P087 Polyarteritis nodosa: a case report

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Azirar ◽  
A Ghannam ◽  
A Elaouli ◽  
M Rkain ◽  
N Benaajiba ◽  
...  

Abstract Background Polyarteritis nodosa is a necrotizing vasculitis of small and medium caliber arteries. Rarely described in children, its pathophysiology is complex and remains poorly elucidated. Two main forms were described in the literature: cutaneous and visceral. Material and results We report the cases of two boys, aged of 7 and 11 years old. They had a history of recurrent sore throat with a recurrent aphthosis in the 11-year-old child. Both boys presented with polyarthralgias, myalgias, polymorphous skin lesions made of livedo reticularis with subcutaneous nodosa on the lower limbs in the first child and distal necrosis of the toes with oedema of the lower limbs in the second. Patients suffered also of cough evolving in a context of alteration of the general state made of fever and asthenia. A biological inflammatory syndrome was present in both children and the skin histology confirmed periarteritis nodosa. The evolution was marked by the disappearance of arthralgias and myalgias after a corticosteroid-based treatment with progressive dose reduction until minimal effective dose. Conclusion The diagnosis of Polyarteritis nodosa should be made in any child presenting with the following signs: fever, altered general condition, myalgias, arthralgias and skin manifestations. The prognosis is usually benign but long-term surveillance is necessary.

2017 ◽  
Vol 6 (1) ◽  
pp. 63 ◽  
Author(s):  
Tuğbay Inan

We must point out that the results of football games affect the competitive balance degree. In other words, the calculations we made in the score table at the end of the season give us a degree of competitive balance. The degree on which the concept of competitiveness is based is cited as competitive balance in football. Sports economics can be defined as the degree to which overall league attendances are raised by such measures as media effect, home advantage, income sharing, all of which aim to strengthen the competitive balance. The aim of this study was to gauge the competitive balance in Turkish football league. Using long term competitive balance analysis, some of the matters encountered and possible precautions to be taken were approached in a way that can discuss the mentioned subjects throughout the 1987-2017 seasons in Turkish Football Super League (TSL). The present study examined the way that competitive balance level followed in the history of super league (30 years). For this purpose, C5 Competitive Balance Index (C5CBI) and a Herfindahl index of competitive balance (HICB) were benefited. Finally, competitive balance factor was observed to have occured time to time; however, when looked in terms of total, a view apart from competitive balance can be clearly seen.


2021 ◽  
Author(s):  
Ana Isabel Lopes ◽  
Isabel O. Cruz ◽  
Rui Môço

A 47-year-old man, obese, without medical problems, presented with a 15-day history of painful erythematous nodular lesions on the anterior side of lower limbs. He had no improvement with antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). He developed migratory and symmetric arthralgias (ankles, knees, elbows) and low-grade fever. The skin lesions progressed to the upper limbs. On physical examination, a mild swelling and tenderness in both ankles was noted, and lesions suggestive of erythema nodosum were seen.[...]


2021 ◽  
Vol 9 (5) ◽  
pp. 1131-1135
Author(s):  
Prasanna N Mogasale ◽  
Radhika. C ◽  
Nagaraj S

Erythroderma also known as generalized Exfoliative dermatitis which refers to a scaling involving 90% or more of the cutaneous surface. Clinicians are challenged to find the cause of exfoliative dermatitis by eliciting history of illness prior to erythema. Patients presenting acutely with exfoliative dermatitis often require admission because their total body functions can require monitoring. In western medicine, the principle management is to maintain skin moisture, avoid scratching, apply topical steroids; prolonged glucocorticoids therapy often is needed. From Ayurvedic perspective it could be correlated to Eka Kusta. Eka Kusta is the Vata Kapha Pradhana Vikara. Where skin lesions are Mahavastu, Masthyashaklopamam, Krisha Aruna in Varna. Here presenting a case of 48 years old female with erythroderma who was on long- term steroidal therapy. Treatment was planned with Shamana line of management based on her Bala. The treatment is carried out for one and half month in OPD and IPD section, all the western medicine was stopped and there was total remission of symptoms with Shamana Aushadhis. Keywords: Erythroderma, Eka Kusta, Shamana Aushadhis


Author(s):  
Vanessa Migliarino ◽  
Alberto Di Mascio ◽  
Irene Berti ◽  
Andrea Taddio ◽  
Egidio Barbi

A 3-year-old boy presented with a 5-day history of bullous skin lesions localised mainly in the upper and lower limbs and in the genital region (figure 1). Lesions were not pruritic nor painful and showed a central crust. There was no family history of skin disorders or autoimmune diseases. The child never had fever and his physical examination was otherwise unremarkable.Figure 1Bullous skin lesions forming around a central crust, localised in the upper and lower limbs.QuestionsWhat is the most likely diagnosis based on this clinical presentation?Bullous impetigo.Bullous pemphigoid.Linear IgA bullous dermatosis.Dermatitis herpetiformis.What would be the next step in the investigation to confirm your diagnosis?Skin biopsy.Swab test for bacterial culture with an antibiogram.Anti-transglutaminase antibody detection.What is the mainstay of management?Dapsone.Systemic steroids.Topical steroids.All of the above answers are correct, according to the severity of the disease.Answers can be found on page 02.


2017 ◽  
Vol 9 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Álvaro Iglesias Puzas ◽  
Laura Mesa Álvarez ◽  
Ángeles Flórez Menéndez ◽  
Susana Romero Yuste ◽  
Olga Prieto Gómez

Eosinophilic cellulitis is an uncommon, inflammatory and chronic disorder of unknown etiology. Corticosteroids are currently considered as the first-line treatment but they are not without significant disadvantages such as contraindications in steroid-resistant cases and patients with frequent recurrences. We report a patient suffering from Wells’ syndrome with a 24-year history of symptomatic and generalized skin lesions. After consultation in our department, treatment with colchicine 1 mg/day was prescribed resulting in large clinical improvement. No side effects have been recorded. To our knowledge, this is an original disease approach. Although small, our clinical experience supports the inclusion of colchicine in the drug armamentarium when treating patients suffering from Wells’ syndrome. Indeed, its excellent safety profile makes it very attractive for patients with frequent recurrent episodes who need secure options for the medium- and long-term disease control.


2020 ◽  
Vol 42 (3) ◽  
pp. 380-383
Author(s):  
Daniel Monteiro Queiroz ◽  
Rolando Guillermo Vermehren Valenzuela ◽  
Ana Wanda Guerra Barreto Marinho ◽  
Samanta Samara Bicharra dos Santos ◽  
Danielle Ochoa da Silva ◽  
...  

ABSTRACT We report an unusual case of a 24-year-old girl with a history of recurrent hypokalemic paralysis episodes and skin lesions on the lower limbs and buttocks, both of which had an acute evolution. In subsequent investigations, the patient also had nephrocalcinosis, nephrolithiasis, hyperchloremic metabolic acidosis and persistent alkaline urinary pH. The findings were consistent with distal renal tubular acidosis as the cause of hypokalemic paralysis. Clinical findings, immunological tests and the result of skin biopsy suggested primary Sjögren's syndrome as an underlying cause. The patient developed azotemia due to obstructive nephrolithiasis. All the features presented in this case are an unusual manifestation of distal renal tubular acidosis; so far, we are not aware of a similar report in the literature.


The details of biography and scientific works of Boris Valkh (1876–1942), one of the leading zoologists who worked in eastern Ukraine in the first half of the 20th century, were analysed. Boris Valkh worked at the interface of zoology, plant protection, and epidemiology and he was a leading specialist in controlling the abundance of economically important groups of rodents and insects (plant protection stations) and an epidemiologist (studying zoonoses). At the same time, he was a nature protector, one of the key organizers of nature reserves in the southeast of Ukraine (Kamiani Mohyly, Bilosaraiska Kosa). The main attention in this review is paid to Valkh's research into zoology (ornithology, entomology, and theriology), and his work upon creation of zoological collections, including the one in the Bakhmut Museum of Local Lore, which was organized with his participation. All of these developments made by the scientist are considered along with details of his biography analysed using family archives and by conversations with Valkh’s descendents, including his grandson Boris Valkh, granddaughter Olympiada Gryshchenko, and great-grandson Sergei Valkh. Significant clarifications and important additions to the biography of Boris Valkh have been made, in particular regarding his education (once in Pavlohrad Gymnasium and twice in Kharkiv University), wife and children, as well as his long-term trips to Turkestan and Azerbaijan. The location of "Hory-Mohyly hamlet", from which most of the zoological samples collected by the Valkhs are derived, is clarified and determined as the same place that was marked on ancient maps as "Horemohylove" The history of the species Mus sergii described by Boris Valkh and its type locality were analysed. The information about the history of accumulation and further fate of his and his son Sergey’s zoological collections including mammal specimens from Hory-Mohyly is summarized. Unique original photographs from the family archives have been used, for most of which the dates and places of taking were determined. Pictures of collections and original zoological labels are also presented.


Author(s):  
Mihir M Sanghvi ◽  
Daniel M Jones ◽  
Jeremy Kalindjian ◽  
Christopher Monkhouse ◽  
Rui Providencia ◽  
...  

Abstract Introduction Implantable loop recorders (ILR) are now routinely implanted for long-term cardiac monitoring in the clinic setting. This study examined the real-world performance of these devices, focusing on the management decision changes made in response to ILR-recorded data. Methods and Results This was a single centre, prospective observational study of consecutive patients undergoing ILR implantation. All patients who underwent implantation of a Medtronic Reveal LINQ device from September 2017 to June 2019 at Barts Heart Centre were included. 501 patients were included. 302 (60%) patients underwent ILR implantation for an indication of pre-syncope/syncope, 96 (19%) for palpitations, 72 (14%) for atrial fibrillation (AF) detection with a history of cryptogenic stroke and 31 (6%) for patients deemed to be high risk of serious cardiac arrhythmia. The primary outcome of this study was that an ILR-derived diagnosis altered management in 110 (22%) of patients. Secondary outcomes concerned sub-group analyses by indication: in patients who presented with syncope/presyncope, a change in management resulting from ILR data was positively associated with age (HR: 1.04 [95%CI 1.02–1.06]; p < 0.001) and negatively associated with a normal ECG at baseline (HR 0.54 [0.31–0.93]; p = 0.03). Few patients (1/57, 2%) aged < 40 years in this group underwent device implantation, compared to 19/62 patients (31%) aged 75 years and over (p = 0.0024). 22/183 (12%) of patients in the 40–74 age range had a device implanted. In patients who underwent ILR insertion following cryptogenic stroke, 13/72 patients (18%) had AF detected leading to a decision to commence anticoagulation. Conclusion These results inform the utility of ILR in the clinical setting. Diagnoses provided by ILR that lead to changes in management are rare in patients under age 40, particularly following syncope, presyncope or palpitations. In older patients new diagnoses are frequently made and trigger important changes in treatment.


Polar Record ◽  
2009 ◽  
Vol 45 (3) ◽  
pp. 207-214 ◽  
Author(s):  
Barbara Wienecke ◽  
Peter Pedersen

ABSTRACTIn 2008, the emperor penguin Aptenodytes forsteri colony at Amanda Bay, East Antarctica, was designated an Antarctic Specially Protected Area by the 31st Antarctic Treaty Consultative Meeting in Kyiv, Ukraine. It is only the third emperor penguin colony in the Australian Antarctic Territory to receive this status. The colony has been known to exist since 1956 and numerous visits have been made to it, especially by personnel from Australia's Davis station. On a number of occasions, attempts were made to estimate the number of birds in the colony in order to obtain an insight into the size of the breeding population. Here we report on the history of visitation to the colony since the 1950s and examine the quality of information collected with regard to the usefulness of this information in terms of population analyses. We also report the results of the first visit to the Amanda Bay colony made in winter with the specific purpose of estimating the number of birds present and of highlighting the need for long term monitoring programmes to assess the viability of emperor penguins in future.


1998 ◽  
Vol 11 (2) ◽  
pp. 708-709
Author(s):  
Nha Il-Seong

The construction of a new museum of astronomy is planned by the present author in Yecheon Prefecture (λ = 128°28’ E, (ϕ> = 36°39’ N), Korea, with the openning date set in October, 1999. The aims of the museum directed in three area: (1) to exhibit astronomical works available in Korea, China, Japan and other regions of the Far East; (2) to serve the publics with written material for the study of history of Oriental astronomy; and (3) to operate a 40-cm reflecting telescope for researches of both professionals and amateur astronomers. A long-term project of the reconstruction of King Sejong’s instruments, which were made in the 15th century in the Kyongbok Palace, Seoul, is also an important subject of this museum.


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