Vasculitis and Vasculopathies

2020 ◽  
Author(s):  
Ana Paula Urzedo ◽  
Mariane Martins Manso ◽  
Thaisa Macarini de Faria
Keyword(s):  
Signs And Symptoms ◽  
Cellular Tissue ◽  
Vascular Network ◽  
Systemic Diseases ◽  
Medical Specialties ◽  
Cutaneous Manifestations ◽  
Palpable Purpura ◽  
Cutaneous Involvement ◽  
Chapel Hill

Our organism, as complex as it is, needs a giant vascular network to deliver nutrients to all cells, so vasculopathies and vasculitis are diseases present in all medical specialties. The skin and subcutaneous cellular tissue are irrigated by a vast vascular network, with cutaneous involvement related to these frequent pathologies. These can be restricted to the integumentary system or be part of systemic diseases with cutaneous manifestations, which make them of great interest to dermatologists. They can affect any caliber of vessels and present with several dermatological manifestations such as erythema, livedo reticularis, palpable purpura, nodules, ulcers, urticaria, hemorrhagic blisters, gangrene and other manifestations that can be isolated or associated with systemic signs and symptoms. However, there is no worldwide consensus regarding the classification of vasculitis, and the classification proposed in this chapter is based on the International Chapel Hill Conference Nomenclature of Vasculitides 2012, which is based on the size of the vessels. The purpose of this chapter is to compile a review of the most current treatments for these conditions.

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

Small Bowel Obstruction

2010 ◽  
Vol 21 (2) ◽  
pp. 187-194
Author(s):  
Colleen Trevino
Keyword(s):  
Small Bowel ◽  
Physical Examination ◽  
Surgical Intervention ◽  
Signs And Symptoms ◽  
Bowel Ischemia ◽  
Key Factors ◽  
The Past ◽  
Factors Influencing ◽  
Imaging Response

Strategies for the management of small bowel obstructions have changed significantly over the years. Nonoperative medical management has become the mainstay of treatment of many small bowel obstructions. However, the key to the management of small bowel obstructions is identifying those patients who need surgical intervention. Identification of those at risk for bowel ischemia and bowel death is an art as much as it is a science. Using the current literature and the past knowledge regarding small bowel obstructions, the clinician must carefully identify the signs and symptoms that suggest the need for operative intervention. Classification of the obstruction, history and physical examination, imaging, response to decompression and resuscitation, and resolution or progression of symptoms are the key factors influencing the management of small bowel obstructions.

scholarly journals Pain in emergency units: correlation with risk classification categories

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Wandressa Letícia Viveiros ◽  
Meiry Fernanda Pinto Okuno ◽  
Cássia Regina Vancini Campanharo ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Gabriella Novelli Oliveira ◽  
...  
Keyword(s):  
Signs And Symptoms ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Risk Classification ◽  
Moderate Intensity ◽  
Ratio Test ◽  
Intense Pain ◽  
Cross Sectional ◽  
Mild Pain

ABSTRACT Objectives: to correlate risk classification categories with the level of pain of patients in an emergency service. Method: cross-sectional study carried out in the Risk Classification of 611 patients. The variables studied were: age, gender, comorbidities, complaint duration, medical specialty, signs and symptoms, outcome, color attributed in the risk classification of and degree of pain. We used Analysis of Variance, a Chi-Square test and a Likelihood Ratio test. Results: the average age was 42.1 years (17.8); 59.9% were women; the green (58.9%) and yellow (22.7%) risk classification prevailed and hypertension (18.3%) was the most common Comorbidity. The most frequent pain intensity was moderate (25.9%). In the red category, patients presented a higher percentage of absence of pain; in the blue, mild pain; and in the green, yellow and orange categories, there was a greater percentage of intense pain (p < 0.0001). Conclusion: among the patients who presented pain, the majority reported moderate intensity. Regarding risk categories, most patients in the red category did not report pain. Those who were classified as green, yellow and orange, reported mostly intense pain. On the other hand, patients in the blue category reported predominantly mild pain.

Laryngeal Clefts

1979 ◽  
Vol 88 (6) ◽  
pp. 837-845 ◽  
Author(s):  
Timothy A. Lim ◽  
Suzanne S. Spanier ◽  
Robert I. Kohut
Keyword(s):  
Literature Review ◽  
Surgical Repair ◽  
Signs And Symptoms ◽  
Endoscopic Examination ◽  
Definitive Diagnosis ◽  
Serial Sectioning ◽  
Posterior Cricoarytenoid ◽  
Histopathologic Findings

The histopathologic findings in a case of laryngeal cleft studied by serial sectioning, and a literature review of this clinical entity are presented. The primary micropathologic findings include a cleft deformity of the posterior cricoid lamina, and alterations in muscle differentiation involving the interarytenoid and posterior cricoarytenoid muscles. Possible embryogenic mechanisms are discussed. The clinical picture is characterized by signs and symptoms of aspiration with airway obstruction, and definitive diagnosis is achieved by endoscopic examination. Treatment consists of surgical repair, although some patients with type 1 laryngeal clefts may be managed on a conservative trial. The need for uniform classification of laryngeal clefts in future reporting is emphasized.

Diagnostic Classification of Neuropsychiatric Signs and Symptoms in Patients With Dementia

1997 ◽  
Vol 8 (S3) ◽  
pp. 273-279 ◽  
Author(s):  
Eric D. Caine
Keyword(s):  
Human Immunodeficiency Virus ◽  
Clinical Research ◽  
Medical Diagnosis ◽  
Chronic Headache ◽  
Signs And Symptoms ◽  
Diagnostic Classification ◽  
Persistent Diarrhea ◽  
Immunodeficiency Virus ◽  
Irritable Bowel

Establishing a medical diagnosis serves two utilitarian purposes: providing information necessary to initiate treatment and communicating information regarding prognosis. A nosology or diagnostic nomenclature (i.e., a classification of diagnoses) provides further utility by establishing a foundation for clinical research. In his book, Wulff outlined four types of diagnoses: (1) symptomatic or pseudoanatomic diagnoses (e.g., chronic headache, persistent diarrhea, or irritable bowel); (2) syndromes; (3) anatomic diagnoses; and (4) causal diagnoses. By definition, syndromes have no means of being validated by measures external to the constructs themselves. Often, specific syndromes reflect diverse origins, and conversely, specific etiologies may cause multiple syndromes (e.g., syphilis, human immunodeficiency virus, and diabetes).

scholarly journals Cutaneous manifestations in children with the new coronavirus infection COVID-19

2021 ◽  
Vol 25 (1) ◽  
pp. 16-24
Author(s):  
O. B. Tamrazova ◽  
A. S. Stadnikova ◽  
E. V. Rudikova
Keyword(s):  
Literature Review ◽  
Viral Infection ◽  
Causative Agent ◽  
The Novel ◽  
Cutaneous Manifestations ◽  
Skin Manifestations ◽  
The World ◽  
Coronavirus Infection ◽  
Novel Coronavirus

In late 2019, a new viral infection appeared in China, which spread around the world, causing a pandemic. The causative agent of the new coronavirus infection COVID-19 is the SARS-CoV-2 coronavirus. The review presents modern data on the epidemiology, pathogenesis and course of the novel coronavirus infection COVID-19 in children. Chinese, American and European scientists have described a variety of cutaneous manifestations in children with COVID-19. The article provides a literature review of the cutaneous manifestations of COVID-19 coronavirus infection in children. During our own observation of 301 patients with coronavirus infection COVID-19 caused by SARS-CoV-2 at the Bashlyaevs Children Hospital in Moscow from May 17 to November 16, 2020, it was revealed that 39 (13 %) patients had skin manifestations. The article presents a classification of skin manifestations characteristic of COVID-19. A brief description of each group is given.

scholarly journals Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mariona Badia ◽  
José Manuel Casanova ◽  
Lluís Serviá ◽  
Neus Montserrat ◽  
Jordi Codina ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cutaneous Lesion ◽  
Skin Lesions ◽  
Intensive Treatment ◽  
Main Diagnosis ◽  
Systemic Diseases ◽  
Cutaneous Manifestations ◽  
Critical Patients ◽  
The Moment

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

scholarly journals Cardiomyopathy Classification: Ongoing Debate in the Genomics Era

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Charles McCartan ◽  
Robert Mason ◽  
S. R. Jayasinghe ◽  
Lyn R. Griffiths
Keyword(s):  
Adverse Effects ◽  
Genetic Information ◽  
Molecular Basis ◽  
Genetic Basis ◽  
Muscle Size ◽  
Systemic Diseases ◽  
Ongoing Debate ◽  
Traditional Classification ◽  
And Function

Cardiomyopathies represent a group of diseases of the myocardium of the heart and include diseases both primarily of the cardiac muscle and systemic diseases leading to adverse effects on the heart muscle size, shape, and function. Traditionally cardiomyopathies were defined according to phenotypical appearance. Now, as our understanding of the pathophysiology of the different entities classified under each of the different phenotypes improves and our knowledge of the molecular and genetic basis for these entities progresses, the traditional classifications seem oversimplistic and do not reflect current understanding of this myriad of diseases and disease processes. Although our knowledge of the exact basis of many of the disease processes of cardiomyopathies is still in its infancy, it is important to have a classification system that has the ability to incorporate the coming tide of molecular and genetic information. This paper discusses how the traditional classification of cardiomyopathies based on morphology has evolved due to rapid advances in our understanding of the genetic and molecular basis for many of these clinical entities.

Rheumatoid Arthritis: Etiology and Pathogenesis

2014 ◽  
Author(s):  
Gary S. Firestein ◽  
Anna-Karin H. Ekwall
Keyword(s):  
Rheumatoid Arthritis ◽  
Intracellular Signaling ◽  
Cartilage Damage ◽  
Signs And Symptoms ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Citrullinated Proteins ◽  
Definition Of

Rheumatoid arthritis (RA) is among the most common forms of chronic inflammatory arthritis. It affects approximately 1% of adults and is two to three times more prevalent in women than in men. There are no specific laboratory tests for RA; diagnosis depends on a constellation of signs and symptoms that can be supported by serology and radiographs. The disease evolves over many years as a consequence of repeated environmental stress causing inflammation and immune activation followed by a breakdown of tolerance in individuals with a specific genetic background. This review describes the definition of RA; its etiology, including genetics, infections, the role of smoking and citrullination of proteins, and epigenetic mechanisms; and its pathogenesis, including synovial histopathology, bone and cartilage damage, adaptive and innate immunity, and the role of cytokines and intracellular signaling. Tables include the 1987 American Rheumatism Association criteria for the classification of RA and the 2010 American College of Rheumatology/European League Against Rheumatism classification for RA. Figures show citrullinated proteins in airway cells, a section of a proliferative synovium from a patient with a classic RA, and scalloped regions of erosion at the junction between a proliferative inflamed rheumatoid synovium and the bone. This review contains 3 highly rendered figures, 2 tables, and 71 references.

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