scholarly journals Tumefactive Acute Disseminated Encephalomyelitis after Recent Covid-19 Infection: A Case Report

2021 ◽  
pp. 1-3
Author(s):  
Brian Patrick Kelley ◽  
Keyword(s):  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Cognitive Changes ◽  
Fibrillary Glomerulonephritis ◽  
University Of Wisconsin ◽  
Progressive Encephalopathy ◽  
Stage Renal Disease ◽  
End Stage ◽  
The University

Objective: To report a case of a patient with recent mild to moderate COVID-19 infection who developed tumefactive acute disseminated encephalomyelitis. Methods: Patient data were obtained from medical records from the University of Wisconsin – Madison Hospitals in Madison, WI, USA. Results: We report a 59-year-old man with past medical history notable for atrial fibrillation, biventricular pacemaker, end-stage renal disease secondary to idiopathic fibrillary glomerulonephritis, on hemodialysis awaiting transplantation, who presented with ongoing cognitive changes and pneumonia. He was repeatedly COVID-19 positive with minimal symptoms for 4 weeks prior to admission. He developed right sided hemiparesis and persistent, progressive encephalopathy manifesting primarily with disorientation, agitation, and aggression. CSF was notable for cell count of 7, protein of 48, and glucose of 65. Anti-MOG antibody and AQP-4 antibody were negative. A series of CT/CTA head imaging with and without contrast showed progressive multifocal supratentorial areas of white matter hypoattenuation and MRI head with and without contrast demonstrated progressive multi-focal large ovoid T2 FLAIR hyperintensities, partially ring enhancing on contrasted portion of study, consistent with tumefactive demyelinating disease. Significant improvement in mental status and right sided hemiparesis symptoms was observed with initiation of corticosteroids. Conclusion: This case study provides neuroimaging evidence and clinical correlation to support that SARS–CoV-2 and resultant COVID-19 infection can lead to tumefactive acute disseminated encephalomyelitis. This complication has not been previously documented associated with recent COVID-19 infection.

scholarly journals Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

2017 ◽  
Vol 45 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Fernanda Payan Schober ◽  
Meghan A. Jobson ◽  
Caroline J. Poulton ◽  
Harsharan K. Singh ◽  
Volker Nickeleit ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Disease Process ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Underlying Disease ◽  
Fibrillary Glomerulonephritis ◽  
Black Patients ◽  
End Stage ◽  
20 Nm ◽  
The University

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

scholarly journals Environmental Analysis of GOES-R Proving Ground Convection-Initiation Forecasting Algorithms

2015 ◽  
Vol 54 (7) ◽  
pp. 1637-1662 ◽  
Author(s):  
Jason M. Apke ◽  
Daniel Nietfeld ◽  
Mark R. Anderson
Keyword(s):  
Environmental Variables ◽  
Environmental Influences ◽  
Principal Component ◽  
University Of Alabama ◽  
Algorithm Performance ◽  
University Of Wisconsin ◽  
Improve Algorithm ◽  
Convection Initiation ◽  
The University

AbstractEnhanced temporal and spatial resolution of the Geostationary Operational Environmental Satellite–R Series (GOES-R) will allow for the use of cloud-top-cooling-based convection-initiation (CI) forecasting algorithms. Two such algorithms have been created on the current generation of GOES: the University of Wisconsin cloud-top-cooling algorithm (UWCTC) and the University of Alabama in Huntsville’s satellite convection analysis and tracking algorithm (SATCAST). Preliminary analyses of algorithm products have led to speculation over preconvective environmental influences on algorithm performance. An objective validation approach is developed to separate algorithm products into positive and false indications. Seventeen preconvective environmental variables are examined for the positive and false indications to improve algorithm output. The total dataset consists of two time periods in the late convective season of 2012 and the early convective season of 2013. Data are examined for environmental relationships using principal component analysis (PCA) and quadratic discriminant analysis (QDA). Data fusion by QDA is tested for SATCAST and UWCTC on five separate case-study days to determine whether application of environmental variables improves satellite-based CI forecasting. PCA and significance testing revealed that positive indications favored environments with greater vertically integrated instability (CAPE), less stability (CIN), and more low-level convergence. QDA improved both algorithms on all five case studies using significantly different variables. This study provides an examination of environmental influences on the performance of GOES-R Proving Ground CI forecasting algorithms and shows that integration of QDA in the cloud-top-cooling-based algorithms using environmental variables will ultimately generate a more skillful product.

Students at the center in emerging academic models: embedded information literacy and distance services in the University of Wisconsin System Flex degree

2015 ◽  
Vol 32 (7) ◽  
pp. 12-15 ◽  
Author(s):  
Kristin M. Woodward
Keyword(s):  
Information Literacy ◽  
Student Body ◽  
Student Centered ◽  
Content Type ◽  
Competency Based Education ◽  
University Of Wisconsin ◽  
Challenges And Opportunities ◽  
Competency Based ◽  
The University

Purpose – As a model of competency-based education (CBE), the University of Wisconsin (UW) System Flex options present a unique case study of challenges and opportunities for embedding student-centered library services and information literacy. Design/methodology/approach – In this paper, we describe strategies for engaging with the evolving Flex curriculum, the needs of an unknown student body and the role of new student support staff. The author notes the relevance of examining the library’s role in Flex at this time, given the potential for growth nationally in CBE. Findings – The challenges the author faced initially were closely tied with opportunities that once examined, formed the basis of the embedded library model for competency-based education. Further, the author found opportunities to articulate their role in Flex on their campus and share with other institutions. Originality/value – This case study is based on the author’s experiences embedding Information Literacy and Distance Services in the Flex option at the University of Wisconsin Milwaukee.

Innovation and the Value of Human Capital in a Collegiate Setting

2016 ◽  
pp. 249-274
Author(s):  
Rachel Erin Johnson
Keyword(s):  
Human Capital ◽  
Front Line ◽  
Academic Unit ◽  
Non Profit ◽  
University Of Wisconsin ◽  
Crucial Component ◽  
Innovation Practices ◽  
The University ◽  
Innovation Capital

This case study illustrates the value of intellectual capital measurement, specific to human capital and innovation capital within an academic unit at a University of Wisconsin System campus. Within the case study, the academic unit was audited for their innovation practices and then examined to identify the value of human capital on their front line employees. Innovation continues to be a crucial component within academia as well as organizations in general to provide a competitive advantage. Understanding the value front line employees brings to a non-profit organization in academia continues to be a growing concern for many Universities'. The case study contains three parts; an innovation audit, several models and formulas to understand the value of human capital within a particular academic unit, and an overall conclusion and recommendation will be given for the current academic unit at the University of Wisconsin System campus.

End-Stage Renal Disease—Patient for Kidney Transplant

2018 ◽  
pp. 155-166
Author(s):  
Ferenc Gyulai
Keyword(s):  
Renal Transplantation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Preoperative Evaluation ◽  
Disease Patient ◽  
Perioperative Morbidity ◽  
Stage Renal Disease ◽  
End Stage ◽  
The 19Th Century

Attempts at organ transplantation have been made since the 19th century. Renal transplantation is the preferred treatment for end stage renal disease. Renal transplant anesthesia requires a thorough understanding of the metabolic and systemic abnormalities in end-stage renal disease, familiarity with transplant medicine, and expertise in managing and optimizing these patients for the best possible outcome. Also, the associated comorbid conditions increase the complexity of anesthesia, pain management, and perioperative morbidity and mortality. Hence a good perioperative management of these patients includes a multidisciplinary collaboration with well-planned anesthetic strategies. This chapter uses a case study of a 69-year-old man who presents for preoperative evaluation prior to consideration of renal transplantation.

Fibrillary Glomerulonephritis

2012 ◽  
Vol 4 (2) ◽  
pp. 69-72
Author(s):  
Karthik P. Karanam ◽  
Brian S. Decker
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
End Stage Renal Disease ◽  
Clinical Success ◽  
Fibrillary Glomerulonephritis ◽  
Biopsy Tissue ◽  
Renal Biopsies ◽  
Polyclonal Immunoglobulin ◽  
Stage Renal Disease ◽  
End Stage

Fibrillary glomerulonephritis (FGN) is a rare disorder characterized by Congo-red negative fibrillary deposits in the glomeruli. The incidence of FGN in native renal biopsies is only 0.8–1.5%. The pathological hallmark of FGN is fibrillary deposits in the mesangium and glomerular basement membrane. These fibrils are straight, non-branching and randomly oriented. In the majority of patients, FGN presents with nephrotic syndrome. Renal insufficiency is present in two-thirds of patients with a mean serum creatinine of 2.1 mg/dL. Approximately one-half of FGN patients progress to end-stage renal disease (ESRD). Renal biopsy establishes the diagnosis of FGN. Light microscopy findings include amorphous acellular deposits in the glomeruli. In the mesangium these deposits have a smudged texture and form a pseudolinear or confluent granular pattern along the basement membrane. Immunofluorescent studies of the biopsy tissue in FGN show staining for polyclonal Immunoglobulin G (IgG) and complement with a tendency towards higher IgG and C3. Electron microscopy reveals extensive infiltration of the glomerular basement membrane with spike formation. Standard therapeutic treatments for FGN have not been well defined. The clinical outcome of patients with FGN is not encouraging. In a recent study, 44% of patients with FGN progressed to ESRD. The average time to progress to ESRD was 2–4 years. Immuno-suppressant therapies that include corticosteroids, cyclophosphamide and cyclosporine, and most recently rituximab, have not demonstrated uniform clinical success.

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