Skin Thickening in a Hemodialysis Patient: A Case of Nephrogenic Fibrosing Dermopathy

2009 ◽  
Vol 13 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Ayman Al Habeeb ◽  
Sara Partington ◽  
Donald Rosenthal ◽  
Samih Salama
Keyword(s):  
Renal Failure ◽  
Subcutaneous Tissue ◽  
Rapid Development ◽  
Abdominal Aneurysm ◽  
Mucin Production ◽  
Vein Thrombosis ◽  
Pathologic Features ◽  
Nephrogenic Fibrosing Dermopathy ◽  
History Of ◽  
Aneurysm Repair

Background: Nephrogenic fibrosing dermopathy (NFD), a rare fibrosing condition of the skin, occurs in patients with renal failure. Worldwide, 215 cases have been reported, but none of them are from Canada. Case Report: A 71-year-old woman with hypertensive vasculopathy and renal failure, hypothyroidism, deep vein thrombosis, and a previous abdominal aneurysm repair presented with the rapid development of indurated skin over her arms and legs. These skin changes developed 5 months after starting hemodialysis. Biopsy Results: Skin biopsies demonstrated thickened collagen bundles in the dermis with extension into the subcutaneous tissue and minimal increased mucin production. There were increased fibroblastic cells that were immunohistochemically CD34 positive. Conclusions: This patient has the clinical and pathologic features of NFD. Interestingly, this patient had a history of vein thrombosis and vascular surgery, emphasizing the possible role these features may play as instigators of fibrosis in this disease.

scholarly journals Fondaparinux in an Obese Child with Heparin-Induced Thrombocytopenia and a History of Renal Failure

2013 ◽  
Vol 18 (4) ◽  
pp. 303-310 ◽  
Author(s):  
Peter N. Johnson ◽  
Emily C. Benefield ◽  
Phi-Yen N. Bui ◽  
Richard A. Marlar ◽  
Morris R. Gessouroun
Keyword(s):  
Renal Failure ◽  
Oral Anticoagulation ◽  
Obese Child ◽  
Total Colectomy ◽  
Factor Xa ◽  
Optimal Dose ◽  
Heparin Induced Thrombocytopenia ◽  
Future Studies ◽  
Vein Thrombosis ◽  
History Of

A 9-year-old obese child with a history of ulcerative colitis was admitted to the intensive care unit for significant blood loss, hemorrhagic shock, and acute renal failure. Following complications from total colectomy secondary to multiple perforations, the patient developed heparin-induced thrombocytopenia (HIT) and subsequent portal vein thrombosis. Subcutaneous (SQ) fondaparinux therapy was initiated because the patient was unable to transition to oral anticoagulation. An anti-factor Xa assay was developed and used to adjust his fondaparinux therapy. Based on hemorrhagic complications and fondaparinux-based anti-factor Xa assay results, the fondaparinux was adjusted to a final dosage of 4.5 mg (0.066 mg/kg) SQ daily. In children unable to transition to oral anticoagulation, fondaparinux may be an alternative for the treatment of thrombosis associated with HIT. We noted that our patient required a lower dose per kilogram of fondaparinux than described in previous published reports. Despite this lower dosage per kilogram, our patient developed bleeding despite dosage reductions; subsequently, a few doses were held. It is unclear if this was related to his obesity, history of renal failure, or a combination of factors. Future studies should determine the optimal dose for special populations of children (e.g., those with obesity and renal failure). Until then, clinicians should routinely monitor and titrate fondaparinux therapy, ideally using a fondaparinux-specific anti-factor Xa assay.

De-novo peri-aortic inflammation after endovascular abdominal aneurysm repair

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
Enrico Gallitto ◽  
Rodolfo Pini ◽  
Chiara Mascoli ◽  
Antonino Logiacco ◽  
Martina Goretti ◽  
...  
Keyword(s):  
De Novo ◽  
Abdominal Aneurysm ◽  
Aneurysm Repair

History—an overview

2018 ◽  
Author(s):  
Oriol Bohigas ◽  
Hans A. Weidenmüller
Keyword(s):  
Random Matrix Theory ◽  
Random Matrix ◽  
Matrix Theory ◽  
Rapid Development ◽  
The Past ◽  
History Of ◽  
And Mathematics

An overview of the history of random matrix theory (RMT) is provided in this chapter. Starting from its inception, the authors sketch the history of RMT until about 1990, focusing their attention on the first four decades of RMT. Later developments are partially covered. In the past 20 years RMT has experienced rapid development and has expanded into a number of areas of physics and mathematics.

A murine model of deep vein thrombosis Characterization and validation in transgenic mice

2005 ◽  
Vol 94 (09) ◽  
pp. 498-503 ◽  
Author(s):  
Linda Szema ◽  
Chao-Ying Chen ◽  
Jeffrey P. Schwab ◽  
Gregory Schmeling ◽  
Brian C. Cooley
Keyword(s):  
Deep Vein Thrombosis ◽  
Murine Model ◽  
Femoral Vein ◽  
Previous History ◽  
Bed Rest ◽  
Major Surgery ◽  
Vein Thrombosis ◽  
Transgenic Lines ◽  
History Of ◽  
Deep Vein

SummaryDeep vein thrombosis (DVT) occurs with high prevalence in association with a number of risk factors, including major surgery, trauma, obesity, bed rest (>5 days), cancer, a previous history of DVT, and several predisposing prothrombotic mutations. A novel murine model of DVT was developed for applications to preclinical studies of transgenically constructed prothrombotic lines and evaluation of new antithrombotic therapies. A transient direct-current electrical injury was induced in the common femoral vein of adult C57Bl/6 mice. A non-occlusive thrombus grew, peaking in size at 30 min, and regressing by 60 min, as revealed by histomorphometric volume reconstruction of the clot. Pre-heparinization greatly reduced clot formation at 10, 30, and 60 min (p<0.01 versus non-heparinized). Homozygous FactorV Leiden mice (analogous to the clinical FactorV Leiden prothrombotic mutation) on a C57Bl/6 background had clot volumes more than twice those of wild-types at 30 min (0.121±0.018 mm3 vs. 0.052±0.008 mm3, respectively; p<0.01). Scanning electron microscopy revealed a clot surface dominated by fibrin strands, in contrast to arterial thrombi which showed a platelet-dominated structure. This new model of DVT presents a quantifiable approach for evaluating thrombosis-related murine transgenic lines and for comparatively evaluating new pharmacologic approaches for prevention of DVT.

Abdominal aortic aneurysm repair in patients with preoperative renal failure

1986 ◽  
Vol 3 (6) ◽  
pp. 867-870 ◽  
Author(s):  
Jon R. Cohen ◽  
John A. Mannick ◽  
Nathan P. Couch ◽  
Anthony D. Whittemore
Keyword(s):  
Renal Failure ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Professional Psychology in Portugal

1997 ◽  
Vol 81 (3_suppl) ◽  
pp. 1211-1222 ◽  
Author(s):  
Teresa Fagulha ◽  
Richard H. Dana
Keyword(s):  
Rapid Development ◽  
Well Being ◽  
Professional Psychology ◽  
Current Status ◽  
Environmental Concerns ◽  
Advanced Degrees ◽  
Professional Degree ◽  
History Of ◽  
Training Research

This paper describes the history and current status of professional psychology in Portugal where a unique perspective combines training, research, and practical contributions from Europe and the Americas with their own history of psychological tradition and expertise. Training in professional psychology includes Social Psychology and Educational and Vocational Guidance specializations in addition to Clinical Psychology and Psychotherapy and Counseling for the professional degree, Licenciatura. Advanced degrees are offered in Environmental Psychology, Career Development, Social Cognition, and other areas, primarily for academic positions. Research in all of these areas is expected to have applied outcomes that contribute to individual well being and an improved quality of life for the entire population. The result has been a rapid development of an indigenous professional psychology to address mental health, social, and environmental concerns that compel psychological attention and resources worldwide as well as those problems of local and national origins.

Orbital and Periorbital Cellulitis

1995 ◽  
Vol 16 (5) ◽  
pp. 163-167
Author(s):  
Keith R. Powell
Keyword(s):  
Inflammatory Process ◽  
Subcutaneous Tissue ◽  
Acute Onset ◽  
Orbital Cellulitis ◽  
The Body ◽  
Vein Thrombosis ◽  
Orbital Septum ◽  
Specific Complication ◽  
Thin Skin ◽  
Doctor's Office

The acute onset of eyelid redness and swelling in a child usually results in a quick visit to the doctor's office or an emergency room. The differential diagnosis for these signs ranges from relatively innocuous problems, such as allergy or an insect sting, to potentially vision-affecting or even life-threatening diseases, such as orbital cellulitis or cavernous vein thrombosis. The orbital contents often are protected from an inflammatory process by the orbital septum, a continuation of the periosteum of the bony orbit to the margins of both the upper and lower eyelids (Figure 1). An inflammatory process occurring in the structures superficial to the orbital septum is defined as preseptal or periorbital cellulitis; an inflammatory process in structures deep to the orbital septum is defined as orbital cellulitis of a specific complication thereof. Bacterial infection can cause both periorbital and orbital cellulitis. Another anatomic feature of importance is that the skin of the eyelid is the thinnest skin of the body. The subcutaneous tissue of the eyelid is composed of musculofibrous tissue and no fat. This combination of thin skin and loose subcutaneous tissues makes it possible for the eyelid to swell dramatically as it fills with edematous fluid. Epidemiology and Pathogenesis of Periorbital Cellulitis

History of Neuropsychology in Asia

2016 ◽  
Author(s):  
Tatia M.C. Lee ◽  
Wang Kai ◽  
Simon L. Collinson
Keyword(s):  
Information Exchange ◽  
Rapid Development ◽  
Sources Of Information ◽  
Clinical Neuropsychology ◽  
The West ◽  
Multiple Processes ◽  
History Of ◽  
The Rich ◽  
External Forces ◽  
Brain Behavior

Clinical neuropsychology in Asia has emerged from the interactions of multiple processes, including the development of psychology and its subdisciplines worldwide, the entering of psychology into Asia and ongoing intellectual influences from outside of Asia, indigenous responses to those external forces, and homegrown initiatives in studying brain-behavior relationships prior to and since the beginnings of modern neuropsychology. This chapter reviews the history of neuropsychology in China, Hong Kong, Singapore, and other Asian regions. With globalization and increasing ease of information exchange, neuropsychological practice in Asia will continue to be shaped by influence from the West interacting with the indigenization process to shape the development of neuropsychology in Asia. Rapid development of neuroscience leads to cutting-edge findings and discovery of brain-behavior relationships, which has and will continue to be one of the rich sources of information that guides and shapes neuropsychological practice in Asia and worldwide.

scholarly journals Post-traumatic pseudolipoma of the forehead

2007 ◽  
Vol 15 (3) ◽  
pp. 173-174 ◽  
Author(s):  
David Horovitz ◽  
Damir B Matic
Keyword(s):  
Subcutaneous Tissue ◽  
Clinical Findings ◽  
Frontal Bone ◽  
Forceps Delivery ◽  
Resonance Imaging ◽  
Frontalis Muscle ◽  
Rare Finding ◽  
History Of ◽  
Post Traumatic ◽  
Fibrofatty Tissue

A forehead lipoma is a rare finding in a child, and one that penetrates the underlying layers of muscle and bone to attach to dura has not previously been reported. Two such cases, both in children who underwent uneventful deliveries aided by forceps, are presented. Both lesions were present at birth and, based on clinical findings, were originally thought to be dermoid cysts. Dermoid cysts could not be ruled out with computed tomography and magnetic resonance imaging. Histopathology identified fibrofatty tissue consistent with lipoma. Both lesions extended from the subcutaneous tissue through the frontalis muscle and frontal bone to the dura. Given these findings and the history of forceps delivery, the most likely diagnosis is posttraumatic pseudolipoma. This lesion should be considered in the differential diagnosis of congenital lesions of the forehead, particularly if there is a history of forceps delivery or other trauma to the area.

scholarly journals Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Acute Onset ◽  
Suppurative Otitis Media ◽  
Vein Thrombosis ◽  
Significant Incidence ◽  
Lower Lung ◽  
History Of ◽  
The Right

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.

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