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  1. Dermopathy of Graves' disease: Clinico-pathological correlation.

    PubMed

    Reddy, Sagili Vijaya Bhaskar; Gupta, Sushil Kumar; Jain, Manoj

    2012-05-01

    Dermopathy of Graves' disease is a classical, but uncommon extrathyroidal manifestation of Graves' disease. The images of a typical case of dermopathy of Graves' disease are presented along with clinico-pathological correlation.

  2. Verrucous hyperplasia: A clinico-pathological study.

    PubMed

    Hazarey, Vinay K; Ganvir, Sindhu M; Bodhade, Ashish S

    2011-05-01

    Oral verrucous hyperplasia (OVH) is a premalignant lesion that may transform into an oral cancer. The present retrospective study was carried out to analyze the clinico-pathological features of verrucous hyperplasia (VH). Total 19 diagnosed cases of verrucous hyperplasia were retrospectively analyzed for demographic, clinical and histopathological features including dysplasia. Average age of occurrence of lesion was 4 (th) decade of life, with male predominance (2:1) and common site of occurrence being buccal mucosa. Clinically it present as verrucous exophytic growth with sharp or blunt projections on surface, which corresponds histologically. Tobacco lime quid placement in buccal vestibule was key etiologic factor. Histopathologicaly 68% cases showed dysplasia out of which moderate dysplasia predominates (42%). Moderately dysplastic cases were found to be associated with mixed habit pattern. Maximum cases were treated with excision. Biopsy specimen comprising of adjacent normal epithelium is key in distinguishing verrucous hyperplasia from verrucous carcinoma. Clinical behavior and recurrence potential needs to be assessed with long term follow up studies.

  3. Verrucous hyperplasia: A clinico-pathological study

    PubMed Central

    Hazarey, Vinay K; Ganvir, Sindhu M; Bodhade, Ashish S

    2011-01-01

    Context: Oral verrucous hyperplasia (OVH) is a premalignant lesion that may transform into an oral cancer. Aims: The present retrospective study was carried out to analyze the clinico-pathological features of verrucous hyperplasia (VH). Materials and Methods: Total 19 diagnosed cases of verrucous hyperplasia were retrospectively analyzed for demographic, clinical and histopathological features including dysplasia. Results: Average age of occurrence of lesion was 4 th decade of life, with male predominance (2:1) and common site of occurrence being buccal mucosa. Clinically it present as verrucous exophytic growth with sharp or blunt projections on surface, which corresponds histologically. Tobacco lime quid placement in buccal vestibule was key etiologic factor. Histopathologicaly 68% cases showed dysplasia out of which moderate dysplasia predominates (42%). Moderately dysplastic cases were found to be associated with mixed habit pattern. Maximum cases were treated with excision. Conclusion: Biopsy specimen comprising of adjacent normal epithelium is key in distinguishing verrucous hyperplasia from verrucous carcinoma. Clinical behavior and recurrence potential needs to be assessed with long term follow up studies. PMID:22529578

  4. Clinico-histologic conferences: histology and disease.

    PubMed

    Shaw, Phyllis A; Friedman, Erica S

    2012-01-01

    Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical context, promote integration and application of science knowledge, and to foster peer teaching and learning: the Clinico-Histologic Conference (CHC) for the Mount Sinai School of Medicine Histology course. Teams of six students were each assigned specific disease processes and were charged with creating oral presentations and handouts that taught their classmates about the clinical manifestations, etiopathogeneses, diagnoses, and treatments of the assigned processes, along with comparisons of normal histology to the pathology of the disease. Each team also created four questions, some of which were used on Histology written examinations. The physician facilitator evaluated the presentation and handouts. About two-thirds of students agreed the CHC enhanced appreciation of the importance of histology, provided a context for integration and application of basic science to patient care and enhanced their ability to teach their peers. Student feedback demonstrated that the CHCs were successful in promoting teamwork, peer teaching, and the application of histology to diagnose diseases. The authors believe that teaching basic science content in this new format enhanced student learning and application of medical knowledge, and that this new teaching format can be adopted by other medical school courses.

  5. Chondroblastoma: a clinico-pathological analysis.

    PubMed

    Nasir-Ud-Din; Ahmed, Arsalan; Pervez, Shahid; Ahmed, Rashida; Kayani, Naila

    2014-12-01

    To determine the clinico-pathological and histological features of Chondroblastoma (CB). Case series. The Aga Khan University Hospital, Karachi, from 2000 to 2013. The histological slides of all reported cases of CB were retrieved and reviewed for morphological features. Clinical features were noted from surgical pathology reports. Frequency of features was noted. Sixty one cases of CB were identified. Pain was the most common presenting symptom. The age ranged from 10 to 38 years (mean 20 ± 1.98 years; M: F 2.5:1) with 61% patients in the second decade of life. Forty six cases occurred in long tubular bones; distal femur being most common site. Metaphysis, clavicle, temporal bone and metacarpal were also involved. Histologically, all CBs were composed of round to polygonal cells and scattered osteoclast-type multinucleated giant cells and majority had hemosiderin pigment. Chicken-wire calcifications and coarse calcifications were seen in 85% and 26% of cases respectively. A spindle cell component was seen in 54% of cases. ABC-like areas were seen in 10 cases. Mitosis ranged from 1 to 6/10 HPFs. Recurrence was seen in 2 cases. Recurrent tumor showed similar morphology when compared with the initial tumor. CB is a benign tumor but has potential for recurrence. Males are more affected, second decade is more common and distal femur is most common site. Metaphysis, clavicle, temporal bone and metacarpal were the rare sites of CB. Histological features predictive of recurrence were not separately identified.

  6. Calcifying epithelial odontogenic tumor: a clinico-radio-pathological dilemma.

    PubMed

    Hada, M S; Sable, M; Kane, S V; Pai, Prathamesh S; Juvekar, S L

    2014-01-01

    The calcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasm of mandible in adults. The presentation of this entity is varied and often confused with a variety of mucosal and jaw lesions and clinical, radiological, and pathological feature of CEOT often-mimic malignancy. The objective of this report is to highlight the clinical features and radiological findings which should arouse suspicion of a benign lesion and importance of providing adequate clinical information to the pathologist to attain accurate diagnosis.We discussed two cases with tumors located in the maxilla. Both presented as expansile lesions with one biopsy proven squamous cell carcinoma. Both were pursued with clinico-radiological suspicion of benign lesions and confirmed with pathological correlation of histology and immunohistochemistry as CEOT. Therefore a High index of suspicion and clinico-radiological information are the key feature for diagnosis of this rare tumor.

  7. Clinico-radiological spectrum of reversible splenial lesions in children.

    PubMed

    Kashiwagi, Mitsuru; Tanabe, Takuya; Shimakawa, Shuichi; Nakamura, Michiko; Murata, Shinya; Shabana, Kousuke; Shinohara, Jun; Odanaka, Yutaka; Matsumura, Hideki; Maki, Koh; Okumura, Kenichi; Okasora, Keisuke; Tamai, Hiroshi

    2014-04-01

    Recently, many cases of children presenting reversible splenial lesions during febrile illness (RESLEF) have been reported; however, their overall clinico-radiological features are unclear. To describe the clinico-radiological features, we retrospectively reviewed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography (EEG) findings, therapy, and prognosis of 23 episodes in 22 children (1 child recurred) who presented neurological symptoms, with RESLEF. The etiologies (pathogens) varied. Seizure occurred in 7 episodes, disturbance of consciousness (DC) in 13, and delirious behavior in 18. Serum sodium levels <136 mEq/L were observed in 18 episodes. Lesions outside the splenium were found in 4 cases. Slow waves were observed on EEG in 10 episodes. Methylprednisolone pulse therapy was given in 7 cases. No case resulted in neurological sequelae. Among 23 episodes, clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) was diagnosed in 6 episodes, whereas non-MERS was observed in 17 episodes. No difference was observed in almost all the clinico-radiological features' data between the 2 groups. The largest differences were observed in the rate of purposeless movement, DC, extension of the abnormal lesions outside the splenium, and marked slowing of background activity on EEG. RESLEF exhibit a spectrum of clinico-radiological features. These results suggest that non-MERS and MERS both are a part of a larger pathological condition, which we have termed as RESLEF spectrum syndrome. Given the view that such a syndrome exists, the clinical characteristics and position of non-MERS and MERS become clear.

  8. [Dementias: mostly clinico-neuropsychological or mostly psychometric diagnosis?].

    PubMed

    Spinnler, Hans

    2005-01-01

    In this paper many critical reflections on diagnosis management of patients affected by dementia have been reported. In particular, the importance of clinico-neuropsychological evaluation of patients with respect to management prevalently based on neuropsychological tests is underlined. In this view a periodic diagnostic exercise with the objective of improving the diagnostic approach of dementias has been proposed to the Alzheimer's disease units (UVA) included in the Cronos Project.

  9. [Clinico-immunological monitoring of the condition of patients with multiple sclerosis].

    PubMed

    Gusev, E I; Demina, T L; Boĭko, A N; Tatarinova, M Iu

    1992-01-01

    The clinico-immunologic monitoring of 50 patients suffering from genuine multiple sclerosis by means of the clinical, neurophysiological and immunologic methods and NMR tomography attests to the relationship between changes in the clinical and immunologic characteristics. The changes in the immunologic characteristics were found to anticipate the clinical ones. The authors provide evidence for the possibility and necessity of the clinico-immunologic monitoring of the patients' status for predicting the further course of the disease.

  10. [Clinico-psychopathological characteristics of a group of mental patients identified at the internal medicine clinic].

    PubMed

    Ostroglazov, V G; Lisina, M A

    1990-01-01

    The authors provide the clinico-psychopathological characteristics of mental patients revealed for the first time during a clinico-epidemiological study of the district therapeutic population. The predominance among them of the somatic psychopathological syndromes was established. The overwhelming majority of those conditions were found to belong to multifactorial mental diseases in whose etiology and pathogenesis the key role is played by interaction between exogenous (psychogenous) and endogenous (thymopathic) factors.

  11. Clinico-Pathological Correlations of the Most Common Neurodegenerative Dementias

    PubMed Central

    Taipa, Ricardo; Pinho, João; Melo-Pires, Manuel

    2012-01-01

    Neurodegenerative dementias are a group of neurological disorders characterized by deterioration in several cognitive domains in which there is selective and progressive loss of specific populations of neurons. The precise neurobiological basis for the different neurodegenerative dementias remains unknown. It is expected that different pathologies reflect different mechanisms, at least early in the neurodegeneration process. The next decades promise treatments directed to causes and mechanisms, bringing an outstanding challenge to clinicians due to heterogeneous clinical presentations with the same molecular pathology. The purpose of this brief review is to describe the key neuropathological features of the most common neurodegenerative dementias (Alzheimer disease, dementia with Lewy bodies and Parkinson’s disease dementia, and frontotemporal lobar degeneration) and the relationship with the clinical syndromes described in clinico-pathological studies. We expect this overview contributes for the understanding of this broad topic integrating the two ends of the spectrum: clinical and pathological. PMID:22557993

  12. Clinico-pathological study of 30 unicystic ameloblastomas.

    PubMed

    Roos, R E; Raubenheimer, E J; van Heerden, W F

    1994-11-01

    The clinico-pathological records of 30 unicystic ameloblastomas collected over a period of 10 years were studied. The mean age at diagnosis was 18.0 years (SD +/- 8.1), most lesions were located in the mandible and were frequently associated with impacted teeth, root resorption and tooth displacement. The unicystic ameloblastomas in 11 patients (4 females and 7 males) exhibited invasion of the fibrous wall, 4 cases (1 female and 3 males) showed intra-luminal proliferation and the remaining 15 specimens (9 females and 6 males) were lined by non-proliferating ameloblastic epithelium. Two cases recurred 3 and 7 years after initial surgical removal. This study reveals the potential aggressive behaviour of unicystic ameloblastomas and underlines the importance of a thorough microscopic examination for sub-classification.

  13. Cutaneous syncytial myoepithelioma:: Clinico-pathological features and differential diagnosis.

    PubMed

    Pizzi, Marco; Facchin, Federico; Kohlscheen, Eva; Sartore, Leonardo; Salmaso, Roberto; Bassetto, Franco

    2016-10-01

    Cutaneous syncytial myoepithelioma (CSM) is a very rare tumor belonging to the spectrum of skin myoepithelial lesions. CSM usually affects the upper extremities of young to middle aged patients and is characterized by peculiar morphological and immunohistochemical features. Unlike classic myoepithelioma, CSM is composed by a densely packed proliferation of spindled to histiocytoid cells, which are variably positive for EMA, S100, SMA, and frequently negative for cytokeratins and GFAP. The peculiar histopathology and the extreme rarity of such lesion (less than 40 cases reported in the literature) can make the diagnosis of CSM a true challenge. In the present case, we report the clinico-pathological features of a primary CSM occurring in a 38 year-old Caucasian man. The differential diagnoses of such lesion are also briefly discussed.

  14. Prediction of Anthracofibrosis Based on Clinico-Radiographic Findings

    PubMed Central

    Park, Tae Yun; Heo, Eun Young; Chung, Hee Soon; Jin, Kwang Nam

    2017-01-01

    Purpose Because anthracofibrosis (AF) is associated with tuberculosis (TB), detection of AF is clinically relevant in Korea, a TB endemic region. We thus sought to develop and validate a predictive model for AF using clinical radiographic data. Materials and Methods Between January 1, 2008 and March 31, 2014, 3849 adult patients who underwent bronchoscopies were retrospectively included from an observational registry. We dichotomized patients based on the presence (n=167) or absence (n=242) of AF. After analyzing their clinico-radiographic characteristics, a logistic prediction model was developed. An area under the curve (AUC) was drawn using the weighted score in logistic regression model. To evaluate the degree of overfitting of the predictive model, a 5-fold cross-validation procedure was performed. Results In multivariate logistic regression, clinical findings such as age >70 years, female gender, active TB, and computed tomography findings including atelectasis, stenosis, bronchial wall thickening, enlarged and calcified lymph nodes were significant diagnostic predictors for AF. The weighed score had an AUC of 0.939 [95% confidence interval (CI)=0.911–0.960], similar to the AUC obtained from internal validation (AUC=0.926, 95% CI=0.896–0.949). Conclusion The prediction model may be helpful for predicting AF based only on clinical and radiographic findings. However, further external validation is necessary. PMID:28120566

  15. Clinico-anthropometric profile of children from Darjeeling tea garden.

    PubMed

    Mondal, Rakesh; Sarkar, Sumantra; Hazra, Avijit; Banerjee, Indira; Saren, Abhisek; Mukherjee, Goutam; Chatterjee, Mridula

    2014-04-01

    To assess clinico-anthropometric profile of hospitalized children and their apparently healthy siblings from the Darjeeling tea garden. This was a descriptive, cross-sectional study, done at North Bengal Medical College, West Bengal, India over a period of 6 mo. Consecutively admitted 157 children and their 301 apparently healthy siblings were included. Clinical diagnosis, height/length, weight, BMI were recorded. Children (n = 157) were mostly admitted for gastroenteritis (36.3 %), respiratory infections (26.75 %), meningo-encephalitis (14.0 %). Among 301 siblings, 30.56 % had nutritional anemia, worm infestation, giardiasis etc. Severe (< -3 Z-score) stunting and wasting were noted in 10 (6.37 %) and 19 (12.1 %) hospitalized children respectively. A quarter of all siblings suffered from moderate malnutrition (stunting 24.92 %, wasting 29.57 %). Distribution of malnutrition in each anthropometric parameter was statistically significant (p < 0.05) in sick children compared to non-admitted siblings. Intergroup comparisons for both sexes were statistically significant for all parameters except in length/height for age for females. Moderate malnutrition (< -2 Z-score) was related to low BMI in 45 % (n = 71) of sick and 27 % (n = 83) of apparently well children. The present study, first of its kind, delineated specific pattern of illness in sick and apparently healthy tea garden children. Malnutrition is statistically significant co-morbid associate in both the groups. Public health policy targeting these children is needed.

  16. [4-year clinico-statistical observation of outpatients].

    PubMed

    Fujisawa, S; Yamamoto, M; Yamamoto, A; Ikeuchi, H; Ishida, S; Igarashi, I; Sazawa, S; Hayakawa, Y; Shimizu, C; Kurosaki, N

    1997-06-01

    Clinico-statistical observations were made on the outpatients visiting the Department of Initial Diagnosis and Emergency, Faculty of Dentistry Hospital, Tokyo Medical and Dental University in 1986, 1987, 1989 and 1990. The following findings were obtained according to sex, age group, and chief complaints of new outpatients. Approximately 60% of the outpatients were female during the year examined. The number of outpatients tended to increase in March and to decrease during the winter. The largest number of new outpatients visiting the hospital was in the 20-24-year-old group in both males and females. In the female patients, the 50-54-year-old group had a relatively higher peak. The greatest chief complaint was tooth pain. Further, the chief complaint involving oral soft tissues was due to inflammation. The main disease diagnosed due to chief complaints was caries in the 20-29-year-old group, marginal periodontitis in the 50-59, pericoronitis of wisdom tooth in the 20-29, temporomandibular joint problem in the < or = 19 and masticatory disturbance in the 60 < or = -year-old groups.

  17. SMART on FHIR Genomics: facilitating standardized clinico-genomic apps.

    PubMed

    Alterovitz, Gil; Warner, Jeremy; Zhang, Peijin; Chen, Yishen; Ullman-Cullere, Mollie; Kreda, David; Kohane, Isaac S

    2015-11-01

    Supporting clinical decision support for personalized medicine will require linking genome and phenome variants to a patient's electronic health record (EHR), at times on a vast scale. Clinico-genomic data standards will be needed to unify how genomic variant data are accessed from different sequencing systems. A specification for the basis of a clinic-genomic standard, building upon the current Health Level Seven International Fast Healthcare Interoperability Resources (FHIR®) standard, was developed. An FHIR application protocol interface (API) layer was attached to proprietary sequencing platforms and EHRs in order to expose gene variant data for presentation to the end-user. Three representative apps based on the SMART platform were built to test end-to-end feasibility, including integration of genomic and clinical data. Successful design, deployment, and use of the API was demonstrated and adopted by HL7 Clinical Genomics Workgroup. Feasibility was shown through development of three apps by various types of users with background levels and locations. This prototyping work suggests that an entirely data (and web) standards-based approach could prove both effective and efficient for advancing personalized medicine. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Effects of feeding calves genetically modified corn bt11: a clinico-biochemical study.

    PubMed

    Shimada, Nobuaki; Murata, Hideo; Mikami, Osamu; Yoshioka, Miyako; Guruge, Keerthi S; Yamanaka, Noriko; Nakajima, Yasuyuki; Miyazaki, Shigeru

    2006-10-01

    Genetically modified corn Bt11 is insect-resistant and expresses Cry1Ab toxin, an insecticidal protein, in kernels. Although Bt11 corn is considered safe based on animal performance, there are no reports available on the clinico-biochemical effects of feeding it to cattle. In this study, we evaluated the effects of feeding Bt11 to calves, using blood and ruminal clinico-biochemical parameters. Our three-month-long feeding experiment demonstrated that calves (n=6), fed with a ration containing 43.3% of Bt11 corn kernels as dry matter, did not develop any discernible clinical, hematological, biochemical, or ruminal abnormalities as compared with control calves (n=6) fed non-Bt11 corn. The results suggest that the transgenic Bt11 has no negative clinico-biochemical effects on calves.

  19. Clinico-hemato-biochemical profile of dogs with liver cirrhosis

    PubMed Central

    Elhiblu, M. A.; Dua, K.; Mohindroo, J.; Mahajan, S. K.; Sood, N. K.; Dhaliwal, P. S.

    2015-01-01

    Aim: The aim of this study was to determine the relevant tools in the diagnosis of liver cirrhosis in dogs. Material and Methods: A total of 140 dogs presented at Veterinary Teaching Hospital, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, showing clinical signs of hepatic insufficiency were subjected to clinico-hemato biochemical, urological, ultrasonographic (USG), and USG guided fine-needle biopsy examinations by standard methods. On the basis of these results, 6 dogs out of 140 dogs were found to be suffering from liver cirrhosis. Six clinically healthy dogs constituted the control group. Results: The dogs suffering from liver cirrhosis manifested inappetence, halitosis, abdominal distension, weight loss, melena, icterus, anemia, and neutrophilic leukocytosis with the left shift. Levels of hemoglobin, lymphocytes, packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH), and platelet count were significantly lower in liver cirrhosis group than control group while total leukocyte count, neutrophils, and MCH concentration were significantly higher. Glucose, total protein, albumin, A/G ratio, and fibrinogen were significantly lower, and creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, prothrombin time, and APTT were significantly higher than the control values. Ultrasound revealed diffuse increase in echogenicity with rounded and irregular liver margins. Cytological examination of the ascitic fluid and fine-needle aspiration biopsy of liver was not fruitful in the diagnosis of liver cirrhosis. Conclusions: Liver cirrhosis causes clinical and hemo-biochemical alterations, which require special consideration when treating diseased animals. USG, diffuse increase in echogenicity of liver, rounding and irregularity of liver margins and microhepatica were the consistent findings. It is suggested that USG along with hemo-biochemical alterations may be used as a diagnostic tool for liver cirrhosis

  20. MELASMA: A CLINICO-EPIDEMIOLOGICAL STUDY OF 312 CASES

    PubMed Central

    Achar, Arun; Rathi, Sanjay K

    2011-01-01

    Background: Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin. The pathogenesis is unknown, but genetic or hormonal influences with UV radiation are important. Aims: Our present research aims to study the clinico-epidemiological pattern and the precipitating or provocation factors in melasma. Materials and Methods: A total of 312 patients were enrolled for the study over a period of one year. Results: The mean age of patients with melasma was 33.45 years, ranging from 14 to 54 years. There was female preponderance with a female to male ratio of approximately 4 : 1. The mean age of onset was 29.99 years, with the youngest and oldest being 11 and 49 years, respectively. The patients sought medical treatment on an average of 3.59 years after appearance of melasma. About 55.12% of our patients reported that their disease exacerbated during sun exposure. Among 250 female patients, 56 reported pregnancy and 46 reported oral contraceptive as the precipitating factors. Only 34 patients had given history of exacerbation of melasma during pregnancy. A positive family history of melasma was observed in 104 (33.33%) patients. Centrofacial was the most common pattern (55.44%) observed in the present study. Wood light examination showed the dermal type being the most common in 54.48% and epidermal and mixed were seen in 21.47% and 24.03% of the cases, respectively. We tried to find an association with endocrinal diseases and observed that 20 of them had hypothyroidism. Conclusion: The exact cause of melasma is unknown. However, many factors have been implicated in the etiopathogenesis of this disorder. Here we try to identify the causative factors and provocation to develop melasma. PMID:21965843

  1. Clinico-Epidemiological Analysis of HIV/AIDS Patients.

    PubMed

    Ertunc, Baris; Kaya, Selcuk; Koksal, Iftihar

    2016-10-01

    The aim of this study was to examine clinico-epidemiological properties of HIV/AIDS patients. For this purpose, 115 HIV/AIDS patients monitored in our clinic between January 1, 1998, and December 31, 2013, were retrospectively evaluated. For the 115 patients with a diagnosis of HIV/AIDS that we monitored, the mean age at the time of presentation was 34.5±13.21 (10-79) years. Eighty-nine (76.5%) patients were male and 27 (23.5%), female. In this study, HIV/AIDS was the most prevalent in the young male population with a low educational and sociocultural level. The most common mode of transmission in our patients was heterosexual relations: approximately 1 patient in 3 had a history of traveling to countries with a high prevalence of HIV/AIDS, namely, Russia and Ukraine. The examination of diagnosis with respect to years showed an increase in new cases since 2008. Only 21 (18.3%) of our patients were diagnosed through clinical symptoms, while 91 (81.7%) during routine scanning. At first presentation, 68% of our patients were stage A; 4.7%, stage B; and 27.3%, stage C. The mean length of the monitoring of our patients was 2.74 years (2-180 months). Thirteen (11.3%) patients died due to opportunistic infections and malignities. The most common opportunistic infection was tuberculosis (16.5%), followed by syphilis and HBV. Malignity, most commonly intracranial tumor, was seen in 8.6% patients. The disease was generally seen in the young male population with a low sociocultural level, and it was most frequently transmitted by heterosexual sexual contact. This clearly shows the importance of sufficient, accurate information, and education on the subject of the disease and its prevention. The fact that many of our patients were diagnosed in the late stage due to stigma and that diagnosis was largely made through scanning tests confirms the importance of these tests in early diagnosis.

  2. Clinico-Epidemiological Analysis of HIV/AIDS Patients

    PubMed Central

    Ertunc, Baris; Kaya, Selcuk; Koksal, Iftihar

    2016-01-01

    Objective: The aim of this study was to examine clinico-epidemiological properties of HIV/AIDS patients. Materials and Methods: For this purpose, 115 HIV/AIDS patients monitored in our clinic between January 1, 1998, and December 31, 2013, were retrospectively evaluated. Results: For the 115 patients with a diagnosis of HIV/AIDS that we monitored, the mean age at the time of presentation was 34.5±13.21 (10–79) years. Eighty-nine (76.5%) patients were male and 27 (23.5%), female. In this study, HIV/AIDS was the most prevalent in the young male population with a low educational and sociocultural level. The most common mode of transmission in our patients was heterosexual relations: approximately 1 patient in 3 had a history of traveling to countries with a high prevalence of HIV/AIDS, namely, Russia and Ukraine. The examination of diagnosis with respect to years showed an increase in new cases since 2008. Only 21 (18.3%) of our patients were diagnosed through clinical symptoms, while 91 (81.7%) during routine scanning. At first presentation, 68% of our patients were stage A; 4.7%, stage B; and 27.3%, stage C. The mean length of the monitoring of our patients was 2.74 years (2–180 months). Thirteen (11.3%) patients died due to opportunistic infections and malignities. The most common opportunistic infection was tuberculosis (16.5%), followed by syphilis and HBV. Malignity, most commonly intracranial tumor, was seen in 8.6% patients. Conclusion: The disease was generally seen in the young male population with a low sociocultural level, and it was most frequently transmitted by heterosexual sexual contact. This clearly shows the importance of sufficient, accurate information, and education on the subject of the disease and its prevention. The fact that many of our patients were diagnosed in the late stage due to stigma and that diagnosis was largely made through scanning tests confirms the importance of these tests in early diagnosis. PMID:28149137

  3. [Clinico-functional features of mitral valve prolapse in young military men].

    PubMed

    Gorbachenko, A V; Shalimov, P M

    2008-01-01

    One hundred and sixty-six young military man with mitral valve prolapse (MVP) aged 19.2+/-0.8 years were examined. Complex system approach to health status was applied to study clinico-functional features of this condition in young military men. The study found that clinico-functional manifestations of MVP in young military men reflected a multifocal character of dysadaptation during the first stages of military service. Conditions of professional military activity potentiate permanent progress of crisp prolapse as well as the severity of mitral regurgitation, structural and functional myocardial alterations, and myocardial electric instability increasing in the presence of abnormal cardiac chords under the influence of a prominent vegetative dysfunction. The reserve of the cardiorespiratory system and the entire organism in military men with MVP was lowered. The study registered inadequate hemodynamic responses to functional orthostatic test and physical load test, typical for hyperventilation syndrome.

  4. Orbital alveolar soft-part sarcoma: clinico-pathological profiles, management and outcomes.

    PubMed

    Mulay, Kaustubh; Ali, Mohammad Javed; Honavar, Santosh G; Reddy, Vijay Anand P

    2014-01-01

    To study the clinico-radiological and clinic-pathological features of orbital alveolar soft-part sarcomas (ASPS). We retrieved 9 cases of orbital ASPS. Histopathological and immunohistochemical features and clinico-radiological findings were evaluated. Age at presentation varied from 1 to 31 years. Both, children and adults were affected. Proptosis was the most common clinical presentation. PAS-positive diastase-resistant crystals and granules were found in all cases. All patients received adjuvant radiotherapy. Two cases had positive surgical margins and were treated with additional adjuvant chemotherapy. None of the patients had recurrence or metastases till the last follow up. Early diagnosis with a multidisciplinary, multimodal approach of treatment is quintessential in achieving a long disease-free survival in patients with ASPS.

  5. Solitary bone plasmacytoma: An interesting case report with unusual clinico-cytological features.

    PubMed

    Saksena, Annapurna; Mahajan, Nidhi; Agarwal, Shipra; Jain, Shyama

    2014-07-01

    Solitary bone plasmacytoma (SBP) is a rare entity characterized by localized proliferation of monoclonal plasma cells primarily occurring in the axial skeleton without systemic involvement. Involvement of the distal extremity is unusual. In the absence of typical clinical presentation, diagnosis may not be suspected clinico-radiologically; hence, fine-needle aspiration cytology may help in early and definitive diagnosis, hastening meticulous diagnostic workup and appropriate management of these patients. Intracytoplasmic crystalline inclusions (CI) have been reported in multiple myeloma and lymphoproliferative disorders. The present case highlights unusual clinico-cytological features of SBP with primary involvement of humerus, progression to tibia, and presence of extracellular and intracytoplasmic CI in plasma cells, a morphologic finding not reported in SBP earlier.

  6. Solitary bone plasmacytoma: An interesting case report with unusual clinico-cytological features

    PubMed Central

    Saksena, Annapurna; Mahajan, Nidhi; Agarwal, Shipra; Jain, Shyama

    2014-01-01

    Solitary bone plasmacytoma (SBP) is a rare entity characterized by localized proliferation of monoclonal plasma cells primarily occurring in the axial skeleton without systemic involvement. Involvement of the distal extremity is unusual. In the absence of typical clinical presentation, diagnosis may not be suspected clinico-radiologically; hence, fine-needle aspiration cytology may help in early and definitive diagnosis, hastening meticulous diagnostic workup and appropriate management of these patients. Intracytoplasmic crystalline inclusions (CI) have been reported in multiple myeloma and lymphoproliferative disorders. The present case highlights unusual clinico-cytological features of SBP with primary involvement of humerus, progression to tibia, and presence of extracellular and intracytoplasmic CI in plasma cells, a morphologic finding not reported in SBP earlier. PMID:25538386

  7. ACGT: advancing clinico-genomic trials on cancer - four years of experience.

    PubMed

    Martin, Luis; Anguita, Alberto; Graf, Norbert; Tsiknakis, Manolis; Brochhausen, Mathias; Rüping, Stefan; Bucur, Anca; Sfakianakis, Stelios; Sengstag, Thierry; Buffa, Francesca; Stenzhorn, Holger

    2011-01-01

    The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obtained.

  8. [Clinico-epidemiological characteristics of transient cerebral ischemia in the region of the Ukrainian Carpathian Mountains].

    PubMed

    Buletsa, B A; Lupich, P P; Litvinova, L A

    1991-01-01

    Altogether 225 patients with transitory derangements of cerebral circulation (TDCC) underwent clinico-laboratory examinations. Arterial hypertension and cerebral atherosclerosis turned out to be among most frequently occurring factors of TDCC. The provoking factors included psychoemotional stress and drops of barometric pressure. The course and outcome of TDCC were greatly affected by an increase in blood concentration of catecholamines and thyroid hormones. The high concentration of triiodothyronine in the blood contributed to the development of cerebral stroke.

  9. [Autosomal-recessive renal cystic disease and congenital hepatic fibrosis: clinico-anatomic case].

    PubMed

    Rostol'tsev, K V; Burenkov, R A; Kuz'micheva, I A

    2012-01-01

    Clinico-anatomic observation of autosomal-recessive renal cystic disease and congenital hepatic fibrosis at two fetuses from the same family was done. Mutation of His3124Tyr in 58 exon of PKHD1 gene in heterozygous state was found out. The same pathomorphological changes in the epithelium of cystic renal tubules and bile ducts of the liver were noted. We suggest that the autopsy research of fetuses with congenital abnormalities, detected after prenatal ultrasonic screening, has high diagnostic importance.

  10. Clinico-morphological features of BRAF inhibition-induced proliferative skin lesions in cancer patients.

    PubMed

    Belum, Viswanath Reddy; Rosen, Alyx C; Jaimes, Natalia; Dranitsaris, George; Pulitzer, Melissa P; Busam, Klaus J; Marghoob, Ashfaq A; Carvajal, Richard D; Chapman, Paul B; Lacouture, Mario E

    2015-01-01

    The use of BRAF inhibitors may lead to the development of cutaneous toxicities such as rashes, photosensitivity, alopecia, palmoplantar erythrodysesthesia, and proliferative skin lesions, including keratoacanthomas (KAs) and cutaneous squamous cell carcinomas (cuSCCs). The latter are noteworthy for their potential to exhibit malignant features, and they may necessitate invasive treatment. Their prompt identification is of primary importance for directing supportive care efforts and maintaining dose intensity while minimizing the morbidity associated with supportive care interventions. Because such lesions are less familiar to oncologists, this study was designed to characterize their clinico-morphological features, which have not been hitherto described. The clinical and dermoscopic characteristics and risk factors of new-onset proliferative skin lesions (benign verrucous lesions and KAs/cuSCCs) developing after the initiation of treatment with vemurafenib, dabrafenib, and XL281 were analyzed; the histopathological diagnoses were ascertained. The majority of the lesions were benign verrucous lesions (78%, n = 87), whereas KAs/cuSCCs represented 22% (n = 25). The median times to biopsy for the initial verrucous lesions and KAs/cuSCCs were 4.8 and 10.5 weeks, respectively. The clinico-morphological features significant for KAs/cuSCCs included a larger size (P < .001), a nodular appearance (P < .001), a central keratin plug (P < .001), a central ulceration or crust (P = .04), an adherent scale (P = .02), an erythematous halo (P = .03), and a scaly ring (collarette; P < .001) at the periphery. Our findings represent the first detailed description of the clinico-morphological characteristics that permit distinction between the benign and malignant skin lesions induced by BRAF inhibitors. They are valuable for the recognition of lesions that require intervention and/or a dermatology referral versus those that permit provisional

  11. Clinico-immunological profile and outcome of antiretroviral therapy in HIV-positive children.

    PubMed

    Choudhary, Nidhi; Gomber, Sunil; Narang, Manish

    2012-08-01

    To study the clinico-immunological, nutritional and growth characteristics of HIV-infected children and the impact of antiretroviral therapy (ART) on these parameters. Retrospective study. Out-patient department of a paediatric ART centre, Delhi, India. HIV-positive children registered at the paediatric ART centre of the hospital were enrolled (n 130). Anthropometric measurements were used to classify children into the type of malnutrition according to definitions of the WHO and US Centers for Disease Control and Prevention. Clinical and immunological status of the children was recorded as per WHO guidelines. First-line ART was started based on guidelines of the National AIDS Control Organization. Nutritional status and clinico-immunological characteristics were followed up annually in children receiving ART. Of children ≤5 years of age (n 54), stunting was noted in 42·5 % contrary to wasting seen in only 12·9 %. In children >5 years of age (n 76), short stature (40·7 %) and underweight (39·4 %) were seen in almost equal proportions. Asymptomatic presentation was noted in 60·0 %. Following ART, a reduction in wasting was noted in 75·0 % of children ≤5 years of age, whereas only 44·4 % of underweight children >5 years of age showed an improvement after therapy. Stunting and short stature continued to persist in all in children (≤5 years and >5 years, respectively). Clinico-immunologically, 67·5 % improved in clinical status and 62·5 % showed immunological improvement. ART improves the acute parameters of nutritional status like wasting. It also improves the clinical outcome and restores the immune system. At present first-line ART is effective in HIV-positive children.

  12. [Clinico-genealogic study of schizophrenia with a predominantly obsessive course].

    PubMed

    Korsun', I V

    1985-01-01

    A clinico-genealogic study of 66 patients with neurosis-like schizophrenia showed a certain genetic heterogeneity of schizophrenia with obsessions. In cases of an unfavourable course of the schizophrenic process in a proband (a malignant disease of obsessions), the familial background was largely determined by disturbances of the schizophrenic spectrum. In cases of a slow progression of the disease (slowly progressive pseudoneurotic schizophrenia), the hereditary background was characterized by a great variability of psychopathological manifestations. Along with schizophrenia-related abnormalities, the families of such patients featured the accumulation of constitutional anomalies, neurotic disturbances and subclinical affective disorders.

  13. Peripheral odontogenic fibroma: a rare gingival neoplasm with clinico-pathological differential diagnosis.

    PubMed

    Kumar, Rajesh; Jaiswal, Shradha; Sharma, Aanchal; Andhare, Vinod; Sabir, Husain

    2015-01-01

    The peripheral odontogenic fibroma (POdF) is a rare gingival neoplasm, characterised by relatively mature collagenous fibrous tissue and varying amounts of odontogenic epithelium. It can be described as a slow growing, firmly attached, solid and smooth gingival mass which may be present asymptomatically for years, which may cause displacement of adjacent teeth. The purpose of this article is to discuss a case of POdF, occurring in the maxillary anterior region, with detailed clinico-pathological differential diagnosis to clarify characteristic features of various gingival overgrowths to enhance easy identification.

  14. Behavioral symptoms after pallido-nigral lesions: a clinico-pathological case.

    PubMed

    Adam, Julien; Baulac, Michel; Hauw, Jean-Jacques; Laplane, Dominique; Duyckaerts, Charles

    2008-01-01

    A 59-year-old patient presented with compulsive behaviors and lasting apathy after carbon monoxide intoxication. The apathy could be overcome by external stimulation (self-activation deficit). There was severe neuronal loss bilaterally in the anterior part of the pallidum and in the substantia nigra, pars reticulata. This first clinico-pathological case of a self-activation deficit illustrates the dissociation between motor and behavioral symptoms in lesions of the pallido-nigral complex, with the behavioral symptoms being related to lesions of the substantia nigra, pars reticulata and of the anterior part of the pallidum.

  15. [Clinico-epidemiological characteristics of mentally ill patients identified in the therapy department].

    PubMed

    Liberman, Iu I; Ostroglazov, V G; Lisina, M A; Eliava, V N

    1990-01-01

    A clinico-epidemiological study was made of the incidence of mental diseases among the adult community visiting the therapeutic department of a city polyclinic. Mental patients registered at the PND (41.9 per 1000 population) underwent examinations. A large group of patients, mainly with borderline mental diseases, was additionally revealed (134.4 per 1000 population). Therefore, the total incidence of mental diseases among the adult community amounted to 176.3 per 1000 population. Both groups are compared in terms of the clinical syndromes, sex, age, and the level of social adaptation.

  16. Clinico-radiological diagnosis and grading of rapidly progressive osteoarthritis of the hip

    PubMed Central

    Zazgyva, Ancuţa; Gurzu, Simona; Gergely, István; Jung, Ioan; Roman, Ciprian O.; Pop, Tudor S.

    2017-01-01

    Abstract Due to the current lack of standard definitions for rapidly progressive osteoarthritis of the hip (RPOH) in the literature, this observational study aimed to describe new diagnostic criteria and a grading system for the disease. From a consecutive series of patients undergoing total hip replacement, 2 groups were selected: 1 with RPOH and 1 with primary hip osteoarthritis (POH), and their clinical, paraclinical, and demographic data were compared. The newly proposed clinico-radiological diagnostic criteria are based on characteristics of pain, joint mobility, and radiological assessment. The radiological grading system's inter- and intraobserver reliability was assessed through serial evaluations by 2 blinded reviewers. From the total 863 cases, 82 cases (9.5%) of RPOH were identified and compared with 107 cases of POH. Mean age and disease bilaterality were similar, with a predominance of female patients in the RPOH group (P = 0.03). There were significant differences between the 2 groups in disease onset and aggravation, and intraoperative blood loss. The grading system showed significant inter- and intraobserver agreement (weighted kappa 0.93, and 0.89). Our study presents distinctive, easily recognizable clinico-radiological characteristics of RPOH and confirmed the inter- and intraobserver reliability of the newly proposed grading system. PMID:28328832

  17. [Leptospirosis-clinico-biological and therapeutical aspects-study of 256 cases].

    PubMed

    Luca, Mihaela Cătălina; Dorobăţ, Carmen; Corcaci, Carmen; Scurtu, Roxana; Luca, V; Mihalache, Doina

    2002-01-01

    Leptospirosis is a zooantroponosis manifested as an infectious disease with a severe evolution, with liver and renal failure and hemorrhagic manifestation. The aim of this study was to present the clinico-biological investigation and the therapeutical aspects of 256 cases of leptospirosis admitted in the Infectious Diseases Hospital Iasi during 4 years (1998-2001). The diagnosis was based on the study of clinico-biological and therapeutical parameters (risk factors, fever, mialgia, headache, algic, eruptive, meningeal, hepatorenal, hemorrhagic syndromes with the serological evidence of the serotypes of leptospirosis); most of the cases were registered in 1998 (23% cases), in adults (31.2%) and male (75.22%). All the patients were serologic confirmed with leptospirosis (RAL and RFC), and L. icterohaemorhagiae was isolated most frequently. The standard anti-leptospirosis treatment was administered with favorable evolution; 6 deaths were registered from the severe forms of the disease. The leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with liver and renal failure.

  18. Carcinoma ex pleomorphic adenoma in a Brazilian population: clinico-pathological analysis of 38 cases.

    PubMed

    Mariano, F V; Noronha, A L F; Gondak, R O; Altemani, A M de A M; de Almeida, O P; Kowalski, L P

    2013-06-01

    Carcinoma ex pleomorphic adenoma (CXPA) is a rare tumour, with different prevalence rates reported among studies. Epidemiological studies of large series of CXPAs in developing countries are scarce. The aim of the present study was to describe Brazilian patients with CXPA; this was a retrospective study of 38 patients. Demographic and clinico-pathological features were evaluated. No preferential gender was found, and the mean age at diagnosis was 57.6 years. The most commonly involved site was the parotid, followed by the submandibular and the minor salivary glands. A prevalence of clinical stages III and IV was observed at diagnosis. The most common histological subtypes were salivary duct carcinoma, adenocarcinoma not otherwise specified, myoepithelial carcinoma, and epithelial-myoepithelial carcinoma. Moreover, by invasive phase, most were frankly invasive carcinoma. Recurrence was observed in seven out of 24 patients with outcome information available, and all were invasive cases. All seven patients died of causes related to the disease. The distributions of cases according to age, gender, tumour location, and clinical stage were similar to those reported in the literature. Frankly invasive cases presented a worse prognosis. More information is needed to further our understanding of the clinico-pathological aspects of CXPA.

  19. Intestinal congenital/infantile fibrosarcoma: a new clinico-pathological entity?

    PubMed

    Berrebi, Dominique; Fournet, Jean-Christophe; Boman, Françoise; Fabre, Monique; Philippe-Chomette, Pascale; Branchereau, Sophie; Fréneaux, Paul; Bouron-Dal Soglio, Dorothée; Michon, Jean; Peuchmaur, Michel

    2015-04-01

    Congenital/infantile fibrosarcoma (IFS) is a relatively rare form of fibrosarcoma diagnosed at birth or during early years of life and that differs from its adult counterpart because of a more favorable behavior. IFS is also known as cellular congenital mesoblastic nephroma, when it affects the kidney and is often but not always characterized by the ETV6-NTRK3 fusion transcript. We report herein the first series of an exceptional tumor of the small intestine occurring in newborns. The four patients shared a stereotyped clinico-pathological presentation with early and acute onset, intestinal perforation, and an infiltration by a highly cellular spindle cell tumor within the dilated intestinal wall exhibiting pathologic features typical of IFS. Molecular studies for the ETV6-NTRK3 translocation were negative in the three cases tested. Patients were treated by surgical wide resection alone and are alive and well (follow-up: 36 months-25 years). Thus, this new clinico-pathological entity, even with lack of documented evidence of the ETV6-NTRK3 translocation, should be included in the differential diagnosis of congenital bowel perforation or obstruction and may represent an intestinal counterpart of IFS.

  20. Clinico-pathological characteristics and prognostic factors of gastrointestinal stromal tumors among a Chinese population

    PubMed Central

    Li, Jiehua; Zhang, Haitian; Chen, Zhibai; Su, Ka

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. GISTs include a group of heterogeneous tumors with different morphology, biologic behavior, and genetic characteristics, so their epidemiology, clinico-pathological features and prognosis is distinct in different countries. The objective of this study is to analyze clinico-pathological characteristics and prognostic factors of GISTs among Chinese population. We investigated 112 GIST patients were diagnosed between July 2008 and January 2013 at the First Affiliated Hospital of Guangxi Medical University. Histologic evaluation and immunohistochemistry analysis was performed on paraffin-embedded tissue from the 112 GISTs. Overall survival analysis was carried out using the Kaplan-Meier method and the log-rank test. Multivariate analysis was performed according to Cox’s proportional hazards model. Three and 5-year OS rates were 71.4 and 58.6% respectively. Univariate analysis showed that the following factors were significant in predicting OS: tumor site, tumor size, metastasis, resection margin status, cell type, invasion of adjacent organ, invasion of smooth muscle, mitotic rate, P53 and adjuvant therapy with imatinib (P<0.05). Multivariate analysis showed that tumor size, metastasis, resection margin status, mitotic rate, P53 and adjuvant therapy with imatinib were independent prognostic factors associated with OS. This may aid in the prediction of clinical evolution and guide treatments in patients with GIST in China. PMID:26884871

  1. Clinico-Pathologic Relevance of Survivin Splice Variant Expression in Cancer

    PubMed Central

    de Necochea-Campion, Rosalia; Chen, Chien-Shing; Mirshahidi, Saied; Howard, Frank D.; Wall, Nathan R.

    2013-01-01

    Survivin is a member of the inhibitor of apoptosis (IAP) family and has multifunctional properties that include aspects of proliferation, invasion and cell survival control. Survivin is a promising candidate for targeted cancer therapy as its expression is associated with poor clinical outcome, more aggressive clinico-pathologic features, and resistance to radiation and chemotherapy. In the present review the different properties of the Survivin splice variants are discussed and their activities correlated with different aspects of cancer cell biology, to include subcellular location. Special emphasis is placed on our current understanding of these Survivin splice variants influence on each other and on the phenotypic responses to therapy that they may control. PMID:23791888

  2. [Clinico-endoscopic classification of acute anastomositis after resection of the stomach].

    PubMed

    Zhizhin, F S; Kapustin, B B

    2002-01-01

    The authors have analyzed the results of resection of the stomach in 106 patients with a complicated course of ulcer disease of the stomach and duodenum. Based on a complex investigation of regeneration of the gastrointestinal anastomoses formed by different methods and a comparison of the endoscopic picture with the clinical course of the early postoperative period the authors propose a clinico-endoscopic classification of acute postgastroresectional anastomosites. Comparison of the frequency and severity of the anastomosites has shown advantages of a one-raw seroserous musculo-submucous suture in the resectional surgery of the stomach when forming gastro-intestinal anastomoses. The classification of acute anastomosites allows the timely detection and correction of the operation complications.

  3. Pulmonary Alveolar Microlithiasis "Stone Lungs": A Case of Clinico-Radiological Dissociation.

    PubMed

    Chu, Andrew; Shaharyar, Sameer; Chokshi, Binna; Bhardwaj, Nikhil

    2016-08-24

    Pulmonary alveolar microlithiasis (PAM) is a rare infiltrative lung disease characterized by deposition of spherical calcium phosphate microliths called calcospherites within the alveoli. PAM was first described by Friedrich in 1856 and then by Harbitz in 1918. The disease pathogenesis is based on mutations in the SLC34A2 gene that encodes for the Type IIb sodium-phosphate cotransporter. The majority of the patients are diagnosed at an early age, usually between the ages of 20 and 40 years. The hallmark of this disease is a striking dissociation between the radiological findings and the mild clinical symptoms.  We report a case of 35-year-old woman who presented post-motor vehicle accident with back pain and with minimal dyspnea on exertion. The final diagnosis was made after computed tomography and lung biopsy. The present case exhibits the remarkable clinico-radiological dissociation with complete calcification of the lungs on radiographic images with a relatively mild clinical presentation.

  4. [Clinico-economical aspects of cardioversion of paroxysmal atrial fibrillation at phehospital stage and during hospitalization].

    PubMed

    Bulanova, N A; Stazhadze, L L; Sidorenko, B A

    2012-01-01

    We carried out clinico-economical analysis of 2 tactics of rhythm restoration in patients with paroxysmal atrial fibrillation (AF) lasting less than 48 hours: cardioversion at prehospital stage with intravenous procainamide and inhospital cardioversion with any method. This retrospective study was based on the data from department of urgent aid of an outpatient clinic. The results showed that within 48 hours inhospital was a was more effective, safe, and more economically profitable compared with administration of procainamide at prehospital stage. Intravenous procainamide resulted in effective cardioversion in 70.6% of patients. It was associated with arterial hypotension and proarrhythmogenic action in 14,7% of cases. Patients with effective cardioversion with procainamide had lesser mean values of left ventricular anterior-posterior dimension (echocardiography) and shorter duration of arrhythmia.

  5. Clinico-Pathologic Subtypes of Breast Cancer Primary Tumors Are Related to Prognosis after Recurrence

    PubMed Central

    Sánchez, Cesar; Camus, Mauricio; Medina, Lidia; Oddo, David; Artigas, Rocío; Sepúlveda, Alejandra Pérez; Domínguez, Francisco; Razmilic, Dravna; Navarro, María Elena; Galindo, Hector; Acevedo, Francisco

    2016-01-01

    Background: Pathological factors, based mainly on immunohistochemistry (IHC) and histological differentiation, are mostly used to differentiate breast cancer (BC) subtypes. Our present aim was to describe the characteristics and survival of a relapsing BC patient cohort based on clinico-pathologic subtypes determined for the primary tumors. Methods: We used a clinico- pathological definition of BC subtypes based on histological grade (HG), estrogen receptor (ER), progesterone receptor (PgR), and epidermal growth factor receptor type 2 (HER2) expression assessed by IHC. We determined variables associated with loco-regional recurrence (LRR), second primaries (SP), systemic recurrence (SR) and post-recurrence survival (PRS). Results: Out of 1,702 patients, 240 (14%) had an event defined as recurrence. Those with recurrent disease were significantly younger than those without, and were initially diagnosed at more advanced stages, with larger tumors, greater lymph nodal involvement and higher HG. With a median follow up of 61 months (1-250), 4.6% of patients without recurrence and 56.6% of patients with an event defined as recurrence had died. The median PRS for the LRR group was 77 months; 75 months for those who developed a SP and 22 months for patients with an SR (p <0.0001). In SR cases, the median PRS was shorter for ER- tumors than for ER+ tumors (15 vs. 26 months, respectively; p = 0.0019, HR 0.44; CI: 0.25-0.44). Conclusions: Subtype, defined through classic histopathologic parameters determined for primary tumors, was found to eb related to type of recurrence and also to prognosis after relapse. PMID:28122438

  6. Clinico-pathological correlates of cervical lymphadenopathy: a hospital based study.

    PubMed

    Biswas, Gautam; Das, Anjan; Haldar, Dibakar; Mukherjee, Ankur; Dutta, Sirshak; Sinha, Ramanuj

    2013-07-01

    Neck is the most common site of peripheral lymph node enlargement and is very frequently encountered in oto-laryngological practice. This study was done to delineate distribution of clinico-demographic parameters in patients presenting with cervical lymphadenopathy in the otolaryngology out-patient department of a state hospital in India in a 1 year period and to correlate them with fine needle aspiration cytological diagnosis. Record-based cross sectional study in the department of Otolaryngology and department of Pathology, Calcutta National Medical College and Hospital, Kolkata. Case reports and cytological reports of 423 patients who underwent Fine Needle Aspiration Cytology (FNAC) of cervical lymph nodes between January 2009 and December 2009 were reviewed in relation to their demographic and clinical profiles. The cases were divided into three groups according to age and different parameters were described according to these groups. In the cyto-pathological diagnosis, tubercular lymph-adenitis was most prevalent diagnosis (45.4%). Among the metastatic secondaries, squamous cell carcinoma was most common (8.5%). Non-specific/reactive lymphadenitis was significantly more common in <14 years, TB lymph node in 15-59 years and malignancy among the ≥60 years age group. Jugulo-omohyoid (level III) and Supraclavicular (level VB) groups of Lymph nodes were found significantly more involved by malignancy whereas Jugulo-diagastric (level II), Post-auricular, Submandibular groups (level IB) were more commonly involved in TB. Malignancy patients presented late in respect to the tuberculosis patients. Knowledge about clinico-demographic perspectives of cervical lymphadenopathy in respect to their cytopathological diagnosis will help care giver practioners to detect/refer the respective cases early for investigations and treatment.

  7. Clinico-Histopathological Spectrum of Infectious Granulomatous Dermatoses in Western India- A Representative Study from Mumbai

    PubMed Central

    Agale, Shubhangi Vinayak; D’Costa, Grace F.; Valand, Arvind G.; Gupta, Vikram Kumar

    2016-01-01

    Introduction Infectious Granulomatous Dermatoses (IGDS) have various aetiological factors with a considerable overlap in the histopathological and clinical features, thus posing a diagnostic dilemma for dermatologists and pathologists. Aim We aimed at determining the histopathological profile of IGDS correlating it with clinical features with an attempt to find the aetiology. Materials and Methods In a cross-sectional study conducted in a tertiary referral center of Mumbai over two years, out of 1872 skin biopsies received, 239 histopathologically diagnosed cases of IGDS were studied for histopathological features of granuloma. A clinico-histopathological correlation was attempted. Chi-square test was used for comparison of proportions of different groups. Results Leprosy (211 cases) and tuberculosis (28 cases) were the commonest histopathologically diagnosed IGDS. Leprosy spectrum included BT (30.33% cases), followed by TT (21.32%), BL and LL and 21.79% cases of lepra reactions. Skin TB biopsies on histopathology showed lupus vulgaris (53.85% cases), scrofuloderma (15.38%), TBVC and papulonecrotic tuberculid (11.54% each). In leprosy maximum clinico-pathological agreement was seen at tuberculoid pole (TT 72.7% and BT 56.6%). Among tuberculosis cases, scrofuloderma (100%) and lupus vulgaris (53.8%) showed maximum agreement. Conclusion Leprosy and skin TB are the commonest IGDS in Mumbai region though difficult to diagnose and subcategorize with certainty during initial stages. Histopathology plays the important role to elucidate the dilemma. This being a single center study, more such studies with a larger sample size are recommended to get more elaborate data and regional prevalence of these IGDS for a better overall approach to prevention, treatment and control. PMID:27190811

  8. BRMS1 gene expression may be associated with clinico-pathological features of breast cancer.

    PubMed

    Lin, Li-Zhong; Cai, Miao-Guo; Dai, Yue-Chu; Zheng, Zhi-Bao; Jiang, Fang-Fang; Shi, Li-Li; Pan, Yin; Song, Han-Bing

    2017-08-31

    Our aim is to investigate whether or not the breast cancer metastasis suppressor 1 (BRMS1) gene expression is directly linked to clinico-pathological features of breast cancer. Following a stringent inclusion and exclusion criteria, case-control studies with associations between BRMS1 and breast cancer were selected from articles obtained by way of searches conducted through an electronic database. All statistical analyses were performed with Stata 12.0 (Stata Corp, College Station, TX, U.S.A.). Ultimately, 1,263 patients with breast cancer were found in a meta-analysis retrieved from a total that included 12 studies. Results of our meta-analysis suggested that BRMS1 protein in breast cancer tissues was significantly lower in comparison with normal breast tissues (odds ratio, OR = 0.08, 95% confidence interval (CI) = 0.04-0.15). The BRMS1 protein in metastatic breast cancer tissue was decreased than from that was found in non-metastatic breast cancer tissue (OR = 0.20, 95%CI = 0.13-0.29), and BRMS1 protein in tumor-node-metastasis (TNM) stages 1 and 2 was found to be higher than TNM stages 3 and 4 (OR = 4.62, 95%CI = 2.77-7.70). BRMS1 protein in all three major types of breast cancer was lower than that of control tissues respectively. We also found strong correlations between BRMS1 mRNA levels and TNM stage and tumor size. The results our meta-analysis showed that reduction in BRMS1 expression level was linked directly to clinico-pathological features of breast cancer significantly; therefore, suggesting the loss of expression or reduced levels of BRMS1 is potentially a strong indicator of the metastatic capacity of breast cancer with poor prognosis. © 2017 The Author(s).

  9. Female pattern hair loss: clinico-laboratory findings and trichoscopy depending on disease severity.

    PubMed

    Zhang, Xingqi; Caulloo, Sillani; Zhao, Ying; Zhang, Bin; Cai, Zeming; Yang, Jian

    2012-01-01

    Female pattern hair loss (FPHL) is a progressive hair loss disorder with unclear triggering and supporting factors. Trichoscopic features of each stage of FPHL have not been specifically elaborated previously. To analyze characteristics and investigate associations of clinico-laboratory and trichoscopic features of female patients in regard to the severity of hair loss in FPHL and to facilitate its diagnosis using noninvasive scalp dermoscopy (trichoscopy) in Fitzpatrick skin type III patients. Clinico-laboratory and trichoscopic data from 60 patients with FPHL were analyzed using Spearman's correlation test. Patients had mean age of 34.4±10.6 years and mean duration of hair loss of 4.49±3.76 years. Of all, 45% (27/60) had a family history of pattern hair loss (PHL) and had an earlier onset of hair loss. Stage of hair loss positively correlated with duration and age at presentation. No association was found between the severity of FPHL and laboratory values including anemic and gonadal hormone profiles. Characteristic trichoscopic features (at 10-fold magnification) of FPHL were peripilar signs (PPS) (brown, BPPS and white, WPPS), white dots, scalp pigmentation, and focal atrichia. WPPS, scalp pigmentation, and focal atrichia positively correlated with the stage and duration of hair loss. Family history of PHL causes an earlier onset of hair loss but does not influence its course or severity. The latter is also not affected by abnormal anemic profile or hormonal levels. PPS, scalp pigmentation, focal atrichia, and white dots are characteristic of PHL. WPPS, scalp pigmentation, and focal atrichia reflect advanced PHL.

  10. Sporadic late-onset nemaline myopathy: clinico-pathological characteristics and review of 76 cases.

    PubMed

    Schnitzler, Lukas J; Schreckenbach, Tobias; Nadaj-Pakleza, Aleksandra; Stenzel, Werner; Rushing, Elisabeth J; Van Damme, Philip; Ferbert, Andreas; Petri, Susanne; Hartmann, Christian; Bornemann, Antje; Meisel, Andreas; Petersen, Jens A; Tousseyn, Thomas; Thal, Dietmar R; Reimann, Jens; De Jonghe, Peter; Martin, Jean-Jacques; Van den Bergh, Peter Y; Schulz, Jörg B; Weis, Joachim; Claeys, Kristl G

    2017-05-11

    Sporadic late-onset nemaline myopathy (SLONM) is a rare, late-onset muscle disorder, characterized by the presence of nemaline rods in muscle fibers. Phenotypic characterization in a large cohort and a comprehensive overview of SLONM are lacking. We studied the clinico-pathological features, treatment and outcome in a large cohort of 76 patients with SLONM, comprising 10 new patients and 66 cases derived from a literature meta-analysis (PubMed, 1966-2016), and compared these with 15 reported HIV-associated nemaline myopathy (HIV-NM) cases. In 6 SLONM patients, we performed a targeted next-generation sequencing (NGS) panel comprising 283 myopathy genes. SLONM patients had a mean age at onset of 52 years. The predominant phenotype consisted of weakness and atrophy of proximal upper limbs in 84%, of proximal lower limbs in 80% and both in 67%. Other common symptoms included axial weakness in 68%, as well as dyspnea in 55% and dysphagia in 47% of the patients. In 53% a monoclonal gammopathy of unknown significance (MGUS) was detected in serum. The mean percentage of muscle fibers containing rods was 28% (range 1-63%). In 2 cases ultrastructural analysis was necessary to detect the rods. The most successful treatment in SLONM patients (all with MGUS) was autologous peripheral blood stem cell therapy. A targeted NGS gene panel in 6 SLONM patients (without MGUS) did not reveal causative pathogenic variants. In a comparison of SLONM patients with and without MGUS, the former comprised significantly more males, had more rapid disease progression, and more vacuolar changes in muscle fibers. Interestingly, the muscle biopsy of 2 SLONM patients with MGUS revealed intranuclear rods, whereas this feature was not seen in any of the biopsies from patients without paraproteinemia. Compared to the overall SLONM cohort, significantly more HIV-NM patients were male, with a lower age at onset (mean 34 years). In addition, immunosuppression was more frequently applied with more

  11. Clinico-pathological characteristics of different types of immunodeficiency-associated smooth muscle tumours.

    PubMed

    Hussein, Kais; Rath, Berenice; Ludewig, Britta; Kreipe, Hans; Jonigk, Danny

    2014-09-01

    Rare Epstein-Barr virus (EBV)+ smooth muscle tumours (SMT) manifest typically under immunosuppression. Three major subtypes are known: human immunodeficiency virus-associated (HIV-SMT), after transplantation (PTSMT) or associated with congenital immunodeficiency syndromes (CI-SMT). So far, there are no analyses which compare the clinico-pathological characteristics of all three subtypes. Case reports and case series on these three tumour types were collected (1990-2012). Meta-data analysis was performed for identification of similarities and differences. A total of 73 HIV-SMT, 66 PTSMT and 9 CI-SMT were evaluated. There was a slight female predominance (55-67%). Children were affected nearly equally in HIV-SMT (33%) and PTSMT (35%), while all CI-SMT occurred in children. HIV-SMT manifested preferentially in the central nervous system, gut/liver, skin, lungs/larynx/pharynx and adrenal glands. PTSMT were predominantly found in the liver, lungs/larynx/pharynx, gut/spleen and brain. CI-SMT were often found in lungs/larynx, brain, liver, adrenal glands and spleen. Antecedent EBV+ lymphoproliferations manifested more often in PTSMT. In all three tumour subtypes, survival analyses did not show any significant differences regarding surgical therapeutic approaches, the occurrence of multiple tumours, tumour size or sarcoma-like histological features. HIV-SMT had the poorest overall survival, which might be attributed to HIV-associated infectious complications. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Progressive anterior operculum syndrome due to FTLD-TDP: a clinico-pathological investigation.

    PubMed

    Otsuki, Mika; Nakagawa, Yoshitsugu; Mori, Fumiaki; Tobioka, Hirotoshi; Yoshida, Hideaki; Tatezawa, Yoshiharu; Tanigawa, Toshio; Takahashi, Ikuko; Yabe, Ichiro; Sasaki, Hidenao; Wakabayashi, Koichi

    2010-07-01

    Pathological investigation of progressive anterior operculum syndrome has rarely been reported. We describe clinico-pathological findings in a patient with progressive anterior operculum syndrome. A 74-year-old right-handed man had noticed speech and swallowing difficulties 1 year previously. Neurological examinations showed no abnormality other than a slight limitation of upward gaze and slow tongue movement without fibrillation. We investigated the patient using neuroimaging and neuropsychological examinations and observed him for 2 years until his death, at which point we obtained pathological findings. The patient's facial and masseteric muscles seemed hypotonic with drooling, but he could laugh and yawn normally, showing automatic voluntary dissociation. Palatal and pharyngeal reflexes were normal. Magnetic resonance imaging showed cortical atrophy in the temporal lobes bilaterally. (123)IMP single photon emission computed tomography and positron emission tomography showed decreased blood flow and activity in the frontotemporal lobes, predominantly on the left side. Neuropsychological examinations showed no aphasia, dementia or other neuropsychological abnormality. Intubation fiberscopy, laryngoscopy and video fluorography showed no abnormality. After 6 months his anarthria and dysphagia became aggravated. He died of aspiration pneumonia 2 years after onset. Postmortem examination revealed neuronal degeneration with TDP-43-positive inclusions in the frontal, temporal and insular cortices, consistent with frontotemporal lobar degeneration with TDP inclusions (FTLD-TDP). However, neuronal loss with gliosis was more prominent in the inferior part of the motor cortices, bilaterally. Progressive anterior operculum syndrome could be classified as a variant of FTLD-TDP.

  13. A template for a clinico-pathological audit of medical liver biopsies.

    PubMed

    Colling, Richard; Fryer, Eve; Cobbold, Jeremy; Collier, Jane; Collantes, Elena; Wang, Lai Mun; Hubscher, Stefan; Wyatt, Judith; Fleming, Kenneth

    2015-11-01

    With changing indications for performing medical liver biopsies, we aimed to develop a tool to allow pathologists to evaluate the current usefulness, value and impact of their medical liver biopsy service. We designed and piloted a questionnaire-based clinico-pathological audit for medical liver biopsies. The audit tool was simple to implement and provided useful information about our service. Hepatologists felt that 96% of reports were clinically useful. 56% of biopsies confirmed clinical diagnoses, 46% helped differentiate between diagnoses and 42% were able to exclude possible diagnoses. 74% resulted in a change of management and 27% of liver biopsies resulted in a diagnosis which was not clinically suspected. We demonstrate the usefulness of an audit tool in providing evidence of the value of the liver pathology service in a large UK regional centre. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Pulmonary Alveolar Microlithiasis “Stone Lungs”: A Case of Clinico-Radiological Dissociation

    PubMed Central

    Shaharyar, Sameer; Chokshi, Binna; Bhardwaj, Nikhil

    2016-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare infiltrative lung disease characterized by deposition of spherical calcium phosphate microliths called calcospherites within the alveoli. PAM was first described by Friedrich in 1856 and then by Harbitz in 1918. The disease pathogenesis is based on mutations in the SLC34A2 gene that encodes for the Type IIb sodium-phosphate cotransporter. The majority of the patients are diagnosed at an early age, usually between the ages of 20 and 40 years. The hallmark of this disease is a striking dissociation between the radiological findings and the mild clinical symptoms.  We report a case of 35-year-old woman who presented post-motor vehicle accident with back pain and with minimal dyspnea on exertion. The final diagnosis was made after computed tomography and lung biopsy. The present case exhibits the remarkable clinico-radiological dissociation with complete calcification of the lungs on radiographic images with a relatively mild clinical presentation. PMID:27688986

  15. [A clinico-morphologico-functional study of the kidneys in glomerulonephritis].

    PubMed

    Varshavskiĭ, V A; Sorokina, M N; Tomlina, N A; Kupriianova, L A

    1975-01-01

    The article deals with the results of a clinico-functional-morphological study of the kidneys in glomerulonephritis (50 observations) which was carried out with the use of the method of puncture biopsy of the kidneys. It was shown that clinical forms of glomerulonephritis, accompanied with hematuria, were characterized by the absence of fixation of immune complexes in the basal membrane of the glomeruli. According to the electron microscopy data, this corresponds to the dissappearance of deposits from the subendothelial parts of the basal membrane. The extramembranous glomerulonephritis, revealed with the help of electron microscopy technique, was characterized by the nephrotic syndrome. An increased tension of immunological processes in the glomeruli was accompanied by a more grave clinical course of glomerulonephritis, by impairment of not only glomerulous but tubular functions as well. A greater dicrease in the function of osmotic concentration of the urine in fibroplastic types of glomerulonephritis, as compared with non-firboplastic ones, was apparently connected not only with lesiones of tubules but rather with more expressed sclerotic changes in the interstitial tissue of the kidney.

  16. A Clinico-Pathological Study of Lichenoid Tissue Reactions-A Tertiary Care experience.

    PubMed

    Kumar U, Mahesh; Yelikar, Balasaheb Ramling; Inamadar, Arun C; Umesh, Swaroopa; Singhal, Amrita; Kushtagi, Anirudha V

    2013-02-01

    The aim of this article was to study the spectrum of clinico-histopathological lesions with an age and sex distribution in various lichenoid reactions of the skin. The spectrum of clinical diseases which is related to the lichenoid tissue reaction is wider. There is a recent increase in the relatively new subgroups of the lichenoid clinical picture. This was a one and a half year prospective study which was conducted in the Dermatopathology Section of the Department of Pathology, from January 2011 to June 2012. All the patients who visited the Dermatology Outpatients/ Inpatients Department and presented with lichenoid tissue reactions were included in the study. The selected patients' clinical findings were noted and their informed consents and an institutional ethical clearance were taken. Light microscopy was used for the histopathological diagnosis. The SPSS, version 14 software was used to analyze the data. Frequencies and percentages were used to describe the data. During the study period, 107 cases were clinically diagnosed as lichenoid reactions, of which 84 cases were concordant on histopathology and 6 cases were diagnosed, solely based on the histology. So, a total of 90 cases were diagnosed histologically, of which 42 were of the Lichen planus type and 48 were lichenoid eruptions. Females were affected more commonly than the males. In our study, the lichenoid reactions were more common in children and the most common prototype was Lichen planus. So, we conclude that histopathology is a dependable tool for identifying the underlying cause in lichenoid reactions.

  17. Clinico-pathological profile of sinonasal masses: a study from a tertiary care hospital of India.

    PubMed

    Lathi, A; Syed, M M A; Kalakoti, P; Qutub, D; Kishve, S P

    2011-12-01

    The present study examined the clinico-pathological profile of sinonasal masses in patients attending an Ear Nose Throat clinic of a rural tertiary care hospital of western Maharashtra in India, between May 2007 to June 2009. During the study period, 112 patients presented with sinonasal masses (male 68, female 44; age group 8-70 years). Nasal polyploid masses were non-neoplastic in 80 (71.4%) subjects, and neoplastic in 32 (28.6%) cases. Nasal obstruction was the most common (97.3%) presenting complaint, followed by rhinorrhoea (49.1%), hyposmia (31.25%), intermittent epistaxis (17.9%), headache (16.9%), facial swelling (11.6%) and eye-related symptoms (10.7%). The most common site of origin of polyploid masses was the middle meatus (54.4%) followed by the lateral wall of the nasal cavity (16.1%) and superior meatus (10.7%). Unilateral nasal masses was present in 47.7% patients, while the remaining patients had bilateral nasal masses. Allergic (62.5%) and inflammatory (25%) polyps were the most common non-neoplastic mass. Haemangioma (47.3%) and inverted papilloma (36.8%) were most common benign neoplastic mass; 92.3% of all malignant masses were squamous cell carcinoma. Surgery was the major mode of treatment. It included Caldwell-Luc operation (7.1%), polypectomy (17.8%), excision of mass (25.0%) and functional endoscopic sinus surgery (44.6%). Malignancies were treated with radiotherapy.

  18. Grey and White Matter Clinico-Anatomical Correlates of Disinhibition in Neurodegenerative Disease

    PubMed Central

    Santillo, Alexander Frizell; Lundblad, Karl; Nilsson, Markus; Landqvist Waldö, Maria; van Westen, Danielle; Lätt, Jimmy; Blennow Nordström, Erik; Vestberg, Susanna; Lindberg, Olof; Nilsson, Christer

    2016-01-01

    Disinhibition is an important symptom in neurodegenerative diseases. However, the clinico-anatomical underpinnings remain controversial. We explored the anatomical correlates of disinhibition in neurodegenerative disease using the perspective of grey and white matter imaging. Disinhibition was assessed with a neuropsychological test and a caregiver information-based clinical rating scale in 21 patients with prefrontal syndromes due to behavioural variant frontotemporal dementia (n = 12) or progressive supranuclear palsy (n = 9), and healthy controls (n = 25). Cortical thickness was assessed using the Freesurfer software on 3T MRI data. The integrity of selected white matter tracts was determined by the fractional anisotropy (FA) from Diffusion Tensor Imaging. Disinhibition correlated with the cortical thickness of the right parahippocampal gyrus, right orbitofrontal cortex and right insula and the FA of the right uncinate fasciculus and right anterior cingulum. Notably, no relationship was seen with the thickness of ventromedial prefrontal cortex. Our results support an associative model of inhibitory control, distributed in a medial temporal lobe-insular-orbitofrontal network, connected by the intercommunicating white matter tracts. This reconciles some of the divergences among previous studies, but also questions the current conceptualisation of the “prefrontal” syndrome and the central role attributed to the ventromedial prefrontal cortex in inhibitory control. PMID:27723823

  19. Trifurcation of superficial brachial artery: a rare case with its clinico-embryological implications.

    PubMed

    Gupta, N; Anshu, A; Dada, R

    2014-01-01

    Literatures on vasculature of upper limbs are crammed with reports of distinctly deviant version of normally prevalent vessels having modified origins, altered branching and odd courses. A unique anatomical variation in vascular pattern was observed during routine dissection of right upper limb in gross anatomy laboratory, AIIMS, New Delhi, India. The brachial artery was placed superficial to median nerve in the arm and therefore it was called superficial brachial artery. In the cubital fossa, 2.8 cm distal to intercondylar line of elbow joint, this superficial brachial artery terminated by trifurcation into radial, common interosseous and ulnar branches. Strikingly the ulnar branch, after its origin ran superficially over the median nerve and epitrochlear superficial flexor group of muscles of forearm in succession for the initial third of its course in the forearm, consequently it was addressed as superficial ulnar artery. The existence of superficial brachial artery in place of normal brachial artery, its termination by trifurcation into radial, common interosseous and superficial ulnar arteries with remarkably different courses, leads to confusing disposition of structures in the arm, cubital fossa and in the forearm and collectively makes this myriad of anatomical variations even rarer. The clinico-embryological revelations for combination of these unconventional observations, apprises and guides the specialized medical personnel attempting blind and invasive procedures in brachium and ante-brachium. This case report depicts the anatomical perspective and clinical implications on confronting a rare variant vasculature architecture pattern of upper limb.

  20. Clinico-epidemiological study of near-hanging cases - An investigation from Nepal.

    PubMed

    Atreya, Alok; Kanchan, Tanuj

    2015-07-01

    Hanging is one of the commonest methods of suicide. Epidemiological data of near-hanging patients from Nepal is limited. The present research from Nepal attempts to review the clinico-epidemiological profile of near-hanging patients. A retrospective review of case records was done for the near hanging patients admitted to a tertiary care teaching hospital in Nepal, between August 2012 and August 2014. Details regarding socio-demographic profile, circumstances of hanging, clinical details, and outcome etc. were obtained and examined. During the study period, 10 near hanging patients were admitted to the hospital. The majority of the patients were below 30 years. Mean age of the study group was 28.8 years. The GCS on arrival ranged between 5/15 and 15/15 with the mean GCS being 9.5/15. Hypoxic encephalopathy and cerebral edema were the only noted complications. None of the patient had a cervical spinal injury. All the patients survived the near hanging episode. The mean ICU and hospital stay were 3.9 days and 6.2 days respectively. Prompt resuscitation, active interventions and intensive care support favors a good prognosis. Psychiatric evaluation and support to the patients and their relatives is the key to preventing such attempts in future.

  1. [Atrophy of the hippocampus of vascular origin. Clinico-pneumoencephalographic study].

    PubMed

    Maslenikov, V; Acevedo de Mendilaharsu, S; Azambuja, N

    1977-01-01

    Among 20 patients with symptoms of cerebrovascular insufficiency, dissociation between memory disturbances and cognitive functions, and PEG studies, there were 13 cases showing atrophy of the hippocampus. The neurological and psychological studies included memory functions tests, IQ, and the analysis of language and praxia. Complementary tests included standard EEG records, EEGs obtained with nasopharingeal electrodes and PEG tomography with selective filling of both temporal horns, in order to demonstrate the inner and lower surface of the temporal lobes. The volume of the Ammon horn was reduced in 13 cases. Hippocampal atrophy was unilateral in 11 patients and bilateral in 2. The fact that hippocampal atrophy was demonstrated by PEG studies in 13 out of 20 cases, appears to be highly significant. This clinico-neuroradiological correlation seems to indicate that hippocampal atrophy, following ischemia in the deep distal vertebro-basilar-posterior cerebral territory, disturbs the function of axial structures (Papez circuit or limbic system) apparently leading to the disturbances of memory functions observed in this group of patients.

  2. Viral aetiology and clinico-epidemiological features of acute encephalitis syndrome in eastern India.

    PubMed

    Rathore, S K; Dwibedi, B; Kar, S K; Dixit, S; Sabat, J; Panda, M

    2014-12-01

    This study reports clinico-epidemiological features and viral agents causing acute encephalitis syndrome (AES) in the eastern Indian region through hospital-based case enrolment during April 2011 to July 2012. Blood and CSF samples of 526 AES cases were investigated by serology and/or PCR. Viral aetiology was identified in 91 (17·2%) cases. Herpes simplex virus (HSV; types I or II) was most common (16·1%), followed by measles (2·6%), Japanese encephalitis virus (1·5%), dengue virus (0·57%), varicella zoster virus (0·38%) and enteroviruses (0·19%). Rash, paresis and cranial nerve palsies were significantly higher (P < 0·05) with viral AES. Case-fatality rates were 10·9% and 6·2% in AES cases with and without viral aetiology, respectively. Simultaneous infection of HSV I and measles was observed in seven cases. This report provides the first evidence on viral aetiology of AES viruses from eastern India showing dominance of HSV that will be useful in informing the public health system.

  3. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    PubMed

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  4. Pulmonary sporotrichosis: case series and systematic analysis of literature on clinico-radiological patterns and management outcomes.

    PubMed

    Aung, Ar Kar; Teh, Bing Mei; McGrath, Christopher; Thompson, Philip J

    2013-07-01

    Pulmonary infections by Sporothrix spp. manifest radiologically as cavitary or non-cavitary disease depending on whether the infection is primary pulmonary or multifocal sporotrichosis. Despite current guidelines, the optimal management for pulmonary sporotrichosis remains unclear. In order to clarify this, we present two cases of pulmonary sporotrichosis, as well as the results of a comprehensive literature review of treatment outcomes based on clinico-radiological presentation patterns of the disease. A literature search of all case reports in English language over the last 50 years (1960-2010) was conducted. Data on patient characteristics, risk factors, clinico-radiological patterns, treatment modalities and outcomes were collected and analyzed. A total of 86 cases were identified, i.e., 64 (74.4%) primary pulmonary and 22 (25.6%) multifocal sporotrichosis. Radiologically, primary pulmonary disease was commonly characterized by cavity formation which was lacking in multifocal infections (P = 0.0001). Immunosuppressant use was more common in multifocal sporotrichosis (P = 0.0001), while hemoptysis was more common in primary pulmonary form (P = 0.01). No other differences in patient characteristics or risk factors were noted. Extra-pulmonary multifocal sporotrichosis most commonly involved skin (81.8%) and joints (45.4%). For patients with cavitary primary pulmonary sporotrichosis, outcomes from medical therapy alone were inferior to surgical intervention (P = 0.02). However, for both primary pulmonary and multifocal sporotrichosis with non-cavitary disease, medical therapy alone provided good outcomes. Only 12 (16.7%) cases were treated with itraconazole. Treatment of pulmonary sporotrichosis should be guided by the clinico-radiological patterns of presentation. Medical therapy alone is likely sufficient for non-cavitary disease while early surgery should be considered for cavitary primary pulmonary sporotrichosis. The experience in treating cavitary disease

  5. [Clinico-genealogical and phenotypic characteristics of patients with late sequelae of closed cranio-cerebral injuries].

    PubMed

    Shogam, I I; Pesochina, E A

    1990-01-01

    As many as 100 patients with late sequelae of closed craniocerebral injuries (CCCI) and 50 healthy persons underwent a clinico-genealogical and phenotypic analysis. Multifactorial diseases (in particular essential hypertension and other cardiovascular diseases) which correlate with the clinical features of late sequelae of CCCI were noted to occur in the patients' pedigree significantly more often as compared to normal persons. The patients manifest a high frequency of the stigmas of dysembryogenesis. After CCCI part of them manifested certain hereditary diseases. Genetic risk factors should be taken into account in forecasting CCCI outcomes and planning follow up measures.

  6. Clinico-pathological nomogram for predicting BRAF mutational status of metastatic colorectal cancer

    PubMed Central

    Loupakis, Fotios; Moretto, Roberto; Aprile, Giuseppe; Muntoni, Marta; Cremolini, Chiara; Iacono, Donatella; Casagrande, Mariaelena; Ferrari, Laura; Salvatore, Lisa; Schirripa, Marta; Rossini, Daniele; De Maglio, Giovanna; Fasola, Gianpiero; Calvetti, Lorenzo; Pilotto, Sara; Carbognin, Luisa; Fontanini, Gabriella; Tortora, Giampaolo; Falcone, Alfredo; Sperduti, Isabella; Bria, Emilio

    2016-01-01

    Background: In metastatic colorectal cancer (mCRC), BRAFV600E mutation has been variously associated to specific clinico-pathological features. Methods: Two large retrospective series of mCRC patients from two Italian Institutions were used as training-set (TS) and validation-set (VS) for developing a nomogram predictive of BRAFV600E status. The model was internally and externally validated. Results: In the TS, data from 596 mCRC patients were gathered (RAS wild-type (wt) 281 (47.1%); BRAFV600E mutated 54 (9.1%)); RAS and BRAFV600E mutations were mutually exclusive. In the RAS-wt population, right-sided primary (odds ratio (OR): 7.80, 95% confidence interval (CI) 3.05–19.92), female gender (OR: 2.90, 95% CI 1.14–7.37) and mucinous histology (OR: 4.95, 95% CI 1.90–12.90) were independent predictors of BRAFV600E mutation, with high replication at internal validation (100%, 93% and 98%, respectively). A predictive nomogram was calculated: patients with the highest score (right-sided primary, female and mucinous) had a 81% chance to bear a BRAFV600E-mutant tumour; accuracy measures: AUC=0.812, SE:0.034, sensitivity:81.2% specificity:72.1%. In the VS (508 pts, RAS wt: 262 (51.6%), BRAFV600E mutated: 49 (9.6%)), right-sided primary, female gender and mucinous histology were confirmed as independent predictors of BRAFV600E mutation with high accuracy. Conclusions: Three simple and easy-to-collect characteristics define a useful nomogram for predicting BRAF status in mCRC with high specificity and sensitivity. PMID:26575603

  7. Clinico-serologic co-relation in bi-directional ABO incompatible hemopoietic stem cell transplantation

    PubMed Central

    Basu, Sabita; Dhar, Supriya; Mishra, Deepak; Chandy, Mammen

    2015-01-01

    Background: The ABO blood group system is of prime significance in red cell transfusion and organ transplantation. However, ABO compatibility is not critical in allogenic hemopoietic stem cell transplantation (HSCT) and approximately 40-50% of hemopoietic stem cell transplants are ABO incompatible. This incompatibility may be major, minor or bi-directional. Though there are descriptions of transfusion practice and protocols in ABO incompatible HSCT, there are considerable variations and transfusion support in these patients can be very challenging. Aims: The immunohematologic observations in two cases of bi-directional ABO incompatible HSCT have been described, and clinico-serologic correlation has been attempted. Materials and Methods: In both cases, peripheral blood stem cell harvests were obtained using the Cobe spectra cell separator. Immunohematologic assessments in the donor and recipient were done as a part of pre HSCT evaluation. Both the standard tube technique and column agglutination method (Ortho Biovue Micro Bead System) was used. Antibody screen was done by column agglutination method using three cell panel (Surgiscreen cells). Isoagglutinin titration was done by the master dilution method and standard validated techniques were used. Results: The pattern of laboratory findings in the two cases was different and so were the clinical outcomes. Although there was early engraftment in the first case, the second case developed pure red cell aplasia and this was well-reflected in the immunohematologic assessments. Conclusion: Immunohematologic assessment correlated well with the clinical picture and could be used to predict clinical outcome and onset of complications in ABO incompatible HSCT. PMID:26420941

  8. A Clinico-Pathological Study of Lichenoid Tissue Reactions-A Tertiary Care experience

    PubMed Central

    Kumar U, Mahesh; Yelikar, Balasaheb Ramling; Inamadar, Arun C; Umesh, Swaroopa; Singhal, Amrita; Kushtagi, Anirudha V

    2013-01-01

    Introduction: The aim of this article was to study the spectrum of clinico-histopathological lesions with an age and sex distribution in various lichenoid reactions of the skin. The spectrum of clinical diseases which is related to the lichenoid tissue reaction is wider. There is a recent increase in the relatively new subgroups of the lichenoid clinical picture. Material And Methods: This was a one and a half year prospective study which was conducted in the Dermatopathology Section of the Department of Pathology, from January 2011 to June 2012. All the patients who visited the Dermatology Outpatients/ Inpatients Department and presented with lichenoid tissue reactions were included in the study. The selected patients’ clinical findings were noted and their informed consents and an institutional ethical clearance were taken. Light microscopy was used for the histopathological diagnosis. The SPSS, version 14 software was used to analyze the data. Frequencies and percentages were used to describe the data. Results: During the study period, 107 cases were clinically diagnosed as lichenoid reactions, of which 84 cases were concordant on histopathology and 6 cases were diagnosed, solely based on the histology. So, a total of 90 cases were diagnosed histologically, of which 42 were of the Lichen planus type and 48 were lichenoid eruptions. Females were affected more commonly than the males. Conclusion: In our study, the lichenoid reactions were more common in children and the most common prototype was Lichen planus. So, we conclude that histopathology is a dependable tool for identifying the underlying cause in lichenoid reactions. PMID:23543246

  9. Biopsy-Proven BK Virus-Associated Nephropathy: Clinico-Pathologic Correlations.

    PubMed

    Jahdali, Sarah; Al Oudah, Noura; Alsaad, Khaled O; Kfoury, Hala; Qurashi, Salem; Al Sayyari, Abdulla

    2017-06-01

    Our objective was to study the clinico-pathologic correlations in BK virus nephropathy. We conducted a retrospective study of all patients with biopsy-proven polyoma (BK) virus infection. We compared their survival and renal outcomes versus BK virus-negative patients with biopsy-proven graft rejection. Histopathologic characterization by a blinded nephropathologist was performed. BK nephropathy was found in 10 patients biopsied for graft dysfunction. All virus-positive patients received antithymocyte globulin induction therapy compared with only 59.3% of the BK-negative group (P = .06). The percentage of patients in the BK-negative group who received acyclovir was significantly higher than that in the BK-positive group (P = .01). After a mean observation period of 6.8 ± 3.2 years, 70% of the BK group had functioning grafts compared with 68% in the BK-negative group (P = .9) with similar 3-year graft survival in the 2 groups (80% and 90%; P = .8). Within the BK group, graft survival was better in the older group (P = .005) and in those with deceased donor kidney grafts (P = .016). Patients in the BK-negative group were heavier (mean weight of 64.3 ± 12.1 vs 46.7 ± 20.6 kg; P = .003). None of the histopathologic features studied had any effect on renal prognosis. The risk factors for developing BK nephropathy were use of antithymocyte globulin, lower weight, and not using acyclovir as early prophylaxis. Within the BK nephropathy group, better graft survival was observed in deceased donor kidney recipients and in older patients. The viral load and polyoma virus nephropathy stage did not affect graft survival in this small sample study.

  10. Mouse model mimics multiple sclerosis in the clinico-radiological paradox.

    PubMed

    Wuerfel, Jens; Tysiak, Eva; Prozorovski, Timour; Smyth, Maureen; Mueller, Susanne; Schnorr, Joerg; Taupitz, Matthias; Zipp, Frauke

    2007-07-01

    The value of experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, in deriving novel diagnostic and therapeutic input has been subject to recent debate. This study is the first to report a disseminated distribution of plaques including cranial nerves, prior to or at early stages of disease in murine adoptive transfer EAE, irrespective of the development of clinical symptoms. We induced EAE by adoptive proteolipid protein-specific T-cell transfer in 26 female SJL/J mice, and applied high-field-strength magnetic resonance imaging (MRI) scans longitudinally, assessing blood-brain barrier (BBB) disruption by gadopentate dimeglumine enhancement. We visualized inflammatory nerve injury by gadofluorine M accumulation, and phagocytic cells in inflamed tissue by very small anionic iron oxide particles (VSOP-C184). MRI was correlated with immunohistological sections. In this study, we discovered very early BBB breakdown of white and grey brain matter in 25 mice; one mouse developed exclusively spinal cord inflammation. Widely disseminated contrast-enhancing lesions preceded the onset of disease in 10 animals. Such lesions were present despite the absence of any clinical disease formation in four mice, and coincided with the first detectable symptoms in others. Cranial nerves, predominantly the optic and trigeminal nerves, showed signal intensity changes in nuclei and fascicles of 14 mice. At all sites of MRI lesions we detected cellular infiltrates on corresponding histological sections. The discrepancy between the disease burden visualized by MRI and the extent of disability indeed mimics the human clinico-radiological paradox. MRI should therefore be implemented into evaluational in vivo routines of future therapeutic EAE studies.

  11. Clinico-epidemiological Study and Quality of Life Assessment in Melasma

    PubMed Central

    Yalamanchili, Ravali; Shastry, Veeranna; Betkerur, Jayadev

    2015-01-01

    Background: Melasma is one of the most common and distressing pigmentary disorders presenting to dermatology clinics. The precise cause of melasma remains unknown. It is notably difficult to treat and has a tendency to relapse. Its population prevalence varies according to ethnic composition, skin phototype, and intensity of sun exposure. Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Aims: To study the clinico-epidemiological pattern, dermascopy, wood's lamp findings and the quality of life in patients with melasma. Settings and Design: Observational/descriptive study. Materials and Methods: Patients with melasma were screened. History, clinical examination, Wood's lamp examination (WLE) and dermoscopy were done. Severity of melasma was assessed by the calculating melasma area severity index (MASI) score. Quality of Life (QOL) was assessed using MELASQOL scale with a standard structured questionnaire. Statistical Analysis: Descriptive, Chi-square test and contingency coefficient analysis. Results: In 140 cases of melasma, 95 (67.9%) were females and 45 (32%) were males. Common age group affected was 31-40 years (65%). Majority were unskilled workers with average sun exposure of more than 4 hours (44%). Family history was observed in 18% cases. Malar type (68%) was the most common pattern observed. Mean MASI score was 5.7. WLE showed dermal type in 69% cases. Common findings on dermoscopy were reticular pigment network with perifollicular sparing and color varying from light to dark brown. Mean MELASQOL score was 28.28, with most patients reporting embarrassment and frustration. Conclusions: This study showed that melasma has a significant negative effect on QOL because though asymptomatic it is disfiguring affecting self-esteem. Dermoscopic examination did not help in differentiating the type of melasma. PMID:26538717

  12. [Clinico-pathological features of papillary thyroid cancer coexistent with Hashimoto's thyroiditis].

    PubMed

    Molnár, Sarolta; Győry, Ferenc; Nagy, Endre; Méhes, Gábor; Molnár, Csaba

    2017-02-01

    Former studies suggest the frequent coexistence of Hashimoto's thyreoditis with papillary thyroid cancer, frequently featured by multifocal carcinogenesis but lower clinical stages compared to thyroid cancers lacking thyroiditis. We examined the clinico-pathological correlations between Hashimoto's thyroditis and papillary thyroid cancer in our region in the North-Eastern part of Hungary. We included a total of 230 patients with papillary thyroid cancer who underwent thyroid surgery at the Surgical Department of the University of Debrecen. Patients' sex, age, multifocality of thyroid cancer and clinical stage were evaluated. Cases included 40 patients (17.4%) with (4 male, 36 female) and 190 (82.6%) patients without HT (44 male, 146 female). Hashimoto's thyroiditis related thyroid cancer was almost exclusively associated with the papillary histological type. Multifocality of papillary cancer was significantly more frequent with coexisting Hashimoto's thyroiditis (16/40; 40.0%) compared to cases uninvolved (45/190; 23.7%; p = 0.034). In contrast, lymph node metastasis was significantly less frequent among patients with Hashimoto's thyroiditis (4 pN1 [36.4%]; 7 pN0 [63.6%]) then without it (34 pN1 [82.9%]; 7 pN0 [17.1%]; p = 0.002). Higher frequency and multifocality of papillary thyroid cancer might be the consequence of preexisting Hashimoto's thyroiditis to be considered as a preneoplastic stimulus supporting carcinogenesis, though the exact pathomechanism of this correlation is not clear yet. Orv. Hetil., 2017, 158(5), 178-182.

  13. Clinico-Pathological Spectrum of Ophthalmic Lesions: An Experience in Tertiary Care Hospital of Central India

    PubMed Central

    Gahine, Renuka; Hussain, Nighat; Memon, Mohd Jafar

    2017-01-01

    Introduction Ophthalmic lesions show varied distribution on the basis of geographical location. Eye being a unique sensory organ needs to be studied both clinically and pathologically. Aim This study was aimed to evaluate the histomorphological and clinico-pathlological spectrum of ophthalmic lesions at a tertiary care hospital of Central India. Materials and Methods We reviewed all the ophthalmic biopsies performed in the Department of Pathology of our institute between January 2008 and November 2014. Total 488 biopsies of the orbito-ocular region were obtained from patients attending the ophthalmology department. Ophthalmic biopsies were studied as per epidemiological and histomorphological data. Results The patients ranged in age from one month to 85 years with bimodal distribution. With a male to female ratio of 1:1. Ophthalmic lesions were highest (44.8%) in less than 20 years age group. Eyelid (33.6%) was the most commonly involved site. Clinical diagnosis was consistent with histopathological diagnosis in approximately 76% cases. The non-neoplastic, benign and malignant lesions were 61.1%, 7.8% and 31.1% respectively. Retinoblastoma formed 40.1% of all malignant lesions followed by sebaceous carcinoma (19.1%) and Squamous Cell Carcinoma (SCC) (10.5%). Rare lesions were primary neuroblastoma of orbit and rhabdomyosarcoma of eyelid. Conclusion Findings suggest that among neoplastic lesions the most common ophthalmic malignancies were retinoblastoma in children and sebaceous carcinoma in adults. Among non-neoplastic lesions, 89% cases of infectious aetiology were of rhinosporidiosis in our study making it an important differential diagnosis among ophthalmic lesions. PMID:28273971

  14. Lichen simplex chronicus of anogenital region: a clinico-etiological study.

    PubMed

    Rajalakshmi, R; Thappa, Devinder Mohan; Jaisankar, Telanseri J; Nath, Amiya Kumar

    2011-01-01

    Lichen simplex chronicus (LSC) of the anogenital region, is a benign, extremely uncomfortable disease. As very little is known about the cause of anogenital LSC (AGLSC), we undertook this study to determine various clinico-etiological factors involved in it and to assess the frequency of AGLSC. This was a descriptive study, including 105 patients with AGLSC, who attended the Dermatology clinic in our institute from September 2007 to June 2009. Detailed history, physical examination, and relevant investigations were done. The collected data were tabulated and analyzed. The frequency of AGLSC among patients presenting with anogenital pruritus was 2.54%. Primary AGLSC was more common than secondary AGLSC (69.5% vs. 30.5%). AGLSC manifested more commonly in males than in females (56.2% vs. 43.8%). The mean duration of the disease was 30.6 months. The common triggering factors for itching were sweating (41.9%), rubbing of thighs while walking for long distances (9.5%), and mental stress (5.7%). Pruritus of AGLSC was related to the intake of various food items in 37.1% of patients. In males, scrotum was the predominant site involved (89.8%), whereas in females, labia majora was the predominant site involved (78.2%). Nearly one-third of cases (30.5%) of AGLSC had some other dermatoses in the anogenital region. Though psychological factors are thought to play an important role in disease causation and perpetuation among AGLSC patients, their significance could not be ascertained by us.

  15. The clinico-pathology and mechanisms of trypanosomosis in captive and free-living wild animals: a review.

    PubMed

    Mbaya, A W; Aliyu, M M; Ibrahim, U I

    2009-10-01

    Reports on the clinico-pathology and mechanisms of trypanosomosis in free-living and captive wild animals showed that clinical disease and outbreaks occur more commonly among captive than free-living wild animals. This is because the free-living wild animals co-exist with the disease until subjected to captivity. In exceptional cases however, draught, starvation and intercurrent diseases often compromised trypanotolerance leading to overt trypanosomosis in free-living wild animals. Meanwhile, in captivity, space restriction, reduced social interactions, change in social herd structure, reduced specie-to-specie specific behaviors, altered habitat and translocation were the major stressors that precipitated the disease. The cumulative effect of these factors produced severe physiological and somatic stress leading to diminished immune response due to increased blood cortisol output from adrenal cortex. The major symptoms manifested were pyrexia, innapetence, increased respiration, anaemia, cachexia and death. At necropsy, pulmonary oedema, splenomegally, hepatomegally, lympadenopathy and atrophy of body fats were the gross changes encountered. At the ultra-structural level, the tissues manifested degenerative changes, haemorghages, necrosis and mononuclear cellular infiltrations. The mechanisms of cellular and tissue injuries were primarily associated with physical and metabolic activities of the organisms. From the foregoing, it is evident that stress is the underlying mechanism that compromises trypanotolerance in wild animals leading to severe clinico-pathological effects.

  16. Clinico-Pathological Study of Cutaneous Granulomatous Lesions- a 5 yr Experience in a Tertiary Care Hospital in India

    PubMed Central

    Chakrabarti, Srabani; Pal, Subrata; Biswas, Biplab Kr; Bose, Kingshuk; Pal, Saswati; Pathak, Swapan

    2016-01-01

    Background: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six sub-types of granulomas found in granulomatous skin diseases- tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body & histoid type. The aims of the present study were clinico-pathological evaluation of granulomatous skin lesions and their etiological classification based on histopathological examination. Methods: It was a five years (Jan 2009- Dec 2013) retrospective study involving all the skin biopsies. Detailed clinical and histopathological features were analyzed and granulomatous skin lesions were categorized according to type of granuloma & etiology. Special stains were used in few cases for diagnostic purpose. Results: Among 1280 skin biopsies, 186 cases (14.53%) were granulomatous skin lesions with a ratio 1:24. In histopathological sub-typing, tuberculoid granuloma was most common type (126 cases, 67.74%). Most common etiology of granuloma in the study was leprosy (107 cases, 57.52%). Other etiologies were cutaneous tuberculosis, foreign body granulomas, fungal lesions, cutaneous leishmaniasis, sarcoidosis and granuloma annulare. Conclusion: Histopathology is established as gold standard investigation for diagnosis, categorization and clinico-pathological correlation of granulomatous skin lesions. PMID:26870144

  17. Verrucous lesions of the oral cavity treated with surgery: Analysis of clinico-pathologic features and outcome

    PubMed Central

    Sadasivan, Anjana; Thankappan, Krishnakumar; Rajapurkar, Mayuri; Shetty, Sharankumar; Sreehari, Sreekala; Iyer, Subramania

    2012-01-01

    Objective: Verrucous lesions of the oral cavity can be of varied histopathology. The present study evaluates the clinico-pathological features of verrucous lesions of the oral cavity and analyzes the treatment outcomes. Materials and Methods: This is a retrospective study of 15 consecutive patients who presented with verrucous lesions of the oral cavity, during the 5-year period from January 2006 to December 2010. Demographic, clinico-pathological features, treatment details, and outcomes were analyzed. Results: Fifteen patients with verrucous lesions of the oral cavity were treated with surgery as the primary modality. The mean age was 62.8 years (range 35–85 years). Wide excision of the primary lesion with adequate mucosal and soft-tissue margins was carried out. Free-flap reconstruction was done in eight patients. All patients remain loco-regionally controlled with good functional speech and swallowing outcome. Conclusions: Verrucous lesions of the oral cavity are a distinct clinical entity with varied histopathology. A surgical excision with wide margins and appropriate reconstruction is necessary to optimize the disease and functional outcome. PMID:22557899

  18. Verrucous lesions of the oral cavity treated with surgery: Analysis of clinico-pathologic features and outcome.

    PubMed

    Sadasivan, Anjana; Thankappan, Krishnakumar; Rajapurkar, Mayuri; Shetty, Sharankumar; Sreehari, Sreekala; Iyer, Subramania

    2012-01-01

    Verrucous lesions of the oral cavity can be of varied histopathology. The present study evaluates the clinico-pathological features of verrucous lesions of the oral cavity and analyzes the treatment outcomes. This is a retrospective study of 15 consecutive patients who presented with verrucous lesions of the oral cavity, during the 5-year period from January 2006 to December 2010. Demographic, clinico-pathological features, treatment details, and outcomes were analyzed. Fifteen patients with verrucous lesions of the oral cavity were treated with surgery as the primary modality. The mean age was 62.8 years (range 35-85 years). Wide excision of the primary lesion with adequate mucosal and soft-tissue margins was carried out. Free-flap reconstruction was done in eight patients. All patients remain loco-regionally controlled with good functional speech and swallowing outcome. Verrucous lesions of the oral cavity are a distinct clinical entity with varied histopathology. A surgical excision with wide margins and appropriate reconstruction is necessary to optimize the disease and functional outcome.

  19. Motor neuron diseases in the university hospital of Fortaleza (Northeastern Brazil): a clinico-demographic analysis of 87 cases.

    PubMed

    Castro-Costa, C M; Oriá, R B; Vale, O C; Arruda, J A; Horta, W G; D'Almeida, J A; Santos, T J; Ramos, R S; Gifoni, M A

    2000-12-01

    In this retrospective (1980-1998) study, we have analyzed clinico-demographically, from the records of the University Hospital of Fortaleza (Brazil), a group of 87 patients showing signs and symptoms of motor neuron diseases (MNDs). Their diagnosis was determined clinically and laboratorially. The WFN criteria were used for amyotrophic lateral sclerosis (ALS) diagnosis. The clinico-demographic analysis of the 87 cases of MNDs showed that 4 were diagnosed as spinal muscular atrophy (SMA), 5 cases as ALS subsets: 2 as progressive bulbar paralysis (PBP), 2 as progressive muscular atrophy (PMA) and 1 as monomelic amyotrophy (MA), and 78 cases of ALS. The latter comprised 51 males and 27 females, with a mean age of 42.02 years. They were sub-divided into 4 groups according to age: from 15 to 29 years (n= 17), 30 to 39 years (n= 18), 40 to 69 years (n= 39) and 70 to 78 years (n= 4). From the 78 ALS patients, 76 were of the classic sporadic form whilst only 2 were of the familial form. The analysis of the 87 patients with MNDs from the University Hospital of Fortaleza showed a predominance of ALS patients, with a high number of cases of juvenile and early onset adult sporadic ALS.

  20. A comparison of the clinico-pathological features with stool pathogens in patients hospitalised with the symptom of diarrhoea.

    PubMed

    Watson, B; Ellis, M; Mandal, B; Dunbar, E; Whale, K; Brennand, J

    1986-01-01

    The clinico-pathological features of 515 adult patients admitted to a major Regional Infectious Diseases Unit in United Kingdom with the symptom complex of diarrhoea were compared to the pathogens detected in their stool specimens. Routine clinical examination supported by basic pathological and laboratory investigations identified 138 (28%) in whom the cause of diarrhoea was extragastrointestinal or non-infectious gastrointestinal. Of the 351 patients (72%) with infectious gastroenteritis 72 (21%) had campylobacter, 59 (17%) had salmonella (22% bacteraemic) and 16 (5%) shigella. Clostridium difficile toxin accounted for a further 15 (4%)--antibiotics had been the antecedent cause in only one half of these. Routine microscopical examination of the faeces for red and white cells distinguished many with "culture positive" diarrhoea from those with "culture negative" infectious diarrhoea. Although there are no clinico-pathological features which are unique to a particular pathogen and unequivocally suggest a particular pathogen, certain features did tend to present more often in association with particular microorganisms, and this knowledge may suggest a bacterial diagnosis whilst awaiting the definitive results of stool microbiology. These features include prior antimicrobial therapy with positive sigmoidoscopical/histological features: Cl. difficile; protracted diarrhoea in elderly severely dehydrated patients: salmonellosis; foreign travel in males with bloody diarrhoea: shigellosis; abdominal pain in younger patients with a small degree of vomiting: campylobacteriosis. Early diagnosis may then prove useful in rationalizing initial therapy, particularly the appropriate use of antimicrobials.

  1. Clinico-pathological features of patients with melanoma and positive sentinel lymph node biopsy: a single institution experience.

    PubMed

    Homolak, Damir; Šitum, Mirna; Čupić, Hrvoje

    2015-01-01

    Sentinel lymph node biopsy (SLNB) is an established method for the assessment of tumor aggressiveness in patients with primary cutaneous melanoma (PCM). To improve the criteria for the selection of SLNB candidates, the aim of our study was to determine clinico-pathohistological parameters that can serve as predictors of metastatic progression. We retrospectively evaluated all available clinico-pathohistological parameters in 844 patients with PCM diagnosed between January 1, 2005 and December 31, 2010. SLNB was conducted in 484 (57.3%) patients, 122 (14.5%) of whom had a positive node. The association between predictors and SLNB outcomes (positive SLNB and metastatic development) was tested using logistic regression analysis. The main predictors of positive SLNB were Breslow thickness (adjusted odds ratio (AOR)=1.22; 95% confidence interval (CI)=1.11-1.33), Clark levels (AOR=1.78; 95% CI=1.31-2.40), ulceration (AOR=3.1; 95% CI=1.65-5.81), microsatellitosis, gender, and tumor localization. The predictors of metastatic spread were Breslow thickness (AOR=1,69; 95% CI=1.51-1.89), Clark level (AOR=3.59; 95% CI=2.79-4.62), nodular type of melanoma (AOR=8.21; 95% CI=1.70-39.53), ulceration, mitotic rate, microsatellitosis, gender, and tumor localization. It seems that these parameters should be taken into consideration when selecting patients for SLNB since tumor thickness is not a sufficient predictor of SLNB outcome, particularly in case of very thin lesions.

  2. Clinico-pathological Analysis of the Lungs from Patients with Lung Transplantation in a Single Institute in Korea.

    PubMed

    Kim, Hyojin; Jeon, Yoon Kyung; Lee, Hyun Joo; Kim, Young Tae; Chung, Doo Hyun

    2015-10-01

    Recently, the numbers of lung transplantation (LT) has been increased in Korea. However, post-LT outcome has not been successful in all patients, which may be partially affected by the primary lung disease. Therefore comprehensive understanding in original pathological diagnosis of patients with LT would be needed for achieving better clinical outcome. To address this issue, we performed clinico-pathological analysis of the explanted lungs from 29 patients who underwent LT over a 9-yr period in Seoul National University Hospital. Among them, 26 patients received single (1/26) or double (25/26) LT, while heart-lung transplantation was performed in 3 patients. The final clinico-pathological diagnoses were idiopathic pulmonary fibrosis/usual interstitial pneumonia (UIP) (n = 6), acute interstitial pneumonia (AIP)/diffuse alveolar damage (DAD) (n = 4), AIP/non-specific interstitial pneumonia with DAD (n = 1), collagen vascular disease-related interstitial lung disease (CVD-ILD)/DAD (n = 3), CVD-ILD/UIP (n = 1), lymphangioleiomyomatosis (n = 1), bronchiectasis (n = 4), pulmonary arterial hypertension (n = 2), tuberculosis (n = 1), bronchiolitis obliterans (BO) (n = 1), and lung cancer (n = 1). Moreover, 4 patients who had chemotherapy and hematopoietic stem cell transplantation due to hematologic malignancy showed unclassifiable interstitial pneumonia with extensive fibrosis in the lungs. Our study demonstrates that pathology of the explanted lungs from Korean patients with LT is different from that of other countries except for interstitial lung disease and bronchiectasis, which may be helpful for optimization of selecting LT candidates for Korean patients.

  3. Correlation of the Kennedy Osteitis Score to clinico-histologic features of chronic rhinosinusitis.

    PubMed

    Snidvongs, Kornkiat; McLachlan, Rohan; Sacks, Raymond; Earls, Peter; Harvey, Richard J

    2013-05-01

    Osteitis is a feature of chronic rhinosinusitis (CRS) and often associated with recalcitrant disease. Radiological characteristics of osteitic sinus changes are commonly reported in practice but the clinical and pathologic significance is poorly defined. The objective of this study was to correlate the Kennedy Osteitis Score (KOS) to clinico-histologic features of CRS. A cross-sectional study of CRS patients undergoing sinus surgery was conducted. Osteitis was scored radiologically using the KOS. Associations between osteitis and histopathology, symptoms, 22-item Sino-Nasal Outcomes Test (SNOT-22), endoscopy, computed tomography (CT) mucosal score, and seromarkers were assessed. Interobserver correlation coefficient was performed. Additionally, the KOS was correlated to an alternate Global Osteitis Score. A total of 88 patients were assessed (45.5% female, age 50.3 ± 13.6 years); 45 (51.1%) patients had osteitis. Patients with KOS >0, had greater endoscopy score (6.1 ± 2.9 vs 4.4 ± 3.6, p = 0.03) and CT score (14.0 ± 6.0 vs 10.1 ± 5.7, p < 0.01) than those without osteitis. There was no difference in symptom score (2.4 ± 1.3 vs 2.4 ± 1.1, p = 0.89) and SNOT-22 (2.0 ± 1.0 vs 1.9 ± 1.1, p = 0.56) in patients with and without osteitis. KOS was higher in patients with tissue eosinophilia >10/high-power field (HPF) (median 3.0 [IQR, 1.0-5.3] vs 0.0 [0.0-4.0], p = 0.03) and serum eosinophilia >0.3 × 10(9) /L (4.0 [2.0-7.0] vs 1.0 [0.0-4.0], p < 0.01). Importantly, this was also true for those without prior surgery. The interobserver correlation coefficient was good (R = 0.86, p < 0.001). There was a significant correlation between the KOS and the Global Osteitis Score (R = 0.93, p < 0.001). The KOS is a simple, easy, and reproducible scale in assessing osteitic bones in patients with CRS and can predict measures of severity in eosinophilic rhinosinusitis. © 2013 ARS-AAOA, LLC.

  4. [From classification medicine to clinical medicine (the end of the XVIII century--1870s). Communication 2. The first stage of clinical medicine development: introduction of the method of clinico-anatomic correlations].

    PubMed

    2011-01-01

    The first stage of clinical medicine development is analysed which covers the period from early 1800s to middle 1870s. Considered are basic research achievements associated with introduction of the method of clinico-anatomic correlations into practical medicine.

  5. Para-clinico-pathological observations of insidious incidence of canine hepatozoonosis from a mongrel dog: a case report.

    PubMed

    Kaur, Paramjit; Deshmukh, S; Singh, Rajsukhbir; Bansal, B K; Randhawa, C S; Singla, L D

    2012-04-01

    A rare case of canine hepatozoonosis in a mongrel dog with para-clinico-pathological observations has been reported. The study included detailed haemato-biochemical changes at two stages, i.e. before treatment and after treatment with adopted therapy. Before therapy, blood picture revealed normocytic hypochromic anaemia and neutrophilic leucocytosis with variable counts of platelets. Thirty-seven percent of neutrophils were found infected with gametocytes of Hepatozoon canis. Following treatment, further decrease in haemoglobin value with a relative increase in lymphocyte count was seen. Biochemically, increase in alkaline phosphatase, blood urea nitrogen and creatinine levels along with hyperproteinemia was seen. The 14 days chemotherapy did not bring a respite for the dog and the level of parasitaemia was 33% after the treatment. The alkaline phosphatase and creatinine level further rose up following therapy with sulphadiazine and clindamycin. Continual study is required to explain the best possible therapeutic combination to deal H. canis.

  6. Primary high grade sarcoma of the specialised prostatic stroma: a case report with clinico-pathological considerations.

    PubMed

    Fraggetta, F; Pepe, P; Giunta, M L; Aragona, F

    2008-12-01

    Malignant tumours of the prostate other than carcinomas are rare. One such malignant tumours arising from the specialised stromal tissue of the prostate is stromal prostatic sarcoma (namely low-grade and high-grade). Herein, we report the clinico-pathological features of a high grade stromal sarcoma of the prostate occurring in a 65-year-old man who presented for urinary obstructive symptoms. The clinical picture suggested a benign prostatic hyperplasia, and surgery consisting in a transcapsular adenomectomy was performed. Following a pathological diagnosis of high grade prostatic stromal sarcoma, a radical cystoprostatectomy and bilateral pelvic node dissection was performed showing residual high grade stromal sarcoma of the prostate and incidental in situ urothelial carcinoma of the bladder. No further medical treatments were planned. One year after surgery the patient is well with no evidence of local disease or distant metastases.

  7. [Comparative clinico-morphological characteristics of the variants of adeno-squamous carcinoma and adenocarcinoma of the endometrium].

    PubMed

    Smirnov, O A; Smirnova, O N

    1985-01-01

    A clinico-morphological analysis of the data available on cases of adeno-squamous carcinoma (72) and endometrial adenocarcinoma (102) pointed to a correlation between the decrease in the degree of cell differentiation in said neoplasms and the decline in the frequency of hyperestrimism and metabolic-endocrine disorders. As a result over 70% of well-differentiated cell tumors were referred to one pathogenetic pattern of endometrial carcinoma (after Bokhman) and more than 50% of poorly-differentiated cell tumors--to another one. These findings further support the rationale for distinguishing the well- and poorly-differentiated cell patterns of adeno-squamous carcinoma. They may be used in establishing individual prognosis as well as choosing optimal scheme of treatment.

  8. Effects of clinico-pathological risk factors on in-vitro mechanical properties of human dilated ascending aorta.

    PubMed

    Ferrara, Anna; Totaro, Pasquale; Morganti, Simone; Auricchio, Ferdinando

    2017-08-31

    Ascending aorta aneurysms (AsAA) are associated with a degeneration of the aortic wall tissue, which leads to changes in tissue mechanical properties. Risk factors for the development of the AsAA disease are recognized in patient age and gender, valve type, hypertension, diabetes mellitus, smoking history, and a prior diagnosis of Marfan syndrome. The present study aims to assess how such clinico-pathological factors can affect the mechanical properties of human dilated ascending aorta. Specimens of AsAA are excised from 68 patients who underwent elective AsAA surgical repair and stretched until rupture during the execution of uniaxial tensile tests. Experimental stress-stretch curves are used to determine tissue mechanical properties (stress and stretch at failure point and at transition point, low and high elastic modulus). Data are divided into groups according to region (anterior vs posterior), direction (circumferential vs longitudinal), and then according to age (young vs old), gender (male vs female), valve type (tricuspid aortic valve, TAV, vs bicuspid aortic valve, BAV), and presence of hypertension, diabetes mellitus, and/or Marfan syndrome (yes/no). Moreover, data are grouped according to the critical value of body mass index (BMI), maximum AsAA diameter, and aortic stiffness index (ASI), respectively. Finally, a non-parametric statistical analysis is performed to find possible significant differences and correlations between mechanical properties and clinico-pathological data. Our results confirm the anisotropy and heterogeneity of the AsAA tissue and highlight that ageing and hypertension make the AsAA tissue weaker and less extensible, whereas the valve type affects the tissue strength with higher values in BAV than in TAV patients. No effects of gender, critical BMI, critical maximum AsAA diameter, critical ASI, smoking status, and presence of diabetes mellitus, and Marfan syndrome are evidenced. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Triggers, risk factors and clinico-pathological features of urticaria in dogs - a prospective observational study of 24 cases.

    PubMed

    Rostaher, Ana; Hofer-Inteeworn, Natalie; Kümmerle-Fraune, Claudia; Fischer, Nina Maria; Favrot, Claude

    2017-02-01

    Urticaria and anaphylaxis are frequently encountered in veterinary practice, but little is known about the causes and relative frequencies of these reactions. This study was designed to improve current knowledge on the triggers, risk factors and clinico-pathological features of urticaria. Twenty four dogs with signs of urticaria with or without anaphylaxis. The study included dogs with cutaneous immediate-type hypersensitivity reactions. The cases were grouped by clinical severity into either an urticaria or an anaphylaxis group. All treatments and diagnostic tests (haematology, biochemical profile, allergy investigation) were recorded. A causality algorithm for urticaria and anaphylaxis (ALUA) was designed to determine the probability of the identified triggers and cofactors. Disease incidence, breed, age and gender predispositions were evaluated statistically. Sixteen of 24 urticaria cases were associated with anaphylaxis whilst 8 of 24 were confined to the skin. The annual hospital incidence was 0.12%. Females seemed to be over-represented (2.4:1) and most of the dog breeds were pure breed (22 of 24), with Rhodesian ridgeback, boxer, beagle, Jack Russell terrier, French bulldog and Vizslas over-represented. In addition to skin lesions, the most frequently and severely affected organ systems were the gastrointestinal and cardiovascular systems. The predominant blood abnormalities were elevated lipase and alanine aminotransferase values. Insects, food and drugs were the most commonly identified triggers. To the best of our knowledge, this is the first study describing the trigger factors and clinico-pathological features of dogs with urticaria in veterinary medicine. Insects, food and drugs were the most frequently detected triggers. © 2016 ESVD and ACVD.

  10. Observation on frequency & clinico-pathological significance of various cytogenetic risk groups in multiple myeloma: an experience from India

    PubMed Central

    Kadam Amare, Pratibha S.; Jain, Hemani; Nikalje, Shraddha; Sengar, Manju; Menon, Hari; Inamdar, Nitin; Subramanian, P. G.; Gujral, Sumeet; Shet, Tanuja; Epari, Sridhar; Nair, Reena

    2016-01-01

    Background & objectives: Multiple myeloma (MM) is a plasma cell malignancy characterized by cytogenetic heterogeneity. In comparison with conventional karyotyping, fluorescence in situ hybridization (FISH) can efficiently detect various genetic changes in non-cycling plasma cells in 50-90 per cent of MM cases. The present study was undertaken in MM patients to evaluate the frequency and clinico-pathological significance of various cytogenetic abnormalities in the Indian population. Methods: Interphase FISH was applied on purified plasma cells of 475 patients with MM using specific probes. Interphase FISH for 1q gain/1q amplification was performed on a separate group of 250 newly diagnosed MM patients. Results: Low frequency of Δ13 [-13/del(13q)] (32%) and t(11;14) (5%) was observed in our 475 patients probably due to ethnic diversity. Clustering of Δ13, del(17) (p13.1) and IgH translocations in non-hyperdiploidy confirmed prognostic significance of ploidy in MM. t(4;14) and del(17) (p13.1) were high-risk groups due to correlation with high serum β2-microglobulin, increased plasma cells and advanced disease. Hyperdiploidy and t(14;16) were associated with higher age group. In a separate group of 250 patients, 1q amplification [amp(1q)] in combination with Δ13 and/or del(17p) with t(4;14) revealed association with adverse clinico-laboratory features, which confirmed progressive role of amp(1q) with adverse prognostic impact. Amp(1q) was clustered at 1q21 and 1q25 loci. Interpretation & conclusions: Based on our findings, it appears that comprehensive analysis of various cytogenetic aberrations by interphase FISH is a powerful strategy being adapted for risk stratification of MM. PMID:28256461

  11. DNA Copy Number Aberrations, and Human Papillomavirus Status in Penile Carcinoma. Clinico-Pathological Correlations and Potential Driver Genes

    PubMed Central

    Lambros, Maryou; Stankiewicz, Elzbieta; Ng, Charlotte K. Y.; Weigelt, Britta; Rajab, Ramzi; Tinwell, Brendan; Corbishley, Cathy; Watkin, Nick; Berney, Dan; Reis-Filho, Jorge S.

    2016-01-01

    Penile squamous cell carcinoma is a rare disease, in which somatic genetic aberrations have yet to be characterized. We hypothesized that gene copy aberrations might correlate with human papillomavirus status and clinico-pathological features. We sought to determine the spectrum of gene copy number aberrations in a large series of PSCCs and to define their correlations with human papillomavirus, histopathological subtype, and tumor grade, stage and lymph node status. Seventy formalin-fixed, paraffin embedded penile squamous cell carcinomas were centrally reviewed by expert uropathologists. DNA was extracted from micro-dissected samples, subjected to PCR-based human papillomavirus assessment and genotyping (INNO-LiPA human papillomavirus Genotyping Extra Assay) and microarray-based comparative genomic hybridization using a 32K Bacterial Artificial Chromosome array platform. Sixty-four samples yielded interpretable results. Recurrent gains were observed in chromosomes 1p13.3-q44 (88%), 3p12.3-q29 (86%), 5p15.33-p11 (67%) and 8p12-q24.3 (84%). Amplifications of 5p15.33-p11 and 11p14.1-p12 were found in seven (11%) and four (6%) cases, respectively. Losses were observed in chromosomes 2q33-q37.3 (86%), 3p26.3-q11.1 (83%) and 11q12.2-q25 (81%). Although many losses and gains were similar throughout the cohort, there were small significant differences observed at specific loci, between human papillomavirus positive and negative tumors, between tumor types, and tumor grade and nodal status. These results demonstrate that despite the diversity of genetic aberrations in penile squamous cell carcinomas, there are significant correlations between the clinico-pathological data and the genetic changes that may play a role in disease natural history and progression and highlight potential driver genes, which may feature in molecular pathways for existing therapeutic agents. PMID:26901676

  12. Cystic lung lesions in Sjogren syndrome: analysis of lymphocyte subsets in tissue with clinico-radiologic-pathologic correlation.

    PubMed

    Jagirdar, Jaishree; Chikkamuniyappa, Shylashree; Sirohi, Deepika; McCarthy, Michael J; Peters, Jay I

    2013-02-01

    Pulmonary complications associated with Sjögren syndrome (SS) have attracted attention in recent years. Sjögren syndrome has been associated with small cyst formation in salivary glands, thymus, and lungs and has been recently brought to the forefront by radiologists due to high-resolution techniques. However, pathologists are less aware of this finding unless clinico-radiologic-pathologic correlation is sought. Formation of large bullae in SS is a rare complication with potential for confusion with other diseases. Here, we present the clinical, radiologic, and pathologic findings in 3 patients with SS associated with multiple pulmonary cystic lesions. All 3 patients had a variable mixed restrictive and obstructive component of the disease. There was good correlation with the pulmonary function tests (PFTs), high-resolution computed tomographic scan, and morphology with regard to the restrictive component. The small cysts appear to correlate with the extent of obstructive changes on the PFTs. However, the large bullae do not, implying noncommunication with the conducting airways. This noncorrelation between the PFTs and extent of bullous disease with predominant involvement of lower lobes in SS enables distinction from bullous emphysema. The mechanism of bulla formation in SS appears to be different from bullous emphysema. A check valve mechanism has been proposed previously in SS, which does not explain cyst formation in the thymus. Alternately, inflammation may play a role with the key suspects being CD4 T-helper cells and perhaps NK cells. This is the first report of a clinico-radiologic-pathologic correlation with analysis of lymphocyte subsets.

  13. RUNX1 mutations in acute myeloid leukemia are associated with distinct clinico-pathologic and genetic features.

    PubMed

    Gaidzik, V I; Teleanu, V; Papaemmanuil, E; Weber, D; Paschka, P; Hahn, J; Wallrabenstein, T; Kolbinger, B; Köhne, C H; Horst, H A; Brossart, P; Held, G; Kündgen, A; Ringhoffer, M; Götze, K; Rummel, M; Gerstung, M; Campbell, P; Kraus, J M; Kestler, H A; Thol, F; Heuser, M; Schlegelberger, B; Ganser, A; Bullinger, L; Schlenk, R F; Döhner, K; Döhner, H

    2016-11-01

    We evaluated the frequency, genetic architecture, clinico-pathologic features and prognostic impact of RUNX1 mutations in 2439 adult patients with newly-diagnosed acute myeloid leukemia (AML). RUNX1 mutations were found in 245 of 2439 (10%) patients; were almost mutually exclusive of AML with recurrent genetic abnormalities; and they co-occurred with a complex pattern of gene mutations, frequently involving mutations in epigenetic modifiers (ASXL1, IDH2, KMT2A, EZH2), components of the spliceosome complex (SRSF2, SF3B1) and STAG2, PHF6, BCOR. RUNX1 mutations were associated with older age (16-59 years: 8.5%; ⩾60 years: 15.1%), male gender, more immature morphology and secondary AML evolving from myelodysplastic syndrome. In univariable analyses, RUNX1 mutations were associated with inferior event-free (EFS, P<0.0001), relapse-free (RFS, P=0.0007) and overall survival (OS, P<0.0001) in all patients, remaining significant when age was considered. In multivariable analysis, RUNX1 mutations predicted for inferior EFS (P=0.01). The effect of co-mutation varied by partner gene, where patients with the secondary genotypes RUNX1(mut)/ASXL1(mut) (OS, P=0.004), RUNX1(mut)/SRSF2(mut) (OS, P=0.007) and RUNX1(mut)/PHF6(mut) (OS, P=0.03) did significantly worse, whereas patients with the genotype RUNX1(mut)/IDH2(mut) (OS, P=0.04) had a better outcome. In conclusion, RUNX1-mutated AML is associated with a complex mutation cluster and is correlated with distinct clinico-pathologic features and inferior prognosis.

  14. In phyllodes tumour of the breast expression of c-kit but not of ALDH1A1 is associated with adverse clinico-pathological features.

    PubMed

    Chougule, Abhijit; Bal, Amanjit; Das, Ashim; Kohli, Pavneet Singh; Singh, Gurpreet

    2016-12-01

    Attempts at identification of an ideal prognostic/predictive biomarker in phyllodes tumour (PT) have not been fruitful so far. Studies evaluating c-kit expression in PT have shown contradictory results. Recently aldehyde dehydrogenase 1A1 (ALDH1A1) was proposed as a stem cell marker for malignant PT but its expression has not been studied in benign and borderline tumours. We aimed to evaluate expression and prognostic significance of c-kit and ALDH1A1 in different grades of PT. Epithelial and stromal c-kit and ALDH1A1 expression were studied in 104 PT cases (86 primary and 18 recurrent tumours) and compared with different clinico-pathological features and recurrence rates. Stromal c-kit expression at 1 % cutoff correlated with increasing tumour grade, larger tumour size, hypercellularity, nuclear atypia, stromal overgrowth, infiltrative margins and mitotic count. These associations, however, were lost with higher (5 or 10 %) cutoffs. Conversely, decreased c-kit expression in the epithelial component correlated with increasing tumour grade, regardless of the cutoffs used. Stromal ALDH1A1 expression did not have significant associations with tumour grade or other adverse clinico-pathological features, regardless of different cutoffs. None of the cases showed significant epithelial ALDH1A1 expression. Expression of c-kit was associated with poorer overall survival (p = 0.011), while ALDH1A1 expression was associated with shorter recurrence-free survival (p = 0.036). In conclusion, c-kit expression was associated with higher tumour grade and adverse clinico-pathological features. However, these associations are cutoff dependent, partly explaining the variability in previously reported studies. ALDH1A1 expression did not have significant correlations with tumour grade and adverse clinico-pathological variables.

  15. Bilateral submandibular gland aplasia with clinico-radiological mass due to prolapsing sublingual salivary tissue through mylohyoid boutonniere: a case report and review.

    PubMed

    Ahmed, M; Strauss, M; Kassaie, A; Shotelersuk, V; DeGuzman, R

    2009-02-01

    Aplasia of major salivary glands is very rare. Compensatory hypertrophy of the rest of the glands can result in clinico-radiological masses. We present a report of a rare case of non-syndromic bilateral submandibular gland aplasia with hypertrophied sublingual salivary tissue, the latter herniating through mylohyoid boutonnière to present as a palpable mass on the left side with corresponding CT findings. Multiplanar evaluation is emphasised by utilizing multidetector CT.

  16. Clinico-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: a retrospective study.

    PubMed

    Mallhi, Tauqeer Hussain; Khan, Amer Hayat; Adnan, Azreen Syazril; Sarriff, Azmi; Khan, Yusra Habib; Jummaat, Fauziah

    2015-09-30

    The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease. A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF. A total 667 dengue patients (30.69 ± 16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P < 0.05) associated with DHF than DF. Multivariate regression analysis demonstrated presence of age > 40 years (OR: 4.1, P < 0.001), secondary infection (OR: 2.7, P = 0.042), diabetes mellitus (OR: 2.8, P = 0.041), lethargy (OR: 3.1, P = 0.005), thick gallbladder (OR: 1.7, P = 0.029) and delayed hospitalization (OR: 2.3, P = 0.037) as independent predictors of DHF. Overall mortality was 1.2 % in our study. Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile. Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF. Prior knowledge of expected

  17. First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases.

    PubMed

    Elidrissi Errahhali, Manal; Elidrissi Errahhali, Mounia; Ouarzane, Meryem; El Harroudi, Tijani; Afqir, Said; Bellaoui, Mohammed

    2017-01-09

    Breast cancer is the most frequent malignancy among women in Eastern Morocco. In this paper, we provide the first report on molecular breast cancer subtypes in this region. This is the largest population-based study on breast cancer among Moroccan women. We analyzed 2260 breast cancer cases diagnosed at the Hassan II Regional Oncology Center between October 2005 and December 2012. Clinico-pathological and therapeutic features were studied. Molecular subtypes were determined and their associations with the clinico-pathological characteristics of the tumors were examined. The mean age at diagnosis was 48.7 years ±11.4. Invasive ductal carcinoma was the predominant histological type (77.1%), followed by lobular invasive carcinoma (15.3%). The mean size of breast tumors was 3.5 cm ± 1.96, and 84% of our patients are diagnosed with tumors of more than 2 cm. Histological grade II tumors were the most frequent (70.4%), followed by advanced histological grade (18%). Lymph node positive tumors were observed in 64.8% of cases and 29.3% of patients had distant metastasis. Most tumors were hormone receptor-positive (73%) and 28.6% were HER2 positive. 86.1% of patients with hormone receptor-positive breast cancer were given hormone therapy, while 68.9% of patients with HER2+ breast cancer received targeted therapy with Herceptin. Luminal A was the commonest molecular subtype, followed by Luminal B, Triple Negative and HER2. The highest prevalence of premenopausal patients was observed in Triple Negative subtype (72.2%), followed by HER2 (64.1%), Luminal B (62.2%), and Luminal A (55.1%). Luminal B subtype had a poorer prognosis than Luminal A. Compared with Triple Negative, HER2 subtype tend to spread more aggressively and is associated with poorer prognosis. Unlike Western countries, breast cancer occurs at an earlier age and is diagnosed at a more advanced stage in Eastern Morocco. In this region, hormone receptor-positive tumors are predominant and so the majority of

  18. Molecular profiles of BRCA1-mutated and matched sporadic breast tumours: relation with clinico-pathological features

    PubMed Central

    Berns, E M J J; Staveren, I L van; Verhoog, L; Ouweland, A M W van de; Gelder, M Meijer-van; Meijers-Heijboer, H; Portengen, H; Foekens, J A; Dorssers, L C J; Klijn, J G M

    2001-01-01

    About 5–10% of breast cancers are hereditary; a genetically and clinically heterogeneous disease in which several susceptibility genes, including BRCA1, have been identified. While distinct tumour features can be used to estimate the likelihood that a breast tumour is caused by a BRCA1 germline mutation it is not yet possible to categorize a BRCA1 mutated tumour. The aim of the present study is to molecularly classify BRCA1 mutated breast cancers by resolving gene expression patterns of BRCA1 and matched sporadic surgical breast tumour specimens. The expression profiles of 6 frozen breast tumour tissues with a proven BRCA1 gene mutation were weighed against those from 12 patients without a known family history but who had similar clinico-pathological characteristics. In addition two fibroblast cultures, the breast cancer cell-line HCC1937 and its corresponding B-lymphoblastoid cell line (heterozygous for mutation BRCA1 5382insC) and an epithelial ovarian cancer cell line (A2780) were studied. Using a high density membrane based array for screening of RNA isolated from these samples and standard algorithms and software, we were able to distinguish subgroups of sporadic cases and a group consisting mainly of BRCA1-mutated breast tumours. Furthermore this pilot analysis revealed a gene cluster that differentially expressed genes related to cell substrate formation, adhesion, migration and cell organization in BRCA1-mutated tumours compared to sporadic breast tumours. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11506493

  19. Clinico-anesthetic changes following administration of propofol alone and in combination of meperidine and pentazocine lactate in dogs

    PubMed Central

    Anandmay, A. K.; Dass, L. L.; Sharma, A. K.; Gupta, M. K.; Singh, K. K.; Roy, B. K.

    2016-01-01

    Aim: The aim of this study is to find out the effect of propofol and its combination with meperidine and pentazocine lactate on certain clinico-anesthetic profiles in dogs. Materials and Methods: 15 apparently healthy mongrel dogs of either sex of about 1 year of age were randomly divided into three groups of five dogs each. The animals of Group I were administered propofol intravenously alone “to effect,” whereas meperidine at 2 mg/kgb.wt. and pentazocine lactate at 2 mg/kg b.wt. were injected intramuscularly 15 min before propofol “to effect” in Groups II and III, respectively. Atropine sulfate at 0.04 mg/kgb.wt. was injected intramuscularly 20 min before each treatment. Rectal temperature, heart rate, respiration rate, and anesthetic indices were recorded before and at 5, 10, 20, 30, and 60 min of induction. Results: As compared to Group I, the animals of Groups II and III exhibited a significant decrease (p<0.05) in the level of rectal temperature, respiration rate, and heart rate. Duration of recumbency, time of standing, time of recovery as well as the duration of analgesia were longer in pentazocine lactate (Group III) followed by meperidine (Group II) as compared to propofol alone (Group I). Meperidine treated dogs showed defecation and muscle twitching during anesthesia. Conclusion: Meperidine and pentazocine are suitable opioids used in combination with propofol for achieving surgical anesthesia and helpful in reduction of propofol dose. PMID:27956765

  20. Clinico-pathological and therapeutic evaluation of Black Bengal goats (Capra hircus) infested with Psoroptes cuniculi mange.

    PubMed

    Kumar, Mritunjay; Pal, Bhabatosh; Purkayastha, R D; Roy, Joybrath

    2016-03-01

    The objective of the present study was to investigate the clinico-pathological changes and therapeutic evaluation of gamma-benzene hexachloride and cetrimide along with vit A, D3, E and H in Black Bengal goat infested Psoroptes cuniculi mange. The study was conducted on 14 Black Bengal goats; 6 clinically infested with Psoroptes mange (group I) and 8 healthy goats (group II). Haemato-biochemical profile viz., haemoglobulin concentration, packed cell volume, total leukocyte count, albumin and albumin globulin ratio revealed significantly (P < 0.05) decreased level; whereas, globulin, alanine aminotransaminase, aspartate aminotransaminase, serum creatinine and blood urea nitrogen level were significantly (P < 0.05) increased in goats of group I animals as compared to healthy control (group II) on day 0. Gamma-benzene hexachloride and cetrimide along with adjunct therapy (group I) showed parasitological recovery on day 21 while complete elimination of clinical signs observed on day 28 of post-therapy in all clinical cases.

  1. The clinico-surgico-pathological spectrum of myxopapillary ependymomas--report of four unusal cases and review of the literature.

    PubMed

    Schittenhelm, J; Becker, R; Capper, D; Meyermann, R; Iglesias-Rozas, J R; Kaminsky, J; Mittelbronn, M

    2008-01-01

    According to the WHO grading system, myxopapillary ependymomas are assigned to WHO Grade I. However, the clinico-pathological spectrum might be very heterogenous. Herein, we report 4 cases exhibiting lumbar tumor masses, 1 causing muscular atrophy over a 30-year period, 3 displaying clinical history of persisting lumbar pain for only several weeks. All tumors were crooked with dura and spinal roots resulting in incomplete resection in three cases. On histological examination, two tumors were almost acellular and showed polycyclic hyaline and fibrotic extracellular matrix leading to differential diagnoses of chordoma, meningioma, fibrolipoma and ependymoma. Finally, together with the immunohistochemical investigations, electron microscopy led to the diagnosis of myxopapillary ependymoma, WHO Grade I, with massive degenerative changes. The other 2 cases presented with the typical neuropathology of myxopapillary ependymomas but showed local recurrence within 1 and 13 years throughout the whole neuraxis, and in 1 case additional metastases of the 3rd ventricle. Although the morphological feature of these myxopapillary ependymomas was benign, the presented cases showed that the biological behavior of myxopapillary tumors might differ greatly and that these tumors present a serious operative and diagnostic challenge. Myxopapillary ependymomas occur most often in the lumbosacral region. Due to the anatomic complexity of the cauda equina, a complete resection can be technically challenging in this region. However, a gross total resection at the primary surgery is the most predictive factor for the outcome.

  2. Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation

    PubMed Central

    Demir, Mustafa Kemal; Yapıcıer, Özlem; Onat, Elif; Toktaş, Zafer Orkun; Akakın, Akın; Urgun, Kamran; Kılıç, Türker

    2014-01-01

    There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated dural neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clinico-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management. PMID:25010368

  3. PAH exposure biomarkers are associated with clinico-chemical changes in the brick kiln workers in Pakistan.

    PubMed

    Kamal, Atif; Malik, Riffat Naseem; Martellini, Tania; Cincinelli, Alessandra

    2014-08-15

    In this study we investigated the clinico-chemical parameters and the level of exposure of brick kiln workers to polycyclic aromatic hydrocarbons (PAHs) in Punjab (Pakistan). The brick kiln workers and a non-occupationally exposed group were recruited for comparative analysis of urinary biomarkers of PAH exposure (i.e. 1-hydroxypyrene (1-OHPyr), α-naphthol and β-naphthol) and blood level of superoxide dismutase (SOD), as a biomarker of oxidative stress and other hematologic parameters. Questionnaires were used to document information on socio-demographic characteristics of all the subjects. The analysis of urinary biomarkers showed higher median concentrations of 1-OHPyr, and α- and β-naphthols in brick kiln workers (1.53, 3.65 and 1.53 μmol/mol-Cr, respectively) than non-occupationally exposed group (0.62, 0.64 and 0.66 μmol/mol-Cr, respectively). The 1-OHPyr in brick kiln workers was above the occupational exposure level. Among the clinical parameters of brick kiln workers, hemoglobin (Hb) and red blood cells (RBCs) were very low and closely associate with 1-OHPyr and β-naphthol. Additionally, the white blood cells (WBCs) and superoxide dismutase (SOD) were also elevated in brick kiln workers, which suggested inflammatory symptoms and high oxidative stress. The results show that regardless of possibly being affected by the poor nutrition, the anemic state and hematological changes observed in brick kiln workers may be associated with their exposure to smoke present in the environment of brick kilns. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Survival Prediction Model Using Clinico-Pathologic Characteristics for Nonsmall Cell Lung Cancer Patients After Curative Resection.

    PubMed

    Wu, Ching-Yang; Fu, Jui-Ying; Wu, Ching-Feng; Hsieh, Ming-Ju; Liu, Yun-Hen; Wu, Yi-Cheng; Yang, Cheng-Ta; Tsai, Ying-Huang

    2015-11-01

    The current TNM staging system did not provide disease relapse information. The aim of study was try to establish a predictive survival model for disease and overall survival in nonsmall cell lung cancer patients who presented as resectable disease and to develop a reference for follow-up imaging tool selection.From January 2005 to December 2011, 442 patients who initially presented as resectable disease (stages I-IIIa) and received anatomic resection and mediastinal lymph node dissection were included in the study.Medical charts were thoroughly reviewed and clinico-pathologic factors were collected and analyzed.Visceral pleural invasion, tumor size >5 cm, and postoperative adjuvant therapy were identified as risk factors for poorer disease-free survival. The 5-year disease-free survival from score 0 to 3 was 68.7%, 46.6%, 31.9%, and 26.1%, respectively. The disease relapse percentage for scores 0 to 3 were 26.49%, 50.61%, 65.05%, and 73.81%, respectively. For analysis of overall survival, age >60 years, tumor size >3 cm, and total metastatic lymph node ratio >0.05 were correlated to worse overall survival. Because greater age may be correlated with poor general condition, we re-scored risk factors that correlated to disease severity that ranging from 0 to 2. The 5-year overall survival range from score 0 to 2 was 56.3%, 43.1%, and 13.1%, respectively.Poor prognostic factors correlated to disease-free survival were tumor size >5 cm, visceral pleural invasion, and patients needing to receive postoperative adjuvant therapy. Disease-free survival of resectable nonsmall cell lung cancer patients and disease relapse can be stratified by these 3 factors. Chest tomography may be recommended for patients with 1 or more poor disease-free survival risk factors.

  5. Chronic lymphocytic leukemia in the elderly: clinico-biological features, outcomes, and proposal of a prognostic model.

    PubMed

    Baumann, Tycho; Delgado, Julio; Santacruz, Rodrigo; Martínez-Trillos, Alejandra; Royo, Cristina; Navarro, Alba; Pinyol, Magda; Rozman, María; Pereira, Arturo; Villamor, Neus; Aymerich, Marta; López, Cristina; Carrió, Anna; Montserrat, Emili

    2014-10-01

    We investigated the clinico-biological features, outcomes, and prognosis of 949 patients with chronic lymphocytic leukemia according to age. No biological differences (cytogenetics by fluorescent in situ hybridization, IGHV, ZAP-70, CD38, NOTCH1, SF3B1) were found across age groups. Elderly patients (>70 years; n=367) presented more frequently with advanced disease (Binet C/Rai III-IV: 10/12% versus 5/5%; P<0.001), were treated less frequently (23.8% versus 41.9% at 3 years; P<0.001) and in most cases did not receive highly effective regimens and thus had a lower overall response rate (49% with 14% having complete responses versus 69% with 31% having complete responses; P<0.001). The elderly patients also had a shorter overall survival (6.6 versus 13.3 years; P<0.001) and higher disease-unrelated mortality (34.9% versus 6.9% at 10 years; P<0.001). However, disease-attributable mortality was not significantly different between younger and older patients. A combination of Binet stage, ZAP-70 level, β2-microglobulin concentration and comorbidity identified two risk groups (low-risk: 0-1 parameters; high-risk: 2-4 parameters) with different overall survivals (median: 6.8 versus 11.4 years, P<0.001). In patients requiring treatment, comorbidity at treatment (Cumulative Illness Rating Scale-T>4; hazard ratio 2.2, P<0.001) and response (treatment failure versus response: hazard ratio 1.60, P<0.04) were the most important prognostic factors for overall survival. In conclusion, in our series, elderly patients with chronic lymphocytic leukemia did not present with any biological features distinct from those of younger patients, but did have a poorer clinical outcome. This study highlights the importance of comprehensive medical care, achieving response to therapy, and specific management strategies for elderly patients with chronic lymphocytic leukemia.

  6. Evolution of Charcot-Marie-Tooth disease type 1A duplication: a 2-year clinico-electrophysiological and lower-limb muscle MRI longitudinal study.

    PubMed

    Pelayo-Negro, Ana L; Gallardo, Elena; García, Antonio; Sánchez-Juan, Pascual; Infante, Jon; Berciano, José

    2014-04-01

    The objective of this study was to analyze Charcot-Marie-Tooth disease type 1A (CMT1A) evolution. We conducted a 2-year longitudinal study in 14 CMT1A patients and 14 age- and sex-matched controls. In the patients, we performed neurological examination with hand-held dynamometry, electrophysiology, and lower-limb muscle MRI, both at baseline and 2 years later, while controls were examined at baseline only. Patients' ages ranged from 12 to 51 years. Outstanding manifestations on initial evaluation included pes cavus, areflexia, lower-limb weakness, and foot hypopallesthesia. In evaluating muscle power, good correlation was observed between manual testing and dynamometry. Compared to controls, Lunge, 10-Meter-Walking, and 9-Hole-Peg tests were impaired. Their CMT neuropathy score and functional disability scale showed that patients exhibited mild phenotype and at most slight walking difficulty. Electrophysiology revealed marked nerve conduction slowing and variable compound muscle action potential amplitude reduction. On lower-limb muscle MRI, there was distally accentuated fatty infiltration accompanied by edema in calf muscles. All these clinico-electrophysiological and imaging findings remained almost unaltered during monitoring. Using multivariate analysis, no significant predictors of progression associated to the disease were obtained. We conclude that in the 2-year period of study, CMT1A patients showed mild progression with good concordance between clinico-electrophysiological and imaging findings.

  7. Clinico-Pathological Spectrum and Novel Karyotypic Findings in Myelodysplastic Syndrome: Experience of Tertiary Care Center in India

    PubMed Central

    Gupta, Ruchi; Rahman, Khaliqur; Singh, Manish Kumar; Kumari, Surabhi; Yadav, Geeta; Nityanand, Soniya

    2017-01-01

    Background Myelodysplastic syndrome (MDS) is a heterogeneous disorder characterized clinically by the presence of cytopenia/s. Limited data are available about the morphological spectrum and cytogenetic profile of Indian MDS patients. The aim of the study was to ascertain the clinico-pathological, morphological and cytogenetic spectrum of Indian MDS patients. Material and methods A retrospective analysis of all patients diagnosed with MDS from June 2012 to December 2016 was performed. Their clinical and laboratory data were collated and reviewed. Results A total of 150 patients with primary MDS were evaluated with M: F ratio of 1.6:1 and the median age of 55.5 years. 64% patients presented with pancytopenia and 31% with bicytopenia. Morphologically they included MDS-MLD [63 (42%)], MDS-EB 2, [33 (22%)], MDS-EB 1 [32 (21.3%)], MDS-SLD [13 (8.6%)] and two cases (1.4%) each of MDS-SLD-RS, MDS-MLD-RS, and RCC. An abnormal cytogenetic profile was detected in 50% patients. Complex karyotype was observed to be the commonest abnormality (32.5%), and chromosome 7 was the most frequently involved chromosome. Isolated deletion 5q was seen in 6.9 % cases. Novel translocations like t(9;22)(q11.2;q34.2), t(1;5)(p22;q33), t(1;12)(p34;p11.2) and t(5;7;9)(q13;q32;p22) were observed in addition to other complex abnormalities. The majority of the patients belonged to the high risk IPSS-R prognostic groups (31.4%); followed by intermediate and very high-risk groups, 29% and 24.4% respectively. Conclusion The median age of patients in India is a decade younger than the western population. Complex karyotype was observed to be the commonest cytogenetic abnormality, while the frequency of deletion 5q and trisomy 8 was much lower as compared to the west. The majority of the patients were in high to very high IPSS-R risk categories and seventy percent individuals below 40 years showed abnormal karyotype, indicating that Indian MDS patients have high disease burden at a young age and thus

  8. Cyclooxygenase-2 (COX2) and p53 protein expression are interdependent in breast cancer but not associated with clinico-pathological surrogate subtypes, tumor aggressiveness and patient survival.

    PubMed

    Serra, Katia Piton; Peres, Raquel Mary Rodrigues; Sarian, Luis Otávio; Vassallo, José; Pinto, Glauce Aparecida; Silva, Geisilene Russano de Paiva; Soares, Fernando Augusto; da Cunha, Isabela Werneck; Espinola, Juliana; Bento, Adriano Mesquita; Del Corso, Leticia Marinho; Derchain, Sophie

    2016-03-01

    In the last decade, different molecular subtypes of breast cancer have been proposed. Although displaying appreciable association with disease prognosis and the prognostic value of cytotoxic and endocrine therapeutic modalities, the subtypes seem to fail at completely explaining disease behavior and response to treatment. Molecules such as those of the cyclocooxigenase (COX) family, currently composed of three entities (COX 1, 2 and 3) have been shown to be associated with breast carcinogenesis, and the analysis of p53 expression in breast tumors may also offer some additional prognostic clues. Our study is aimed at assessing COX2 and p53 expression in these clinico-pathological surrogate subtypes, and to evaluate whether the expression of these molecules can help further explain the variability in prognosis still found within the clinico-pathological subtypes groups of breast cancer. A total of 183 breast cancer samples were obtained from women treated at the Womeńs Hospital of Campinas State University, Campinas, Brazil, between June 2008 and January 2011. Immunohistochemistry was performed to detect the expression of ER, PR, ki67, COX2, and p53 and the HER2 status of the 183 specimens was assessed using FISH. Two COX2 staining thresholds were used to define COX2 positivity: low threshold (LT): moderate and intense staining were considered positive; high-threshold (HT): only intense staining was considered positive. There was no trend in COX2 overexpression from Luminal A-like to Triple-negative subtypes. By contrast, p53 was expressed in roughly 67% of the Luminal A-like tumors, 50% of the Luminal B-like HER2 positive tumors, 60.9% of the Luminal B-like HER2 negative, approximately 82% of the HER2 positive (non-luminal) and 87% of the Triple-negative tumors (p for trends=0.06). There was a significantly higher proportion of COX2 positive (LT) tumors (66.9%) when p53 was also positive compared to when the tumor was negative for p53 (in which case only18.0% of

  9. [Clinico-radiological profile of acute disseminated encephalomyelitis in the childhood population. A retrospective analysis of a series of 20 patients in a tertiary hospital].

    PubMed

    Tomás-Vila, Miguel; Menor, Francisco; Otero-Reigada, M Carmen; Pérez-Tamarit, Amparo; Téllez de Meneses, Montserrat; Pitarch-Castellanos, Inmaculada

    2014-01-01

    Introduccion. La encefalomielitis aguda diseminada (EAD) es un trastorno inflamatorio del sistema nervioso central mediado inmunologicamente y de patogenia desconocida. Puede presentarse en cualquier edad, pero es mucho mas frecuente en niños. La EAD no tiene marcador biologico especifico y el diagnostico se basa en hallazgos clinicos y neurorradiologicos. Objetivo. Mejorar el conocimiento del perfil clinicorradiologico de esta enfermedad. Pacientes y metodos. Estudio retrospectivo con inclusion de pacientes menores de 14 años ingresados en un hospital terciario en los ultimos 15 años con el diagnostico de EAD. Se revisaron antecedentes, signos clinicos de presentacion, datos analiticos en sangre/liquido cefalorraquideo y la semiologia radiologica. En 16 casos se realizo un seguimiento medio de 25 meses. Resultados. Se revisaron 20 pacientes, un 70% niños, con una edad media de 4,4 años. El 40% tuvo un episodio febril previo. El 85% presento fiebre o vomitos, y el 70%, afectacion del estado de consciencia. Predominaron los deficits motores (45%), las convulsiones (35%) y la afectacion de pares craneales (30%). Tres niños presentaron una evolucion recidivante, y otros tres, secuelas motoras. Los estudios de resonancia magnetica mostraron lesiones hiperintensas en secuencias T2, con patron de realce escaso o nulo, que predominaron en los talamos (70%), la medula (67%) y la sustancia blanca subcortical (50%). En dos pacientes se diagnostico EAD hemorragica. Conclusiones. La EAD representa una entidad con importante afectacion general y repercusion neurologica, que muestra un potencial secuelar considerable. Los datos clinicoanaliticos y la resonancia magnetica cerebral y medular son relevantes para el diagnostico inicial y seguimiento de pacientes con EAD.

  10. Japanese encephalitis associated acute encephalitis syndrome cases in West Bengal, India: A sero-molecular evaluation in relation to clinico-pathological spectrum.

    PubMed

    Sarkar, Arindam; Datta, Somenath; Pathak, Bani K; Mukhopadhyay, Subhra K; Chatterjee, Shyamalendu

    2015-08-01

    Japanese encephalitis (JE) is a major public health problem in Asia and worldwide and it is responsible mainly for viral acute encephalitis syndrome (AES). The sole etiologic agent of JE is Japanese encephalitis virus (JEV). Although JE/AES cases have been regarded traditionally as a disease of children, a growing number of patients with JE/AES cases are also seen in the adult age group every year in the state of West Bengal, India in spite of vaccination. Therefore, a systematic study was performed to differentiate and characterize the clinico-pathological parameters and viral diversity among the patients of different age groups. Viral diversity was also evaluated from the JE/AES cases, depending on their disease severity. A total of 441 JE/AES cases were included in this study. By MAC-ELISA, 111 samples were found JEV IgM positive and among the IgM negative cases, 26 samples were found RT-PCR positive against JEV infection. Neck rigidity, abnormal behavior, convulsion, protein in CSF, WBC in CSF, and aspartate transaminase in blood differed significantly among the patients of pediatric-adolescent and adult group in both IgM positive and RT-PCR positive cases. Viral diversity was increased significantly in the pediatric-adolescent group compared to adult patients. Interestingly, with the rise in disease severity the viral diversity was found to be increased among the patients, irrespective of their age distribution. Based on clinico-pathological parameters and analysis of viral diversity, it can be concluded that viral diversity which occurs naturally is likely to affect disease severity, especially in the patients of pediatric-adolescent group. © 2015 Wiley Periodicals, Inc.

  11. CROP – The Clinico-Radiologico-Ophthalmological Paradox in Multiple Sclerosis: Are Patterns of Retinal and MRI Changes Heterogeneous and Thus Not Predictable?

    PubMed Central

    Rauschka, Helmut; Beutelspacher, Sven; Kukurová, Ivica Just; Valkovič, Ladislav; Khan, Adnan; Prayer, Daniela; Kristoferitsch, Wolfgang

    2015-01-01

    Background To date, no direct scientific evidence has been found linking tissue changes in multiple sclerosis (MS) patients, such as demyelination, axonal destruction or gliosis, with either steady progression and/or stepwise accumulation of focal CNS lesions. Tissue changes such as reduction of the retinal nerve fiber layer (RNFL) and the total macular volume (TMV), or brain- and spinal cord atrophy indicates an irreversible stage of tissue destruction. Whether these changes are found in all MS patients, and if there is a correlation with clinical disease state, remains controversial. The objective of our study was to determine, whether there was any correlation between the RNFL or TMV of patients with MS, and: (1) the lesion load along the visual pathways, (2) the ratios and absolute concentrations of metabolites in the normal-appearing white matter (NAWM), (3) standard brain atrophy indices, (4) disease activity or (5) disease duration. Methods 28 MS patients (RRMS, n = 23; secondary progressive MS (SPMS), n = 5) with moderately-high disease activity or long disease course were included in the study. We utilised: (1) magnetic resonance imaging (MRI) and (2) -spectroscopy (MRS), both operating at 3 Tesla, and (3) high-resolution spectral domain-OCT with locked reference images and eye tracking mode) to undertake the study. Results There was no consistency in the pattern of CNS metabolites, brain atrophy indices and the RNFL/TMV between individuals, which ranged from normal to markedly-reduced levels. Furthermore, there was no strict correlation between CNS metabolites, lesions along the visual pathways, atrophy indices, RNFL, TMV, disease duration or disability. Conclusions Based on the findings of this study, we recommend that the concept of ‘clinico-radiologico paradox’ in multiple sclerosis be extended to CROP–‘clinico-radiologico-ophthalmological paradox’. Furthermore, OCT data of MS patients should be interpreted with caution. PMID:26565967

  12. [Correlation of clinico-neurological peculiarities and morphological signs of small hernias (protrusion) of the lumbar intervertebral discs in formation of discogenic pain syndromes in patients of different age].

    PubMed

    Khizhniak, M V; Makeeva, T I; Priĭmak, I V

    2014-01-01

    Morphological signs of small hernias (protrusion) of intervertebral discs (IVD), the results of a neurovisualizing methods of investigation and clinico-neurological features of osteochondrosis as well, were summarized. In young and middle age patients morphological chatacteristics of small hernias (protrusion) of IVD, data of neurovisualizing methods of investigation have had correlated with clinico-neurological features of the disease and were the key determinants while performance of the puncture laser microdiscectomy. In a middle age and elderly patients a weak correlation was noted between the IVD protrusion dimensions and intensity of a lumbar and radicular pain syndromes, functional activity (Osvestry index), what have had permitted to apply a pathogenetically substantiated method of a durable epidural pharmacotherapy. The investigation results witness the necessity of differentiated application of the puncture methods of treatment for the pain discogenic syndromes in patients of different age.

  13. Renal cell carcinoma co-existent with other renal disease: clinico-pathological features in pre-dialysis patients and those receiving dialysis or renal transplantation.

    PubMed

    Peces, Ramón; Martínez-Ara, Jorge; Miguel, José Luis; Arrieta, Javier; Costero, Olga; Górriz, José Luis; Picazo, Mari-Luz; Fresno, Manuel

    2004-11-01

    Patients on chronic dialysis are prone to developing acquired cystic kidney disease (ACKD), which may lead to the development of renal cell carcinoma (RCC). The risk factors for the development of RCC so far have not been determined in pre-dialysis patients with co-existent renal disease. The aim of this study was to evaluate the clinico-pathological features of RCC in pre-dialysis patients with associated renal diseases or in those undergoing chronic dialysis and renal transplantation. We studied 32 kidneys from 31 patients with RCC and associated renal diseases. Of those, 18 kidneys were from 17 patients not on renal replacement therapy (RRT) when diagnosed with RCC; 14 patients received dialysis or dialysis followed by renal transplantation. Several clinico-pathological features were analysed and compared between the two groups. Overall, there was a preponderance of males (75%); nephrosclerosis was the predominant co-existent disease (31%). The median intervals from renal disease to RCC in the dialysis and transplanted groups were significantly longer than in the pre-dialysis group (15.8+/-1.1 vs 2.4+/-0.7 years, P<0.0001). In contrast to pre-dialysis RCC, the dialysis and transplant RCC groups had greater frequency of ACKD (100 vs 28%, P<0.0001), papillary type RCC (43 vs 11%, P<0.05) and multifocal tumours (43 vs 5%, P<0.05). At the end of the study, 71% of dialysis and transplanted patients and 72% of pre-dialysis patients were alive. ACKD develops in dialysis patients, as it does in those with renal disease prior to RRT. The duration of renal disease, rather than the dialysis procedure itself, appears to be the main determinant of ACKD and RCC. The RCC occurring in patients with ACKD and prolonged RRT is more frequently of the papillary type and multifocal than the RCC occurring in patients with no or few acquired cysts and a short history of renal disease. Long-term outcomes did not differ between the two groups.

  14. Clinico-epidemiological analysis of Post kala-azar dermal leishmaniasis (PKDL) cases in India over last two decades: a hospital based retrospective study.

    PubMed

    Ramesh, V; Kaushal, Himanshu; Mishra, Ashwani Kumar; Singh, Ruchi; Salotra, Poonam

    2015-10-26

    Patients with Post kala-azar dermal leishmaniasis (PKDL) are considered a reservoir of Leishmania donovani. It is imperative to identify and treat them early for control of visceral leishmaniasis (VL), a current priority in the Indian subcontinent. We explored trends in clinico-epidemiological features of PKDL cases over last two decades, for improving management of the disease. Clinically suspected cases were diagnosed with rK39 strip test followed by parasitological confirmation by microscopy and/or PCR/qPCR in skin tissue/slit aspirates. Patients were treated with antimonials till 2008 and subsequently with miltefosine. The study indicated higher incidence of PKDL cases in areas of high endemicity for VL, with 20 % cases reporting no history of VL. Approximately 26 % cases of PKDL were initially misdiagnosed at primary health centers. Duration between onset of PKDL and diagnosis was above 12 months in 80 % cases. Diagnostic sensitivity was 32-36 % with microscopy and 96-100 % with PCR/qPCR. Compliance to treatment was over 85 % with miltefosine while 15 % with antimonials. Relapse rate with miltefosine was up to 13.2 %. PKDL patients tend to delay reporting and are often misdiagnosed. Confirmatory diagnosis using minimally invasive skin slit aspirate samples would help overcome such issues. There was a paradigm shift in compliance with miltefosine; however, increasing relapse rate indicated the need for newer therapies with oral formulations.

  15. Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009-2010).

    PubMed

    Kabapy, Ahmed F; Kotkat, Amira M; Shatat, Hanan Zakaria; Abd El Wahab, Ekram W

    2016-01-31

    Fever of unknown origin (FUO) is one of the most challenging diagnostic dilemmas in the field of infectious diseases and tropical medicine. Clinicians should use the frequency distribution of disorders causing FUO to guide their diagnostic approach in patients with prolonged, unexplained fevers meeting the definition of FUO. The present study was undertaken to examine the etiologies, clinico-epidemiologic profile, and prognosis of classical FUO in patients reporting to the Alexandria Fever Hospital in Egypt. Records of 979 patients admitted to the fever hospital (from January 2009 to January 2010) and diagnosed as having FUO were examined carefully. FUO was defined as three outpatient visits or three days in the hospital without elucidation of cause of fever. A total of 979 cases (57.0% males and 43.0% females), with ages ranging from 0.2 to 90 years, were investigated. The mean duration of fever before hospitalization was 31 ± 10 days. The etiology of FUO was delineated in 97% of cases, and only 3% remained undiagnosed. Diagnoses were grouped into five major categories. Infectious causes of FUO were strongly associated with better outcome (73.7% improved). Smoking, contact with animals or birds, drug addiction, and HIV seropositivity were important risk factors associated with infections. Infections are the most common cause of FUO, followed by collagen vascular diseases, in our region. A three-step diagnostic work-up approach is recommended to be applied in Egypt in order to improve the quality of medical service provided to FUO patients.

  16. [Shortening of PR interval, bradycardia and polymorphic ventricular tachycardia--clinico-electrocardiografical syndrome with high risk of sudden death in children].

    PubMed

    Makarov, L M; Kuryleva, T A; Chuprova, S N

    2003-01-01

    To elucidate clinical and electrocardiographical characteristics of children and adolescents with malignant idiopathic polymorphic ventricular tachycardia. Patients aged 6-14 years (n=16) with polymorphic bidirectional tachycardia registered either on standard 12-lead ECG (n=6), or during treadmill exercise test (n=2) and Holter ECG monitoring (n=8). None of the patients had overt heart or coronary artery disease, chronic extracardiac pathology or electrolyte disturbances. There was no QT, QT(s) prolongations, or ST segment elevations in right precordial leads. Eleven patients (68.8%) had shortening of PR interval -110 ms without signs of Wolf-Parkinson-White syndrome. All patients with shortened PR had history of syncopal states (9.1+/-9.2 per year), 4 patients (36.4%) had family history of sudden death in young age. Among patients without PR shortening 2 (40%) had history of syncopal attacks (1-2 or 0.6+/-0.89 per year). All patients with short PR had bradycardia while in sinus rhythm (55.5+/-9.1 bpm compared with 78.1+/-2.8 bpm in patients without PR shortening). Shortened PR and bradycardia were found to be associated with frequent attacks of syncope in this series of children with polymorphic tachycardia. Therefore combination of short PR, bradycardia and polymorphic ventricular tachycardia was suggested to comprise clinico-electrocardiographic syndrome with high risk of malignant ventricular tachyarrhythmia and sudden death.

  17. Clinico-socio-demographic profile and predictors of poor outcome in children with liver abscess: a hospital-based study in northern India.

    PubMed

    Ramachandran, Smita; Mishra, Kirtisudha; Choudhury, Subhasis Roy; Saxena, Rahul

    2012-10-01

    Liver abscess (LA) is a common health problem among children in tropical countries. We conducted a prospective, observational study at a tertiary-care medical college in order to examine the clinico-socio-demographic profile and assess a possible association between certain predictors of a poor outcome in children admitted with LA. Of a total of 53 children, only 24.4% were malnourished. Staphylococcus aureus was the most common organism observed. Amoebic LA was noted in 7.5%. Right-sided pleural effusion was the most common complication recorded (20.7%). The most successful treatment modality was therapeutic percutaneous aspiration with antimicrobials (90.5% success). An elevated alkaline phosphatase and open surgery were associated with a poor outcome (P = 0.04 in each case). The rate of hospital admissions of children with LA remains high and most are of pyogenic origin. Of the different treatment modalities, therapeutic aspiration along with antimicrobials achieved the best results. Raised alkaline phosphatase and open surgery were predictors of a poor outcome.

  18. The clinico-pathological conference, based upon Giovanni Battista Morgagni's legacy, remains of fundamental importance even in the era of the vanishing autopsy.

    PubMed

    Zampieri, Fabio; Rizzo, Stefania; Thiene, Gaetano; Basso, Cristina

    2015-09-01

    Walter Cannon and Richard Cabot inaugurated the clinico-pathological conference (CPC) at Harvard Medical School at the beginning of the twentieth century, but this approach to anatomo-clinical correlation was first introduced by Giovanni Battista Morgagni at the University of Padua in the eighteenth century. The CPC consists of the presentation of a clinical case, in which past and recent medical histories of the patient, with all relevant information about laboratory tests including biopsy results, therapy and, eventually in a fatal case, the autopsy, are discussed. This is done for an audience of trainees and all physicians involved in the care for the patient. The CPC is still in use in many academic hospitals, as a teaching tool not only for undergraduate and graduate medical trainees, but also for postgraduate continuous medical education, in spite of the progressively declining autopsy rate. CPCs represent the ideal occasion for fruitful discussion between the two "souls" of medicine, i.e., the clinical, with its focus on the patient, and the pathological, with its focus on understanding disease. To discontinue using them would be equal to denying that modern medicine originated in Morgagni's method.

  19. Combined effect of ampicillin, colistin and dexamethasone administered intramuscularly to dairy cows on the clinico-pathological course of E. coli-endotoxin mastitis.

    PubMed

    Ziv, G; Shem-Tov, M; Ascher, F

    1998-01-01

    The effects of a single intramuscular injection of a drug product containing ampicillin, colistin and dexamethasone, as a suspension in a diester of propylene glycol of medium-chain fatty acids, on the clinico-pathological course of experimental Escherichia coli-endotoxin mastitis was examined in 30 dairy cows. Cows were divided into five groups, six cows per group, and 24 of them were infused with E. coli endotoxin into two quarters of their udders. The drug product was injected at 25,000 IU colistin sulphate, 10.0 mg ampicillin anhydrate and 0.025 mg dexamethasone acetate.kg-1 body weight as follows: Group 2 cows, immediately post-endotoxin infusion (PEI); Group 3 cows, 2 h PEI and, Group 4 cows, 4 h PEI. Group 1 cows were not treated with the product and served as a positive (endotoxin only) control while Group 5 cows were not challenged with endotoxin and were not treated with the product. A clinical mastitis score (CMS) was developed to quantitatively assess the degree of inflammation. Blood biochemistry and hematological parameters were used to monitor the immediate effects of treatment on several conventional inflammatory markers. Milk somatic cell counts (MSCC), milk electrical conductivity and daily milk production were among the parameters used to monitor systemic and local inflammatory reactions. Administration of the drug product immediately PEI and 2 h PEI clearly nullified some of the most severe early systemic reactions to inflammation but the effect of therapy on the local inflammatory markers was not as obvious. Notewhorthy, however, were the effects of the treatment on reducing the duration of elevated quarter MSCC and the increase in the speed of return to pre-endotoxin challenge daily milk production levels.

  20. Small Bowel Carcinomas in Coeliac or Crohn's Disease: Clinico-pathological, Molecular, and Prognostic Features. A Study From the Small Bowel Cancer Italian Consortium.

    PubMed

    Vanoli, Alessandro; Di Sabatino, Antonio; Furlan, Daniela; Klersy, Catherine; Grillo, Federica; Fiocca, Roberto; Mescoli, Claudia; Rugge, Massimo; Nesi, Gabriella; Fociani, Paolo; Sampietro, Gianluca; Ardizzone, Sandro; Luinetti, Ombretta; Calabrò, Antonio; Tonelli, Francesco; Volta, Umberto; Santini, Donatella; Caio, Giacomo; Giuffrida, Paolo; Elli, Luca; Ferrero, Stefano; Latella, Giovanni; Ciardi, Antonio; Caronna, Roberto; Solina, Gaspare; Rizzo, Aroldo; Ciacci, Carolina; D'Armiento, Francesco P; Salemme, Marianna; Villanacci, Vincenzo; Cannizzaro, Renato; Canzonieri, Vincenzo; Reggiani Bonetti, Luca; Biancone, Livia; Monteleone, Giovanni; Orlandi, Augusto; Santeusanio, Giuseppe; Macciomei, Maria C; D'Incà, Renata; Perfetti, Vittorio; Sandri, Giancarlo; Silano, Marco; Florena, Ada M; Giannone, Antonino G; Papi, Claudio; Coppola, Luigi; Usai, Paolo; Maccioni, Antonio; Astegiano, Marco; Migliora, Paola; Manca, Rachele; Martino, Michele; Trapani, Davide; Cerutti, Roberta; Alberizzi, Paola; Riboni, Roberta; Sessa, Fausto; Paulli, Marco; Solcia, Enrico; Corazza, Gino R

    2017-08-01

    An increased risk of small bowel carcinoma [SBC] has been reported in coeliac disease [CD] and Crohn's disease [CrD]. We explored clinico-pathological, molecular, and prognostic features of CD-associated SBC [CD-SBC] and CrD-associated SBC [CrD-SBC] in comparison with sporadic SBC [spo-SBC]. A total of 76 patients undergoing surgical resection for non-familial SBC [26 CD-SBC, 25 CrD-SBC, 25 spo-SBC] were retrospectively enrolled to investigate patients' survival and histological and molecular features including microsatellite instability [MSI] and KRAS/NRAS, BRAF, PIK3CA, TP53, HER2 gene alterations. CD-SBC showed a significantly better sex-, age-, and stage-adjusted overall and cancer-specific survival than CrD-SBC, whereas no significant difference was found between spo-SBC and either CD-SBC or CrD-SBC. CD-SBC exhibited a significantly higher rate of MSI and median tumour-infiltrating lymphocytes [TIL] than CrD-SBC and spo-SBC. Among the whole SBC series, both MSI─which was the result of MLH1 promoter methylation in all but one cases─and high TIL density were associated with improved survival at univariable and stage-inclusive multivariable analysis. However, only TILs retained prognostic power when clinical subgroups were added to the multivariable model. KRAS mutation and HER2 amplification were detected in 30% and 7% of cases, respectively, without prognostic implications. In comparison with CrD-SBC, CD-SBC patients harbour MSI and high TILs more frequently and show better outcome. This seems mainly due to their higher TIL density, which at multivariable analysis showed an independent prognostic value. MSI/TIL status, KRAS mutations and HER2 amplification might help in stratifying patients for targeted anti-cancer therapy.

  1. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations.

    PubMed

    Wang, Dong-Yu; Done, Susan J; Mc Cready, David R; Leong, Wey L

    2014-07-04

    Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). The original training cohort reached a statistically significant difference (p < 0.05) in disease-free survivals between the three CMTC groups after an additional two years of follow-up (median = 55 months). The prognostic value of the triad classification was reproduced in the second independent internal cohort and the new external validation cohort. CMTC achieved even higher prognostic significance when all available patients were analyzed (n = 4,851). Oncogenic pathways Myc, E2F1, Ras and β-catenin were again implicated in the high-risk groups. Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments.

  2. Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study

    PubMed Central

    Das, Swati; Jhingran, Rajesh; Bains, Vivek Kumar; Madan, Rohit; Srivastava, Ruchi; Rizvi, Iram

    2016-01-01

    Objectives: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. Materials and Methods: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Results: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. Conclusion: The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration. PMID:27095909

  3. Surgical treatment of lateral clavicle fractures associated with complete coracoclavicular ligament disruption: Clinico-radiological outcomes of acromioclavicular joint sparing and spanning implants

    PubMed Central

    Bhatia, Deepak N.; Page, Richard S.

    2012-01-01

    Purpose: Distal clavicle fracture associated with complete coracoclavicular ligament disruption represents an unstable injury, and osteosynthesis is recommended. This study was performed (1) to retrospectively analyse the clinico-radiological outcomes of two internal fixation techniques, and (2) to identify and analyse radiographic fracture patterns of fracture that are associated with this injury. Materials and Methods: A total of 15 patients underwent osteosynthesis with either (1) acromioclavicular joint-spanning implants (Group 1, Hook plate device, n = 10) or (2) joint-sparing implants (Group 2, distal radius plate, n = 5); these were reviewed at a mean period of 26.1 months (12 to 40 months). Clinical outcomes were measured using Constant Score (CS), Simple Shoulder Test (SST), and Walch ACJ score (WS). Radiographs and ultrasonography were used to assess the glenohumeral and acromioclavicular joints, and the subacromial space. Preoperative radiographs were analyzed for assessment of fracture lines to identify radiographic patterns. Statistical analysis of the data was performed to determine any significant differences between the two groups. Results: The overall clinical outcome was satisfactory (CS 80.8, SST 11.3, WS 17.6) and a high union rate (93.3%) was observed. Radiographic complications (acromioclavicular degeneration and subluxation, hook migration, abnormal ossification) did not negatively influence the final clinical outcomes. Four distinct radiographic fracture patterns were observed. A statistically significant difference ( P < 0.05) was observed in the reoperation rates between the two groups. Conclusions: Internal fixation of this fracture pattern is associated with a high union rate and favorable clinical outcomes with both techniques. A combination of distal radius plate and ligament reconstruction device resulted in stable fixation and significantly lower reoperation rates, and should be used when fracture geometry permits (Types 1 and 2

  4. Alteration in clinico-biochemical profile and oxidative stress indices associated with hyperglycaemia with special reference to diabetes in cattle--a pilot study.

    PubMed

    Deepa, Padinjare Melepat; Dimri, Umesh; Jhambh, Ricky; Yatoo, Mohd Iqbal; Sharma, Bhaskar

    2015-01-01

    The present study aimed to assess hyperglycaemia with special reference to diabetes mellitus in cattle by clinico-biochemical estimation and evaluation of oxidative stress indices. A total of 256 cattle exhibiting weakness, poor body condition and reduced milk yield in lactating cattle were included in the study. These animals were screened with blood glucose level, urine glucose and ketone bodies. Out of these, 32 (12.5%) cattle showed hyperglycaemia and glycosuria, of which 25% exhibited ketonuria. Diabetes was confirmed in five cattle by estimation of fasting blood glucose, glycated haemoglobin, serum fructosamine, intravenous glucose tolerance test and insulin level. This reports first confirmation of diabetes in cattle in India. All these five animals revealed low level of serum insulin suggestive of insulin-dependent diabetes mellitus in cattle. The level of aspartate aminotransferase (AST) and gamma glutamyl transferase (GGT) was found to be increased in diabetic cattle. Oxidant/antioxidant balance was assessed in hyperglycaemic cattle and five age-matched Holstein Friesian (HF) cross-bred healthy control animals. Diabetic cattle revealed significantly higher (P ≤ 0.01) levels of erythrocytic lipid peroxides in comparison with other hyperglycaemic cattle and healthy controls whereas the level of superoxide dismutase (SOD) and catalase was found to be significantly lower in diabetes-affected animals in comparison to healthy controls. Reduced glutathione did not show a significant difference between hyperglycaemic and control groups. It is concluded from the present study that oxidative stress associated with diabetes in cattle is obvious compared with other hyperglycaemic cattle.

  5. Mixed exocrine-neuroendocrine carcinoma of the nasal cavity: clinico-pathologic and molecular study of a case and review of the literature.

    PubMed

    La Rosa, Stefano; Furlan, Daniela; Franzi, Francesca; Battaglia, Paolo; Frattini, Milo; Zanellato, Elena; Marando, Alessandro; Sahnane, Nora; Turri-Zanoni, Mario; Castelnuovo, Paolo; Capella, Carlo

    2013-03-01

    Sinonasal intestinal-type adenocarcinomas (ITACs) are rare neoplasms histologically resembling intestinal adenocarcinomas. Although a neuroendocrine differentiation in ITACs has been described, true mixed exocrine-neuroendocrine carcinomas, neoplasms in which each component represents at least 30 % of the lesion, are extremely rare and their molecular alterations are largely unknown. We describe herein the clinico-pathologic features, the methylation profile, chromosomal gains and losses, and mutation analysis of KRAS, BRAF and p53 in a nasal mixed exocrine-neuroendocrine carcinoma resected in a 79-year-old man. The tumor was composed of an ITAC and a poorly differentiated neuroendocrine carcinoma. Both exocrine and neuroendocrine components were CK8, CK20, CDX2 and p53 positive, and CK7 and TTF1 negative. The neuroendocrine component also showed immunoreactivity for chromogranin A, synaptophysin, serotonin and glicentin. Gains and losses were found at following chromosome regions: 17p13 (TP53), 14q24 (MLH3), 19q13 (KLK3), 5q21 (APC), 7q21 (CDK6), 9q34 (DAPK1), 12p13 (TNFRSF 1A, CDKN1B), 13q12 (BRCA2), 17p13.3 (HIC1), 18q21 (BCL2), and 22q12 (TIMP3). Aberrant methylation was detected only in the neuroendocrine component and involved APC and DAPK1 genes. No mutation of KRAS (exons 2-4), BRAF (exon 15), and p53 (exons 4-10) was found in both components. The results suggest a monoclonal origin of the tumor from a pluripotent cell undergoing a biphenotypic differentiation and that the neuroendocrine differentiation may be from an exocrine to an endocrine pathway. We have also reviewed the literature on sinonasal mixed exocrine-neuroendocrine carcinomas to give to the reader a comprehensive overview of these very rare tumor types.

  6. Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital

    PubMed Central

    Pal, Souren; Sen, Kaushik; Biswas, Nirendra Mohan; Ghosal, Anirban; Rousan Jaman, S. K.; Yashavantha Kumar, K. Y.

    2016-01-01

    Background and Objective: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. Materials and Methods: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. Results: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. Conclusion: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome. PMID:26933357

  7. Validation of the prognostic gene portfolio, ClinicoMolecular Triad Classification, using an independent prospective breast cancer cohort and external patient populations

    PubMed Central

    2014-01-01

    Introduction Using genome-wide expression profiles of a prospective training cohort of breast cancer patients, ClinicoMolecular Triad Classification (CMTC) was recently developed to classify breast cancers into three clinically relevant groups to aid treatment decisions. CMTC was found to be both prognostic and predictive in a large external breast cancer cohort in that study. This study serves to validate the reproducibility of CMTC and its prognostic value using independent patient cohorts. Methods An independent internal cohort (n = 284) and a new external cohort (n = 2,181) were used to validate the association of CMTC between clinicopathological factors, 12 known gene signatures, two molecular subtype classifiers, and 19 oncogenic signalling pathway activities, and to reproduce the abilities of CMTC to predict clinical outcomes of breast cancer. In addition, we also updated the outcome data of the original training cohort (n = 147). Results The original training cohort reached a statistically significant difference (p < 0.05) in disease-free survivals between the three CMTC groups after an additional two years of follow-up (median = 55 months). The prognostic value of the triad classification was reproduced in the second independent internal cohort and the new external validation cohort. CMTC achieved even higher prognostic significance when all available patients were analyzed (n = 4,851). Oncogenic pathways Myc, E2F1, Ras and β-catenin were again implicated in the high-risk groups. Conclusions Both prospective internal cohorts and the independent external cohorts reproduced the triad classification of CMTC and its prognostic significance. CMTC is an independent prognostic predictor, and it outperformed 12 other known prognostic gene signatures, molecular subtype classifications, and all other standard prognostic clinicopathological factors. Our results support further development of CMTC portfolio into a guide for personalized breast cancer treatments. PMID

  8. Clinico-pathology and hemato-biochemistry responses in buffaloes infected with Pasteurella multocida type B:2 immunogen outer membrane protein.

    PubMed

    Chung, Eric Lim Teik; Abdullah, Faez Firdaus Jesse; Marza, Ali Dhiaa; Saleh, Wessam Monther Mohammed; Ibrahim, Hayder Hamzah; Abba, Yusuf; Zamri-Saad, Mohd; Haron, Abd Wahid; Saharee, Abdul Aziz; Lila, Mohd Azmi Mohd; Norsidin, Mohd Jefri

    2017-01-01

    The aim of this study was to investigate the clinico-pathology and haemato-biochemistry alterations in buffaloes inoculated with Pasteurella multocida type B:2 immunogen outer membrane protein via subcutaneous and oral routes. Nine buffalo heifers were divided equally into 3 treatment groups. Group 1 was inoculated orally with 10 mL of phosphate buffer saline (PBS); Group 2 and 3 were inoculated with 10 mL of outer membrane protein broth subcutaneously and orally respectively. Group 2 buffaloes showed typical haemorrhagic septicaemia clinical signs and were only able to survive for 72 h of the experiment. However, Group 3 buffaloes were able to survive throughout the stipulated time of 21 days of experiment. There were significant differences (p < 0.05) in the rectal temperature between the experimental and control group. In the hematology and biochemistry findings, there were significant differences (p < 0.05) in packed cell volume, mean corpuscular volume, mean corpuscular haemoglobin concentration, leukocytes, band neutrophils, segmented neutrophils, lymphocytes, eosinophils, basophils, gamma glutamyl transferase, total protein, and globulin between Group 2 and control group. In contrast, Group 3 and control group revealed significant differences (p < 0.05) in erythrocytes, haemoglobin, mean corpuscular haemoglobin concentration, segmented neutrophils, lymphocytes, monocytes, eosinophils, basophils, thrombocytes, gamma glutamyl transferase, total protein, globulin, and albumin:globulin ratio. In Group 2 buffaloes, there were gross lesions observed in the lung, trachea, heart, liver, spleen, kidney and submandibulae lymph nodes. In contrast, lesions were only observed in the lung, and liver of Group 3 buffaloes. There were significant differences (p < 0.05) in hemorrhage and congestion; necrosis and degeneration; and inflammatory cells infiltration between experimental groups and control group. However, there were no significant differences (p > 0

  9. Recent outbreak of cutaneous anthrax in Bangladesh: clinico-demographic profile and treatment outcome of cases attended at Rajshahi Medical College Hospital

    PubMed Central

    2012-01-01

    Background Human cutaneous anthrax results from skin exposure to B. anthracis, primarily due to occupational exposure. Bangladesh has experienced a number of outbreaks of cutaneous anthrax in recent years. The last episode occurred from April to August, 2011 and created mass havoc due to its dreadful clinical outcome and socio-cultural consequences. We report here the clinico-demographic profile and treatment outcome of 15 cutaneous anthrax cases attended at the Dermatology Outpatient Department of Rajshahi Medical College Hospital, Bangladesh between April and August, 2011 with an aim to create awareness for early case detection and management. Findings Anthrax was suspected primarily based on cutaneous manifestations of typical non-tender ulcer with black eschar, with or without oedema, and a history of butchering, or dressing/washing of cattle/goat or their meat. Diagnosis was established by demonstration of large gram-positive rods, typically resembling B. anthracis under light microscope where possible and also by ascertaining therapeutic success. The mean age of cases was 21.4 years (ranging from 3 to 46 years), 7 (46.7%) being males and 8 (53.3%) females. The majority of cases were from lower middle socioeconomic status. Types of exposures included butchering (20%), contact with raw meat (46.7%), and live animals (33.3%). Malignant pustule was present in upper extremity, both extremities, face, and trunk at frequencies of 11 (73.3%), 2 (13.3%), 1 (6.7%) and 1 (6.7%) respectively. Eight (53.3%) patients presented with fever, 7 (46.7%) had localized oedema and 5 (33.3%) had regional lymphadenopathy. Anthrax was confirmed in 13 (86.7%) cases by demonstration of gram-positive rods. All cases were cured with 2 months oral ciprofloxacin combined with flucoxacillin for 2 weeks. Conclusions We present the findings from this series of cases to reinforce the criteria for clinical diagnosis and to urge prompt therapeutic measures to treat cutaneous anthrax

  10. Survey of ferns and clinico-pathological studies on the field cases of Enzootic bovine haematuria in Himachal Pradesh, a north-western Himalayan state of India.

    PubMed

    Rai, Sarvesh K; Sharma, Rinku; Kumari, Alka; Rasmussen, Lars H; Patil, Rajendra D; Bhar, Rasbehari

    2017-08-09

    Enzootic bovine haematuria (EBH) in cattle occurs in upland areas of the world. In India, the disease is present in isolated pockets in the Himalayas and in the Nilgiri Hills. The variation in the disease incidence has been attributed to different environmental conditions and animal rearing practices followed in the different regions. The aim of the study was to conduct field surveys in parts of EBH endemic regions of Himachal Pradesh, a north-western Himalayan state of India. Out of the total 103 plant samples collected, a total of 95 samples were identified as ferns. The major ferns identified included, Onychium japonicum (Thunb.) Kunze, Polystichum piceopaleaceum Tagawa, Dryopteris juxtaposita Christ, Pseudocyclosorus canus (Baker) Holttum and J.W. Grimes, Onychium contiguum C. Hope, Dryopteris nigropaleacea (Fraser-Jenk.), Pteridium aquilinum (L.) Kuhn, Diplazium esculentum (Retz.) Sw., Allantodia maxima (D. Don) Ching, Woodwardia unigemmata (Makino) Nakai, Pteris cretica L., Pteris vittata L., Asplenium trichomanes L., Thelypteris phegopteris (L.) Sloss. ex Rydb, Adiantum venustum D. Don and Paraceterach vestita (Hook.) R.M. Tryon. The concentration of ptaquiloside (PTA) and pterosin B (PtB) in some of the ferns collected from Kullu and Chamba regions ranged from 0 to 358.6 ± 70.5 μg/g and 0 to 652.4 ± 50.0 μg/g, respectively. In addition, field cases of the disease in cattle were also studied in the EBH endemic districts. A total of sixteen cattle urine samples and one urinary bladder of EBH affected cattle were collected. On physical, chemical (benzidine test) and microscopic examination of urine sediment, all the sixteen field samples were found to be positive for erythrocytes and the cases were diagnosed as macrohaematuria. The clinico-pathological studies on the field cases and the presence of PTA and PtB in the ferns indicated that EBH is a prevalent disease and there is an association between chronic fern ingestion and EBH in cattle. On the

  11. Analysis of peptidyl-propyl-cis/trans isomerase 1 (PIN1) gene -842(G > C) and -667(T > C) polymorphic variants in relation to breast cancer risk and clinico-pathological parameters.

    PubMed

    Naidu, Rakesh; Har, Yip C; Taib, Nur A M

    2011-10-01

    The purpose of this study was to investigate the association between the peptidyl-propyl-cis/trans isomerase 1 (PIN1) -842(G > C) and -667(T > C) polymorphic variants and breast cancer risk among Malaysian ethnic groups namely the Malays, Chinese and Indians, as well as clinico-pathological characteristics of the patients. The polymerase chain reaction-restriction fragment length polymorphism was used to genotype 387 breast cancer patients and 252 normal and healthy women who had no history of any malignancy. The distribution of -842(G > C) and -667(T > C) genotypes and alleles frequencies between breast cancer cases and normal individuals showed lack of statistical significance among the Malays (p > 0.05), Chinese (p > 0.05) and Indians (p > 0.05), respectively. Multivariate logistic regression analysis showed that the Malay, Chinese and Indian women who were -842CC homozygotes (p = 0.198, 0.089, 0.620), -842GC heterozygotes (p = 0.492, 0.176, 0.377) and -842C allele carriers (P = 0.226, 0.059, 0.669), respectively, were not associated with breast cancer risk. Furthermore Malay, Chinese and Indian women who were heterozygous (p = 0.777, 0.319, 0.710) and homozygous (p = 0.864, 0.986, 0.954) for -667C allele or carriers of -667C allele (p = 0.977, 0.915, 0.880), respectively, were not associated with an increased risk of breast cancer. None of the -842C and -667C allele genotypes were significantly associated with the clinico-pathological characteristics. Our findings suggest that the polymorphic variants of -842(G > C) and -667(T > C) genes may not appear to have an influence on breast cancer risk among Malaysian Malay, Chinese and Indian women.

  12. Childhood Henoch-Schönlein purpura nephritis and IgA nephropathy: one disease entity?--A clinico-pathologically comparative study.

    PubMed

    Zhou, Jianhua; Huang, Aixia; Liu, Tonglin; Kuang, Yujiu

    2005-01-01

    .6% of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn't be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5% of IgA nephropathy had consistent hematuria and proteinuria and 16.1% had active nephritides (P < 0.05). It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn't support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.

  13. Genotype-Phenotype Correlation in Indian Patients with MEN2-Associated Pheochromocytoma and Comparison of Clinico-Pathological Attributes with Apparently Sporadic Adrenal Pheochromocytoma.

    PubMed

    Rajan, Sendhil; Zaidi, Ghazala; Agarwal, Gaurav; Mishra, Anjali; Agarwal, Amit; Mishra, Saroj Kanta; Bhatia, Eesh

    2016-03-01

    Pheochromocytoma (PCC) manifests in up to 50% of MEN2 patients. We correlated the clinico-pathological features of MEN2-associated PCC (MEN-PCC) with RET mutations and compared them with non-MEN adrenal-PCCs. In this retrospective single institution study on a large PCC database (n = 208, 1997-2014) 24 MEN-PCC patients with known RET mutations were reviewed. Excluding 7 with incomplete data, the study cohort of 17 MEN-PCC patients from 11 kindreds (M:F::7:10) was identified. Clinical, biochemical, pathological attributes, and outcomes in the MEN-PCC group were correlated with the genotype, and further compared with non-MEN, apparently sporadic adrenal-PCCs (n = 132, excluding 37 extra-adrenal and 15 VHL/NF1/SDH-associated PCC). Components of MEN2 encountered included MTC in 13(76.5%), Marfanoid habitus in 2, and PHPT, cutaneous lichen amyloidosis and mucosal neuromas in 1 patient each. In 11(64.7%), PCC was the first detected MEN2 component (Symptomatic:8, Incidentaloma:3). Four (23.5%) were normotensive; 8(47.1%) had bilateral PCC (7 synchronous, 1 metachronous). Surgery for PCC included laparoscopic adrenalectomy in 12; and cortical-sparing adrenalectomy in 2 of 8 bilateral PCC patients. Mean MEN-PCC tumor size was 6.9 ± 3.9 cm, and 6(35%) had additional adrenal medullary hyperplasia. Four different genotypes were encountered, commonest involving codon 634, others being 804 and 918. Mean age in MEN-PCC (27.7 ± 12.2 years) was lower than non-MEN PCC (39.4 ± 15.7, p = 0.018). Proportion of pediatric patients (35.3% in MEN-PCC vs. 12.9% in non-MEN-PCC, p = 0.007), bilateral tumors (47.1% in MEN-PCC, 4.5% in non-MEN-PCC, p < 0.001), and adrenal medullary hyperplasia (35.2% in MEN-PCC, 0.7% in non-MEN-PCC, p < 0.001) were different. Median 24-hour urinary metanephrines was significantly higher in index MEN-PCC patients, than non-MEN-PCC (634 vs. 214 mcg/24 h, p value = 0.006), but was non-significantly higher in non-index MEN-PCC patients. Mean tumor sizes were

  14. Assessment of the prognostic role of a 94-single nucleotide polymorphisms risk score in early breast cancer in the SIGNAL/PHARE prospective cohort: no correlation with clinico-pathological characteristics and outcomes.

    PubMed

    Curtit, Elsa; Pivot, Xavier; Henriques, Julie; Paget-Bailly, Sophie; Fumoleau, Pierre; Rios, Maria; Bonnefoi, Hervé; Bachelot, Thomas; Soulié, Patrick; Jouannaud, Christelle; Bourgeois, Hugues; Petit, Thierry; Tennevet, Isabelle; Assouline, David; Mathieu, Marie-Christine; Jacquin, Jean-Philippe; Lavau-Denes, Sandrine; Darut-Jouve, Ariane; Ferrero, Jean-Marc; Tarpin, Carole; Lévy, Christelle; Delecroix, Valérie; Trillet-Lenoir, Véronique; Cojocarasu, Oana; Meunier, Jérôme; Pierga, Jean-Yves; Kerbrat, Pierre; Faure-Mercier, Céline; Blanché, Hélène; Sahbatou, Mourad; Boland, Anne; Bacq, Delphine; Besse, Céline; Thomas, Gilles; Deleuze, Jean-François; Pauporté, Iris; Romieu, Gilles; Cox, David G

    2017-08-22

    Genome-wide association studies (GWAS) have to date identified 94 genetic variants (single nucleotide polymorphisms (SNPs)) associated with risk of developing breast cancer. A score based on the combined effect of the 94 risk alleles can be calculated to measure the global risk of breast cancer. We aimed to test the hypothesis that the 94-SNP-based risk score is associated with clinico-pathological characteristics, breast cancer subtypes and outcomes in early breast cancer. A 94-SNP risk score was calculated in 8703 patients in the PHARE and SIGNAL prospective case cohorts. This score is the total number of inherited risk alleles based on 94 selected SNPs. Clinical data and outcomes were prospectively registered. Genotyping was obtained from a GWAS. The median 94-SNP risk score in 8703 patients with early breast cancer was 77.5 (range: 58.1-97.6). The risk score was not associated with usual prognostic and predictive factors (age; tumor, node, metastasis (TNM) status; Scarff-Bloom-Richardson grade; inflammatory features; estrogen receptor status; progesterone receptor status; human epidermal growth factor receptor 2 (HER2) status) and did not correlate with breast cancer subtypes. The 94-SNP risk score did not predict outcomes represented by overall survival or disease-free survival. In a prospective case cohort of 8703 patients, a risk score based on 94 SNPs was not associated with breast cancer characteristics, cancer subtypes, or patients' outcomes. If we hypothesize that prognosis and subtypes of breast cancer are determined by constitutional genetic factors, our results suggest that a score based on breast cancer risk-associated SNPs is not associated with prognosis. PHARE cohort: NCT00381901 , Sept. 26, 2006 - SIGNAL cohort: INCa RECF1098, Jan. 28, 2009.

  15. An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery.

    PubMed

    Dwivedi, Raghav C; Chisholm, Edward J; Khan, Afroze S; Harris, Nicholas J; Bhide, Shree A; St Rose, Suzanne; Kerawala, Cyrus J; Clarke, Peter M; Nutting, Christopher M; Rhys-Evans, Peter H; Harrington, Kevin J; Kazi, Rehan

    2012-04-01

    There are insufficient data on swallowing and the consequences of its dysfunction in patients with cancers of the oral cavity (OC) and oropharynx (OP) that are treated with primary surgery. The study attempts to explore the effect of important clinico-demographic variables on post-treatment swallowing and related quality of life (QOL) in post-surgical OC and OP cancer patients. Sixty-two consecutive OC and OP cancer patients completed the MD Anderson Dysphagia Inventory (MDADI) questionnaire. Mean scores were computed. Comparison of scores based on mean ranks were performed using Mann-Whitney U test or Kruskal-Wallis test. Level of significance was set at P ≤ 0.02. Adjustments were made for multiple comparisons. Significantly worse mean (SD) QOL scores were observed in late T-stage (T3/T4) versus early T-stage (T1/T2) patients for global domain, physical domain, functional domain and emotional domains [44.4 (21.9) vs. 78.7 (22.7) (P < 0.001); 50.0 (9.4) vs. 75.9 (16.3), (P < 0.0001); 57.8 (20.6) vs. 84.1 (16.7), (P < 0.001) and 55.2 (18.0) vs. 78.5 (16.3), (P < 0.001)], respectively. Patients undergoing reconstruction versus without reconstruction had worse QOL scores; 58.8 (26.9) versus 79.5 (22.8), (P < 0.01); 61.2 (15.1) versus 76.4 (17.5), (P = 0.002); 65.4 (20.5) versus 86.3 (15.9), (P < 0.0001) and 63.3 (18.8) versus 79.8 (16.3), (P < 0.01), respectively, for global, physical, functional and emotional domains. Advanced T-stage, reconstruction, younger age and base of tongue tumours have a negative impact on post-treatment swallow function and related QOL in these patients.

  16. Leucémie aiguë myéloblastique et translocation (8;16) (p11;p13), premier cas marocain d'une entité clinico- biologique distinct

    PubMed Central

    Bakkali, Adiba; Lemchaheb, Mouna; Had, Nezha; Dehbi, Hind; Benchekroun, Said; Quessar, Asma

    2015-01-01

    La cytogénétique constitue un outil indispensable pour le diagnostic et le pronostic de la leucémie aigue myéloïde (LAM). La t(8;16)(p11;p13) est rare au cours de cette pathologie. Nous décrivons le cas d'une patiente de 22 ans, admise pour un syndrome d'insuffisance médullaire complet associé à une altération de l’état général. L'examen clinique initial montrait un purpura ecchymotique diffus et des adénopathies latérocérvicales centimétriques bilatérales. L'hémogramme avait montré une anémie à 7,6g /dl normochrome normocytaire, des globules blancs à 87,8×109/L, 15% de polynucléaires neutrophiles, 60% de blastes, 24% de lymphocytes, 1% de Monocytes et 65×109/L de plaquettes. Le myélogramme avait objectivé une LAM1. Sur l'immunophenotypage les marqueurs positifs étaient le CD33 (99%), le CD15 (73%), le CD38 (95%) et l'HLA-DR (88%), les marqueurs monocytoïdes CD14 et CD64 étaient positifs, le CD34, les marqueurs lymphopïdes, la MPO (26%) et le CD13 (2%) étaient négatifs. Le caryotype avait montré: t(8,16)(p11, p13) add16 (20/20). L'inversion du chromosome 16 recherchée par FISH était négative. Le traitement avait consisté en 2 cures d'induction et 2 cures de consolidation selon le protocole national de traitement des LAM (Cytarabine, daunorubicine, etoposide), la rémission complète avait été obtenue en fin d'induction I, maintenue 9 mois suivie d'une rechute; Vu l'absence de possibilité d'une allogreffe, un traitement palliatif a été instauré, la malade est décédée de sa maladie un mois après la rechute. Notre cas se présente comme les cas décrits dans la littérature avec des données clinico- biologiques particulières. PMID:26327984

  17. [Clinico-epidemiologic study of microtia].

    PubMed

    Sánchez, O; Méndez, J R; Gómez, E; Guerra, D

    1997-12-01

    Microtia is a congenital malformation characterized by total or partial absence of the whole auricle or any of its components, varying from a small auricle to the total absence (anotia). There may be associated atresia of the external auditory meatus. The frequency varies in different parts of the world between 0.4 and 5.5/10,000 newborns. In this paper we report the clinical and epidemiological characterization of this congenital malformation in a sample of 97.759 neonates born at the Ruíz y Páez Hospital in Ciudad Bolivar, Venezuela, between April 1978 and December 1994. A total of 38 patients with microtia were identified. The global frequency was 3.8 per 10,000/newborns. In 47.4% of the patients microtia was an isolated malformation and in 52.6% was associated to other malformations. Sixty three percent of the affected were males. The unilateral form was present in 81.5% of the cases, more frequently on the right side. The annual frequency of the defect was stable over the studied years. The clinical classification of the cases with associated malformations allowed us to establish that 18.4% of the cases correspond to developmental fields defects, associated to preauricular dimples and/or tags, 7.8% were cases of the facio-auriculo-vertebral spectrum and in 15.7% the microtia was part of a monogenic or chromosomal syndrome. In 10.5% it was not possible to define any etiological or pathogenic mechanism. The frequency obtained in this study for microtia shows intermediate values when compared with others reports from Latin America.

  18. Clinico-Histologic Conferences: Histology and Disease

    ERIC Educational Resources Information Center

    Shaw, Phyllis A.; Friedman, Erica S.

    2012-01-01

    Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical…

  19. Clinico-Histologic Conferences: Histology and Disease

    ERIC Educational Resources Information Center

    Shaw, Phyllis A.; Friedman, Erica S.

    2012-01-01

    Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical…

  20. [Renal dysplasia: clinico-pathologic review].

    PubMed

    Cunha, A S; de Sousa, J F; Garcia, C

    1992-05-01

    Histology records from 63 nephrectomies were reviewed; 22 patients had unilateral totally dysplastic kidneys and 5 had polar or segmental dysplasia. A clinicopathological study of these cases was undertaken. In the first group, there was a slight male preponderance and 75% of the patients presented were under two years of age. Urinary tract infection was the most common complaint. 4 patients were diagnosed in utero by ultrasound and 5 infants presented an abdominal mass. Hypertension was documented in a newborn baby. Ipsilateral lower urinary tract anomalies were found in 12 patients and those of the contralateral kidney in 2 children. There were 3 cases of extrarenal anomalies. Histological examination revealed 13 cases of multicystic dysplasia and 9 of solid dysplasia. Metaplastic cartilage was found in 1 case. In the group of segmental dysplasia, age ranging from 27 weeks' gestation to 8 years, at the time of the diagnosis. They all had duplex kidneys and 4 had ureterocele. Histological study in these cases was similar to the one found in the previous series, although superimposed inflammatory changes were more pronounced. Some of the theories regarding the pathogenesis of this disorder are reviewed and the importance of its diagnosis is emphasised.

  1. Clinico-pathologic conference: case 4.

    PubMed

    Ocampo-Acosta, Fabian; Robledo, Juliana; Aldape-Barrios, Beatriz; Garcia-Vazquez, Francisco J

    2009-12-01

    A 45 years old male patient presented with an asymptomatic right mandibular mass that extended from the angle to the premolar area. It had been present for 3 months at the time of the initial presentation. Panoramic radiograph revealed an ill-defined unilocular radiolucency. Previous dental treatment included molar extractions and antibiotic therapy. Considerable bleeding was encountered during incisional biopsy.

  2. Clinico-pathological correlation in dementias.

    PubMed Central

    Teixeira, F; Alonso, E; Romero, V; Ortíz, A; Martínez, C; Otero, E

    1995-01-01

    The object of this study is to investigate whether or not there are clinical signs and symptoms in patients with dementia that, by themselves or jointly, can be associated with the pathological diagnosis of Alzheimer's disease. Twelve patients with dementia were studied, in whom the clinical diagnosis of Alzheimer's disease was made according to established criteria. A sample of leptomeninges, cortex and subcortical white matter was obtained from each patient and was processed for light and electron microscopy. In the cases in whom neuritic plaques and neurofibrilary tangles were present, pathological changes were quantified. The diagnosis of Alzheimer's disease was confirmed in 5 cases, whereas in 3 patients spongiform encephalopathy was present. In the remaining patients, the number of neuritic plaques was within normal limits for the age of the subjects. Comparison of the data in Alzheimer (n = 5) and non-Alzheimer (n = 7) groups showed an increased, statistically significant incidence of acalculia, abnormalities of judgment, impairment of abstraction and primitive reflexes in the former. Although good fitting models were obtained, none achieved perfect discrimination. The model that included alterations of judgment and acalculia gave the best fit. PMID:7647080

  3. [Clinico-tomographic correlations in acute pancreatitis].

    PubMed

    Lese, M; Pop, C; Brânduşe, M; Achim, V; Grigorescu, D; Nemeş, S

    1998-01-01

    In the surgery ward from Baia Mare, in the period 1989-1997 have been operated yearly, on an average, 16-17 acute pancreatitis, out of which 8-9 were necrotic-haemorrhagic acute pancreatitis. The possibility of carrying out the computerized tomography allowed a more precise pre-surgery diagnosis and after surgery was improved observation of evolution of the inflammatory phenomena from the pancreatic zone so that the volume, the structure and the outline of the pancreas, the abdominal or pleural liquid collections and the aspect of the neighboring tissues have been correlated in dynamics, with the clinic aspect of the acute pancreatitis and the prognostic indexes. Even if the computerized tomography allowed a more correct evaluation of the patients suffering of acute pancreatitis, there have been 4-6 decreases due to this affection and its complications, the post-surgery death rate remaining at 17-21%.

  4. Paraneoplastic limbic encephalitis: clinico-pathological correlations.

    PubMed Central

    Bakheit, A M; Kennedy, P G; Behan, P O

    1990-01-01

    Three new cases of limbic encephalitis in association with malignancy are reported. The literature on this condition is reviewed and the clinical, laboratory and histopathological features of cases proven at necropsy are correlated. The possible pathogenic mechanism of this disorder is discussed. PMID:1963440

  5. Genetic and clinico-pathologic analysis of metastatic uveal melanoma.

    PubMed

    Griewank, Klaus G; van de Nes, Johannes; Schilling, Bastian; Moll, Iris; Sucker, Antje; Kakavand, Hojabr; Haydu, Lauren E; Asher, Marina; Zimmer, Lisa; Hillen, Uwe; Thompson, John F; Scolyer, Richard A; Schadendorf, Dirk; Murali, Rajmohan

    2014-02-01

    Uveal melanoma is the most common malignant tumor of the adult eye. Fifty percent of tumors will eventually metastasize, and there are no effective treatments for them. Recent studies of uveal melanoma have identified activating mutations in GNAQ and GNA11, loss-of-function mutations in the tumor suppressor gene BAP1, and recurrent mutations in codon 625 of SF3B1. Previous studies have reported the existence of a higher frequency of GNA11 than GNAQ mutations, frequent BAP1 loss, and rare SF3B1 mutations in metastatic uveal melanoma. We analyzed a cohort of 30 uveal melanoma metastases for the occurrence of GNAQ, GNA11, and SF3B1 mutations, as well as BAP1 loss, and correlated these parameters with clinical and histopathologic features. Most (92%) tumors were composed of cells with an epithelioid or mixed (<100% spindle cells) morphology. Tumor samples composed exclusively of spindle cells were rare (n=2, 8%). Most tumors showed a moderate to marked degree of nuclear pleomorphism (n=24, 96%), and contained hyperchromatic, vesicular nuclei with variably conspicuous nucleoli. GNA11 mutations were considerably more frequent than GNAQ mutations (GNA11, GNAQ, and wild-type in 18 (60%), 6 (20%), and 6 (20%) cases, respectively). SF3B1 mutation was found in 1 of 26 tumors (4%), whereas loss of BAP1 expression was present in 13 of 16 tumors (81%). Patients with GNA11-mutant tumors had poorer disease-specific survival (60.0 vs 121.4 months, P=0.03) and overall survival (50.6 vs 121.4 months, P=0.03) than those with tumors lacking GNA11 mutations. The survival data, combined with the predominance of GNA11 mutations in metastases, raises the possibility that GNA11-mutant tumors may be associated with a higher risk of metastasis and poorer prognosis than GNAQ-mutant tumors. Further studies of uveal melanoma are required to investigate the functional and prognostic relevance of oncogenic mutations in GNA11 and GNAQ.

  6. [Clinico-morphological variants of gastric mucosa atrophic lesions].

    PubMed

    Naumova, L A; Pal'tsev, A I; Beliaeva, Ia Iu

    2009-01-01

    To characterize clinicomorphological manifestations of atrophic process (AP) in gastric mucosa (GM) in chronic atrophic gastritis (CAG) associated and not associated with Helicobacter pylori infection. Clinicoendoscopic and pathomorphological (light microscopy of gastric biopsies, 6 point scale assessment of dysregeneratory alterations) investigations were made in 98 patients aged 16 to 68 years. H. pylori-negative CAG was diagnosed in 52 of them, H. pylori-positive one in 46 patients (groups 1 and 2, respectively). A comparative clinicomorphological analysis has identified 2 variants of AP morphogenesis in GM. Variant 1 is not associated with H. pylori but associated with a combined action of several endogenic risk factors of chronic gastritis or failure of regeneration, with diffuse or diffuse-focal changes with initial prevalence of dysregeneratory changes in a fundal stomach manifesting as a trend to atrophy of the glands. Clinically, this variant is characterized by longer disease, frequent systemic atrophic lesions of gastrointestinal mucosa, prevalent complaints of dyspeptic pain. Variant 2 is associated with a combined action of endo- and exogenic factors, H. pylori infection in particular, pathogenetic components of "chemical" gastritis (duodenogastric reflux, malnutrition), prevalence of dysregeneratory and sclerotic alterations in the antral stomach. GM atrophy is characterized by a significant frequency of concomitant endocrinopathies, undifferentiated connective tissue dysplasia, systemic lesions, structurally--by multidirectional disorders of proliferation and differentiation. First of all, it is the result of impaired regulation of regenerative processes. AP polyetiology and different morphogenetic variants in GM suggest necessity of both individual diagnostic algorithm and pathogenetically sound therapy in each individual case.

  7. Antibiotic Sensitivity and Clinico- epidemiological Profile of Staphylococcal Infections.

    PubMed

    Mahapatra, Manas Kumar; Mukherjee, Devdeep; Poddar, Sumon; Kundu, Ritabrata

    2016-10-08

    This hospital-based study describes the antibiotic sensitivity of 66 S. aureus isolates from the admitted children (age 0-18 y) in a tertiary hospital of Kolkata, India. Methicillin-resistant S. aureus constituted 16.7% (n=11) of the isolates. Clindamycin-resistance was observed in 60% and 82% of methicillin-sensitive and methicillin-resistant strains, respectively.

  8. [Clinico-diagnostic evaluation of acute delirious syndromes in schizophrenia].

    PubMed

    Panteleeva, G P

    1989-01-01

    Psychopathologic and nosologic issues of acute paranoid and Kandinsky-Clerambault syndromes are discussed on the background of clinical studies of 225 schizophrenic patients with these syndromes being initial manifestations. The data on the syndromes typology, clinical value and prognosis of acute delirious disorders are presented. These are shown to be not confined to progredient schizophrenia, including its paranoid form. Rather, they can manifest a course of the disease unspecific for schizophrenia, the so-called schizophrenic reactions and phasic states thus reflecting the course of latent schizophrenia. A differentiated approach to clinical and psychopathological analysis of acute delirious syndromes in schizophrenia is essential for adequate choice of medicosocial measures and epidemiologic investigations.

  9. [The clinico-pathogenetic aspects of sex dimorphism in gout].

    PubMed

    Siniachenko, O V; Kosheleva, E N; Mukhin, I V; Siniachenko, T Iu; Tkachenko, L I; Tolstoĭ, V A

    1993-01-01

    The examination of 241 gout patients (207 males and 34 females) revealed a marked sexual dimorphism of the disease related to the articular and renal syndromes. Male gout is characterized by higher blood levels of uric acid and oxypurinole in reduced clearance of the latter, while in female gout there were hyperxanthinoxidasemia and hypo-cAMPemia. Unbalance of sex and gonadotropic hormones, which appeared multidirectional and dependent on the sex, was observed in males in the form of lower concentrations of blood testosterone and estradiol against elevated levels of progesterone and lutropin, in females manifested with hypoprogesteronemia and reduced gonadotropin.

  10. Wegener's granulomatosis: clinico-radiological finding at initial presentation.

    PubMed

    Stević, Ruza; Jovanović, Dragana; Obradović, Ljudmila Nagorni; Milenković, Branislava; Skodrić-Trifunović, Vesna; Stanković, Ivana

    2012-06-01

    Diagnosis of Wegener's granulomatosis at the early stage is difficult because of the nonspecific symptoms which mimic other disorders. The aim of this paper is to describe clinical and radiological features of Wegener's granulomatosis (WG) in a Serbian population at initial presentation. A retrospective review of 37 patient's case records was carried out. All those patients were diagnosed with WG and they attended the Institute for lung diseases in Belgrade over the period of 15 years. There were 20 males and 17 females, ranging in age from 18 to 73 years (mean age 46.2 years). The mean period from the onset of the first symptoms to diagnosis of WG was 4.59 +/- 6.15 months. The criteria of American College of Rheumatology were fulfilled in all patients. Twenty-five of 37 patients had systemic, generalized form of WG and while 12 of them had a limited involvement of upper and lower respiratory system. The frequency of different system involvement was: upper respiratory tract 64.8%, lower respiratory tract 100%, kidneys 67.5%, musculoskeletal system 40.5%, skin 27.2%, eyes 8.1%, and nervous system two patients. ANCA (antineutrophil cytoplasmic antibodies) test was positive in 32 ((86.5%) patients, and negative in 5 (13.5%). All patients were ANA negative. Histological evidence of granulomatous vasculitis was obtained in 34 (91.9%), whereas in three patients the diagnosis was based on clinical manifestations and positive c-ANCA test. There are minor variations in our data when compared with those reported in literature.

  11. The epigenomics revolution in myelodysplasia: a clinico-pathological perspective.

    PubMed

    Tan, Peter T; Wei, Andrew H

    2011-10-01

    Rapid advances in molecular technologies are continually re-shaping the way we view and understand the mechanisms driving oncogenesis. The last decade has witnessed unparalleled change in the biology and therapy of the myelodysplastic syndromes (MDS), a heterogeneous collection of clonal myeloid disorders characterised by ineffective haematopoiesis and susceptibility to acute leukaemia transformation. Pivotal studies demonstrating the positive effects of hypomethylating agents on clinical outcome have brought an 'epigenomics revolution' to this disease, emphasising the importance of epigenetic mechanisms to the underlying pathogenesis of MDS. One of the most important future challenges in the MDS field will be to determine whether epigenetic therapies can be made more 'targeted' through identification of biomarkers which define subsets of patients most likely to benefit from treatment. A wave of novel mutations have recently been reported in MDS and other myeloid disorders, several of which regulate endogenous methylation networks within cells (including TET2, DNMT3A, IDH and EZH2). The relevance of these lesions in being able to predict response to epigenetic modulators and their correlation with epigenetic signatures in MDS are beginning to emerge.

  12. [Idiopathic hypereosinophilic syndrome. Current clinico-therapeutic state].

    PubMed

    Mercadanti, M; Cavalieri, F; Ferraccioli, G F; Ambanelli, U

    1985-10-13

    Idiopathic hypereosinophilic syndrome is a term labelling clinical illnesses characterized by blood hypereosinophilia and widespread infiltration of organs and tissues by mature eosinophils. Although any tissue can be affected the involvement of the nervous system and of the myocardium usually indicates worse prognosis. Histopathological studies carried out on myocardial tissues of hypereosinophilic patients, suggest that eosinophils are the main inducers of tissue damages. These cells seem to affect first the coronary endothelial cells, so leading to thrombi formation and then fibrosis. Eventually restrictive cardiomyopathy may occur. The pathogenetic events are not fully understood. However several studies have been focused on two eosinophil proteins: the major basic protein (MBP) as possible mediator of tissue damages and the cationic eosinophil protein (ECP) involved in thrombotic events. In the bone marrow a marked hyperplasia of the eosinophil series is usual, while in the blood only mature eosinophils circulate. Non specific abnormalities either of the cellular or humoral immunity have been described. Previous reports of a definitely incurable disease have been improved by modern therapeutic programs.

  13. [Adenoids and sickly children: clinico-morphological parallels].

    PubMed

    Lukashevich, M G; Kiselev, V V; Kiriĭ, G I

    2010-01-01

    This paper presents comparative clinical and somatometric characteristics of sickly children. Statistical analysis demonstrated the relationship between immunological characteristics, somatic types, degree of enlargement of the pharyngeal tonsil, and mucociliary transport time. The authors undertook an attempt to address the problem of adenoids with reference to constitutional types of the patients.

  14. [Clinico-radiologic correlations in common neck pain].

    PubMed

    Pacciani, E; Salsano, M L; Donnetti, L; Urso, S

    1996-05-01

    Patients with spontaneous neck pain, headache, dizziness and/or pain to the upper limbs are frequently observed. Common cervicodynia, due to the involvement of arthromuscular structures of the cervical spine, was diagnosed in the patients with these symptoms in the absence of trauma or neurologic signs. The authors investigated the clinical-radiologic correlation in a series of 130 symptomatic patients and considered it a metameric disorder. The frequent association of many radiographic signs at the same level often prevents single radiographic signs from being assessed individually; therefore, the authors selected some patients with just one radiographic change per functional unit, to assess its relationship with clinical symptoms. The patients underwent anteroposterior, lateral and functional (flexion-extension) radiographs of the cervical spine. Vertebral rotation, detected on antero-posterior views as a spinous process deviation, was the most frequent isolated sign (79/130 cases) per metameric level, with strong clinical correlation (70/79 cases). Vertebral rotation was probably due to unilateral muscular stiffness. Other single radiologic signs per functional unit with strong clinical correlation follow: atloaxial rotation (13/130 with clinical-radiologic agreement of 12/13), functional blockage (13/130 with clinical-radiologic agreement of 11/13), angular flexion (21/130 with clinical-radiologic agreement of 19/21) and overall disc space thinning (12/130 with clinical-radiologic agreement of 10/12). Atloaxial rotation is represented as an asymmetry of the spaces between the odontoid and the lateral masses of the atlas; functional blockage consists of insufficient or lacking physiological width of the occipito-atlantoid or interspinous space in functional tests. Angular flexion consists of a single flexion angle of the cervical spine in functional tests; two or more angles indicate normal flexion of the cervical spine. This study confirmed the poorer clinical impact of degenerative changes, mostly interapophyseal arthrosis, than of other radiologic signs. Interapophyseal arthrosis alone was isolated in single functional units in 46/130 patients, mostly at C7-D1, with clinical-radiologic agreement in 19/46 patients. Clinical-radiologic correlation proved the high diagnostic value of anteroposterior, lateral and functional radiographs of the cervical spine in common cervicodynia, which make them a valuable tool for the clinician.

  15. [Clinico-pathogenetic features of viral hepatitis A course].

    PubMed

    Pak, S G; Volchkova, E V; Umbetova, K T

    1999-01-01

    To study mechanisms enhancing realization of autoimmune disorders in acute viral hepatitis A at initial stages. 32 patients with moderate and 4 patients with severe VHA (17 females and 19 males, age from 15 to 38 years) verified by finding serum anti-HAV IgM at enzyme immunoassay (EIA) have undergone examination which included: measurement of beta 2-microglobulin, C5-components of complement, circulating immune complexes (CIC), zero lymphocytes; test for antinuclear antibodies (ANA) and smooth muscle antibodies (SMA). All the patients exhibited high levels of beta 2-microglobulin, zero lymphocytes, CIC, low concentration of C5-components of complement. SMA were detected at the height of intoxication in 27 patients, in early convalescence--in 31 patients. ANA were discovered only in one patient. The findings suggest development of autoimmune reactions in acute VHA patients. These reactions may trigger onset of autoimmune hepatitis.

  16. Crouzon Syndrome: Clinico-Radiological Illustration of a Case

    PubMed Central

    Mohan, Raviprakash Sasankoti; Vemanna, Naveen Shanker; Verma, Sankalp; Agarwal, Neha

    2012-01-01

    Crouzon syndrome, also called craniofacial dysostosis, is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder characterized by premature closure of cranial sutures, midfacial hypoplasia, and orbital defects. Here, we report a case of this rare entity. The patient presented with brachycephaly, maxillary hypoplasia, exophthalmos, mandibular prognathism, along with dental and orbital abnormalities. PMID:23393627

  17. Crouzon syndrome: clinico-radiological illustration of a case.

    PubMed

    Mohan, Raviprakash Sasankoti; Vemanna, Naveen Shanker; Verma, Sankalp; Agarwal, Neha

    2012-01-01

    Crouzon syndrome, also called craniofacial dysostosis, is an autosomal dominant disorder with complete penetrance and variable expressivity. Described by a French neurosurgeon in 1912, it is a rare genetic disorder characterized by premature closure of cranial sutures, midfacial hypoplasia, and orbital defects. Here, we report a case of this rare entity. The patient presented with brachycephaly, maxillary hypoplasia, exophthalmos, mandibular prognathism, along with dental and orbital abnormalities.

  18. Cleidocranial Dysplasia: A Clinico-radiographic Spectrum with Differential Diagnosis

    PubMed Central

    Patil, Purva Prakash; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G.

    2015-01-01

    Introduction: Cleidocranial dysplasia (CCD) is characterized by aplasia or hypoplasia of the clavicles, characteristic craniofacial malformations, and the presence of numerous supernumerary and unerupted teeth. It affects bones derived from both intra-membranous and endochondral ossification. Incidence has been reported as 1 in 10,00,000. It is caused by mutation in the gene encoding transcription factor Core Binding Factor Subunit Alpha l (CBFAl) or Runt related transcription factor 2 (RUNX2). Case Report: This presentation discusses the clinical and radiographic features of a familial case of cleidocranial dysplasia occurring in a father and a child. All the clinical and radiographic features, except that of the chest x-ray, were more prominent in the child than the father. This supports the fact that CCD is transmitted by an autosomal-dominant mode of inheritance with high penetrance and variable expressivity. It is sporadic in about 40% of cases. Each child of an individual with CCD has a 50% chance of in heriting the mutation. Conclusion: Diagnosis is mostly made on the basis of clinical and radiographic features. Molecular genetic testing such as sequence analysis or deletion analysis can be used in cleidocranial dysplasia. Some cases are diagnosed through incidental findings by physicians, treating patients for unrelated conditions. Treatment of these patients requires a multidisciplinary approach which includes orthopaedic and dental corrections along with management of any complications of cleidocranial dysplasia. PMID:27299035

  19. [Clinico-pathological factors and prognosis scale for portal cholangiocarcinoma].

    PubMed

    Zharikov, Yu O; Kovalenko, Yu A; Olifir, A A; Kalinin, D V; Czhao, A V

    2017-01-01

    Введение. Разработан способ прогнозирования общей выживаемости у больных воротной холангиокарциномой, перенесших хирургическое вмешательство, в основу которого положены значимые клинико-патологические факторы опухоли. Материал и методы. В анализ включены 55 пациентов с воротной холангиокарциномой, проходивших лечение с 2011 по 2015 г. в Институте хирургии им. А.В.Вишневского. Хирургическое лечение после билиарной декомпрессии было проведено у 37 (67,3%) больных. В отдаленные сроки наблюдались 36 (97,3%) оперированных больных. Проанализирована зависимость общей продолжительности жизни от клинико-патологических факторов опухоли с помощью моно- и полифакторного анализа регрессионной модели пропорционального риска Кокса у всех оперированных больных. Результаты. Общая 1—3-, 5-летняя выживаемость составила 75,1, 60,5, 37,7, 35% соответственно. При монофакторном анализе значимыми прогностическими факторами являются периневральная (p=0,05) и сосудистая инвазия (р=0,049), R1 резекция (p=0,01), стадия заболевания III и выше (p=0,03), инвазия в SI печени (p=0,004), степень дифференцировки клеток опухоли (grade) 2 и выше (p=0,0006). При полифакторном анализе было выявлено, что низкую общую выживаемость обусловливали: периневральная (p = 0,05) и сосудистая инвазия (p=0,008), степень дифференцировки клеток опухоли (p=0,001), стадия заболевания (p=0,05), хирургический край резекции (р=0,0345). Разработанный способ прогнозирования общей выживаемости представляет собой многофакторную балльную оценку факторов прогноза. Выводы. Шкала индивидуального прогноза у больных с опухолями проксимальных желчных протоков, учитывающая как клинические, так и патогистологические характеристики опухоли, может быть полезна для оптимизации лечебной тактики, при принятии решения о проведении оперативного вмешательства и его объема, а также индивидуализировать показания к проведению адъювантной химиолучевой терапии.

  20. [Clinico-prognostic analysis of course of thyroid medullary carcinoma].

    PubMed

    Kravcheniuk, A M; Reĭzin, D B; Pilets'kyĭ, A M; Reĭzin, V I

    2013-07-01

    Analysis of localization, character of development, sizes and metastatic potential of tumors in patients, suffering various forms of thyroid medullary carcinoma (THMC), was accomplished, permitting to establish a certain dependence of these characteristics from the recurrence occurrence frequency and lethality in groups of patients, owing different gender. The tumor diameter more than 2 cm and presence of metastases in time with diagnosis establishing have constituted the unfavorable factors, causing lethality enhancement in sporadic form of THMC. In women patients more frequent multifocal development coincide with lesser frequent metastasizing and lesser lethality in comparison with such in men. Lethality in men in sporadic form of THMC is twice as more, than in women patients, and it is explained by tumor diagnosis in them in later stages, although their postoperative life span is longer, taking into account the unfavorable impact of intraoperative age (bigger, than in men) on the results of treatment and prognosis. Lethality in inherited forms of THMC is significantly lesser, than in sporadic form, independently from impact of such existing factors, as more frequent multifocal tumor development, bilateral thyroid affection and similar frequency of metastasizing. In men the metastasizing is occurring more frequently, as it take place in cases of a sporadic form of the disease, causing higher lethality in them, comparing with such in women, suffering inherited forms of THMC.

  1. [Thin glomerular membrane nephropathy. Clinico-pathological observations].

    PubMed

    Trinn, C; Tassi, D; Túri, S; Sonkodi, S; Ormos, J; Nagy, J

    1997-10-19

    In two nephrology centres between 1983 and 1993 among 1545 kidney biopsies 34 cases of thin basement membrane nephropathy have been diagnosed. All patients had a varying degree of microscopic dysmorph haematuria, occasional slight proteinuria--except two nephrotic children; and normal blood pressure with one exception. 5 children and 7 adults experienced repeated bouts of macroscopic haematuria mainly after exercise or upper respiratory tract infection, one child after tonsillectomy. All patients had normal renal function and retained it during the follow-up period (mean 61 months, 3 months to 22 years), except a 46 year old patient, who was found to have the joint occurrence of light chain gammopathy and hypertension. Seven patients had positive family history for microscopic haematuria, in four family members of three patients renal biopsy disclosed mesangioproliferative glomerulonephritis with thin GBM segments. As a cut off value for thin basement membrane nephropathy we considered 264 nm. The morphometric analysis of the electron micrographs revealed a mean thickness of 210 nm. No differences in basement membrane thickness were measured regarding gender, age or the presence of macroscopic haematuria. The thin basement membrane is considered to be the pathological basis and predisposing alteration leading to haematuria.

  2. A clinico-pathological study of primary neuritic leprosy.

    PubMed

    Pannikar, V K; Arunthathi, S; Chacko, C J; Fritschi, E P

    1983-04-01

    Normally neural involvement in leprosy is an ascending neuritis from the nerve involvement in the dermal lesions. However, in some cases neural involvement is seen in the absence of any dermal lesions. In some of these pure neuritic cases, dermal lesions appear sometime later. It is, therefore, more appropriate to designate such cases as 'primary neuritic' cases. This study is aimed at diagnosing primary neuritic leprosy among patients presenting with only neuritic symptoms. An attempt is also made to classify primary neuritic leprosy on a clinical and histopathological basis. During the period 1979-80, 30 patients reported to the out patient department of Schieffelin Leprosy Research and Training Centre, Karigiri with complaints of neuritic origin. In addition to clinical examination and routine skin smears, investigations such as skin, nerve and nasal biopsies, nerve conduction velocity and lepromin testing were carried out where feasible. 17 of these patients were diagnosed as primary neuritic leprosy and in 7 patients other neurological conditions were diagnosed. The remaining 6 patients were kept under observation and have not shown evidence of leprosy during a two year period of following-up. It is interesting that 4 of the 17 primary neuritic cases developed patches during follow-up period of two years. In the final analysis 7 patients (41.2%) were classified into the lepromatous group and 10 patients (58.8%) in the non-lepromatous group (Table-6). This classification will have a bearing on duration of treatment and for their subsequent release from control.

  3. [Clinico-mycological study of onychomycosis in elderly patients].

    PubMed

    Rodríguez-Soto, M E; Fernández-Andreu, C M; Moya Duque, S; Rodríguez Díaz, R M; Martínez-Machín, G

    1993-01-01

    Physical examination of nails was carried out in 210 elderly patients and nail scrapings were obtained from onychomycosis suggested lesions in order to determine their causative agents, incidence and clinical characteristics. Diagnostic was confirmed by the isolation of the agents from 74 patients, mainly from toe-nails (incidence 35.2). Tinea pedis occurred in 25% of the cases and Diabetes mellitus was the most prevalent associated disease and the most frequent clinical characteristics were the thickening, the opacity and the presence of longitudinal strias in the surface of the nails. It was compared the results obtained by microscopic examination and by culture. Trichophyton rubrum was the most common dermatophyte isolated; Candida parapsilosis was dominant among Candida species.

  4. [Paratesticular neoplasms of mesenchymatous origin. Clinico-pathologic study].

    PubMed

    Castiñeiras, J; Varo, C; Sánchez Bernal, C; Juarez, A; Castro, C; López, A; Sánchez-Ferragut, C; Paublete, M C; Rodríguez-Rubio, F

    1995-01-01

    There is a group of malignant intrascrotal tumours which represent a very small number when compared to testicular neoplasias and which are known as paratesticular neoplasias. More than 90% belong to the sarcomatous species. From a clinical point of view and based on the patient's age, two groups can be distinguished: sarcomas affecting children and adolescents (primarily rabdomiosarcomas) and those occurring in adulthood, the more frequent histopathological variants being fibrosarcoma, leiomiosarcoma and liposarcoma. This work contributes five paratesticular sarcomas (two rabdomiosarcomas, one liposarcoma, one leiomiosarcoma and one fibrosarcoma). The features related to histogenesis, diagnosis (revealing signs and clinical examination), natural history (dissemination routes based on histopathology) and treatment are reported. With regard to treatment, both the local surgery (total orchiectomy by inguinoscrotal approach with or without hemiscrotectomy), and indications for lymphadenectomy and radiotherapy in relation to staging are discussed though insisting on the chemotherapy approach.

  5. Clinico-pathological aspects of the neurosyphilitic psychoses

    PubMed Central

    Dewhurst, Kenneth

    1968-01-01

    (1) The immediate causes of death of eighteen patients with neurosyphilitic psychosis are analysed. There were five females and thirteen males. Their average age was 56 years, and the mean length of stay in a mental hospital was approximately 2½ years. (2) Of the original ninety-one patients, twenty-eight had malaria therapy. There was one death due to malaria therapy, giving a mortality rate of 3·6%. It is concluded that the risk associated with malaria is too great and fever induced by bacterial pyrogens is safer and just as effective. (3) The duration of mental symptoms before treatment was started is analysed. In one group there was a delay of between 1 and 4 years before treatment was given. In six patients the disease ran a rapidly fatal course in spite of adequate antibiotics. Combined treatment may be beneficial in such cases as fever facilitates the penetration of penicillin into the cerebrospinal fluid. (4) Of the four cases that came to necropsy, only one had a full pathological and histological examination of the brain and meninges. Although these four patients had profound dementia and considerable deterioration of the personality only minimal neuropathological and histological changes were found. It would seem that the widespread use of antibiotics has modified the pathological and histological picture in neurosyphilis, corresponding to alterations recently reported in the clinical features of the disease. (5) Such adverse presenting symptoms as epilepsy, and profound dementia associated with pupillary and reflex abnormalities, are discussed. PMID:5738047

  6. Clinico-pathological feature of pilomyxoid astrocytomas: three case reports.

    PubMed

    Nagaishi, Masaya; Yokoo, Hideaki; Hirato, Junko; Yoshimoto, Yuhei; Nakazato, Yoichi

    2011-04-01

    Pilomyxoid astrocytoma (PMA) is a newly identified variant of pilocytic astrocytoma (PA). We report three cases of PMA with comparison to seven cases of PA in terms of their clinicopathological features. The three cases occurred at the ages of 2, 36 and 6 years, and their tumors were located in the left basal ganglia, the pineal gland, and the cerebellum, respectively. They were diagnosed PMA by surgical specimens that showed a characteristic monomorphous architecture with an angiocentric growth pattern and myxoid background. One patient developed localized relapse at 6 months after the surgery, but the other patients remained alive without tumor progression more than 5 years after treatment. In analysis of the immunohistochemical association in PMA and PA, no specific staining was found to be useful for differential diagnosis of PMA from PA. The expression of biomarkers including O-6-methylguanine-DNA methyltransferase, p53, MIB-1, and EGF receptor neither distinguished PMA from PA nor correlated with outcome. But almost all PMA and PA that demonstrated prominent positivity for nestin showed a high MIB-1 labelling index (LI), and four of these five patients suffered a relapse in the early phase. These results suggest that immunohistochemical expression of nestin and MIB-1 LI may correlate with the aggressiveness of the tumor in PA and PMA.

  7. A Clinico-Pathological Study of Cervical Lymph Nodes.

    PubMed

    Batni, Gaurav; Gaur, Sushil; Sinha, O N; Agrawal, Siddhant Priya; Srivasatva, Abhinav

    2016-12-01

    Cervical lymphadenopathy is one of the commonest presenting complaint of patient in ENT OPD Fine Needle Aspiration Cytology (FNAC) is one of the most reliable, less expensive, and basic diagnostic procedure for the definitive and conclusive diagnosis for the immune system which reciprocates in the form of enlarged lymph nodes. A study was conducted in ENT Department of Santosh Medical College, Ghazibad from August 2015 to May 2016 on 64 patients with enlarged cervical lymph nodes. FNAC was done to make the diagnosis. Out of 64 patients (51.5 %) was reactive non-specific, 28 % tubercular, 3.1 % lymphoma and 17 % were malignant. FNAC is one of the most dependable diagnostic tools in case of cervical lymphadenopathy for early diagnosis and detection for the better management.

  8. Clinico-pathologic conference: case 4. Langerhans cell histiocytosis (LCH).

    PubMed

    Muramatsu, Takashi; Hall, Gillian L; Hashimoto, Sadamitsu; Miyauchi, Jun; Shimono, Masaki

    2010-12-01

    A 13-month-old Japanese boy presented with painless swelling in a left mandible and cheek. Intraoral examination revealed swelling in the left mandible and hemorrhage of oral mucosa due to biting. CT images revealed a wide osteolytic lesion of the left mandible with floating teeth. Biopsy was carried out and histopathological diagnosis was discussed.

  9. Cowden syndrome- Clinico-radiological illustration of a rare case.

    PubMed

    Patil, Prashant B; Sreenivasan, V; Goel, Sumit; Nagaraju, K; Vashishth, Shirin; Gupta, Swati; Garg, Kanika

    2013-01-01

    Cowden syndrome (CS) or multiple hamartoma syndrome is an infrequent genodermatoses, which is inherited as an autosomal dominant trait resulting from the mutation in the Phosphatase and Tensin homolog gene on the arm 10q and is principally characterized by multiple hamartomas with an increased risk of development of malignancies. Facial and oral signs are remarkable in the form of multiple papules and trichilemmomas on the face. We report one such rare case of CS in a 19-year-old patient who was diagnosed on the basis of her oral mucosal lesions and was further investigated and diagnosed with other hamartomas. The present case report signifies the responsibility of the oral physician in the early diagnosis of this progressive pathological syndrome as it leaves its footmark in the oral cavity in the form of oral mucosal lesions.

  10. Macrodystrophia lipomatosa: Review of clinico-radio-histopathological features.

    PubMed

    Majumdar, Banashree; Jain, Atul; Sen, Debashis; Bala, Sanchaita; Mishra, Pranshu; Sen, Sumit; Biswyas, Projna; Behra, Akhilesh

    2016-01-01

    We report clinical, radiological, and pathological features of three cases of macrodystrophia lipomatosa, which is characterized by progressive proliferation of all mesenchymal elements, with a disproportionate increase in fibroadipose tissue. The peculiarity in our report is the involvement of contralateral hand and feet in our 1(st) case in contrast to usual presentations of this rare condition, which is often unilateral. In our 2(nd) case, the lateral aspect of foot was involved as against the usual finding of involvement of medial aspect in lower limbs, also another surprising finding in this case is increase in the size of lesion after puberty. Coming to our 3(rd) case, enlargement of almost whole of an upper extremity with profound involvement of middle, ring and little finger along with total sparing of the thumb is in itself an extremely rare occurrence as in upper limb, mainly the lateral aspect of hand and related digits bear the burnt and more over involvement of whole limb is itself an unique phenomenon.

  11. Cleidocranial dysplasia: clinico-radiological illustration of a rare case.

    PubMed

    Mohan, Ravi Prakash S; Suma, Gundareddy N; Vashishth, Shirin; Goel, Sumit

    2010-03-01

    Cleidocranial dysplasia is an autosomal dominant condition caused by mutation of RUNX2, characterized by generalized dysplasia of the bones and teeth. Affected individuals have short stature, atypical facial features, and skeletal anomalies affecting mainly the skull and clavicle. The dental manifestations are mainly delayed exfoliation of the primary teeth and delayed eruption of the permanent teeth, with multiple impacted supernumeraries, and absence of cellular cementum. The frequency of this disorder is 1 per million individuals. Here we report a rare case of CCD in a 9-year-old male patient having most of the characteristic features of this syndrome. Interestingly, disorganized dentinal tubules were found in the roots of an extracted deciduous first molar, which seems to be a unique feature not reported previously.

  12. Nummular headache: Clinico-epidemiological features in South Indian population

    PubMed Central

    Rammohan, K.; Mundayadan, Shyma M.; Mathew, Robert

    2016-01-01

    Context: Nummular headache (NH) is a primary disorder characterized by head pain exclusively felt in a small-rounded area typically 2–6 cm in diameter. Aims: The aim of this review is to study the clinical and epidemiological features of NH in a patient population of South India and to compare this with that of described in the international literature. Settings and Design: A prospective, observational study conducted in a tertiary care center. Materials and Methods: Patients attending the medicine and neurology outpatient departments of a tertiary referral hospital in South India diagnosed to have NH as per the International Classification of Headache Disorders 3 beta (2013) criteria were studied over 30 months. All of the patients had a normal neurological examination. Neuroimaging findings were normal, except in one patient. Results: A total of 19 females and 10 males were studied. The mean age of onset was 47.62 years (range 36–60). The duration of headache varied from a minimum of 3 months to a maximum of 5 years, with a mean of 24.17 months. The site of headache was predominantly in the parietal area 15 (51.72%), followed by the occipital area 7 (24.13%). The mean diameter of the affected area was 3.23 cm. The intensity of the headache proved to be mild to moderate with a mean visual analog scale score of 5.03. The quality of pain was mainly felt as burning dysesthesia 12 (41.38%). In the majority of patients, i.e. 21 (72.41%), pain was chronic and continuous. None of the patients had any significant trophic change even though paresthesias, dysesthesias, and allodynia were reported by a significant minority of patients, i.e. 9 (31.03%). Only one (3.45%) patient gave a history of head injury. Ten (34.48%) out of 29 patients had other types of concurrent headaches; the majority of which proved to be migrainous, i.e. 7 (24.14%), 2 patients (6.89%) with tension headache, and 1 patient (3.45%) with trigeminal neuralgia. Conclusion: Our study proves the existence of the newly described primary headache syndrome called NH in South Indian population. In comparing our results with the international literature, the number of similarities is much greater than the differences. The etiology of pain in our series appeared to be primarily peripheral with a role for central pain sensitization in some cases due to a variety of concurrent central causes of head pain. PMID:27695232

  13. A clinico-epidemiological study of rescuer burns.

    PubMed

    Basra, Baljeet Kumar; Suri, Manav P; Patil, Nilesh; Atha, Ravish; Patel, Natvar; Sachde, Jayesh P; Shaikh, M F

    2014-08-01

    Rescuer burn is a relatively newer terminology introduced to define the burns sustained by a person attempting to rescue a primary burn victim. Few studies have been published thus far on this peculiar type of burns. Due to the general neglect of the rescuer burns victim and discontinuation of treatment in most cases, once the primary victim dies, the rescuer often ends up in badly infected wounds and has a delayed return to work. A prospective study was conducted at the B J Medical College and Civil Hospital, Ahmedabad from January 2009 to December 2012 on the rescuer burns patients treated in its burns and plastic surgery department. 3074 patients of burns received treatment during the period of study. Of these, 48 patients gave the history of sustaining burns while trying to rescue a burns victim. Male to female ratio of rescuers was approximately 7:1. It was significantly higher as compared to the ratio of 1:0.8 of females to male burn victims observed at our centre (p≤0.01). Average age of the rescuers was higher in males as compared to females but the difference was not significant (p≥0.05). Of the 45 cases of female primary burns victims, male rescuer was husband of the primary victim in 41/45 cases (91.1%), mother was rescuer in three cases (6.6% cases) and sister was rescuer in one case. Though multiple people came to rescue a burns victim, in all cases, it was seen that it was the first rescuer who sustained burns himself or herself. None of the rescuers had any knowledge of the techniques and precautions to be taken while performing a rescue operation irrespective of their education status, indirectly pointing to the lack of any teaching on burns rescue in the school education curriculum. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Proposed Clinico-Pathological Classification for Oral Exophytic Lesions

    PubMed Central

    Boyd, Doryck; Laxminarayana, Kumaraswamy Kikeri

    2015-01-01

    Oral exophytic lesions often have proven to be diagnostically challenging due to the varied clinical presentation. The exophytic growth of the oral lesions is due to the type of pathology and histological changes. Careful clinical interpretation with a better histological understanding of exophytic lesions may ease the diagnosis from the differential diagnosis panel. The purpose of proposing classification system is to categorize the exophytic lesions of interest under specific clinical and/or histological explanation; and this will eventually lead to better understanding of the pathological condition that is described. To the best of our knowledge, there is no such classification system available for oral exophytic lesions and hence proposal of classification system is attempted in this study. Further, proposing a new classification system is not just to influence the academic contribution, but also to assist at greatest extent for diagnosis during clinical practice. PMID:26501030

  15. [Clinico-etiological characteristics of intestinal diseases in young children].

    PubMed

    Luvsandagva, E; Altantsétség, Zh; Suvdaa, M; Nortmaa, M

    1990-01-01

    Intestinal disorders in infants are determined in 96.9% of cases by the opportunistic flora with the predominance of Pr. mirabilis (25.5%), E. coli (19.1%), Enterobacter aerogenes (12.6%) and with the less frequent occurrence of Klebsiella (4.1%) and pathogenic staphylococci (5.8%). As a result of the unbased use of antibiotics, the majority of children demonstrate dysbacteriosis and the growth of the number of resistant hospital strains. It is suggested that in children with ARVI, the drugs containing lactic acid bacteria and lactose should be used on a wider basis to prevent dysbacteriosis and reduction of resistant strains.

  16. [Acute appendicitis: clinico-diagnostic and therapeutic considerations].

    PubMed

    Carditello, A; Bartolotta, M; Bonavita, G; Lentini, B; Sturniolo, G

    1985-04-01

    Since january 1970-december 1982, 58 patients underwent emergently appendectomy for acute appendicitis. 31 (53,4 percent) where males; the average age was 21 +/- 2,3 years (M +/- SEM). The duration of symptoms ranged from 1-6 hours (10,3 percent of cases) to over 48 hours, before the hospital admission (15,4 percent of cases). 27 patients (46,5 percent) had a clinical examination at home by a physician. 21 patients (36,4 percent) came to hospital emergency unit without previous physical examination; 10 (17,2 percent) were transferred from other departments. In 6,9 percent of cases was present a perforated appendicitis with peritonitis. During operation, in 50 percent of patients was performed a therapeutic peritoneal lavage. In 63,7 percent of cases multiple drains were placed in peritoneal cavity. In all patients was effected postoperative antibiotic profilaxis. The mortality rate was 3,4 percent. General complications were observed more in patients with perforated appendicitis. This review suggests the following remarcable data: morbidity of this disease is still high; the physical examination is more important than laboratory work (especially in the elderly patients, which are often immunodepressed and in children, with leucocitosis-lack at hospital admission); early surgery is the most important factor to the improvement of prognosis in these cases and the results of surgical treatment are improved by large vertical incisions, peritoneal lavage and application of multiple intracavitary drains.

  17. Clinico- pathological profile of patients with breast diseases

    PubMed Central

    2013-01-01

    Background To evaluate the spectrum of breast diseases and their association with presenting complains of patients. Methodology It was a cross sectional study conducted from 1st January 2010 – 30th December 2012. A total of 254 breast specimens of patients, who were admitted in Civil Hospital Karachi with breast complaints, were included. Specimens were collected either from mastectomy, lumpectomy or needle biopsy from the admitted patients. Informed written consent was taken from all the patients. All patients with primary breast diseases were included. Patients undergoing chemotherapy or with secondary breast disease and slides with insufficient specimen were excluded. All data was entered and analyzed through SPSS 19. Result There were 254 breast lesions, histologically diagnosed in 3 year review period. The overall mean age of patients with breast lesion was 25.18, SD ± 11.73 with a wide age range of 12–74 years. Most common cases identified are benign 191(75.3%), followed by inflammatory 30(11.8%) and malignant lesions 30(11.8%). Most patients presenting with the complain of pain have diagnosis of fibroadenoma 24 (63.2%) while patient with complain of lump also have the most common diagnosis of fibroadenoma 147 (72.8%). Conclusions Study shows that in Pakistani females, mostly encountered breast lesion was fibroadenoma. Due to lack of awareness breast diseases present lately. Awareness must be created among women to reduce the mortality and morbidity with breast lesions. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1037059088969395. PMID:23659667

  18. [Fecal incontinence and rectal prolapse. Clinico-functional assessment].

    PubMed

    Santini, L; Pezzullo, L; Caracò, C; Candela, G; Esposito, B

    1995-09-01

    Rectal Prolapse is a rare and distressing condition, with a multifactorial etiopathogenesis. Often, this pathology is associated with fecal incontinence. The recommended approach to the patient with rectal prolapse and fecal incontinence is to repair the prolapse first, then deal particularly with fecal incontinence at a second operation. A retrospective, clinical and manometric study has varying degrees of fecal incontinence. Clinically five of their operation, and a further three patients improved, in two patients the degree of fecal incontinence remained invariable. One patient was worsened after surgery. Manometrically resting and pressure (RAP) was significantly higher in continent patients than in voluntary contraction pressure (MVCP) (p < 0.05) in preoperative testing. Postoperatively, there was a significant increase in the resting anal pressure as well as in maximum voluntary contraction pressure. Patients who remained incontinent had a significantly lower RAP and MVCP than patients who improved our regained continence. In conclusion this study shows an alteration of internal and external sphincteric function in patients with rectal prolapse. The surgical treatment of this disease improves sphincteric function. Incontinent patients with RAP < 10 mmHg and MCVP < 20 mmHg, probably they would be better treated simultaneously either for rectal prolapsus and incontinence. In this kind of patients the perianal proctectomy with total sphincteroplasty could be the elective treatment.

  19. [Papillary cancer of the breast (clinico-morphological aspects)].

    PubMed

    Ermilova, V D; Krylova, M O

    1990-01-01

    Examinations of 23 specimens of papillary carcinoma of the mammary gland helped single out the basic criteria for the morphologic diagnosis of papillary carcinoma: numbers of cystic dilated ducts with ramified true and epitheliocyte-formed papillae. The cells are monomorphic, medium-sized, with large polymorphous and hyperchromic nuclei. Metastases to the regional lymph nodes were detected in 8.7 percent of cases. Total 3-year, 5-year, and 10-year survival in this form are 95.45 +/- 4.44, 89.09 +/- 7.41, and 89.09 +/- 7.41 percent, respectively. Since the prediction is favorable, radical resection of the mammary gland is recommended for patients with Stages I and II A papillary carcinomas of the mammary gland.

  20. [Efficacy of educational intervention for patients wearing peripherall inserted central catheter. A pilot study].

    PubMed

    Fusco, Federica; Armando, Tiziana; Storto, Silvana; Mussa, Maria Valentina

    2016-01-01

    Introduzione: Il Peripherally Inserted Central Catheter (PICC) è un catetere venoso centrale adatto per pazienti in regime di Day Hospital. Il suo utilizzo è considerato vantaggioso ma comporta degli oneri di gestione a carico della persona. E' bene formare il paziente ad una corretta gestione domiciliare del presidio attraverso un'educazione strutturata. Obiettivo: In un gruppo di pazienti portatori di PICC, valutare l'efficacia di un intervento educativo mirato attraverso la comparazione di: colloquio informativo, opuscolo cartaceo, video informativo. Metodo: Studio clinico randomizzato e controllato monocentrico, schema comparativo semplice a tre bracci. Popolazione: tutti i pazienti sottoposti all'impianto di PICC nel periodo di osservazione tra Ottobre 2013 e Febbraio 2014 presso l'Unità Operativa Day Hospital Oncologico e Breast Unit, presidio Molinette di Torino. L'intervento educativo standard è erogato attraverso un colloquio con l'infermiere che esegue l'impianto. Il team di impiantatori è costituito da due infermieri con comprovata esperienza in ambito oncologico ed in possesso di Master di I Livello "Gestione degli accessi venosi". I pazienti eleggibili, dopo randomizzazione, sono stati divisi in tre gruppi: gruppo A colloquio informativo; gruppo B opuscolo; gruppo C video. I pazienti dei gruppi B e C hanno ricevuto informazioni standard inte- grate con informazioni audiovisive oppure cartacee, in base al braccio al quale erano stati destinati; il grado di conoscenza raggiunto è stato indagato attraverso la somministrazione di questionari costruiti ad hoc, non vali- dati in quanto non presenti in letteratura. Risultati: Adesione allo studio di 40 pazienti, campione di convenienza costituito da persone di età compresa tra 18 e 75 anni, consenzienti e risiedenti al proprio domicilio. L'analisi delle conoscenze apprese in seguito all'intervento educativo mostra una differenza statisticamente significativa in diversi ambiti necessari per la

  1. Correlation of Clinico-pathological Classification of Hansen's Disease in a South Indian City.

    PubMed

    Lobo, A C; Pai, R R; Gautam, K; Kuruvila, M

    2014-01-01

    Hansen's Disease (HD) presents itself in different forms depending on the individual's immune status, and based on this Ridley-Jopling classified the disease into five sub-groups. The aim of this study was to evaluate the role of histopathology and bacteriological index (BI) in accurate staging of HD with clinical correlation. Fifty HD patients with clinical diagnosis confirmed by histopathology were included. Patients in reaction and on treatment were excluded. Case records and histopathological slides were viewed and BI was recorded. In 10/50 cases, a diagnosis of HD was made or suspected, but were not clinically classified. In these, histopathology proved useful in diagnosis and classification. Indeterminate HD was the most common histopathological diagnosis (6 cases). The remaining 40 patients, were clinically classified using the Ridley-Jopling classification, as Indeterminate Leprosy (IL) in 10/40 (25%), Tuberculoid Leprosy (TT) 5/40 (12.5%), Borderline Tuberculoid (BT) 16/40 (40%), Borderline Lepromatous (BL) 4/40 (10%) and Lepromatous Leprosy (LL) 5 (12.5%). HD was common in males with male to female ratio of 1.66:1 and affected the younger individuals (maximum in 21 to 30 years). On histopathology BT was the most common type (40%) followed by IL (27.5%), BL (12.5%), TT (10%) and LL (10%). No case of Mid-Borderline (BB) type was diagnosed clinically or histopathologically. Overall concordance between clinical and histopathological diagnosis was 65% (26/40 cases) and for each type was IL = 80%, TT = 20%, BT = 75%, BL = 50% and LL = 60%. Where classification seemed difficult as in cases of BT and BL, II played an important role. The overall concordance between clinical classification and histopathological diagnosis of DO is 65% in this study. Th *discordance that is observed is between BT and TT, the paucibacillary type and BL andILL the multibacillary type and hence the treatment is not affected. Overall, IL was a common diagnosis on histopathology in this study'(11/40 cases and 6/10 cases). If clinically warranted, a repeat deeper punch of skin biopsyrmay be required for a proper categorization of the cases.

  2. Bacteremia following scaling and root planing: A clinico-microbiological study

    PubMed Central

    Waghmare, Alka S.; Vhanmane, Priyanka B.; Savitha, B.; Chawla, Ruhee L.; Bagde, Hiroj S.

    2013-01-01

    Background: Bacteremia frequently occurs after treatment procedures such as extractions, scaling, root planing, periodontal surgery. There is currently significant interest in the possibility that bacteremia with oral bacteria may play role in pathogenesis of atherosclerosis. There are well-conducted studies that have determined the frequency of passage of periodontal microorganisms to the bloodstream after periodontal treatment. There is scarce information related to the incidence of periodontopathic microorganisms during bacteremia induced by this procedure. Aim: The aim of this study was to establish the frequency of passage of periodontopathic microorganisms in peripheric blood after scaling and root planing in patients with periodontitis. Materials and Methods: Forty subjects with chronic periodontitis were included in the study. Blood samples were drawn from each patient at following intervals pre-treatment i.e., before SRP (P1), immediately after SRP (P2), and 30 minutes after SRP (P3). Following SRP, blood samples were analyzed for following microorganisms: Porphyromonasgingivalis, Tannerella. forysthus, Eikenellanella. corrodens, Campylobacter species, Micromonas. micros, and Prevotella. intermedia. Statistical Analysis Used: Chi-square test. Results: Bacteremia was found in 70% (28/40) immediately after SRP and after 30 min, it was reduced to 25% (10/40) and 7.5% (3/40) presented bacteremia before SRP. Conclusions: It was concluded that bacteremia frequently occurs immediately after SRP with P. gingivalis showing the highest frequency in blood. PMID:24554880

  3. Oral lichenoid lesions: clinico-pathological mimicry and its diagnostic implications.

    PubMed

    Hiremath, Santhosh Kumar S; Kale, Alka D; Charantimath, Seema

    2011-01-01

    Oral cavity is commonly affected by number of lichenoid lesions, whose clinical and histopathologic features overlap due to the presence of inflammatory cells in connective tissue. Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. The literature discussed in the article is an attempt to segregate individual lichenoid lesions by defining clinical and histopathologic variations among each other, which avoids the diagnostic problem.

  4. [Clinico-immunological variants of extremely severe course of hepatitis B].

    PubMed

    Sorinson, S N; Korochkina, O V; Malysheva, E B; Zhaliauskas, A B; Tsybasova, A I

    1989-01-01

    Analysis of the results of comprehensive clinical and immunologic examinations of 29 patients with hepatitis B running a particularly severe course has helped single out 2 variants of the immunogenesis of this form of the disease. Contribution of hyperimmune and autoimmune mechanisms and a high degree of the determination of the immunopathologic process are the major features of the first variant. In the second variant the infectious process per se plays the major role due to the direct viral cytolysis of the hepatocytes and/or a higher infective dose. Dynamic monitoring of hepatitis B specific markers, of the T-lymphocyte reaction, of autoimmune process markers, together with immunologic screening help predict the possible development of various patterns of particularly severe course of the disease and thus give grounds for differentiated therapy.

  5. [Clinico-psychopathologic varieties of the acute Kandinsky-Clerambault syndrome in schizophrenia].

    PubMed

    Dikaia, V I

    1985-01-01

    Acute cases of the Kandinsky-Clerambault syndrome first manifested in adulthood were studied in schizophrenic patients. On the basis of the clinical mechanisms of the development of psychosis and the specific features of acute delirious disturbances in the structure of psychosis 3 clinical variants of the acute syndrome of psychic automatism were identified: developing according to the type of reaction in the structure of acute paranoid (the first variant), according to the regularities of endogenic paroxysm in the picture of acute sensory delirium (the second variant) and according to the mechanism of exacerbation of chronic delirium entering the structure of acute interpretative delirium (the third variant).

  6. Idiopathic giant cell myocarditis--a distinctive clinico-pathological entity.

    PubMed Central

    Davies, M J; Pomerance, A; Teare, R D

    1975-01-01

    Eleven cases of idiopathic giant cell myocarditis are described, The pathological features are unmistakable with serpiginous areas of myocardial necrosis, at the margins of which giant cells can be seen on histological examination. The aetiology of the condition remains obscure but associated pathology suggests that altered immunity may be a factor. The rapid clinical course is, however, highly suggestive of an infective cause though none has been found. Images PMID:1122272

  7. [Clinico-pathological studies on Is, Ip polyps and flat elevations in the large intestine].

    PubMed

    Kida, M; Tanaka, K; Hattori, F; Kondou, S; Harada, W; Takagi, A; Itou, K; Matsumoto, H; Kojima, K; Taniyama, K

    1990-05-01

    We histologically compared 3 types of adenoma and cancer of the large intestine using 620 adenoma specimens (509 Is type lesions, 83 Ip type lesions, and 28 flat type lesions) and 113 specimens of early stage cancer (51 Is type lesions, 39 Ip type lesions, and 23 flat type lesions) obtained during the past 5-year period at our department. More than 90% of the Is and Ip type polyps were adenoma or carcinoma in adenoma while 25.5% of the flat elevations were m or sm carcinoma. Flat elevations even less than 10 mm in diameter were frequently carcinomas (26.3%) compared with the other types (both Is and Ip types, 6.7%), and all of those 10 mm or more in size were carcinomas. The distribution of the flat type early cancers in the large intestine was similar to that of advanced cancer with high percentages of carcinoma at each site compared with the other types. These results suggest that the carcinogenesis and progression of flat type early stage cancer differ from those of the other types.

  8. What's new in bronchial obstruction? Experimental pathology and clinico-pathologic correlation.

    PubMed

    Hartung, W

    1985-03-01

    The aim of general pathology, which following Virchow also should be pathophysiology (and pathobiochemistry), is to elucidate general principles and main mechanisms of diseases. Conceptions like reticulo-endothelial system or coronary insufficiency, inflammations and its mediators, modes of metastasis and many comparable topics are examples of this type of scientific approach, and its tools are careful morphological analysis as well as experimental work of different kinds. In pulmonary pathology the obstruction of airways is one of the most important pathogenetical pathways. Among a broad spectrum of pulmonary diseases it is the main symptom of a developing chronic obstructive pulmonary disease (COPD) and the outstanding cause of cardio-respiratory failure. In German literature the last comprehensive survey on general respiratory pathology was written some twenty years ago and a review of the main techniques of investigation was given at about the same time. Since then - parallel to the invention of new measuring techniques and to the progress in clinical pathophysiology - a rapid further development in the understanding of the pathology of respiratory disorders has taken place, particularly in connection with research in chronic bronchitis and emphysema. Some examples of this development and of the present state of discussion will be reviewed briefly.

  9. [Clinico-histologic-morphometric correlations in pulmonary arteries among patients with heart malformations ].

    PubMed

    Fischbach, H; Hoffmeister, H M; Hoffmeister, H E; Apitz, J; Schmidt, C

    1982-01-01

    To improve the evaluation of grades of pulmonary vascular lesions in congenital heart malformations, we studied the extent to which there is a measurable relationship between pressure conditions in the pulmonary circulation and the area of the media in small and medium-sized pulmonary arteries, and the possibility of a correlation between the subjective evaluation of grades of hypertensive pulmonary vascular lesions according to Heath and Edwards (1958). Material and methods. The lungs in 68 children (mean age, 22.7 months) with congenital malformations of the heart or great vessels resulting in pulmonary hypertension were examined. The lungs were fixed in a 4% formalin solution passed via the trachea under a constant filling pressure of 150 cm H2O. Peripheral as well as central tissue was removed from all lobes of the lungs; the specimens were stained with Elastica-van Gieson. The extent of hypertensive pulmonary vasculopathy was staged, without knowledge of the pressure conditions, according to the grading system developed by Heath and Edwards. The diameter and the area of all muscular arteries with diameters smaller or larger than 100 micron were measured using a semiautomatic measurement device for quantitative morphometric analysis (MOP/AM 01). Cardiac catheter values were available for all cases. The quotient of systolic pressures in the pulmonary artery and the aorta was taken as the measure of hemodynamic conditions in the pulmonary circulation. The Pearson-Bravais correlation coefficient (r) was computed from the respective area quotient and the corresponding pressure values. In addition, the coefficient of determination (r2) and regression functions were determined. Results. A linear correlation (r = 0.70) exists between the pressure quotient (Psyst. pulm. art./ Psyst. aorta) and the vessel area quotient (media area/total area). The correlation is expressed by the following functions: x = 1.89 y - 0.08 y = 0.26 x + 0.24 Using the Heath and Edwards grading, the following frequencies were obtained: Grade 0: 21, Grade I: 7, Grade II: 16, Grade III: 15, Grade IV: 6, and 3 children were undeterminable. No relationship exists between the grades and certain heart malformations. In spite of the fact that hypertensive vasculopathy becomes progressively more severe as the child grows older, we found four cases of Grade IV in children under the age of one. On the whole, a comparison of the measured area quotients and the Heath and Edwards grading showed a good correlation. Although we considered only pressure quotients and no other hemodynamic parameters, conclusions can be drawn about the operability of congenital heart malformations based on these findings. Using measured pressure values, the morphologic state of the pulmonary arteries can be approximately evaluated.

  10. Hereditary spastic paraplegia: clinico-pathologic features and emerging molecular mechanisms

    PubMed Central

    Fink, John K.

    2014-01-01

    Hereditary spastic paraplegia (HSP) is a syndrome designation describing inherited disorders in which lower extremity weakness and spasticity are the predominant symptoms. There are more than 50 genetic types of HSP. HSP affects individuals diverse ethnic groups with prevalence estimates ranging from 1.2 to 9.6 per 100,000 [39, 70, 77, 154, 185]. Symptoms may begin at any age. Gait impairment that begins after childhood usually worsens very slowly over many years. Gait impairment that begins in infancy and early childhood may not worsen significantly. Post mortem studies consistently identify degeneration of corticospinal tract axons (maximal in the thoracic spinal cord) and degeneration of fasciculus gracilis fibers (maximal in the cervico-medullary region). HSP syndromes thus appear to involve motor-sensory axon degeneration affecting predominantly (but not exclusively) the distal ends of long central nervous system (CNS) axons. In general, proteins encoded by HSP genes have diverse functions including axon transport (e.g. SPG30/KIF1A, SPG10/KIF5A and possibly SPG4/Spastin); endoplasmic reticulum morphology (e.g. SPG3A/Atlastin, SPG4/Spastin, SPG12/reticulon 2, and SPG31/REEP1, all of which interact); mitochondrial function (e.g. SPG13/chaperonin 60/heat shock protein 60, SPG7/paraplegin; and mitochondrial ATP6; 4) myelin formation (e.g. SPG2/Proteolipid protein and SPG42/Connexin 47); 5) protein folding and ER-stress response (SPG6/NIPA1, SPG8/K1AA0196 (Strumpellin), SGP17/BSCL2 (Seipin) [113-115], “mutilating sensory neuropathy with spastic paraplegia” due to CcT5 mutation and presumably SPG18/ERLIN2); 6) corticospinal tract and other neurodevelopment (e.g. SPG1/L1 cell adhesion molecule and SPG22/thyroid transporter MCT8); 7) fatty acid and phospholipid metabolism (e.g. SPG28/DDHD1, SPG35/FA2H, SPG39/NTE, SPG54/DDHD2, and SPG56/CYP2U1); and 8) endosome membrane trafficking and vesicle formation (e.g. SPG47/AP4B1, SPG48/KIAA0415, SPG50/AP4M1, SPG51/AP4E, SPG52/AP4S1, and VSPG53/VPS37A). The availability of animal models (including bovine, murine, zebrafish, Drosophila, and C. elegans) for many types of HSP permits exploration of disease mechanisms and potential treatments. This review highlights emerging concepts of this large group of clinically similar disorders. For recent review of HSP including historical descriptions, differential diagnosis, and additional references see [78]. PMID:23897027

  11. White matter in temporal lobe epilepsy: clinico-pathological correlates of water diffusion abnormalities

    PubMed Central

    Rodríguez-Cruces, Raúl

    2015-01-01

    Using magnetic resonance imaging, it is possible to measure the behavior of diffusing water molecules, and the metrics derived can be used as indirect markers of tissue micro-architectural properties. Numerous reports have demonstrated that patients with temporal lobe epilepsy (TLE) have water diffusion abnormalities in several white matter structures located within and beyond the epileptogenic temporal lobe, showing that TLE is not a focal disorder, but rather a brain network disease. Differences in severity and spatial extent between patients with or without mesial temporal sclerosis (MTS), as well as differences related to hemispheric seizure onset, are suggestive of different pathophysiological mechanisms behind different forms of TLE, which in turn result in specific cognitive disabilities. The biological interpretation of diffusion abnormalities is based on a wealth of information from animal models of white matter damage, and is supported by recent reports that directly correlate diffusion metrics with histological characteristics of surgical specimens of TLE patients. Thus, there is now more evidence showing that the increased mean diffusivity (MD) and concomitant reductions of diffusion anisotropy that are frequently observed in several white matter bundles in TLE patients reflect reduced axonal density (increased extra-axonal space) due to smaller-caliber axons, and abnormalities in the myelin sheaths of the remaining axons. Whether these histological and diffusion features are a predisposing factor for epilepsy or secondary to seizures is still uncertain; some reports suggest the latter. This article summarizes recent findings in this field and provides a synopsis of the histological features seen most frequently in post-surgical specimens of TLE patients in an effort to aid the interpretation of white matter diffusion abnormalities. PMID:25853084

  12. Chronic thinner intoxication: clinico-pathologic report of a human case.

    PubMed Central

    Escobar, A; Aruffo, C

    1980-01-01

    A 27 year old Mexican male addicted for 12 years to glue-sniffing and thinner inhalation developed neurological and behavioural disturbances which led to hospital admission and death. Autopsy disclosed diffuse cerebral and cerebellar cortex atrophy and giant axonopathy both central and peripheral. The corpus callosum was atrophic secondarily to neuron loss in the neocortex. Images PMID:7441282

  13. Clinico-pathological aspects of a residual natal tooth: a case report.

    PubMed

    Tsubone, Hanako; Onishi, Tomoyuki; Hayashibara, Tetsuyuki; Sobue, Shizuo; Ooshima, Takashi

    2002-04-01

    A Japanese girl was referred to Osaka University Dental Hospital for examination of a tooth-like structure that had erupted following spontaneous exfoliation of a natal tooth in the lower left primary central incisor region. The structure had erupted at 6 months of age, and radiographic and clinical examination showed composition of pulp and dentin, but no enamel. On histological examination, the majority of the dentin area had a tubular dentin-like appearance, while the outer area of the root appeared to be composed of an osteodentin-like substance. Most of the dentin was covered by cementum. These findings suggest that the structure had originated from a developing remnant of the extracted natal tooth, which must have remained in the gingival tissues. We termed this calcified structure a residual natal tooth.

  14. Assessment of Streptococcus mutans in healthy versus gingivitis and chronic periodontitis: A clinico-microbiological study

    PubMed Central

    Dani, Sneha; Prabhu, Ashwin; Chaitra, K. R.; Desai, N. C.; Patil, Sudhir R.; Rajeev, Ranjan

    2016-01-01

    Background: Dental caries and periodontal disease are most common oral diseases. Streptococcus mutans are considered to be the major pathogens in initiation of dental caries. Evidence shows that periodontal disease and caries share a number of contributory factors. Thus in view of these findings it would be worthwhile to examine whether Streptococcus mutans persist within the saliva and subgingival environment of the periodontitis patients and to determine whether there is any association between Streptococcus mutans colonization, pH of saliva and sub-gingival plaque pH in periodontal diseases before therapy. Methods: The study comprises of 75 subjects aged between 20-70 years, reporting to department of Periodontology, KLEs Institute of Dental Sciences, Bangalore. Subjects were divided into 3 groups of 25 each. Group 1 – Healthy controls, Group 2 – Gingivitis Group, 3 – Chronic periodontitis. Unstimulated saliva was collected in sterile container and immediately pH was evaluated. Subgingival plaque samples were collected from four deepest periodontal pockets in chronic periodontitis and from first molars in healthy subjects using 4 sterile paper points. In gingivitis subjects samples were collected from areas showing maximum signs of inflammation. All paper points and saliva samples were cultured on mitis salivarius agar culture media with bacitracin for quantification of the Streptococcus mutans colonies. Results: Increased colonization of Streptococcus mutans was seen in chronic periodontitis subjects both in saliva and sub-gingival plaque samples. There was also a positive correlation seen with the periodontal parameters. Conclusion: More severe forms of periodontal disease may create different ecological niches for the proliferation of Streptococcus mutans. PMID:27994423

  15. The clinico-pathological effect of bluetongue virus serotype 20 in sheep.

    PubMed

    Uren, M F; Squire, K R

    1982-01-01

    Fifty-four Merino crossbred sheep were inoculated with bluetongue virus serotype 20 (BTV-20) by the intravenous, subcutaneous and intradermal routes. BTV-20 was successfully transmitted by Culicoides (Avaritia) spp. No. 5 to two additional sheep. Clinical and pathological effects were studied. In the artificially infected sheep, clinical signs were observed after an incubation period of 6 to 10 days and consisted of pyrexia, oral and subcutaneous hyperaemia mild oedema of the ears, face and lips, and coronitis. The major internal pathological changes were petechial and ecchymotic haemorrhages in the tunica media of the pulmonary artery near its junction with the heart and mild haemorrhage and mild oedema in the intestines, coronet, lips, cheeks and ears. Viraemia was detected between day 2 and day 14 post inoculation. The two sheep infected by insect transmission were mildly affected and became viraemic between 16 and 19 days after transmission. No deaths occurred and under experimental conditions BTV-20 caused only mild disease in housed sheep. To date there has been no reported outbreak of natural bluetongue infection in Australia. Compared to other serotypes BTV-20 appears to be of low pathogenicity in sheep.

  16. Dermatofibrosarcoma Protuberans: A comprehensive review on the spectrum of clinico-radiological presentations.

    PubMed

    Sung, Tony Ht; Tam, Annie Cw; Khoo, Jennifer Ls

    2017-02-01

    Dermatofibrosarcoma Protuberans (DFSP) is a rare malignant soft-tissue neoplasm which is often misdiagnosed due to its indolent clinical course and non-specific radiological appearances. An observation case series was conducted with retrospective review of clinical and radiological data of DFSP patients presenting to a major tertiary hospital in Hong Kong for radiological assessment between November 2006 and February 2016. Seven patients with confirmed histological diagnosis of DFSP were included. Tumour sizes at presentation ranged from 1 to 5 cm, most commonly (n = 6) occurred over chest wall and abdominal wall. History of previous local trauma or surgery was identified in the majority of cases (n = 4). There was poor correlation between pre-imaging clinical diagnoses and pathological diagnoses. Local recurrence and tumour de-differentiation with sarcomatous changes occurred in the minority of cases (n = 2). A common radiological 'claw' sign at the lesion/skin interface formed by elongated appendages of the tumour superficially was appreciated in most cases (n = 6). A history of previous local trauma or surgery serves as a possible etiological factor for the development of DFSP. High clinical suspicion for the entity is essential in its detection and differentiation from simple wound complications and local recurrence of other benign lesions. The radiological 'claw' sign at the lesion/skin interface might serve as a tell-tale sign for cutaneous tumour involvement. A comprehensive analysis of imaging findings in conjunction with individual clinical presentations is the key to accurate diagnoses and proper management. © 2016 The Royal Australian and New Zealand College of Radiologists.

  17. Rice (Oryza sativa) allergy in rhinitis and asthma patients: a clinico-immunological study.

    PubMed

    Kumar, Raj; Srivastava, Prakriti; Kumari, Dolly; Fakhr, Hena; Sridhara, S; Arora, Naveen; Gaur, S N; Singh, B P

    2007-01-01

    Sensitization to foods varies in different countries reflecting a possible interaction of genetic factors, cultural and dietary habits. Rice is a major food consumed world wide and needs evaluation for IgE mediated reactions. The present study was carried out to identify rice allergy in patients of rhinitis and asthma and identify the allergenic proteins in raw and cooked rice. Of 1200 patients screened using standard questionnaire, 165 presented with history of rice allergy. Of these, 20 (12.1%) patients demonstrated marked positive skin prick test (SPT) and 13 showed significantly raised specific IgE to rice compared to normal controls. Double blind placebo controlled food challenge (DBPCFC) confirmed rice allergy in 6/10 patients. Immunoblot with hypersensitive individual patients' sera showed 14-16, 33, 56 and 60 kDa proteins as major IgE-binding components in rice. Boiled rice retained four IgE reactive proteins of 16, 23, 33 and 53 kDa. In summary, IgE-mediated rice allergy affects 0.8% [(0.42-1.58) at 95% CI] of asthma and rhinitis cases. The subjects with severe SPT reactions (4 mm or above) and specific IgE, 6.9 ng/ml to rice demonstrated positive blinded food challenge with clinical symptoms.

  18. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course

    PubMed Central

    Ganie, Farooq Ahmad; Lone, Hafeezulla; Lone, Ghulam Nabi; Wani, Mohd Lateef; Singh, Shyam; Dar, Abdual Majeed; Wani, Nasir-u-din; wani, Shadab nabi; Nazeer, Nadeem-ul

    2013-01-01

    Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion includes ventilation/perfusion mismatching, increased intrapulmonary shunting, increased lung water, segmental lung damage, and a loss of compliance. Clinically, patient’s presents with hypoxiemia, hypercarbia and increase in laboured breathing. Patients are treated with supplemental oxygen and mechanical ventilation whenever indicated. Treatment is primarily supportive. Computed tomography (CT) is very sensitive for diagnosing pulmonary contusion. Pulmonary contusion occurs in 25–35% of all blunt chest traumas. PMID:27162815

  19. [Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency].

    PubMed

    Mironiuc, A; Palcau, L; Andercou, O; Rogojan, L; Todoran, M; Gordan, G

    2008-01-01

    The interest manifested for the conjunctive tissue pathology leaded to the study of the structural disorder that appears in the varicose veins walls. The study is a prospective one initiated in March 2007 made on 11 patients with varicose disease hospitalized at Cluj-Napoca within Surgery Clinic no. II. The purpose of this study is to point out the histopathological modifications in the varicose venous wall (great saphenous vein cross, communicating veins, perforating veins), as well as the correlation of histopathological results with the evolutive stage of chronic vein insufficiency (CEAP classification) and with the clinical score at these patients. The histopathological (HP) results for 2 of the patients revealed hypertrophy of the media, intimal hyperplasia (stage II) corresponding to a CEAP 3. Six patients were integrated in HP stage III due to the partial intimal fibrosis corresponding to a CEAP 6 for one case, CEAP 4 one case, CEAP 3 four cases. One patient had HP stage I with CEAP 3 and two patients had HP stage IV corresponding to CEAP 5, respectively CEAP 6.

  20. Correlation of CA-125 serum level and clinico-pathological characteristic of patients with endometriosis

    PubMed Central

    Karimi-Zarchi, Mojgan; Dehshiri-Zadeh, Najmeh; Sekhavat, Leili; Nosouhi, Fahime

    2016-01-01

    Background: Cancer antigen 125 (CA-125) is a glycoprotein biomarker that is used in women with pelvic masses such as endometriosis and maybe is useful in practice of patients suspicious to endometriosis. Objective: The aim of this study was to evaluate the association between preoperative serum CA-125 levels and clinic pathological characteristic in women with endometriosis, and find out the best serum CA-125 levels cut-off in pre and post menopause women. Materials and Methods: Serum CA-125 levels in 87 women aged 21-54 years suspected to endometriosis with pelvic pain, dysmenorrhea, or dyspareunia were measured preoperatively. Also the association between clinic pathological characteristic and serum CA-125 level were analyzed. Results: The mean age of women was 32.22±6.91. The mean serum CA-125 level was 49.93±4.30 U/mL. There was a significant correlation between the endometriosis stage, lesion size, adhesion score and preoperative CA-125 plasma concentration. However, we did not found significant differences in age, marital status, patient’s complaints, and pelvic pain associated to Ca125 serum level. The suggested preoperative serum cut-off levels in premenopausal and postmenopausal patients were 37 U/ml and 35 U/ml, respectively. Conclusion: According to the results, preoperative serum CA-125 is an important predictor for patients with endometriosis and it should be taken into consideration when surgical management is suspected, especially if stage of disease, lesion size and adhesion score are undertaken. PMID:28008424

  1. Efficacy and tolerance of papain gel with conventional drilling method: a clinico-microbiological study.

    PubMed

    Goyal, P A; Kumari, R; Kannan, V P; Madhu, S

    2015-01-01

    Conventional methods of caries removal are commonly associated with pain, fear and discomfort. Chemomechanical methods were introduced to instill a positive dental attitude. Agents like GK-101, Caridex, Carisolv did not prove effective alternatives owing to their high cost, need of special instruments and taste of chlorine. A new chemomechanical agent, Papacarie®, has been introduced to overcome these deficiencies. This study was aimed to compare the effectiveness and tolerance of Papacárie® with the conventional method. 25 children with at least two primary teeth with broad cavitated occlusal or cervical lesion were selected. One carious tooth from each patient was randomly treated with each of Papacarie® and conventional drilling method, one after the other. Time taken for caries excavation, child's pain perception, change in anxiety levels, microbial flora and child's preference of treatment were recorded separately for both the methods. Although the mean time taken for caries removal by the Papacarie® method was slightly longer (P≯0.05) but it led to reduction in pain and anxiety (p<0.05). The viable bacterial counts were significantly reduced by either of the two methods (P <0�0001). More patients preferred Papacarie® over conventional method of treatment (P<0.05). Papacárie® method seems to be a better alternative to conventional method of caries removal.

  2. An unusual array of extensor musculature and tendons of the hand clinico-anatomical insight.

    PubMed

    Dave, V; Gandhi, S; Mehta, V; Kumar, A; Arora, J; Suri, R K; Rath, G

    2014-01-01

    Extensor tendon injury is a frequent finding in clinical practice. During a routine dissection class of undergraduate medical students examining the extensor aspect of the right hand, they found an interesting pattern of extensor tendons. The extensor digitorum (ED) exhibited three tendons for the middle and ring fingers. The intermediate tendon of the ED was found to pass to the junctura connecting the tendons of the ring and middle fingers. Additionally the Extensor carpi ulnaris displayed two tendinus slips. The lateral slip was inserted on the base of fifth metacarpal as usual, whereas the medial slip divided into two strands- proximal and distal. Apart from the above findings in the current case specimen, there was an accessory muscle belly for the index finger and the extensor digiti minimi bifurcated into two tendinus slips which gained attachment to the dorsal digital expansion of the little finger. These accessory muscle bellies and tendons could possibly be utilized for tendon reconstructions such as repairs, tenoplasties or tendon transfers.

  3. Epithelial toll-like receptor 9 signaling in colorectal inflammation and cancer: Clinico-pathogenic aspects

    PubMed Central

    Fűri, István; Sipos, Ferenc; Germann, Tiana M; Kalmár, Alexandra; Tulassay, Zsolt; Molnár, Béla; Műzes, Györgyi

    2013-01-01

    Toll-like receptors (TLRs) recognize specific motifs which are frequently present in bacteria, fungi, prokaryotes and viruses. Amongst TLRs, TLR9 can be activated by such bacterial or viral DNA fragments, immunoglobulin-DNA complexes or synthetic oligonucleotides, which all contain unmethylated cytosine-guanine nucleotide sequences (CpGs). Emerging data indicate that TLR9 signaling has a role in, and may influence, colorectal carcinogenesis and colonic inflammation. CpGs are classified into three groups according to their influence on both the antigen-specific humoral- and cellular immunity, and the production of type 1 interferons and proinflammatory cytokines. TLR9 activation via CpGs may serve as a new therapeutic target for several cancerous and various inflammatory conditions. Due to its probable anti-cancer effects, the application possibilities of TLR9-signaling modulation may be extremely diverse even in colorectal tumors. In this review we aimed to summarize the current knowledge about TLR-signaling in the pathogenesis and therapy of inflammatory bowel diseases and colorectal cancer. Due to the species-specific differences in TLR9 expression, however, one must be careful in translating the animal model data into the human system, because of the differences between CpG-oligodeoxynucleotide-responsive cells. TLR9 agonist DNA-based immunomodulatory sequences could also represent a promising therapeutic alternative in systemic inflammatory conditions and chronic colonic inflammations as their side effects are not significant. PMID:23864774

  4. [Clinico-occupational history in neurology and scope of occupational neurology].

    PubMed

    Motis-Dolader, J C

    The occupational environment generates a large amount of illness which involves several specialities, including neurology. However, there is little awareness--or little training--in this field as in most medical specialities, since in the basic tool of a doctor's work, the clinical history, importance is sometimes given to aspects such as sex, race etc. and data referring to the patient's occupation and the risks this may imply for his health are considered to matter less. The creation of a new working party within the Sociedad Española de Neurología, that of Neurología del Trabajo (Occupational Neurology) aims to correct these deficiencies, and to make colleagues aware of the importance of assessing the occupational hazards of patients and attempt to relate them to the clinical picture which presents. In order to do this we must first mark out our field of action, the commonest diseases and the administrative route used for claiming for these conditions. Then we will have to evaluate our relationship with other professional colleagues in the field of occupational health and finally consider the tasks of training, investigation and promotion of occupational health.

  5. Bacterial Viability within Dental Calculus: An Untrodden, Inquisitive Clinico-Patho- Microbiological Research

    PubMed Central

    Jain, PK; Kumra, Madhumani; Rehani, Shweta; Mathias, Yulia; Gupta, Ramakant; Mehendiratta, Monica; Chander, Anil

    2016-01-01

    Introduction Chronic inflammatory periodontal diseases i.e. gingivitis and periodontitis are one of the most common afflictions faced by human beings. Dental plaque, which is a pool of pathogenic microorganisms, remains to be current mainstay in etiopathogenesis. Dental calculus, which is a mineralized product of this plaque remains ignored and is considered merely as an ash heap of minor significance. However, the intriguing array in disease etiopathogenesis bulldozed researchers to suspect the role of calculus in disease chrysalis but still the viability of bacteria inside calculus and thus its pathogenicity remains an intricacy; the answer to which lies in the Pandora’s Box. Aim The present study was undertaken to investigate the viability of bacteria within dental calculus along with their identification. Also, to classify dental calculus on the basis of mineralization and to observe the variation of viable microflora found in dental calculus with the extent of mineralization and disease severity. Materials and Methods A total of 60 samples were obtained, by harvesting two samples of supragingival calculus from each patient having chronic inflammatory periodontal disease. These samples were divided into two groups (Group A and Group B). Samples of Group A were kept non-irradiated and samples of Group B were exposed to UV radiation. The samples were categorized into less, moderately and highly mineralized according to the force required for crushing them. All the crushed calculus samples were then divided into three parts. These were used for dark-field microscopy, gram staining and bacterial cultures. Bacterial identification of the cultures obtained was also carried out by performing various biochemical assays. Results The present study revealed the presence of motile spirochaetes within the samples under dark-field microscope. Gram staining revealed presence of numerous gram positive cocci and gram negative bacilli. Bacterial cultures showed growth of variety of aerobic and capnophilic microorganisms. Conclusion The present study concludes the presence of viable aerobic and capnophilic bacteria inside dental calculus which may reside within the lacunae and channels in the calculus. PMID:27630958

  6. Progressive anarthria with secondary parkinsonism: a clinico-pathological case report.

    PubMed

    Broussolle, E; Tommasi, M; Mauguière, F; Chazot, G

    1992-07-01

    The pathological process and lesion topography in patients with the syndrome of progressive aphasia are heterogeneous and few necropsy examination cases have been investigated. This is a case report of a 53 year old right handed man with progressive anarthria and secondary Parkinsonism over a period of six years. Positron emission tomography (PET) showed a decreased cerebral blood flow and metabolism in the frontal cortex, which was more pronounced on the left. Neuropathology disclosed a spongiform vacuolation in layer II of the frontal cortex, mostly in the Broca area, and neuronal loss in the substantia nigra. This original case reinforces the view that there are different entities of the syndrome of progressive aphasia which can be identified on the basis of clinical, neuroimaging and anatomical data.

  7. Clinico-immunological aspects of vernal catarrh in hilly terrains of Himachal Pradesh.

    PubMed

    Bisht, R; Goyal, A; Thakur; Singh, T; Sharma; Vijay; Goyal, B K

    1992-01-01

    Very few immunological studies in vernal catarrh have been conducted in India and abroad, but none in Himachal Pradesh in spite of its high incidence in the State. In the present study 25 patients of vernal catarrh residing at a height ranging between 1000 to 2500 meters above mean sea level have been evaluated. Their immunological status of serum and tears after detailed clinical assessment was studied by single radial immunodiffusion technique of Mancini et al. The values of serum IgA and IgM were significantly higher in patients than in controls. The serum IgE level had no significant difference. The IgG was significantly lower in patients with vernal catarrh. The values of tear IgM, IgE and IgA in these patients were significantly higher than in controls. However, in no case or control group C3C and C4 were detected in tears. The limbal type of vernal catarrh was found to be the most common in this part of the country. No mixed case was seen. Derangement of the immune system in the pathogenesis of vernal catarrh is suggested.

  8. Hartnup syndrome, progressive encephalopathy and allo-albuminaemia. A clinico-pathological case study.

    PubMed

    Schmidtke, K; Endres, W; Roscher, A; Ibel, H; Herschkowitz, N; Bachmann, C; Plöchl, E; Hadorn, H B

    1992-12-01

    Clinical, biochemical, neuropathological and neurochemical findings in a case of Hartnup syndrome are reported. After initially normal development, the affected girl suffered progressive neuropsychiatric decline with statomotor and mental retardation and intractable seizures and died at the age of 2 years. Postmortem neuropathological and neurochemical investigations showed a combination of extensive neuronal degeneration and cerebral dysmyelination. Pathogenetic hypotheses and the relationship between neuropsychiatric disease and Hartnup syndrome are discussed. Additionally, a fast type bisalbuminaemia present in the girl and her mother is described.

  9. Clinico-Immunological Analysis of Eggplant (Solanum melongena) Allergy Indicates Preponderance of Allergens in the Peel.

    PubMed

    Babu, Bheemanapalli N Harish; Venkatesh, Yeldur P

    2009-09-01

    : Eggplant (Solanum melongena L.) is known to cause food allergy in some Asian countries but detailed studies on eggplant allergy are lacking. : The objective is to investigate sensitization to different parts of eggplant fruit, and detection of the allergens. : Six eggplant-allergic subjects were assessed for sensitization to eggplant (peel/pulp, and raw/cooked) by skin prick test, allergen-specific IgE, and immunoblots. Allergens were analyzed for glycoprotein nature by staining/lectinoblots, and in vitro stability in simulated gastric fluid. : All the eggplant-sensitized subjects showed positive skin prick test with peel, pulp, raw, and cooked eggplant extracts; allergen-specific IgE to all these was positive. Raw eggplant contains 5 allergens in the range 36-71 kD. Most allergens are localized in the eggplant peel (9 allergens; 26-71 kD range) than the pulp (3 allergens; 52-71 kD); among these, the 26, 28, 36, and 71 kD allergens seem to be heat-stable. The 43, 45, 64, and 71 kD allergens are detected as glycoproteins; the 26, 64, and 71 kD allergens are stable displaying retention of IgE-binding ability in simulated gastric fluid digestion. : Eggplant is a multiallergenic vegetable in the context of presence of allergens in all edible parts of eggplant having preponderance in the peel.

  10. Clinico-Immunological Analysis of Eggplant (Solanum melongena) Allergy Indicates Preponderance of Allergens in the Peel

    PubMed Central

    2009-01-01

    Background Eggplant (Solanum melongena L.) is known to cause food allergy in some Asian countries but detailed studies on eggplant allergy are lacking. Objective The objective is to investigate sensitization to different parts of eggplant fruit, and detection of the allergens. Methods Six eggplant-allergic subjects were assessed for sensitization to eggplant (peel/pulp, and raw/cooked) by skin prick test, allergen-specific IgE, and immunoblots. Allergens were analyzed for glycoprotein nature by staining/lectinoblots, and in vitro stability in simulated gastric fluid. Results All the eggplant-sensitized subjects showed positive skin prick test with peel, pulp, raw, and cooked eggplant extracts; allergen-specific IgE to all these was positive. Raw eggplant contains 5 allergens in the range 36-71 kD. Most allergens are localized in the eggplant peel (9 allergens; 26-71 kD range) than the pulp (3 allergens; 52-71 kD); among these, the 26, 28, 36, and 71 kD allergens seem to be heat-stable. The 43, 45, 64, and 71 kD allergens are detected as glycoproteins; the 26, 64, and 71 kD allergens are stable displaying retention of IgE-binding ability in simulated gastric fluid digestion. Conclusions Eggplant is a multiallergenic vegetable in the context of presence of allergens in all edible parts of eggplant having preponderance in the peel. PMID:23283148

  11. Variant lumbrical musculature of the left hand: Clinico-anatomic elucidation.

    PubMed

    Singh, S; Loh, H K; Mehta, V

    2016-12-01

    Human hand is haughtily described in literature as 'revolution in evolution'. Lumbricals form an intricate part of its musculature playing a vital role in complex digital movements. By virtue of their origin from the volar aspect of palm and their insertion onto the dorsal aspect to the extensor digital expansion of the digits, lumbricals display complex actions flexing the metacarpophalangeal joint and extending the interphalangeal joints. Such manoeuvres of the digits are vital for skilful and precision movements. During routine dissection of the teaching program of undergraduate medical students, unusual origin and morphology of all the four lumbrical muscles in the left hand of a male cadaver was observed. Clinicians and hand surgeons should be aware of its variations while designing and dealing with hand surgeries. An attempt has been made to comprehend its clinical, embryological and phylogenetic aspects. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. A Clinico-Pathological and Immunoparasitological Study on Toxocariasis in Egypt.

    DTIC Science & Technology

    1978-05-31

    incidence of Toxocara infection in dogs in these areas. Moreover, Toxocara infection was studied in cases associated with clinical syndromes and also...chances of close contact with infected dogs and the heavy soiling by the ova present in the faeces from a dog with Toxocara , contamination of food of...concluded that the dog is a very important source for Toxocara infection of the human beings by the larval stages, next to follow the contamination soil with T.canis ova. (Author)

  13. The cancer research campaign (King's/Cambridge trial for early breast cancer: clinico-pathological aspects.

    PubMed Central

    Elston, C. W.; Gresham, G. A.; Rao, G. S.; Zebro, T.; Haybittle, J. L.; Houghton, J.; Kearney, G.

    1982-01-01

    Analysis of pathological data in the 10th year of follow-up of a multicentre trial of the management of operable breast cancer has confirmed the correlation of prognosis with tumour grade, tumour size and lymph-node status. For each factor examined there was no difference in survival between the 2 treatment groups ("watch policy" and radiotherapy) but patients in the WP group whose tumours were of Grade II or III or greater than 2 cm, or with lymph-node metastases, had a greater chance of local recurrence. Cellular reaction had no relationship with prognosis, except in patients with Grade III tumours. The clinical relevance and application of these results are discussed. PMID:7044401

  14. [Clinical and clinico-histological markers in chronic destructive adult periodontitis].

    PubMed

    Hernández Vallejo, G; García Rodríguez, M D; Tejerina Lobo, J M; López Sánchez, A F; De la Roca, C

    1989-05-01

    This study was designed to evaluate the significance and interrelationship of clinical parameters and their association with histologic changes in advanced destructive periodontitis. 158 patients with PDI greater than 4 (Ramfjord) were selected, evaluating the size, contouring, bleeding, consistency, colour and gingival pain. Epithelial ulceration of soft periodontal pockets were also evaluated. The results showed a statistically significant association between purplish colour and gingival fibrosis and advanced stage of the disease. Gingival bleeding on probing was the most important clinical parameter in advanced phases of the disease, either alone or in association with other parameters such as the presence of epithelial ulcerations. The Periodontal Disease Index (Ramfjord) has proven effective in the evaluation of generalized patterns of disease.

  15. [Clinico-radiological study of the skull deformation in the plagiocephaly without synostosis].

    PubMed

    Captier, G; Leboucq, N; Bigorre, M; Canovas, F; Bonnel, F; Bonnafé, A; Montoya, P

    2003-03-01

    The aim of this study was to analyze the mechanism of the skull deformation observed in frontal and occipital plagiocephaly without synostosis. From 1987 to 2001, 96 plagiocephalies without synostosis, 72 males and 24 females, were examined. There were 72 Frontal Plagiocephalies (FP) and 24 Occipital Plagiocephalies (OP). The clinical examination of the neck muscles was performed to find out a torticolis with or without retraction. All patients underwent a 3D CT scan of the skull to exclude a craniostenosis. Cephalic Index (CI) was also calculated. The FP had a torticollis in 89.3% of cases associated with a muscle retraction (54.8%), a tonus asymmetry (16.6%), or in association (28.6%). The skull had a parallelepiped shape and the greater axis was oblique. The CI was 0.85. The OP had a torticollis in 50% of case associated with a retraction (28.6%), a tonus asymmetry (57.1%), or the association (14.3%). The skull had a square shape with an occipital flat and the CI was 0.95. The FP and OP are two deformations whose mechanism is different. The FP corresponds to a three plans skull asymmetry secondary to muscle traction on the base of the skull, and the OP corresponds to a posterior localized asymmetry of the skull secondary to compression. The traction and/or compression deformation start in utero or in the newborn period and the supine position is an aggravating positional factor.

  16. [Comparative clinico-genealogical analysis of slowly progressive schizophrenia and hysterical-type psychopathy].

    PubMed

    Dubnitskaia, E B; Fil'ts, A O; Chernikova, T S

    1988-01-01

    A genetic correlational analysis of two variants of slowly progressive schizophrenia (SPS) (hysterical schizophrenia--70 families, paranoid schizophrenia--40 families) and hysterical psychopathy (30 families) has demonstrated that there is a definite genetic heterogeneity between nosologically heterogeneous hysterical manifestations in SPS and constitutional psychopathy which reflects the influence of the general constitutional "axis" in systems of genetic determination of these forms. At the same time no significant genetic correlations (according to hysterical predisposition) have been found between the above forms and the paranoid variant of SPS. The results corroborate the hypothesis about a multiaxial structure of hereditary predisposition in SPS.

  17. A new clinico-pathological classification system for mesial temporal sclerosis

    PubMed Central

    Pauli, Elisabeth; Clusmann, Hans; Schramm, Johannes; Becker, Albert; Elger, Christian; Merschhemke, Martin; Meencke, Heinz-Joachim; Lehmann, Thomas; von Deimling, Andreas; Scheiwe, Christian; Zentner, Josef; Volk, Benedikt; Romstöck, Johann; Stefan, Hermann; Hildebrandt, Michelle

    2007-01-01

    We propose a histopathological classification system for hippocampal cell loss in patients suffering from mesial temporal lobe epilepsies (MTLE). One hundred and seventy-eight surgically resected specimens were microscopically examined with respect to neuronal cell loss in hippocampal subfields CA1–CA4 and dentate gyrus. Five distinct patterns were recognized within a consecutive cohort of anatomically well-preserved surgical specimens. The first group comprised hippocampi with neuronal cell densities not significantly different from age matched autopsy controls [no mesial temporal sclerosis (no MTS); n = 34, 19%]. A classical pattern with severe cell loss in CA1 and moderate neuronal loss in all other subfields excluding CA2 was observed in 33 cases (19%), whereas the vast majority of cases showed extensive neuronal cell loss in all hippocampal subfields (n = 94, 53%). Due to considerable similarities of neuronal cell loss patterns and clinical histories, we designated these two groups as MTS type 1a and 1b, respectively. We further distinguished two atypical variants characterized either by severe neuronal loss restricted to sector CA1 (MTS type 2; n = 10, 6%) or to the hilar region (MTS type 3, n = 7, 4%). Correlation with clinical data pointed to an early age of initial precipitating injury (IPI < 3 years) as important predictor of hippocampal pathology, i.e. MTS type 1a and 1b. In MTS type 2, IPIs were documented at a later age (mean 6 years), whereas in MTS type 3 and normal appearing hippocampus (no MTS) the first event appeared beyond the age of 13 and 16 years, respectively. In addition, postsurgical outcome was significantly worse in atypical MTS, especially MTS type 3 with only 28% of patients having seizure relief after 1-year follow-up period, compared to successful seizure control in MTS types 1a and 1b (72 and 73%). Our classification system appears suitable for stratifying the clinically heterogeneous group of MTLE patients also with respect to postsurgical outcome studies. PMID:17221203

  18. [Dermatosis cinecienta. A clinico-pathological study of 20 patients (1989-1990)].

    PubMed

    Domínguez Soto, L; Vega Memije, M E; Arenas, R; Waxtein Morgenstein, L

    1992-01-01

    Ashen dermatosis (D.C.), or dyschromic perstans erythema, is a chronic dermatosis, which is asymptomatic and practically exclusive in Latin-American countries. Its clinical characteristics have been well defined (blue-gray patches), as well as its nonspecific histopathologic patterns; its etiology is unknown. This paper studies 20 patients suffering from ashen dermatitis. There was a majority of female patients, the dermatosis was disseminated, bilateral and symmetric. It is different from pigmented lichen although the histopathologic patterns is similar.

  19. Allergie affections of the larynx in children-a clinico pathological study.

    PubMed

    Sahoo, G C

    1999-07-01

    Laryngeal manifestation of allergy though less common than, Rhinosinusitis, tubotympanitis and bronchopulmanary allergy but it is not that uncommon which is usually misdiagnosed and mistreated in children. Hence the importance of larynx as the allergic shock organ in children with spasmodic croup and laryngotracheo bronchits. In the present study in children bellow five years, presenting with stridor and/or hoarsness were evaluated regarding the history of allergy, direct laryngoscopic finding, mesurement of serum 1 g E. Presence of eosinophilia and histopathological examination of laryngeal biopsy. Out of the 80 cases studied 9 cases (11.2%) presented with associated allergic manifestation, 8 cases (10%) having family history of allergy, 4 cases (5%) having raised serum 1 g E, 12 cases (15%) with eosinophilia 3 cases (3.75%) with eosinophilic infiltration on histopathological examination of the biopsy material taken during the direct laryngoscopy.

  20. Unilateral left paramedian infarction of thalamus and midbrain: a clinico-pathological study.

    PubMed Central

    Bogousslavsky, J; Miklossy, J; Deruaz, J P; Regli, F; Assal, G

    1986-01-01

    In a patient with a unilateral embolic infarct in the left posterior thalamo-subthalamic paramedian artery territory, neuropathological studies showed involvement of the intralaminar, dorsomedial, and internal part of the ventral posterior nuclei of the thalamus, of the rostral part of the mesencephalic reticular formation, and of the posterior commissure. The patient showed upgaze palsy for voluntary saccades, smooth pursuit and vestibulo-ocular movements, sustained downgaze, right-sided motor hemineglect and facio-brachial hypaesthesia, motor transcortical aphasia and anterograde amnesia. This case confirms that unilateral destruction of the posterior commissure, rostral interstitial nucleus of the MLF and interstitial nucleus of Cajal produces a non-dissociated upgaze palsy. Involvement of the nucleus of Cajal probably produced the sustained downward deviation of the eye, by causing predominance of downward vestibulo-ocular inputs. This case also shows that thalamic aphasia and anterograde amnesia may be related to a paramedian lesion of the thalamus, with special reference to involvement of the dorsomedial nucleus, in the absence of lesion of the pulvinar and mamillo-thalamic tract and of conspicuous involvement of the ventral lateral nucleus. Selective hemineglect for motor tasks may occur in infarction of the dominant thalamus, involving the intralaminar nuclei. Images PMID:3734825

  1. Visual associative agnosia: a clinico-anatomical study of a single case.

    PubMed Central

    McCarthy, R A; Warrington, E K

    1986-01-01

    A single case study of a patient with visual associative agnosia is described. The patient had well preserved language, spatial, visual, and perceptual abilities but nevertheless was impaired in recognising visually presented common objects. It is argued that his deficit cannot be accounted for in terms of a disconnection syndrome. Behavioural and anatomical (MRI scan) evidence for focal unilateral dysfunction is presented. It is concluded that the left hemisphere plays a crucial role in recognising the meaning of common objects. Images PMID:3794729

  2. Clinico-Epidemiological Study and Treatment Outcome of Multinodular Goitre at A Tertiary Care Hospital

    PubMed Central

    Chandra, Bharat; Balakrishna, Manniganahalli Appaiah; Ramesh, Deepthi Bomman

    2015-01-01

    Background Thyroid enlargement has been a common problem encountered in general surgical practice. Thyroid being an endocrine gland, its involvement has a diverse issue from a meagre cosmetic problem to a more concerned malignancy. Aim This study was conducted to study the age and sex distribution along with the mode of presentation of Multinodular Goitre (MNG). The incidence of malignancy and the surgical complications in the study population were also studied. Materials and Methods In this descriptive study, patients diagnosed with MNG from January 2011 to July 2012 were chosen from the in-patient of our teaching hospital. One hundred such patients who qualified to undergo surgery were included in the study after a detailed history and clinical examination. Patients underwent Fine needle aspiration cytology (FNAC) for preoperative pathological diagnosis and the goitre was confirmed to be benign. Patients diagnosed with malignancy were excluded from the study. Following thyroidectomy, the thyroid specimens were subjected to histopathological examination. Results Among the 100 cases of MNG, 59% patients belonged to 3rd and 4th decade of life, 90% patients were females, 82% presented before 5yrs. The most common symptom at presentation was swelling (100%). Among the patients 80% were in euthyroid state, 19% were hyperthyroid and 1% hypothyroid. Most of the patients were treated with sub-total thyroidectomy (59%), followed by total (20%), near total (11%), and Hemithyroidectomy (10%). Following surgery complications like stridor and laryngeal oedema (3%), wound infection (2%), hypocalcemia (2%), haemorrhage (1%) and seroma (1%) were noted. On Histopathological examination (HPE) of the surgical specimen, 3% were reported to be malignant. Conclusion As noted by this study, Multinodular Goitre is more common among females in the third and fourth decades. Patients can present with various complaints. MNG can present as hyperthyroid, hypothyroid but mostly in euthyroid state. The indication for surgery in patients with MNG includes cosmesis, hyperthyroidism, local compressive symptoms and most importantly malignancy. Subtotal thyroidectomy is the preferred surgery, but a trend towards total and near total thyroidectomy is noticeably replacing the old belief in subtotal thyroidectomy. PMID:26266163

  3. "Epizoonosis of dermatophytosis": a clinico- mycological study of dermatophytic infections in central Nepal.

    PubMed

    Mathur, M; Kedia, S K; Ghimire, R Bk

    2012-01-01

    Identification of dermatophytic species in clinical settings are important not only for epidemiological but also for the treatment. Present study was carried out to find out the clinical variants of Dermatophytosis and species of fungus responsible for the disease. The prospective observational analysis of 200 clinically suspected cases of dermatophytic infection attending Dermatology department of College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan, Nepal. Skin scraping, hair and nail samples were collected and processed according to standard protocol. Maximum number of patients enrolled in study were reported for treatment 5-8 weeks after the onset of disease. Overall male predominance was observed and ages between 26-30 years. Tinea corporis was the most common clinical type of tinea with female dominance in our study. 10 % of cases were having extensive Tinea. 71.5% of samples were positive on direct microscopy and 62 % positive on culture. Samples from T capitis were highest positive by direct microscopy (80%) and over all dominant species of fungus isolated in our study was Trichophyton verrucosum (30.6%). The study highlighted Tinea corporis as the most common clinical type with female predominance. Overall predominant causative fungal species isolated was Trichophyton verrucosum.

  4. Autoimmune hepatitis, one disease with many faces: Etiopathogenetic, clinico-laboratory and histological characteristics

    PubMed Central

    Gatselis, Nikolaos K; Zachou, Kalliopi; Koukoulis, George K; Dalekos, George N

    2015-01-01

    Autoimmune hepatitis (AIH) is an unresolving progressive liver disease of unknown etiology characterized by hypergammaglobulinemia, autoantibodies detection and interface hepatitis. Due to the absence of specific diagnostic markers and the large heterogeneity of its clinical, laboratory and histological features, AIH diagnosis may be potentially difficult. Therefore, in this in-depth review we summarize the substantial progress on etiopathogenesis, clinical, serological and histological phenotypes of AIH. AIH has a global distribution affecting any age, both sexes and all ethnic groups. Clinical manifestations vary from asymptomatic to severe or rarely fulminant hepatitis. Hypergammaglobulinemia with selective elevation of IgG is found in most cases. Autoimmune attack is perpetuated, possibly via molecular mimicry, and favored by the impaired control of T-regulatory cells. Histology (interface hepatitis, emperipolesis and hepatic rosette formation) and autoantibodies detection although not pathognomonic, are still the hallmark for a timely diagnosis. AIH remains a major diagnostic challenge. AIH should be considered in every case in the absence of viral, metabolic, genetic and toxic etiology of chronic or acute hepatitis. Laboratory personnel, hepato-pathologists and clinicians need to become more familiar with disease expressions and the interpretation of liver histology and autoimmune serology to derive maximum benefit for the patient. PMID:25574080

  5. Clinico-biochemical studies on acute toxic nephropathy in goats due to uranyl nitrate

    SciTech Connect

    Dash, P.K.; Joshi, H.C.

    1989-02-01

    Acute toxic nephropathy was produced in 6 healthy goats by injecting intravenously 1% uranyl nitrate (UN) (15 mg/kg body weight). The early painful clinical signs simulating shock progressed with subnormal temperature, slow-shallow respiration and arrhythmic pulse followed by death due to respiratory failure within 96 to 120 hr. All the affected goats had normocytic normochromic anemia, leucocytosis, neutrophilia with left shift eosinopenia, decreased monocytes and presence of 1-2% reticulocytes in the peripheral blood smears. On blood chemical analysis, a uniform and continuous rise was seen in serum creatinine with a concomitant daily increase of serum urea and uric acid. Simultaneous analysis of urine indicated polyuria leading to oliguria, acidic pH, albuminuria, glycosuria with presence of neutrophils, RBC's, epithelial and fatty casts, increase of triple phosphate, and cystine crystals reflecting acute damage of kidneys in the affected goats.

  6. A Clinico-pathological study on the effect of vincristine on transmissible venereal tumour in dogs.

    PubMed

    Nak, D; Nak, Y; Cangul, I T; Tuna, B

    2005-09-01

    Transmissible venereal tumour (TVT) is a coitally transmitted neoplasm of dogs and is common among sexually active dogs, where sexual behaviour is not under control. Several treatment options are available for the treatment of the tumour, with chemotherapy being the most commonly employed. In this study, we investigated the clinical and cytological changes after weekly vincristine sulphate administration in 38 cases of naturally occurring TVT. Tumours totally regressed in 31 dogs after two to seven doses (mean 3.54 +/- 1.01) of vincristine. One dog died after the fifth dose of vincristine, and in six dogs, an additional treatment with doxorubicin was needed. Masses were still present in four dogs and the histopathological examination revealed small nodules of granulation tissue in two dogs, while viable tumour cells were identified in the remaining two cases. No recurrences were observed in a follow-up period of 7-49 months (mean 13.64 +/- 9.66); in one dog, granulation tissue was detected in the surgery site after 2 months. Treatment success could easily be followed by the cytological changes. In conclusion, vincristine was found to be effective chemotherapeutic agent.

  7. The clinico-radiological spectrum of Dyke-Davidoff-Masson syndrome in adults.

    PubMed

    Ayas, Zeynep Özözen; Asil, Kıyasettin; Öcal, Ruhsen

    2017-07-21

    Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, seizure, contralateral hemiplegia/hemiparesis, and mental retardation. In this study, clinical and radiological investigations of seven patients who were diagnosed with DDMS as adult age were evaluated and discussed. Seven patients (four male, three female) were included. The mean age ± SD of the patients was 46 ± 21 years. Clinical presentation of six patients was epileptic seizure. One patient was presented with head trauma due to a fall. Two patients had complex partial seizures, three patients had generalized tonic-clonic seizures (GTC), and one had GTC and myoclonic seizure. Mental retardation was in five patients. A congenital cause was detected in one patient in the etiologic investigation and acquired causes in two patients. In four patients, the etiology was not identified. We observed left-hemisphere involvement in four patients and right-hemisphere involvement in three patients. Brain imaging was performed by CT only in four patients and by MRI only in three patients. All patients were diagnosed with DDMS at adulthood. Atrophy in basal ganglia was detected in five patients, and atrophy in brain stem in four patients. Calvarial thickening was observed in four patients. Three patients had hyperpneumatization in mastoid cells. Sinus hyperpneumatization, including the paranasal and frontal sinuses, was seen in six patients. DDMS can also be diagnosed in adulthood symptomatically (mild-severe) or asymptomatically in adulthood. As a result, DDMS is a syndrome with wide clinical and radiological spectra that can be variably symptomatic at different stages of life.

  8. Clinico-pathologic, immunohistochemical, and TUNEL study in early cardiac allograft failure.

    PubMed

    Panizo-Santos, A; Lozano, M D; Distefano, S; Inogés, S; Pardo, J

    2000-01-01

    Early cardiac allograft failure (ECAF) was defined as acute allograft failure in the early transplant period. The aim of this study is to elucidate the clinicopathological and immunohistochemical characteristics and the role of apoptosis in ECAF in nine patients. We reviewed preoperative clinical data and morphological data at the time of autopsy or retransplantation. We also performed TUNEL assay and immunohistochemistry to study fibronectin and tubulin beta-II. The average recipient and donor age was 48 +/- 10.3 and 28 +/- 7.11 respectively. Seven patients died at a mean time of 26 hours. The remaining two patients underwent retransplantation and are alive. The mean cold ischemic time was 124. 1 +/- 44.5 minutes. No patient had a panel reactive antibody >15% and lymphocytic crossmatch was positive in one case. All cases had grade 2-3 of coagulative necrosis, which correlated positively with fibonectin accumulation in myocyte cytoplasm, and cytoplasmic tubulin loss (p < 0.05). TUNEL technique showed in all cases some degree of DNA strand breaks in cardiomyocytes. Endothelium DNA strand breaks were seen in seven cases. Patients transplanted because of idiopathic dilated cardiomyopathy had a significantly higher degree of DNA strand breaks in cardiomyocytes and endothelial cells (p = 0.03 and p = 0.02) than those transplanted because of ischemic cardiomyopathy. These results indicate that ECAF may be caused by ischemic-reperfusion damage to the donor heart assessed by myocyte coagulative necrosis, fibronectin accumulation in myocytes, tubulin loss, and DNA strand breaks of cardiomyocytes and endothelium. The use of a combination of these techniques might be appropriate in the diagnosis of ECAF in endomyocardial biopsies when it is suspected clinically.

  9. Odontoameloblastoma. Clinico-pathologic study of three cases and critical review of the literature.

    PubMed

    Mosqueda-Taylor, Adalberto; Carlos-Bregni, Roman; Ramírez-Amador, Velia; Palma-Guzmán, José Mario; Esquivel-Bonilla, Daniel; Hernández-Rojase, Luis Angel

    2002-12-01

    The odontoameloblastoma (OA), is an infrequent neoplasm. To date, there are less than 50 cases reported as OA or ameloblastic odontoma in the English dental literature, but only 14 (including three of our own material), fulfill the histological criteria of the current WHO histological classification of odontogenic tumours. Nine occurred in men and five in women (male to female ratio 1.8:1). Age ranged from 2 to 50 years (mean 20.2 years), and nine cases (64.2%) were diagnosed during the first two decades. Maxilla and mandible were equally involved, and most cases occurred posterior to the canines (71.4%). Follow-up ranged from 6 months to 8 years (mean: 25.5 months). Of the 12 cases with informed follow-up, two recurred once (at 24 and 18 months, respectively), and one case had two documented recurrences, at 6 and 49 months. Although OA tends to occur at an earlier age than conventional ameloblastoma, it has practically the same potential to produce bone expansion, root resorption and recurrence. For these reasons OA should be treated in a similar fashion, with wide surgical excision and close follow-up for at least 5 years.

  10. Clinico-pathologic study of odontogenic cysts in a Mexican sample population.

    PubMed

    Ledesma-Montes, C; Hernández-Guerrero, J C; Garcés-Ortíz, M

    2000-01-01

    Odontogenic cysts are uncommon lesions that frequently behave agressively and attain a large size. Unfortunately, information on the relative incidence of these cysts from different populations is not abundant. In Mexico, for example, only a few examples have been reported. The aim of this study was to ascertain the frequency of odontogenic cysts in a Mexican sample and to compare these data with previously reported studies from other countries. The files of the Oral and Maxillofacial Pathology Diagnosis Service at the School of Dentistry at the Universidad Nacional Autónoma de México (UNAM) were reviewed and all accessions of odontogenic cysts were listed. Clinical and radiographic data were recorded and microscopic slides evaluated according to the most recent World Health Organization (WHO) classification (1992). Three hundred and four cases of odontogenic cysts (55.9% male predominance) were found. The most frequent odontogenic cysts were the following: periapical cyst (38. 8%); dentigerous cyst (35.5%), and odontogenic keratocyst (18.8%). Periapical cyst was more frequent in females, and maxillary anterior teeth were most commonly involved. Dentigerous cysts appeared in males at a rate of 64.8%, this cyst found more frequently between the 1st and 2nd decades of life and in the molar zone. Odontogenic keratocyst was more frequent in males (59.6%), between the 2nd and 4th decades of life and more common in the molar zone. More than 50% of the sample were aggressive cysts (dentigerous and keratocyst). Our results suggest that Mexican patients develop aggressive odontogenic cysts more commonly than other populations. Our figures point to the need for a precise diagnosis in order to institute the correct surgical procedure, prevent recurrence, and forestall more extensive tissue destruction.

  11. A new report on the occurrence of clinico-histopathological diagnostic criteria for Spinodiplotriaena.

    PubMed

    Javanbakht, Javad; Hosseini, Ehsan; Karimi, Shahram; Hassan, Mehdi Aghamohammad; Sabbagh, Atefeh; Mousavi, Shadi; Fattahi, Roohollah; Khaki, Fariba; Shafiee, Radmehr

    2014-09-01

    Parasitic diseases of wild birds follows its companion volume, infectious diseases of wild birds, both of which complement the third edition of infectious diseases of wild mammals and second edition of parasitic diseases of wild mammals. In October 2012, a mature black male mynah with lack of balance and ataxia was brought into the birds department of educational hospital in veterinary medicine faculty of Tehran University. Because of no cure in clinical signs after several days of empirical therapy euthanasia and clinical pathology studies were performed. There was no microscopic pathological lesions in brain, bone marrow, heart, lung, liver and the microscopic results were as following; bone marrow: hemophagocytosis reactive macrophages, liver: infiltration of inflammatory cells (hepatitis) and hemosiderin-laden macrophages. Lung: hemosiderin-laden macrophages and spleen findings: infiltration of inflammatory cells, heterophils with phagocytic bacteria. In abdominal cavity two male and one female parasite was detect. Three parasites were cleared with lactophenol and investigated under the light microscopy and important morphological parts of them measured. Also these parasites in serum containing send to the department of parasitology. Based on all collecting data, Spinodiplotriaena (three parasites each by the length of 2/5, 1/7 and 1/5 cm were found) were diagnosed. Report of this case in important because of first report of this infection in a black mynah in Iran.

  12. Chronic gastritis with intestinal metaplasia: clinico-statistical, histological and immunohistochemical study.

    PubMed

    Dîrnu, Rodica; Secureanu, F A; Neamţu, Carmen; Totolici, B D; Pop, O T; Mitruţ, P; Mălăescu, D Gh; Mogoantă, L

    2012-01-01

    Chronic gastritis has a high incidence in adults, causing progressive destruction of glandular structures, favoring the development of gastric atrophy. The association of chronic gastritis with intestinal type metaplasia of gastric mucosa has a poor outcome as intestinal metaplasia is regarded as a precancerous lesion. Metaplasia is common in patients with Helicobacter pylori infection and also heavy smokers. The aim of our study was to evaluate the relationship between chronic gastritis and intestinal metaplasia. The study was conducted on a total of 1218 patients, aged between 5 and 90 years, who presented for dyspeptic disorders in the period 2007-2010 and were examined clinically and endoscopically. During the gastroscopic examination, fragments of gastric mucosa were collected for the histopathological study and for highlighting the H. pylori infection. For the histopathological study, the Hematoxylin-Eosin and PAS-Alcian Blue stains were performed, while for the immunohistochemical study the anti-TAG72 and anti-PCNA antibodies were used. A diagnosis of gastritis was established in 615 patients, representing approximately 50.5% of all cases. Most cases with gastritis were found in people of middle age. Gastritis was present in almost all age groups, from teenagers to the elders. Of the 615 cases of gastritis, urease test was positive in 353 patients, representing approximately 57.40% of all patients with gastritis. Histopathological examination identified the presence of intestinal metaplasia in 61.60% of patients with chronic gastritis, mostly complete metaplasia. PCNA immunohistochemistry revealed that cell proliferation processes are intensified in intestinal metaplasia. This study highlights the importance of chronic gastritis, intestinal metaplasia, and H. pylori infection in the etiopathogeny of gastric cancer.

  13. Clinico-Pathological Profile of Deep Neck Space Infection: A Prospective Study.

    PubMed

    Das, Rumpa; Nath, Gorakh; Mishra, Anupam

    2017-09-01

    Deep neck space infections (DNI) has been a common and serious disease, involving several spaces created by planes of greater and lesser resistance between the fascial layers of the neck. Infection of deep neck space has been dangerous due to its potential ease of spread from one space to other space, associated sepsis and upper airway obstruction. This prospective study was done in 45 patients of DNI over a period of 1 year. Patients with age of 1 month to 80 years of both the sexes were included. Patient's particular, clinical presentation and associated co-morbid conditions, physical examination, routine laboratory investigations and radiological investigations were analyzed. Patients were treated, response to the treatment was assessed and follow-up was done. In present study, DNI was more commonly seen in rural population (67%) with a male predominance (69%). Mean age of presentation was 34.4 years. Odontogenic infection (64.11%) was the commonest etiological factor and diabetes mellitus (26.66%) was the commonest co-morbid condition. Most common presenting symptom was neck pain and neck swelling (91.1%) and submandibular space (66.6%) was the most commonly involved space followed by sublingual space (44.6%). Both medical and surgical treatment was needed in most of the cases (77.77%). 77.7% cases showed complete regression, 15.5% showed partial regression and they lost to follow-up, 4.4% expired and 2.2% showed progressive deterioration. DNI is a common and life-threatening disease. Early diagnosis and management is necessary for complete cure and to prevent complications associated with DNIs.

  14. Correlation between clinico-pathological outcome and typing of Haemophilus parasuis field strains.

    PubMed

    Aragon, Virginia; Cerdà-Cuéllar, Marta; Fraile, Lorenzo; Mombarg, Mark; Nofrarías, Miquel; Olvera, Alexandre; Sibila, Marina; Solanes, David; Segalés, Joaquim

    2010-05-19

    Haemophilus parasuis is the etiologic agent of Glässer's disease in pigs, which is pathologically characterized by serofibrinous polyserositis and arthritis. H. parasuis include virulent and non-virulent strains and confirmation of virulence in H. parasuis is still dependent on experimental reproduction of the disease. Since the variability in virulence is supported by serotyping and genotyping (particularly, multilocus sequence typing [MLST]), we examined the relationship between the classification of 8 field strains by these methods and their capacity to cause disease in snatch-farrowed, colostrum-deprived piglets. The severity of clinical signs and lesions produced by the different strains correlated with the quantity of H. parasuis recovered from the lesions. However, the virulence of the strains in the animal model did not show a total correlation with their serovar or their classification by MLST. More studies are needed to identify a virulence marker that could substitute animal experimentation in H. parasuis. In addition, we reproduced disease in domestic pigs with a strain isolated from the nasal cavity of wild boars. This result indicates the existence of virulent strains of H. parasuis in wild suids, which could produce disease under appropriate circumstances, and suggests a possible source of infection for domestic pigs. Copyright 2009 Elsevier B.V. All rights reserved.

  15. Clinico-microbiological study of dermatophytosis in a tertiary-care hospital in North Karnataka

    PubMed Central

    Noronha, Tonita M.; Tophakhane, Raghavendra S.; Nadiger, Shobha

    2016-01-01

    Context: The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age. Aims: The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations. Settings and Design: This was a hospital-based observational study. Materials and Methods: One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail) and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Statistical Analysis Used: Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis. Results: Out of 150 patients studied, majority belonged to the age group of 21–30 years (22.7%). Male-to-female ratio was 1.63:1. Tinea corporis (24.7%) was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%). Conclusions: The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka. PMID:27559499

  16. Oxyphil Cell Parathyroid Adenomas Causing Primary Hyperparathyroidism: a Clinico-Pathological Correlation.

    PubMed

    Howson, Pamela; Kruijff, Schelto; Aniss, Ahmad; Pennington, Thomas; Gill, Anthony J; Dodds, Tristan; Delbridge, Leigh W; Sidhu, Stan B; Sywak, Mark S

    2015-09-01

    Oxyphil cell parathyroid adenomas (OPA) are considered to be an uncommon cause of primary hyperparathyroidism (PHPT), and were historically thought to be clinically silent. It has been our clinical impression that these adenomas present more often than previously thought and may manifest a more severe form of primary hyperparathyroidism than classical adenoma. The aim of this study was to describe the incidence and clinical presentation of OPA. An observational case-control study was undertaken. The study group comprised patients undergoing parathyroidectomy for PHPT where the final pathology confirmed OPA. The controls were made up of an age- and sex-matched group of patients having parathyroidectomy in the same time period where the final pathology confirmed a classical or non-oxyphil adenoma. OPA were defined as parathyroid tumours containing >75% oxyphilic cells. The OPA cases were obtained by reviewing all histopathology slides over an 11-year period (2002-12) where the reports contained the words 'oxyphil' or 'oxyphilic' parathyroid adenomas. These were then reviewed by two independent pathologists to confirm a diagnosis of OPA. The primary outcome measures were preoperative serum calcium and parathyroid hormone (PTH) levels. Secondary outcome measures were symptoms at presentation, accuracy of preoperative localization studies, parathyroid gland weight following surgery, and type of surgery undertaken. In the period 2002-2012, 2739 patients underwent surgery for PHPT. Following pathological review, 91 cases were confirmed as being OPA and formed the study group. A control group (n = 91) from the same period was selected following matching on the basis of age at presentation and sex. OPA were associated with higher preoperative serum calcium (10.84 versus 10.48 mg/dL, p < 0.001) and parathyroid hormone (139 versus 64 ng/L, p < 0.001). At presentation, a lower proportion of OPA cases had asymptomatic disease (15 versus 29%, p = 0.03). There was a trend toward a higher rate of renal calculi at presentation in the OPA group (9 versus 3%, p = 0.07). Preoperative ultrasound was less accurate in localization of OPA when compared with classical adenoma. The rate of minimally invasive surgery was 67% for OPA and 78% for the control group (p = 0.06). All patients were cured of hypercalcaemia at 6-month follow up. There was no significant difference in the weight of removed parathyroid tissue between the groups (868 mg for OPA versus 789 mg for the control group, p = 0.6). OPA are frequently symptomatic and are associated with higher preoperative serum calcium and parathyroid hormone levels than classical types of parathyroid adenomas. OPA are less likely to be localised on preoperative ultrasound examination.

  17. Clinico-epidemiological factors of health related quality of life among people with type 2 diabetes.

    PubMed

    Mamaghanian, Azra; Shamshirgaran, Seyed Morteza; Aiminisani, Nayyereh; Aliasgarzadeh, Akbar

    2017-08-15

    To investigate the quality of life (QOL) and its clinical and epidemiological correlates among people with type 2 diabetes. This cross-sectional study was conducted in Tabriz, Northwest of Iran, including a total of 394 people with type 2 diabetes using convenient sampling method from November 2014 to March 2015. General information including demographic, socioeconomic status and lifestyle factors were collected by trained interviewers. Clinical information was retrieved from clinic's record and QOL was assessed using the 26-item WHOQOL-BRIFE questionnaire. Univariate and multivariate linear regression were performed to assess the related factors and QOL dimensions. The mean of overall health related QOL was 52.11 ± 11.53 and the maximum and minimum dimensions were respectively seen in psychological (60.38 ± 14.54) and social (38.32 ± 16.94) dimensions. The results of multiple linear regression showed a significant overall relationship between HRQOL and age (b = -1.48%, 95%CI: -0.03 and -2.93) level of education (b = 4.12%, 95%CI: 2.73 and 5.5), number of comorbidities (b = -2.41%, 95%CI: -3.89 and -9.41), and level of income (b = 1.98, 95%CI: 0.05 and 3.9), functional limitation (b = -3.59, 95%CI: -2.26 and -4.92) and psychological distress (b = -2.02%, 95%CI: -2.83 and -1.21). Level of education, functional limitation, psychological distress were associated with the score of physical, mental and environmental dimensions, and number of comorbidities was associated with the score of physical and mental dimensions. Based on our findings, lifestyle modification and increasing facilities of clinics providing service can be effective steps to improve the QOL among people with type 2 diabetes.

  18. RET/PTC Translocations and Clinico-Pathological Features in Human Papillary Thyroid Carcinoma

    PubMed Central

    Romei, Cristina; Elisei, Rossella

    2012-01-01

    Thyroid carcinoma is the most frequent endocrine cancer accounting for 5–10% of thyroid nodules. Papillary histotype (PTC) is the most prevalent form accounting for 80% of all thyroid carcinoma. Although much is known about its epidemiology, pathogenesis, clinical, and biological behavior, the only documented risk factor for PTC is the ionizing radiation exposure. Rearrangements of the Rearranged during Transfection (RET) proto-oncogene are found in PTC and have been shown to play a pathogenic role. The first RET rearrangement, named RET/PTC, was discovered in 1987. This rearrangement constitutively activates the transcription of the RET tyrosine-kinase domain in follicular cell, thus triggering the signaling along the MAPK pathway and an uncontrolled proliferation. Up to now, 13 different types of RET/PTC rearrangements have been reported but the two most common are RET/PTC1 and RET/PTC3. Ionizing radiations are responsible for the generation of RET/PTC rearrangements, as supported by in vitro studies and by the evidence that RET/PTC, and particularly RET/PTC3, are highly prevalent in radiation induced PTC. However, many thyroid tumors without any history of radiation exposure harbor similar RET rearrangements. The overall prevalence of RET/PTC rearrangements varies from 20 to 70% of PTCs and they are more frequent in childhood than in adulthood thyroid cancer. Controversial data have been reported on the relationship between RET/PTC rearrangements and the PTC prognosis. RET/PTC3 is usually associated with a more aggressive phenotype and in particular with a greater tumor size, the solid variant, and a more advanced stage at diagnosis which are all poor prognostic factors. In contrast, RET/PTC1 rearrangement does not correlate with any clinical–pathological characteristics of PTC. Moreover, the RET protein and mRNA expression level did not show any correlation with the outcome of patients with PTC and no correlation between RET/PTC rearrangements and the expression level of the thyroid differentiation genes was observed. Recently, a diagnostic role of RET/PTC rearrangements has been proposed. It can be searched for in the mRNA extracted from cytological sample especially in case with indeterminate cytology. However, both the fact that it can be present in a not negligible percentage of benign cases and the technical challenge in extracting mRNA from cytological material makes this procedure not applicable at routine level, at least for the moment. PMID:22654872

  19. Demographic and Clinico-Epidemiological Features of Dengue Fever in Faisalabad, Pakistan

    PubMed Central

    Raza, Faiz Ahmed; Rehman, Shafiq ur; Khalid, Ruqyya; Ahmad, Jameel; Ashraf, Sajjad; Iqbal, Mazhar; Hasnain, Shahida

    2014-01-01

    This cross-sectional study was carried out to explore the epidemiological and clinical features of dengue fever in Faisalabad, Pakistan during 2011 and 2012. During the study period, anti-dengue IgM positive cases were reported in the post-monsoon period during the months of August–December. Certain hotspots for the dengue infection were identified in the city that coincide with the clusters of densely populated urban regions of the city. Out of total 299 IgM positive patients (male 218 and female 81); there were 239 dengue fever (DF) and 60 dengue hemorrhagic fever (DHF) patients. There was decrease in the median age of dengue patients from 31 years in 2011 to 21.5 years in 2012 (p<0.001). Abdominal pain was seen in 35% DHF patients followed by nausea in 28.3%, epistaxis in 25% and rash in 20% patients (p<0.05). Patients reported to be suffering from high-grade fever for an average of 8.83 days in DHF as compared to 5.82 days in DF before being hospitalized. Co-morbidities were found to be risk factor for the development of DHF in dengue patients. Clinical and laboratory features of dengue cases studied could be used for the early identification of patients at risk of severe dengue fever. PMID:24595236

  20. X-linked recessive nephrogenic diabetes insipidus: a clinico-genetic study.

    PubMed

    Hong, Che Ry; Kang, Hee Gyung; Choi, Hyun Jin; Cho, Min Hyun; Lee, Jung Won; Kang, Ju Hyung; Park, Hye Won; Koo, Ja Wook; Ha, Tae-Sun; Kim, Su-Yung; Il Cheong, Hae

    2014-01-01

    A retrospective genotype and phenotype analysis of X-linked congenital nephrogenic diabetes insipidus (NDI) was conducted on a nationwide cohort of 25 (24 male, 1 female) Korean children with AVPR2 gene mutations, comparing non-truncating and truncating mutations. In an analysis of male patients, the median age at diagnosis was 0.9 years old. At a median follow-up of 5.4 years, urinary tract dilatations were evident in 62% of patients and their median glomerular filtration rate was 72 mL/min/1.73 m2. Weights and heights were under the 3rd percentile in 22% and 33% of patients, respectively. One patient had low intelligence quotient and another developed end-stage renal disease. No statistically significant genotype-phenotype correlation was found between non-truncating and truncating mutations. One patient was female; she was analyzed separately because inactivation and mosaicism of the X chromosome may influence clinical manifestations in female patients. Current unsatisfactory long-term outcome of congenital NDI necessitates a novel therapeutic strategy.

  1. Visual apperceptive agnosia: a clinico-anatomical study of three cases.

    PubMed

    Warrington, E K; James, M

    1988-03-01

    The visuo-perceptual abilities of three cases with unilateral lesions of the right hemisphere selected on the basis of the co-occurrence of impaired performance on a test of visual object perception and normal performance on a test of shape discrimination are reported. Their performance was also impaired on other tests of visual object recognition in which the perceptual difficulty of the task was manipulated by obscuring the salient features of the representation. At the same time it was found that on a variety of other tests of visual-sensory processing their performance was entirely normal, as was their performance on tests of visual semantic knowledge, tests that were failed by a patient with a visual associative agnosia. It is argued that this syndrome has all the hallmarks of an apperceptive agnosia, a failure of perceptual categorisation in which the physical identity of the object is specified. The two discontinuities between visual-sensory processing, perceptual categorisation and visual-semantic processing are discussed in terms of a 2 categorical stage model of object recognition.

  2. Autoimmune hepatitis, one disease with many faces: etiopathogenetic, clinico-laboratory and histological characteristics.

    PubMed

    Gatselis, Nikolaos K; Zachou, Kalliopi; Koukoulis, George K; Dalekos, George N

    2015-01-07

    Autoimmune hepatitis (AIH) is an unresolving progressive liver disease of unknown etiology characterized by hypergammaglobulinemia, autoantibodies detection and interface hepatitis. Due to the absence of specific diagnostic markers and the large heterogeneity of its clinical, laboratory and histological features, AIH diagnosis may be potentially difficult. Therefore, in this in-depth review we summarize the substantial progress on etiopathogenesis, clinical, serological and histological phenotypes of AIH. AIH has a global distribution affecting any age, both sexes and all ethnic groups. Clinical manifestations vary from asymptomatic to severe or rarely fulminant hepatitis. Hypergammaglobulinemia with selective elevation of IgG is found in most cases. Autoimmune attack is perpetuated, possibly via molecular mimicry, and favored by the impaired control of T-regulatory cells. Histology (interface hepatitis, emperipolesis and hepatic rosette formation) and autoantibodies detection although not pathognomonic, are still the hallmark for a timely diagnosis. AIH remains a major diagnostic challenge. AIH should be considered in every case in the absence of viral, metabolic, genetic and toxic etiology of chronic or acute hepatitis. Laboratory personnel, hepato-pathologists and clinicians need to become more familiar with disease expressions and the interpretation of liver histology and autoimmune serology to derive maximum benefit for the patient.

  3. Clinico-electrophysiological profile and predictors of functional outcome in Guillain-Barre syndrome (GBS).

    PubMed

    Verma, Rajesh; Chaudhari, Tejendra Sukdeo; Raut, Tushar Premraj; Garg, Ravindra Kumar

    2013-12-15

    Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy with varied severity of presentation. To study the clinical and electrophysiological profile of patients with GBS and to determine the factors associated with poor functional outcome and need for mechanical ventilation. It was a hospital-based prospective observational study. 90 patients with GBS diagnosed as per Asbury and Cornblath criteria were enrolled and followed up for 6 months. Various epidemiological, clinical and electrophysiological parameters were evaluated. Hughes motor scale was used to measure functional outcome. Factors associated with poor functional outcome and need for mechanical ventilation were determined. 90 patients (56 males; 34 females; mean age of 29.3±15.2 years) were enrolled in this study. Amongst these 6 (6.7%) patients died during in-hospital stay. Antecedent infection was present in 29 (32.2%), autonomic dysfunction in 31 (34.4%), bulbar palsy in 21 (23.3%), neck flexor weakness in 52 (57.8%). 60 cases (66.7%) were of axonal variety and 30 (33.3%) of demyelinating variety. On univariate analysis, predictors associated with poor functional outcome at 6 months were autonomic dysfunction (p=0.013), neck flexor weakness (p=0.009), requirement of ventilatory assistance (p=<0.001), MRC sum score<30 on admission (p=<0.001) and axonal pattern on electrophysiological assessment (p=<0.001). On multivariate analysis, MRC sum score<30 on admission (p=0.007) and axonal pattern on electrophysiological assessment (p=<0.001) were independently associated with poor functional outcome at 6 months. Factors associated with need for mechanical ventilation were presence of autonomic dysfunction (p=<0.001), cranial nerve palsy including facial palsy (p=<0.001) and bulbar palsy (p=0.002), neck flexor weakness (p=<0.001), low MRC sum score (<30) (p=0.001), and low proximal CPN CMAP amplitude to distal CPN CMAP amplitude ratio (p=0.042); none of them being significant on multivariate analysis. Detailed evaluation of the clinical and electrophysiological profile may help in predicting the functional outcome and need for mechanical ventilation in patients with GBS. © 2013.

  4. [Clinical and social adaptation of patients with paroxysmal schizophrenia (clinico-epidemiologic study)].

    PubMed

    Krasik, E D; Logvinovich, G V

    1987-01-01

    In 186 patients with paroxysmal schizophrenia the authors analyzed their social relations and functions as compared with a premorbid period. Four compensated and three decompensated levels of social adaptation have been identified. Variants of combination of clinical and social levels of adaptation are systematized in the form of four types. It has been established that integrative and destructive types of adaptation develop in patients with partial or complete correlation of clinical and social characteristics. Extrovert and introvert types reflect contrast combinations of clinical and social levels of adaptation. The results are of interest for examination of the mechanisms of adaptation formation and optimization of rehabilitation programmes.

  5. Diagnosis and Clinico-Radiological Presentation in an Aggressive Maxillary Brown Tumour

    PubMed Central

    Mubeen; KR, Vijayalakshmi; Singh, Chandravir

    2014-01-01

    Brown’s tumour is an uncommon focal giant cell lesion which arises as a result of the effect of increased parathyroid hormone on bone tissues in hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area and a maxillary involvement is rare. The severity of the lesion, caused by a Brown’s tumour, may lead to evident osteolysis and gross deformity in the maxillofacial region, which suggests the need for making an early diagnosis and giving prompt treatment. We are reporting a male patient who presented with a massive painful swelling in the right maxilla as the first manifestation of primary hyperparathyroidism, caused by a parathyroid adenoma. PMID:24995255

  6. Pattern Analysis and Decision Support for Cancer through Clinico-Genomic Profiles

    NASA Astrophysics Data System (ADS)

    Exarchos, Themis P.; Giannakeas, Nikolaos; Goletsis, Yorgos; Papaloukas, Costas; Fotiadis, Dimitrios I.

    Advances in genome technology are playing a growing role in medicine and healthcare. With the development of new technologies and opportunities for large-scale analysis of the genome, genomic data have a clear impact on medicine. Cancer prognostics and therapeutics are among the first major test cases for genomic medicine, given that all types of cancer are related with genomic instability. In this paper we present a novel system for pattern analysis and decision support in cancer. The system integrates clinical data from electronic health records and genomic data. Pattern analysis and data mining methods are applied to these integrated data and the discovered knowledge is used for cancer decision support. Through this integration, conclusions can be drawn for early diagnosis, staging and cancer treatment.

  7. Verrucous carcinoma, hyperplasia and leukoplakia of the oral mucosa: a clinico-histopathological and histometric study.

    PubMed

    Keszler, A; Gutierrez, R; Dominguez, F V

    1985-01-01

    Thirteen cases of verrucous leucoplakia (VL), 3 of verrucous hyperplasia (VH) and 19 of verrucous carcinoma (VC) were evaluated by means of 4 clinical features, 12 microscopic parameters and 6 epithelial histometric measurements. No significant clinical differences were detected, but histologic data showed that orthokeratinization was more frequent in VL and VH, while parakeratinization proved more common in VC. Sharp epithelial projections predominated in all three lesion types, though lymphoplasmatic infiltration and Russell bodies were more frequent in VH. Histometrically, there were statistical differences between VL or VH vs VC in three parameters, namely connective tissue-epithelial interface (Ice), epithelial height (He) and connective tissue-epithelial interface plus verrucous epithelial surface (Ice + Sve). To conclude, in this series, VH failed to exhibit significant clinical or histologic differences vs VL or VC, but histometric analysis was able to detect epithelial differences between both premalignant lesions and VC.

  8. [Clinico-pathologic correlation of dementia produced by thinner and cocaine].

    PubMed

    Barroso Moguel, R; Méndez Armenta, M; Villeda Hernández, J

    1993-01-01

    Industrial solvents mixed from thinner, used in paints, leathers, rubber, varnishes, have neurotoxic action. By laboral inhalation or spontaneously these are absorbed from the lungs, transported by blood and because of this high lipophilic section are retained within the lipid rich nervous system. Euphoric effects appear accompanied with visual and additive halucinations. In chronic abusers it produce schizophrenic-paranoid consequences with encephalic and peripheral neuronal and nervous fibers destruction, accompanied of blindness and paralysis. Cocaine is another neurotoxic drug. At first it produces euphoria, arterial hypertension and symptoms suggestive of underlying psychiatric diseases. The cocaine addicts often suffer depression, paranoia, hallucinations, seizures and suicidal ideation. The morphological base of the symptomatology is the encephalic and peripheral neuronal and nerve fibers destruction.

  9. [The detection of antibodies against HIV-1 24-kd protein. A clinico-serological correlation].

    PubMed

    Díaz Torres, H; Silva Cabrera, E; Rodríguez García, O; Bárcenas Moses, J; Lubián Caballero, A L

    1996-01-01

    The presence of antibodies against the HIV protein of 24 kd was studies by the parallel use of the DAVIH BLOT western blot and of the DAVIH AC P24 ELISA in serum samples from 176 patients at different HIV-1 infection stages. The results were correlated with the clinical classification of the patient at the moment of taking the sample and with the further evolution during 6 months. 57% of the patients with opportunistic minor infections and 96% of AIDS patients had low antibodies titres. Dead patients showed no reactivity or presented very low titres in samples taken before dying. Different titrations were observed in serum groups with an apparently uniform reactivity in the western blot. The results show and adequate clinical and serological correlation. Therefore, the DAVIH AC P24 ELISA could be useful in the clinical follow-up of HIV-1 infected persons.

  10. [Fulminant Wilson's disease in Costa Rica. Clinico-pathological study of 7 cases].

    PubMed

    Herra, S A; Hevia, F J; Vargas, M; Schosinsky, K

    1990-01-01

    In the last eighteen years, from 1972 to 1989, around 150 cases of Wilson's disease have been diagnosed in Costa Rica (6/100.000 inhabitants). In the San Juan de Dios Hospital, 120 cases have been studied during this period, seven of whom died with a picture of acute hepatic insufficiency, hemolytic anemia, encephalopathy, intestinal bleeding and renal insufficiency. In four of the cases, postmortem histopathologic studies were done with high resolution microscopy, which revealed extensive submassive necrosis of the liver, with severe cholestatic, lytic and acidophilic necrosis with nodular, irregular regeneration and specially microvacuolar steatosis, different from that observed in other forms of fulminant hepatitis. With the clinical, laboratory and histopathologic findings, we concluded that fulminant Wilson's disease is a well-defined pathological clinical entity of fatal evolution with no response to therapy, including early treatment with penicillamine and steroids.

  11. Clinico-radiological correlation of nutcracker syndrome: a single centre experience.

    PubMed

    Taktak, Aysel; Hakan Demirkan, Tulin; Acar, Banu; Gu R, Gökçe; Köksoy, Adem; Uncu, Nermin; Çaycı, Fatma Ş; Çakar, Nilgu N

    2017-04-01

    The term nutcracker syndrome (NS) refers to the compression of left renal vein between the aorta and the superior mesenteric artery (SMA) causing renal venous hypertension. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. The purpose of this study is to evaluate the clinical characteristics of patients with NS and the correlation between clinical and laboratory findings with Doppler sonographic measurements. Sixty-three patients were evaluated (19 boys and 44 girls) since January 2004 to January 2014. The mean age of the patients was 12.21 ± 3.21 years (range 7-17). Hematuria and proteinuria disappeared during the follow up of 9/63 patients. These nine patients showed statistically significant difference in upright SMA angles (p= 0.035). Doppler sonographic evaluation is a non-invasive method for diagnosis NS. Upright SMA angle measurement is more efficient than supine SMA angle measurement on clinicoradiological correlation.

  12. [Non-neoplastic enlargement of salivary glands: clinico-histologic analysis].

    PubMed

    González Guevara, Martha Beatriz; Torres Tejero, Marco Antonio; Martínez Mata, Guillermo

    2005-01-01

    We carried out a retrospective study on non-neoplastic enlargement of the salivary glands at the Oral Histopathology Diagnostic Center of the Autonomous Metropolitan University at Xochimilco (UAM-Xochimilco) in Mexico during a period of 24 years (1979-2003). From 5,625 biopsies received and analyzed, a total of 461 (8.2%) were non-neoplastic enlargement of the salivary glands; for each case, we registered demographic data as well as clinic characteristics. These lesions were characterized as a heterogeneous group of pathologic entities among which we included local, obstructive, infectious, and immunopathologic lesions. The most frequent lesion was the extravasation cyst in 341 (74%) cases, followed by chronic sialoadenitis and Sjögren's syndrome with 54 (11.7%) and 41 (8.8%) cases, respectively, and at a lesser percentage mucous retention cyst, sialosis, benign lymphoepithelial lesions and those related with sialolytes. Females were affected more frequently; mean age was second to third life decades. These lesions were most frequently localized on inferior labial mucosa.

  13. Posterior spinal artery syndrome showing marked swelling of the spinal cord: A clinico-pathological study

    PubMed Central

    Matsubayashi, Jun; Tsuchiya, Kuniaki; Shimizu, Soichiro; Kitagawa, Naoyuki; Wakabayashi, Yukari; Kuroda, Masahiko; Sakurai, Michio; Nagao, Toshitaka

    2013-01-01

    Objective To describe a rare autopsy case of posterior spinal artery syndrome with marked swelling of the spinal cord, an unusually subacute onset and short clinical course. Methods Case report. Findings An 84-year-old Japanese woman presented with bilateral muscle weakness of the lower legs and sensory disturbance 1 week after head contusion. Neurological findings worsened gradually. She developed phrenic nerve paralysis and died of respiratory failure 6 weeks after the onset of neurological symptoms. On pathological examination, the spinal cord was markedly swollen in the cervical and upper thoracic segments. Microscopically, there was loss of myelin sheath in the bilateral posterior columns and neuronal loss of the posterior horns in all of the spinal segments. However, findings were unremarkable in the bilateral anterior columns and bilateral anterior horns in most of the spinal segments. Posterior spinal arteries had no stenosis, occlusion, or thrombosis. We considered that pathogenesis was infarction associated with head injury. Conclusion To our knowledge, this is the first report of a case of posterior spinal artery syndrome with a markedly swollen spinal cord and poor prognosis. PMID:23433332

  14. The effects of a dentifrice containing propolis on Mutans Streptococci: a clinico-microbiological study.

    PubMed

    Mohsin, S; Manohar, B; Rajesh, S; Asif, Y

    2015-01-01

    Propolis is a natural resinous mixture produced by honeybees, which exhibits anti-microbial, anti-inflammatory, cytostatic and cariostatic properties. The aim of the study was to evaluate the anti-bacterial efficacy of a propolis based dentifrice on Mutans Streptococci colonizing the oral cavity of young patients using Dentocult® SM strip mutans test. Screening of 367 male subjects within the age group of 7-12 years was carried out. A total of 30 children were included in the study. They were instructed to use a Propolis dentifrice (Probee,™ Quasi-Medical Products, Seoul Propolis) daily for three minutes over a period of four weeks. Plaque and salivary samples were collected at baseline, 1(st) week, 3(rd) week and 4(th) week and were analyzed for Mutans Streptococci count using Dentocult® SM strip Mutans kit (Orion Diagnostica Oy, Finland). Student paired t-test and Friedman test were used for statistical analysis. It was unveiled that mean Mutans streptococci count at 1(st) week and 4(th) week, showed significant reduction (p≤0.0001), compared to baseline scores. Using Friedman's test, statistically significant difference was found between baseline and 1(st) week, 3(rd) week and 4(th) week follow up (P < 0.001). Propolis dentifrice reduces in-vivo microbial load in microenvironments especially against Mutans streptococci in the oral cavity of young patients. Thus, it's potential to be inculcated and used as an alternative measure to prevent dental caries can be considered and further investigation involving greater number of participants is recommended.

  15. White matter in temporal lobe epilepsy: clinico-pathological correlates of water diffusion abnormalities.

    PubMed

    Rodríguez-Cruces, Raúl; Concha, Luis

    2015-04-01

    Using magnetic resonance imaging, it is possible to measure the behavior of diffusing water molecules, and the metrics derived can be used as indirect markers of tissue micro-architectural properties. Numerous reports have demonstrated that patients with temporal lobe epilepsy (TLE) have water diffusion abnormalities in several white matter structures located within and beyond the epileptogenic temporal lobe, showing that TLE is not a focal disorder, but rather a brain network disease. Differences in severity and spatial extent between patients with or without mesial temporal sclerosis (MTS), as well as differences related to hemispheric seizure onset, are suggestive of different pathophysiological mechanisms behind different forms of TLE, which in turn result in specific cognitive disabilities. The biological interpretation of diffusion abnormalities is based on a wealth of information from animal models of white matter damage, and is supported by recent reports that directly correlate diffusion metrics with histological characteristics of surgical specimens of TLE patients. Thus, there is now more evidence showing that the increased mean diffusivity (MD) and concomitant reductions of diffusion anisotropy that are frequently observed in several white matter bundles in TLE patients reflect reduced axonal density (increased extra-axonal space) due to smaller-caliber axons, and abnormalities in the myelin sheaths of the remaining axons. Whether these histological and diffusion features are a predisposing factor for epilepsy or secondary to seizures is still uncertain; some reports suggest the latter. This article summarizes recent findings in this field and provides a synopsis of the histological features seen most frequently in post-surgical specimens of TLE patients in an effort to aid the interpretation of white matter diffusion abnormalities.

  16. A clinico-epidemiological study of ulcerative sexually transmitted diseases with human immunodeficiency virus status

    PubMed Central

    Mehta, Bhavesh

    2014-01-01

    Introduction: Genital ulcerative diseases are a major public health problem. The advert of human immunodeficiency virus (HIV)/AIDS over the past 25 years has deepened the scope of morbidity, mortality, and various forms of clinical presentations of sexually transmitted diseases (STDs). Materials and Methods: A total of 50 cases having Genital ulcerative diseases and STD reporting to STD clinic during the period of the year from November 2005 to December 2006 were included and detailed history and clinical examination were carried out and provisional diagnosis is made. Laboratory confirmation of clinically diagnosed cases was done using laboratory tests such as S. HIV, venereal disease research laboratory, Tzanck smear, gram stain, and Giemsa stain. Result: In the present study, the incidence of herpes progenitalis was (38%) followed by primary syphilis (32%), chancroid (26%), lymphogranuloma venereum (02%), and genital scabies (02%). HIV sero-positivity was detected in 12% (n = 6) cases. Conclusion: HIV was found to be more common among genital ulcer disease patients, especially syphilis and genital herpes. PMID:24958991

  17. Rheumatic heart disease in rural south India: A clinico-observational study

    PubMed Central

    Sriharibabu, Manne; Himabindu, Yalamanchali; Kabir, Zubair

    2013-01-01

    Background Rheumatic heart disease (RHD) is still a public health issue in many countries in the world, and particularly in Southeast Asia. India, for example, contributes 25%–50% of the global burden of RHD. Clinic-based and epidemiological studies on RHD in India have used different methodologies and clinical criteria to estimate RHD burden in India. The present study employs strict clinical criteria, including echocardiography, to estimate RHD prevalence and associated clinical complications in a large unique rural population in southern India covered through a governmental health insurance scheme. Materials and methods Total 44,164 eligible patients were screened from 238 primary care health centers in rural southern India between October 2007 and March 2012 using strict clinical criteria and objective ascertainment. A total of 403 patients aged 15 years or above were finally analyzed based on both the inclusion and exclusion criteria. Detailed information on both demographic and clinical characteristics was obtained through personal interviews and clinical examinations. Descriptive analyses were performed, including age standardization. Results The age-standardized RHD prevalence rate was 9.7/1000 populations—more common in younger age groups (<44 years) and relatively high among females. Pulmonary hypertension was the most common clinical complication followed by CHF, tricuspid regurgitation, as well as infective endocarditis. More than two-thirds had no past history of RHD or penicillin prophylaxis. Conclusions RHD rates are still high in rural India among populations covered through governmental health insurance scheme. Both primary and secondary preventive measures, including widespread coverage of penicillin prophylaxis, must be considered mainstay tools to both prevent and reduce RHD burden in endemic populations, including rural India. PMID:24023467

  18. [Clinico-immunological study of 16 cases of benzoate intolerance in children].

    PubMed

    Pétrus, M; Bonaz, S; Causse, E; Micheau, P; Rhabbour, M; Netter, J C; Bildstein, G

    1997-02-01

    The authors report a sery of 16 cases of intolerance to the benzoates in children. Sixteen children (9 boys and 7 girls) were directed to the Hospital of Tarbes from June 1995 to July 1995, for recurring urticaria (7/16) combined with asthma (1/16), atopic eczema (2/16), dermorespiratory syndrome (2/16) and asthma (1/16). All were subject to an immunological examination comprising alimentation inquiry, prick test, IgE determination, RAST, oral provocation test to benzoates, which establishes the diagnosis, whose confirmation is certified by the benefit of the food eviction. To conclusion, the authors underline several points: the presumable underestimation of the intolerance, the often mentioned atopic familial context, the observed pathology (urticaria, asthma, eczema), the importance of the provocation test. Finally, besides food such as grey shrimps, sodas and antibiotic syrups, one finds benzoates in the antiallergic syrups initially prescribed as a preventive measure.

  19. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features.

    PubMed

    Arduino, Paolo G; Porter, Stephen R

    2008-02-01

    Herpes Simplex Virus Type 1 (HSV-1) is a nuclear replicating enveloped virus, usually acquired through direct contact with infected lesions or body fluids (typically saliva). The prevalence of HSV-1 infection increases progressively from childhood, the seroprevalence being inversely related to socioeconomic background. Primary HSV-1 infections in children are either asymptomatic or following an incubation period of about 1 week gives rise to mucocutaneous vesicular eruptions. Herpetic gingivostomatitis typically affects the tongue, lips, gingival, buccal mucosa and the hard and soft palate. Most primary oro-facial HSV infection is caused by HSV-1, infection by HSV-2 is increasingly common. Recurrent infections, which occur at variable intervals, typically give rise to vesiculo-ulcerative lesions at mucocutaneous junctions particularly the lips (herpes labialis). Recurrent HSV-1 infection within the mouth is uncommon in otherwise healthy patients, although in immunocompromised patients, recurrent infection can be more extensive and/or aggressive. The diagnosis of common herpetic infection can usually be based upon the clinical history and presenting features. Confirmatory laboratory diagnosis is, however, required when patients are, or may be, immunocompromised.

  20. Clinico-epidemiological study of Schistosomiasis mansoni in Waja-Timuga, District of Alamata, northern Ethiopia.

    PubMed

    Abebe, Nigus; Erko, Berhanu; Medhin, Girmay; Berhe, Nega

    2014-04-01

    Intestinal schistosomiasis, caused by digenetic trematodes of the genus Schistosoma, is the most prevalent water related disease that causes considerable morbidity and mortality. Although prevalence of Schistosoma mansoni infection has been reported for the present study area, earlier studies have not estimated intensity of infections in relation to periportal fibrosis, which would have been crucial for epidemiological and clinical evaluations. Hence, a community based cross sectional study was conducted from December 2011 to March 2012 to assess prevalence of infection and schistosomal periportal fibrosis in Waja-Timuga, northern Ethiopia. In a cross sectional study involving 371 randomly selected individuals, fresh stool samples were collected and processed by the Kato-Katz method and examined microscopically. Ultrasonography was used to determine status of schistosomal periportal fibrosis and to detect hepatomegaly and/or splenomegaly. Serum was collected for assay of hepatic activity. Statistical analysis was performed using STATA 11 statistical soft ware. P-value <0.05 was reported as statistically significant. The prevalence of S.mansoni infection was 73.9%, while the prevalence of schistosomal periportal fibrosis was 12.3% and mean intensity of infection was 234 eggs per gram of stool. Peak prevalence and intensity of S.mansoni infection was documented in the age range of 10-20 years. Among the study individuals, hepatomegaly was recorded in 3.7% and splenomegaly was recorded in 7.4% of the study individuals. Similarly, among the study individuals who had definite periportal fibrosis, 5.9% had elevated liver enzyme levels. The high prevalence of Schistosoma mansoni infection and schistosomal periportal fibrosis observed in the study area calls for a periodic deworming program to reduce disease, morbidity and transmission. Preventive chemotherapy complemented with other control measures is highly required for sustainable control of schistosomiasis in the study area.

  1. Probable Zika virus-associated Guillain-Barré syndrome: Challenges with clinico-laboratory diagnosis.

    PubMed

    Miller, Eliza; Becker, Zoe; Shalev, Daniel; Lee, Christopher T; Cioroiu, Comana; Thakur, Kiran

    2017-04-15

    A 55year old woman in New York City presented in May 2016 with progressive weakness, ataxia, paresthesia, and areflexia, shortly after returning from the Dominican Republic. Lumbar puncture revealed cytoalbuminological dissociation. Due to her recent travel, Zika-associated Guillain Barré syndrome (GBS) was suspected and she underwent evaluation for recent flavivirus exposure. Zika virus RNA was not detected in serum, but Zika virus immunoglobulin M (IgM) was detected in both serum and cerebrospinal fluid. Dengue virus IgM in serum was equivocal and dengue virus IgG was detected in the serum. Plaque-reduction neutralization testing showed elevated titers to both Zika virus and dengue virus, providing evidence of recent infection with a flavivirus. The patient was diagnosed with probable Zika virus-associated GBS based on clinical findings, ancillary testing, and laboratory assays according to current guidance from the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists. Zika virus transmission in the Americas is resulting in increasing numbers of patients presenting with Zika virus-associated neurological syndromes. Clinical and laboratory diagnosis in these cases can be challenging and may be aided by consultation with CDC, and state and local public health agencies. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Clinico-pathological studies of Plasmodium falciparum and Plasmodium vivax - malaria in India and Saudi Arabia.

    PubMed

    Khan, Wajihullah; Zakai, Haytham A; Umm-E-Asma

    2014-06-01

    Malaria is one of the most devastating diseases of tropical countries with clinical manifestations such as anaemia, splenomegaly, thrombocytopenia, hepatomegaly and acute renal failures. In this study, cases of thrombocytopenia and haemoglobinemia were more prominent in subjects infected with Plasmodium falciparum (Welch, 1897) than those with Plasmodium vivax (Grassi et Feletti, 1890). However, anaemia, jaundice, convulsions and acute renal failure were significantly high (3-4 times) in subjects infected with P. falciparum than those infected with P. vivax. The incidence of splenomegaly and neurological sequelae were 2 and 6 times higher in P. falciparum infections compared to the infections of P. vivax. Both in P. vivax and P. falciparum malaria, the cases of splenomegaly, jaundice and neurological sequelae were almost double in children (<10 years) compared to older patients. The liver enzymes were generally in normal range in cases of low and mild infections. However, the AST, ALT, ALP activities and serum bilirubin, creatinine, and the urea content were increased in P. falciparum and P. vivax malaria patients having high parasitaemia, confirming liver dysfunction and renal failures in few cases of severe malaria both in India and Saudi Arabia.

  3. The clinico-radiological spectrum of masseteric venous malformation: Case report.

    PubMed

    Agarwal, Kavita; Umarji, Hemant R; Kadam, Sonali; Agrawal, Neeraj

    2016-11-01

    Due to its location, intra-masseteric venous malformation often mistaken for a parotid swelling and clinical examination alone frequently underestimates the deep extension of the lesion and rarely gives accurate pre-operative diagnosis. But once it is diagnosed, the feasibility of the treatment and the plan of approach depend on accurate delineation of the extent, size and location of the lesion. Therefore, complimentary radiographic studies are essential for its management. In this case report, typical features of venous malformation within the masseter muscle, including clinical findings (turkey wattle sign) and imaging are presented. Ultrasonography and CT scan were non-contributory in the diagnosis, while on MRI, masseteric venous malformations have a typical appearance that allowed early identification, patient education and its management.

  4. Fetal MR Imaging Analysis of Sirenomelia with Clinico Radiographic Correlation: A Case Report.

    PubMed

    Nori, Madhavi; Prasad, Raghavendra G; Reddy, Arvind K; Cheguri, Sandeep Reddy

    2016-06-01

    Sirenomelia is a social curiosity, a medical and diagnostic challenge prenatally compounded by varied diagnostic difficulties. Prenatal diagnosis of sirenomelia was and continues to be a challenge although von klippel et al., described a case at 10 weeks of gestational age. However, they needed a second imaging at 12(th) week for confirmation. First trimester or early second trimester anatomic survey on ultrasound and MRI is accurate for the diagnosis thereby avoiding unnecessary complex pregnancy. We report a case of second trimester diagnosed sirenomelia, with detailed analysis of image findings on ultrasound and fetal MRI.

  5. Clinico-radiological improvement in an immunocompetent patient presented with scedosporium apiospermum osteomyelitis.

    PubMed

    Mohan, Rahul; Gopakumar, T S

    2016-01-01

    Scedosporium apiospermum is frequently found as a saprophyte in soil, sewage and contaminated water. Its manifestations in immunocompetent patients are usually localised and in immunodeficient patients, it causes invasive systemic diseases. We are reporting the case of a 40-year-old male, who presented with pain, oedema and multiple discharging sinuses over the lateral aspect of the left foot with history of thorn prick. On examination, there were multiple active sinuses with tenderness and local rise in temperature. Calcaneum on palpation showed a thickened and irregular surface with limitation of ankle and subtalar movements. Blood investigations showed a moderate rise in ESR and CRP. X-rays showed typical features of chronic osteomyelitis with sclerosis, cavities and irregular bone contour. CT report showed features of osteomyelitis involving calcaneum, talus, cuneiforms and navicular bone with periarticular soft tissue involvement and mild focal collection in the calcaneum. On repeated culture, it was found to be scedosporium apiospermum fungus. We managed the case with voriconazole therapy and it responded with excellent clinical and radiological improvement by 9 months.

  6. Excellent Functionality Despite Clinico-Radiological Deformity in Osteomyelitis Variolosa - A Case Report.

    PubMed

    Mugalur, Aakash; Shahane, Sunil M; Samant, Ashwin; Pathak, Aditya C; Reddy, Rajeev

    2015-01-01

    Despite the eradication of smallpox from the world in 1980 the osteo-articular sequelae of smallpox are still occasionally noticed in previously endemic areas. The sequelae of osteomyelitis variolosa may raise a diagnostic challenge to the untrained eyes of the surgeon. We present a case of "osteomyelitis variolosa" in a 70 years old patient. The patient had bilateral dislocation of the elbow joint with multidirectional instability. There was distortion of the articular surfaces and ankylosis of the bilateral proximal radio-ulnar joint. Hypoplasia of the right ulna with short fourth and fifth metacarpals of the left hand and hypoplasia of right fourth metacarpal with cortical thickening was noted radiologically. The patient had minimal disability of his elbows despite the striking radiological abnormality and was functionally independent.

  7. Peripheral desmoplastic ameloblastoma in adolescent age: clinico-pathological and immunohistochemical analisys of a case.

    PubMed

    Oteri, Giacomo; Lentini, Maria; Pisano, Michele; Cicciù, Marco

    2014-01-01

    The Extraosseous or Peripheral Ameloblastoma (PA) is a rare and benign odontogenic tumour, representing 1% to 5% of all ameloblastomas. It is usually localized in the soft oral tissues, without deep bone involvement. Its biological behaviour is specific, and several authors define PA as a non-infiltrating hamartomatous lesion. Indeed, recurrences rarely occur and progression in malignant tumors appears to be rare. The PA originates from the tooth-forming apparatus and it consists of proliferating odontogenic epithelium, exhibiting the same histological cell types and patterns of the intraosseous counterpart or infiltrating ameloblastoma. The peripheral desmoplastic ameloblastoma (PDA) can be classified as a newly recognized and very rare histological variant. To our knowledge, only a few cases of adult patients affected by PDA have been published. The aim of this paper is to report a case of PDA affecting an adolescent patient. The clinical-pathological and immunohistological features are discussed in order to improve knowledge regarding a correct diagnosis and to differentiate PDA lesions from similar diseases.

  8. Clinico-pathological features of breast myxoma: report of a case with histogenetic considerations.

    PubMed

    Magro, Gaetano; Cavanaugh, Barbara; Palazzo, Juan

    2010-05-01

    We herein report the clinical, radiological, and pathological findings of a rare case of myxoma occurring in the breast parenchyma of a 75-year-old female. The tumor was incidentally detected at a mammographic screening and, ultrasonographically, presented as an ovoid mass. Histologically, an encapsulated hypocellular, myxoid tumor with low vascularization was evident. Neoplastic cells were round- to spindle/stellate-shaped and stained with vimentin and focally with calponin. We emphasize that morphology remains preeminent in the diagnosis of a breast myxoma, while immunohistochemistry may assist in ruling out other tumor entities. Differential diagnosis with all benign and malignant myxoid lesions, primarily occurring in the breast, is provided. The histogenesis of breast myxoma is unknown. The lack of expression of desmin, alpha-smooth muscle actin, CD34, CD99, CD10, bcl-2 protein, and estrogen/progesterone/androgen receptors, all markers characteristically expressed by "the benign spindle cell tumors of the mammary stroma," would suggest that breast myxoma does not fall into this tumor category and that its putative precursor mesenchymal cell resides in the interlobular stroma.

  9. Pulmonary Alveolar Microlithiasis - Clinico-Radiological dissociation - A case report with Radiological review.

    PubMed

    Khaladkar, Sanjay Mhalasakant; Kondapavuluri, Sushen Kumar; Kamal, Anubhav; Kalra, Raghav; Kuber, Rajesh

    2016-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare chronic lung disease characterized by deposition of intra alveolar calcium and phosphate in bilateral lung parenchyma with predominance in lower and mid zones. Etiology and pathogenesis is not fully understood. However, mutation in SLC34A2 gene that encodes a sodium phosphate co-transporter in alveolar type-II cells resulting in formation and accumulation of microliths rich in calcium phosphate due to impaired clearance is considered the cause of disease. Patients with PAM are asymptomatic till development of hypoxemia and cor pulmonale. It remains static, while in some it progresses to pulmonary fibrosis, respiratory failure and cor pulmonale. We report a case of 44 year old male patient presenting with progressive shortness of breath on exertion for one year in duration with dry cough, more since last six months. Chest radiograph showed dense micronodular opacities giving classical sandstorm appearance. High resolution computed tomography (HRCT) showed microcalcification, subpleural cystic changes and calcified pleura. Lung biopsy showed calcospherites within alveolar spaces.

  10. Antibodies to chondroitin sulfates A, B, and C: clinico-pathological correlates in neurological diseases.

    PubMed

    Briani, C; Santoro, M; Latov, N

    2000-08-01

    Anti-chondroitin sulfates (ChSs) antibodies have been reported in neuropathy and neurodegenerative diseases. Differences in specificities may account for their association with different diseases. Sera from 303 neurological patients were tested for antibodies to ChSs A, B, C. Titers >/=51,200 were found in 16 patients (eight peripheral neuropathy, three motor neuron disease, four multiple sclerosis, one myelitis). Three patients also had anti-sulfatides antibodies, which in two cases cross-reacted with ChSs. By indirect immunofluorescence, positive sera stained nuclei on normal human peripheral nerve sections. These findings indicate that human anti-ChSs antibodies are broadly reactive and not specific to any neurological disease.

  11. Clinico-microbiological study of dermatophytosis in a tertiary-care hospital in North Karnataka.

    PubMed

    Noronha, Tonita M; Tophakhane, Raghavendra S; Nadiger, Shobha

    2016-01-01

    The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age. The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations. This was a hospital-based observational study. One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail) and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis. Out of 150 patients studied, majority belonged to the age group of 21-30 years (22.7%). Male-to-female ratio was 1.63:1. Tinea corporis (24.7%) was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%). The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka.

  12. Clinico-Radiological Correlation in a Cohort of Cervical Myelopathy Patients

    PubMed Central

    Kalpana, R.Y.

    2015-01-01

    Objective: Though both clinical evaluation and MRI are complimentary in detection and precise localization of the level of lesion in patients with cervical myelopathy, there is paucity of data comparing segment specific clinical features with the MRI abnormalities in cervical myelopathy. Materials and Methods: Thirty one patients with cervical myelopathy and abnormal MRI of the cervical spine (signal changes in the cord) admitted to the neurology and neurosurgery wards during the study period were included in the study. The patients were prospectively evaluated by a detailed neurological examination. Clinically, the site of lesion was determined by highest of the pyramidal, sensory or segmental features of involvement. The MRI lesions were categorized based on the vertebral level at which the abnormalities were seen. The patients were divided into three groups according to the site of lesion on MRI: (1) cervico-medullary (foramen magnum to C1) lesions (2) upper cervical (C2-C4) lesions and (3) lower cervical (C5-T1) lesions. Comparisons of clinical symptoms, signs and level of lesion with MRI abnormalities were done and the level of significance was set at p < 0.05. Results: Clinical evaluation showed limb weakness in all, sensory loss in 90%, sphincter disturbances in 67.7%, scissoring gait in 32.2%, diaphragmatic weakness in 12.9% of patients. Based on clinical examination the site of lesion was cervico-medullary in 9, upper cervical region in 4 and lower cervical region of involvement in five patients. The maximal antero-posterior extent of the lesion and neurological deficits were concordant (p-0.05). As compared to pyramidal signs or sensory abnormalities, segmental features – segmental sensory loss, weakness, wasting or ‘reflex’ loss – were most concordant with the MRI level of lesion (p - 0.03). Among ‘motor’, ‘sensory’ and ‘reflex’ levels, the ‘reflex (DTR)’ levels were most concordant with the MRI level of lesion (p – 0.04). Conclusion: Segmental features form the foundation for clinical localization of the level of lesion. Though the clinical level of lesion and MRI level of lesion were discordant in 14 patients, clinical evaluation may still provide useful information. PMID:25738053

  13. Central Myxoma / Myxofibroma of the Jaws: A Clinico-Epidemiologic Review

    PubMed Central

    Rowland, Agbara; Benjamin, Fomete; Athanasius-Chukwudi, Obiadazie; Uchenna-Kevin, Omeje; Modupeola-Omotara, Samaila

    2017-01-01

    Introduction: Myxomas are a group of benign rare tumors of connective-tissue origin that occur in both hard (central) and soft tissues of the body. The aim of this study is to highlight our experience in the management of central myxoma of the jaw, with emphasis on its clinic-epidemiologic features as seen in our environment. Materials and Methods: All patients who were managed for central myxoma of the jaw at the Oral and Maxillofacial Surgery department of a regional University Teaching Hospital between September 1997 and October 2015 were retrospectively studied. Details sourced included age, sex, site of tumor, duration, signs/symptoms, treatment given, and complications. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2007 (Microsoft, Redmond, WA, USA). Results from descriptive statistics were represented in the form of tables and charts, with a test for significance (ρ) using Pearson Chi-square (χ2) set at 0.05. Results: A total of 16 patients were managed within the period reviewed, consisting of 10 (62.5%) females and six (37.5%) males, giving a male-to-female ratio of 1:1.7. The ages of patients ranged from 5 to 70 years, with a mean of 27.06±15.45 years. The mandible accounted for nine (56.3%) cases and the maxilla for six (37.5%) cases, while a combination of the maxilla and the zygoma were involved in one (6.3%) case. Bucco-lingual or bucco-palatal expansion were the most common presentation (six [46.2%] cases each). Histological assessment of tissue specimens showed that fibromyxoma accounted for seven (43.8%) cases, while the remaining nine (56.3%) cases were diagnosed as myxoma. All patients had jaw resections, and these consisted of mandibulectomies in nine (60.0%) patients and maxillectomies in six (40.0%) patients. The duration of hospital stay ranged from 5 to 29 days, with a mean of 17.86±7.68 days. Complications were noted in three patients, and all were surgical wound infections. Conclusion: Most patients in our environment present late with large tumors and are usually not compliant with follow-up review. Thus, a radical approach is favored in most patients. PMID:28229061

  14. RELN and VLDLR mutations underlie two distinguishable clinico-radiological phenotypes.

    PubMed

    Valence, S; Garel, C; Barth, M; Toutain, A; Paris, C; Amsallem, D; Barthez, M-A; Mayer, M; Rodriguez, D; Burglen, L

    2016-12-01

    Pontocerebellar hypoplasias (PCH) are characterized by lack of development and/or early neurodegeneration of cerebellum and brainstem. We report five patients referred for PCH, showing atypical clinical and magnetic resonance imaging (MRI) features suggestive of defects in the Reelin pathway. We screened for mutations in RELN or VLDLR and compared the phenotype of these patients with that of previously reported patients. All patients had profound cerebellar hypoplasia on MRI with peculiar cerebellar morphology, associated with flattened pons and neocortical abnormalities. Patient 1 had profound motor and intellectual disability with moderate lissencephaly suggestive of RELN mutations and was shown to harbor a splicing homozygous RELN mutation. The four other patients had a milder phenotype consistent with CARMQ1 (cerebellar ataxia and mental retardation with or without quadrupedal locomotion). These patients showed mild simplification or thickening of cortical gyration and had VLDLR mutations. Reelin signaling regulates neuronal migration in the developing mammalian brain. VLDLR is a key component of the Reelin pathway. Our patients had a very small and dysplatic cerebellar vermis that should suggest the involvement of these genes. Moreover, differences in clinical severity, involvement of the cerebellar hemispheres, together with the severity of the neocortical defect, enables RELN-mutated patients to be distinguished from VLDLR-mutated patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Clinico-epidemiological and mycological aspects of tinea incognito in Iran: A 16-year study.

    PubMed

    Ansar, Akram; Farshchian, Mahmoud; Nazeri, Haleh; Ghiasian, Seyed Amir

    2011-01-01

    Tinea incognito is a dermatophytic infection in which topical or systemic steroids have modified the clinical appearance of the mycosis and mimicking other skin diseases. A large retrospective study was carried out to identify the clinical aspects and type of dermatophytes involved in tinea incognito cases in Iran during 1993-2008. Out of 6325 subjects suspected to have dermatophytoses, 56 patients (29 males, 27 females, mean age 32.6 years) were affected with tinea incognito. The causative agents were identified macroscopically and microscopically after the clinical samples were subjected to potassium hydroxide examination and culture isolation. The most common type of infection was tinea corporis (32.1%), which significantly affected male patients. The prevalence of the other tineas in decreasing order was as follows: tinea faciei (26.8%), tinea cruris (14.3%), tinea manuum (12.5%), tinea pedis (8.9%), and tinea capitis (5.4%). The clinical features were to some extent diverse, ranging from eczema-like, seborrhoeic dermatitis-like, pyoderma-like and folliculitis to alopecia on scalp, trunk and limbs. Trichophyton verrucosum was the most frequently isolated species representing 33.9% of isolates, followed by T.mentagrophytes (28.6%), T. rubrum (12.5%), Epidermophyton floccosum (10.7%), Microsporum canis (8.9%), T. violaceum (3.6%), and T. schoenleinii (1.8%). To the best of our knowledge, this is the first broad investigation dealing with tinea incognito in Iran. The etiological agents of tinea incognito in Iran are consistent with those of the general population.

  16. Lingual and fusiform gyri in visual processing: a clinico-pathologic study of superior altitudinal hemianopia.

    PubMed Central

    Bogousslavsky, J; Miklossy, J; Deruaz, J P; Assal, G; Regli, F

    1987-01-01

    A macular-sparing superior altitudinal hemianopia with no visuo-psychic disturbance, except impaired visual learning, was associated with bilateral ischaemic necrosis of the lingual gyrus and only partial involvement of the fusiform gyrus on the left side. It is suggested that bilateral destruction of the lingual gyrus alone is not sufficient to affect complex visual processing. The fusiform gyrus probably has a critical role in colour integration, visuo-spatial processing, facial recognition and corresponding visual imagery. Involvement of the occipitotemporal projection system deep to the lingual gyri probably explained visual memory dysfunction, by a visuo-limbic disconnection. Impaired verbal memory may have been due to posterior involvement of the parahippocampal gyrus and underlying white matter, which may have disconnected the intact speech areas from the left medial temporal structures. Images PMID:3585386

  17. [Li-Fraumeni syndrome: clinico-molecular diagnostics and medico-genetic counseling].

    PubMed

    Liubchenko, L N

    2011-01-01

    Li-Fraumeni syndrome (sarcoma family syndrome, OMIM 151623) is a rare clinically and genetically hetergoeneous autosomal dominant disorder characterized by the evolvement and accumulation of soft-tissue osteogenic sarcomas in members of a family, as well as uni- and bilateral breast cancer in young women, brain tumours, adrenocortical cancer, and lymphoproliferative diseases. Germinal mutations of the TP53 gene constitute the etiological genetic basis of Li-Fraumeni syndrome. American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network developed recommendations for genetic testing and observation of carriers of TP53 mutations. In vitro and in vivo studies demonstrated correlation between the TP53-mutant genotype and resistance to standard therapeutic modalities. This finding gave impetus to the development of new genotherapeutic approaches to the treatment of TP53-associated tumours in patients with Li-Fraumeni syndrome.

  18. Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media.

    PubMed

    Vikram, B K; Khaja, N; Udayashankar, S G; Venkatesha, B K; Manjunath, D

    2008-05-01

    This study aimed to compare the clinical and epidemiological profiles of cases of complicated and uncomplicated chronic suppurative otitis media, based on their prognostic factors. This was a prospective, cross-sectional study conducted in a tertiary care medical college hospital over a period of two and a half years. The study group comprised 187 ears, out of which 62 had complications while 125 did not. The two groups were compared with respect to nine prognostic variables: age distribution, sex, patient's domicile, literacy status, duration of ear discharge at presentation, ear pathology, predisposing disease focus in the nose or throat, ear swab microbiology, and hearing loss. Patients in the complicated chronic suppurative otitis media group had a higher male predominance and were younger. Rural and illiterate patients had a higher risk of developing complications. Cholesteatoma and granulation tissue were potential risk factors in the complicated chronic suppurative otitis media group. Ears with complications were more prone to develop sensorineural hearing loss. Age, sex, duration of ear discharge, predisposing disease focus in nose or throat, and ear swab microbiology were all less useful prognostic indicators of complications. Early detection and timely treatment of chronic suppurative otitis media in rural and illiterate patients may prevent life-threatening complications and reduce their incidence. Ears that harbour relatively large quantities of both cholesteatoma and granulation tissue together require more urgent surgical intervention and more extensive disease clearance in order to prevent complications.

  19. Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka

    PubMed Central

    Galgamuwa, Lahiru Sandaruwan; Sumanasena, Buthsiri; Yatawara, Lalani; Wickramasinghe, Susiji; Iddawela, Devika

    2017-01-01

    Cutaneous leishmaniasis (CL) caused by Leishmania donovani is an endemic vector-borne disease in Sri Lanka. Over 2,500 cases have been reported since 2000 and the number of CL cases has dramatically increased annually. Total 57 clinically suspected CL patients attending the dermatology clinic in Anuradhapura Teaching Hospital were recruited from January to June 2015. Slit skin smears and skin biopsies were taken from each of the subjects. Clinical and epidemiological data were obtained using interviewer administered questionnaire. Forty-three (75.4%) patients among 57 were confirmed positive for L. donovani. The majority of infected patients was males (P=0.005), and the most affected age group was 21–40 years. Soldiers in security forces, farmers, and housewives were identified as high risk groups. The presence of scrub jungles around the residence or places of occupation (P=0.003), the presence of sandflies (P=0.021), and working outsides more than 6 hr per day (P=0.001) were significantly associated with CL. The number of lesions ranged from 1–3, and the majority (76%) of the patients had a single lesion. Upper and lower extremities were the prominent places of lesions, while the wet type of lesions were more prevalent in females (P=0.022). A nodular-ulcerative type lesion was common in both sexes. The presence of sandflies, scrub jungles, and outdoor activities contributed to spread of Leishmania parasites in an endemic pattern. Implementation of vector control programs together with health education with regard to transmission and prevention of CL are necessary to control the spread of this infection. PMID:28285499

  20. [Primary IgA mesangial nephropathy (Berger's disease): clinico-pathological study].

    PubMed

    Nussenzveig, I; Saldanha, L B; Marcondes, M

    1989-01-01

    From 1976 to December 1984 IgA nephropathy (IgAN) was diagnosed in 40 patients at the Nephrology Division of the Hospital das Clínicas, São Paulo University. In order to estimate the incidence of the disease in our city, we reviewed the kidney biopsies of the year 1984: IgAN constituted 6.5% of all biopsies of primary glomerular nephropathies. Of the 40 patients 67.5% were males and 32.5% females. Their age varied between 4 and 49 years and 72.5% were in the 2nd and 3rd decades of life at the beginning of the disease. From the racial standpoint, 82.5% of the patients were white, 10% were yellow and 7.5% black. The most frequent clinical manifestation, presented by 62.5% of patients, was macroscopic hematuria in close association with an acute infectious process. In the remaining 37.5% of cases the clinical picture of the disease was very variable, and did not evoke the diagnosis of IgAN. The initial laboratory investigation showed proteinuria in 92.5% of patients; it was under 1g/24h in 40%, it ranged from 1 to 3g/day in 37.5% and was over 3.5g/24h in 15% of them. Hematuria was present in all 40 cases and the red cells displayed moderate dismorphism. Glomerular filtration rate, evaluated by creatinine clearance in 39 patients, was over 90 ml/min/1.73m2 in 70%, ranged between 50 and 89 ml/min/1.73m2 in 7.5% and was under 25 ml/min/1.73m2 in 20% of them. Total complement CH50 was found normal in 79.4% and was slightly reduced in 20.6%. The C3 fraction showed slight reduction in 9.5% and C4 was found normal in all instances. Serum IgA was increased in 21% of the cases. All patients were submitted to percutaneous renal biopsy. Proliferative mesangial lesions were found in 82.5% of cases; they were focal in 42.5% and diffuse in 40%. In 15% of the patients, the glomeruli were entirely normal on light microscopy. In one case they were crescent-shaped, exhibiting 82% of the glomeruli this form. The immunofluorescence findings were quite uniform, with granular deposits occupying only the mesangium, with a global and diffuse distribution in all glomeruli. IgA was the dominant immunoglobulin deposited in the 40 cases and C3 was also found in the same localization and distribution in all biopsies, generally with a lesser intensity than IgA. IgG was present in 85% of cases and IgM in 32.5% of the biopsies, in the majority of them with the intensity of traces.(ABSTRACT TRUNCATED AT 400 WORDS)

  1. Skin Cancer: ClinicoPathological Study of 204 Patients in Southern Governorates of Yemen.

    PubMed

    AlZou, Amer Bin; Thabit, Mazen Abood Bin; AlSakkaf, Khalid Abdulla; Basaleem, Huda Omer

    2016-01-01

    Skin cancer is a group of heterogeneous malignancies, in general classified into nonmelanoma skin cancer (NMSC) and melanoma skin cancer (MSC). Incidences are high in many parts in the world with considerable geographical and racial variation. In the Yemen, there has been scarce information about skin cancer. The aim of this study was to evaluate the demographic characteristics and histological trend of skin cancer in Southern Governorates of Yemen. This retrospective study covered 204 cases of skin cancer at the Modern Histopathology Laboratory and Aden Cancer Registry and Research Center, Faculty of Medicine and Health Sciences, University of Aden, for the period 20062013. Data were classified regarding different demographic and tumor related variables and analyzed using CanReg4 for cancer registry and SPSS (version 21). The commonest encountered skin cancer was NMSC (93.1%). Generally, skin cancer appears slightly more frequently in females than males with a 1:1.06 male: female ratio, with a mean age of 62.9 years. Slightly higher than onethird (36.3%) were from Aden governorate. The head and neck proved to be the most common site in both males and females (58%). Basal cell carcinoma (BCC) is the most common histological type of skin cancer (50.5%). Skin cancer is a common cancer in patients living in southern governorates of Yemen. The pattern appears nearly similar to the international figures with a low incidence of MSC.

  2. [Alcoholic polyneuropathy and myopathy--a contribution to clinico-neurologic diagnosis of alcoholic patients].

    PubMed

    Grosse Aldenhövel, H

    1990-07-01

    Neurological lesions due to alcohol most frequently affect the peripheral nervous system. Alcoholic myopathy or the combination of alcoholic neuropathy and myopathy are less frequent. The features of these disorders are discussed in detail. To support the clinical diagnosis of alcoholic neuropathy and/or myopathy various criterions corresponding to their clinical relevance are set up. It is suggested that a clear diagnosis ordinarily points to alcohol endangering or even to alcohol addiction and it therefore is incompatible with administering a driving license.

  3. Clinico-Mycological Study of Dermatophyte Toenail Onychomycosis in New Delhi, India

    PubMed Central

    Yadav, Pravesh; Singal, Archana; Pandhi, Deepika; Das, Shukla

    2015-01-01

    Introduction: There is a constant need to define the epidemiological and mycological characteristics of onychomycosis (OM) for optimal management strategies. Objectives: To define the epidemiological and mycological characteristics of patients with dermatophyte toenail OM in a tertiary care hospital. Materials and Methods: Hundred consecutive patients of KOH and culture-positive dermatophyte toenail OM were subjected to detailed history, clinical examination and investigations. Results: Maximum number of patients (40%) belonged to 31-45 years age group and there was a male preponderance (M:F = 6.7:1). The mean duration of disease was 54 months. Thirty-three patients had fingernail involvement in addition to the toenail OM and 37% had co-existent cutaneous dermatophyte infection. Discoloration was the most common symptom (98%). Ninety-four (94%) patients had distal lateral subungual onychomycosis (DSLO) while two had superficial onychomycosis (SO) and only one had proximal superficial onychomycosis (PSO). Trichophyton interdigitale was the most common etiological agent (61%) followed by Trichophyton rubrum and Trichophyton verrucosum. Conclusions: Toenail OM is more common in males. DSLO was the most common clinical variant and T. interdigitale the most common etiological fungus responsible for toenail OM in our region. The importance of early diagnosis and treatment is highlighted as long-standing toenail OM predisposes to fingernail onychomycosis and recurrent tinea pedis. PMID:25814703

  4. Large Cell Neuroendocrine Carcinoma of the Lung: Clinico-Pathologic Features, Treatment, and Outcomes.

    PubMed

    Naidoo, Jarushka; Santos-Zabala, Maria L; Iyriboz, Tunc; Woo, Kaitlin M; Sima, Camelia S; Fiore, John J; Kris, Mark G; Riely, Gregory J; Lito, Piro; Iqbal, Afsheen; Veach, Stephen; Smith-Marrone, Stephanie; Sarkaria, Inderpal S; Krug, Lee M; Rudin, Charles M; Travis, William D; Rekhtman, Natasha; Pietanza, Maria C

    2016-09-01

    Large cell neuroendocrine carcinoma (LCNEC) accounts for approximately 3% of lung cancers. Pathologic classification and optimal therapies are debated. We report the clinicopathologic features, treatment and survival of a series of patients with stage IV LCNEC. Cases of pathologically-confirmed stage IV LCNEC evaluated at Memorial Sloan Kettering Cancer Center from 2006 to 2013 were identified. We collected demographic, treatment, and survival data. Available radiology was evaluated by Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria. Forty-nine patients with stage IV LCNEC were identified. The median age was 64 years, 63% of patients were male, and 88% were smokers. Twenty-three patients (n = 23/49; 47%) had brain metastases, 17 at diagnosis and 6 during the disease course. Seventeen LCNEC patients (35%) had molecular testing, of which 24% had KRAS mutations (n = 4/17). Treatment data for first-line metastatic disease was available on 37 patients: 70% (n = 26) received platinum/etoposide and 30% (n = 11) received other regimens. RECIST was completed on 23 patients with available imaging; objective response rate was 37% (95% confidence interval, 16%-62%) with platinum/etoposide, while those treated with other first-line regimens did not achieve a response. Median overall survival was 10.2 months (95% confidence interval, 8.6-16.4 months) for the entire cohort. Patients with stage IV LCNEC have a high incidence of brain metastases. KRAS mutations are common. Patients with stage IV LCNEC do not respond as well to platinum/etoposide compared with historic data for extensive stage small-cell lung cancer; however, the prognosis is similar. Prospective studies are needed to define optimum therapy for stage IV LCNEC. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Psychiatric and clinico-psychologic epidemiology: critique of methods and systematization approach].

    PubMed

    Bochmann, F; Petermann, F

    1994-01-01

    The development of typical epidemiological questions is discussed. Possible definitions und fields of applications for simple status-diagnostics as well as for epidemiological longitudinal research are presented. Examples for the application of complex mathematical models like LOGIT- or LISREL-analysis are presented. Insufficient methodological systematisation and problems in comparing studies of different origin (i.e. for metaanalysis) are identified as problems for the future development of epidemiology. A classification system of epidemiological methods is presented that includes content aspects as well as methodological aspects on four levels. These are: the demand of the study (descriptive vs. inferential), the time dimension (status diagnostics vs. longitudinal research), the content level of operationalisation (micro- vs. macrolevel) and the level of explanation (correlative vs. causal). Examples show that this system can be used for classification of existing studies as well as for the conceptualisation and optimization of planned studies.

  6. [Peculiar clinico-diagnostic features of ischemic stroke in subjects employed in "hazardous" occupations].

    PubMed

    Khozhenko, E V

    2009-01-01

    The aim of the study is to analyse the structure, clinical course, and outcomes of ischemic stroke in neuorologic departments of a specialized clinic for optimization of preventive and rehabilitative treatment in patients of hazardous employment, such as servicemen, peace-keepers, members of special force and counter-terrorism action groups, participants of local wars, and armed conflicts. A total of 242 acute ischemic cerebrovascular attacks were analysed using data from case records for 2004 to 2007. The frequency of stroke was estimated with reference to age, gender, risk factors, social status, and subtypes of ischemic stroke. The role of risk factors, such as ischemic heart disease, cardioarrythmia, hypertensive disease, and diabetes mellitus, in the development of different subtypes of ischemic stroke was assessed. It was shown that medical services of the clinic manage to achieve a greater reduction of the lethality rate compared with other domestic and foreign hospitals. A lower disability rate is probably attributable to adequate primary preventive treatment in the prehospitalization period and active therapy in the acute phase of stroke. The lethality rate is highest among patients with cardioembolic stroke which suggests the necessity to improve preventive treatment of men with cardioarrhythmia. Close relationship between lethality and risk factors underscores the importance of multidisciplinary management of patients with ischemic stroke.

  7. Clinico-radiological aspects of neurocysticercosis in pediatric population in a tertiary hospital.

    PubMed

    Shrestha, Bandana; Mainali, Prabha; Sayami, Sujan; Shrestha, Om Kumar

    2013-01-01

    Neurocysticercosisis common in developing countries including Nepal. Clinicalpresentations vary depending on the CT scan findings of head. Adequate information of neurocysticercosis in children from Western Nepal is lacking. This study was conducted with an objective of evaluating the most common clinical and radiological picture in children suffering from NCC at a tertiary care teaching hospital in Western Nepal. Hospital records of all pediatric inpatients, admitted from 16th June 2010 to 15th December 2012, consistent with the diagnosis of Neurocysticercosis were reviewed. Forty nine cases of neurocysticercosis were enrolled. Their age varied 2.6 years to 14 years with the mean age of 10.6 years and the peak age was at 12 years with slight male predominance, ratio being male:female 1.2:1. The commonest presentation was seizures (n=38; 77.5 %); partial seizures being most common. Most of the lesions were single (n=44; 89.8%), predominantly in the parietal region (n=20; 40.8%) and most were in transitional stage (61.22%) in Computed tomography (CT).However, number of lesions from CT scan of head showed no significance in association with seizure types (p=0.84). In addition, perilesional edema and scolex within the lesion were noted in 67.34% and 18.36% of the cases respectively. Any child presenting with acute onset of afebrile seizure should be screened for neurocysticercosis provided other common infective and metabolic causes are ruled out. CT scan is the valuable diagnostic tool to support our diagnosis.

  8. Control of AA amyloidosis complicating Crohn's disease: a clinico-pathological study.

    PubMed

    Denis, Marie A; Cosyns, Jean-Pierre; Persu, Alexandre; Dewit, Olivier; de Galocsy, Chantal; Hoang, Pierre; Maldague, Philippe; Wallemacq, Pierre; Zerbib, Frank; Fiasse, René

    2013-03-01

    Immunosuppressive drugs may prevent or partially reverse progression of renal AA-amyloidosis, a rare complication of Crohn's disease, often fatal due to renal failure. The clinical, biological and pathological data of 16 patients treated since 1976 were reviewed. Serum amyloid A was determined in surviving patients. The median age of the 16 patients (13 men) was 23·5 years (range 16-69). At Crohn's disease onset, Montreal phenotypes were similar to reported data. Out of 15 patients with renal insufficiency, 8 developed a nephrotic syndrome and 7 a low grade proteinuria. The single patient without renal insufficiency had nephrotic syndrome. A significant correlation (P < 0·05) between the extension of renal amyloid A and sclerosis was found in 12 patients. One patient had a 10 year remission of nephrotic syndrome with immunosuppressive drugs. In 6 patients treated with anti-TNF-α (Tumor-Necrosis-Factor-α) agents, anaphylactic reaction (1/6), death from septic shock (1/6), 5-year remission (1/6) or reduction of nephrotic syndrome (1/6) and stabilization of renal insufficiency (2/6) were observed. Surgery was performed in 10 patients. Kidney transplantation was performed in 5 of the 8 patients dialysed for end-stage renal failure. Among 6/16 patients (37%) still alive, 3 belong to the 5 transplanted patients (survival: 3-20 years) and 3 to the anti-TNF-α drugs treated patients; all but one exhibited a low serum amyloid A level. Suppression of Crohn's disease inflammation potentially leads to the control of amyloid A production, assessed by a decrease of serum amyloid A. Kidney transplantation provides a long survival. © 2013 The Authors. European Journal of Clinical Investigation © 2013 Stichting European Society for Clinical Investigation Journal Foundation.

  9. Demographic and clinico-epidemiological features of dengue fever in Faisalabad, Pakistan.

    PubMed

    Raza, Faiz Ahmed; Rehman, Shafiq ur; Khalid, Ruqyya; Ahmad, Jameel; Ashraf, Sajjad; Iqbal, Mazhar; Hasnain, Shahida

    2014-01-01

    This cross-sectional study was carried out to explore the epidemiological and clinical features of dengue fever in Faisalabad, Pakistan during 2011 and 2012. During the study period, anti-dengue IgM positive cases were reported in the post-monsoon period during the months of August-December. Certain hotspots for the dengue infection were identified in the city that coincide with the clusters of densely populated urban regions of the city. Out of total 299 IgM positive patients (male 218 and female 81); there were 239 dengue fever (DF) and 60 dengue hemorrhagic fever (DHF) patients. There was decrease in the median age of dengue patients from 31 years in 2011 to 21.5 years in 2012 (p<0.001). Abdominal pain was seen in 35% DHF patients followed by nausea in 28.3%, epistaxis in 25% and rash in 20% patients (p<0.05). Patients reported to be suffering from high-grade fever for an average of 8.83 days in DHF as compared to 5.82 days in DF before being hospitalized. Co-morbidities were found to be risk factor for the development of DHF in dengue patients. Clinical and laboratory features of dengue cases studied could be used for the early identification of patients at risk of severe dengue fever.

  10. [120 biopsies of pituitary adenomas studied by immunohistochemistry and electron microscopy. A clinico-pathological correlation].

    PubMed

    Félix, I A; Rodríguez Mendoza, L; Guinto, G; Torres Corzo, J; Wussterhaus, C A

    1992-01-01

    Study of biopsies from 120 pituitary adenomas from the Hospital de Especialidades, Centro Médico Nacional, and the Hospital 20 de Noviembre, ISSSTE, were studied over a period of 55 months. 70 cases were female and 50 male. Ages varied between 18 and 67 years of age (with an average of 31 years). Histologically 41 tumors were chromophobes, 34 acidophilic, 37 mixed and 8 basophilic. 101 patients were operated by trans-sphenoidal (84.5%) and 19 were operated (15.5%) by trans-cranial approaches. 99 tumors were macroadenomas (81.1%) and 21 were microadenomas (18.9%). More than one hormone was found in the cytoplasm of 69 adenomas, although only 20 fulfilled the criteria of being plurihormonal. Those adenomas classified as "non-functional", mostly produced glycoprotein hormones corresponding to oncocytomas and null cell adenomas, from an ultrastructural point of view. 85 patients developed different degrees of visual impairment, with 30 tumoral relapses, of which 10 received radiotherapy. 40 adenomas produced prolactin, although only 29 patients developed clinical signs of hyperprolactinemia; 38 tumors contained growth hormone, of which only 25 had acromegaly; 8 tumors contained ACTH in the cytoplasm, although only 7 developed Cushing's Syndrome and 57 patients (47.5%) were classified as nonfunctional and did not show any endocrinological data. All the cases are studied with a light microscope, electron microscope, and they were all submitted to a complete set of adenohypophyseal hormone with immunoperoxidase technique.

  11. Epidemio-Clinico-Microbiological Study of Mycotic Keratitis in North-West Region of Rajasthan.

    PubMed

    Binnani, Abhishek; Gupta, Priyanka Soni; Gupta, Ankur

    2016-12-29

    Mycotic keratitis, with its diverse clinical presentation and difficulties in treatment, makes it a challenging task for clinicians and an important object of study. The aim of present study was to determine the frequency of occurrence and epidemiological association with identification of fungal isolates from mycotic keratitis cases. This was a prospective and observational study conducted in Mycology Laboratory, Department of Microbiology, S.P. Medical College, Bikaner, on corneal scrapings and swabs of a total of 480 patients attending the Ophthalmology OPD, P.B.M. Hospital, Bikaner, during July 2005 to June 2012. Out of 480 suspected cases, 180 were found to be positive for fungus by smear/culture examination. Increased incidence was seen in the months of May to September with Aspergillus fumigatus being the most common isolate. Mycotic keratitis, though an age-old disease, still presented with challenging aspects of diagnosis and treatment. The study showed fungal keratitis is prevalent in rural parts of north-west Rajasthan, mainly found in males (age group 21-40 years) with low socio-economic status (farm or factory workers). The most common cause of fungal keratitis was found to be species of Aspergillus.

  12. A Clinico-Bacteriological Study of Pyodermas at a Tertiary Health Center in Southwest Rajasthan

    PubMed Central

    Singh, Ajit; Gupta, Lalit Kumar; Khare, Ashok Kumar; Mittal, Asit; Kuldeep, CM; Balai, Manisha

    2015-01-01

    Background: The spectrum of pyoderma changes constantly, and so does the antibiotic susceptibility pattern. Aims: This study was done to assess the magnitude and clinical patterns of pyodermas, their causative micro-organisms, and the antibiotic susceptibility patterns. Materials and Methods: Five hundred consecutive, clinically diagnosed and untreated cases of pyoderma, attending the Dermatology OPD of RNT Medical College and MB Government Hospital, Udaipur, from October 2010 to September 2011 were the subjects of this study. A detailed clinical examination, and relevant investigations including bacterial culture and sensitivity, were carried out and recorded. Statistical Analysis: For statistical analysis of data, the software ‘EPI-INFO Version 6’ was used, and Chi-square (χ2) test was applied. Results: Of 19576 cases attending skin OPD during the study period, pyoderma was seen in 500 patients; the incidence being 2.55%. Males outnumbered females. The highest number of cases (109; 21.8%) was observed in 1st decade. Lower extremities were the commonest site of predilection. Primary pyodermas outnumbered secondary pyodermas. Furuncle (136; 27.2%) and infectious eczematoid dermatitis (62; 12.4%) were the commonest entities among primary and secondary pyoderma respectively. Staphylococcus aureus was the commonest causative agent in both primary and secondary pyoderma. It showed high susceptibility to amoxycillin + sulbactam, aminoglycosides and cefoperazone, moderate susceptibility to linezolid, while low susceptibility to fluoroquinolones and cephalexin. Conclusion: Such studies help to assess the changing trend of bacterial infections, their causative organisms and antibiotic susceptibility pattern. PMID:26538696

  13. Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia.

    PubMed

    Unnikrishnan, Vineetha; Dutta, Tarun Kumar; Badhe, Bhawana A; Bobby, Zachariah; Panigrahi, Ashish K

    2008-12-01

    This study was conducted to study the clinical and laboratory parameters in patients with macrocytic anemia and to determine the etiology of macrocytic anemia with special reference to megaloblastic anemia. This study was a cross-sectional descriptive study carried over a period of 18 months on 60 adult patients (age ≥13 years) of macrocytic anemia. Macrocytic anemia was identified when peripheral blood examination showed anemia with a mean red blood corpuscular volume of >95 fl. The most common cause of macrocytic anemia was megaloblastic anemia (38.4%). The major causes of nonmegaloblastic macrocytic anemia were primary bone marrow disorders (35%), liver diseases (15%) and hemolytic anemia (8.3%). There was a significant male preponderance in the study (65%). The megaloblastic anemias observed were due to either vitamin B(12) deficiency (78.3%) or combined B(12) and folate deficiency (21.7%). A significant proportion of non-vegetarians (73.9%) had megaloblastic anemia. Patients with an MCV of >110fl were more likely to have megaloblastic anemia (p value 0.0007). Three patients (mean age 55 years) with a megaloblastic marrow did not respond to vitamin replacement and were found to have myelodysplastic syndrome. Megaloblastic anemia due to Vitamin B(12) or folate deficiency remains the most important cause of macrocytic anemia. In settings with limited laboratory facilities, a therapeutic trial of vitamins B(12) or folic acid is useful in determining the specific vitamin deficiency.

  14. Clinico-microbiological study and antimicrobial drug resistance profile of diabetic foot infections in North India.

    PubMed

    Zubair, Mohammad; Malik, Abida; Ahmad, Jamal

    2011-03-01

    The study was carried out in diabetic patients with foot ulcer to determine the microbiological profile of infected ulcer, antibiotic resistance of the isolates and to find out the potential risk factors for infection with multidrug resistance and the outcome of these infections. A detailed clinical history and physical examination was carried out in each patient. Pus samples for bacterial culture were collected from 102 patients admitted with diabetic foot infections. All patients had ulcer with Texas grades 1-3. Seventeen patients (16.6%) had coexisting osteomyelitis. Aerobic gram negative bacilli were tested for extended spectrum β lactamase (ESBL) production by phenotypic and genotypic methods. Staphylococcus isolates were tested for susceptibility to oxacillin and cefoxitin by disk method. Potential risk factors for MDRO positive samples were explored. Gram negative aerobes were most frequently isolated (63.8%), followed by gram positive aerobes (36.1%) and anaerobes (31.4%). Forty five percent of patients were positive for MDROs. ESBL production and methicillin resistant was noted in 68.5% and 43.2% of bacterial isolates respectively. 34.5% gram negative strains were positive for bla(CTX-M) gene followed by bla(SHV) (23%) and bla(TEM) (7.4%). Among the anaerobic organism 17(31.4%) from 54 patients, most commonly isolated were Peptostreptococcus sp. (35.2%). MDRO positive status was associated with the presence of neuropathy (P<0.001), osteomyelitis (P<0.03), and ulcer size >4 cm(2) (P<0.01) [corrected] but not with patients characteristic, ulcer type and type of diabetes, or duration of hospital stay. Poor glycemic control in 68.6% patients, duration of infection>1 month (36.2%) and ulcer size >4 cm(2) (75.4%) were independently associated with risk of MDR organisms infection. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Bacterial Keratitis: Perspective on Epidemiology, Clinico-Pathogenesis, Diagnosis and Treatment

    PubMed Central

    Al-Mujaini, Abdullah; Al-Kharusi, Nadia; Thakral, Archana; Wali, Upender K

    2009-01-01

    Bacterial keratitis is an acute or chronic, transient or recurrent infection of the cornea with varying predilection for anatomical and topographical parts of the cornea like marginal or central. It is a potentially sight-threatening corneal infection in humans that is generally found in eyes with predisposing elements, the most common of which is contact lens wear. The epidemiological data reveals the universal occurrence of this disease. With advances in the understanding of its pathogenesis, laboratory investigations like immunohistochemistry, fluorescent microscopy, enzyme immunoassays and molecular biology, and the availability of fourth generation antibiotics, the overall visual outcome in bacterial keratitis has improved with time. Particular attention should be given to this condition as it can progress very rapidly with complete corneal destruction occurring within 24–48 hours. Early diagnosis, which is primarily clinical and substantiated largely by microbiological data, and prompt treatment are needed to minimise the possibility of permanent visual loss and reduce structural damage to the cornea. PMID:21509299

  16. [Clinico-psychopathological characteristics of states in patients with suicidal attempts].

    PubMed

    Ostroglazov, V G; Lisina, M A

    2000-01-01

    A total psychiatric examination of the persons, after attempted suicides was performed during a month of stay in the department of resuscitation of the N.V. Sklifosovsky Institute for the Emergency Medical care. In all the patients some mental pathology was found that took place in the moment of suicide and long before it. In most of the cases the disorders of either affective (48.7%) or schizophrenic (38.5%) spectrum were diagnosed. Psychogenic reactions to stress and personality disorders were in only 10.2% of the patients. In most of the patients (74.7%) a mental disease wasn't diagnosed before in spite of its long duration (11.5 years on the average).

  17. A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management

    PubMed Central

    Majumdar, Banashree; Jain, Atul; Maiti, Prasanta Kumar; Chatterjee, Gobinda

    2015-01-01

    Introduction Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country. Aim The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents. Materials and Methods Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features. Results Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment. Conclusion A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses. PMID:26816977

  18. Clinico-Pathological Profile and Surgical Outcome of Patients of Gastrointestinal Tuberculosis Undergoing Laparotomy.

    PubMed

    Pathak, Priyank; Sahu, Shantanu Kumar; Agrawal, Saurabh

    2016-01-01

    Tuberculosis is one of the earliest diseases affecting the mankind. Abdominal tuberculosis constitutes a common public health issue in developing countries like ours. Gastrointestinal tuberculosis often involves the ileocecal region. Surgery in case of abdominal tuberculosis is required to overcome the deleterious effects of the disease like tissue disorganization, obstruction and perforatio.

  19. A Clinico-Epidemiological Study of Macular Amyloidosis from North India

    PubMed Central

    Bandhlish, Anshu; Aggarwal, Asok; Koranne, Ravinder V

    2012-01-01

    Background: Macular amyloidosis (MA) is the most subtle form of cutaneous amyloidosis, characterized by brownish macules in a rippled pattern, distributed predominantly over the trunk and extremities. MA has a high incidence in Asia, Middle East, and South America. Its etiology has yet to be fully elucidated though various risk factors such as sex, race, genetic predisposition, exposure to sunlight, atopy and friction and even auto-immunity have been implicated. Aim: This study attempts to evaluate the epidemiology and risk factors in the etiology of MA. Materials and: Methods: Clinical history and risk factors of 50 patients with a clinical diagnosis of MA were evaluated. Skin biopsies of 26 randomly selected patients were studied for the deposition of amyloid. Results: We observed a characteristic female preponderance (88%) with a female to male ratio of 7.3:1, with a mean age of onset of MA being earlier in females. Upper back was involved in 80% of patients and sun-exposed sites were involved in 64% cases. Incidence of MA was high in patients with skin phototype III. Role of friction was inconclusive Conclusion: Lack of clear-cut etiological factors makes it difficult to suggest a reasonable therapeutic modality. Histopathology is not specific and amyloid deposits can be demonstrated only in a small number of patients. For want of the requisite information on the natural course and definitive etiology, the disease MA remains an enigma and a source of concern for the suffering patients. PMID:22837559

  20. Clinico-microbiological study of candidemia in a tertiary care hospital of southern part of India

    PubMed Central

    Banerjee, Barnini; R.M, Saldanha Dominic; Baliga, Srikala

    2015-01-01

    Background and Objectives: Over the last two decades, both the incidence of nosocomial candidaemia and the proportion of blood stream infection due to Candida spp. other than Candida albicans have increased. The aims of this study was to identify different species of Candida and risk factors associated with bloodstream infection and detection of biofilm production. Materials and Methods: This study was conducted in an 840 bedded tertiary care hospital, over a period of one year. All blood isolates received from patients during this period were screened for candidemia prospectively. Speciation was carried out by standard microbiological method. Biofilm production detection was done by Brachini et al method. Result: A total of 80 cases of candidemia were identified. Most important risk factor was placement of vascular access devices in all the age groups. Candida albicans accounted for 22 isolates (27.5%) whereas non-albicans Candida spp. accounted for 58 isolates (72.5%). Biofilm production was found in 31 strains (38.75%). Biofilm production was seen more in non-albicans Candidaspp. (83.87%) especially in C. tropicalis (66.67%, 8 of 12). Conclusions: Non-albicansspecies of Candida were most frequently recovered in our study. So, the epidemiology of Candida infection is changing. Non–albicans Candida spp have the capacity to produce significant amount of biofilm which may be the cause of their reduced susceptibility to antifungal agents. PMID:26644875

  1. A CAD system for nodule detection in low-dose lung CTs based on region growing and a new active contour model

    SciTech Connect

    Bellotti, R.; De Carlo, F.; Gargano, G.; Tangaro, S.; Cascio, D.; Catanzariti, E.; Cerello, P.; Cheran, S. C.; Delogu, P.; De Mitri, I.; Fulcheri, C.; Grosso, D.; Retico, A.; Squarcia, S.; Tommasi, E.; Golosio, Bruno

    2007-12-15

    A computer-aided detection (CAD) system for the selection of lung nodules in computer tomography (CT) images is presented. The system is based on region growing (RG) algorithms and a new active contour model (ACM), implementing a local convex hull, able to draw the correct contour of the lung parenchyma and to include the pleural nodules. The CAD consists of three steps: (1) the lung parenchymal volume is segmented by means of a RG algorithm; the pleural nodules are included through the new ACM technique; (2) a RG algorithm is iteratively applied to the previously segmented volume in order to detect the candidate nodules; (3) a double-threshold cut and a neural network are applied to reduce the false positives (FPs). After having set the parameters on a clinical CT, the system works on whole scans, without the need for any manual selection. The CT database was recorded at the Pisa center of the ITALUNG-CT trial, the first Italian randomized controlled trial for the screening of the lung cancer. The detection rate of the system is 88.5% with 6.6 FPs/CT on 15 CT scans (about 4700 sectional images) with 26 nodules: 15 internal and 11 pleural. A reduction to 2.47 FPs/CT is achieved at 80% efficiency.

  2. [Comment on "La Calidad de Atencion en la Provision de Servicios Clinicos" of Juan Diaz and Hans Halbe].

    PubMed

    Trias, M

    1990-12-01

    Rather than a commentary on a specific article, this work contains reflections on the concept of quality in provision of family planning services and its possible use to deflect family planning efforts. Quality is a difficult concept to define precisely. Applied to family planning, it may be defined as the totality of attributes possessed by a program that does not place impediments in the way of comfortable adoption of a contraceptive method. Another definition of quality, achievable only by a long list of ideal characteristics which are often expensive and sometimes unattainable, has been and continues to be used by enemies of family planning to slow its diffusion; they hold that if perfect quality is not offered, it is better to offer nothing. A specific tactic of this group is to oppose the quantity of services with their quality. The hard-fought campaign to discredit the measurement of concrete goals and results is part of this strategy. But it is apparent that without a reasonably satisfactory quality of service, no program would achieve significant growth. People would not continue to come, and in growing numbers, to a program where they received poor quality service. Each goal, each statistic, each percentage represents human problems confronted and resolved by programs and personnel. Profamilia has become 1 of the largest nongovernmental family planning organizations. Profamilia has always paid attention to the quality of its services and has conducted numerous studies to assess results and identify shortcomings. The high percentage of positive results attests to the quality of Profamilia programs. In an age of scarce resources and tight budgets, the objective of family planning programs is to provide an austere but acceptable quality of attention so that the quantity of services will be sufficient to meet demand. Program elements that have a real cost without offering a measurable benefit should be avoided. Another problem is that integrated programs that aim to combine family planning with maternal-child health or other services often end by neglecting the family planning component. Profamilia believes that good information should be provided with services, but it is limited to what is needed for proper and safe use of each method. And integration is not presently needed to disguise or dress up family planning programs. It is justifiable only when for political reasons there is no alternative or when it can provide other resources to subsidize family planning programs.

  3. Clinico-laboratory profile of dengue patients returning from tropical areas to Poland during 2010-15.

    PubMed

    Kuna, A; Bykowska, M; Kulawiak, N; Biernat, B; Szostakowska, B; Nahorski, W L; Pawlowski, W; Chomicz, L

    2016-01-01

    Dengue is a mosquito-borne viral disease, incidences of which have increased rapidly in the past decade. About 400 million new infections are recorded annually worldwide, and 40% of the human population lives in the areas at risk of dengue transmission. In this study, the clinical and laboratory profile of dengue diagnosed patients returning to Poland from tropical areas has been analyzed. This is a retrospective study of 65 patients based on clinical symptoms and serological tests conducted in the Department of Tropical Parasitology of Institute of Maritime and Tropical Medicine (IMTM) in Gdynia, Poland during 2010-15. The diagnosis of dengue virus (DENV) infection was based on the detection of specific immunoglobulin M (IgM) and IgA antibodies performed by specific ELISA assays. The samples were considered as positive, if the absorbance was >10% above the cut-off value. Among 65 persons with dengue selected for the analysis, 59 patients were admitted to the hospital because of clinical symptoms of the disease; the six persons initially asymptomatic were hospitalized due to routine control treatment returning from tropical regions. Patients reported various destinations, purpose and duration of their travels. All of them had returned from dengue endemic regions and were positive for IgM antibodies against DENV. Common clinical symptoms observed were fever (ranging from 38 to 40°C in 43% of patients), weakness, headache and rash. Laboratory tests revealed elevated levels of transaminase activity, leukopenia and thrombocytopenia in 35.3, 24.6 and 20% of patients, respectively. The number of Polish travelers to subtropics and tropics increases every year. As cases of fever and other symptoms appear to be increasingly in Polish people returning from tropical regions of Asia, America and Africa, their screening and management should be taken seriously. The study also suggests that the disease might be more widespread than it was known previously.

  4. Hydroxyurea in sickle cell disease--a study of clinico-pharmacological efficacy in the Indian haplotype.

    PubMed

    Italia, Khushnooma; Jain, Dipty; Gattani, Sushma; Jijina, Farah; Nadkarni, Anita; Sawant, Pratibha; Nair, Sona; Mohanty, Dipika; Ghosh, Kanjaksha; Colah, Roshan

    2009-01-01

    There is clinical variability in the presentation of sickle cell disease among Indians. Vaso-occlusive crisis is common among non-tribal patients. Hydroxyurea, induces fetal hemoglobin (HbF) synthesis and reduces the clinical severity of sickle cell disease but individual patients have a variable response. This study was undertaken to investigate the efficacy and safety of hydroxyurea in Indians with severe manifestations where the beta(s) gene is linked to the Arab-Indian haplotype and is associated with higher HbF levels. Seventy-seven patients (29 adult sickle homozygous, 25 pediatric sickle homozygous, 23 adult sickle beta-thalassemia) selected for hydroxyurea therapy were evaluated for clinical, hematological, biochemical and genetic parameters and were followed for 24 months. Ninety-eight point seven percent of the sickle chromosomes were linked to the Arab-Indian haplotype, 27% of patients had associated alpha thalassemia and 65% were Xmn I +/+. Seventy-eight percent of the patients had no further crises after starting hydroxyurea. This effect was accompanied by a significant increase in HbF (p<0.001), but this increase was variable in individual cases. There was also an increase in gamma gene mRNA expression in the few cases so studied. Hemoglobin levels increased significantly (p<0.001) resulting in the cessation of blood transfusions. Leucopoenia was observed in one patient. Hydroxyurea was effective in reducing the clinical severity in Indian patients who initially had higher HbF levels and the presence of ameliorating factors, such as alpha-thalassemia and the Xmn I polymorphism. Hydroxyurea therapy with careful monitoring can thus change the quality of life of Indians with sickle cell disease.

  5. HER-2 overexpression/amplification in Barrett's oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study.

    PubMed

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Della Casa, Domenico; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-09-01

    Barrett's oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37-84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation.

  6. Limits of Fine-Needle Aspiration Cytology in Diagnosing Pilomatrixoma: A Series of 25 Cases with Clinico-Pathologic Correlations

    PubMed Central

    Ieni, A; Todaro, P; Bonanno, A M; Catalano, F; Catalano, A; Tuccari, Giovanni

    2012-01-01

    Background: Pilomatrixoma (PMX) is a benign, quite uncommon, skin neoplasm, which is frequently misdiagnosed by clinicians. Aim: We have analyzed 25 PMX to determine the agreement between clinical diagnosis, preoperative FNA characteristics, and corresponding histopathological specimens; moreover, reliable cytologic criteria for PMX and the differential diagnosis to avoid cytological pitfalls have been emphasized. Materials and Methods: By fine-needle aspiration (FNA) cytology a series of consecutive cases of PMX collected during last 5 years were studied. Smears were stained by Papanicolau and May-Grünwald-Giemsa. Results: Patients affected by PMX were 11 males, 14 females (ratio 1:1.27); the mean age was 32.72 years with age range 3-78 years, being 72% (18/25) of patients 40 years or less. PMX was mainly distributed in the head-neck region (52%), scalp (16%), upper/lower arms (28%), and chest (4%). The observed diagnostic cytological features were represented by clusters of basaloid epithelial cells, shadow or ghost cells, inflammatory background, calcification, and giant cells. Unfortunately, not all these morphological aspects were always disclosed in smears, thus making the cytological preoperative diagnosis questionable and problematic. Conclusions: The experience of a well-trained cytopathologist should distinguish the relevant FNA features in terms of smear background, architecture, and cell morphology. The most dangerous mistake in FNA diagnosis of PMX regards a diagnosis of primary malignant or metastatic cutaneous lesions. PMID:22615520

  7. Limits of fine-needle aspiration cytology in diagnosing pilomatrixoma: a series of 25 cases with clinico-pathologic correlations.

    PubMed

    Ieni, A; Todaro, P; Bonanno, A M; Catalano, F; Catalano, A; Tuccari, Giovanni

    2012-03-01

    Pilomatrixoma (PMX) is a benign, quite uncommon, skin neoplasm, which is frequently misdiagnosed by clinicians. We have analyzed 25 PMX to determine the agreement between clinical diagnosis, preoperative FNA characteristics, and corresponding histopathological specimens; moreover, reliable cytologic criteria for PMX and the differential diagnosis to avoid cytological pitfalls have been emphasized. By fine-needle aspiration (FNA) cytology a series of consecutive cases of PMX collected during last 5 years were studied. Smears were stained by Papanicolau and May-Grünwald-Giemsa. Patients affected by PMX were 11 males, 14 females (ratio 1:1.27); the mean age was 32.72 years with age range 3-78 years, being 72% (18/25) of patients 40 years or less. PMX was mainly distributed in the head-neck region (52%), scalp (16%), upper/lower arms (28%), and chest (4%). The observed diagnostic cytological features were represented by clusters of basaloid epithelial cells, shadow or ghost cells, inflammatory background, calcification, and giant cells. Unfortunately, not all these morphological aspects were always disclosed in smears, thus making the cytological preoperative diagnosis questionable and problematic. The experience of a well-trained cytopathologist should distinguish the relevant FNA features in terms of smear background, architecture, and cell morphology. The most dangerous mistake in FNA diagnosis of PMX regards a diagnosis of primary malignant or metastatic cutaneous lesions.

  8. [Clinico-epidemiologic characteristics, course and outcomes of asthmatic bronchitis and bronchial asthma in the arid climate of Turkmenistan].

    PubMed

    Annadurdyev, O A; Allakov, K A; Mashakova, D Ch; Tashliev, A R; Sakhatova, I N

    1991-01-01

    Analysis of the data of the statistical accounting, mass examinations of the population, observation over the clinical course of the disease and review of the autopsy material attest to the high prevalence of AB and BA in the Southern and South-Eastern parts and the low one in the Western and Northern parts of the republic as well as to their greatest prevalence among the newcomers of the cities. In the newcomers, BA was characterized by its incidence among those over 45 years of age, by the rarity of ABA, predominance of the disease of medium gravity. Meanwhile among the indigenous population, the incidence of IABA, primarily grave course and BA incidence in persons of the young and mature ages were recorded. The lethal outcomes were mainly registered in winter and summer.

  9. Do we need femoral derotation osteotomy in DDH of early walking age group? A clinico-radiological correlation study.

    PubMed

    Mootha, Aditya Krishna; Saini, Raghav; Dhillon, Mandeep; Aggarwal, Sameer; Wardak, Emal; Kumar, Vishal

    2010-07-01

    The occurrence of exaggerated femoral anteversion and the role of femoral derotation osteotomy in developmental dysplasia of hip, especially early walking age group are controversial. We evaluated femoral anteversion, acetabular anteversion, acetabular index in 15 dislocated hips and 11 normal hips in cases of unilateral dislocation of hip in DDH of age group 12-48 months. We correlated this femoral anteversion with the intra operative "test of stability" which is described by Zadeh et al. We found that there was no statistically significant difference in femoral anteversion between dislocated and normal hips. In all the 15 cases we did open reduction by anterior approach (Somerville approach) and evaluated the position for maximum stability. In 3 cases we were unable to perform test of stability as they needed femoral shortening for reduction of joint. In the rest 12 hips, 10 were stable in flexion and abduction while 2 were stable in flexion. None of the hips required internal rotation for stability. Hence we did salters osteotomy in all the hips and femoral shortening through lateral approach in 3 cases. At a minimum follow up of 18 months all the hips were clinically stable and none of them dislocated till final follow up. The mean correction of acetabular index was 15.4 degrees and the outcome was excellent in 8 hips and good in 7 hips as per modified McKay's criteria. Hence we recommend that femoral derotation osteotomy is not needed in DDH of early walking age group. As the surgical treatment of DDH involves complex osteotomies around the hip and these surgeries have effect on long term outcome, MRI evaluation of femoral anteversion as a part of pre operative evaluation is advised. Also, as the intra operative evaluation needs enough clinical experience and it can not be performed in cases requiring femoral shortening for reduction, we consider pre operative evaluation of femoral anteversion by MRI as essential rather than adjunctive.

  10. Post-transfusional vs. sporadic non-A, non-B chronic hepatitis. A clinico-pathological and evolutive study.

    PubMed

    Jové, J; Sánchez-Tapias, J M; Bruguera, M; Mas, A; Costa, J; Barrera, J M; Rodés, J

    1988-02-01

    The clinical, morphological and evolutive features of 60 patients with chronic hepatitis, presumably caused by non-A, non-B virus infection, have been retrospectively analyzed. In all the cases the disease began as an acute episode of viral hepatitis that was followed by persistently abnormal liver function tests. No patient had evidence of current or past hepatitis B virus infection and other known causes of chronic liver disease were excluded. Thirty patients had received blood transfusions in the recent past, five were drug addicts and the source of the infection was not identified in the remaining 25, in whom the disease was considered to be sporadic. Clinical or biochemical differences between patients with post-transfusional and sporadic non-A, non-B chronic hepatitis were not observed, but liver histology showed a higher proportion of patients with chronic persistent hepatitis in the sporadic (72%) than in the transfusional group (53%). On follow-up, sustained normalization of liver function tests was observed in 46% of the cases with sporadic hepatitis but only in 13% of the cases with post-transfusion hepatitis. These observations suggest that non-A, non-B chronic hepatitis is more severe in patients with transfusion-related infection than in sporadic cases.

  11. Mixed Mucinous and Infiltrating Carcinoma Occurring in Male Breast- Study of Clinico-Pathological Features: A Rare Case Report.

    PubMed

    Gupta, Kavita; Sharma, Swati; Kudva, Ranjini; Kumar, Sandeep

    2015-06-01

    Mucinous carcinoma is a less common histologic variant of breast cancer. Cases of mucinous carcinomas in male breast are extremely rare. Here, we describe a case of mixed mucinous carcinoma i.e. mucinous carcinoma with infiltrating ductal carcinoma component and showing apocrine differentiation in a 73-year-old man. This uncommon tumour entity has dismal prognosis and treatment depends largely on the tumour type, size, lymph node involvement and hormonal status.

  12. [Clinico-statistical analysis of arterial hypertension complicated with hypertensive crisis in Moscow in 2005-2009].

    PubMed

    Gaponova, N I; Plavunov, N F; Tereshchenko, S N; Baratashvili, V L; Abdurakhmanov, V R; Komissarenko, I A; Filippov, D V; Podkopaev, D V

    2011-01-01

    Clinicostatistical analysis of arterial hypertension complicated with hypertensive crisis using data of Moscow A.S.Puchkov Station of Urgent and Emergent Medical Aid revealed 14% rise in number of hypertensive crises during the period from 2005 to 2009. Number of hypertensive crises increased among persons of young age (18-35 years). Frequency of cerebrovascular complications of hypertensive crises was age dependent with maximal values among men aged 36-74 years and women older than 75 years.

  13. A clinico-histopathological study of lupus vulgaris: A 3 year experience at a tertiary care centre.

    PubMed

    Pai, Varadraj Vasant; Naveen, Kikkeri Narayanshetty; Athanikar, S B; Dinesh, U S; Divyashree, A; Gupta, Gaurang

    2014-10-01

    Lupus vulgaris is the most common form of cutaneous tuberculosis in adults. Lupus vulgaris is caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body. histologically it is charecterised by typical tubercles with or without caseation, surrounded by epitheloid histiocytes and multinucleate giant cells in the superficial epidermis with prominent peripheral lymphocytes. All cases of clinically and histopathologicaly diagnosed lupus vulgaris over the previous five years were included in the study. Fourteen cases of lupus vulgaris cases reported during the study period with eaqual incidence among males and females. Plaque type of lupus vulgaris was the most common type. Histopathologically tubercular granulomas were seen in all cases as compared to other studies. Different patterns of lupus vulgaris are reported.

  14. Incidence of various clinico-morphological variants of cutaneous tuberculosis and HIV concurrence: a study from the Indian subcontinent

    PubMed Central

    Varshney, Anupam; Goyal, Tarang

    2011-01-01

    BACKGROUND AND OBJECTIVES: There are few reports of cutaneous tuberculosis with immunosuppressed states such as HIV, use of immunosuppressants or malignancy. Diagnosis is thus difficult and despite scientific advances such as polymerase chain reaction, it is frequently missed. Although rare, given its worldwide prevalence and the rising incidence of HIV, it is important for clinicians to recognize the variants and promptly treat the patient. DESIGN AND SETTING: Retrospective study of all cases of cutaneous tuberculosis diagnosed from October 2007 to November 2009 at an outpatient clinic of a tertiary-care hospital in northern India. METHODS: We collected information on the clinical form of disease, histopathology and HIV concurrence rates and looked for differences in presentation between mmunocompetent and immunocompromised states. We also looked for differences and HIV concurrence between immunocompetent and immunocomprised patients. Diagnosis was based on clinical, histopathological and microbiological tests for tuberculosis and a test for HIV. RESULTS: The overall incidence of cutaneous tuberculosis was 0.7% (131 of 18720 outpatients). HIV concurrence was 9.1% (12 cases) of all cutaneous tuberculosis cases. Most common variants seen were scrofuloderma (36.5%), lupus vulgaris (31%), tuberculosis verruca cutis (12.9%), lichen scrofulosorum (11.4%), papulonecrotic tuberculids (3.8%), erythema nodosum (2.2%) and erythema induratum of Bazin (1.5%). CONCLUSIONS: Cutaneous tuberculosis rates were slightly higher in our study than in other studies from India. HIV co-infection rates were similar to those in other studies. Many atypical morphological forms and presentations were observed in HIV co-infected patients. Due to the varied clinical presentations, physician awareness and a high index of suspicion are necessary to diagnose cutaneous forms of tuberculosis. PMID:21403410

  15. A clinico-histopathological study of lupus vulgaris: A 3 year experience at a tertiary care centre

    PubMed Central

    Pai, Varadraj Vasant; Naveen, Kikkeri Narayanshetty; Athanikar, S. B.; Dinesh, U. S.; Divyashree, A.; Gupta, Gaurang

    2014-01-01

    Background: Lupus vulgaris is the most common form of cutaneous tuberculosis in adults. Lupus vulgaris is caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body. histologically it is charecterised by typical tubercles with or without caseation, surrounded by epitheloid histiocytes and multinucleate giant cells in the superficial epidermis with prominent peripheral lymphocytes. Materials and Method: All cases of clinically and histopathologicaly diagnosed lupus vulgaris over the previous five years were included in the study. Results: Fourteen cases of lupus vulgaris cases reported during the study period with eaqual incidence among males and females. Discussion: Plaque type of lupus vulgaris was the most common type. Histopathologically tubercular granulomas were seen in all cases as compared to other studies. Conclusion: Different patterns of lupus vulgaris are reported PMID:25396129

  16. Chemical leucoderma: a clinico-aetiological study of 864 cases in the perspective of a developing country.

    PubMed

    Ghosh, S; Mukhopadhyay, S

    2009-01-01

    Chemical leucoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, has been increasing rapidly in incidence in developing countries such as India. This study attempts to detect clinical and epidemiological patterns of chemical leucoderma. Detailed history-taking, especially of exposure to contributory chemicals, clinical examination, relevant investigations, data recording and analysis were done. In a total of 864 cases of chemical leucoderma, 65.6% cases started de novo and vitiligo patches were pre-existing in the remaining cases. Patches were limited to the contact area in 73.7% but had spread to remote areas in 26.3% cases. The face (41.1%) and scalp (5.9%) were the commonest and least involved sites. Confetti macules were seen in 89% and pruritus was complained of in 21.8%. Aetiological agents identified were hair dye 27.4% (21% self-use; 6.4% not self-use), deodorant and spray perfume 21.6%, detergent and cleansers 15.4%, adhesive bindi 12%, rubber chappal 9.4%, black socks and shoes 9.1%, eyeliner 8.2%, lipliner 4.8%, rubber condoms 3.5%, lipstick 3.3%, fur toys 3.1%, toothpaste 1.9%, insecticides 1.7%, 'alta' 1.2%, amulet string colour 0.9%. Therapeutic response was much better in 'pure' chemical leucoderma (73.4%) than in those with co-existing vitiligo (20.9%). Chemical leucoderma, a disease of mostly industrial origin in developed countries, may be induced by common domestic products in developing countries. Diagnosis and differentiation from other causes of hypopigmentation can be done confidently by following the clinical criteria as proposed. The therapeutic response of chemical leucoderma is better than that of vitiligo.

  17. Clinico-Haematological Profile of Hereditary Haemolytic Anaemias in a Tertiary Health Care Hospital in South India.

    PubMed

    Venkataswamy, Chaitra; Devi, Am Shanthala

    2017-06-01

    Hereditary haemolytic anaemia is a common inherited disorder causing varying degree of morbidity and mortality. This includes disorders due to haemoglobin defect, membrane defect, and enzyme defect. Among them haemoglobinopathies, a single gene disorder, constitutes the major part of the disorder and is distributed worldwide with an incidence of 5%. These inherited disorders pose a major public health problem and increase the burden both on the patient and the society. Presently, these disorders are not curable but can only be prevented. Improved awareness about these diseases among medical fraternity leading to diagnosis of carrier state, genetic counselling, and antenatal diagnosis may help in decreasing the prevalence of the disease. To determine the prevalence of hereditary haemolytic anaemia and to correlate clinical and haematological features. The study was carried for duration five and half years (four years of retrospective and one and a half years prospective). All the patients diagnosed as hereditary haemolytic anaemia based on peripheral smear and special haematological investigation were included in the study. The clinical parameters and haematological parameters of all these patients were studied. A total of 322 cases of hereditary haemolytic anaemia were diagnosed over a period of five and a half years. Of them thalassaemia syndrome constituted 165 cases (51.24%), sickle cell disorders 78 cases (24%), hereditary spherocytosis 43 cases (13.3%), G6PD deficiency 20 cases (6.29%) and HbE disorder 12 cases (3.7%). One case of hereditary elliptocytosis and one case of HbD Punjab was detected. Among thalassaemia syndromes beta thalassaemia was commonest clinically presenting disorder with a high morbidity. Sickle cell anaemia showed a higher level of HbF and a relatively milder clinical course. Hereditary spherocytosis had varied age at presentation. In G6PD deficiency drug induced haemolysis was the commonest clinical presentation. HbE disorders were from the north eastern states. Haemoglobinopathies constitute the major group of hereditary haemolytic anaemia (74%). Genetic counselling is an important step in reducing the incidence of thalassaemia major.

  18. Clinico-pathology, hematology, and biochemistry responses toward Pasteurella multocida Type B: 2 via oral and subcutaneous route of infections

    PubMed Central

    Chung, Eric Lim Teik; Abdullah, Faez Firdaus Jesse; Adamu, Lawan; Marza, Ali Dhiaa; Ibrahim, Hayder Hamzah; Zamri-Saad, Mohd; Haron, Abdul Wahid; Saharee, Abdul Aziz; Lila, Mohd Azmi Mohd; Omar, Abdul Rahman; Bakar, Md Zuki Abu; Norsidin, Mohd Jefri

    2015-01-01

    Background: Pasteurella multocida a Gram-negative bacterium has been identified as the causative agent of many economically important diseases in a wide range of hosts. Hemorrhagic septicemia is a disease caused by P. multocida serotype B:2 and E:2. The organism causes acute, a highly fatal septicemic disease with high morbidity and mortality in cattle and more susceptible in buffaloes. Therefore, the aim of this study was to investigate the clinical signs, blood parameters, post mortem and histopathology changes caused by P. multocida Type B:2 infections initiated through the oral and subcutaneous routes. Methods: Nine buffalo heifers were divided equally into 3 treatment groups. Group 1 was inoculated orally with 10 ml of phosphate buffer saline; Groups 2 and 3 were inoculated with 10 ml of 1012 colony forming unit of P. multocida Type B:2 subcutaneously and orally respectively. Results: There was a significant difference (p<0.05) in temperature between the subcutaneous and the control group. The results revealed significant differences (p<0.05) in erythrocytes, hemoglobin, packed cell volume, leukocytes, monocytes, and A: G ratio between the subcutaneous and the control group. Furthermore, there were significant differences (p<0.05) in leukocytes, band neutrophils, segmented neutrophils, lymphocytes, eosinophils, basophils, thrombocytes, plasma protein, icterus index, gamma glutamyl tranferase and A: G ratio between the oral and the control group. The post mortem lesions of the subcutaneous group buffaloes showed generalized hyperemia, congestion and hemorrhage of the immune organs, gastro-intestinal tract organs and vital organs. The oral group buffaloes showed mild lesions in the lung and liver. Histologically, there were significant differences (p<0.05) in hemorrhage and congestion; necrosis and degeneration; inflammatory cells infiltration; and edema in between the groups. Conclusion: This study was a proof that oral route infection of P. multocida Type B:2 can be used to stimulate host cell responses where oral vaccine through feed can be developed in the near future. PMID:27065648

  19. [Clinico-functional efficacy of medicinal and photon stabilization of cell membrane in patients with angina pectoris].

    PubMed

    Vasil'ev, A P; Senatorov, Iu N; Strel'tsova, N N; Gorbunova, T Iu

    2003-01-01

    Modification of erythrocytic membrane and the trend in clinicofunctional indices were studied in 90 patients with angina of effort (FC I-IV) in the course of treatment with a combination of membranoprotective drugs (group 1), magneto-laser radiation (group 2) and imitation of laser radiation (group 3). In patients of groups 1 and 2 the treatment resulted in stabilization of cell membrane accompanied with a hypotensive effect and increased exercise tolerance due to more effective cardiac performance.

  20. Clinico-Haematological Profile of Hereditary Haemolytic Anaemias in a Tertiary Health Care Hospital in South India

    PubMed Central

    Devi, AM Shanthala

    2017-01-01

    Introduction Hereditary haemolytic anaemia is a common inherited disorder causing varying degree of morbidity and mortality. This includes disorders due to haemoglobin defect, membrane defect, and enzyme defect. Among them haemoglobinopathies, a single gene disorder, constitutes the major part of the disorder and is distributed worldwide with an incidence of 5%. These inherited disorders pose a major public health problem and increase the burden both on the patient and the society. Presently, these disorders are not curable but can only be prevented. Improved awareness about these diseases among medical fraternity leading to diagnosis of carrier state, genetic counselling, and antenatal diagnosis may help in decreasing the prevalence of the disease. Aim To determine the prevalence of hereditary haemolytic anaemia and to correlate clinical and haematological features. Materials and Methods The study was carried for duration five and half years (four years of retrospective and one and a half years prospective). All the patients diagnosed as hereditary haemolytic anaemia based on peripheral smear and special haematological investigation were included in the study. The clinical parameters and haematological parameters of all these patients were studied. Results A total of 322 cases of hereditary haemolytic anaemia were diagnosed over a period of five and a half years. Of them thalassaemia syndrome constituted 165 cases (51.24%), sickle cell disorders 78 cases (24%), hereditary spherocytosis 43 cases (13.3%), G6PD deficiency 20 cases (6.29%) and HbE disorder 12 cases (3.7%). One case of hereditary elliptocytosis and one case of HbD Punjab was detected. Among thalassaemia syndromes beta thalassaemia was commonest clinically presenting disorder with a high morbidity. Sickle cell anaemia showed a higher level of HbF and a relatively milder clinical course. Hereditary spherocytosis had varied age at presentation. In G6PD deficiency drug induced haemolysis was the commonest clinical presentation. HbE disorders were from the north eastern states. Conclusion Haemoglobinopathies constitute the major group of hereditary haemolytic anaemia (74%). Genetic counselling is an important step in reducing the incidence of thalassaemia major. PMID:28764172

  1. [Clinico-pathological characteristics and prognosis of IgA nephropathy patients with microalbuminuria and deposition of complement C3].

    PubMed

    Guo, Z Y; Zhou, S G; Wang, Y Y; Li, X; Xu, Y; Du, X Y; Zhang, W; Wu, Y M

    2016-03-08

    To analyze the clinical and pathological data and prognosis of IgA nephropathy patients with microalbuminuria and deposition of C3, and to investigate the significance of C3 deposition in IgA nephropathy with microalbuminuria. The clinical and pathological data of 127 IgA nephropathy patients with microalbuminuria confirmed by renal biopsy in the Jining No.1 People's Hospital from January 2009 to January 2015 and minimum 6-month follow-up was reviewed, and patients were divided into positive group (72 cases, 56.7%)and negative group (55 cases, 43.3%) according to the deposition of C3 in the mesangial area of glomeruli. 24 h urine quantitative protein being more than 1 g, or serum creatinine level becoming abnormal or double by renal biopsy was defined as endpoint of follow-up. Renal survival was calculated by Kaplan-Meier survival analysis. A total of 127 IgA nephropathy patients with microalbuminuria were followed up successfully, with an average follow-up of (49.6±22.7) months. 24 h urine albumin[(261.3±47.4) vs (238.7±51.9) mg, P=0.011], serum creatinine value[98.0(56.4, 118.6) vs 85.7(51.9, 107.8) μmol/L, P=0.003], uric acid value[(384.0±93.7) vs (360.5±88.4) μmol/L, P=0.043] and serum IgA value[(3.36±1.17) vs (3.12±1.05) g/L, P=0.044] were significantly higher in the C3 positive group than those in the negative group, while the serum complement C3 was significantly lower [(0.70±0.42) vs (0.98±0.49) mg, P=0.047]. Pathological changes [Lee's grade Ⅲ and above Ⅲ: 21(16.5%) vs 11(8.7%), P=0.034], glomerular sclerosis or adhesions [29(22.8%) vs 19(15.0%), P=0.047], renal tubular atrophy or interstitial fibrosis [13(10.2%) vs 8(6.3%), P=0.027] and crescent formation [7(5.5%) vs 2(1.6%), P=0.035] in the complement C3 positive group were more severe than those in the negative group. 38 cases of complement C3 positive group and 14 cases of negative group accomplished the study, and Kaplan-Meier survival analysis showed that there was a significant difference in the median survival time between the two groups [(52.6±8.9) vs (66.1±9.7) months, P=0.019]. The clinical and pathological features in IgA nephropathy patients with microalbuminuria and deposition of complement C3 were more severe than those without complement C3 deposition, and the prognosis was not optimistic. Therefore, early and active intervention treatment should be considered for these patients.

  2. Clinico-pathological findings of Clostridium perfringens type D enterotoxaemia in goats and its hemolytic activity in different erythrocytes

    PubMed Central

    Ali Nasir, A.; Younus, M.; Rashid, A.; Abdul Khaliq, S.; Khan, E.; Shah, S. H.; Aslam, A.; Ghumman, M. A.; Joiya, M. H.

    2015-01-01

    The present investigation was conducted to study the effects of experimental Clostridium perfringens type D enterotoxaemia in teddy goats. Clinical signs started to appear after 30 min of experimental infection like anorexia, diarrhea, dehydration, frothing and dyspnea. Gross lesions consisted of severe congestion in tissues of varying intensity with enlarged mesenteric lymph nodes while histological examination revealed edema of lungs, kidney, and lymph nodes and to some extent in brain along with hemorrhages in lungs and intestines. Clostridium perfringens type D carrying alpha and epsilon toxin genes were amplified with amplicon size about 247 bp and 665 bp, respectively. Human erythrocytes showed the highest hemolysis, 68%, followed by mice, 57%, against culture supernatants. The percentage of hemolysis was significantly higher at 37°C as compared to 25°C except for rabbit and dog. PMID:27175159

  3. Histopathologic spectrum of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): a diagnosis that needs clinico-pathological correlation.

    PubMed

    Borroni, G; Torti, S; Pezzini, C; Vassallo, C; Rosso, R; D'Ospina, R M; Tomasini, C; Brazzelli, V

    2014-06-01

    Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is characterized by an heterogeneous group of severe dermatologic manifestations and systemic involvement, due to several groups of medicaments. A series of 9 consecutive cases, observed from 2008 to 2013 in the Department of Dermatology, University of Pavia, is reported, all satisfying the clinical, hematological and systemic diagnostic criteria of DRESS. Clinically, 4 out of 9 patients had an urticarial and papular eruption, 2 an erythema-multiforme-like (EM-like) pattern, 2 erythroderma and 1 had an erythematous and macular reaction. Aim of the study was to describe the histopathologic features of DRESS and to trace a possible correlation between the four clinical recognized types of the syndrome and the histopathological patterns. Predominantly, a superficial perivascular lymphocytic infiltrate, extravasation of erythrocytes, and focal interface changes characterized DRESS cases. Less frequently, histopathology revealed the presence of necrotic keratinocytes; surprisingly, only in 2 cases the presence of rare dermal eosinophils was detected, even if all the patients had significant peripheral eosinophilia. A histopathological diagnosis of DRESS seems per se, according to our data, not feasible, since the main histopathological changes (interface changes, superficial perivascular dermatitis, focal spongiosis, lichenoid infiltrate, rare presence of necrotic keratinocytes) can be interpreted generically as a drug induced dermatitis. The above mentioned histopathological changes, however, when associated with clinical information on cutaneous and systemic involvement of the patient, allow the pathologist or the dermatopathologist to make a diagnosis of DRESS with a reliable margin of certainty.

  4. Evaluation of the JACO robotic arm: clinico-economic study for powered wheelchair users with upper-extremity disabilities.

    PubMed

    Maheu, Veronique; Frappier, Julie; Archambault, Philippe S; Routhier, François

    2011-01-01

    Many activities of daily living, such as picking up glasses, holding a fork or opening a door, which most people do without thinking, can become insurmountable for people who have upper extremity disabilities. The alternative to asking for human help is to use some assistive devices to compensate their loss of mobility; however, many of those devices are limited in terms of functionality. Robotics may provide a better approach for the development of assistive devices, by allowing greater functionality. In this paper, we present results of a study (n=31) which objectives were to evaluate the efficacy of a new joystick-controlled seven-degree of freedom robotic manipulator and assess its potential economic benefits. Results show that JACO is easy to use as the majority of the participants were able to accomplish the testing tasks on their first attempt. The economic model results inferred that the use of the JACO arm system could potentially reduce caregiving time by 41%. These study results are expected to provide valuable data for interested parties, such as individuals with disabilities, their family or caregivers.

  5. The efficacy of a herbal-based toothpaste in the control of plaque and gingivitis: a clinico-biochemical study.

    PubMed

    George, Jacob; Hegde, Shashikant; Rajesh, K S; Kumar, Arun

    2009-01-01

    A double-blinded controlled clinical trial with parallel groups was designed to investigate the effectiveness of a herbal-based toothpaste in the control of plaque and gingivitis as compared with a conventional dentifrice. The efficacy of Colgate Herbal over Colgate tooth paste was assessed in this study. Thirty subjects with gingivitis participated in the study. All participants had at least 20 natural teeth with no probing depths greater than 3 mm and a plaque index score of 2 or more at baseline. At baseline, the clinical parameters like gingival index, plaque index and salivary pH were estimated. Paired t-test was used to compare the difference within the groups and unpaired t-test was used to compare the difference between the groups at baseline and on the 30th day. At the end of the study, there were statistically significant reductions in the gingival index and the plaque index scores within the test group. However, there were no statistically significant differences between the test and the control groups. The salivary pH changes were not statistically significant in the test group but were displaced more toward the acidic range in the control group. It was however concluded that the herbal-based toothpaste was as effective as the conventionally formulated dentifrice in the control of plaque and gingivitis.

  6. Her2/neu Protein Expression and Oncogene Amplification in Gastric Carcinoma with Clinico-Pathological Correlation in Egyptian Patients

    PubMed Central

    Hadi, Ahmed Abdel; Hindawi, Ali El; Hareedy, Amal; Khalil, Heba; Ashiry, Ranya Al; Elia, Shady; Sadek, Ahmed; Magdy, Mona; Atta, Rafatt; Anas, Amgad; Bakr, Hisham; Hammam, Olfat

    2016-01-01

    AIM: Amplification of the Her2/neu gene and overexpression of the Her2/neu protein in gastric carcinoma (GC) is a golden criterion for target therapy with trastuzumab (Herceptin). We aim to evaluate the immunohistochemical protein expression and amplification of the oncogene Her2/neu by FISH technique in the epithelial gastric carcinoma and to compare their association with different clinicopathologic parameters aiming at identifying positive cases that may benefit from targeted therapy. MATERIALS AND METHODS: This study was done on eighty-five tumour tissue samples from patients with GC as well as thirty non-malignant lesions (Gastritis, intestinal metaplasia, adenoma with low-grade dysplasia, adenoma with high-grade dysplasia). All were immunohistochemically stained with Her2/neu antibody. RESULTS: All equivocal and some selected GC cases were submitted for FISH technique to detect Her2/neu gene amplification. By immunohistochemistry twenty-three cases (27%) were defined as positive for Her2/neu gene amplification and/or protein overexpression. The levels of Her2/neu positive (3+), Her2/neu equivocal (2+) and Her2/neu negative (1+/0) were measurable in 14.2%, 32.9% and 52.9% of the samples, respectively. FISH showed that Her2/neu gene was amplified in 22 cases, 10 Her2/neu positive (3+), 11 (39.3%) Her2/neu equivocal (2+) and 1 Her2/neu negative (1+) cases with IHC staining those who can benefit from anti Her2/neu target therapy. Her2/neu was overexpressed positivity (3+) more in intestinal type and mixed carcinoma, and moderately differentiated tumours. None of gastritis, intestinal metaplasia or adenoma with low-grade dysplasia cases showed positivity for Her2/neu (3+). The Her2/neu positivity (3+) was associated with both adenocarcinoma cases and high-grade dysplasia (P = 0.002). CONCLUSIONS: The results highlight the necessity of FISH test for further categorization when gastric cancer cases are equivocal (2+) by IHC to determine eligibility for the targeted therapy. Stepwise increase in the expression of Her2/neu was seen in low-grade dysplasia, high-grade dysplasia and carcinoma cases implying its role in cancer evolution. Overexpression of Her 2/neu in GC patients can be promising in selecting those who can get benefit from anti-Her2/neu target therapy. PMID:28028387

  7. Clinico-histopathologic and outcome features of cutaneous infundibular keratinizing acanthoma: a case report and literature review

    PubMed Central

    2014-01-01

    The infundibular keratinizing acanthoma (IKA) is a rare epithelial benign keratin-containing neoplasm of hair follicles. The purpose of this study was to evaluate the defining histopathologic architecture of IKA. A typical IKA consisted of a keratin-filled crypt in the dermis and subcutis that opened to the skin surface. Most of this tumor occurred on the back, neck, head, and the shoulders. Microscopically, the dermal nodules were focally contiguous in both the dermis and subcutis. Furthermore, most histological lesions are consistent with a simple or multiloculated cyst filled with keratin and lined by a wall of stratified squamous epithelium; keratin appears as a concentric lamellar mass, with a keratotic pearly aspect. Histological examination of the cutaneous lesions revealed that the growths were comprised of IKA. IKA of man and dog were compared, and it was concluded that although they are similar in many respects, they are not identical entities. To the best of our knowledge, this is the first report on the prevalence of IKAs among the population of owned dogs in Iran. PMID:24890648

  8. Regional brain volumes distinguish PSP, MSA-P, and PD: MRI-based clinico-radiological correlations.

    PubMed

    Paviour, Dominic C; Price, Shona L; Jahanshahi, Marjan; Lees, Andrew J; Fox, Nick C

    2006-07-01

    Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders, each with a prevalence of around 5 per 100,000. Regional brain atrophy patterns differ in the two disorders, however, and magnetic resonance imaging is sometimes helpful in distinguishing them in the later stages. We measured whole brain and regional volumes, including cerebellum, pons, midbrain, superior cerebellar peduncle (SCP), and ventricular volumes as well as frontal and posterior-inferior cerebral regions in 18 subjects with PSP, 9 with MSA-P (parkinsonian phenotype), 9 with Parkinson's disease (PD), and 18 healthy controls. Associations between these volumes, cognitive profiles, and clinical measures of disease severity and motor disability were assessed. Mean midbrain volume was 30% smaller in PSP than in PD or controls (P < 0.001) and 15% smaller than in MSA-P (P = 0.009). The mean SCP volume in PSP was 30% smaller than in MSA-P, PD, or controls (P < 0.001). Mean cerebellar volumes in MSA-P were 20% smaller than in controls and PD and 18% smaller than in PSP (P = 0.01). Mean pontine volume in MSA-P was 30% smaller than in PD or controls (P < 0.001) and 25% smaller than in PSP (P = 0.01). Motor disability was most strongly associated with midbrain volume, and more severe executive dysfunction was associated with reduced frontal volume. These distinct patterns of cortical and subcortical atrophy, when considered together rather than independently, better differentiate PSP and MSA-P from each other and also from healthy controls.

  9. [The clinico-pathogenetic correlations in schizophrenia in adolescents and young people with a course of psychopathic-like disorders].

    PubMed

    Golik, A N

    1995-01-01

    The influence of heredity and of premorbid personal peculiarities on the psychopathic-like disorders development in schizophrenic patients of adolescent-juvenile age was analysed. Psychopathic-like disturbances were divided into 2 groups exactly with either positive (type I) or negative or type II symptoms predominance in a whole clinical pattern. Symptoms mentioned above were observed in 47 and 53 patients respectively. As well as probands 216 relatives in the range of 1-3 degree of relation were examined too. It was revealed that in patients with type I of disorders schizophrenia debuted in adolescent-juvenile age meanwhile in type II it started in childhood. More severe hereditary loading in the form of various psychic pathologies took place in the case type I patients as compared with type II. Schizotype and hyperthymic personality characteristics prevailed in the first case, just as dissociated and passive features presented in type II.

  10. Progressive late delayed postirradiation encephalopathy with Klüver-Bucy syndrome. Serial MRI and clinico-pathological studies.

    PubMed

    Thajeb, P

    1995-08-01

    The first pathologically documented case of progressive late delayed postirradiation encephalopathy in a 37-year-old man with Klüver-Bucy syndrome (KBS) is reported here. The pathological findings and clinical course of KBS with recurrent stroke-like episodes and partial epilepsy within a 7-year period following a 'safe dose' radiation therapy for pituitary tumor are presented. Serial magnetic resonance imaging shows, at different stages of the disease, a pontine infarct, enlarged temporal lobes with serpentine hyperintense signal at cortical gyri on T2-weighted and proton density MRI, and progressive brain calcification which appears hyperintense on T1-weighted images and hypointense on T2-weighted images.

  11. [Clinico-morphologic analysis of subacute sclerosing panencephalitis in patients up to the 19th year of life].

    PubMed

    Sobaniec-Lotowska, M; Sobaniec, W; Sulkowski, S; Sulik, M; Ostapiuk, H

    Deaths of patients with the subacute sclerosing panencephalitis were analysed in the non-selected autopsy material within 1976-1985. Fifteen cases of the disease, i.e. 0.12% of all autopsies and 3.8% of autopsies in the age group between 1 and 19 years, were noted. Fourteen cases of the subacute sclerosing panencephalitis were noted in the age group of 5-14 years. Mean age was 9.3 years. The disease was nearly three-fold more frequent in male patients. Time lapse between measles infection or antimeasles vaccination and hospitalization for the subacute sclerosing panencephalitis was 4.2 years for both sexes and was much lower for male patients--2.9 years. Morphological lesions characteristic for the subacute sclerosing panencephalitis were seen in the white matter and cortex of the brain in all examined patients. Lesions to the basal ganglia were noted in 9 cases, and additionally to the brain stem and vermiform lobe in 3 cases. The most frequent clinical symptoms accompanying the subacute sclerosing panencephalitis at the beginning of the hospitalization, other diseases and conformation of the clinical diagnosis with sectional findings are also discussed.

  12. [R.E.A.L. classification of non-Hodgkin lymphoma from the clinico-oncologic viewpoint].

    PubMed

    Meusers, P; Brittinger, G

    1998-06-03

    In 1994 the International Lymphoma Study Group (ILSG) published the "Revised European-American Classification of Lymphoid Neoplasms" (R.E.A.L. Classification). Lymphomas were classified according to their presumed normal counterparts, to the extent possible. Within both T- and B-cell categories differentiation between lymphomas and/or leukemias of "precursor" or "peripheral" neoplasms are defined arising from antigen independend or antigen reactive cell proliferation. Lymphomas undoubtedly characterized by currently available morphologic, immunologic, and genetic technics represent "real" disease entities. Provisional categories include lymphomas that have been described in some detail, but without consensus within the ILSG. Proposed names are based predominantly on established usage. With respect to similar treatment approaches and difficulties of the ILSG members in subclassifying large cell lymphomas, centroblastic, immunoblastic and large cell anaplastic lymphomas of B-cell type were "lumped" together as large B-cell lymphomas. Within a prospective treatment trial overall survival was significantly better in centroblastic as compared to B-cell immunoblastic lymphoma diagnosed by optimal histomorphology according the criteria of the Kiel Classification. Thus the R.E.A.L. Classification fails to identify patients who may require other than standard treatment. Future studies will demonstrate whether subclassifying the proposed "peripheral" T-cell lymphomas, unspecified into T-zone lymphoma, lymphoepitheloid (Lennert's) lymphoma and pleomorphic, small, medium, and large cell lymphomas according the Kiel Classification is of clinicopathologic relevance. On the contrary the subtypes of chronic lymphocytic leukemia of T-cell type form two distinct entities within the R.E.A.L. Classification separating T-CLL/prolymphocytic leukemia from large granular lymphocyte leukemia of T- and NK-cell type. Within the R.E.A.L. Classification the lymphoplasmacytoid immunocytoma of the Kiel Classification will be subsumed together with the prognostically significantly better B-cell chronic lymphocytic leukemia. Opposite to the original intention of the ILSG two proposals are developed on clinical grouping of entities. Clinical indolent lymphoid neoplasms usually have "low grade" histologic appearances, with a predominance of small cells subsuming with the exception of the mantle cell lymphoma all of the low grade lymphomas of the Kiel classification. Aggressive lymphomas (intermediate risk) are defined as tumors whose survival if untreated is measured in months, highly or very aggressive lymphomas and/or leukemias will kill untreated patients within weeks. Unlike the Kiel Classification proposed categories subsume lymphomas irrespective of cytomorphology, thus grouping together potentially curable and uncurable diseases. Undoubtedly the R.E.A.L. Classification forms at present the best compilation of existing knowledge upon neoplasms of the immune system, enabling cooperation between clinicians and scientists all over the world. According to the ILSG this proposal should be considered a starting point for future periodic reevaluations.

  13. Clinico-Epidemiological Profile of Psychiatric Disorders Among Children in a Tertiary Care Hospital of Southern India

    PubMed Central

    Subba, Sonu Hangma; Guha, Arunav

    2016-01-01

    Introduction According to the World Health Organization (WHO), mental health disorders are one of the leading causes of disability worldwide and it is as common in children. Anywhere between one to three children may be suffering from psychiatric disorders at any point in time. Aim This study intended to find the pattern of psychiatric disorders and associated sociodemographic factors among children attending the psychiatric department in a tertiary care hospital in Southern India. Materials and Methods An analysis was conducted of patients who attended the psychiatric clinic from April 2012 to March 2013. Disorders were classified according to International Classification of Diseases, 10th edition (ICD-10) criteria. Data obtained was analysed by SPSS 11.5 version. Chi-square test was used to see association and p<0.05 was taken as significant. Results The mean age of the children was 10.9 years (SD=4.3). Predominance of males was noticed. It was seen that the male children, mostly suffered from Pervasive and specific developmental disorders (n=105; 31.1%). While in the female children, a prominence of anxiety, dissociative, stress-related, somatoform and other non-psychotic mental disorders was seen (n=52; 27.1%). Co-morbidity of psychiatric disorders was seen with intellectual disability and a seasonal predominance of psychiatric disorders was seen during autumn. Conclusion Children presenting with psychiatric disorders in the hospital showed a wide age range and among them, males outnumbered females. Psychiatric disorders showed seasonal variation and the types of disorder varied significantly with age, gender and religion. PMID:27134978

  14. Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association

    PubMed Central

    Sarkozy, Clémentine; Molina, Thierry; Ghesquières, Hervé; Michallet, Anne-Sophie; Dupuis, Jehan; Damotte, Diane; Morsschauser, Franck; Parrens, Marie; Martin, Laurent; Dartigues, Peggy; Stamatoullas, Aspasia; Hirsch, Pierre; Fabiani, Bettina; Bouabdallah, Krimo; da Silva, Maria Gomes; Maerevoet, Marie; Laurent, Camille; Coiffier, Bertrand; Salles, Gilles; Traverse-Glehen, Alexandra

    2017-01-01

    Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B-cell lymphoma immunophenotype, primary mediastinal B-cell lymphoma-like morphology (30.3%) with classical Hodgkin lymphoma or composite (5.1%) (synchronous occurrence of classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma). The median age was 32 years (13–83 years); 55% were women. Thirteen of 81 evaluable cases (16%) were Epstein-Barr virus-positive. Twenty-eight percent of patients presented primary refractory disease (progression under first-line treatment or relapse within one year). The 3-year event-free and overall survival rates were 63% and 80%, respectively. Patients treated with a standard regimen (RCHOP/ABVD) had worse event-free survival (P=0.003) and overall survival (P=0.02) than those treated with a dose-intensive chemotherapy (high-dose RCHOP/escalated BEACOPP). Rituximab added to chemotherapy was not associated with better event-free survival (P=0.55) or overall survival (P=0.88). Radiotherapy for patients in complete remission had no impact on event-free survival. In multivariate prognostic analysis, ECOG-PS and anemia were the strongest factors associated with a shorter event-free survival and overall survival, respectively. In conclusion, this report describes the largest series of mediastinal gray zone lymphoma. Our data suggest that a dose-intensive treatment might improve the outcome of this rare and aggressive disease. PMID:27758822

  15. [Clinico-laboratory effectiveness of modern ointments with a polyethylene glycol base in the treatment of purulent wounds].

    PubMed

    Blatun, L A; Svetukhin, A M; Pal'tsyn, A A; Liapunov, N A; Agafonov, V A

    1999-01-01

    The 25-year experience with the underbandage treatment of soft tissue purulent wounds of various location and genesis with modern ointments with polyethylene glycol as the basis was analyzed. Levocin, levomecole, dioxycole, 5-percent dioxydinic, 1-percent iodopyronic, 0.5-percent quinifuryl and furagel ointments proved to preserve their high activity against aerobic grampositive and gramnegative flora. 10-percent mafenide acetate ointment had a high selective effect on Pseudomonas aeruginosa. The new ointments nitacid and streptonitole containing nitazole and white streptocide were highly active against both aerobic and anaerobic infections. The use of the ointments with the polyethylene glycol as the basis made it possible to decrease 2 times the period of the patient hospitalization in surgical units and to shorten the terms of the systemic antibacterial therapy. The marked therapeutic effect of such ointments due to their high dehydrating capacity and broad antibacterial spectrum enabled to consider them as the drugs of choice in the local treatment of purulent wounds during the 1st phase of the wound process, trophic and decubic ulcers, infected burns, diabetic and atherosclerotic gangrene, furuncles, carbuncles, mastitis, etc. The ointments in the water soluble vehicle can be as well used with success for the prophylactic treatment of infected wounds after the suture. The multitarget effect of the ointments in the water soluble vehicle and their ability to prevent severe purulent complications permitted to consider them as the 1st order drugs in cases of emergency.

  16. A comparative study of the clinico-aetiological profile of hyponatremia at presentation with that developing in the hospital

    PubMed Central

    Agarwal, S. Mahavir; Agrawal, Aparna

    2011-01-01

    Background & objectives: Hyponatremia is a common problem encountered in patients presenting with nonspecific symptoms. We undertook this study to investigate the clinical profile of patients with hyponatremia, the precipitating factors, the response to therapy and to compare, using these parameters, hyponatremia at presentation to that developing in the hospital. Methods: Seventy consecutive patients with serum sodium less than or equal to 125 mmol/l at presentation or at any time during hospital admission were identified and studied using a proforma. The severity of hyponatremia, therapy given and time taken for recovery were analysed. Results: The mean age of patients was 48.1 ± 16.1 yr. The mean serum sodium was 117.8 ± 6.4 mmol/l. Confusion, headache and malaise were the most common symptoms, two patients had seizures, and 20.0 per cent patients showed no clinical manifestations. Nausea was significantly (P<0.05) more common in patients presenting with hyponatremia. 22 patients (31.4%) developed hyponatremia during their stay in the hospital. 3 patients (4.3%) presented with hyponatremia which got worse during the admission period. Most had multiple precipitating factors, decreased intake being the most common (82.9%), followed by increased losses (65.7%) and miscellaneous factors (70.0%). Drugs, fluid overload and inappropriate Ryle's tube feeds more commonly precipitated hyponatremia in in-hospital patients. Time taken for recovery showed negative correlation with the serum sodium. Patients with in-hospital hyponatremia took significantly longer time to recover (P<0.05). Interpretation & conclusions: Decreased intake was found to be the commonest cause of hyponatremia, thus, ensuring adequate oral intake, especially in patients on liquid diet and in manual labourers, and correction of hyponatremia as soon as an abnormality is detected is important. PMID:21808144

  17. Analysis of inorganic ions in gingival crevicular fluid as indicators of periodontal disease activity: A clinico-biochemical study.

    PubMed

    Koregol, Arati C; More, Shobha P; Nainegali, Sangamesh; Kalburgi, Nagaraj; Verma, Siddharth

    2011-10-01

    Gingival crevicular fluid (GCF) is regarded as a promising medium for detection of markers of periodontal disease activity. Very few investigators have examined concentration of electrolytes in GCF, but most results are not in agreement to one another. This study was undertaken with an objective of quantitative estimation of sodium, potassium and calcium concentrations of GCF in gingivitis and periodontitis, to find the reliability of these ions as diagnostic markers and to analyze the relation of these ions to one another. This will indicate stage of disease activity which helps in early diagnosis, prevention and treatment of periodontal diseases. The patients selected for the study included both sexes, aging from 18 to 55 years, divided into two groups: gingivitis (group I) and periodontitis (group II). Using volumetric microcapillary pipette, 5 μl GCF was collected for quantitative analysis of sodium, potassium and calcium using flame photometry. The concentrations of sodium, potassium and calcium in GCF and their significant correlation with gingival index and pocket depth measurements reflect the clinical status of gingival and periodontal tissues. Estimation of these electrolytes may be used as potential diagnostic markers of active disease status in periodontal tissues and to predict the effective methods of prevention and treatment.

  18. Analysis of inorganic ions in gingival crevicular fluid as indicators of periodontal disease activity: A clinico-biochemical study

    PubMed Central

    Koregol, Arati C.; More, Shobha P.; Nainegali, Sangamesh; Kalburgi, Nagaraj; Verma, Siddharth

    2011-01-01

    Aim: Gingival crevicular fluid (GCF) is regarded as a promising medium for detection of markers of periodontal disease activity. Very few investigators have examined concentration of electrolytes in GCF, but most results are not in agreement to one another. This study was undertaken with an objective of quantitative estimation of sodium, potassium and calcium concentrations of GCF in gingivitis and periodontitis, to find the reliability of these ions as diagnostic markers and to analyze the relation of these ions to one another. This will indicate stage of disease activity which helps in early diagnosis, prevention and treatment of periodontal diseases. Materials and Methods: The patients selected for the study included both sexes, aging from 18 to 55 years, divided into two groups: gingivitis (group I) and periodontitis (group II). Using volumetric microcapillary pipette, 5 μl GCF was collected for quantitative analysis of sodium, potassium and calcium using flame photometry. Results: The concentrations of sodium, potassium and calcium in GCF and their significant correlation with gingival index and pocket depth measurements reflect the clinical status of gingival and periodontal tissues. Conclusions: Estimation of these electrolytes may be used as potential diagnostic markers of active disease status in periodontal tissues and to predict the effective methods of prevention and treatment. PMID:22346152

  19. A multilocular radiolucency of mandible as the first evidence of multiple myeloma: A clinico-radiographic case report

    PubMed Central

    Mohan, Ravi Prakash Sasankoti; Gill, Navneet; Verma, Sankalp; Chawa, Venkateshwar Rao; Tyagi, Kuber; Agarwal, Neha

    2014-01-01

    The incidence of multiple myeloma (MM) affecting the jaws is 30% and on rare occasions the oral involvement can be the first indication of the disease. Authors report a case of MM in a 40-year-old woman who presented with a multilocular radiolucent lesion in the left mandible initially mistaken as an ameloblastoma. Conventional radiographs revealed a multilocular lesion on the molar region. Computed tomography (CT) and 3 dimensional CT revealed lytic, space occupying lesion perforating the inferior cortex. Magnetic resonance imaging (MRI) revealed a hypointense lesion on T1 weighted image and hyperintense lesion on T2 weighted image. Histopathological and lab investigations lead to the diagnosis of MM. MRI is superior in depicting the size of the lesion as compared to CT and conventional radiographs. PMID:24932201

  20. Clinico-microbiological profile and outcomes of nosocomial sepsis in an Indian tertiary care hospital--a prospective cohort study.

    PubMed

    Saravu, Kavitha; Prasad, Madhura; Eshwara, Vandana Kalwaje; Mukhopadhyay, Chiranjay

    2015-07-01

    Nosocomial infections are linked to rising morbidity and mortality worldwide. We sought to investigate the pattern of nosocomial sepsis, device usage, risk factors for mortality and the antimicrobial resistance pattern of the causative organisms in medical intensive care units (ICUs) in an Indian tertiary care hospital. We conducted a single-centre based prospective cohort study in four medical ICUs and patients who developed features of sepsis 48 hours after admission to the ICUs were included. Patients' demographics, indwelling device usage, microbiological culture reports, drug resistance patterns and the outcomes were recorded. The Acute Physiology and Chronic Health Evaluation (APACHE) III score and the relative risk of variables contributing towards non recovery were calculated. Pneumonia (49%) was the commonest nosocomial infection resulting in sepsis, followed by urosepsis (21.8%), bloodstream infection (BSI) (10.3%) and catheter-related bloodstream infection (CRBSI) (5%). Sixty three percent of the Acinetobacter baumannii and 64.4% of the Pseudomonas aeruginosa were multidrug-resistant (MDR). Seventy percent of the Klebsiella pneumoniae were extended spectrum beta-lactamase producers and 7.4% were resistant to carbapenems. Forty three percent of the Staphylococcus aureus were methicillin-resistant S. aureus. Resistance to carbapenems was 35.2% in this study. High APACHE III scores (P = 0.006 by unpaired t-test) and chronic kidney disease (P = 0.023) were significantly associated with non-recovery. A high degree of multidrug resistance was observed among both Gram-positive and -negative organisms in nosocomial sepsis patients. Carbapenem resistance was a common occurrence. Chronic kidney disease and high APACHE III scores were significantly associated with non-recovery. Male gender and sepsis leading to cardiovascular failure were the independent predictors of mortality.

  1. Hematopoietic progenitor cells (HPCs) in node-negative invasive breast carcinomas: Immunohistochemical analysis and clinico-pathological correlations.

    PubMed

    Giuffrè, G; Adamo, V; Ieni, A; Colonese, F; Barresi, V; Caristi, N; Adamo, B; Tuccari, G

    2011-08-15

    Using immunohistochemistry, we investigated 603 negative lymph nodes from 51 patients affected by invasive breast cancer (BC) to recognize bone marrow-derived hematopoietic progenitor cells (HPCs). HPC aggregates, revealed by CD34, CD133, VEGFR1, and CD117 antisera, were determined by an intensity-distribution score (ID). Cases with an ID-score >3 at least for one marker were considered to strongly express HPCs. Twenty-five of 51 (49%) high expressor patients were identified by CD34 antiserum, while 24/51 (47.1%), 17/51 (33.3%), and 15/51 (29.4%) were identified by CD117, CD133, and VEGFR1, respectively. No significant relationships were found between HPCs status and histotype, tumor grade, stage, and hormone receptors, as determined at the moment of the first diagnosis. A significant correlation was recorded for Ki-67 values, as well as for death from invasive BC. No statistical significance was achieved regarding HER2 status, although a tendency toward a statistically significant P value was obtained. A significant relationship (P<0.001) was found between high expressors of HPC and progression of disease, documented by the development of distant metastases. An equivalent P value was ascertained for osseous localizations, with a lesser value in other metastatic sites. Regarding the appearance of distant metastases, the greatest efficiency value was obtained by CD133 (85.7%). Overall survival (OS) and distant metastases-free survival (DMFS) revealed a high statistical significance for HPC expression, Ki-67 values, and HER2 status. By multivariate analysis, HPC expression and Ki-67 values emerged as the higher independent prognostic variables in the analysis of DMFS and OS, respectively. Copyright © 2011 Elsevier GmbH. All rights reserved.

  2. Diagnostic certainty of idiopathic pulmonary fibrosis/usual interstitial pneumonia: The effect of the integrated clinico-radiological assessment.

    PubMed

    Tominaga, Junya; Sakai, Fumikazu; Johkoh, Takeshi; Noma, Satoshi; Akira, Masanori; Fujimoto, Kiminori; Colby, Thomas V; Ogura, Takashi; Inoue, Yoshikazu; Taniguchi, Hiroyuki; Homma, Sakae; Taguchi, Yoshio; Sugiyama, Yukihiko

    2015-12-01

    To reevaluate idiopathic pulmonary fibrosis (IPF) cases which had surgical lung biopsy (SLB) for diagnosis of usual interstitial pneumonia (UIP), and examine the influence of computed tomography (CT) findings and clinical information based on diagnostic certainty. Ninety-five cases with multidisciplinary diagnoses of IPF were identified from eight institutions. All cases had SLB. Two expert chest radiologists and five expert pulmonologists used a 5-point scale to grade their level of certainty in the diagnosis of a radiological pattern of UIP or a clinical diagnosis of IPF (level 1 "definitely no" to level 5 "definitely yes"). Radiologists independently evaluated thin-section CT images and pulmonologists independently assessed clinical information. The two groups then discussed their diagnosis to obtain a final consensus, and listed alternative diagnoses. Changes in the level of certainty during the diagnostic process were investigated. The level of certainty for IPF was judged as low (level 1 or 2) in 32 cases (34%) by radiologists and in three cases (3%) by pulmonologists; in the final consensus 39 cases (41%) were judged as low. Chronic hypersensitivity pneumonitis (CHP), interstitial pneumonia associated with collagen tissue diseases (CTD-IP), and idiopathic nonspecific interstitial pneumonia (idiopathic NSIP) were listed as alternative diagnoses. In this retrospective series, some cases that had UIP confirmed on SLB for IPF diagnosis were classified into a low-level certainty group by expert chest radiologists and pulmonologists. When a diagnosis of IPF is made, the possibility of CHP, CTD-IP, and idiopathic NSIP must be also considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Clinico-pathology, diagnosis and management of Cysticercus fasciolaris and Hymenolepis diminuta co-infection in wistar rats

    PubMed Central

    Singh, Y. Damodar; Arya, Rahul Singh

    2015-01-01

    Aim: The present study was undertaken to study the pathology and control of sudden unexplained mortality in wistar rats. Materials and Methods: This study was conducted in a colony of 25 male wistar rats where there was mortality of nine rats. The dead rats were subjected to thorough post-mortem examination and necropsy samples were processed for hematoxylin and eosin staining for histopathological studies. Faecal samples of live rats were studied for the presence of parasitic eggs. Treatment with anthelmintics was given to manage the mortality and infections. Results: The investigation revealed a natural co-infection of Cysticercus fasciolaris and Hymenolepis diminuta in wistar rats, which were pathogenic enough to cause mortality. Typical lesions associated with the parasites were found in the dead rats. The mortality and infection were managed with common anthelmintics. Conclusion: C. fasciolaris and H. diminuta infection can cause mortality in wistar rats even when individually they cause asymptomatic infection. The mortality and infection can be managed with common anthelmintics. PMID:27047007

  4. Relationships Between Clinico-Epidemiological Patterns of Invasive Meningococcal Infections and Complement Deficiencies in French South Pacific Islands (New Caledonia).

    PubMed

    Daures, Maguy; John, Michele; Balter, Cécile Veysseyre; Simon, Olivier; Barguil, Yann; Missotte, Isabelle; Grangeon, Jean-Paul; Laumond-Barny, Sylvie; Noel, Martine; Besson-Leaud, Laurent; Spasic, Pierre-Emmanuel; de Suremain, Aurélie; Gourinat, Ann-Claire; Descloux, Elodie

    2015-01-01

    Invasive Meningococcal Disease (IMD) is three fold more common in New Caledonia (NC) than in metropolitan France and many IMD cases (35.7%) are due to Y and W135 serogroups. The purpose of our study was to identify IMD risk factors in NC. A retrospective study of all IMD cases that occurred in NC between 2005 and 2011 was conducted. Socio-environmental, clinical and biological data were collected. A search for immune deficiency was proposed to all cases. IMD presentation and outcome were compared according to meningoccal serogroups and the complement deficiency status (C-deficiency). Sixty-six sporadic IMD cases (29 B serogroup, 20 Y or W135, 6 C, 1 A, 10 unknown) occurred in 64 patients often <24 years-old and of Melanesian origin. Five patients died (7.8%). No socio-environmental risk factors were identified. No asplenia, HIV infection or immunoglobulin deficiencies were found. Two patients had diabetes and 28 of 53 (52.8%) patients had C-deficiency including 20 (71.4%) cases of late complement component deficiency. Patients with C-deficiency were mainly Melanesian (92.8%) originating from the Loyalty Islands (62.1%). They were mostly infected with Y/W135 (42.9%) or B serogroups (32.1%). They often developed later and more severe disease than patients without C-deficiency (need for intensive cares in 60% versus 28.0% of cases, p = 0.01). A high prevalence of C-deficiency in the Melanesian population may explain epidemiological and clinical features of IMD in NC. Our results imply an adaptation of meningococcal vaccine strategies in NC.

  5. Clinico-epidemiological study of oral squamous cell carcinoma: A tertiary care centre study in North India

    PubMed Central

    Singh, Mahendra Pratap; Kumar, Vijay; Agarwal, Akash; Kumar, Rajendra; Bhatt, M.L.B.; Misra, Sanjeev

    2015-01-01

    Introduction Oral squamous cell carcinoma (OSCC) ranks 12th most common cancer in the world. Objective The aim of this study was to retrospectively evaluate the OSCC. Methods A retrospective study of 611 OSCC patients from January 2010 to December 2013 was carried out in Department of Surgical Oncology, King George's Medical University, Lucknow, India. Details of patient's sex, age, tobacco habit and site of cancer were noted. Data were analyzed by Student's t test and chi-squire (χ2) test. Results The prevalence of OSCC was significantly (p < 0.001) higher in males (75.9%) than females (24.1%). The mean age of female patients was higher than males (p < 0.001). In both the genders, the buccal mucosa and gingivobuccal sulcus were found to be the most affected sites. Moreover, the smokeless form of tobacco was found to be significantly associated with OSCC, especially in females. Conclusion The study concluded that OSCC is more common in men as compared to women, probably due to habit of tobacco consumption. Smokeless tobacco use is an important risk factor, especially in females. PMID:26937366

  6. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

    PubMed Central

    Sadek, Abdelrahim Abdrabou; Mohamed, Montaser Mohamed; Sharaf, El-Zahraa El-Said Ahmed; Magdy, Rofaida Mohamed; Allam, Ahmed Ahmed

    2016-01-01

    Introduction Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. Methods An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). Results During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. Conclusion BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country. PMID:27279996

  7. [Clinico-biochemical aspects of human adaptation in central Antarctica as applied to the problems of space biology and medicine].

    PubMed

    Kurbanov, V V; Khmel'kov, V P; Krupina, T N; Kuznetscv, A G; Kuz'min, M P

    1977-01-01

    The paper presents the results of clinical, physiological and biochemical examination of 27 polar explorer--members of the 17th Soviet Antartic Expedition at the Vostok station. It gives data on the morbidity rate and describes the development of the asthenic-neurotic syndrome. On the basis of studies of catecholamines and serotonin, the role of the sympatho-adrenal system in the human adaptation to the harsh environments of the Central Antarctica has been shown.

  8. Medullary thyroid cancer: clinico-pathological profile and outcome in a tertiary care center in North India.

    PubMed

    Mehrotra, Prateek Kumar; Mishra, Anjali; Mishra, Saroj Kanta; Agarwal, Gaurav; Agarwal, Amit; Verma, Ashok Kumar

    2011-06-01

    Recent advances in genetic screening have ushered in a new era in diagnosis and management of medullary thyroid cancer (MTC). However, the same is not true for a resource-poor country, where clinicians are still struggling to diagnose and adequately manage this relatively uncommon thyroid malignancy. We hereby present our experience of managing MTC at a tertiary care referral center in North India. This was a retrospective study conducted between January 1990 and July 2009. Demographics, clinical profiles, details of surgical procedures, and follow-up records were reviewed. A total of 71 patients with MTC were identified. Mean age of this group was 39.9±14.1 years, and men outnumbered women 1.7:1. Some 84.5% of patients had seemingly sporadic MTC, and 15.5% had familial MTC (MEN2a=14.1%, MEN 2b=1.4%). All patients had a thyroid nodule at the time of presentation. Mean tumor diameter was 4.9 cm. Cervical lymphadenopathy, mediastinal lymphadenopathy, extrathyroidal invasion, and distant metastases were present in 59%, 7.2%, 10%, and 4.2% of patients, respectively. Staging showed that 4.8% of patients were stage I, 17.5% stage II, 14.3% stage III, and 63.6% stage IV. Treatment was as follows: 92.6% of patients had total thyroidectomy (primary or secondary); 67.6% central compartment lymph node dissection, 62.3% lateral cervical lymph node dissection, and 7.2% trans-sternal mediastinal lymph node dissection performed. Some 66.7% of patients suffered from persistent hypercalcitoninemia, and 11.4% of those underwent reoperation. The 5-year and 10-year overall survival (OS) was 74.6% and 58%, respectively. The majority of the patients with MTC presented at stage IVa, contributing to the high rate of persistent hypercalcitoninemia. Despite a policy of observation and intervening only in overtly symptomatic patients with persistent hypercalcitoninemia, overall survival (OS) in our study was comparable to other series, reinforcing the belief that persistent hypercalcitoninemia has an indolent course in most patients.

  9. Mechanism of cell death in acute-on-chronic liver failure: a clinico-pathologic-biomarker study.

    PubMed

    Adebayo, Danielle; Morabito, Vincenzo; Andreola, Fausto; Pieri, Giulia; Luong, Tu-Vin; Dhillon, Amar; Mookerjee, Rajeshwar; Jalan, Rajiv

    2015-12-01

    Mortality of patients who develop acute-on-chronic liver failure (ACLF) is unacceptably high but the predominant mode of cell death is unknown. The aim of this study was to evaluate whether plasma levels of caspase-cleaved cytokeratin M30 (marker of apoptosis) and uncleaved cytokeratin M65 (marker of total cell death) are altered in ACLF patients and relate this to liver histology. Twenty-seven patients with acute decompensation of liver disease were divided into two groups: no-ACLF (n = 11) or ACLF (n-16). Healthy controls (n = 8) and acute liver failure (ALF) patients (n = 10) were also enrolled. Cell death was assessed in plasma using an ELISA kit (M30 and M65). Simultaneous biopsy samples were analysed for M30 and caspase-3 staining. Plasma M30 value was significantly elevated in ACLF patients compared with healthy volunteers (P = 0.0001), it was also significantly higher in ACLF patients compared with no-ACLF patients (P = 0.002). M65 levels were higher in ALF compared with ACLF patients (P = 0.002) but the apoptotic index defined by M30/M65 ratio was significantly higher in ACLF patients. Patients with extra-hepatic failure had higher M30 levels compared with patients without organ failure (P = 0.03). M30 staining in liver was more marked in the patients with ACLF and was observed in all the patients that died. The results of this study suggest that hepatocyte apoptosis is the predominant mode of cell death in ACLF, which can be identified in the peripheral blood. Further studies are required to validate our findings and to determine whether M30 can be used as a biomarker of apoptosis or as a target for therapy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Effects of cypermethrin on some clinico-hemato-biochemical and pathological parameters in male dwarf goats (Capra hircus).

    PubMed

    Khan, Ahrar; Faridi, Hafiz A M; Ali, Muhammad; Khan, Muhammad Zargham; Siddique, Muhammad; Hussain, Iftikhar; Ahmad, Maqbool

    2009-03-01

    This study was carried out on 30 dwarf bucks to determine the effects of cypermethrin (CY) on clinical, hemato-biochemical and histopathological parameters. Animals were divided randomly into five equal groups, and each group was dipped in 0%, 0.1%, 0.4%, 0.8% or 1.6% CY, on days 0 and 15. Animals were monitored for clinical signs. Blood and serum samples were collected on day 0 and then fortnightly till day 75. Severe clinical signs comprising itching, restlessness, salivation, skin scratching and head shaking appeared at high doses (0.8% and 1.6% CY). Erythrocyte counts, hemoglobin, hematocrit, total protein, globulin and fibrinogen decreased significantly while total leukocyte counts, alanine aminotransferase and aspartate aminotransferase concentration increased significantly in all the treated groups. In the liver, necrosis of hepatocytes along with cytoplasmic vacuolation and fibroblasts proliferation were observed at a high dose of CY (1.6%). Microscopically kidneys showed congestion of parenchyma and condensation of epithelial cells of tubules along with deposition of casts in tubules. Shrinkage of glomerular capillaries and increased urinary spaces were pronounced in the high-dose group. Lungs exhibited accumulation of fibrinous exudation, thickening of alveolar walls, collapse and broken alveoli in animals treated with a high dose of CY. It was concluded that CY caused dose-dependent effects on all parameters studied. High doses of CY (0.8% and 1.6% solution) affected the parameters on erythrocytes and leukocytes for whole evaluation period, while effects on plasma proteins were transient and on ALT, AST and fibrinogen were transient but lasted a few weeks longer.

  11. Germline or somatic GPR101 duplication leads to X-linked acrogigantism: a clinico-pathological and genetic study.

    PubMed

    Iacovazzo, Donato; Caswell, Richard; Bunce, Benjamin; Jose, Sian; Yuan, Bo; Hernández-Ramírez, Laura C; Kapur, Sonal; Caimari, Francisca; Evanson, Jane; Ferraù, Francesco; Dang, Mary N; Gabrovska, Plamena; Larkin, Sarah J; Ansorge, Olaf; Rodd, Celia; Vance, Mary L; Ramírez-Renteria, Claudia; Mercado, Moisés; Goldstone, Anthony P; Buchfelder, Michael; Burren, Christine P; Gurlek, Alper; Dutta, Pinaki; Choong, Catherine S; Cheetham, Timothy; Trivellin, Giampaolo; Stratakis, Constantine A; Lopes, Maria-Beatriz; Grossman, Ashley B; Trouillas, Jacqueline; Lupski, James R; Ellard, Sian; Sampson, Julian R; Roncaroli, Federico; Korbonits, Márta

    2016-06-01

    Non-syndromic pituitary gigantism can result from AIP mutations or the recently identified Xq26.3 microduplication causing X-linked acrogigantism (XLAG). Within Xq26.3, GPR101 is believed to be the causative gene, and the c.924G > C (p.E308D) variant in this orphan G protein-coupled receptor has been suggested to play a role in the pathogenesis of acromegaly.We studied 153 patients (58 females and 95 males) with pituitary gigantism. AIP mutation-negative cases were screened for GPR101 duplication through copy number variation droplet digital PCR and high-density aCGH. The genetic, clinical and histopathological features of XLAG patients were studied in detail. 395 peripheral blood and 193 pituitary tumor DNA samples from acromegaly patients were tested for GPR101 variants.We identified 12 patients (10 females and 2 males; 7.8 %) with XLAG. In one subject, the duplicated region only contained GPR101, but not the other three genes in found to be duplicated in the previously reported patients, defining a new smallest region of overlap of duplications. While females presented with germline mutations, the two male patients harbored the mutation in a mosaic state. Nine patients had pituitary adenomas, while three had hyperplasia. The comparison of the features of XLAG, AIP-positive and GPR101&AIP-negative patients revealed significant differences in sex distribution, age at onset, height, prolactin co-secretion and histological features. The pathological features of XLAG-related adenomas were remarkably similar. These tumors had a sinusoidal and lobular architecture. Sparsely and densely granulated somatotrophs were admixed with lactotrophs; follicle-like structures and calcifications were commonly observed. Patients with sporadic of familial acromegaly did not have an increased prevalence of the c.924G > C (p.E308D) GPR101 variant compared to public databases.In conclusion, XLAG can result from germline or somatic duplication of GPR101. Duplication of GPR101 alone is sufficient for the development of XLAG, implicating it as the causative gene within the Xq26.3 region. The pathological features of XLAG-associated pituitary adenomas are typical and, together with the clinical phenotype, should prompt genetic testing.

  12. Entérite nécrotique chez le poulet de gril I. Aspect clinico-pathologique

    PubMed Central

    Bernier, G.; Phaneuf, J.-B.; Filion, R.

    1974-01-01

    This study represents an analysis of the principal clinical factors and pathological lesions of 150 cases of necrotic enteritis encountered during 1968 and 1969 in Quebec. Following multiple investigations no common factor was observed which might have explained the pathogenesis of the condition which was observed during every month of the year, especially from May to November. Birds two to four weeks of age were the most susceptible. The main lesion was a fibrino-necrotic enteritis always localized in the small intestine, either in its entire length or just a segment and characterized by the disappearance of the surface epithelium and necrosis of the villi. The lumen was filled with desquamated epithelial cells and bacteria. Foci of coagulation necrosis were observed in the liver and foci of nephrosis in the kidneys. A Gram+ bacillus, strictly anaerobic, was always isolated from the viscera. ImagesPhoto 1.Photo 2.Photo 3.Photo 4.Photo 5.Photo 6.Photo 7. PMID:4277240

  13. Erythropoiesis: Paroxysmal Cold Haemoglobinuria: A Clinico-Pathological Study of Patients with a Positive Donath-Landsteiner Test.

    PubMed

    Sokol, R. J.; Booker, D. J.; Stamps, R.

    1999-01-01

    52 patients (30 male, 22 female) with paroxysmal cold haemoglobinuria (PCH) were identified by critically examining the records of all cases with Donath-Landsteiner antibodies seen over a 37 year period. Although ages ranged from 1-82 years, PCH was much commoner in young children; the median age at presentation was 5 and the peak incidence, 0.4 per year per 100,000 of the population at risk, was in the 4 years and under group. 44 patients had acute transient PCH, 3 chronic non-syphilitic PCH and 1 chronic syphilitic PCH; 4, in whom the positive Donath-Landsteiner tests were incidental findings, could not be classified. Acute PCH typically presented in young children as sudden onset of malaise, haemoglobinuria and pallor, often associated with mild jaundice - all 30 patients who were 13 or younger had this type. There was usually a history of a recent viral type infection, most commonly of the upper respiratory tract. The occurrence of acute PCH had no obvious relation to exposure to cold. Dramatic and rapid falls in haemoglobin level were common, often accompanied initially by relative or absolute reticulocytopenia. The illness was severe, but the prognosis was generally good and the majority of patients had completely recovered within one month, some requiring no treatment. In approximately 68% of patients, blood transfusion was needed; the P blood group was not taken into account, but the patients were kept warm throughout. Steroids (usually prednisolone) were given in many cases; but since there was no evidence to support their benefit, it was recommended that they were stopped as soon as the diagnosis was confirmed. Chronic non-syphilitic PCH was much rarer; the patients had a characteristic presentation of severe systemic symptoms (paroxysms) and haemoglobinuria brought on by exposure to cold. The clinical manifestations varied in intensity between individuals; at the extreme, severe debility was experienced over many years. Warmth and avoidance of cold were an effective treatment, though in a severely afflicted patient, an attack could be precipitated by relatively little exposure to cold. With chronic syphilitic PCH there was the added need to treat the specific infection. The direct antiglobulin test was almost always positive (50 out of 51 cases tested), with C3d coating the red cells. The Donath-Landsteiner antibodies were of IgG class, but this was rarely demonstrated unless direct antiglobulin tests were carried out at 4 degrees C. The antibodies showed the classical anti-P specificity in 27 of the 30 patients tested; other specificities were unusual. Although acting much better as haemolysins, Donath-Landsteiner antibodies could also cause weak agglutination at room temperature. This was paralleled in vivo by predominantly intravascular haemolysis with an extravascular component. Diagnosis was usually easy when PCH was suspected, though in some patients Donath-Landsteiner tests did not become positive until more sensitive techniques involving papainised red cells or two-stage procedures were employed. Of particular interest was the association in some cases with lymphoproliferative disorders, collagen disease, myelodysplastic syndrome, delayed haemolytic transfusion reaction and other types of autoimmune haemolytic anaemia. In one patient, an aetiological relationship was confirmed by a saline extract of lymphoma tissue behaving as a strong Donath-Landsteiner antibody with the same anti-P specificity as the serum. 4 patients had other types of autoimmune haemolysis concomitant with, but distinct from, the PCH; in 3 cases this was cold haemagglutinin disease and in one it was warm type autoimmune haemolytic anaemia.

  14. Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India

    PubMed Central

    Kumar Sahu, Srikant; Das, Sujata; Sharma, Savitri; Sahu, Kalyani

    2012-01-01

    Medical and microbiology records of seventeen patients (17 eyes), diagnosed as scleritis of infectious origin were reviewed; to study clinical features, predisposing risk factors, microbiologic profile and treatment outcome of infectious scleritis. The mean patient age was 52.3 ± 19.75 years. Twelve patients (70.6%) had history of trauma/prior surgery. Isolated organisms included Staphylococcus species (spp) (n = 5), Fungus (n = 4), Nocardia spp (n = 3), two each of atypical Mycobacterium spp and Streptococcus pneumoniae and one Pseudomonas aeruginosa. Treatment included intensive topical antimicrobial in all eyes and systemic medication in 15 (88.2%) patients; surgical exploration was needed for 13 (76.5%) patients and scleral patch graft was done in four (23.5%) patients. Lesions resolved in all patients and none required evisceration. The presenting log MAR visual acuity of 1.77 ± 1.40 and improved to 0.99 ± 0.91. (P ≤ 0.039) after treatment with a mean follow up of 22.57 ± 19.53 weeks. A microbiological confirmation, appropriate medical and/or surgical intervention has a good tectonic and visual outcome. PMID:22164345

  15. Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association.

    PubMed

    Sarkozy, Clémentine; Molina, Thierry; Ghesquières, Hervé; Michallet, Anne-Sophie; Dupuis, Jehan; Damotte, Diane; Morsschauser, Franck; Parrens, Marie; Martin, Laurent; Dartigues, Peggy; Stamatoullas, Aspasia; Hirsch, Pierre; Fabiani, Bettina; Bouabdallah, Krimo; da Silva, Maria Gomes; Maerevoet, Marie; Laurent, Camille; Coiffier, Bertrand; Salles, Gilles; Traverse-Glehen, Alexandra

    2017-01-01

    Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B-cell lymphoma immunophenotype, primary mediastinal B-cell lymphoma-like morphology (30.3%) with classical Hodgkin lymphoma or composite (5.1%) (synchronous occurrence of classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma). The median age was 32 years (13-83 years); 55% were women. Thirteen of 81 evaluable cases (16%) were Epstein-Barr virus-positive. Twenty-eight percent of patients presented primary refractory disease (progression under first-line treatment or relapse within one year). The 3-year event-free and overall survival rates were 63% and 80%, respectively. Patients treated with a standard regimen (RCHOP/ABVD) had worse event-free survival (P=0.003) and overall survival (P=0.02) than those treated with a dose-intensive chemotherapy (high-dose RCHOP/escalated BEACOPP). Rituximab added to chemotherapy was not associated with better event-free survival (P=0.55) or overall survival (P=0.88). Radiotherapy for patients in complete remission had no impact on event-free survival. In multivariate prognostic analysis, ECOG-PS and anemia were the strongest factors associated with a shorter event-free survival and overall survival, respectively. In conclusion, this report describes the largest series of mediastinal gray zone lymphoma. Our data suggest that a dose-intensive treatment might improve the outcome of this rare and aggressive disease.

  16. Primary and Secondary T-cell Lymphomas of the Breast: Clinico-pathologic Features of 11 Cases

    PubMed Central

    Gualco, Gabriela; Chioato, Lucimara; Harrington, William J.; Weiss, Lawrence M.; Bacchi, Carlos E.

    2009-01-01

    Breast involvement by non-Hodgkin lymphomas is rare, and exceptional for T-cell lymphomas; we studied the morphologic, immunophenotypic, and clinical features of 11 patients with T-cell non-Hodgkin lymphomas involving the breast. Four cases fulfilled the definition criteria for primary breast lymphomas, 3 females and 1 male, with a median age of 51 years. One primary breast lymphomas was T-cell lymphoma unspecified, other was subcutaneous panniculitis-like T-cell lymphoma, and 2 cases were anaplastic large cell lymphomas. One of the anaplastic large cell lymphoma cases was found surrounding a silicone breast implant and presented as clinically as mastitis; whereas the other case occurred in a man. T-cell lymphoma secondarily involved the breast in 7 patients, all women and 1 bilateral, with a median age of 29 years. These secondary breast lymphomas occurred as part of widespread nodal or leukemic disease. Three patients had adult T-cell leukemia/lymphoma, including the patient with bilateral lesions, 3 others had precursor T-lymphoblastic lymphoma/leukemia, and the other presented with a peripheral-T-cell lymphoma nonotherwise specified type. Breast T-cell lymphomas are very infrequent and are morphologically and clinically heterogeneous. PMID:19318917

  17. The prevalence of parastomal hernia after formation of an end colostomy. A new clinico-radiological classification.

    PubMed

    Moreno-Matias, J; Serra-Aracil, X; Darnell-Martin, A; Bombardo-Junca, J; Mora-Lopez, L; Alcantara-Moral, M; Rebasa, P; Ayguavives-Garnica, I; Navarro-Soto, S

    2009-02-01

    Parastomal hernia (PH) is a common complication of end colostomy, found in over 50% of patients. Abdominal computerized tomography (CT) may help diagnosis. The prevalence of PH may be higher than previously reported. We present a new CT classification for use in clinical practice. A cross-sectional, descriptive observational study was carried out, assessing the clinical and radiological prevalence of PH in 75 patients with an end colostomy operated on since 1997. Clinical examinations were performed by a single surgeon. Abdominal CTs were assessed by a single radiologist. PH was observed clinically in 33 (44%) of 75 patients and 27 (82%) were symptomatic. Using the classification 0 (Normal), I (Hernial sac containing stoma loop), II (Sac containing omentum), III (Sac containing a loop other than stoma), radiological PH was observed in 35 (47%) patients. Clinical/radiological concordance (Kappa index = 0.4) increased proportionally with sac size. All type-III PHs (n = 9) were symptomatic. The combined prevalence of PH detected by one or other method was 60.8%. Clinical and radiological prevalence of PH is high. As there is no gold standard for PH detection, we recommend a combination of the two methods. A new classification for use in clinical practice is proposed.

  18. First case report of anaphylaxis caused by Rajgira seed flour (Amaranthus paniculatus) from India: a clinico-immunologic evaluation.

    PubMed

    Kasera, Ramkrashan; Niphadkar, P V; Saran, Aditya; Mathur, Chandni; Singh, A B

    2013-03-01

    The prevalence of food allergy is reported to be 3-4% in adults and about 6% in children. However food allergy across different countries accounts for 35-50 % all cases of anaphylaxis to foods. In the present study, we have reported a case of anaphylaxis to Amaranth grain (Amaranthus paniculatus) commonly known as Rajgira (Ramdana) in India. A 60 year old female suffered anaphylaxis after consuming Rajgira seed flour generally consumed during fasting. Food allergy to Amaranth seeds is not reported so far. The patient reported to hospital with complaints of itching in mouth, choking throat, redness and swelling of face and burning abdomen within 5 min of consuming Rajgira flour. Clinical and immunological investigations revealed SPT and oral challenge positivity beside high allergen specific IgE in the serum of the patient. Three IgE binding protein fractions were detected in roasted Rajgira seed flour extract which could be considered to be allergenically important for triggering anaphylaxis.

  19. Renal clear cell carcinoma metastasis to salivary glands - a series of 9 cases: clinico-pathological study.

    PubMed

    Majewska, H; Skálová, A; Radecka, K; Stodulski, D; Hyrcza, M; Stankiewicz, C; Biernat, W

    2016-03-01

    Metastatic tumors involving salivary glands arising from the non-head and neck area are very rare. Renal cell carcinoma (RCC) is known for its high propensity for metastasis to unusual localizations. RCC metastasis to the maxillofacial area is an uncommon event (16%), but metastasis to salivary glands is extremely rare. We report a series of 9 such cases retrieved from two institutions. The group included 6 females and 3 males. The age at diagnosis ranged from 60 to 97 years (mean 72.6 years). The tumors involved the parotid gland in 7 cases, and the submandibular and small salivary gland of the oral cavity in 1 case each. The size of tumors ranged from 0.4 to 5 cm. Total parotidectomy with selective neck dissection was performed in 4 cases, while superficial parotidectomy was performed in 1 case and simple resection in 3 cases. Histologically, all the tumors were clear cell renal cell carcinomas, and therefore the differential diagnosis mainly included clear cell variants of salivary gland carcinomas. The parotid gland was the initial manifestation of renal malignancy in 4 of the cases, while in the remaining 5 cases a history of RCC had been known. The salivary gland involvement developed from 11 months to 13 years after the time of diagnosis of the primary tumor. In 2 cases it was the first site of dissemination. Pathologists need to maintain a high index of suspicion for the possibility of metastasis when confronted with oncocytic or clear cell neoplasms developing in salivary glands. RCC, although rare, should be included in this differential diagnosis.

  20. Multidrug-resistant Fusarium in keratitis: a clinico-mycological study of keratitis infections in Chennai, India.

    PubMed

    Tupaki-Sreepurna, Ananya; Al-Hatmi, Abdullah M S; Kindo, Anupma J; Sundaram, Murugan; de Hoog, G Sybren

    2017-04-01

    In this study, we aimed to present the first molecular epidemiological data from Chennai, India, analyse keratitis cases that have been monitored in a university hospital during 2 years, identify the responsible Fusarium species and determine antifungal susceptibilities. A total of 10 cases of keratitis were included in the study. Fusarium isolates were identified using the second largest subunit of the RNA polymerase gene (RPB2) and the translation elongation factor 1 alpha (TEF1). Antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. The aetiological agents belonged to Fusarium solani species complex (FSSC) (n = 9) and Fusarium sambucinum species complex (FSAMSC) (n = 1), and the identified species were Fusarium keratoplasticum (n = 7), Fusarium falciforme (n = 2) and Fusarium sporotrichioides (n = 1). All strains showed multidrug resistance to azoles and caspofungin but exhibited lower minimum inhibitory concentration (MIC) to natamycin and amphotericin B. Fusarium keratoplasticum and Fusarium falciforme belonging to the Fusarium solani species complex were the major aetiological agents of Fusarium keratitis in this study. Early presentation and 5% topical natamycin was associated with better patient outcome. Preventative measures and monitoring of local epidemiological data play an important role in clinical practice.

  1. Clinico-radiological Approach to a Rare Case of Early Clavicle Tuberculosis: A Case Discussion Based Review of Differential Diagnosis.

    PubMed

    Akhtar, Mohammad Nasim; Agarwal, Sharat; Athar, Rizwan

    2015-06-01

    A patient of 41 years of age presented with insidious onset atraumatic swelling arising from medial end of right clavicle with apparently normal radiograph. Initial computed tomography ascribed it to benign bony pathology requiring no specific treatment but patient did not respond to symptomatic management. FNAC done elsewhere was inconclusive, with no bacteria on Gram's staining and negative bacterial culture and AFB smear examinations. Patient had possible exposure to tuberculosis and Mantoux skin test done which showed significant induration. Possible differential diagnoses related to clavicle including infective, neoplastic, rheumatological, degenerative and idiopathic conditions considered. Magnetic resonance imaging (MRI) showed focal periosteal reaction with marrow signal changes with sparing of sternoclavicular joint. Correlation between patient's history, clinical findings and investigations done and diagnosis of isolated clavicle tuberculosis was made. Patient showed good response to anti-tubercular chemotherapy. Repeat MRI showed resolution of initial imaging findings. At the end of 2 years patient was completely symptom free.

  2. Clinico-histopathologic and outcome features of cutaneous infundibular keratinizing acanthoma: a case report and literature review.

    PubMed

    Tavasoly, Abbas; Gholami, Hossein; Rostami, Amir; Anissian, Ali; Touni, Seyed Rashid; Khaleghian, Pooyan; Mokarizadeh, Aram; Javanbakht, Javad; Nasoori, Alireza

    2014-06-03

    The infundibular keratinizing acanthoma (IKA) is a rare epithelial benign keratin-containing neoplasm of hair follicles. The purpose of this study was to evaluate the defining histopathologic architecture of IKA. A typical IKA consisted of a keratin-filled crypt in the dermis and subcutis that opened to the skin surface. Most of this tumor occurred on the back, neck, head, and the shoulders. Microscopically, the dermal nodules were focally contiguous in both the dermis and subcutis. Furthermore, most histological lesions are consistent with a simple or multiloculated cyst filled with keratin and lined by a wall of stratified squamous epithelium; keratin appears as a concentric lamellar mass, with a keratotic pearly aspect. Histological examination of the cutaneous lesions revealed that the growths were comprised of IKA. IKA of man and dog were compared, and it was concluded that although they are similar in many respects, they are not identical entities. To the best of our knowledge, this is the first report on the prevalence of IKAs among the population of owned dogs in Iran.

  3. A multilocular radiolucency of mandible as the first evidence of multiple myeloma: A clinico-radiographic case report.

    PubMed

    Mohan, Ravi Prakash Sasankoti; Gill, Navneet; Verma, Sankalp; Chawa, Venkateshwar Rao; Tyagi, Kuber; Agarwal, Neha

    2014-03-01

    The incidence of multiple myeloma (MM) affecting the jaws is 30% and on rare occasions the oral involvement can be the first indication of the disease. Authors report a case of MM in a 40-year-old woman who presented with a multilocular radiolucent lesion in the left mandible initially mistaken as an ameloblastoma. Conventional radiographs revealed a multilocular lesion on the molar region. Computed tomography (CT) and 3 dimensional CT revealed lytic, space occupying lesion perforating the inferior cortex. Magnetic resonance imaging (MRI) revealed a hypointense lesion on T1 weighted image and hyperintense lesion on T2 weighted image. Histopathological and lab investigations lead to the diagnosis of MM. MRI is superior in depicting the size of the lesion as compared to CT and conventional radiographs.

  4. Clinico-microbiological study of Pseudomonas aeruginosa in wound infections and the detection of metallo-β-lactamase production.

    PubMed

    Bangera, Divya; Shenoy, Suchitra M; Saldanha, Dominic Rm

    2016-12-01

    Pseudomonas aeruginosa is a common opportunistic pathogen of humans among the Gram-negative bacilli. Clinically, it is associated with nosocomial infections like burns and surgical-site wound infections and remains a major health concern, especially among critically ill and immunocompromised patients. This is a prospective laboratory-based 2 year study conducted to isolate P. aeruginosa from wound specimens and the antimicrobial susceptibility pattern with reference to metallo-β-lactamase (MBL) production. Two hundred and twenty-four samples of P. aeruginosa isolated from wound specimens were included in the study. Antimicrobial susceptibility was done as per Clinical Laboratory Standard Institute (CLSI) guidelines. MBL-producing P. aeruginosa was detected using the EDTA disk diffusion synergy test. Statistical analysis was done using the SPSS 11 package (SPSS Inc., Chicago, IL). Out of the 224 P. aeruginosa isolates, 100% were susceptible to polymyxin B and colistin, 92·8% were sensitive to imipenem, 38% showed resistance to gentamicin followed by ceftazidime (31·69%) and meropenem (33·03). Sixteen (7·14%) isolates showed MBL production. Infection caused by drug-resistant P. aeruginosa is important to identify as it poses a therapeutic problem and is also a serious concern for infection control management. The acquired resistance genes can be horizontally transferred to other pathogens or commensals if aseptic procedures are not followed. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  5. Clinico-Pathologic Features of Fatal Disease Attributed to New Variants of Endotheliotropic Herpesviruses in Two Asian Elephants (Elephas maximus)

    PubMed Central

    Garner, M. M.; Helmick, K.; Ochsenreiter, J.; Richman, L. K.; Latimer, E.; Wise, A. G.; Maes, R. K.; Kiupel, M.; Nordhausen, R. W.; Zong, J. C.; Hayward, G. S.

    2013-01-01

    The first herpesviruses described in association with serious elephant disease were referred to as endotheliotropic herpesviruses (EEHV) because of their ability to infect capillary endothelial cells and cause potentially fatal disease. Two related viruses, EEHV1 and EEHV2, have been described based on genetic composition. This report describes the similarities and differences in clinicopathologic features of 2 cases of fatal endotheliotropic herpesvirus infections in Asian elephants caused by a previously unrecognized virus within the betaherpesvirus subfamily that is markedly divergent from the 2 previously studied fatal probosciviruses, based on polymerase chain reaction sequence analysis of 2 segments of the viral genome. In addition to ascites, widespread visceral edema, petechiae, and capillary damage previously reported, important additional findings with EEHV3 infection were the presence of grossly visible renal medullary hemorrhage, a tropism for larger veins and arteries in various tissues, relatively high density of renal herpetic inclusions, and involvement of the retinal vessels. These findings indicate a less selective organ tropism, and this may confer a higher degree of virulence for EEHV3. PMID:19112123

  6. Smokeless Tobacco and Stroke - A Clinico-epidemiological Follow-up Study in A Tertiary Care Hospital

    PubMed Central

    Kabi, Shobhitendu; Panda, Baikuntha Nath; Kameswari, B.C.; Payal; Behera, Ishwar Chandra; Tripathy, Subrat Kumar; Mahanta, Seemanchana

    2016-01-01

    Introduction Among the modifiable risk factors for stroke, tobacco smoking is well recognized. In some studies the use of Smokeless Tobacco (ST) has also been contributed as a risk factor for ischemic stroke. Use of ST is very common in South-East Asia. The form of ST varies according to the geographical and cultural variation. Aim To study the various clinical symptoms and radiological findings of stroke due to different types of ST. Materials and Methods This was a prospective hospital based study carried out over a period of 2 years. All the cases within age group of 16 – 60 years and with a clinical and radiological diagnosis of acute stroke were included in the study. The Fagerström Test for Nicotine Dependence for ST of more than 6 was taken as the inclusion criteria. Patients having other addictions like smoked tobacco, alcohol, etc., and with important risk factors like hypertension, diabetes, dyslipidemia were excluded. The cases were extensively investigated and followed up for at least 6 months. Analysis was done using the Statistical Package for Social Sciences (SPSS- version 16.0). Descriptive statistics like percentage, mean were used wherever appropriate. Results During a period of 2 years, a total of 54 patients were studied. Forty two (77.7%) were males and 12(22.3%) were females. The mean age at presentation was 42.72(± 8.6) years and among all 96.3% patients were diagnosed as ischemic stroke. Among ST, pan was most commonly used in 21(38.9%) patients with an average of 14.6(±3.27) years of addiction. Hemiplegia was the predominant symptom on presentation (46, 85.2%). According to Oxfordshire Stroke Classification, partial anterior circulation infarct was most common in 20(38.4%). The mean Modified Rankin scale after 5 days of hospital stay was 3.83(±1.03) and after 6 months of follow-up was 2.1(±0.8). Patients were counseled for deaddiction and after 6 months follow-up 48(88.8%) patients had quit ST. Conclusion ST is an important etiological factor for young ischemic stroke. This is the first study depicting clinical symptomatology of ST addicted ischemic stroke patients from India. Considering the increasing prevalence of ST use in south-east Asia, further long term studies are needed from this region. PMID:27891376

  7. Clinico-radiological assessment and their correlation in clubfeet treated with postero-medial soft-tissue release.

    PubMed

    Prasad, Prabhudev; Sen, Ramesh K; Gill, Shivender S; Wardak, Emal; Saini, Raghav

    2009-02-01

    The controversy regarding the radiographic parameter which best represents the various deformities of clubfoot continues. The aim of our study was to clear up this controversy. Fifty surgically treated (soft-tissue release) congenital clubfeet were studied clinically using Laaveg and Ponseti score and radiologically using twelve different radiographic parameters in weight-bearing AP and lateral views. The talo-calcaneal angle (TCA) in AP and lateral view showed statistically significant correlation with the functional rating, but significant variation in the dimension of the angles among the different functional groups was found with AP angle only. The talo-first metatarsal angle in AP and lateral view averaged 10 degrees and 19 degrees respectively, and showed significant correlation with the functional rating. The talo-navicular subluxation in AP, the calcaneo-fifth metatarsal angle and the first-fifth metatarsal angle in lateral view did not show any significant correlation with function. Talo-calcaneal index averaged 44 degrees in the clubfeet and showed significant correlation. The wide range of parameters representing each of the deformities gives a better radiological assessment of the clubfoot than any single parameter.

  8. Persistent neuroleptic-induced rigidity and dystonia in AIDS dementia complex: a clinico-pathological case report.

    PubMed

    Factor, S A; Podskalny, G D; Barron, K D

    1994-12-01

    Patients with AIDS dementia complex (ADC) appear to have an increased likelihood of developing acute onset parkinsonism and dystonia when treated with dopamine antagonists. It has been hypothesized, based on clinical evidence, that hypersensitivity to these drugs in ADC is probably related to direct invasion of the basal ganglia by the HIV virus and a secondary alteration in dopaminergic mechanisms. We report the first pathological description of a patient with ADC who developed acute onset, generalized rigidity and dystonia after a brief trial of low dose neuroleptic therapy administered for psychotic symptoms. An unusual clinical feature of this case was the persistence of his movement disorder. Pathological examination revealed a generalized encephalitic process with substantial neuronal loss observed primarily in the medial and lateral globus pallidus. Correlation with a current model of basal ganglia pathophysiology and other disorders with pallidal lesions is discussed. Clinical and pathological features of this case confirm the previous contention and indicate that dopamine antagonists should be utilized with extreme caution in patients with ADC.

  9. Clinico-toxinological characterization of the acute effects of the venom of the marine snail, Conus loroisii.

    PubMed

    Saminathan, R; Babuji, S; Sethupathy, S; Viswanathan, P; Balasubramanian, T; Gopalakrishanakone, P

    2006-01-01

    The venom of the marine snail, Conus loroisii, was studied to assess its risk and lethal factors in regard of human welfare. The lethality of the crude venom (LD50-5.0 mg/kg via i.p.) in mice was associated with reduced motor activity, asphyxiation, followed by respiratory failure. The effects on vital tissues revealed vascular congestion and inflammatory cell infiltration around the portal triad of the liver, spongiosis of the brain, hemorrhages/congested blood vessels in lung and endothelial cells of the renal tubule. Repeated measures of hematological profiles indicated that the venom significantly reduced erythrocytes (P<0.001, GLM repeated measures), followed associated with depletion of hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and platelet count. Serum enzymes such as, glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, lactate dehydrogenase and alkaline and acid phosphatases were altered significantly (P<0.05, Friedman test), which in turn confirmed the damage of vital organ tissues. Dual effect of the venom on the activity of mouse brain acetylcholinesterase stand for concentration specific, whereas maximal inhibition (60.41%, P<0.05, Wilcoxon signed rank test) in erythrocyte acetylcholinesterase did not show the dual activity observed in brain. The Ciphergen ProteinChip analysis of the envenomed serum further revealed that the venom causes changes in definite molecules involved in inflammatory process and ionic transport. In all, the venom of C. loroisii is potentially lethal to mammals, through its rapid action on the central and peripheral nervous systems by blocking neurotransmission with selective interference of ionic channels/receptors.

  10. [Clinico-immunological study of the effectiveness of vaccination against tick-borne encephalitis in the Maritime Territory].

    PubMed

    Leonova, G N; Krugliak, S P; Stepanova, N M; Gorelikov, V N

    1987-01-01

    Analysis of the severity of the clinical course of tick-borne encephalitis (TBE) in the Maritime Territory, 1966-1983, showed a decline in the incidence of the disease by 20% in the group of subjects vaccinated against TBE, whereas the severity of the disease showed no statistically significant difference from that among nonvaccinated subjects. The causes of the poor protective effect of the liquid tissue culture vaccine produced by the Research Institute of Vaccines and Sera, Ministry of Health of the USSR, Tomsk, were demonstrated alongside with the advantages of the lyophilized concentrated vaccine manufactured by the Institute for Poliomyelitis and Viral Encephalitides of the USSR Academy of Medical Sciences, which should be used for prophylactic vaccinations of subjects working in forests who comprised 29% of the vaccines. In this way, TBE incidence in the region could be reduced considerably.

  11. Clinico-biochemical factors to early predict biliary etiology of acute pancreatitis: age, female gender, and ALT

    PubMed Central

    Zarnescu, NO; Costea, R; Zarnescu (Vasiliu), EC; Neagu, S

    2015-01-01

    Background/ Aims: Despite the existence of an easy tool to diagnose biliary tract disease as an etiology for acute pancreatitis (AP), the sensitivity of abdominal ultrasound is around 80%, which can be even lower in certain conditions. Methodology: We have retrospectively reviewed data of 146 patients admitted for acute pancreatitis between 1999 and 2013. Bivariate analysis for clinical and biochemical variables was performed with respect to etiology of AP (biliary versus non-biliary). Multivariate analysis was performed by using binary logistic regression. Results: There were 87 males (59.6%) and 59 females (40.4%), with a median age of 51. The etiology of acute pancreatitis was biliary in 71 patients (48.6%). Bivariate analysis found the following as significant association (p=0.001) with biliary pancreatitis: older age, female gender, and elevated AST, ALT. A binary logistic regression analysis identified as predictor factors for biliary etiology of acute pancreatitis: age OR = 1.031 (95% CI 1.004 - 1.059, p = 0.024), sex (female) OR = 2.34 (95% CI 1.022 - 5.359, p = 0.044) and ALT OR = 1.004 (95% CI 1.001 - 1.007, p =0.004). The two clinical scores included the three variables (A.S.ALT scores) in categorical format were generated and then checked with the ROC curves (areas under curve are 0.768 and 0.778). Conclusions: Age, female gender, and elevated ALT can help identifying cases with biliary etiology of acute pancreatitis. PMID:26664483

  12. Expression of hormonal receptors in osteosarcomas of the jaw bones: Clinico-pathological analysis of 21 case

    PubMed Central

    Domínguez-Malagón, Hugo R.; González-Conde, Esther; Cano-Valdez, Ana M.; Luna-Ortiz, Kuauhyama

    2014-01-01

    Background: Sexual hormones have an important role in many hormone-dependant tumors like breast and prostate carcinomas, and also a relationship has been found with bone metabolism and bone tumors. Some studies have demonstrated that the expression of hormonal receptors (HR) in osteosarcomas (OS) of long bones is associated with gender, histological grade, histological type, and possibly may be connection with pathogenesis and evolution. However, to our knowledge there are no studies of HR in osteosarcomas of craniofacial bones (OS-CF). Objectives: To assess the expression of hormonal receptors in OS-CF. Material and Methods: Twenty one cases of OS-CF were included in this study. Clinical outcome was obtained from clinical charts. Histological sections were reviewed, and immunohistochemistry studies for estrogen, progesterone and androgen receptors were performed. Results: A striking female predominance was found (2:1), with a median age of 35 years. The predominant type of OS was osteoblastic (52.4%), and histological grade was high in 86%. Follow-up was obtained in 13 cases and ranged from 6 to 118 months (median 29 months). There were 8 patients (61.5%) dead or alive with progressive disease in the last follow up. Negative expression of HR was found in 19/21 cases; one showed weak nuclear expression for estrogen receptor, and another for androgen receptor. Progesterone receptor was negative in all cases. Conclusions: OS-CF mostly affected females, most of them were of the osteoblastic type and of high grade. Hormonal expression was practically negative in osteosarcoma of craniofacial bones. Key words:Osteosarcoma, jaws, estrogen, progesterone, androgen receptors. PMID:24121902

  13. [Malattia di Marchiafava-Bignami con coinvolgimento della corteccia frontale e insorgenza tardiva di sintomi psichiatrici resistenti: un caso clinico].

    PubMed

    Gramaglia, Carla; Feggi, Alessandro; Vecchi, Camilla; Di Marco, Sarah; Venesia, Alessandra; Delicato, Claudia; Chieppa, Nunzia; De Marchi, Fabiola; Cantello, Roberto; Zeppegno, Patrizia

    2016-01-01

    RIASSUNTO. Scopo. Descrivere il management di un paziente con malattia di Marchiafava-Bignami (MBD) associata a lesioni frontali corticali, senza sintomi specifici al primo accesso in Pronto Soccorso, e insorgenza tardiva di sintomi psichiatrici atipici. Metodi. Descriviamo il caso di un paziente di 44 anni con storia di abuso cronico di alcol, a cui è stata diagnosticata la MBD. Risultati. La risonanza magnetica ha evidenziato lesioni nello splenio e corpo del corpo calloso e lesioni bilaterali della corteccia frontale. Il paziente ha sviluppato sintomi psichiatrici atipici a insorgenza tardiva, che sono risultati essere resistenti alle terapie farmacologiche impostate. Discussione. Il caso che descriviamo sembra supportare le attuali, ma ancora scarse evidenze che descrivono il coinvolgimento corticale nella MBD, suggerendone l'associazione con una prognosi peggiore. I sintomi psichiatrici possono risultare difficili da trattare a causa della resistenza alle terapie. Conclusione. Il coinvolgimento di psichiatri, radiologi e neurologi secondo un approccio di consultazione-liaison si è dimostrato di fondamentale importanza per la diagnosi e l'impostazione della terapia adeguata al paziente.

  14. A clinico-pathological and follow up study of 10 cases of essential type II cryoglobulinaemic neuropathy.

    PubMed Central

    Cavaletti, G; Petruccioli, M G; Crespi, V; Pioltelli, P; Marmiroli, P; Tredici, G

    1990-01-01

    Ten patients with essential cryoglobulinaemia type II were examined for peripheral nerve damage. In six cases distal symmetrical nerve involvement was present, while in three other cases abnormalities restricted to single nerves were found. Electrophysiological and morphological data were consistent with axonal damage, the larger myelinated fibres being most affected. Although active signs of vasculitis and immunoperoxidase staining for immunoglobulins were not present, endoneurial vessels were widely damaged, with abnormally thick endothelial cells and redundant basal membranes. These findings, together with a patchy distribution of myelinated fibre loss, suggest ischaemia as a cause of peripheral neuropathy during essential cryoglobulinaemia type II. A follow up examination, performed one year after haematologial remission, revealed that no further peripheral nerve damage had occurred. PMID:2176233

  15. Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases.

    PubMed

    Bilginer, Burcak; Narin, Firat; Hanalioglu, Sahin; Oguz, Kader Karlı; Soylemezoglu, Figen; Akalan, Nejat

    2014-08-01

    Cavernous malformations (CMs) of the central nervous system (CNS) are angiographically occult vascular lesions that affect approximately 0.5 % of the general population, and one quarter of all CMs occurs in children. We retrospectively analyzed demographic, clinical, radiological, management, and follow-up data of 36 pediatric patients with CMs from a single institution. The mean age of the children at first presentation and at operation was 8.7 and 9.6 years, respectively. However, a bimodal age distribution was found with peak under 4 years and above 12 years. Seizure was the most common single presenting symptom (38.9 %), and 61.1 % of patients had at least one seizure before the admission. Focal neurological deficits (410.7 %), intracranial hypertension (27.8 %), and headache (2.8 %) were the other manifestations. Acute/subacute hemorrhage was evident at presentation in 63.9 %. The patients under 6 years of age were found to have significantly more giant cavernomas (69 vs 20 %; p = 0.011), and more overt hemorrhages (81 vs 47 %; p = 0.065) at diagnosis than those patients above 12 years. Surgery was performed in 31 patients (32 CMs), with 26 total and 6 incomplete resections. Mean follow-up duration was 6.9 ± 4.1 years. Of all patients, 63.8 % had excellent and 30.5 % had good clinical outcomes, and also 90.9 % of the epileptic patients were seizure-free (Engel Class I) at the last follow-up. Younger children tend to harbor larger CMs and present with hemorrhage more frequently than older ones. Microsurgical resection should be the treatment of choice in symptomatic and accessible CMs.

  16. Comparative study of clinico-bacterio-radiological profile and treatment outcome of smokers and nonsmokers suffering from pulmonary tuberculosis

    PubMed Central

    Rathee, Deepti; Arora, Piyush; Meena, Manoj; Sarin, Rohit; Chakraborty, Pitambar; Jaiswal, Anand; Goyal, Mukesh

    2016-01-01

    Introduction: Tuberculosis (TB) is one of the leading causes of death and disease worldwide. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to affirm the strength of association between smoking and pulmonary TB. Materials and Methods: Pulmonary TB patients aged between 18 and 65 years were enrolled and followed-up until treatment completion. Two consecutive sputum smears were examined from each patient for the presence of acid-fast bacilli (AFB) using Ziehl–Neelsen technique. Radiological severity of disease was assessed using guidelines of National TB Association of USA. Sputum smears for AFB were graded for positivity as per WHO Revised National TB Control Programme criteria. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes. Results: Sputum smear grading of 3+ increased from 12.5% to 68.18% and 66.66% as smoking index increased from <100 to 100–299 and >300 (P < 0.05). In nonsmokers, 79.2% patients had minimal disease while only 4.2% had advanced disease as compared to smokers where 52.4% had moderate disease, 26.2% advanced disease, and 21.4% minimal disease (P < 0.01). Smokers had significantly lower treatment success rate (69%) as against nonsmokers and former smokers (93.8% and 90.9%, respectively, P = 0.001) owing to a higher default rate among smokers (28.5%) than nonsmokers (6.3%) and former smokers (9.1%). Conclusion: Smokers during initial presentation, as well as at end of the treatment demonstrate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also have a poorer treatment success rate largely due to high percentage of default rate thus suggesting noncompliance as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers. PMID:27625444

  17. Infectious vasculopathy of intracranial large- and medium-sized vessels in neurological intensive care unit: a clinico-radiological study.

    PubMed

    Katchanov, J; Siebert, E; Klingebiel, R; Endres, M

    2010-06-01

    Infections are a well-known cause of cerebral vasculopathy and vasculitis. We aimed to analyze the frequency of intracranial vasculopathy attributable to infection, the spectrum of causative microorganisms, imaging, and cerebrospinal fluid (CSF) characteristics as well as clinical course and outcome. We used our institution's medical record system to identify all patients diagnosed with nonatherosclerotic central nervous system vasculopathy from January 1, 1999 through February 28, 2009. We reviewed their clinical charts, imaging data, and results of CSF studies. Twenty-five adult patients with nonatherosclerotic cerebral vasculopathy of large- and medium-sized intracranial vessels were identified. Eight patients had vasculopathy attributable to infection (32%). The underlying pathologies were acute bacterial meningitis (n = 4), varicella zoster virus (VZV) infection (n = 2), borreliosis (n = 1), and syphilis (n = 1). In six patients, magnetic resonance angiography was performed and showed vasculopathic changes in all patients examined (100%). In both patients with VZV-associated vasculopathy, the arterial wall enhanced on magnetic resonance imaging. The CSF examination of the patients with infectious vasculopathy showed a significantly higher white blood cell count. The outcome of the infectious cohort was unfavorable with one death, two patients with locked-in syndrome, and five patients discharged from intensive care with severe neurological deficits. In this cohort, one-third of all cases of nonatherosclerotic vasculopathy were due to infectious vasculopathy of large and medium intracranial vessels.

  18. Clinico-Radiological Correlation of Subcoracoid Impingement with Reduced Coracohumeral Interval and its Relation to Subscapularis Tears in Indian Patients

    PubMed Central

    Rao, Srivatsa Nagaraja; Kumaran, Chandrababu Kadassery; Kochukunju, Bhaskaran Vadakkekottu

    2016-01-01

    Introduction Clinically, subcoracoid impingement is characterized by pain at the anterior aspect of the shoulder that is induced by adduction, internal rotation and forward flexion. This position leads to narrowing of the Coraco-Humeral Interval (CHI)-that is, the space between the coracoid process and the lesser tuberosity of the humerus. Structures in the rotator interval are at greatest risk for impingement which includes the Subscorapularis tendon, tendon of the long head of the biceps, and the middle gleno-humeral ligament. This may result in Rotator interval pathologies such as subscapularis tear and long head of biceps tendon subluxation or fraying. Aim To study the prevalence of radiological evidence of reduced Coraco-Humeral Interval (CHI) in patients with clinically evident Subcoracoid impingement and to examine the presence of Subscapularis tears in these patients. Materials and Methods Twenty four patients (6 males, 18 females, average age 52.83 years) were included in this prospective study who were diagnosed to have rotator cuff tears clinically. Nine of these patients were clinically found to have concomitant subcracoid impingement. All patients were subjected to MRI of shoulder. Measurement of the CHI was done in images with humerus in maximal internal rotation. Presence of subscapularis tear was examined intraoperatively. Statistical evaluation of the data was performed using Student’s t-test and Fisher’s exact test and the results were applied to two cohorts of patients. One cohort consisted of patients who had a CHI value of less than 5.5mm and the other cohort had a CHI value greater than 5.5mm. Average CHI values in patients with and without a subscapularis tear were determined. Results Nine patients who had clinical subcoracoid impingement were found to have an average CHI of 5.33mm. All nine of them had an associated tear of subscapularis with long head of Biceps tendon subluxation and/or fraying. Remaining 15 patients had an average CHI of 10.48 and they did not have either signs of Subcracoid impingement or subscapularis tear but had a tear elsewhere (Supraspinatus or Infraspinatus). Difference between these two groups was found highly significant (p-value<0.001). All patients with a CHI value of equal to, or less than 5.5mm had a subscapularis tear, whereas only 11% of patients with a CHI value more than 5.5mm had a tear (p-value<0.001, highly significant). Conclusion Reduction in the CHI has a significant association with rotator interval pathologies such as subscapularis tears and subluxation or fraying of long head of biceps tendon. Treatment of such patients should include modalities such as coracoplasty or anterior shoulder stabilisation. We recommend that clinical evidence of subcoracoid impingement should lead to further Investigation in the form of MRI and estimation of CHI. A CHI of less than 5.5 mm may indicate subscapulais tear in Indian patients. PMID:27790534

  19. A Clinico-Etiological Study of Dermatoses in Pediatric Age Group in Tertiary Health Care Center in South Gujarat Region

    PubMed Central

    Jawade, Sugat A; Chugh, Vishal S; Gohil, Sneha K; Mistry, Amit S; Umrigar, Dipak D

    2015-01-01

    Background: Dermatologic conditions have different presentation and management in pediatric age group from that in adult; this to be studied separately for statistical and population based analysis. Objective: To study the pattern of various dermatoses in infants and children in tertiary health care center in South Gujarat region. Materials and Methods: This is a prospective study; various dermatoses were studied in pediatric patients up to 14 years of age attending the Dermatology OPD of New Civil Hospital, Surat, Gujarat over a period of 12 months from June 2009 to June 2010. All patients were divided into four different study groups: <1 month (neonates), 1 month to 1 year, >1 to 6 years and 7 to 14 years. Results: There were 596 boys and 425 girls in total 1021 study populations. Majority of the skin conditions in neonates were erythema toxicum neonatorum (12.97%), scabies (9.92%), mongolian spot (9.16%), and seborrheic dermatitis (7.63%). In > 1 month to 14 years age group of children among infectious disorder, children were found to be affected most by scabies (24.49%), impetigo (5.96%), pyoderma (5.62%), molluscum contagiosum (5.39%), tinea capitis (4.49%), leprosy (2.02%), and viral warts (1.35%) while among non-infectious disorders, they were affected by atopic dermatitis (4.27%), pityriasis alba (4.16%), seborrheic dermatitis (3.60%), pityriasis rosea (3.15%), others (3.01%), phrynoderma (2.70%), lichen planus (2.58%), contact dermatitis (1.57%) and ichthyosis (1.45%). Conclusion: There is a need to emphasize on training the management of common pediatric dermatoses to dermatologists, general practitioners and pediatricians for early treatment. PMID:26677296

  20. Evaluation of specifically designed implants placed in the low-density jaw bones: A clinico-radiographical study

    PubMed Central

    Munjal, Sumit; Munjal, Seema; Hazari, Puja; Mahajan, Harsh; Munjal, Akshay; Mehta, D. S.

    2015-01-01

    Aim: In the less dense bone, it is difficult to obtain implant anchorage. The present study was undertaken to determine the survival rate of Maestro™ implants placed in d3 and d4 bones. Materials and Methods: Fourteen patients (10 males and 4 females) were selected for the study and implants were evaluated for posttreatment changes in at 3, 6, 9 and 12 months from implant placement. The implant probing depth and mobility were recorded 3 and 6 months after prosthesis placement. Also, peri-implant bone level was assessed at the baseline and 12 months postoperatively, followed by a statistical analysis. Results: The mean plaque and gingival indices showed a reduction at repeated intervals. The mean sulcular bleeding showed a slight reduction which was statistically significant. An overall mean bone loss was observed after 12 months follow-up, which was statistically not significant. The overall survival rate of implants was reported as 92.3%. Conclusion: The specific implant used in the study is advantageous in the soft bone condition. Clinical Significance: Although, there is a great evidence of implant failure in compromised jaw quality, the newer designs and approaches suggest that the poor quality is not a contraindication. PMID:25684910

  1. Clinico-Epidemiological Profile of Snakebite Cases Admitted in a Tertiary Care Centre in South India: A 5 Years Study

    PubMed Central

    Thapar, Rekha; Darshan, B. B.; Unnikrishnan, Bhaskaran; Mithra, Prasanna; Kumar, Nithin; Kulkarni, Vaman; Holla, Ramesh; Kumar, Avinash; Kanchan, Tanuj

    2015-01-01

    Objectives: This study was conducted to assess the clinic-epidemiological profile of snakebite cases admitted at a Tertiary Care Centre in South India. Materials and Methods: A record based retrospective study was carried out at Kasturbha Medical College affiliated hospitals in Mangalore. All the snakebite cases admitted to the hospitals from January 2007 to December 2011 were included in the study. Data were collected using a pretested semi-structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS version 11.5). The results are expressed as percentages. Results: The study included 198 cases of snakebite victims. The majority of the cases were males (68.2%). The mean age of the study population was 34.8 years. Maximum numbers of snakebite cases were reported during the month of September to December (47.9%). The peak time of snakebite was between 18.01 and 24.00 h which was reported in 40.5% of the cases. Lower extremities were the most common site of bite in more than three-fourth of the cases (80.9%). The most common symptoms were a pain (45.9%) and swelling (44.9%). The case fatality rate was observed to be 3.0%. Conclusion: Snakebite still remains a major public health problem in this part of the world. Knowledge must be imparted regarding the prevention of snakebites through community health programs. Messages regarding prompt reporting of such cases and importance of effective treatment must be disseminated among people through mass media and role plays. PMID:26862263

  2. Neuroendocrine neoplasms of liver - A 5-year retrospective clinico-pathological study applying World Health Organization 2010 classification

    PubMed Central

    Burad, Deepak Kalyansingh; Kodiatte, Thomas Alex; Rajeeb, Sayd Mohamed; Goel, Ashish; Eapen, Chundamannil Eapen; Ramakrishna, Banumathi

    2016-01-01

    AIM To study the clinicopathological characteristics of neuroendocrine neoplasms (NEN) on liver samples and apply World Health Organization (WHO) 2010 grading of gastroenteropancreatic (GEP) NEN. METHODS Clinicopathological features of 79 cases of NEN of the liver diagnosed between January 2011 to December 2015 were analyzed. WHO 2010 classification of GEP NEN was applied and the tumors were graded as G1, G2 or G3. Two more categories, D1/2 (discordant 1/2) and D2/3 (discordant 2/3) were also applied. The D1/2 grade tumors had a mitotic count of G1 and Ki-67 index of G2. The D2/3 tumors had a mitotic count of G2 and Ki-67 index of G3. The follow up details which were available till the end of the study period (December 2015) were collected. RESULTS Of the 79 tumors, 16 each were G1 and G2, and 18 were G3 tumors. Of the remaining 29 tumors, 13 were assigned to D1/2 and 16 were D2/3 grade. Male preponderance was noted in all tumors except for G2 neoplasms, which showed a slight female predilection. The median age at presentation was 47 years (range 10-82 years). The most common presentation was abdominal pain (81%). Pancreas (49%) was the most common site of primary followed by gastrointestinal tract (24.4%) and lungs (18%). Radiologically, 87% of the patients had multiple liver lesions. Histopathologically, necrosis was seen in only D2/3 and G3 tumors. Microvascular invasion was seen in all grades. Metastasis occurred in all grades of primary NEN and the grades of the metastatic tumors and their corresponding primary tumors were similar in 67% of the cases. Of the 79 patients, 36 had at least one follow up visit with a median duration of follow up of 8.5 mo (range: 1-50 mo). This study did not show any impact of the grade of tumor on the short term clinical outcome of these patients. CONCLUSION Liver biopsy is an important tool for clinicopathological characterization and grading of NEN, especially when the primary is not identified. Eighty-seven percent of the patients had multifocal liver lesions irrespective of the WHO grade, indicating a higher stage of disease at presentation. Follow up duration was inadequate to derive any meaningful conclusion on long term outcome in our study patients. PMID:27833387

  3. Evaluation of chemokines in gingival crevicular fluid in children with band and loop space maintainers: A clinico-biochemical study

    PubMed Central

    Kumar, Naveen Kommineni; Reddy, Veera Kishore Kasa; Padakandla, Prathyusha; Togaru, Harshini; Kalagatla, Swathi; Reddy, Vinay Chand M.

    2016-01-01

    Background: Chemokines are pro-inflammatory cells that can be induced during an immune response to recruit cells of the immune system to a site of infection. Aim: This study was conducted to detect the presence of chemokines, macrophage inflammatory protein-1α (MIP-1α), and 1β (MIP-1β) and estimate their levels in gingival crevicular fluid (GCF) in children with band and loop space maintainers. Materials and Methods: MIP-1α and MIP-1β levels were estimated in GCF samples from twenty healthy children and twenty children with band and loop space maintainers. Periodontal status was evaluated by measuring gingival index, plaque index, and Russell's periodontal index. The GCF samples were quantified by ELISA, and the levels of MIP-1α and MIP-1β were determined. Results: The mean MIP-1α concentrations in healthy children and those with space maintainers were 395.75 pg/µl and 857.85 pg/µl, respectively, and MIP-1β was 342.55 pg/µl and 685.25 pg/µl, respectively. MIP-1α and MIP-1β levels in GCF from children with space maintainers were significantly higher than in the healthy group, and statistically significant difference existed between these two groups. Conclusion: MIP-1α and MIP-1β can be considered as novel biomarkers in the biological mechanism underlying the pathogenesis of gingival inflammation in children with space maintainers. PMID:27630491

  4. [Rapid determination of antibiotics resistance in clinico-surgical practice on the basis of radioactive carbon dioxide measurements].

    PubMed

    Alánt, O; Jászsági-Nagy, E; Lendvay, J; Schmidt, M

    1979-01-01

    The radiometric method is founded on the measurement of the 14CO2 which has gone free. This method was worked out of our team. It is a prompt sensitive and quantitative procedure for the control of antibiotic effect on bacteria. The method is a support in critical clinical situations. The prompt establishment of the antibiotic sensitivity can be live-saving. The empirics descended from 312 surgical patients. The antibiotical sensitivity of secretion samples is to be obtained within 4-6 hours. The results show in comparison with the classic bacteriological examinations five per cent less deviation. At the same time the computer analysis enables a finer distinction. 22 variable findings are possible within the categories: sensible, middling sensible and resistant. In that way the tested antibiotics are classified in an order of rank. The apparatus for the examination is producible without particular expenses. The measurements can be carried out at each hospital or clinical laboratory.

  5. HER-2 overexpression/amplification in Barrett’s oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study

    PubMed Central

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Casa, Domenico Della; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-01-01

    Barrett’s oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37–84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation. PMID:19292734

  6. Clinico-epidemiology of stings and envenoming of Hottentotta tamulus (Scorpiones: Buthidae), the Indian red scorpion from Jaffna Peninsula in northern Sri Lanka.

    PubMed

    Kularatne, Senanayake A M; Dinamithra, Nandana P; Sivansuthan, Sivapalan; Weerakoon, Kosala G A D; Thillaimpalam, Bhanu; Kalyanasundram, Vithiya; Ranawana, Kithsiri B

    2015-01-01

    In recent years, stings of a lethal scorpion species were recorded from Jaffna Peninsula in the northern dry zone of Sri Lanka. This species was identified as Hottentotta tamulus (Scorpiones: Buthidae) which is the Indian red scorpion commonly found in Maharashtra, India. The Teaching Hospital, Jaffna recorded 84 H. tamulus stings over a year in 2012 and of them, 23 cases provided offending scorpions (proven cases). Three localities in Jaffna were recorded as hotspots of scorpion stings namely Palali, Achchuvali and Karainagar. Of the proven cases, 13 (57%) and 10 (43%) were males and females respectively and had a mean age of 30 years (SD ± 20 years). Among them, 5 (22%) were children below 12 years. In 13 (57%) patients stings occurred inside their houses including two children (40%). Six (26%) stings occurred at night when the victims were in sleep. Median time taken to arrive at the hospital from the time of stinging was 58 min (range 8-550 min). Signs of over activation of autonomic nervous system predominated the clinical picture-tachycardia in 14 (61%), high blood pressure in 11 (48%), excessive sweating in 9 (39%), excessive salivation in 5 (22%), hypotension in 4 (17%) and piloerection in 3 (13%). Children showed higher predilection to develop tachycardia - 4 (80%) and excessive salivation - 3 (60%). Priapism was not observed and 17 (74%) patients have developed intense pain at the site of sting. The commonest ECG change was tachycardia (73%) and occasional T wave inversion. Prazosin as a treatment was given to 22 (96%) patients. All patients made recovery and 13 (57%) patients left the hospital within two days. In future, there is a potential risk of spreading this species to elsewhere in the country and may disturb the ecological balance. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Nephrotic syndrome due to minimal change disease secondary to spider bite: clinico-pathological case of a non-described complication of latrodectism

    PubMed Central

    Enos, Daniel; Moreira, José Luis; Alvaredo, Fátima; Oddó, David

    2017-01-01

    Abstract The patient was an 18-year-old man who developed nephrotic syndrome after a ‘wheat spider’ bite (Latrodectus mactans). Due to this atypical manifestation of latrodectism, a renal biopsy was performed showing minimal change disease. The nephrotic syndrome subsided after 1 week without specific treatment. This self-limited evolution suggests that the mechanism of podocyte damage was temporary and potentially mediated by a secondary mechanism of hypersensitivity or direct effect of the α-latrotoxin. The patient did not show signs of relapse in subsequent checkup. This is the first reported case of nephrotic syndrome due to a minimal change lesion secondary to latrodectism. PMID:28396739

  8. A comparative clinico-radiographic study of guided tissue regeneration with bioresorbable membrane and a composite synthetic bone graft for the treatment of periodontal osseous defects

    PubMed Central

    Srivastava, Sumedha; Tandon, Pradeep; Gupta, Krishna Kumar; Srivastava, Amitabh; Kumar, Vinod; Shrivastava, Trilok

    2015-01-01

    Aim: The aim was to evaluate the bonefill in periodontal osseous defects with the help of guided tissue regeneration, bioresorbable membrane (PerioCol) + bone graft (Grabio Glascera) in combination and with bonegraft (Grabio Glascera) alone. Materials and Methods: The study involved total 30 sites in systemically healthy 19 patients. The parameters for evaluation includes plaque index sulcus bleeding index with one or more periodontal osseous defects having (i) probing depth (PD) of ≥ 5 mm (ii) clinical attachment loss (CAL) of ≥ 5 mm and (iii) ≥3 mm of radiographic periodontal osseous defect (iv) bonefill (v) crestal bone loss (vi) defect resolution. The study involved the three wall and two wall defects which should be either located interproximally or involving the furcation area. The statistical analysis was done using Statistical Package for Social Sciences, the Wilcoxon signed rank statistic W + for Mann–Whitney U-test. Results: The net gain in PD and CAL after 6 months for Group I ([PerioCol] + [Grabio Glascera]) and Group II (Grabio Glascera) was 3.94 ± 1.81 mm, 3.57 ± 2.21 mm and 3.94 ± 1.81, 3.57 ± 2.21 mm, respectively. The results of the study for Group I and Group II with regards to mean net bonefill, was 3.25 ± 2.32 (58%) mm and 5.14 ± 3.84 (40.26 ± 19.14%) mm, crestal bone loss − 0.25 ± 0.68 mm and − 0.79 ± 1.19 mm. Defect resolution 3.50 ± 2.34 mm and 5.93 ± 4.01 mm, respectively. Conclusion: On comparing both the groups together after 6 months of therapy, the results were equally effective for combination of graft and membrane versus bone graft alone since no statistical significant difference was seen between above parameters for both the groups. Thus, both the treatment modalities are comparable and equally effective. PMID:26392691

  9. Evaluation of the efficacy of a probiotic drink containing Lactobacillus casei on the levels of periodontopathic bacteria in periodontitis: A clinico-microbiologic study.

    PubMed

    Imran, Faizuddin; Das, Sushma; Padmanabhan, Shyam; Rao, Ravi; Suresh, Aparnna; Bharath, Dhana

    2015-01-01

    This study was designed to evaluate whether the oral administration of lactobacilli could change the bacterial population in subgingival plaque. Forty-two healthy volunteers with chronic generalized mild to moderate periodontitis were given a probiotic drink containing Lactobacillus casei for 1 month. Subgingival plaque samples were collected at baseline, after which the patients were asked to consume the probiotic drink once daily for 1 month. At the 1 month interval, plaque samples were collected, and the drink discontinued. The patients were recalled at 2 months interval for collection of the final samples. The bacterial amounts in the plaque samples were analyzed by multiplex polymerase chain reaction procedure. Of the three periodontopathic bacteria selected, Porphyromonas gingivalis showed highly significant reductions in the bacterial levels at 1-month and 2 months intervals. In comparison, Aggregatibacter actinomycetemcomitans, when present higher than 10 × 10(3) at baseline, and Prevotella intermedia present higher than 2 × 10(3) at baseline, showed moderately significant reduction in their numbers. Oral administration of the probiotic lactobacilli reduced the numerical sum of the three selected periodontopathic bacteria and could contribute to the beneficial effects on periodontal conditions.

  10. Comparison of the efficacy of subgingival irrigation with 2% povidone-iodine and tetracycline HCl in subjects with chronic moderate periodontitis: A clinico microbiological study

    PubMed Central

    Perayil, Jayachandran; Menon, Keerthy S.; Biswas, Raja; Fenol, Angel; Vyloppillil, Rajesh

    2016-01-01

    Background: This study was performed to evaluate and compare the clinical and antimicrobial efficacy of subgingival irrigation with tetracycline and povidone-iodine as an adjunct to nonsurgical periodontal therapy. Materials and Methods: Twenty subjects with chronic moderate periodontitis were recruited in this split-mouth study with probing pocket depth of >3 and ≤5 mm and clinical attachment loss of 3-4 mm in relation to 16, 36, and 46. In each subject, three selected periodontal pockets were assigned to receive one out of three irrigants (1) sterile water (control) in 16; (2) tetracycline at 10 mg/ml in 36; (3) 2% povidone-iodine in 46, and these sites were designated as Group A, Group B, and Group C, respectively. Plaque score, gingival score, pocket probing depth, and clinical attachment level were evaluated before treatment and at 1 and 3 months posttreatment. Multiplex polymerase chain reaction was used to detect Porphyromonas gingivalis and Tannerella forsythensis which have been implicated as the major risk factors for periodontal disease. Subgingival plaque collected before treatment and at 1 and 3 months posttreatment. Data were analysed using ANOVA and repeated measure ANOVA. Results were considered significant if P < 0.05. Results: Clinical and microbiological parameters were reduced posttreatment, the reduction being significantly higher in Group B compared to Group C. Conclusion: It can be concluded that chemical and mechanical therapies were of slight benefit in the treatment of chronic moderate periodontitis, and there was an adjunctive effect of significance when scaling and root planing was combined with a single subgingival irrigation with tetracycline or povidone-iodine in lower concentration. PMID:27076823

  11. Comparison of the efficacy of subgingival irrigation with 2% povidone-iodine and tetracycline HCl in subjects with chronic moderate periodontitis: A clinico microbiological study.

    PubMed

    Perayil, Jayachandran; Menon, Keerthy S; Biswas, Raja; Fenol, Angel; Vyloppillil, Rajesh

    2016-01-01

    This study was performed to evaluate and compare the clinical and antimicrobial efficacy of subgingival irrigation with tetracycline and povidone-iodine as an adjunct to nonsurgical periodontal therapy. Twenty subjects with chronic moderate periodontitis were recruited in this split-mouth study with probing pocket depth of >3 and ≤5 mm and clinical attachment loss of 3-4 mm in relation to 16, 36, and 46. In each subject, three selected periodontal pockets were assigned to receive one out of three irrigants (1) sterile water (control) in 16; (2) tetracycline at 10 mg/ml in 36; (3) 2% povidone-iodine in 46, and these sites were designated as Group A, Group B, and Group C, respectively. Plaque score, gingival score, pocket probing depth, and clinical attachment level were evaluated before treatment and at 1 and 3 months posttreatment. Multiplex polymerase chain reaction was used to detect Porphyromonas gingivalis and Tannerella forsythensis which have been implicated as the major risk factors for periodontal disease. Subgingival plaque collected before treatment and at 1 and 3 months posttreatment. Data were analysed using ANOVA and repeated measure ANOVA. Results were considered significant if P < 0.05. Clinical and microbiological parameters were reduced posttreatment, the reduction being significantly higher in Group B compared to Group C. It can be concluded that chemical and mechanical therapies were of slight benefit in the treatment of chronic moderate periodontitis, and there was an adjunctive effect of significance when scaling and root planing was combined with a single subgingival irrigation with tetracycline or povidone-iodine in lower concentration.

  12. Prevalence of denture-related oral lesions among patients attending College of Dentistry, University of Dammam: A clinico-pathological study

    PubMed Central

    Mubarak, Suhayla; Hmud, Ali; Chandrasekharan, Suresh; Ali, Aiman A.

    2015-01-01

    Background: Heterogeneous groups of oral lesions are likely to develop among denture wearers. The objectives of this study were to determine the exact prevalence of oral lesions among denture wearers attending the clinics of the College of Dentistry, University of Dammam. Materials and Methods: All denture wearers attending the dental clinics in the period between January 2012 and April 2013 were included in this study. Of the total 210 patients, 166 (79%) were males and 44 (21%) were females. Comprehensive oral examination was performed for all patients. Any denture-induced lesion was biopsied. Data collected were analyzed using SPSS program. Results: Oral lesions were found in 20.5% of the cases under study (43 out of the total 210 denture wearers). Denture-induced fibrous hyperplasia was the most common type of lesion detected (41.9%). A significant correlation (P = 0.004) was found between the type of denture and oral lesions in this study. Conclusion: The prevalence of denture-induced oral lesions was found to differ significantly from that reported in other studies. The diversity of these lesions among different studies depends on the quality and materials of dentures delivered, the techniques used, and the methods of patients’ instructions adopted. PMID:26759806

  13. Clinico-pathology, hematology and biochemistry responses in buffaloes towards Pasteurella multocida type B: 2 immunogen lypopolysaccharide via oral and intravenous routes of infection.

    PubMed

    Chung, Eric Lim Teik; Abdullah, Faez Firdaus Jesse; Ibrahim, Hayder Hamzah; Marza, Ali Dhiaa; Zamri-Saad, Mohd; Haron, Abdul Wahid; Lila, Mohd Azmi Mohd; Norsidin, Mohd Jefri

    2016-02-01

    Haemorrhagic septicaemia is a disease caused by Pasteurella multocida serotype B: 2 and E: 2. The organism causes acute, highly fatal septicaemic disease with high morbidity and mortality in cattle and more susceptible in buffaloes. Lipopolysaccharide can be found on the outer cell wall of the organism. Lipopolysaccharide is released during multiplication which leads to inflammatory reaction. It represents the endotoxin of P. multocida type B: 2 and responsible for toxicity in haemorrhagic septicaemia which plays an important role in the pathogenesis of the disease. Therefore, the aim of this study was to investigate the clinical signs, blood parameters, gross post mortem lesions and histopathology changes caused by P. multocida type B:2 immunogen lipopolysaccharide infections initiated through intravenous and oral routes of infection. 9 buffalo heifers were divided equally into 3 treatment groups. Group 1 was inoculated orally with 10 ml of phosphate buffer saline (PBS); Group 2 and 3 were inoculated with 10 ml of lipopolysaccharide broth intravenously and orally respectively. For the clinical signs, there were significant differences (p < 0.05) in temperature between the control, intravenous and oral group. In hematology and biochemistry findings, there were significant differences (p < 0.05) in erythrocytes, haemoglobin, PCV, MCV, lymphocytes, monocytes, eosinophils, GGT and albumin between the control, intravenous and oral group. However, there were no significant differences (p > 0.05) in the MCHC, leukocytes, band neutrophils, basophils, thrombocytes, plasma protein, icterus index, total protein, globulin and A:G ratio between intravenous and oral group. For Group 2 buffaloes, there were gross lesions in the lung, trachea, heart, liver, spleen, and kidney. In contrast, lesions were only observed in the lung, trachea and liver of Group 3 buffaloes. There were significant differences (p < 0.05) in hemorrhage and congestion; necrosis and degeneration; and inflammatory cells infiltration between experimental groups and control group. However, there were no significant differences (p > 0.05) in edema lesion between groups. In conclusion, this study is a proof that oral route infection of P. multocida type B:2 immunogen lipopolysaccharide can be used to stimulate host cell responses where oral vaccine through feed could be developed in the near future.

  14. Evaluation of peri-implant soft tissue and bone levels around early loaded implant in restoring single missing tooth: A clinico-radiographic study

    PubMed Central

    Bhardwaj, Isha; Bhushan, Anoop; Baiju, Chandrababu Sudha; Bali, Shweta; Joshi, Vaibhav

    2016-01-01

    Background: One-stage nonsubmerged protocol which can achieve success rates comparable to implants placed in a two-staged submerged procedure also the preconditions for periimplant bone regeneration has lead to more refined concepts of implant loading. Materials and Methods: Twenty sites with single missing tooth were included in this study. Clinical parameters included sulcus bleeding index (sBI), probing pocket depth (PD), and papilla index (PI) and radiographic parameters included crestal bone level were assessed for a period of 9 months. Results: The crestal bone loss showed mean value ranging from baseline 0.25 ± 0.11 to 0.31 ± 0.08 at 3 weeks, to 0.67 ± 0.13 at 3 months, to 0.85 ± 0.09 at 6 months, and to 0.88 ± 0.12 at 9 months. Probing PD, the mean value for probing PD at 3 weeks 1.20 ± 0.83, 3 months 1.60 ± 1.1, at 6 months 1.40 ± 1.14, and at 9 months 1.20 ± 1.0. sBI, mean value for sBI at 3 weeks 0.00 ± 0.00, 3 months 0.3 ± 0.11, at 6 months 0.09 ± 0.25, and at 9 months 0.08 ± 0.24. PI, showed a significant difference among at different points of time with P = 0.000. Conclusion: The dental implants showed <1 mm of crestal bone loss at 9 months follow-up, clinically significant marginal bone loss occurred between the time of implant placement and 3 months. Subsequent to that, bone loss observed around the implant up to 9 months was minimal. The periimplant soft tissue maturity was maintained throughout the study. PMID:27041836

  15. The influence of soft tissue biotype on the marginal bone changes around dental implants: A 1-year prospective clinico-radiological study

    PubMed Central

    Bhat, Pragathi Raghavendra; Thakur, Srinath Lakshman; Kulkarni, Sudhindra Sushilendra

    2015-01-01

    Background: The peri-implant mucosa undergoes surgical and bacterial assaults in various stages of implant therapy, however, the literature on changes occurring in the peri-implant mucosa is minimal. This study was thus conducted to evaluate the change in the peri-implant mucosal thickness and its effect on the marginal bone levels around dental implants treated in a conventional two-stage implant therapy. Materials and Methods: A total of 36 implants were placed in 22 subjects. Two subjects dropped out. Thirty-three implants in 20 subjects were then evaluated. Initial mucosal thickness, marginal bone levels on radiographs, pain, and exudation were evaluated. All these parameters were recorded at the time of implant placement, at the time of cementation of final restoration, 6 months and 12 months post cementation/restoration. Results: The peri-implant mucosal thickness reduced from implant placement to second stage and till restorations and was statistically significant, in both the thick and thin biotypes, however, at 12 months there was a rebound of the tissue thickness, which was more in the thick biotype (P < 0.05). At 1-year follow-up, there was a reduction in the marginal bone levels, which was more in the thick biotype as compared to the thin biotype (P < 0.05). Conclusion: The mucosa at implant sites undergoes a reduction in thickness from the time of implant placement till the placement of final restorations. The placement of the final restorations and then end of active therapy leads to a rebound of the tissue thickness. Sites with thicker tissues preoperatively have a lesser bone loss and better rebound as compared to thinner tissues. PMID:26941514

  16. Evaluation of clinical and metabolic changes after non surgical periodontal treatment of type 2 diabetes mellitus patients: A clinico biochemical study

    PubMed Central

    Kudva, Praveen; Tabasum, Syeda Tawkhira; Garg, Nidhi

    2010-01-01

    Aim: To evaluate the clinical and metabolic changes following nonsurgical periodontal therapy of type-2 diabetic patients and nondiabetic patients. Materials and Methods: Fifteen nondiabetics and fifteen type-2 diabetics with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams graduated periodontal probe and comparisons of the clinical and biochemical parameters like plaque index, gingival index, probing depth, glycated hemoglobin, and lipid profile (total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides and very low density lipoprotein) were done between and within two groups at baseline and 3 month. Results: A correlation was observed between clinical and biochemical parameters between and within two groups at baseline and 3 month. The P value of diabetic group was<0.001 in all clinical parameters (plaque index PI, Gingival index GI, and Probing Pocket Depth PPD) in diabetic and nondiabetic group, showed statistically highly significant difference in GI, PI, PPD, <.01 in Glycated Hemoglobulin (HbAlc1) in test group and<0.05 in control group showed statistically significant difference. The P value of test group was >0.05 in Lipid profile (total cholesterol, low density lipoprotein, high density lipoprotein, serum triglyceride, very low density lipoprotein) that showed no significant difference and in control group<0.05 in total Cholesterol, high density lipoprotein and <0.01 in Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, respectively, showed statistically significant in Total cholesterol, Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, not significant in high density lipoprotein. The P value >0.05 showed no statistical significance of correlation between the test and control groups. Conclusion: Both groups of patients showed an improvement in clinical and metabolic parameters assessed at 3 months after nonsurgical periodontal therapy. PMID:21731253

  17. Brain metastases in patients with EOC: Clinico-pathological and prognostic factors. A multicentric retrospective analysis from the MITO group (MITO 19).

    PubMed

    Marchetti, Claudia; Ferrandina, Gabriella; Cormio, Gennaro; Gambino, Angela; Cecere, Sabrina; Lorusso, Domenica; De Giorgi, Ugo; Bogliolo, Stefano; Fagotti, Anna; Mammoliti, Serafina; Narducci, Filomena; Bergamini, Alice; Scollo, Paolo; Biglia, Nicoletta; Breda, Enrico; Tamberi, Stefano; Marinaccio, Marco; Angioli, Roberto; Salerno, Laura; Eusebi, Maria Chiara; Loizzi, Vera; Scambia, Giovanni; Panici, Pierluigi Benedetti

    2016-12-01

    Brain metastases (BM) from epithelial ovarian cancer (EOC) are considered a rare and unfavourable event. There is no consensus regarding the best management of these patients. A multicenter retrospective analysis of patients with BM from EOC treated between 1997 and 2014 in 18 institutions of the MITO (Multicenter Italian Trials in Ovarian cancer) group was conducted. Univariate and multivariate analysis were performed. A total of 174 women were identified as having BM from EOC. The median time interval between primary diagnosis of EOC and occurrence of BM was 26months (range 2-129months). The median overall survival from primary EOC diagnosis was 48months (95% CI 39.5-56.4months) and from diagnosis of BM was 12months (95% CI 9.6-14.3months). The majority of enrolled women (81.7%) were classified as sensitive to platinum-based chemotherapy. Four variables were significantly associated with poor overall survival in multivariate analysis: multiple BM [HR: 1.86 (95% CI: 1.22-2.84)], presence of extracranial disease [HR: 1.77 (95% CI: 1.11-2.83)] age [HR: 1.74 (95% CI: 1.17-2.59)], and monotherapy [HR: 2.57 (95% CI: 1.64-3.86)]. On the contrary, residual tumor at primary surgery, FIGO stage at primary diagnosis and platinum sensitivity were found to have no significant impact on survival from diagnosis of brain lesions. Our results suggest that BM is a rare and late manifestation of EOC, with a 12-month life-span expectation. Multiple approach is a positive independent prognostic factor and should be proposed to carefully selected patients. Copyright © 2016. Published by Elsevier Inc.

  18. Correlation of vascular endothelial growth factor expression with fibroblast growth factor-8 expression and clinico-pathologic parameters in human prostate cancer

    PubMed Central

    West, A F; O'Donnell, M; Charlton, R G; Neal, D E; Leung, H Y

    2001-01-01

    Vascular endothelial growth factor (VEGF) mediates neo-angiogenesis during tumour progression and is known to cooperate with the fibroblast growth factor (FGF) system to facilitate angiogenesis in a synergistic manner. In view of this, we have investigated VEGF expression in 67 cases of prostate cancer previously characterized for fibroblast growth factor-8 (FGF-8) expression. Cytoplasmic VEGF staining was detected in malignant cells in 45 out of 67 cases. Cytoplasmic staining was found in adjacent stromal cells in 32 cases, being particularly strong around nests of invasive tumour. Positive VEGF immunoreactivity in benign glands was restricted to basal epithelium. A significant association was observed between tumour VEGF and FGF-8 expression (P = 0.004). We identified increased VEGF immunoreactivity in both malignant epithelium and adjacent stroma and both were found to be significantly associated with high tumour stage (P = 0.0047 and P = 0.0002, respectively). VEGF expression also correlated with increased serum PSA levels (P = 0.01). Among positively stained tumours, VEGF expression showed a significant association with Gleason score (P = 0.04). Cases showing positive VEGF immunoreactivity in the stroma had a significantly reduced survival rate compared to those with negative staining (P = 0.037). Cases with tumours expressing both FGF-8 in the malignant epithelium and VEGF in the adjacent stroma had a significantly worse survival rate than those with tumours negative for both, or only expressing one of the two growth factors (P = 0.029). Cox multivariate regression analysis of survival demonstrated that stromal VEGF and tumour stage were the most significant independent predictors of survival. In conclusion, we report for the first time a correlation of both tumour and stromal VEGF expression in prostate cancer with clinical parameters as well as its correlation to FGF-8 expression. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11506499

  19. Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study.

    PubMed

    Yadav, Suresh; Tyagi, Shallu; Puri, Naveen; Kumar, Prince; Kumar, Puneet

    2013-04-01

    To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter's classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

  20. Clinico-radiological Outcome Analysis of Parallel Plating with Perpendicular Plating in Distal Humeral Intra-articular Fractures: Prospective Randomised Study

    PubMed Central

    Shekhawat, Vishal; Banshiwal, Ramesh Chandra; Verma, Rajender Kumar

    2017-01-01

    Introduction The distal humeral fractures are common fractures of upper limb and are difficult to treat. These fractures, if left untreated or inadequately treated, leads to poor outcomes. Management of distal humeral fractures are pertained to many controversies and one among them is position of plates. Aim To compare the clinical and radiological outcomes in patients with intra-articular distal humerus fractures, treated using parallel and perpendicular double plating methods. Materials and Methods A total of 38 patients with distal humerus fractures, 20 in perpendicular plating group (group A) and 18 in parallel plating group (group B), were included in this prospective randomised study. At each follow up patients were evaluated clinically and radiologically for union and the outcomes were measured in terms of Mayo Elbow Performance Score (MEPS) consisting of pain intensity, range of motion, stability and function. MEP score greater than 90 is considered as excellent; Score 75 to 89 is good; Score 60 to 74 is fair and Score less than 60 is poor. Results In our study, 15 patients (75%) in group A, and 13 patients (72.22%) in group B achieved excellent results. Two patients (10%) in group A and 4 patients (22.22%) in group B attained good results. Complications developed in 2 patients in each groups. No significant differences were found between the clinical outcomes of the two plating methods. Conclusion Neither of the plating techniques are superior to the other, as inferred from the insignificant differences in bony union, elbow function and complications between the two plating techniques. PMID:28384948

  1. Tau aggregation influences cognition and hippocampal atrophy in the absence of beta-amyloid: a clinico-imaging-pathological study of primary age-related tauopathy (PART).

    PubMed

    Josephs, Keith A; Murray, Melissa E; Tosakulwong, Nirubol; Whitwell, Jennifer L; Knopman, David S; Machulda, Mary M; Weigand, Stephen D; Boeve, Bradley F; Kantarci, Kejal; Petrucelli, Leonard; Lowe, Val J; Jack, Clifford R; Petersen, Ronald C; Parisi, Joseph E; Dickson, Dennis W

    2017-02-03

    We investigate whether there is any association between the Braak neurofibrillary tangle (NFT) stage and clinical and MRI features in definite primary age-related tauopathy (PART). We analysed 52 cases with a Braak NFT tangle stage >0 and ≤IV, and a Thal phase of 0 (no beta-amyloid present). Twenty-nine (56%) were female. Median age at death was 88 years (IQR 82-92 years). Fifteen (29%) were TDP-positive (75% TDP stage I), 16 (31%) had argyrophilic grain disease and three (6%) had alpha-synuclein-positive Lewy bodies. TDP-43 inclusion when present were rare and predominantly perivascular. Of the 15 with TDP-43, three showed a moderate number of inclusions and also had hippocampal sclerosis, neuronal intranuclear inclusions and fine neurites of the CA1 region of the hippocampus. Four cases (8%) had an apolipoprotein epsilon 4 (APOE4) allele. There was a significant correlation between age at death and Braak NFT stage (r = 0.32, p = 0.02). After accounting for age at clinical examination, there were significant associations between Braak NFT stage, and WAIS-R Block Design and Trail Making Tests A and B, with higher Braak stage associated with poorer performances. Thirty of the 52 cases had completed an antemortem volumetric head MRI. Two separate MRI analyses revealed an association between higher Braak NFT stage and grey matter atrophy in the head of the left hippocampus. There were no significant clinical or radiologic associations with TDP-43. Findings from this study demonstrate that aggregated tau distribution is associated with poorer cognitive performance, as well as atrophy, in the absence of beta-amyloid. These findings support the parcellation of definite PART as a useful construct. The relatively low frequencies of APOE4, TDP-43, Lewy bodies, and hippocampal sclerosis, and the rarity and morphology of TDP-43 lesions are noted contrasts to what is typically observed in Alzheimer's disease of the old.

  2. Clinico-pathological features and somatic gene alterations in refractory ceramic fibre-induced murine mesothelioma reveal mineral fibre-induced mesothelioma identities

    PubMed Central

    Andujar, Pascal; Lecomte, Céline; Renier, Annie; Fleury-Feith, Jocelyne; Kheuang, Laurence; Daubriac, Julien; Janin, Anne; Jaurand, Marie-Claude

    2007-01-01

    Although human malignant mesothelioma (HMM) is mainly caused by asbestos exposure, refractory ceramic fibres (RCFs) have been classified as possibly carcinogenic to humans on the basis of their biological effects in rodents’ lung and pleura and in cultured cells. Hence, further investigations are needed to clarify the mechanism of fibre-induced carcinogenicity and to prevent use of harmful particles. In a previous study, mesotheliomas were found in hemizygous Nf2 (Nf2+/−) mice exposed to asbestos fibres, and showed similar alterations in genes at the Ink4 locus and in Trp53 as described in HMM. Here we found that Nf2+/− mice developed mesotheliomas after intra-peritoneal inoculation of a RCF sample (RCF1). Clinical features in exposed mice were similar to those observed in HMM, showing association between ascite and mesothelioma. Early passages of 12 mesothelioma cell cultures from ascites developed in RCF1-exposed Nf2+/− mice demonstrated frequent inactivation by deletion of genes at the Ink4 locus, and low rate of Trp53 point and insertion mutations. Nf2 gene was inactivated in all cultures. In most cases, co-inactivation of genes at the Ink4 locus and Nf2 was found and, at a lower rate, of Trp53 and Nf2. These results are the first to identify mutations in RCF-induced mesothelioma. They suggest that nf2 mutation is complementary of p15Ink4b, p16Ink4a and p19Arf or p53 mutations and show similar profile of gene alterations resulting from exposure to ceramic or asbestos fibres in Nf2+/− mice, also consistent with the one found in HMM. These somatic genetic changes define different pathways of mesothelial cell transformation. PMID:17272307

  3. Clinico-pathological features and somatic gene alterations in refractory ceramic fibre-induced murine mesothelioma reveal mineral fibre-induced mesothelioma identities.

    PubMed

    Andujar, Pascal; Lecomte, Céline; Renier, Annie; Fleury-Feith, Jocelyne; Kheuang, Laurence; Daubriac, Julien; Janin, Anne; Jaurand, Marie-Claude

    2007-07-01

    Although human malignant mesothelioma (HMM) is mainly caused by asbestos exposure, refractory ceramic fibres (RCFs) have been classified as possibly carcinogenic to humans on the basis of their biological effects in rodents' lung and pleura and in cultured cells. Hence, further investigations are needed to clarify the mechanism of fibre-induced carcinogenicity and to prevent use of harmful particles. In a previous study, mesotheliomas were found in hemizygous Nf2 (Nf2(+/-)) mice exposed to asbestos fibres, and showed similar alterations in genes at the Ink4 locus and in Trp53 as described in HMM. Here we found that Nf2(+/-) mice developed mesotheliomas after intra-peritoneal inoculation of a RCF sample (RCF1). Clinical features in exposed mice were similar to those observed in HMM, showing association between ascite and mesothelioma. Early passages of 12 mesothelioma cell cultures from ascites developed in RCF1-exposed Nf2(+/-) mice demonstrated frequent inactivation by deletion of genes at the Ink4 locus, and low rate of Trp53 point and insertion mutations. Nf2 gene was inactivated in all cultures. In most cases, co-inactivation of genes at the Ink4 locus and Nf2 was found and, at a lower rate, of Trp53 and Nf2. These results are the first to identify mutations in RCF-induced mesothelioma. They suggest that nf2 mutation is complementary of p15(Ink4b), p16(Ink4a) and p19(Arf) or p53 mutations and show similar profile of gene alterations resulting from exposure to ceramic or asbestos fibres in Nf2(+/-) mice, also consistent with the one found in HMM. These somatic genetic changes define different pathways of mesothelial cell transformation.

  4. Differentiating secondary from primary dengue using IgG to IgM ratio in early dengue: an observational hospital based clinico-serological study from North India.

    PubMed

    Changal, Khalid Hamid; Raina, Ab Hameed; Raina, Adnan; Raina, Manzoor; Bashir, Rehana; Latief, Muzamil; Mir, Tanveer; Changal, Qayum Hamid

    2016-11-28

    Secondary dengue causes more severe disease than the primary. Early on, it is important to differentiate the two. We tried to find important clinical and laboratory differences between the two for the purpose of early differentiation. One hundred fourteen patients confirmed on reverse transcriptase-polymerase chain reaction (RT PCR) were studied. On day 2 of illness IgM and IgG indices were studied for calculation of IgG/IgM ratio. A one-step immunochromatographic assay was used for classification of patients into primary and secondary dengue. Patient characteristics were also studied. Dengue serotype 1 was the most common found in 60.5% patients. 66.7% (76 patients) had secondary dengue. Secondary dengue cases had a higher mean temperature (101.56 ± 1.55 vs. 100.79 ± 1.25,°F, p 0.015), lower platelet counts (50.51 ± 38.91 vs. 100.45 ± 38.66, x 10(3)/micl, p <0.0001) and a significantly higher percentage of Dengue hemorrhagic fever/Dengue shock syndrome (38.2% vs. 2.6%, p <0.0001). In early phase of dengue NS1 and PCR were found to be better tests for diagnosis and later IgM is better. The IgG/IgM ratio of ≥ 1.10 had a sensitivity of 100%, specificity of 97.4% and accuracy of 67.5% in differentiating secondary from primary dengue. Early on in the clinical course, IgG/ IgM ratio can play an important role to differentiate the two. We found the ratio of ≥ 1.10 to be the best cut off for the same.

  5. Midterm clinico-radiologic findings of an open label observation study of add-on tacrolimus with biologics or non-biologic DMARDs.

    PubMed

    Takakubo, Yuya; Tamaki, Yasunobu; Hirayama, Tomoyuki; Iwazaki, Kiyoshi; Yang, Suran; Sasaki, Akiko; Nakano, Haruki; Konttinen, Yrjö T; Takagi, Michiaki

    2012-11-01

    Tacrolimus (TAC) suppresses immune-inflammation by an intermediary inhibition of calcineurin activation in the treatment of rheumatoid arthritis (RA). Various combination therapies for RA have been reported to be superior to monotherapies. The aim was therefore to study add-on TAC in a combination with biologics (BIO) and/or non-BIO disease-modifying anti-rheumatic drugs (DMARDs) in treatment-resistant patients. In eight RA patients, TAC was added on to BIO (TAC/BIO group) and in forty-one to non-BIO DMARDs (TAC/non-BIO group). The mean C-reactive protein (CRP) decreased from 33 mg/l at the baseline to 16 mg/l at first year in the TAC/BIO group (P < 0.05), from 41 to 14 mg/l in the TAC/non-BIO group (P < 0.05); the mean DAS28-CRP (28 joint count) disease activity score decreased from 5.3 to 4.4 in the TAC/BIO group (P < 0.05) and from 5.0 to 3.9 in the TAC/non-BIO group (P < 0.05). The median of Δ modified total Sharp score decreased from 43 during the year preceding the baseline to 3 during the first year of the follow-up in the TAC/BIO group (P < 0.05) and from 22 to 0 during the second year in the TAC/non-BIO group (P < 0.05). Twenty-six adverse events occurred in this study in 26 patients (53% in all); however, the only severe adverse event was one case of an atypical mycobacterial disease (2%). The combination therapy of TAC with BIO or non-BIO DMARDs represents an effective and relatively safe mode of therapy in treatment-resistant RA.

  6. [Clinico-pathological diagnostic agreement among 429 autopsies from the Instituto Nacional de la Nutrición Salvador Zubirán].

    PubMed

    Angeles-Angeles, A; Quintanilla Martínez, L; Muñoz Fernández, L; Espinoza Vázquez, B; Victoría Peralta, P

    1992-01-01

    Comparison of clinical and autopsy findings of the cases studied between 1984 and 1988, were made at the Department of Pathology of the Instituto Nacional de la Nutricion Salvador Zubiran in Mexico City. The goal was to determine the accuracy of clinical diagnoses. The total number of cases was 429. A decreasing number of autopsies as a function of time was observed. Thus, in 1985, 34.65% of the deaths was autopsied, whereas in 1988, the number dropped to 21.16%, overall mean of 27.31%. In 229 autopsies (53.8%), 353 findings of clinical significance were found; of these, 86 were in the main diagnoses and 267 in the causes of death. There were 171 overdiagnoses with therapeutic implications, 38 in the main diagnoses and 133 in the causes of death. Overdiagnoses and underdiagnoses were most common in infectious diseases, followed by respiratory and digestive diseases, while endocrinologic and rheumatologic diseases had the highest diagnostic concordance. It was also found that the diagnostic accuracy did not improve with time of hospitalization. A brief analyses of the probable causes of the decrease in the number of autopsies is made. It is concluded that, in spite of the great advances in clinical and technological knowledge, the high frequency of disagreements between clinical and anatomical diagnoses, indicate that autopsy continues playing a key role in the quality control of medical practice. This justifies by itself the performance of necropsies.

  7. Nephrotic syndrome due to minimal change disease secondary to spider bite: clinico-pathological case of a non-described complication of latrodectism.

    PubMed

    Méndez, Gonzalo P; Enos, Daniel; Moreira, José Luis; Alvaredo, Fátima; Oddó, David

    2017-04-01

    The patient was an 18-year-old man who developed nephrotic syndrome after a 'wheat spider' bite (Latrodectus mactans). Due to this atypical manifestation of latrodectism, a renal biopsy was performed showing minimal change disease. The nephrotic syndrome subsided after 1 week without specific treatment. This self-limited evolution suggests that the mechanism of podocyte damage was temporary and potentially mediated by a secondary mechanism of hypersensitivity or direct effect of the α-latrotoxin. The patient did not show signs of relapse in subsequent checkup. This is the first reported case of nephrotic syndrome due to a minimal change lesion secondary to latrodectism.

  8. Clinico-Radiological Profile and Outcome of Novel H1N1-Infected Patients During 2009 to 2014 Pandemic at Tertiary Referral Hospital in Rajasthan.

    PubMed

    Maheshwari, Monika; Maheshwari, Sanjeev

    2015-05-01

    The 21st century Influenza A (H1N1) pandemic arrived during spring of 2009 and has posed a serious public health challenge world-wide. We describe the clinic-radiological profile and outcome of patients who were found H1N1 positive in Jawahar Lal Nehru Hospital, Ajmer of Rajasthan from 5th August 2009 to 31st May 2014. Primary objective was to study clinical and radiological profile of the patients admitted with confirmed H1N1 infection. Secondary objective was to observe the risk factors and associated comorbid conditions with complications and need of mechanical ventilation and / or death among H1N1-infected patients Hospitalized patient with laboratory-confirmed H1N1 flu by reverse transcriptase PCR during August 2009 to May 2014 in JLN Hospital, Ajmer, were included in this retrospective study. Data was collected from hospital isolation ward admission register. Statistical analysis was done by SPSS, version 16. Binary logistic regression was used to find out independent risk factors for morbidity. A total of 94 PCR-confirmed H1N1-infected patients were included in the study, of them 32 (34%) males and 62 (66%) females. Median age was 35 years and median duration of symptoms before hospitalization was 5 days. Common presenting symptoms include fever 83 (88%), cough 79 (84%), breathlessness 67 (71%), rhinnorrhoea/ common cold 25 (26.5%), throat pain 13 (13.8%), chest pain 5 (5.3%) and haemoptysis 4 (4.2%). Bilateral crepitations were audible in 86 (91.4%) and tachypnoea in 73 (78%) cases. Co-morbidities were seen in 75 (79.7%) patients. Ventilatory support was required in 57 (60.6%) patients. On presentation, chest x-ray showed pulmonary opacities in 72 (76.5%) patients. We observed no significant side effects of oseltamivir 150 mg twice day dose for 5-7 days. Forty-one (43.6%) patients were cured and discharged from hospital, 53 (56.3%) patients died. Development of ARDS, involvement of bilateral lower zones of lungs in chest skiagram, requirement of mechanical ventilator and associated pregnancy (third trimester) were independent predictors of mortality. During evaluation period from 2009 to 2014, H1N1 influenza caused severe illness requiring hospitalization, including pneumonia, acute respiratory distress and complications involving renal, liver and cardiac dysfunction. Maximum patients were between age group of 20-40 year. Fever and cough were most common presenting symptoms. Common comorbidities were pregnancy, diabetes, hypertension, and obesity. Mortality rate was high in H1N1-infected patients with development of ARDS, associated pregnancy and patients who required ventilatory support.

  9. Estimation of N-terminal telopeptides of type I collagen in periodontal health, disease and after nonsurgical periodontal therapy in gingival crevicular fluid: A clinico-biochemical study.

    PubMed

    Aruna, G

    2015-01-01

    This study explored gingival crevicular fluid (GCF) N-terminal telopeptides of type I collagen (NTx) levels in periodontal health, disease and after nonsurgical periodontal therapy along with its association with the clinical parameters. Study comprised of three groups of 10 subjects each: Healthy (Group I), gingivitis (Group II), and periodontitis (Group III), while Group III patients after scaling and root planning (SRP) constituted Group IV. Gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and radiological parameters were recorded. GCF samples were analyzed by competitive-enzyme-linked immunosorbent assay. Samples in Group III and Group IV tested positive for NTx whereas in Group I and Group II, NTx was not detected. Mean NTx levels were higher in Group III (6.79 ± 0.94 nanomole bone collagen equivalents per liter [nm BCE/L]) compared to Group IV (5.73 ± 0.95 nm BCE/L) which was statistically significant. Positive correlation was seen between the clinical parameters and the NTx levels in Group III and IV. As NTx is specific bone turnover marker, it is detected only in periodontitis Group and the values decline after SRP. Failure to detect NTx in Group I and II, relates to the minimum or no resorption at the sample sites.

  10. Clinical progression in Charcot-Marie-Tooth disease type 1A duplication: clinico-electrophysiological and MRI longitudinal study of a family.

    PubMed

    Berciano, José; Gallardo, Elena; García, Antonio; Ramón, César; Infante, Jon; Combarros, Onofre

    2010-10-01

    Long-term follow-up studies in Charcot-Marie-Tooth disease type 1 duplication (CMT1A) are scanty. Here we describe a longitudinal study in a CMT1A pedigree. Our CMT1A pedigree comprised 11 examined patients, ages between 13 and 83 (median, 36) years, serially evaluated for up to 26 years. In all 11 patients we carried out electrophysiological evaluation, and in three of them magnetic resonance imaging (MRI) of lower-limb musculature. The 54-year-old proband patient, yearly examined as of age 28, developed at age 48 gradual and progressive distal lower-leg weakness ascending to thigh musculature. His serial electrophysiological studies showed diffuse slowing of motor conduction velocity, absence or severe attenuation of distal compound muscle action potentials, and spontaneous muscle activity in the tibialis anterior and rectus femoris. Two MRI studies of lower limbs, at ages 51 and 54, showed extensive fatty atrophy of lower-leg musculature, and progressive and distally accentuated fatty atrophy of anterior and posterior femoral muscles. An outstanding finding in the first MRI was the presence of marked edema of anterior femoral musculature, which to a great degree was replaced by fatty atrophy in the second study. Muscle edema was also noted in lower-leg and posterior femoral musculature. There was minimal fatty atrophy of the gluteus maximus, the remaining pelvic muscles being preserved. The other ten patients showed mild or moderate phenotype, which remained quiescent over the period of observation. Electrophysiological studies disclosed diffuse and uniform slowing of nerve conduction velocities; in no case was spontaneous muscle activity recorded. MRI showed the CMT1A characteristic pattern of distally accentuated fatty atrophy involving foot and lower-leg musculature with preservation of thigh musculature. We conclude that a small proportion of patients with CMT1A develop a late progression of disease manifested with accentuated distal leg weakness ascending to involve thigh musculature, and that long-term follow-up is essential for its detection.

  11. [The clinico-neurophysiological study of the effect of cerebrolysin on brain function in the acute and early recovery periods of hemispheric ischemic stroke].

    PubMed

    Gusev, E I; Burd, G S; Gekht, A B; Skvortsova, V I; Bogomolova, M A; Selikhova, M V; Fidler, S M

    1994-01-01

    Thirty patients with acute ischemic stroke and at early terms of postapoplectic recovery received cerebrolysin in daily doses 10, 20 and 30 ml for 5 days or 10 ml, i. v. for 10 days, respectively. The patients were examined for neurological status and cerebral function. In acute stroke the highest effect occurred in the affection of moderate severity. In severe stroke the drug stimulated recovery of impaired functions which tended to restore more quickly than in control subjects. In early convalescents cerebrolysin improved motor functions. Details of the results of the combined neurophysiological examination in the course of the treatment are discussed.

  12. Natural course of typical and atypical parenchymal solitary cysticercus granuloma of the brain: a 3-year prospective clinico-radiological study

    PubMed Central

    Kumar, Neeraj; Malhotra, Hardeep Singh; Gupta, Rakesh Kumar; Verma, Rajesh; Sharma, Praveen Kumar

    2015-01-01

    Objective To evaluate the role of advanced magnetic resonance (MR) sequences (fast imaging employing steady-state acquisition (FIESTA), T2 star-weighted angiography (SWAN) and spoiled gradient recalled echo (SPGR)) in patients with single small enhancing computed tomography lesions and scolex demonstration in typical and atypical parenchymal neurocysticercosis. Methods In this study, 59 patients of new-onset seizures with single small enhancing computed tomography lesions of the brain were included. Along with routine MR sequences, advanced MR sequences, like SWAN, FIESTA, and pre and post-contrast SPGR, were performed. Follow-up MR studies focussing on the morphology of the lesions and demonstration of scolex were performed 6 monthly for 3 years. Results The majority of patients (62.7%) were men with partial seizure as the most common manifestation. On SPGR, contrast lesions were identified as either ‘typical’ (42, 71.2%) or ‘atypical’ (17, 28.8%). In the typical lesion group, SWAN and FIESTA sequences detected scolex in 30 (71.4%) and 32 (76.2%), respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 35 (83.3%) patients compared to 19 (45.2%) by routine sequences (P < 0.001). In the atypical lesion group, SWAN and FIESTA sequences detected scolex in 15 (88.2%) and 16 (94.1%) patients, respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 16 (94.1%) patients compared to 10 (58.8%) by routine sequences (P < 0.001). Follow-up showed greater resolution with lesser calcification in the typical group compared to the atypical group. Conclusion This study provides an insight into the natural course of typical and atypical solitary cysticercus granuloma lesions, and the utility of SPGR-contrast, FIESTA and SWAN MR sequences in scolex demonstration and identification of atypical lesions. PMID:26659345

  13. [The clinico-dopplerographic characteristics of the initial manifestations of cerebral circulatory insufficiency in patients with vertebral artery hypoplasia combined with osteochondrosis of the cervical spine].

    PubMed

    Gongal'skiĭ, V V; Tsiurko, B O

    2000-01-01

    In the examination of 44 patients with primary hypoplasia of the vertebral artery (less than 2.5 mm in diameter) associated with osteochondrosis of the cervical segment of the vertebral column there have been revealed the following neuropathological manifestations of cerebral circulation insufficiency in the vertebral-basilar basin: cephalalgia, cochlear syndrome, vestibulocerebellar syndrome, vegetovascular dystonia. Ultrasound investigation of the vertebral arteries bloodflow showed a decrease in bloodflow in the intracranial length of the hypoplastic artery and an increase in the resistance to bloodflow in the extracranial segments (V2, V3). Ten patients with functional disorders in the cervical portion of the spine were exposed to orthopedic therapy directed to restoration of mobility and of topography of individual motor segments of the spinal cervical section. The studies made showed that hypoplasia of vertebral arteries can present as cerebral circulatory insufficiency in the vertebral-basilar basin, which tends to increase or reveals itself in a concurrent development of vertebrogenic reflex vasoconstriction. Restoration of the spine function (mobility) is an effective medico-prophylactic measure aimed to resolve the vertebrogenically caused spasm of the artery.

  14. A Clinico-analytical Study on Seed of Wrightia antidysenterica Linn. as a Therapeutic Emetic Agent (Vamaka Yoga) in the Management of Psoriasis

    PubMed Central

    Bhattacharyya, Nirupam; Pujar, Muralidhar P.; Chaturvedi, Ashutosh; Kumar, M. Ashvini; Lohith, B. A.; Kumar, K. N. Sunil

    2016-01-01

    Objectives: Wrightia antidysenterica Linn. (WA) is male variety Kutaja stated to be potent therapeutic emetic agent in skin disorders. Expulsion of doshas through oral route is termed as Vamana Karma (VK) (therapeutic emesis). However, so far, its utility for Vamana is not explored in detail, therefore there is a need to revalidate the utility of WA for Vamana. Hence, the above study was conducted to ascertain the efficacy as a therapeutic emetic agent (vamaka yoga) in the management of psoriasis along with quality control and standardization of this herb. Materials and Methods: The drug was standardized as per analytical procedures in Pharmacopeias. Thirty patients of psoriasis fulfilling inclusion criteria were taken for the study and Vamana with WA was conducted. Criteria were prepared to assess the signs and Symptoms of psoriasis. VK was assessed using the classical Lakshanas (features) such as Anthiki shudhi (Ending symptoms of emesis), Vaigiki shudhi (features of vomiting bouts), Maniki shudhi (Quantitative and qualitative purification), complications. Result: VK with WA showed significant relief in parameters of psoriasis such as scaling, itching, candle grease sign (P < 0.001), and psoriasis area and severity index score (P = 0.001). In VK with WA, mean number of Vegas (vomiting bouts) was 6.91. 66% patients showing quantitative purification between 301 and 600 ml. 73.33% showed all Symptoms of purification. 73.33% patients showed Kaphanta vamana (Moderate expulsion of desire humor). In the level of biopurification, 66.66% patients showed moderated purification. No complication was noted with moderate drug palatability. Conclusion: Pharmacopeial analytical study showed its standardized values for testing the drug used for the study. It is proved as potent therapeutic emetic agent with no complication showed its clinical benefits over skin disorder like psoriasis. SUMMARY Seeds of Wrightia antidysenterica (WA) Linn. free from any foreign matter were selected for the study. Loss on drying revealed 6.535% moisture content; total ash indicating of total inorganic content was found to be 5.12%; acid insoluble ash is the acid insoluble part of total ash, mainly silica, WA showed 0.393% acid insoluble ash; ethanol and water soluble extractive is indicative of percentage active constituents were found to be 25.66 and 20.854%, respectively. High-performance thin layer chromatography fingerprinting profiles of WA under 254 nm showed the presence of 7 spots (all in green) at Rf values ranging from 0.21 to 0.88. Under 366 nm there were 4 prominent spots (all in fluorescent) at Rf 0.49 to 0.82 and, when scanned under white light 620 nm following derivatization with vanillin sulfuric acid 6 spots (in different colors) were evident at Rf 0.28 to 0.58. Among these spot with Rf of 0.58 was common when visualized under all the three methods. Rf values by densitometric scan of WA showed 12 peaks at 254 nm and 5 peaks at 366 nm. However, in clinical trial, it was found to be a potent emetic agent without any complication. Abbreviations Used: WA: Wrightia antidysenterica; Linn.; VK: Vamana karma; BT: Before treatment; FP: Freidman's P value; CHS: Chi-square value; NR: Negative ranks; PR: Positive ranks; N: Sample number, AS: Austipz sign; CG: Candle grease test; SSL: Samyak Snigdha Lakshana PMID:27114687

  15. The influence of gonadotropins on clinico-biological ICSI outcome: a retrospective comparative study rFsH vs HP-hmg.

    PubMed

    Khlifi, Abdeljalil; Kacem, Olfa; Maroueni, Maher; Elgoul, Leila; Hidar, Samir; Fekih, Meriem; Boughizane, Sassi; Essaidi, Habib; Ben Regaya, Lassad; Bibi, Mohamed; Ajina, Mounir; Khairi, Hedi

    2016-06-01

    Objective To investigate the difference in the outcome of ICSI-ET cycles among respondents patients, taking into account the molecule inducer of controlled ovarian stimulation: HP-hMG ou rFSH. Patients and Methods A comparative retrospective study over 62 months including a total of 1005 infertile couples, divided into two groups: HP-HMG (n=125) and rFSH (n=880). Results - The average numbers of retrieved oocytes and matures oocytes were significantly higher in rFSH group rFSH (7,94 ± 2,49, HP-HMG vs 9,05 ± 3,40, rFSH, p=0.0001and  3±2,68, HP-HMG vs 6,65±3,05 , rFSH, p=0,02 respectively). There was no statistically significant difference in the endometrial thickness and estradiol level on hCG injection day, the total amount of administrated gonadotropin and the duration of stimulation. In addition, we did not find a significant difference between the two groups regarding the fertilization, the maturation, the cleavage, top quality embryo, implantation, clinical pregnancy, multiple pregnancies, live birth and miscarriage rates. There was no case of severe ovarian hyperstimulation syndrome. Conclusion - Inspite of a higher number of retrieved and mature oocytes obtained with rFSH, the latter showed no superiority over HP-hMG which seem to be equally efficient and safe for ICSI treatment cycles.

  16. A clinico-pathological conference on constrictive pericarditis secondary to rheumatoid arthritis: a case report with expert commentary and review of the literature.

    PubMed

    Jordan, Adam D; Khan, Muhammad E A; Hoey, Edward T; Rassl, Doris; Nashef, Samer A M

    2011-01-01

    Constrictive pericarditis is the commonest cardiac complication of rheumatoid arthritis (RA). Two percent of patients with RA develop significant clinical symptoms of pericarditis, which may not correlate with joint disease duration or severity. Symptoms are often vague and non-specific, which frequently delays the diagnosis and subsequent management. Surgical excision of the pericardium is the only definitive treatment option. We present the case of a 60 year-old lady with RA who presented with symptoms due to pericardial constriction and underwent radical pericardectomy.

  17. Synchronous clear cell renal cell carcinoma and multilocular cystic renal cell neoplasia of low malignant potential: A clinico-pathologic and molecular study.

    PubMed

    Raspollini, Maria Rosaria; Castiglione, Francesca; Cheng, Liang; Montironi, Rodolfo; Lopez-Beltran, Antonio

    2016-05-01

    We report a rare case of synchronous clear cell renal cell carcinoma and multilocular cystic renal cell neoplasia of low malignant potential in the same kidney. The tumors were seen incidentally in a 45-year-old man. Pathologic study revealed that the former tumor was nucleolar grade 2, and the multilocular cystic renal cell neoplasia of low malignant potential was nucleolar grade 1. At immunohistochemistry, the clear cells in both tumors were positive for CD10 and CA IX. Interestingly, these uncommon synchronous tumors showed a different KRAS/NRAS mutation analysis that was characterized by KRAS mutation at codon p.G12C in the clear cell renal cell carcinoma, while this mutation was not present in the case of multilocular cystic renal cell neoplasia of low malignant potential. NRAS mutation was not seen in any of the tumors.

  18. Clinico-pathologic, dermoscopic and ultrasound examination of a rare acral tumour involving the nail - case report and review of the literature.

    PubMed

    Grigore, Lavinia Elena; Baican, Corina Iulia; Botar-Jid, Carolina; Rogojan, Liliana; Letca, Alina Florentina; Ungureanu, Loredana; Cosgarea, Rodica

    2016-01-01

    There is a large spectrum of tumors presenting as nodular lesions that may affect the subungual space. We report the case of a 62-year-old woman presenting with a rapidly growing nodular lesion under the nail of the first left toe. Non-invasive examinations using dermoscopy, ultrasonography and elastography were performed for the preoperative assessment of the lesion. The biopsy of the lesion revealed superficial acral fibromyxoma, a benign tumor with predisposition for acral sites. The patient underwent radical surgery with wide resection margins. This is the first case report of a superficial acral fibromyxoma affecting the subungual region characterized by dermoscopic, ultrasonographic and elastographic features. We also performed a short review of the literature.

  19. A case of a spontaneous intraorbital arteriovenous fistula: clinico-radiological findings and treatment by transvenous embolisation via the superior ophthalmic vein.

    PubMed

    Naqvi, Jawad; Laitt, Roger; Leatherbarrow, Brian; Herwadkar, Amit

    2013-04-01

    A 72-year-old male presented with progressive right axial proptosis and red eye. Catheter angiography demonstrated an intraorbital arteriovenous fistula (IAVF) distal to the central retinal artery (CRA). Transvenous embolisation following direct surgical exposure of the superior ophthalmic vein (SOV) resulted in rapid resolution of his symptoms and signs. Transvenous embolisation via the SOV is a safe, effective alternative to transarterial embolisation for treating spontaneous IAVF where transarterial embolisation poses a risk of CRA occlusion.

  20. Pauci-immune necrotizing crescentic glomerulonephritis with crescentic and full moon extracapillary proliferation: clinico-pathologic correlation and follow-up study.

    PubMed

    Unlu, Mehtat; Kiremitci, Saba; Ensari, Arzu; Ozluk, Yasemin; Kilicaslan, Isin; Ozdemir, Binnaz Handan; Ates, Deniz; Ertoy Baydar, Dilek; Gonul, Ipek Isik; Memis, Leyla; Sarsik, Banu; Sen, Sait; Akkaya, Bahar; Orhan, Diclehan; Gonlusen, Gulfiliz; Ellidokuz, Hulya; Ada, Sibel; Cavdar, Caner; Akagun, Tulin; Kamali, Sevil; Aksu, Kenan; Yazisiz, Veli; Paydas, Saime; Soylu, Alper; Sarioglu, Sulen

    2013-02-15

    The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necrotizing crescentic glomerulonephitis (PIGN) was evaluated in this study. In 141 PIGN cases, all glomeruli with ECP were grouped according to type (cellular, fibrocellular and fibrous) and extent of the lesions in Bowman's space; (segmental, semicircumferential and circumferential, which might be termed full moon-FM). Cases with cellular and fibrous lesions involving ≥ 50% of glomeruli with ECP were classified as cellular and fibrous groups, respectively, while the remaining cases were classified as fibrocellular. Cases with segmental and circumferential (FM glomerulus) lesions involving ≥ 50% of glomeruli with ECP were classified as ECPI and ECPIII (FM) groups, respectively, while the rest were classified as ECPII. All the cases were classified according to Berden et al. Significant results were only nearly obtained for the FM group, including the need for dialysis. The Cox regression model revealed a 2.6-fold risk for FM cases regarding dialysis requirement. We propose that the percentage of FM glomeruli should be noted in the pathology report, and cases with more than 50% of FM glomeruli (FM group) should be identified in the group with increased risk of dialysis requirement. Our series also suggests that classification according to Berden et al. is of clinical relevance. Copyright © 2012 Elsevier GmbH. All rights reserved.

  1. Lung involvement in systemic sclerosis: role of high resolution computed tomography and its relationship with other pulmonary and clinico-serological features.

    PubMed

    Colaci, M; Sebastiani, M; Manfredi, A; Giuggioli, D; Cassone, G; Manzini, C U; Ghizzoni, C; Cerri, S; Ferri, C

    2014-01-01

    The study investigated the characteristic of interstitial lung disease in a large series of systemic sclerosis (SSc) patients by means of HRCT and the correlations between functional lung parameters, serological features and the extent of lung involvement evaluated by high-resolution computed tomography (HRCT). One hundred and seven SSc patients, consecutively investigated by means of HRCT, standard chest X-ray, and pulmonary function tests, were retrospectively evaluated. Chest radiogram and HRCT scores were strongly associated (Pearson’'s r=0.82, p < .0001); moreover, the first significantly correlated with spirometric parameters, even if weakly. Anti-Scl70 and anti-centromere antibodies were associated with higher (p=0.01) and lower HRCT score (p=0.0002), respectively. The extension of interstitial lung involvement in SSc evaluated with HRCT is directly proportional to functional lung parameters. HRCT, spirometry and DLco should be considered essential in the core-set of non-invasive diagnostic tools for the first-line assessment of scleroderma lung involvement.

  2. A Clinico-analytical Study on Seed of Wrightia antidysenterica Linn. as a Therapeutic Emetic Agent (Vamaka Yoga) in the Management of Psoriasis.

    PubMed

    Bhattacharyya, Nirupam; Pujar, Muralidhar P; Chaturvedi, Ashutosh; Kumar, M Ashvini; Lohith, B A; Kumar, K N Sunil

    2016-03-01

    Wrightia antidysenterica Linn. (WA) is male variety Kutaja stated to be potent therapeutic emetic agent in skin disorders. Expulsion of doshas through oral route is termed as Vamana Karma (VK) (therapeutic emesis). However, so far, its utility for Vamana is not explored in detail, therefore there is a need to revalidate the utility of WA for Vamana. Hence, the above study was conducted to ascertain the efficacy as a therapeutic emetic agent (vamaka yoga) in the management of psoriasis along with quality control and standardization of this herb. The drug was standardized as per analytical procedures in Pharmacopeias. Thirty patients of psoriasis fulfilling inclusion criteria were taken for the study and Vamana with WA was conducted. Criteria were prepared to assess the signs and Symptoms of psoriasis. VK was assessed using the classical Lakshanas (features) such as Anthiki shudhi (Ending symptoms of emesis), Vaigiki shudhi (features of vomiting bouts), Maniki shudhi (Quantitative and qualitative purification), complications. VK with WA showed significant relief in parameters of psoriasis such as scaling, itching, candle grease sign (P < 0.001), and psoriasis area and severity index score (P = 0.001). In VK with WA, mean number of Vegas (vomiting bouts) was 6.91. 66% patients showing quantitative purification between 301 and 600 ml. 73.33% showed all Symptoms of purification. 73.33% patients showed Kaphanta vamana (Moderate expulsion of desire humor). In the level of biopurification, 66.66% patients showed moderated purification. No complication was noted with moderate drug palatability. Pharmacopeial analytical study showed its standardized values for testing the drug used for the study. It is proved as potent therapeutic emetic agent with no complication showed its clinical benefits over skin disorder like psoriasis. Seeds of Wrightia antidysenterica (WA) Linn. free from any foreign matter were selected for the study. Loss on drying revealed 6.535% moisture content; total ash indicating of total inorganic content was found to be 5.12%; acid insoluble ash is the acid insoluble part of total ash, mainly silica, WA showed 0.393% acid insoluble ash; ethanol and water soluble extractive is indicative of percentage active constituents were found to be 25.66 and 20.854%, respectively. High-performance thin layer chromatography fingerprinting profiles of WA under 254 nm showed the presence of 7 spots (all in green) at Rf values ranging from 0.21 to 0.88. Under 366 nm there were 4 prominent spots (all in fluorescent) at Rf 0.49 to 0.82 and, when scanned under white light 620 nm following derivatization with vanillin sulfuric acid 6 spots (in different colors) were evident at Rf 0.28 to 0.58. Among these spot with Rf of 0.58 was common when visualized under all the three methods. Rf values by densitometric scan of WA showed 12 peaks at 254 nm and 5 peaks at 366 nm. However, in clinical trial, it was found to be a potent emetic agent without any complication. Abbreviations Used: WA: Wrightia antidysenterica; Linn.; VK: Vamana karma; BT: Before treatment; FP: Freidman's P value; CHS: Chi-square value; NR: Negative ranks; PR: Positive ranks; N: Sample number, AS: Austipz sign; CG: Candle grease test; SSL: Samyak Snigdha Lakshana.

  3. Evaluation of peri-implant tissues around nanopore surface implants with or without platelet rich fibrin: A clinico-radiographic study.

    PubMed

    Khan, Zia Arshad; Jhingran, Rajesh; Bains, Vivek Kumar; Srivastava, Ruchi; Madan, Rohit; Rizvi, Iram

    2017-09-28

    To comparatively evaluate peri-implant tissue changes around nano-pore implant surface with or without platelet rich fibrin (PRF). Material and Methods: For the present study total number of 17 patients was initially enrolled for the study (6 females, 11 males) with 38 sites (19 control and 19 experimental sites) were finally randomly assigned to receive either as Group 1 (Control) i.e. Extraction site received immediate implants without any PRF, and Group 2 (Experimental) i.e. Extraction sites received immediate implants with PRF. Clinical and radiographic parameters were recorded till 9 months after implant-loading phase. Results: Clinically, there was significant (p<0.001) increase in peri-implant probing depth (PIPD) from prosthetic phase to 9 months in both the groups and the increase was more in control group. However, the mean difference of change between the two groups was non-significant. Modified gingiva index (mGI) for Group II is significantly lower than that for Group I in prosthetic phase. Radiographically, in control group and experimental group, there was significant increase (<0.01) in bone loss (BL) in mesial and distal aspect of implant from surgical to prosthetic phase, surgical to 9 months and from prosthetic phase to 9 months. There was greater BL in control group than in experimental group, in both mesial and distal aspect of implant, however the difference in BL was non-significant (<0.01). There was greater BL in the distal aspect than in the mesial aspect in both the groups; however the difference in BL was non-significant. Conclusion: PRF treatment may be a way to prevent bone loss during the surgical-to-prosthetic phase. These result were based on short term low sample randomized clinical study, therefore long term study with more sites with homogenous sampling are recommended. Keywords: Implant, extraction socket, probing pocket depth, platelet rich fibrin . © 2017 IOP Publishing Ltd.

  4. A Comparative Evaluation of Serum Magnesium in Diabetes Mellitus Type 2 Patients with and without Periodontitis - A Clinico-biochemical Study.

    PubMed

    Shetty, Akshatha; Bhandary, Rahul; Thomas, Biju; Ramesh, Amitha

    2016-12-01

    Magnesium is an essential cation playing a crucial role in many physiological functions and its imbalance is associated with greater number of pathological situations. Oxidative stress is usually increased due to decreased essential nutrients. Hence, any imbalance of essential nutrients like serum magnesium can significantly play a role in the pathobiology of periodontitis in the presence of diabetes, as diabetes and chronic periodontitis are two chronic diseases that have been biologically linked. To evaluate the association of serum magnesium in type 2 diabetes mellitus and chronic periodontitis patients, also to evaluate and associate the influence of serum magnesium on periodontal health. A single blinded, randomized study was conducted that comprised of 120 subjects divided into four groups. Individuals with periodontitis and type 2 diabetes mellitus formed the test group. Subjects with chronic periodontitis diagnosed clinically according to 1999 American Academy of Periodontology classification, without any medical history and drug history were included as the study subjects. Gingival Index and Plaque Index were scored for all the groups at baseline and after 21 days of scaling and root planing. Scaling and root planing was done only in the test group. Blood was drawn from the patients at baseline and 21 days after scaling and root planning and estimation of serum magnesium level was done using semi-autoanalyzer. Data obtained was statistically analyzed using the paired t-test, one-way ANOVA, post-hoc test. The result of the present study showed that mean serum magnesium among healthy was 1.40±0.565mmol/l as compared to 1.01±0.287mmol/l among subjects with periodontitis, 0.920±0.23mmol/l among diabetics with periodontitis and 0.93±0.29mmol/l among diabetics without periodontitis. Serum magnesium was significantly decreased in chronic periodontitis and diabetic patients with and without chronic periodontitis as compared to controls. Imbalance of serum magnesium level was seen in patients with chronic periodontitis and type 2 diabetes mellitus. Hence, it can be a biomarker which can predict the occurrence of type 2 diabetes mellitus and chronic periodontitis.

  5. Natural course of typical and atypical parenchymal solitary cysticercus granuloma of the brain: a 3-year prospective clinico-radiological study.

    PubMed

    Kumar, Neeraj; Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Gupta, Rakesh Kumar; Verma, Rajesh; Sharma, Praveen Kumar

    2016-02-01

    To evaluate the role of advanced magnetic resonance (MR) sequences (fast imaging employing steady-state acquisition (FIESTA), T2 star-weighted angiography (SWAN) and spoiled gradient recalled echo (SPGR)) in patients with single small enhancing computed tomography lesions and scolex demonstration in typical and atypical parenchymal neurocysticercosis. In this study, 59 patients of new-onset seizures with single small enhancing computed tomography lesions of the brain were included. Along with routine MR sequences, advanced MR sequences, like SWAN, FIESTA, and pre and post-contrast SPGR, were performed. Follow-up MR studies focussing on the morphology of the lesions and demonstration of scolex were performed 6 monthly for 3 years. The majority of patients (62.7%) were men with partial seizure as the most common manifestation. On SPGR, contrast lesions were identified as either 'typical' (42, 71.2%) or 'atypical' (17, 28.8%). In the typical lesion group, SWAN and FIESTA sequences detected scolex in 30 (71.4%) and 32 (76.2%), respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 35 (83.3%) patients compared to 19 (45.2%) by routine sequences (P < 0.001). In the atypical lesion group, SWAN and FIESTA sequences detected scolex in 15 (88.2%) and 16 (94.1%) patients, respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 16 (94.1%) patients compared to 10 (58.8%) by routine sequences (P < 0.001). Follow-up showed greater resolution with lesser calcification in the typical group compared to the atypical group. This study provides an insight into the natural course of typical and atypical solitary cysticercus granuloma lesions, and the utility of SPGR-contrast, FIESTA and SWAN MR sequences in scolex demonstration and identification of atypical lesions. © The Author(s) 2015.

  6. Clinico-microbiological study and antibiotic resistance profile of mecA and ESBL gene prevalence in patients with diabetic foot infections

    PubMed Central

    CHAUDHRY, WAQAS NASIR; BADAR, RABIA; JAMAL, MUHSIN; JEONG, JASON; ZAFAR, JAMAL; ANDLEEB, SAADIA

    2016-01-01

    Diabetic foot infections (DFIs) constitute a major complication of diabetes mellitus. DFIs contribute to the development of gangrene and non-traumatic lower extremity amputations with a lifetime risk of up to 25%. The aim of the present study was to identify the presence of neuropathy and determine the ulcer grade, microbial profile and phenotypic and genotypic prevalence of the methicillin-resistance gene mecA and extended spectrum β-lactamase (ESBL)-encoding genes in bacterial isolates of DFI in patients registered at the Pakistan Institute of Medical Sciences (Islamabad, Pakistan). The results indicated that 46/50 patients (92%), exhibited sensory neuropathy. The most common isolate was Staphylococcus aureus (25%), followed by Pseudomonas aeruginosa (P. aeruginosa; 18.18%), Escherichia coli (16.16%), Streptococcus species (spp.) (15.15%), Proteus spp. (15.15%), Enterococcus spp. (9%) and Klebsiella pneumoniae (K. pneumoniae; 3%). The prevalence of the mecA gene was found to be 88% phenotypically and 84% genotypically. K. pneumoniae was shown to have the highest percentage of ESBL producers with a prevalence of 66.7% by double disk synergy test, and 100% by the cefotaxime + clavulanic acid/ceftazidime + clavulanic acid combination disk test. P. aeruginosa and K. pneumoniae had the highest (100%) proportion of metallo β-lactamase producers as identified by the EDTA combination disk test. The overall prevalence of β-lactamase (bla)-CTX-M, bla-CTX-M-15, bla-TEM, bla-OXA and bla-SHV genes was found to be 76.9, 76.9, 75.0, 57.7 and 84.6%, respectively, in gram-negative DFI isolates. The prevalence of mecA and ESBL-related genes was found to be alarmingly high in DFIs, since these genes are a major cause of antibiotic treatment failure. PMID:26998033

  7. [Clinico-neurological and stabilometric analysis of betahistine (betaserc) efficacy in the patients with vertigo in the rehabilitation period of ischemic stroke].

    PubMed

    Gekht, A B; Vialkova, A B; Galanov, D V

    2005-01-01

    A study of betahistine (betaserc) in 65 patients aged 59,48 +/- 8,63 years with vertigo in early rehabilitation period of ischemic stroke has been carried out. Thirty-five patients got atiplatelet and antihypertensive therapy and were also treated by betaserc--8-16 mg 3 times per day for 14 days per os, after meals. The control group of 30 patients received only atiplatelet and antihypertensive therapy. Both groups were similar in demographic and clinical characteristics. The treatment with betahistine reduced the intensity and duration of vertigo, led to improvement of coordination and equilibrium, increase stability of a vertical posture that was accompanied by significant (p<0,05) improvement of the values on the Hoffenberth and Bohannon scales. Betahistine treatment also resulted in marked authentic (p<0,05) improvement of stabilometric parameters in biological feedback task that might be explained by activation of the mechanisms maintaining vertical balance. An improvement of clinical and neurophysiologic traits was more pronounced in the group treated with betaserc as compared to the control group.

  8. Chronic multifocal neuropathy with persistent conduction block (Lewis-Sumner syndrome). A clinico-morphologic study of two further cases with review of the literature.

    PubMed

    Gibbels, E; Behse, F; Kentenich, M; Haupt, W F

    1993-01-01

    We present data of 2 patients suffering from chronic motor-sensory multifocal neuropathy with persistent conduction block. The first case concerns a 9-year follow-up of a female, aged 24 years at onset with persistent multiple conduction blocks and a tendency towards generalization of clinical deficits. Eight years after onset sural nerve biopsy revealed extreme interfascicular variations of de/remyelination, onion bulb formation, fiber loss, edema, and proliferation of basal lamina of endoneurial capillaries. Serum antibodies against GM1 gangliosides were not detected. The second case, a 29-year-old Yemenitic male with a 5-year history, exhibited conduction blocks in motor and sensory fibers, and a normal sural nerve biopsy. Our results are discussed with respect to those of some 30 cases individually reported in the literature.

  9. Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

    PubMed Central

    Gomez-Moreta, Juan A.; Hernandez-Vicente, Javier

    2015-01-01

    Background We present our experience in the treatment of patients with isthmic or degenerative spondylolisthesis, by means of a posterior lumbar interbody fusion (PLIF) and instrumented posterolateral fusion (IPLF), and we compare them with those published in the literature. We analyse whether there exists any statistical association between the clinical characteristics of the patient, radiological characteristics of the disease and our surgical technique, with the complications and the clinical-radiological prognosis of the cases. Method We designed a prospective study. A total of 36 cases were operated. The patients included were 14 men and 22 women, with an average age of 57.17±27.32 years. Our technique consists of PLIF+IPLF, using local bone for the fusion. The clinical results were evaluated with the Visual Analogical Scale (VAS) and the Kirkaldy-Willis criteria. The radiological evaluation followed the Bratingan (PLIF) and Lenke (IPLF) methodology. A total of 42 variables were statistically analysed by means of SPSS18. We used the Paired Student's T-test, logistic regression and Pearson's Chi-square-test. Results The spondylolisthesis was isthmic in 15 cases and degenerative in 21 cases. The postoperative evaluations had excellent or good results in 94.5% (n = 34), with a statistically significant improvement in the back pain and sciatica (p < 0.01). The rate of circumferential fusion reached was approximately 92%. We had 13.88% of transitory morbility and 0% of mortality associated with our technique. A greater age, degree of listhesis or length of illness before the intervention, weakly correlated with worse clinical results (p< -0.2). In our series, the logistical regression showed that the clinical characteristics of the patient, radiological characteristics of the lesion and our surgical technique were not associated with greater postoperative complications. Conclusion Although a higher level of training is necessary, we believe that the described technique is a very effective decision in cases of spondylolisthesis, isthmic or degenerative, refractory to conservative treatment, for the obtaining the best clinical results and rates of fusion, with similar risks to those of the other published techniques. Our statistical analysis could contribute to improve outcomes after surgery. PMID:26196029

  10. A Comparative Evaluation of Serum Magnesium in Diabetes Mellitus Type 2 Patients with and without Periodontitis - A Clinico-biochemical Study

    PubMed Central

    Bhandary, Rahul; Thomas, Biju; Ramesh, Amitha

    2016-01-01

    Introduction Magnesium is an essential cation playing a crucial role in many physiological functions and its imbalance is associated with greater number of pathological situations. Oxidative stress is usually increased due to decreased essential nutrients. Hence, any imbalance of essential nutrients like serum magnesium can significantly play a role in the pathobiology of periodontitis in the presence of diabetes, as diabetes and chronic periodontitis are two chronic diseases that have been biologically linked. Aim To evaluate the association of serum magnesium in type 2 diabetes mellitus and chronic periodontitis patients, also to evaluate and associate the influence of serum magnesium on periodontal health. Materials and Methods A single blinded, randomized study was conducted that comprised of 120 subjects divided into four groups. Individuals with periodontitis and type 2 diabetes mellitus formed the test group. Subjects with chronic periodontitis diagnosed clinically according to 1999 American Academy of Periodontology classification, without any medical history and drug history were included as the study subjects. Gingival Index and Plaque Index were scored for all the groups at baseline and after 21 days of scaling and root planing. Scaling and root planing was done only in the test group. Blood was drawn from the patients at baseline and 21 days after scaling and root planning and estimation of serum magnesium level was done using semi-autoanalyzer. Data obtained was statistically analyzed using the paired t-test, one-way ANOVA, post-hoc test. Results The result of the present study showed that mean serum magnesium among healthy was 1.40±0.565mmol/l as compared to 1.01±0.287mmol/l among subjects with periodontitis, 0.920±0.23mmol/l among diabetics with periodontitis and 0.93±0.29mmol/l among diabetics without periodontitis. Serum magnesium was significantly decreased in chronic periodontitis and diabetic patients with and without chronic periodontitis as compared to controls. Conclusion Imbalance of serum magnesium level was seen in patients with chronic periodontitis and type 2 diabetes mellitus. Hence, it can be a biomarker which can predict the occurrence of type 2 diabetes mellitus and chronic periodontitis. PMID:28209006

  11. [Clinico-endoscopic evaluation of the effectiveness of the treatment of uncomplicated gastroduodenal ulcers after local administration of solcoseryl and aevit].

    PubMed

    Granov, A M; Aiskhanov, S K; Nikolaev, L I; Smirnova, N A

    1989-12-01

    The complex of conservative measures for noncomplicated peptic ulcers included curative endoscopy in 105 patients, in 61 of them Aevitum was used as an application with additional injections of Solcoseryl around the ulcers. In 44 patients Aevitum was used along with Solcoseryl which was injected into the submucous layer around the pathological focus of the stomach and duodenum. The results obtained gave a convincing evidence of advantages of interstitial administration of Aevitum allowing to considerably shorten time of treatment (up to 10-12 days) of noncomplicated ulcers of the stomach and duodenum.

  12. Hypersensitivity to pollen of four different species of Brassica: a clinico-immunologic evaluation in patients of respiratory allergy in India

    PubMed Central

    Shahi, Shipra; Katiyar, Raj Kishore; Gaur, Shailendra; Jain, Vikram

    2014-01-01

    Background Rapeseed-mustard is the second most important source of edible oil in India. Several species of Brassica are grown in different parts of country for its oilseeds. Objective The objective was to investigate allergenicity to antigenic extracts of pollen of 4 species of Brassica. Methods Brassica campestris, Brassica juncea, Brassica nigra, and Brassica napus were selected for the detailed investigation. Pollen samples from each of the four species were collected from the polliniferous materials. The antigenic and allergenic profiles of these extracts were evaluated by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Skin prick test, enzyme linked immuno sorbent assay and Western blot on atopic individuals. Results Out of the 159 atopic subjects tested, 21.38% were positive to at least one or other species of Brassica pollen, with highest skin positivity (13.20%) to B. campestris extract. Raised IgE with significant linear correlation with intensity of skin reactions was obtained. Protein fractions of 20, 25, 32, 37, 56, and 90 kDa were recognized by B. campestris and B. juncea whereas 56, 76, 87, and 90 kDa were recognized by B. nigra and B. napus as major IgE binding protein fractions. The patients also showed positivity to other inhalant pollen allergens tested. Conclusion IgE mediated hypersensitivity varied from 4.40% to 13.20% in Indian atopic subjects to pollen of one or the other species of Brassica. Protein fractions of 47, 56, 76, 87, and 90 kDa were identified as IgE binding by all the four species, however individual heterogeneity exists. Thus a local species may be more pertinent for immunotherapy. The major allergen needs to be further characterized. PMID:25379479

  13. Automatic lung segmentation in CT images with accurate handling of the hilar region.

    PubMed

    De Nunzio, Giorgio; Tommasi, Eleonora; Agrusti, Antonella; Cataldo, Rosella; De Mitri, Ivan; Favetta, Marco; Maglio, Silvio; Massafra, Andrea; Quarta, Maurizio; Torsello, Massimo; Zecca, Ilaria; Bellotti, Roberto; Tangaro, Sabina; Calvini, Piero; Camarlinghi, Niccolò; Falaschi, Fabio; Cerello, Piergiorgio; Oliva, Piernicola

    2011-02-01

    A fully automated and three-dimensional (3D) segmentation method for the identification of the pulmonary parenchyma in thorax X-ray computed tomography (CT) datasets is proposed. It is meant to be used as pre-processing step in the computer-assisted detection (CAD) system for malignant lung nodule detection that is being developed by the Medical Applications in a Grid Infrastructure Connection (MAGIC-5) Project. In this new approach the segmentation of the external airways (trachea and bronchi), is obtained by 3D region growing with wavefront simulation and suitable stop conditions, thus allowing an accurate handling of the hilar region, notoriously difficult to be segmented. Particular attention was also devoted to checking and solving the problem of the apparent 'fusion' between the lungs, caused by partial-volume effects, while 3D morphology operations ensure the accurate inclusion of all the nodules (internal, pleural, and vascular) in the segmented volume. The new algorithm was initially developed and tested on a dataset of 130 CT scans from the Italung-CT trial, and was then applied to the ANODE09-competition images (55 scans) and to the LIDC database (84 scans), giving very satisfactory results. In particular, the lung contour was adequately located in 96% of the CT scans, with incorrect segmentation of the external airways in the remaining cases. Segmentation metrics were calculated that quantitatively express the consistency between automatic and manual segmentations: the mean overlap degree of the segmentation masks is 0.96 ± 0.02, and the mean and the maximum distance between the mask borders (averaged on the whole dataset) are 0.74 ± 0.05 and 4.5 ± 1.5, respectively, which confirms that the automatic segmentations quite correctly reproduce the borders traced by the radiologist. Moreover, no tissue containing internal and pleural nodules was removed in the segmentation process, so that this method proved to be fit for the use in the

  14. [Clinical substantiation of nootropic preparation use for premedication in outpatient stomatology].

    PubMed

    Novikova, S G

    2008-01-01

    The clinico-pharmacological description of nooclerin is given. The premedication effectiveness in patients with various individual typological features in out-patient stomatologic treatment was studied.

  15. Evaluation of anorganic bovine-derived hydroxyapatite matrix/cell binding peptide as a bone graft material in the treatment of human periodontal infrabony defects: A clinico-radiographic study

    PubMed Central

    Fatima, Ghousia; Shivamurthy, Ravindra; Thakur, Srinath; Baseer, Mohammad Abdul

    2015-01-01

    Background: Various bone graft materials have been used in the treatment of periodontal defects. A synthetic bone substitute material composed of P-15 with anorganic bone mineral has been scantly studied. Hence, the present study was aimed to evaluate and compare the efficacy of anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) in human periodontal infrabony defects with that of open flap debridement (OFD) alone. Materials and Methods: A split-mouth, randomized controlled clinical study was designed to investigate the efficacy of ABM/P-15. In this clinical trial, 10 patients having bilateral periodontal infrabony defects were treated either with ABM/P-15 or OFD and followed for a period of 9 months. At baseline and at 9 months probing pocket depth (PPD), relative attachment level (RAL), depth of a defect, and radiographic bone level were measured; and compared between test and control sites. Results: A statistically significant reduction (P < 0.001) in PPD was observed in test sites compared to control sites. Both sites showed a gain in RAL without any significant difference. Similarly, the radiographic evaluation revealed significantly higher radiographic defect fill in test sites as compared to control sites (P < 0.001). Conclusion: ABM/P-15 bone graft material appears to be useful and beneficial in the treatment of human periodontal infrabony defects. PMID:26941516

  16. Coordinator(a) de Servicios Clinicos. Parte I (Unidad I-IV). Parte II (Unidad V-VI). Guia. Documento de Trabajo (Clinical Services Coordinator. Part I. Units I-IV. Part II. Units V-VI. Guide. Working Document).

    ERIC Educational Resources Information Center

    Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

    This guide is intended for instructing secondary students in the occupation of clinical services coordinator in a hospital. The first part contains four units on the following subjects: the occupation of clinical services coordinator; interpersonal relationships; ethical/legal aspects; and communications (telephone, intercom, and others). For each…

  17. Diagnosis, classification and grading of canine mammary tumours as a model to study human breast cancer: an Clinico-Cytohistopathological study with environmental factors influencing public health and medicine.

    PubMed

    Shafiee, Radmehr; Javanbakht, Javad; Atyabi, Nahid; Kheradmand, Pegah; Kheradmand, Danial; Bahrami, Alimohammad; Daraei, Hasti; Khadivar, Farshid

    2013-01-01

    The human "Elston and Ellis grading method" was utilized in dogs with mammary tumor to examine its relation to prognosis in this species, based on a 2-year follow-up period. Although cytopathology is widely used for early diagnosis of human neoplasms, it is not commonly performed in veterinary medicine. Our objectives in this study were to identify cytopathology criteria of malignancy for canine mammary tumors and the frequency of different types of mammary lesions and their relationship with histologic grade was investigated. Another aim of this study was to differentiate the simple and adenocarcinoma tumors from the complex or mixed tumor described by Elston and Ellis grading method. The study was performed in 15 pure or mixed-breed female dogs submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female dogs were mainly terriers (9 dogs) or mixed (3 dogs), the 3 other animals were a German shepherd, Dachshund and Pekingese. Before surgical excision of the tumour, FNAC was performed using a 0.6 mm diameter needle attached to a 10 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain, or ethanol-fixed for Papanicolaou stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained. We obtained a correct cytohistological correlation in 14/15 cases (93.3%) when all cytopathological examinations were considered. Of the 15 cases examined, 2(13.3%) had well-differentiated (grade I), 6(40%) had moderately differentiated (grade II) and 7(46.7%) had poorly differentiated (grade III) tumours. Classification of all canine mammary gland lesions revealed 13(86.7%) malignant and 2(13.3%) benign tumors. The histological examination showed that the most common tumor types of mammary glands in bitches were: complex carcinoma, adenocarcinoma, malignant mixed tumour, benign mixed tumour, simple carcinoma- (5/15; 33.3%), (3/15; 20%), (3/15; 20%) and (2/15;13.3%), respectively. Simple carcinoma and cystic hyperplasia were less common - (1/15; 6.7%), and (1/15; 6.7%), respectively. Moreover, the most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. Our results demonstrate that, because of the similarity of the cytohistopathological findings in the human and canine mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of canine mammary gland tumours. Furthemoer, routine use of this human grading method would help the clinician to make a more accurate prognosis in the interests of post-surgical management in dogs with mammary carcinomas. Furthermore, this research will allow a more discriminating classification of mammary tumors and probably has a bearing on cytohistopathology, epidemiology, pathogenesis and prognosis. The most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. This interesting regional difference may be due to a) the duration of the growth before the diagnosis; b) the age of the dogs; and c) high prevelance of unspayed animals. Moreover, the most common type of tumor was complex carcinoma - 33.3% (5 cases).

  18. Lumbar vertebral growth is governed by "chondral growth force response curve" rather than "Hueter-Volkmann law": a clinico-biomechanical study of growth modulation changes in childhood spinal tuberculosis.

    PubMed

    Rajasekaran, S; Natarajan, Raghu N; Babu, J Naresh; Kanna, P Rishi Mugesh; Shetty, Ajoy Prasad; Andersson, Gunnar B J

    2011-10-15

    Vertebral defects were created in a validated 3D finite element model (FEM) to simulate destructive tubercular lesions of increasing severity. Forces in various parts of the spine were then calculated and correlated to deformity progression and growth modulation (GM) changes. To understand the biomechanical basis of GM, which governs spinal growth and the progression of kyphosis in posttubercular kyphotic (PTK) deformities. Hueter-Volkmann Law (HVL), chondral growth force response curve (CGFRC), and regional growth acceleratory phenomenon have all been proposed to explain the modulation of growth in limbs but have not been tested in vertebral end plates (VEP). We have previously documented various GM changes in posttubercular kyphotic. By simulating the kyphotic collapse in a validated FEM, the mechanical basis of GM can be established. Sixty-three children with tuberculosis treated conservatively formed the clinical material. The progress of deformity and GM changes in the fusion mass and the kyphotic curve was documented. Defects simulating lesions of four levels of severity (types A, B, C, and D) were created in a validated 3D FEM and subjected to load till restabilization occurred. The stresses at the end plates, discs, facet joints, and the points of contact were calculated. Regional growth acceleratory phenomenon and favorable growth changes were found in type A collapse where the facets were intact. With increasing destruction, the forces in the facet capsules increased beyond 30 MPa predicting facet dislocations in types B, C, and D collapse. As the contact stress on the VEP increased to 16.6 MPa (type B) and 40 MPa (type C), this was associated with growth suppression. Type D collapse involved facet dislocation at multiple levels leading to "buckling collapse". Acceleratory growth was found both in tension and compression phases proving that VEP growth followed principles of CGFRC rather than HVL. This is the first study in the current literature to demonstrate that spinal growth follows CGFRC rather than HVL. This observation opens a potential window of opportunity to treat spinal deformities by mechanical GM.

  19. [The clinico-pathogenetic characteristics of neurosis-like states in the participants in the cleanup of the aftermath of the accident at the Chernobyl Atomic Electric Power Station].

    PubMed

    Pishel', V Ia

    2000-03-01

    A clinical and paraclinical examination was done in 120 individuals with neurosis-like disorders, who had taken part in the elimination of the aftermath of the Chernobyl Nuclear Power Plant breakdown. A complex of etiological factors in the disorder has been identified. The most important syndrome was cerebral asthenia associated with depressive disorders and apparent vegetovascular dysfunction. Cerebral influences were implicated in the origination and development of neurosis-like disorders, with functional inadequacies having been disclosed in the patients' bodily catecholamine and immune systems.

  20. Coordinator(a) de Servicios Clinicos. Parte I (Unidad I-IV). Parte II (Unidad V-VI). Guia. Documento de Trabajo (Clinical Services Coordinator. Part I. Units I-IV. Part II. Units V-VI. Guide. Working Document).

    ERIC Educational Resources Information Center

    Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

    This guide is intended for instructing secondary students in the occupation of clinical services coordinator in a hospital. The first part contains four units on the following subjects: the occupation of clinical services coordinator; interpersonal relationships; ethical/legal aspects; and communications (telephone, intercom, and others). For each…

  1. Diagnosis, classification and grading of canine mammary tumours as a model to study human breast cancer: an Clinico-Cytohistopathological study with environmental factors influencing public health and medicine

    PubMed Central

    2013-01-01

    Background The human “Elston and Ellis grading method” was utilized in dogs with mammary tumor to examine its relation to prognosis in this species, based on a 2-year follow-up period. Although cytopathology is widely used for early diagnosis of human neoplasms, it is not commonly performed in veterinary medicine. Our objectives in this study were to identify cytopathology criteria of malignancy for canine mammary tumors and the frequency of different types of mammary lesions and their relationship with histologic grade was investigated. Another aim of this study was to differentiate the simple and adenocarcinoma tumors from the complex or mixed tumor described by Elston and Ellis grading method. Methods The study was performed in 15 pure or mixed-breed female dogs submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female dogs were mainly terriers (9 dogs) or mixed (3 dogs), the 3 other animals were a German shepherd, Dachshund and Pekingese. Before surgical excision of the tumour, FNAC was performed using a 0.6 mm diameter needle attached to a 10 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain, or ethanol-fixed for Papanicolaou stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained. Results We obtained a correct cytohistological correlation in 14/15 cases (93.3%) when all cytopathological examinations were considered. Of the 15 cases examined, 2(13.3%) had well-differentiated (grade I), 6(40%) had moderately differentiated (grade II) and 7(46.7%) had poorly differentiated (grade III) tumours. Classification of all canine mammary gland lesions revealed 13(86.7%) malignant and 2(13.3%) benign tumors. The histological examination showed that the most common tumor types of mammary glands in bitches were: complex carcinoma, adenocarcinoma, malignant mixed tumour, benign mixed tumour, simple carcinoma– (5/15; 33.3%), (3/15; 20%), (3/15; 20%) and (2/15;13.3%), respectively. Simple carcinoma and cystic hyperplasia were less common - (1/15; 6.7%), and (1/15; 6.7%), respectively. Moreover, the most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. Conclusions Our results demonstrate that, because of the similarity of the cytohistopathological findings in the human and canine mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of canine mammary gland tumours. Furthemoer, routine use of this human grading method would help the clinician to make a more accurate prognosis in the interests of post-surgical management in dogs with mammary carcinomas. Furthermore, this research will allow a more discriminating classification of mammary tumors and probably has a bearing on cytohistopathology, epidemiology, pathogenesis and prognosis. The most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. This interesting regional difference may be due to a) the duration of the growth before the diagnosis; b) the age of the dogs; and c) high prevelance of unspayed animals. Moreover, the most common type of tumor was complex carcinoma – 33.3% (5 cases). PMID:23937693

  2. [Computer-assisted gnatho-prosthodontic diagnosis].

    PubMed

    Burlui, V; Rädäuceanu, C; Orhei, G; Dumitraşcu, C

    1991-01-01

    The program is very useful by its rapidity, reliability and releasing the dentist from calculating the multiple variants of some clinico-biological indices. The computer-assisted gnatho-prosthetic diagnosis also makes possible a more adequate therapeutical plan.

  3. A comparative evaluation of bovine-derived xenograft (Bio-Oss Collagen) and type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of intrabony defects: A clinico-radiographic study

    PubMed Central

    Palachur, Deepthi; Prabhakara Rao, K. V.; Murthy, K. Raja V.; Kishore, D. Trinath; Reddy, M. Narendra; Bhupathi, Anitha

    2014-01-01

    Background and Objectives: The purpose of this study was to compare the efficacy of bovine-derived xenograft (Bio-Oss Collagen) and Type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of periodontal infrabony defects. Materials and Methods: Fourteen healthy patients in the age range of 20 to 60 years, showing bilateral or contralateral infrabony defects were selected. The defects were assigned randomly to Site A (bovine-derived xenograft [Bio-Oss Collagen] with bioresorbable Type I collagen membrane [Bio-Gide]) and Site B (fibrin fibronectin sealing system [TISSEEL] with bovine-derived xenograft [Bio-Oss Collagen]). The radiographic parameters were recorded at baseline, 6 months, and 9 months postoperatively. Results: All fourteen patients returned for recall at regular intervals till the completion of the study. Both the experimental groups showed clinically and radiographically statistically significant reduction in probing pocket depth and gain in clinical attachment level. Conclusion: Both groups showed potential for enhancing the periodontal regeneration with no statistically significant between the two groups; however, on comparison the Bio-Oss Collagen and TISSEEL group were slightly better. PMID:25024548

  4. A comparative evaluation of bovine-derived xenograft (Bio-Oss Collagen) and type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of intrabony defects: A clinico-radiographic study.

    PubMed

    Palachur, Deepthi; Prabhakara Rao, K V; Murthy, K Raja V; Kishore, D Trinath; Reddy, M Narendra; Bhupathi, Anitha

    2014-05-01

    The purpose of this study was to compare the efficacy of bovine-derived xenograft (Bio-Oss Collagen) and Type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of periodontal infrabony defects. Fourteen healthy patients in the age range of 20 to 60 years, showing bilateral or contralateral infrabony defects were selected. The defects were assigned randomly to Site A (bovine-derived xenograft [Bio-Oss Collagen] with bioresorbable Type I collagen membrane [Bio-Gide]) and Site B (fibrin fibronectin sealing system [TISSEEL] with bovine-derived xenograft [Bio-Oss Collagen]). The radiographic parameters were recorded at baseline, 6 months, and 9 months postoperatively. All fourteen patients returned for recall at regular intervals till the completion of the study. Both the experimental groups showed clinically and radiographically statistically significant reduction in probing pocket depth and gain in clinical attachment level. Both groups showed potential for enhancing the periodontal regeneration with no statistically significant between the two groups; however, on comparison the Bio-Oss Collagen and TISSEEL group were slightly better.

  5. [Nursing students' satisfaction and perception of their first clinical placement: observational study].

    PubMed

    Comparcini, Dania; Simonetti, Valentina; Tomietto, Marco; Galli, Francesco; Fiorani, Catia; Di Labio, Luisa; Cicolini, Giancarlo

    2014-01-01

    Background. Gli ambienti di apprendimento clinico sono definiti come una rete di fattori interagenti nel contesto, in grado di influenzare gli esiti dell’apprendimento degli studenti. La soddisfazione degli studenti è considerata un indicatore del raggiungimento degli esiti dell’apprendimento ed è determinante a partire dalla prima esperienza di tirocinio. Scopo. Analizzare l’esperienza di apprendimento clinico degli studenti infermieri del primo anno di corso dopo il primo tirocinio clinico ed identificare i principali determinanti della soddisfazione degli studenti. Metodo. Lo studio osservazionale è stato realizzato in cinque sedi universitarie italiane del Corso di Laurea in Infermieristica. 420 studenti hanno compilato la versione italiana della “Clinical Learning Environment, Supervision and plus Nurse Teacher (CLES+T) scale” al termine del primo tirocinio clinico. Risultati. I punteggi medi assegnati alle dimensioni della scala variano da 4.02 (clima di apprendimento) a 3.30 (relazione di tutorato). La maggior parte degli studenti è soddisfatto della propria esperienza di tirocinio (75.6%), ma sono emerse differenze in relazione alle diverse sedi di tirocinio clinico. Discussione. I principali determinanti della soddisfazione sono lo stile di leadership del coordinatore infermieristico e l’integrazione teoria-pratica nella relazione fra tutor clinico, universitario e studente. Conclusioni. I risultati dello studio contribuiscono alla comprensione della prima esperienza di tirocinio degli studenti. Tuttavia, sono necessarie ulteriori ricerche per determinare le variabili organizzative specifiche e i modelli tutoriali in grado di aumentare la soddisfazione degli studenti, per sviluppare strategie formative basate sull’integrazione tra tutor universitari e guide di tirocinio.

  6. Perceived quality in Day Surgery Units Proposal of an enquiry postoperative questionnaire.

    PubMed

    Palumbo, Piergaspare; Perotti, Bruno; Amatucci, Chiara; Pangrazi, Maria Pia; Leuzzi, Barbara; Vietri, Francesco; Illuminati, Giulio

    2016-01-01

    La soddisfazione dei pazienti assume particolare importanza nell’attività chirurgica in Day Surgery, al fine di mantenere ed incrementare la domanda di prestazioni da parte dell’utenza ed inoltre di valutare le abilità e le competenze dello staff clinico dedicato. Sono stati valutati i risultati di un questionario somministrato dal 2007 al 2012, divisi in due gruppi, alla dimissione e a 30 giorni dall’intervento. Tali risultati hanno permesso di valutare i principali vantaggi e limiti del questionario in termini di comprensibilità, di corretto timing di somministrazione, e di utilità per lo staff clinico.

  7. Tuberous sclerosis in a term newborn with opisthotonus - The value of ultrasound.

    PubMed

    Poggiani, C; Laiolo, A; Bellini, M; Cavalli, P

    2008-03-01

    Sommario INTRODUZIONE: Vengono descritti il caso clinico e le anomalie ecografiche cerebrali di un neonato affetto da sclerosi tuberosa complessa, quadro malformativo raro con interessamento neurocutaneo e implicazioni genetiche. La diagnosi si basa sull'esame clinico, sulle indagini per imaging. METODI: Vengono confrontati i risultati ottenuti con le metodiche di indagine di riferimento (RM e US). Gli autori enfatizzano il fatto che, in assenza di una segnalazione ecografica prenatale, è importante fare affidamento sui segni clinici e impostare un corretto completamento diagnostico in epoca neonatale. CONCLUSIONI: L'ecografia transfontanellare occupa un ruolo importante anche nel neonato a termine.

  8. [Halotherapy in combined non-puncture therapy of patients with acute purulent maxillary sinusitis].

    PubMed

    Grigor'eva, N V

    2003-01-01

    Halotherapy was applied for non-puncture treatment of 45 patients with acute purulent maxillary sinusitis. The response was evaluated by changes in clinico-immunological, cytological, x-ray and bacteriological parameters. Halotherapy was found effective in the treatment of acute purulent maxillary sinusitis without puncture.

  9. [Various theoretical questions concerning the pathogenesis of endogenous psychoses as related to population patterns].

    PubMed

    Bespal'ko, I G

    1987-01-01

    Two types of exponential and clinico-statistical correlations which determine the time-course of endogenic psychoses have been analyzed. On the basis of this analysis the author proposes a new probability theory explaining these correlations by the presence in endogenic psychoses of protective stabilizing (rather than pathologic) processes.

  10. Pathologic characterization of genotypes XIV and XVII Newcastle disease viruses and efficacy of classical vaccination on specific pathogen-free birds

    USDA-ARS?s Scientific Manuscript database

    To characterize the clinico-pathological characteristics of recently-described genotypes of Newcastle disease virus (NDV), one representative strain of genotype XIV and two of genotype XVII, all isolated from West Africa, were used to infect four-week-old, specific pathogen free (SPF) chickens. The ...

  11. Colon cancer: it's CIN or CIMP.

    PubMed

    Issa, Jean-Pierre

    2008-10-01

    Combined genetic and epigenetic analysis of sporadic colon cancer suggest that it can no longer be viewed as a single disease. There are at least three different subsets with distinct clinico-pathologic features, with important implications for preventions, screening, and therapy.

  12. Arg72Pro polymorphism of p53 may predict poor response to medical treatment in ulcerative colitis.

    PubMed

    Vietri, Maria Teresa; Riegler, Gabriele; Pellino, Gianluca; Molinari, Anna Maria; Cioffi, Michele

    2014-01-01

    dominio ricco di proline del gene Tp53. Tale polimorfismo può determinare lo sviluppo di diversi tipi di cancro, quali il tumore della mammella, del polmone, della cervice, del colon-retto e del fegato. Studi precedenti hanno riportato un’associazione tra omozigosi Pro72 ed il decorso clinico della Colite Ulcerosa (CU).

  13. Brain oncology. Biology, diagnosis and therapy

    SciTech Connect

    Chatel, M.; Darcel, F.; Pecker, J.

    1987-01-01

    The book's contents are as follows: Part I: Oncogenesis. Part II: Neuropathology. Part III: Tumoral Immunobiology and Oncobiology. Part IV: Biological and Diagnostic Imaging. Part V: Clinico-Pathological Studies. Part VI: Neurosurgical Procedures and Radiotherapy Trends. Part VII: Chemotherapy and Immunotherapy.

  14. [Kartagener syndrome and hemangiomatous proliferation of lung capillaries: case report and literature review].

    PubMed

    Słodkowska, J; Słupek, A; Burakowski, J; Bestry, I; Filipecki, S; Radomski, P

    1996-01-01

    The authors present a case of Kartagener syndrome complicated by pulmonary hypertension accompanied by the lung capillaries haemangiomatous proliferation (post mortem diagnosis). Review of a literature (23 published cases) of the haemangiomatous proliferation of lung capillaries emphasizes clinico-pathological aspects and differential diagnosis. A rarity of Kartagener syndrome is another interesting point of a published case.

  15. Safety pin - The UNSAFE foreign body of air passage.

    PubMed

    Dasgupta, K S; Lanjewar, K Y; Joshi, S V

    2006-10-01

    Foreign bodies in the air passage are familiar otolaryngological emergencies. The diagnosis and management in most cases is based on clinico-radiological findings. Here, we are reporting three cases of open safety pin at various locations in the respiratory tract i.e. in the nose, nasopharynx and larynx. Their clinical presentation and management are described in detail.

  16. [Rifapex, a new antituberculosis agent].

    PubMed

    Sokolova, G B; Krasnov, V A; Reĭkhrud, T A; Tsybanev, A A

    2009-01-01

    Clinico-roentgenologic and bacteriologic efficacy and safety of rifapex (rifapentin) were investigated in the complex therapy of 90 patients with newly recorded drug-susceptible tuberculosis. Pifapex was shown to be effective in the treatment of the patients during the acute phase of the disease, during the treatment completeness and during the short preoperative period.

  17. Fraser syndrome in three consecutive siblings.

    PubMed

    Kalaniti, Kaarthigeyan; Sandhya, V

    2011-05-01

    Fraser syndrome (FS) is a rare disorder characterized by a combination of acrofacial and urogenital malformations with or without cryptophthalmos. We report a newborn and its two elder siblings who had multiple congenital anomalies and clinico-radiological features consistent with FS.

  18. Poisoning and Intoxication by Trace Elements in Children. An Abstract Review of the Worldwide Medical Literature 1966-1971.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Washington, DC. Bureau of Community Environmental Management.

    This annotated bibliography of 247 entries is divided into the following categories: (a) general aspects and reviews; (b) sources of poisoning, epidemiology, and pica studies; (c) clinico-pathological studies; (d) diagnosis and screening; (e) laboratory methods; and (f) treatment and prevention. A subject and author index is included. (PD)

  19. Fifteen-Year Follow-Up of 92 Hospitalized Adults with Down's Syndrome: Incidence of Cognitive Decline, Its Relationship to Age and Neuropathology

    ERIC Educational Resources Information Center

    Margallo-Lana, M. L.; Moore, P. B.; Kay, D. W. K.; Perry, R. H.; Reid, B. E.; Berney, T. P.; Tyrer, S. P.

    2007-01-01

    Background: The clinical and neuropathological features associated with dementia in Down's syndrome (DS) are not well established. Aims: To examine clinico-pathological correlations and the incidence of cognitive decline in a cohort of adults with DS. Method: A total of 92 hospitalized persons with DS were followed up from 1985 to December 2000.…

  20. Separate evolution of virulent newcastle disease virus from Mexico and Central America

    USDA-ARS?s Scientific Manuscript database

    A poultry outbreak of Newcastle disease (ND) was reported in Belize in 2008. The characteristics of three virulent Newcastle Disease Virus (NDV) isolates from this outbreak (NDV-Belize-3/08, NDV-Belize-12/08, NDV-Belize-4/08) were assessed by genomic analysis and by clinico-pathological characteriz...

  1. World Reference Center for Arboviruses

    DTIC Science & Technology

    1994-06-07

    Rodriguez, S.C., Tesh, R., Travassos da Rosa, J.F.S., and Travassos da Rosa, E.S. Infeccao humana adquirida in laboratorio causada pelo virus SPH 114202...Arenavirus: familia Arenaviridae): Aspectos clinicos e laboratoriais. Rev. Inst. Med. Trop. Sao Paulo 35:521-525, 1993. Vodkin, M.H., McLaughlin, G.L

  2. Fifteen-Year Follow-Up of 92 Hospitalized Adults with Down's Syndrome: Incidence of Cognitive Decline, Its Relationship to Age and Neuropathology

    ERIC Educational Resources Information Center

    Margallo-Lana, M. L.; Moore, P. B.; Kay, D. W. K.; Perry, R. H.; Reid, B. E.; Berney, T. P.; Tyrer, S. P.

    2007-01-01

    Background: The clinical and neuropathological features associated with dementia in Down's syndrome (DS) are not well established. Aims: To examine clinico-pathological correlations and the incidence of cognitive decline in a cohort of adults with DS. Method: A total of 92 hospitalized persons with DS were followed up from 1985 to December 2000.…

  3. [Early detection and stability of diagnosis in autism spectrum disorders].

    PubMed

    Canal-Bedia, R; Magan-Maganto, M; Bejarano-Martin, A; De Pablos-De la Morena, A; Bueno-Carrera, G; Manso-De Dios, S; Martin-Cilleros, M V

    2016-01-01

    Introduccion. La intervencion temprana en los niños con un trastorno del espectro autista (TEA) depende de una deteccion precoz y fiable. Aunque de manera general se habla de un diagnostico estable, se ha evidenciado la necesidad de profundizar mas en los factores que influyen en dicha estabilidad. Pacientes y metodos. Los participantes de la muestra fueron 142 menores con TEA (118 varones y 24 mujeres), con una mediana de 33 meses y un recorrido intercuartilico de 12 en la primera evaluacion, y con una mediana de 47 meses y un recorrido intercuartilico de 29 en el seguimiento. Los diagnosticos se realizaron con las siguientes pruebas: escala Merrill-Palmer revisada, escala de Leiter revisada, escala de inteligencia de Wechsler para preescolar y primaria III y escala de inteligencia de Wechsler para niños revisada y IV; ademas de la escala Vineland y la escala de observacion diagnostica del autismo generica (ADOS-G), basandose el diagnostico clinico en los criterios diagnosticos del Manual diagnostico y estadistico de los trastornos mentales, cuarta edicion, texto revisado (DSM-IV-TR), y quinta edicion (DSM-5). Para la evaluacion de la estabilidad diagnostica, se realizaron tablas de contingencia para las valoraciones del diagnostico en funcion del juicio clinico y los resultados de la ADOS-G. Resultados. El diagnostico clinico basado en los criterios del DSM-IV-TR, el DSM-5 y el juicio clinico se mantiene estable a traves del tiempo en un 96% de los casos. Si se valora la estabilidad diagnostica teniendo en cuenta los resultados del ADOS-G (n = 30), el 87% de los casos mantiene el diagnostico. El ANOVA muestra diferencias estadisticamente significativas para las medidas del factor intrasujeto del cociente intelectual y la edad social global, pero no para el diagnostico. Conclusiones. La estabilidad diagnostica se beneficia de un uso informado del criterio clinico y de la participacion de un equipo multidisciplinar.

  4. Carcinoma cuniculatum arising in the tongue.

    PubMed

    Thavaraj, Selvam; Cobb, Alistair; Kalavrezos, Nicholas; Beale, Timothy; Walker, Donald Murray; Jay, Amrita

    2012-03-01

    Carcinoma cuniculatum (CC) is a rare, distinct clinico-pathological variant of squamous cell carcinoma (SCC) that is defined histologically by the characteristic infiltrative pattern of a deep, broad, and complex proliferation of stratified squamous epithelium with keratin cores and keratin-filled crypts. Herein, we present a case report of CC of the oral tongue and discuss its diagnosis, management, and outcome, as well as briefly review the world literature. To our knowledge, this is the first documented case of CC of the tongue to be reported in the English literature. We draw attention to its clinico-pathological features and highlight that awareness of this entity as a distinct variant of SCC facilitates its correct management.

  5. A novel large deletion in the RYR1 gene in a Belgian family with late-onset and recessive core myopathy.

    PubMed

    Remiche, Gauthier; Kadhim, Hazim; Abramowicz, Marc; Mavroudakis, Nicolas; Monnier, Nicole; Lunardi, Joël

    2015-05-01

    We report a novel and particularly unusual type of mutation, namely, large deletion in the RYR1 gene, in a Belgian family with myopathy: Patients were found to be compound heterozygous and presented a clinico-pathological phenotype characterized by late-onset and recessive myopathy with cores. We depict the clinical, electrophysiological, pathological and molecular genetic characteristics of family members. To date, large deletions in the RYR1 gene have been reported in only two cases. Both involved different mutations and, in sharp contrast to our cases, presented with a very early-onset, neonatal, and a very severe or lethal phenotype. Overview of reported clinico-pathologic phenotypes, also highlights the rarity of combined late-onset/recessive co-occurrence in this group of myopathies with cores. Finally, this report underlines the broadening spectrum in this group of myopathologic disorders and highlights the concept of 'RYR1-associated/related core myopathies'.

  6. Staging of transitional cell carcinoma: Has anything changed?

    PubMed Central

    Kulkarni, J. N.; Bakshi, G. K.

    2008-01-01

    Objective: This article is a systematic review of various changes in the evolution of the contemporary clinico-pathological staging of transitional cell carcinoma (TCC). Materials and Methods: A thorough search of the literature was done by Medline and other internet references. Results: Accurate staging of TCC is necessary for designing optimal therapy in clinical practice. Further, the current emphasis on bladder conservation and improved long-term disease free survival (DFS) necessitates minimal errors in staging and it's predictability towards recurrence and progression. Traditionally, the staging of TCC revolves around clinical and pathological findings. The staging has evolved through the understanding of various clinico- pathological factors like tumor appearance, number, size, grade, depth of invasion, muscle substratification, lymphovascular invasion and has reached the standard TNM classification. Cystoscopy and transurethral resection still remain the mainstay of staging and noninvasive imaging techniques have further enhanced the accuracy. Conclusion: The TNM classification for bladder cancer is currently the gold standard for TCC. PMID:19468363

  7. Giovanni Battista Morgagni in the murals of Diego Rivera at the National Institute of Cardiology of Mexico City.

    PubMed

    Estañol, Bruno; Delgado, Guillermo R

    2014-07-01

    The Italian physician Giovanni Battista Morgagni was the founder of the clinico-anatomical method. His masterpiece De sedibus, et causis morborum per anatomen indagatis represented a major breakthrough in the history of medicine. In the murals of Diego Rivera at the National Institute of Cardiology, Morgagni appears at the center of the fresco. With his left index finger points to the chest of a dying patient with a bulging pulsating aortic aneurysm below the left clavicle, and with his right hand, that holds a scalpel, shows the aneurysm found at the autopsy table. With this striking image the clinico-anatomical method is succinctly depicted. Professor Ignacio Chávez, the founder of the National Institute of Cardiology, gave the artist the elements to draw Morgagni, but the disposition and the importance of Morgagni in the fresco were due to the talent of Rivera.

  8. [Plastic repair using the demineralized matrix of flat allogeneic bone in an operation for ventral hernia].

    PubMed

    Isaĭchev, B A; Chikaleva, V I

    1990-11-01

    Investigations were performed in experiments on 36 dogs. Clinico-morphological results of plasty of artificial defects of the anterior abdominal wall by demineralized matrix of a flat allogeneic bone have shown good taking by tissues. In clinic the demineralized matrix of flat allogeneic bone (scapula, skull fornix) was used in ventral hernias in 36 patients. No recurrent hernias were noted in these patients within 20 months after operation.

  9. [Difficulties of differential roentgeno-diagnosis of aneurysmal cysts and tumors of flat bones and the spine].

    PubMed

    Kalinichenko, L V; Vesnin, A G; Murenkov, O V; Kochnev, V A

    1988-01-01

    Clinico-roentgenologic data on 33 cases of aneurysmal cyst of the bone (flat bones--12, spinal cord--21) were assessed. Such peculiarities of the aneurysmal cyst of flat bones as large size, cellular--trabecular structure and a peripheral periosteal "shell" were identified. Vertebral cysts involved processes, arches and body resulting in compression fracture. They sometimes extended to adjacent vertebrae and ribs. Vertebral cysts should be differentiated mainly from giant-cell tumors, metastases and myeloma.

  10. Biodynamic Response to Windblast.

    DTIC Science & Technology

    1975-07-01

    and of the ca reful clinical and medico -legal study of injuries due to ejection and the dynamics of their production, it will be possible to achieve...Laboratory, Wright-Patter son Air Force Base, Ohio, 1973. 17.- ROTONDO G. : "Considerazioni clinico-etatidtiche a medico -legali su alcune tipiche...34Contributo allo studio dei problemi medico -legali relativi alla lesi- vith da disastri aersi". Riv.Med.Aeron.e SDaz., 1967, 30, 251. 20.- ROTONDO

  11. Department of Clinical Investigation Annual Research Progress Report: Fiscal Year 1990

    DTIC Science & Technology

    1990-09-30

    Survey of Army Meeting, US Retirees University of the Health Sciences 10/01/89 DEPARTMENT OF PEDIATRICS Atkinson AW Receptive Language Annual Meeting...81/12 Stages I and II Carcinoma of the Endometrium DOWNEY GO 0 GOG #40: A Clinical-Pathologic Study 270 #81/79 of Stages I and II Uterine Sarcomas...Recurrent Carcinoma of the Endometrium DOWNEY GO C GOG 83: A Clinico-Pathologic Study of 284 #85/90 Simultaneous Endometrial and Ovarian Carcinomas 39

  12. Brainstem variant of posterior reversible encephalopathy syndrome: A case report

    PubMed Central

    Caranci, Ferdinando; Belfiore, Maria Paola; Manzi, Francesca; Pagliano, Pasquale; Cirillo, Sossio

    2015-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition, generally observed in conjunction with severe and acute hypertension, that involves mainly the posterior head areas (occipital and temporal lobes) and anterior “watershed” areas. In this syndrome it is rare to observe a predominant involvement of the brainstem. We describe the clinical and radiological findings in a patient with brainstem involvement, discussing its pathophysiological features and possible differential diagnosis. PMID:26515750

  13. Brainstem variant of posterior reversible encephalopathy syndrome: A case report.

    PubMed

    Tortora, Fabio; Caranci, Ferdinando; Belfiore, Maria Paola; Manzi, Francesca; Pagliano, Pasquale; Cirillo, Sossio

    2015-12-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition, generally observed in conjunction with severe and acute hypertension, that involves mainly the posterior head areas (occipital and temporal lobes) and anterior "watershed" areas. In this syndrome it is rare to observe a predominant involvement of the brainstem. We describe the clinical and radiological findings in a patient with brainstem involvement, discussing its pathophysiological features and possible differential diagnosis.

  14. CINRG: Infrastructure for Clinical Trials in Duchenne Dystrophy

    DTIC Science & Technology

    2013-09-01

    Jerusalem, Israel X Pending Apollo Hospitals, Chennai , India X In review University of California, Sacramento, CA X X X Centro Clinico NEMO...Membership and Scientific Meeting The CINRG CC organized and conducted an Investigator meeting in November, 2012 at the Crystal City Marriott in...CRYSTAL CITY MARRIOTT AT REGAN NATIONAL AIRPORT 1999 Jefferson Davis Highway Arlington, Virginia 22202 Thursday November 8th, 2012 7:00 8:00

  15. Primary solitary fibrous tumor of the retroperitoneum

    PubMed Central

    Charhi, Hind; Bernoussi, Zakiya; Haddan, Azzouz; Mesmoudi, Siham; Elktaibi, Abderrahim; Mansouri, Fatima; Elktaibi, Rachid; Lahlou, Khalid; Jahid, Ahmed; Mahassini, Najat

    2011-01-01

    Solitary fibrous tumor is an uncommon neoplasm affecting adults and typically located in the pleura and can also occur in a large number of other extra thoracic sites. We present the case of a solitary fibrous tumor (SFT) of the retroperitoneum and describe their histopathological and immunohistochemical features. The identification of SFT in the retroperitoneum is of importance because its clinico-pathological behaviour is still unclear. The pathologist plays a fundamental role in establishing both the positive and differential diagnosis. PMID:24765378

  16. Biological and Genomic Differences of ERG Oncoprotein-Stratified Prostate Cancers from African and Caucasian Americans

    DTIC Science & Technology

    2016-10-01

    associations and racial differences of key clinico-pathologic features and SNPs for both ERG positive and ERG negative CaP. It is anticipated that...The PTEN/AKT pathway, which is often associated with aggressive CaP, will also be tested in this cohort by PTEN expression assay. Finally, we...propose that the incorporation of ERG-typing, somatic mutations/markers in ERG-negative CaP, and ERG-type associated SNPs, will complement traditional

  17. [Cryptogenic organizing pneumonia].

    PubMed

    Lebowitz, D; Lebowitz, D; Lebowitz, D; Rochat, T

    2013-11-20

    Cryptogenic organizing pneumonia (COP) is a distinct clinico-pathologic entity described for the first time by Davison in 1983 and 2 years later by Epler under the name of idiopathic Bronchiolitis Obliterans Organizing Pneumonia (BOOP). It most often presents with the clinical and radiological features of an infectious pneumonia which fails to respond to antibiotic therapy. In this article, we will review the clinical and radiographic features, diagnostic assessment, and the treatment of COP.

  18. Melanoma sentinel node biopsy and prediction models for relapse and overall survival

    PubMed Central

    Mitra, A; Conway, C; Walker, C; Cook, M; Powell, B; Lobo, S; Chan, M; Kissin, M; Layer, G; Smallwood, J; Ottensmeier, C; Stanley, P; Peach, H; Chong, H; Elliott, F; Iles, M M; Nsengimana, J; Barrett, J H; Bishop, D T; Newton-Bishop, J A

    2010-01-01

    Background: To optimise predictive models for sentinal node biopsy (SNB) positivity, relapse and survival, using clinico-pathological characteristics and osteopontin gene expression in primary melanomas. Methods: A comparison of the clinico-pathological characteristics of SNB positive and negative cases was carried out in 561 melanoma patients. In 199 patients, gene expression in formalin-fixed primary tumours was studied using Illumina's DASL assay. A cross validation approach was used to test prognostic predictive models and receiver operating characteristic curves were produced. Results: Independent predictors of SNB positivity were Breslow thickness, mitotic count and tumour site. Osteopontin expression best predicted SNB positivity (P=2.4 × 10−7), remaining significant in multivariable analysis. Osteopontin expression, combined with thickness, mitotic count and site, gave the best area under the curve (AUC) to predict SNB positivity (72.6%). Independent predictors of relapse-free survival were SNB status, thickness, site, ulceration and vessel invasion, whereas only SNB status and thickness predicted overall survival. Using clinico-pathological features (thickness, mitotic count, ulceration, vessel invasion, site, age and sex) gave a better AUC to predict relapse (71.0%) and survival (70.0%) than SNB status alone (57.0, 55.0%). In patients with gene expression data, the SNB status combined with the clinico-pathological features produced the best prediction of relapse (72.7%) and survival (69.0%), which was not increased further with osteopontin expression (72.7, 68.0%). Conclusion: Use of these models should be tested in other data sets in order to improve predictive and prognostic data for patients. PMID:20859289

  19. [Oligomeganephronic renal hypoplasia complicated by glomerulonephritis].

    PubMed

    Kan'shina, N F; Rykov, V A; Lakhno, P A

    1990-01-01

    Clinico-anatomical data of a rare condition congenital oligomeganephronic renal hypoplasia with a glomerulonephritis as a complication are available for a 13-year-old girl who died of chronic renal failure. Large aglomerular