed in the general population but likely also in pregnancy, mostly because providers do not appropriately screen for the disorder. Sleep disordered breathing may manifest differently in women, since women report more fatigue and less snoring than men do. This paper discusses typical presentations of sleep disordered breathing but also reports some less obvious presentations to help providers recognise those manifestations and screen for the disorder when warranted. Our case series describes patients with diagnoses such as chronic hypertension, pre-eclampsia, pulmonary hypertension, nocturnal asthma and panic attacks, who were diagnosed with sleep disordered breathing and offered treatment with CPAP during pregnancy. PMID:22663313

  17. Pet killing as a manifestation of impulse control disorder secondary to pramipexol.

    PubMed

    Micheli, Federico; Pellene, Alejandro; Arcushin, Daniela; Calzinari, Aldo; Farret, Michel Sáenz

    2015-01-01

    Impulse control disorders are frequent in Parkinson disease and are commonly associated with dopamine agonists intake. Typical manifestations include punding, hypersexuality, pathological gambling, and other compulsive behaviors. Symptoms often promptly disappear when dopamine agonists are discontinued, but if the origin is misinterpreted, symptoms may become a problem. We here report the case of a patient with juvenile Parkinson disease treated with 4.5 mg/d of pramipexol, who developed the need to adopt cats. He adopted almost 50 of them, but after he adopted them, he felt the need to kill them. The case became well known, and he became depressed and isolated. He was admitted to a psychiatric hospital and thought that he was a psychotic. However, when pramipexol was replaced by levodopa, the symptoms disappeared. This case illustrates the wide range of manifestations of impulse control disorders and warrants the inclusion of violent behaviors among them. PMID:25768852

  18. Morphological manifestations of the Dandy-Walker syndrom in female members of a family.

    PubMed

    Titli?, Marina; Alfirevi?, Stanko; Koli?, Krešimir; Soldo, Anamarija; Tripalol, Ana Batoš

    2015-03-01

    The Dandy-Walker syndrome (DWS) is a hereditary disorder, appearing somewhat more frequently in women. The most important characteristics of the DWS are the lack of the cerebellar vermis, varying from a partial lack to a complete agenesis, and enlargement of the cerebrospinal spaces, especially in the fourth ventricle. The above mentioned morphological changes clinically manifest in ataxia, increased intracranial pressure and hydrocephalus. Here is presented a family with DWS, where the disease is contracted only by female members, in two generations, whereas no signs of DWS have been noticed in male family members. DWS is clinically manifested from early childhood to middle age, with the morphological changes varying from hypoplastic cerebellar vermis to widening of the brain ventricles and hydrocephalus and arachnoid cyst in the occipital part. PMID:26040095

  19. Childhood adrenoleukodystrophy - Classic and variant - Review of clinical manifestations and magnetic resonance imaging.

    PubMed

    Santosh Rai, P V; Suresh, B V; Bhat, I G; Sekhar, Mithun; Chakraborti, Shrijeet

    2013-09-01

    Adrenoleukodystrophy (ALD) is a genetic disease associated with demyelination of the central nervous system, adrenal insufficiency, and accumulation of very long-chain fatty acids in tissue and body fluids. The attempt of this paper is to review the classical and not-so-classical MR imaging manifestations of adrenoleukodystrophy. A review of literature is done to describe the pathophysiology of the disease and the imaging differences between childhood and adult-onset of the disease. The literature is reviewed to explain the link with Addison's disease. In consensus the magnetic resonance imaging (MRI) findings of symmetrical occipital white matter lesions which progress in a rostro-caudal direction is the classical appearance of ALD. Familiarity with the clinico-pathologic manifestations and progressive MR imaging features of childhood cerebral X-linked ALD will be helpful in evaluating the affected patients. PMID:24470810

  20. Mixed connective tissue disease: an overview of clinical manifestations, diagnosis and treatment.

    PubMed

    Ortega-Hernandez, Oscar-Danilo; Shoenfeld, Yehuda

    2012-02-01

    The most common clinical manifestations of mixed connective disease are Raynaud's phenomenon, arthralgias, swollen joints, esophageal dysfunction, muscle weakness and fingers sausage-like appearance together with the presence of anti-ribonucleoprotein (RNP) antibodies. However, organ involvement is more extensive than first descriptions reported. The disease can be serious with development of pulmonary, kidney, cardiovascular, gastrointestinal and central nervous system manifestations. The worst prognosis and high mortality are associated with the presence of pulmonary disease. Although a different set of clinical criteria have been proposed, there is no consensus about the most accurate. There is no full agreement about treatment and the initial impression of a satisfactory response to low doses of steroids is not always the rule. Herein, we review available evidence to a better approach to all previous topics. PMID:22424193