scholarly journals RS3PE and the role of ultrasound. A case report and brief review of the literature

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Mariaeva Romano ◽  
Silvia Sirotti ◽  
Georgios Filippou ◽  
Piercarlo Sarzi-Puttini
Keyword(s):  
Morning Stiffness ◽  
Cost Effective ◽  
Acute Onset ◽  
Elderly Males ◽  
Subcutaneous Edema ◽  
Magnetic Resonance Imaging Mri ◽  
Hands And Feet ◽  
Underlying Diseases ◽  
Pitting Edema

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) is a rare syndrome characterised by acute onset of symmetrical distal synovitis and tenosynovitis, associated with severe pitting edema of the dorsum of the hands and feet, seronegativity for autoimmunity and dramatic response to glucocorticoids. First described by McCarty et al. in 1985, RS3PE is reported mostly in elderly males, but it can also rarely occur in young people. Although it was initially regarded as a form of rheumatoid arthritis (RA), it is now considered a clinical distinct entity that can be associated with other rheumatologic conditions or be secondary to underlying diseases, such as cancer. As revealed by magnetic resonance imaging (MRI), the typical landmark of RS3PE is extensor tenosynovitis. Due to extensive subcutaneous edema of the extremities, the clinical assessment of synovitis and tenosynovitis is difficult. On the other hand, the use of MRI is expensive, time-consuming and requires experienced staffs. Musculoskeletal ultrasound (MSUS) may be a viable, reliable and cost-effective tool for evaluation of RS3PE patients. We hereby report the case of an 84 year-old woman presenting with bilateral hand and wrist swelling and morning stiffness. Clinical examination, laboratory tests and imaging led to a diagnosis of RS3PE. The aim of this report is to discuss the role of MSUS in RS3PE for the purpose of diagnosis and differential diagnosis compared with other rheumatologic conditions.

scholarly journals A Case of Paraneoplastic Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Improved by Chemotherapy

2017 ◽  
Vol 10 (3) ◽  
pp. 1131-1137 ◽  
Author(s):  
Takahiko Sakamoto ◽  
Shuji Ota ◽  
Terunobu Haruyama ◽  
Masashi Ishihara ◽  
Maika Natsume ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Lung Tumor ◽  
Laboratory Data ◽  
Acute Onset ◽  
Imaging Data ◽  
Primary Lung Adenocarcinoma ◽  
Rs3pe Syndrome ◽  
Hands And Feet ◽  
Endothelial Growth Factor ◽  
Pitting Edema

The patient was a 69-year-old male who had started experiencing acute-onset pain in both shoulder joints and edema of both hands and feet. His symptoms progressively worsened within 1 month. Laboratory data indicated elevated CRP and erythrocyte sedimentation rate despite the normal range of antinuclear antibodies and rheumatoid factor and normal organ function. Furthermore, imaging data of the hand indicated synovitis without bone erosions. Meanwhile, chest CT revealed a lung tumor, leading to a diagnosis of primary lung adenocarcinoma with EGFR mutation (cT2aN3M0, stage IIIB). Based on these findings, he was diagnosed as suffering from paraneoplastic remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Thereafter, his symptoms disappeared as the tumor size was rapidly decreased by gefitinib therapy for lung adenocarcinoma. Currently, RS3PE syndrome can be classified as a vascular endothelial growth factor (VEGF)-associated disorder. Given that his symptoms improved by chemotherapy, the present case further supported the possible hypothesis that paraneoplastic RS3PE syndrome might be caused by tumor-induced VEGF. Therefore, the present case suggested that the symptoms of acute-onset joint pain accompanied by pitting edema in elderly patients should be considered suspicious for a malignant tumor, thereby warranting a detailed full-body examination.

Magnetic Resonance Imaging of Rheumatoid Arthritis: Peripheral Joints and Spine

2018 ◽  
Vol 22 (02) ◽  
pp. 127-146 ◽  
Author(s):  
Annette Helm-Mil ◽  
Iris Eshed ◽  
Claudia Schueller-Weidekamm ◽  
Monique Reijnierse
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cost Effective ◽  
Resonance Imaging ◽  
Early Disease Detection ◽  
Clinical Background ◽  
Magnetic Resonance Imaging Mri ◽  
Effective Medication

AbstractBoth the fields of rheumatology and radiology are changing rapidly. Effective medication has become available for rheumatoid arthritis (RA) and transformed it from a progressive disabling disease into a chronic disease. Indications for magnetic resonance imaging (MRI) have changed accordingly, shifting toward early detection. There is also an overall increased clinical demand for high-end imaging. Together with improvement of MRI units and sequences, MRI protocols are adapted based on clinical indications. This article addresses (1) the clinical background and present role of MRI in early disease detection, (2) RA involvement of peripheral joints, (3) RA involvement of the spine, and (4) state-of-the-art RA MRI protocols. The key toward cost-effective MRI examination in RA is communication between radiologist and rheumatologist as well as awareness and knowledge of the basics and advancements in both fields.

scholarly journals The cost effective role of Eschmarch tourniquet and psychosocial awareness of disease as a key factor in decompressive therapy of filarial lymphedema

2019 ◽  
Vol 6 (8) ◽  
pp. 2895
Author(s):  
Arun Y. Mane ◽  
Narendra G. Naik
Keyword(s):  
Job Insecurity ◽  
Cost Effective ◽  
Secondary Lymphedema ◽  
The People ◽  
Key Factor ◽  
Effective Role ◽  
The Cost ◽  
Pitting Edema

Background: The filiariasis is the most common cause of secondary lymphedema of the lower limb. Due to poor awareness of this disease in the people of the lower socioeconomic strata, the patient understands the importance of conservative modality of therapy very late. The cutaneous changes and its complications develop in patient due to unawareness about the nature of noncurable progressive disease. The self-negligence to their own limb also contributes to increase in the morbidity of the disease. The article discusses about cost effective role of Eschmarch tourniquet as a decompressive therapy. The disease causes socioeconomic impairments, stigmatization due to elephantiasis and job insecurity due to cosmetic and functional disability.Methods: This was a retrospective study done in 28 cases of filarial lymphedema. All patients received limb elevation and decompressive therapy by Eschmarch tourniquet.Results: Out of 28 cases, 14 cases in study group of filarial lymphedema with pitting edema (71.42%) and non-pitting edema feet with minimal cutaneous changes (28.57%) showed significant reduction in size of limb girth and satisfactory fluctuating limb girth during the follow up period in OPD respectively, by adequate limb elevation, elastic stockinet and decompressive therapy by Eschmarch tourniquet as compared to the remaining 14 patients of control who received only limb elevation. The better follow up results are noticed by proper guidance to the patient about the disease and its conservative modality of treatment.Conclusions: It is a challenge for the treating consultant to create early awareness about the nature of the filarial disease and early guidance about the conservative treatment which helps to restrict the rapid growth of limb size in filiariatic lymphedema. The eschmarch tourniquet is one of the cost effective decompressive therapy. 

scholarly journals Role of MRI in audio-vestibular dysfunction; is it cost-effective?

2017 ◽  
Vol 4 (1) ◽  
pp. 80 ◽  
Author(s):  
Ali Amer Al-Barki ◽  
Jibril Yahya Hudise ◽  
Nadeem Malik ◽  
Montasir Junaid ◽  
Ali Almothahbi
Keyword(s):  
Hearing Loss ◽  
Cost Effectiveness ◽  
Sensorineural Hearing Loss ◽  
Cerebellopontine Angle ◽  
Cost Effective ◽  
Armed Forces ◽  
Sensorineural Hearing ◽  
Referral Criteria ◽  
Magnetic Resonance Imaging Mri

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Till date, debate still exists among researchers regarding the use of magnetic resonance imaging (MRI) in all the cases presenting as asymmetrical sensorineural hearing loss (SNHL). The objective of the study was to investigate cost-effectiveness of MRI for evaluating patients with audiovestibular symptoms. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A retrospective study was carried out included all adult patients (&gt;12 years) presenting over a 12 month period between November 2014 and October 2015 at Otolaryngology department clinic, Armed Forces Hospital. Khamis Mushait, Saudi Arabia with asymmetrical sensorineural hearing loss (sudden or progressive) and have underwent MRI of cerebellopontine angle and internal auditory meati for evaluation of audiovestibular symptoms.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included 52 patients with audiovestibular symptoms. Their mean age (±SD) was 46 (±13.9) years and almost two-thirds of them (65.4%) were males. Majority of them were presented with deafness (84.6%). Vertigo and tinnitus were presented in 38.5% and 53.8% of them, respectively. Over the studied 52 patients, MRI of cerebellopontine angle yielded no detectable lesion in any case. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">MRI was not cost-effective, so it is important that clinical and audiometric indications for MRI referral criteria should be reviewed and analyzed to ensure cost-effectiveness of MRI in detecting audiovestibular dysfunctions, particularly in situations with financial restraints and long waiting time.</span></p>

Pseudotumor of Infancy — the Role of Ultrasonography

1996 ◽  
Vol 75 (4) ◽  
pp. 248-254 ◽  
Author(s):  
John Maddalozzo ◽  
John D. Goldenberg
Keyword(s):  
Cost Effective ◽  
Neck Mass ◽  
Physical Exam ◽  
Diagnostic Challenge ◽  
Cost Effective Method ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up ◽  
Complete History

Pseudotumor of infancy (POI) occurs within the first month of life as a benign neck mass and affects 0.4% of all newborns. Differentiating these lesions from a malignancy or a congenital anomaly requiring surgical intervention can represent a diagnostic challenge for the clinician. While 80-90% of these masses resolve spontaneously within the first six months of life, there is still considerable time expended and cost incurred in the evaluation of POI. We have established and implemented a protocol for the evaluation of these patients consisting of a complete history and physical exam, ultrasonography and routine follow-up every four to six weeks. Seventeen patients were identified who had been evaluated and followed in the aforementioned manner. Two patients underwent diagnostic imaging studies prior to referral, consisting of magnetic resonance imaging (MRI) and computed tomography (CT). Ultrasonography appeared identical in 80% of the cases of POI with a heterogeneous pattern of internal echogenicity and a hypoechoic surrounding rim. The remaining ultrasound studies differed only subtly with regard to the internal echo pattern. There were no patients with pseudotumor of infancy in whom the ultrasound was normal. We concluded that a work-up including a history and physical exam and ultrasound is an accurate and cost-effective method for evaluating newborns with a neck mass, when suspicious for POI. Ultrasonography has a 100% sensitivity for the diagnosis of POI in this clinical scenario.

Role of Cardiac MRI in Detecting Familial Hypertrophic Cardiomyopathy: Review

2016 ◽  
Vol 1 (1) ◽  
pp. 4
Author(s):  
Marymol Koshy ◽  
Bushra Johari ◽  
Mohd Farhan Hamdan ◽  
Mohammad Hanafiah
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Genetic Disorder ◽  
Familial Hypertrophic Cardiomyopathy ◽  
Non Invasive ◽  
Wide Range ◽  
Proper Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Potential Use

Hypertrophic cardiomyopathy (HCM) is a global disease affecting people of various ethnic origins and both genders. HCM is a genetic disorder with a wide range of symptoms, including the catastrophic presentation of sudden cardiac death. Proper diagnosis and treatment of this disorder can relieve symptoms and prolong life. Non-invasive imaging is essential in diagnosing HCM. We present a review to deliberate the potential use of cardiac magnetic resonance (CMR) imaging in HCM assessment and also identify the risk factors entailed with risk stratification of HCM based on Magnetic Resonance Imaging (MRI).

Role of Rasayana in Prevention of COVID-19 - A Review

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 716-722
Author(s):  
Sneha Dhakite ◽  
Sadhana Misar Wajpeyi
Keyword(s):  
Immune System ◽  
Respiratory System ◽  
Viral Infections ◽  
Cost Effective ◽  
The Body ◽  
Healthy Life ◽  
Vital Functions ◽  
Healthy Life Style ◽  
And Control

The “Coronavirus disease 19 (COVID-19)” is caused by “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)”, a newly discovered member of the Coronaviridae family of viruses which is a highly communicable. There is no effective medical treatment till date for Coronavirus disease hence prevention is the best way to keep disease away. Rasayana proved to be highly efficacious and cost effective for the Prevention and Control of viral infections when vaccines and standard therapies are lacking. Rasayana Chikitsa is one of the eight branches of Ashtanga Ayurveda which helps to maintain healthy life style. Rasayana improves immunity and performs many vital functions of human body. Vyadhikshamatva that is immune mechanism of the body is involved in Prevention of the occurrence of a new disease and it also decreases the virulence and progression of an existing disease. In COVID-19 the Respiratory system mainly get affected which is evident from its symptoms like cold, cough and breathlessness. Here the drugs help in enhancing immune system and strengthening functions of Respiratory system can be useful. For this purpose, the Rasayana like Chyavanprasha, Agastya Haritaki, Pippali Rasayana, Guduchi, Yashtimadhu, Haridra, Ashwagandha, Tulsi are used. Rasayana working on Respiratory system are best for Prevention of Coronavirus and boosting immune system. Rasayana Chikitsa can be effective in the Prevention as well as reducing symptoms of COVID-19.

The Role of Computer Modeling in Combined Sewer Overflow Abatement Planning

1992 ◽  
Vol 26 (7-8) ◽  
pp. 1831-1840 ◽  
Author(s):  
L. A. Roesner ◽  
E. H. Burgess
Keyword(s):  
System Modeling ◽  
Cost Effective ◽  
Combined Sewer Overflows ◽  
Sewer System ◽  
New Techniques ◽  
Hydraulic Simulation ◽  
Continuous Simulation ◽  
Combined Sewer ◽  
The U.S

Increased concern regarding water quality impacts from combined sewer overflows (CSOs) in the U.S. and elsewhere has emphasized the role of computermodeling in analyzing CSO impacts and in planning abatement measures. These measures often involve the construction of very large and costly facilities, and computer simulation during plan development is essential to cost-effective facility sizing. An effective approach to CSO system modeling focuses on detailed hydraulic simulation of the interceptor sewers in conjunction with continuous simulation of the combined sewer system to characterize CSOs and explore storage-treatment tradeoffs in planning abatement facilities. Recent advances in microcomputer hardware and software have made possible a number of new techniques which facilitate the use of computer models in CSO abatement planning.

Green synthesis of silver nanoparticles using sustainable resources and their use as antibacterial agents: A review

2020 ◽  
Vol 13 ◽  
Author(s):  
Kumari Jyoti ◽  
Punyasloka Pattnaik ◽  
Tej Singh
Keyword(s):  
Silver Nanoparticles ◽  
Plant Extracts ◽  
Metallic Nanoparticles ◽  
Cost Effective ◽  
Biological Properties ◽  
Metal Species ◽  
Sustainable Resources ◽  
Research Areas ◽  
Low Toxicity

Background:: Synthesis of metallic nanoparticles has attracted extensive vitality in numerous research areas such as drug delivery, biomedicine, catalysis etc. where continuous efforts are being made by scientists and engineers to investigate new dimensions for both technological and industrial advancements. Amongst numerous metallic nanoparticles, silver nanoparticle (AgNPs) is a novel metal species with low toxicity, higher stability and significant chemical, physical and biological properties. Methods:: In this, various methods for the fabrication of AgNPs are summarized. Importantly, we concentrated on the role of reducing agents of different plants parts, various working conditions such as AgNO3 concentration; ratio of AgNO3/extract; incubation time; centrifugal conditions, size and shapes. Results:: This study suggested that eco-friendly and non toxic biomolecules present in the extracts (e.g. leaf, stem and root) of plants are used as reducing and capping agents for silver nanoparticles fabrication. This method of fabrication of silver nanoparticles using plants extracts is comparatively cost-effective and simple. A silver salt is simply reduced by biomolecules present in the extracts of these plants. In this review, we have emphasized the synthesis and antibacterial potential of silver nanoparticles using various plant extracts. Conclusion:: Fabrication of silver nanoparticles using plant extracts have advantage over the other physical methods, as it is safe, eco-friendly and simple to use. Plants have huge potential for the fabrication of silver nanoparticles of wide potential of applications with desired shape and size.

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