Power Doppler enhancement of accessory pulleys confirming disease localization in psoriatic dactylitis

Rheumatology ◽  
2019 ◽  
Vol 59 (8) ◽  
pp. 2030-2034 ◽  
Author(s):  
Ilaria Tinazzi ◽  
Dennis McGonagle ◽  
Pierluigi Macchioni ◽  
Sibel Zehra Aydin
Keyword(s):  
Clinical Assessment ◽  
Power Doppler ◽  
Thickness Measurement ◽  
Contralateral Side ◽  
Doppler Signals ◽  
History Of ◽  
Thickening Power ◽  
Almost All ◽  
Flexor Tenosynovitis ◽  
A1 Pulley

Abstract Objective The digital accessory pulleys are highly mechanically stressed mini-entheses that are thickened in patients with a history of PsA-related dactylits. This study explored whether these pulleys are involved in PsA dactylitis as assessed by intra-pulley US power Doppler changes. Methods Fifty-eight PsA patients with dactylitis had US of the second to fourth digits for pulleys of the dactylitic and contralateral digits. The Leeds Dactylometer was used for thickness measurement. The presence of digital pain, tenderness, and swelling in the dactylitis finger and in the contralateral side was evaluated. Results We recruited 34 patients with acute and 24 patients with chronic dactylitis, 45/58 (77%) of which had tenderness on clinical assessment. Intra-pulley power Doppler was more frequently found in the dactylitic digits compared with contralateral sides and linked to A1, A2 and A4 pulleys thickening [power Doppler signals in A1 pulley (51%), A2 (22%) and A4 (12%) in dactylitic digit; compared with 1 A1, A2 and A4 pulleys each in the contralateral side (1.7%)]. Almost all cases had peri-tendinous oedema, and 82.6% of dactylitic digits had flexor tenosynovitis with power Doppler signals in 65.2% of flexor tendons. Conclusion Despite their small size and relatively avascular, the accessory pulleys exhibit power Doppler change in active Psoriatic dactylitis, supporting a pivotal role in dactylitis-related tenosynovitis and extra-tendinous disease.

From the Tower of London to the Thomas More Society of Buenos Aires: “Give me thy grace, good Lord, to set the world at nought”

Moreana ◽  
2005 ◽  
Vol 42 (Number 164) (4) ◽  
pp. 187-206
Author(s):  
Clare M. Murphy
Keyword(s):  
Buenos Aires ◽  
Short History ◽  
Thomas More ◽  
Tower Of London ◽  
Hebrew Poetry ◽  
Prayer Book ◽  
The World ◽  
History Of ◽  
Book Of Hours ◽  
Almost All

The Thomas More Society of Buenos Aires begins or ends almost all its events by reciting in both English and Spanish a prayer written by More in the margins of his Book of Hours probably while he was a prisoner in the Tower of London. After a short history of what is called Thomas More’s Prayer Book, the author studies the prayer as a poem written in the form of a psalm according to the structure of Hebrew poetry, and looks at the poem’s content as a psalm of lament.

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

Do Deeper Levels of Cervical Biopsies Preceded by a Pap Smear Diagnosis of LSIL, ASCUS, or NILM/HPV+ Increase the Yield of Identifying Clinically Significant Lesions?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin
Keyword(s):  
Pap Smear ◽  
Past History ◽  
Prior History ◽  
Cervical Biopsy ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Significant Difference ◽  
History Of ◽  
Clinically Significant ◽  
Almost All

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.

scholarly journals AB0450 PERIPHERAL MACROVASCULAR INVOLVEMENT IN SYSTEMIC SCLEROSIS AS COMPARED WITH HEALTHY CONTROLS: A SMALL COHORT STUDY BY COLOR AND SPECTRAL DOPPLER ULTRASONOGRAPHY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1252.2-1252
Author(s):  
R. D’alessandro ◽  
E. Garcia Gonzales ◽  
P. Falsetti ◽  
C. Baldi ◽  
F. Bellisai ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Clinical Features ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Power Doppler Ultrasonography ◽  
Digital Ulcers ◽  
Healthy Controls ◽  
History Of

Background:Together with autoimmune-inflammation and fibrosis, microvasculopathy is a hallmark of SSc. However, also macrovascular changes may occur including peripheral proliferative vasculopathy. Whether this changes may represent a specific SSc marker with a predictive value remains a matter of debate.[1,2,3]Objectives:To study peripheral macrovascular involvement by color doppler ultrasound (CDUS) with spectral wave analysis (SWA) in a cohort of 40 SSc patients as compared to healthy controls. To further analyze any differences among the SSc population.Methods:Forty SSc patients and 36 healthy controls were examined by CDUS with SWA of both hands. Macrovascular involvement was assessed by measuring the resistivity index (RI) of distal ulnar and radial arteries. Examinations were performed with an Esaote MyLab Twice machine equipped with a linear 10-22 MHz probe. Ultrasound examination was carried out by two independent rheumatologists blinded to clinical conditions of the patients. Statistical analysis was performed by using MaxStat software.Results:The RI index resulted increased in the SSc cohort as compared with healthy controls (left ulnar RI 0.977 vs 0.715; right ulnar RI 0.996 vs 0.699; left radial RI 0.988 vs 0.706; right radial RI 0.999 vs 0.688; p<0.001). SSc patients with an increased RI in one artery were more probable to have an increased RI in the other vessels too (r 2 = 0.35; p<0.01). In addition, 8 out of 40 SSc patients presented left ulnar artery occlusion (UAO) and 7 out of 40 SSc patients presented right UAO, of which 6 presented bilateral UAO. Awaiting to enlarge the cohort for further analysis, descriptive data regarding increased RI at CDUS/SWA and clinical features, including years from onset of the disease, subtype of SSc, mRSS, history of digital ulcers, interstitial lung disease and PAH are described in Table 1.Conclusion:Peripheral macrovascular involvement was observed in SSc patients as compared with healthy controls. Further studies will determine whether this feature may have specificity for diagnosis/prognosis in SSc.References:[1]Lescoat A, Yelnik CM, Coiffier G et al. Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study. Arthritis Rheumatol. 2019;71:983-990.[2]Lescoat A, Coiffier G, Rouil A et al. Vascular Evaluation of the Hand by Power Doppler Ultrasonography and New Predictive Markers of Ischemic Digital Ulcers in Systemic Sclerosis: Results of a Prospective Pilot Study. Arthritis Care Res (Hoboken). 2017;69:543-551.[3]Schioppo T, Orenti A, Boracchi P, De Lucia O, Murgo A, Ingegnoli F. Evidence of macro- and micro-angiopathy in scleroderma: An integrated approach combining 22-MHz power Doppler ultrasonography and video-capillaroscopy. Microvasc Res. 2019;122:125-130.Table 1.Main clinical features of the SSc cohort (n=40) studied by CDUS for macrovascular involvement.SSc cohort (n = 40)Years from onsetrange (35 y – 0 y)mean = 10.5 yAutoantibodiesACA 13/40Anti-TopoI 14/40Other 13/40mRSSrange (0 -30)mean = 3ILD17/40PAH7/40Capillaroscopy patternEarly 10/40Active 11/40Late 6/40History of digital ulcers16/40Left ulnar IR0.977Left radial IR0.988Right ulnar IR0.996Right radial IR0.999Disclosure of Interests:None declared.

scholarly journals On the supposed first stage larva of Leptohylemyia coarctata, Fall.

1917 ◽  
Vol 8 (2) ◽  
pp. 121-123 ◽  
Author(s):  
D. Keilin
Keyword(s):  
Life History ◽  
Recent Work ◽  
European Countries ◽  
Stage Larva ◽  
History Of ◽  
Almost All

It has been well known since the studies of Taschenberg (1864–1872) that the larvae of Leptohylemyia coarctata, Fall., attack wheat and rye. The damage due to this fly has been observed many times in almost all European countries, and many papers have been devoted to its life-history. Of these papers the most important are those of E. Ormerod (1882–1895), S. Rostrup (1905–1911), T. Hedlund (1906- 1907), P. Marchal (1909) and finally the recent work of Kurdjumov (1914).

scholarly journals The sportification of judo: global convergence and evolution

2013 ◽  
Vol 8 (2) ◽  
pp. 299-317 ◽  
Author(s):  
Shohei Sato
Keyword(s):  
Nineteenth Century ◽  
Global Convergence ◽  
Martial Arts ◽  
Way Of Life ◽  
The West ◽  
Modern Times ◽  
The World ◽  
History Of ◽  
Almost All ◽  
Olympic Sport

AbstractThis article re-examines our understanding of modern sport. Today, various physical cultures across the world are practised under the name of sport. Almost all of these sports originated in the West and expanded to the rest of the world. However, the history of judo confounds the diffusionist model. Towards the end of the nineteenth century, a Japanese educationalist amalgamated different martial arts and established judo not as a sport but as ‘a way of life’. Today it is practised globally as an Olympic sport. Focusing on the changes in its rules during this period, this article demonstrates that the globalization of judo was accompanied by a constant evolution of its character. The overall ‘sportification’ of judo took place not as a diffusion but as a convergence – a point that is pertinent to the understanding of the global sportification of physical cultures, and also the standardization of cultures in modern times.

Literary Center of Constructivists on Its Way to the RAPP (From the History of Literary Life at the Turn of the 1920s — 1930s)

2021 ◽  
Vol 6 (3) ◽  
pp. 304-321
Author(s):  
Natalia V. Kornienko ◽  
Ruslan E. Klementiev
Keyword(s):  
Left Wing ◽  
Literary Life ◽  
The Press ◽  
Archival Documents ◽  
History Of ◽  
Almost All ◽  
Russian Association

The article examines one of the episodes of the literary struggle of the late 1920s — early 1930s — the history of the entry of the Literary Center of Constructivists (LCC) into the Russian Association of Proletarian Writers (RAPP). At the beginning of 1930, almost all literary groups and associations faced the need to define a new level of interaction with RAPP. LCC, as one of the literary groups closest to RAPP, seemed to have all the prerequisites for a successful association with the RAPP. But in reality, this did not happen. Members of RAPP are suspicious of constructivists; attacks at LCC are becoming more frequent in the press. Always considered a left-wing association, LLC is declared a petty-bourgeois group, with which, despite its disbandment, an irreconcilable struggle is required. This article bears upon not only the periodicals of 1930 but also and mainly upon the hitherto unstudied transcripts and other archival documents of RAPP. New archival materials reveal internal processes of the literary struggle at the turn of the decade, and make it possible to demonstrate how, even after the acceptance of the Constructivists by RAPP, the former continue to be perceived as a hostile group whose past was to always blame them.

TOOTH-RASHES AS DESCRIBED BY MICHAEL UNDERWOOD (1737-1820), THE FOUNDER OF MODERN PEDIATRICS

PEDIATRICS ◽  
1969 ◽  
Vol 43 (3) ◽  
pp. 459-459
Author(s):  
T. E. C.
Keyword(s):  
Scarlet Fever ◽  
Erythema Nodosum ◽  
Whole Body ◽  
Deciduous Teeth ◽  
History Of ◽  
History Of Pediatrics ◽  
Benign Nature ◽  
Almost All ◽  
As If

I know of no contemporary pediatrician who believes that the cutting of deciduous teeth causes skin rashes. But, almost all the great figures in the history of pediatrics believed firmly that teething was associated with a riety of rashes. Michael Underwood, who more than anyone else laid the foundation of modern pediatrics, wrote about tooth-rashes as follows: A very common rash, appears chiefly in teething children, which yery much resembles the measles, and has been sometimes mistaken for it. It is preceded by sickness at the stomach, but is attended by very little fever; though the rash continues very florid for three days, like the measles, but does not dry off in the manner of that disease. . . . While the double or eye-teeth are cutting, I have noticed a rash Which at its first appearance is very similar to the above, and has likewise been mistaken for the measles. It, however, soon spreads into larger spots and patches of bright red, and afterwards of a darker hue, resembling the ill-looking petechiae which appear in bad fevers, but is, nevertheless, of a benign nature. It is, indeed, attended with some fever, arising possibly from the irritation occasioned by teething, and has been followed by small and hard round tumours on the legs, which softening in two or three days, always appear as if they would suppurate, though I believe they never do . . . [? erythema nodosum, T. E. C., Jr.] I have seen a third kind of rash, in appearance resembling the measles, and, like it, covering the whole body, but with larger intermediate patches, like the eruption in the scarlet fever. . . .

scholarly journals Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan
Keyword(s):  
Doppler Ultrasound ◽  
Renal Allograft ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Imaging Findings ◽  
Unenhanced Ct ◽  
Doppler Signals ◽  
History Of ◽  
Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

scholarly journals Women and Gender in 1917

Slavic Review ◽  
2017 ◽  
Vol 76 (3) ◽  
pp. 694-702 ◽  
Author(s):  
Rochelle Goldberg Ruthchild
Keyword(s):  
Political Parties ◽  
Significant Issue ◽  
Women And Gender ◽  
One Dimensional ◽  
History Of ◽  
Key Issues ◽  
And Gender ◽  
Almost All ◽  
The Revolution

This paper argues for greater integration of considerations of women and gender in the history of the 1917 Russian Revolutions. Two key issues have long been discussed by historians: the spontaneity/consciousness paradigm, and the role of class in the revolution. Neither has been adequately analyzed in relation to gender. Women's suffrage has been largely neglected despite the fact that it was a significant issue throughout the year and represented a pioneering advance won by a countrywide coalition of women and men from the working class and intelligentsia, and from almost all political parties. In this centennial year, accounts of the Revolution remain one-dimensional; women remain the other.

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