scholarly journals Clinicopathological and immunofluorescence study of vesiculobullous disorders

Author(s):  
Geetha K. Gopalakrishnan ◽  
V. Bindu ◽  
Najeeba Riyaz

<p class="abstract"><strong>Background:</strong> Vesiculobullous diseases are mostly immune mediated and diagnosed based on the clinical features, histology and Immunofluorescence. The aim of the study was to identify the immunofluorescence pattern in auto immune vesiculobullous diseases and correlate it with the clinical profile and histology.</p><p class="abstract"><strong>Methods:</strong> Patients attending the dermatology outpatient department in a tertiary hospital with vesiculobullous diseases, suggestive of auto immune aetiology were evaluated clinically. Histopathology and direct immuno-fluorescence were done in all patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the one year period from June 2008 to July 2009, 40 patients with vesiculobullous disorders clinically suggestive of auto immune aetiology attended the outpatient department. Out of the 40 patients, 22 (55%) patients were diagnosed to have intraepidermal with female preponderance and 18 patients (45%) sub epidermal blistering diseases. Bullous pemphigoid was the commonest sub epidermal disease, seen in 8 patients.</p><p class="abstract"><strong>Conclusions:</strong> In all cases diagnosed clinically as pemphigus a histological diagnosis of pemphigus was made (100%). The clinical variants of pemphigus could also be diagnosed in all cases histologically (100%). The positive and negative predictive value was 100% in pemphigus group cases. Histology of all patients showed subepidermal bulla (100%). A specific diagnosis could be made in 18 patients with sub epidermal disease (100%). DIF was found to be an invaluable tool in diagnosing different diseases belonging to the sub epidermal group, but it was not of much help in sub classifying variants of pemphigus.</p><p class="abstract"> </p>

2007 ◽  
Vol 121 (4) ◽  
pp. 378-381 ◽  
Author(s):  
K Wu ◽  
E Walker ◽  
G Owen

Objectives: Balancing new referrals with limited clinic capacity is a challenge. At Lincoln County Hospital, referrals for tonsillectomy have been managed by an experienced ENT nurse practitioner, in order to deal with this problem more effectively. We reviewed tonsillectomy referrals made in a one year period to determine if surgical outcomes were satisfactory. Results were compared with figures available from the national prospective tonsillectomy audit.Methods: This was a retrospective study, assessing patients referred to the ENT department at Lincoln County Hospital. We reviewed the number of patients who had proceeded to surgery and the rate of complications.Results: One hundred and fifty-nine patients had been referred for tonsillectomy over the one year period. One hundred and forty-seven patients had been seen in clinic and 12 had not attended their clinic appointment. Following consultation with the nurse practitioner, 125 patients had proceeded to surgery. Five episodes of bleeding were recorded as complications postoperatively; giving a bleeding complication rate of 4.7 per cent, compared with a rate of 5.7 per cent from the national prospective tonsillectomy audit.Conclusion: A trained nurse practitioner can safely and effectively facilitate the complete process of managing a routine pre-operative tonsillectomy patient, from primary care referral to arranging admission for surgery.


Knygotyra ◽  
2019 ◽  
Vol 72 ◽  
pp. 62-89 ◽  
Author(s):  
Alma Braziūnienė

Based on the initiative of Duke Nicolaus Christophorus Radziwill the Orphan (1549–1616), Great Marshal of Lithuania (1579–1586) and Voivode of Vilnius (1604–1616), a map of the Grand Duchy of Lithuania, titled Magni Ducatus Lithuaniae caeterumque regionum illi adiaciencium exacta descriptio…, was printed in 1613 in the printing house of Willem Janszoon (Blaeu), which was famous at that time for the manufacture of globes and wall maps. It was drawn by Hessel Gerritsz (Lat. Gerardus) and prepared by a team of professionals gathered by N. Ch. Radziwill. The written part of the map (which addresses the reader), separately published also in 1613, glued together from three pages, and designated to the buyers of the wall map of the GDL, was prepared by the famous GDL painter Tomasz Makowski (1575–1630). From 1613 to 1631, this map of the GDL functioned only as a wall map. When W. Blaeu began to publish atlases as well, he included the 1613 wall map of the GDL, which was pressed from four copper plates and included a narrow ornamental edging, in his atlas Appendix Theatri A.Ortelii et Atlantis G. Mercatoris. The readers of the atlas could not observe the territory of the GDL in its entirety, as it was depicted in four pages. Thus, already in another edition of the atlas that was published during the same year of 1631, the map of the GDL was changed and its copper plates were reordered: the segment depicting the lower part of the Dnieper was cut away, and the whole ornamental edging of the map was discarded. Two maps then took shape: one of the GDL’s territory, glued together from four disproportionate plates, and one depicting the lower part of the Dnieper, glued together from two plates. Such a large map of the GDL’s territory (73 × 75 cm) was collapsible and would be included in Blaeu’s atlases near a written piece on Lithuania in the editions of 1631, 1634–1649, and even in one that was published in c. 1670. This map, unconventional for usage in atlases (as it was not bound), was replaced in 1649 by another map made on the basis of the original 1613 variant by W. Blaeu’s son, Joan. This particular specimen was a smaller-scale version of the GDL’s map and was oriented toward the west, not the north. However, as Blaeu’s printing house began to include the 1613 map of the GDL in its atlases, this does not mean that it had also stopped publishing it as a wall map – the buyer could have it made in the same printing shop and purchase, for example, a wide ornamental edging as a supplement to their order (e.g., the specimen belonging to the Uppsala University Library). Only two copies of this 1613 wall map of the GDL are extant, and these can be found in the Uppsala University Library and the Herzogin Anna Amalia Library in Weimar. These specimens are unique in that they allow us to see how an authentic 1613 wall map of the GDL looks like, together with T. Makowski’s text about Lithuania, also marked by a 1613 date. Knowing the history of how the copper plates of this map were used, we may state that the Weimar copy is of earlier origin than the one housed in Uppsala (at least by one year within the 1631 period). This article examines the 1613 map of the GDL from the perspective of book science – we provide an analysis of the publications devoted to the 1613 map of the GDL based on the aspect of how it was published. An all-encompassing historiographical study of the 1613 GDL map is not the goal of the present paper. By chronologically analyzing the works of Lithuanian and foreign authors in an historiographical retrospective, it is emphasized how the various authors writing about this map chose to consider its bibliographical information, how did the perspective regarding the structure of this map shift, etc. An historiographical analysis of the publications on the 1613 map of the GDL has demonstrated that the formal aspects of the map’s origins (what kind of copper plates were prepared for the wall map, of what structure was the map used by William Janszoon Blaeu in the atlases of his printing house and how exactly was it used, etc.) are important in attempting to discern how its functioning had developed over the years.


2021 ◽  
Author(s):  
Jun Sung Park ◽  
Young-Hoon Byun ◽  
Seung Jun Choi ◽  
Jong Seung Lee ◽  
Jeong-Min Ryu ◽  
...  

Abstract Objectives: Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigated the epidemiologic and clinical changes of intussusception from before to after the COVID-19 outbreak, when communicable diseases other than COVID-19 have dramatically decreased due to social lockdown.Methods: The incidence of intussusception and the total monthly visits, including communicable and non-communicable diseases, aged ≤7 years, were investigated from February 2019 to January 2021 in a single pediatric emergency department of a university-affiliated tertiary hospital. The relationship between the incidence of communicable disease and intussusception was analyzed. The clinical characteristics of patients with intussusception were compared for the one-year periods before (February 2019–January 2020) and after (February 2020–January 2021) social lockdown due to COVID-19.Results: Incidence of communicable disease, non-communicable disease, and intussusception is decreased after COVID-19 outbreak (15,932 to 3,880 [24.4%], 12,994 to 8,050 [62.0%], and 87 to 27 [31.0%], respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, Odds ratio=2.15, 95% CI=1.08–4.26, P=0.029). Compared with non-pandemic period, patients of pandemic period showed higher proportions of pathologic leading point and hospitalization (14.8% vs. 2.3%, 18.5% vs. 4.6%, respectively), lower base excess (-4.8 mmol/L vs. -3.6 mmol/L), and higher lactate concentration (1.7 mmol/L vs. 1.5 mmol/L).Conclusions: The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe disease and PLPs were higher after the COVID-19 pandemic.


2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.


VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Asciutto ◽  
Lindblad

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients’ grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.


2016 ◽  
Author(s):  
Olubukola Ojo ◽  
Olalekan Ojo ◽  
Adebola Omosehin ◽  
Kayode Oluwatusa ◽  
Sulaeman Okoro ◽  
...  
Keyword(s):  

2012 ◽  
Vol 3 (1) ◽  
pp. 63-73 ◽  
Author(s):  
I. Csáky ◽  
F. Kalmár

Abstract Nowadays the facades of newly built buildings have significant glazed surfaces. The solar gains in these buildings can produce discomfort caused by direct solar radiation on the one hand and by the higher indoor air temperature on the other hand. The amplitude of the indoor air temperature variation depends on the glazed area, orientation of the facade and heat storage capacity of the building. This paper presents the results of a simulation, which were made in the Passol Laboratory of University of Debrecen in order to define the internal temperature variation. The simulation proved that the highest amplitudes of the internal temperature are obtained for East orientation of the facade. The upper acceptable limit of the internal air temperature is exceeded for each analyzed orientation: North, South, East, West. Comparing different building structures, according to the obtained results, in case of the heavy structure more cooling hours are obtained, but the energy consumption for cooling is lower.


2020 ◽  
Vol 63 (3) ◽  
pp. 286-302
Author(s):  
Damian Mowczan ◽  

The main objective of this paper was to estimate and analyse transition-probability matrices for all 16 of Poland’s NUTS-2 level regions (voivodeship level). The analysis is conducted in terms of the transitions among six expenditure classes (per capita and per equivalent unit), focusing on poverty classes. The period of analysis was two years: 2015 and 2016. The basic aim was to identify both those regions in which the probability of staying in poverty was the highest and the general level of mobility among expenditure classes. The study uses a two-year panel sub-sample of unidentified unit data from the Central Statistical Office (CSO), specifically the data concerning household budget surveys. To account for differences in household size and demographic structure, the study used expenditures per capita and expenditures per equivalent unit simultaneously. To estimate the elements of the transition matrices, a classic maximum-likelihood estimator was used. The analysis used Shorrocks’ and Bartholomew’s mobility indices to assess the general mobility level and the Gini index to assess the inequality level. The results show that the one-year probability of staying in the same poverty class varies among regions and is lower for expenditures per equivalent units. The highest probabilities were identified in Podkarpackie (expenditures per capita) and Opolskie (expenditures per equivalent unit), and the lowest probabilities in Kujawsko-Pomorskie (expenditures per capita) and Małopolskie (expenditures per equivalent unit). The highest level of general mobility was noted in Małopolskie, for both categories of expenditures.


2011 ◽  
Vol 15 (2) ◽  
Author(s):  
Peter P. Smith

The United States is in a bind. On the one hand, we need millions of additional citizens with at least one year of successful post-secondary experience to adapt to the knowledge economy. Both the Gates and Lumina Foundations, and our President, have championed this goal in different ways. On the other hand, we have a post-secondary system that is trapped between rising costs and stagnant effectiveness, seemingly unable to respond effectively to this challenge. This paper analyzes several aspects of this problem, describes changes in the society that create the basis for solutions, and offers several examples from Kaplan University of emerging practice that suggests what good practice might look like in a world where quality-assured mass higher education is the norm.


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