scholarly journals Raynaud Phenomenon: Diagnosis and Management

2020 ◽  
Vol 4 (2) ◽  
pp. 32-49
Author(s):  
Fitriani ◽  
Citra Tresna Murti ◽  
Soenarto K
Keyword(s):  
Arterial Disease ◽  
Coordinated Care ◽  
Raynaud Phenomenon ◽  
Female Ratio ◽  
Digital Ischemia ◽  
Neurologic Disorders ◽  
Secondary Form ◽  
Underlying Diseases ◽  
Endocrine Disturbance ◽  
Primary Form

ABSTRACT Raynaud’s phenomenon (RP) is a chronic episodic attack of digital ischemia provoked by exposure to cold or emotional stres. This phenomenon affects 3-5% of the population, with female ratio more than men and is categorized into a primary and secondary form. Primary form of RP is idiopathic, meanwhile the secondary form is associated with underlying diseases and other condition such as connective tissue disease, obstructive arterial disease, neurologic disorders, drugs and toxin, hyperviscosity disorders, infections, endocrine disturbance, neoplasms, and occupation or environmental exposure. Until today, to classified and build the diagnosis of RP is still a clinical challenge. Therefore, a careful history and a physical examination, together with laboratory tests and nailfold capillaroscopy are mandatory. A combination of conservative measures and medications can help in the management of RP. The approach to the RP patients requires therefore a coordinated care of specialists including dermatology.

scholarly journals IMMUNODIAGNOSIS IN MEMBRANOUS NEPHROPATHY

2020 ◽  
Vol 73 (9) ◽  
pp. 1861-1866
Author(s):  
Magdalena Ratajczak ◽  
Ewa Poleszak ◽  
Tomasz Chrościcki
Keyword(s):  
Membranous Nephropathy ◽  
Antinuclear Antibodies ◽  
Aim Analysis ◽  
Non Invasive ◽  
Phospholipase A2 Receptor ◽  
Secondary Form ◽  
Stage Renal Disease ◽  
End Stage ◽  
Receptor Antibodies ◽  
Primary Form

One of the diseases leading to chronic end-stage renal disease is membranous nephropathy (MN). The main cause of this disease is the formation of antibodies to foreign and native antigens. Membranous nephropathy can be conventionally divided into 2 types: primary form (when the primary disease is unknown) and secondary form. Detection of appropriate antibodies is one of the methods to recognize and differentiate primary and secondary forms. A large role in non-invasive diagnosis of MN and differentiation of the primary form from the secondary play antinuclear antibodies (ANA), antibodies against granulocyte cytoplasm (ANCA), antiglomerular basement antibodies (anti-GBM) and phospholipase A2 receptor antibodies (anti-PLA2R). Differentiation matters when choosing a treatment choice. In the primary form, it is immunosuppression, and in the form of secondary treatment, it consists in curing or controlling diseases that can cause symptoms of MN. The aim: Analysis of serological methods helpful in immunodiagnosis of membranous nephropathy.

Primary and secondary effects of processing instruction on Spanish clitic pronouns

2015 ◽  
Vol 53 (2) ◽  
Author(s):  
Justin White
Keyword(s):  
Adult Learners ◽  
Future Research ◽  
Secondary Effects ◽  
Processing Instruction ◽  
Secondary Target ◽  
Structured Input ◽  
Target Form ◽  
Secondary Form ◽  
Primary And Secondary Effects ◽  
Primary Form

AbstractThis study investigates the effects of token item frequency in Structured Input activities on both a primary target form (Spanish accusative clitics) and a secondary target form (Spanish dative clitics). Participants included 460 adult learners enrolled in a beginning-level Spanish language course and they were exposed to either 40, 60, 80, 100, 120, or 140 target form tokens. This study included a pretest, immediate posttest, and a delayed posttest measuring interpretation and production of both primary and secondary target forms. Findings reveal that primary form interpretation effects across all frequencies, however, production findings present themselves with the 60 and 80 token groups only. Secondary form interpretation findings reveal themselves across all frequency levels with the exception of the lowest frequency investigated (40 tokens) and secondary form production mirror those found in previous studies on the same forms. As such, we discuss the theoretical and methodological ramifications of these findings as well as directions for future research.

Current Trends in Indications and Epidermiological Characteristics of Amputations in Nigeria

2020 ◽  
Author(s):  
Ekpenyong Christopher Edet
Keyword(s):  
Public Health ◽  
Diabetic Foot ◽  
Local Community ◽  
Arterial Disease ◽  
Economic Implications ◽  
Female Ratio ◽  
Upper And Lower Extremities ◽  
The Face ◽  
Peripheral Arterial ◽  
Epidemiological Characteristics

Background: Recently, we have witnessed a surge in the population of Diabetics and of course in the cases of Diabetic Foot Syndrome(DFS) requiring amputation. However, accepting amputation is difficult for patients and this has become a family or community decision to undergo amputation despite being a lifesaving procedure in most cases. Some patients have preferred to die with their gangrenous limbs in the face of ascending severe foot infection and septicemia rather than have an amputation. Aim: This study seeks to identify the current indications for amputation and its epidemiological characteristics in our hospital and by extension, our local community. Perhaps, this can be extrapolated and communicated as a Public Health warning and strategy to control the incidence, prevalence, and devastating effects of Amputation in our community. Methods: It was a descriptive, quantitative, and prospective study of the indications and epidemiological characteristics of Amputations in Uyo, Niger Delta region of Nigeria. This was done between the periods of January 2018 to December 2019 amongst patients who underwent Amputation at the University of Uyo Teaching Hospital, Uyo, Nigeria. Results: We did a total of 44 unilateral amputations of both upper and lower extremities. The age range was 19 to 71 years. The average age was 48.5 years they were 21 males and 23 females giving a Male: Female ratio of 1:1.1. The 4th to 6th decades of life had the highest number of amputations with a peak in the 5th decade. Diabetic Foot Gangrene (DFG) contributed the majority of 25 amputations (56.8%), most of which were in the 4th to 6th Decades, 23 (52.3%). They were 14 females (31.8%) and 11 males (25.0%) with DFG. Trauma contributed 14 amputations (31.8%), and most were in the 2nd to 4th decades of life but more were males 10 (22.7%) while females were 4 (9.1%). Fracture-Traditional BoneSetter-Gangrene (F-TBS-G) and Peripheral Arterial Disease each contributed 2 amputations (4.5%). Conclusion: The commonest indication for amputation was Diabetic Foot Gangrene(DFG) affecting patients in the 4th to 6th decades of life while Trauma, the 2nd commonest, affected patients in the 2nd to 4th decades of life. Therefore, in the face of the increasing prevalence of Diabetes in our society, Public Health measures aimed at early diagnosis and management of Diabetes as well as prevention of Trauma will reduce the rate of amputations, its attendant morbidity, and negative economic implications in our society.

Studies on Differential Proteins of Two Forms of Xenorhabdus Nematophilus

2019 ◽  
Vol 13 (4) ◽  
pp. 446-455
Author(s):  
Fengqin Zhang ◽  
Yajie Guo ◽  
Xiongduo Liu ◽  
Yong Liu ◽  
Liuliang Peng ◽  
...  
Keyword(s):  
Metabolic Pathways ◽  
Glutamate Synthase ◽  
Xenorhabdus Nematophila ◽  
Tumor Drug Resistance ◽  
Anti Cancer ◽  
Differential Proteins ◽  
Cytotoxic Compounds ◽  
Specific Proteins ◽  
Secondary Form ◽  
Primary Form

As an entomopathogenic bacterium, Xenorhabdus nematophila (X. nematophila) can be parasitic in the gut of entomopathogenic nematodes. Compared with the primary form of X. nematophila, its secondary form has more differences in physiological characteristics and metabolic pathways, such as insecticide, antibacterial, anti-cancer and other functions. Many studies about the application of X. nematophila as biological agents in ecological environment have been reported. However, its pathogenic mechanism and specific functional molecules remain to be studied. Therefore, this study is dedicated to research differential proteins between the primary and the secondary bacteria with iTRAQ technique to further explore the functional mechanism and functional proteins of X. nematophila. A total number of 367 differentially expressed proteins were detected with iTRAQ technique. Besides Xenocoumacin and Xnph1 proteins that had been widely studied by some scholars, other specific proteins in primary bacteria excavated are as follows: Xcn and Xnph1 proteins with antibacterial property, proteins related to the attachment of X. nematophila to the host insects including flagellin, fimbrial adaptor, fimbrial adhesion and capsular synthesis regulator component B, glutamate synthase that plays an important role in multiple metabolic pathways in the primary bacteria, multidrug resistance secretion proteins with the property of tumor drug resistance and defense effects against cytotoxic compounds produced by normal cells and malignant cells.

Digital ischemia: angiographic differentiation of embolism from primary arterial disease

1981 ◽  
Vol 137 (6) ◽  
pp. 1183-1187 ◽  
Author(s):  
MH Maiman ◽  
JJ Bookstein ◽  
EF Bernstein
Keyword(s):  
Arterial Disease ◽  
Digital Ischemia

scholarly journals Evaluation of Biomarkers of Severity in Patients with COVID-19 Infection

2021 ◽  
Vol 10 (17) ◽  
pp. 3775
Author(s):  
Akitaka Yamamoto ◽  
Hideo Wada ◽  
Yuhuko Ichikawa ◽  
Hikaru Mizuno ◽  
Masaki Tomida ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Severe Disease ◽  
Japanese Patients ◽  
Disease Stage ◽  
Female Ratio ◽  
Reactive Protein ◽  
Severe Stage ◽  
Male Female Ratio ◽  
Laboratory Biomarkers ◽  
Underlying Diseases

Object: Although many Japanese patients infected with coronavirus disease 2019 (COVID-19) only experience mild symptoms, in some cases a patient’s condition deteriorates, resulting in a poor outcome. This study examines the behavior of biomarkers in patients with mild to severe COVID-19. Methods: The disease severity of 152 COVID-19 patients was classified into mild, moderate I, moderate II, and severe, and the behavior of laboratory biomarkers was examined across these four disease stages. Results: The median age and male/female ratio increased with severity. The mortality rate was 12.5% in both moderate II and severe stages. Underlying diseases, which were not observed in 45% of mild stage patients, increased with severity. An ROC analysis showed that C-reactive protein (CRP), ferritin, procalcitonin (PCT), hemoglobin (Hb) A1c, albumin, and lactate dehydrogenase (LDH) levels were significantly useful for the differential diagnosis of mild/moderate I stage and moderate II/severe stage. In the severe stage, Hb levels, coagulation time, total protein, and albumin were significantly different on the day of worsening from those observed on the day of admission. The frequency of hemostatic biomarker abnormalities was high in the severe disease stage. Conclusion: The evaluation of severity is valuable, as the mortality rate was high in the moderate II and severe stages. The levels of CRP, ferritin, PCT, albumin, and LDH were useful markers of severity, and hemostatic abnormalities were frequently observed in patients in the severe disease stage.

scholarly journals EP.WE.561The impact of COVID-19 on infra-inguinal revascularisation in patients with symptomatic peripheral occlusive arterial disease

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sophie Tait ◽  
Kay McGillivray ◽  
Roisin McKenna ◽  
Keith Hussey
Keyword(s):  
Arterial Disease ◽  
Specific Reference ◽  
Peripheral Occlusive Arterial Disease ◽  
Female Ratio ◽  
Patient Demographics ◽  
Occlusive Arterial Disease ◽  
Male To Female ◽  
Clear Change ◽  
Extremity Amputation ◽  
Index Cases

Abstract Introduction Standard Operating Procedures were revised in response to the Covid-19 pandemic. There are descriptions from across Europe of increased rates of major extremity amputation. We have explored practice in a regional vascular unit serving two Health Boards in Scotland with specific reference to infra-inguinal revascularisation for patients with symptomatic peripheral occlusive arterial disease. Methods A retrospective review of the administrative theatre database was performed. Pre-Covid (1st April–July 31st 2019) and peri-Covid (1st April-31st July 2020) periods were examined and index cases identified. Practice and outcomes were examined. Results There was a 50% reduction in scheduled theatre sessions during the peri-Covid period. There were 100 procedures performed pre-Covid and 71 procedures performed during the peri-Covid period. The patient demographics were comparable – mean age 68-years with a male to female ratio of 1.6:1. Intervention for chronic limb threatening ischaemia was much more common in the peri-Covid period than in the pre-Covid period (94% versus 64% respectively). There was a clear change in anaesthetic practice with regional anaesthesia more commonly performed in the peri-Covid period (49% versus 12% respectively). There was no difference in the types of revascularisation performed. The 30-day mortality in the peri-Covid period was less than in the pre-Covid period (3% vs 1.4%). Conclusion The Covid-19 pandemic created imperatives that necessitated re-structure of service. Despite a reduction in theatre access we have managed to maintain a limb salvage service for patients with chronic limb threatening ischaemia.

scholarly journals Positive Relationships between Smoking and the Arterial Stiffness Index in Adults without Underlying Diseases

2017 ◽  
Vol 35 (2) ◽  
pp. 159 ◽  
Author(s):  
Piyanuch Thitiwuthikiat ◽  
Jirapas Jongjitwimol ◽  
Teonchit Nuamchit
Keyword(s):  
Cigarette Smoking ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Stiffness Index ◽  
P Value ◽  
Positive Relationships ◽  
Smoking Duration ◽  
Arterial Stiffness Index ◽  
Peripheral Arterial ◽  
Underlying Diseases

Objective: Smoking is a leading risk factor for various diseases including peripheral arterial disease (PAD). PADis a form of cardiovascular disease that affects the blood vessels, resulting in vascular stiffness and occlusion. The ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) are non-invasive techniques for detection of vascularocclusion and stiffness, respectively. To determine the association between cigarette smoking and peripheral arterialconditions, the ABI and CAVI of smokers and non-smokers were investigated.Material and Method: One hundred and forty one middle-aged participants without underlying diseases wereenrolled, 49 smokers and 92 non-smokers. A questionnaire was developed to collect the demographic information,medical history, and smoking behaviours of the participants, and their ABI and CAVI were measured.Results: Our results showed that the CAVI values of smokers (7.88±1.26) were significantly differed from those ofnon-smokers (7.17±0.94) at p-value <0.001. In addition, age and cigarette smoking were independent factors significantlyrelated to the CAVI values by a multivariate analysis. Likewise, we found a positive relationship between the CAVIvalues and the number of cigarettes smoked per day (r=0.31) and the length of smoking duration (r=0.42) at p-value<0.001. However, the ABI values between smokers and non-smokers were not different.Conclusion: This study demonstrated that age and smoking were significantly related to CAVI, and a greater number ofcigarettes smoked per day and longer smoking duration had positive relationships to CAVI values.

scholarly journals Common sites and causes of chronic cervical lymphadenopathy among a sample of Iraqi patients

2018 ◽  
Vol 5 (3) ◽  
pp. 892
Author(s):  
Hussein Ali Alkumasi ◽  
Mohammed Reda Al Ghadhban ◽  
Faris Talib Mohammed
Keyword(s):  
Age Distribution ◽  
Cervical Lymphadenopathy ◽  
Metastatic Tumor ◽  
Living Standard ◽  
Major Health Problem ◽  
Female Ratio ◽  
Common Cause ◽  
Reactive Hyperplasia ◽  
A Prospective Study ◽  
Underlying Diseases

Background: Chronic cervical lymphadenopathy may result from a variety of different underlying diseases. It could be a sign of inflammation, metastatic tumor or lymphoma.Methods: This is a prospective study of 60 patients with cervical lymphadenopathy who attended Al Karama Teaching Hospital for the period (1/12/2008 to 1/2/2010). Data includes their demographic information, clinical presentation, investigations and histopathological results.Results: Twenty six patients were males (43.3%) and 34 were females (56.7%). The male to female ratio was 1:1.3. Age distribution had shown that the highest incidence occurred in those between (11-20) years old (15 patients, 25%), followed by those between (1-10) years old. The mean age was 31.2±21.5 SD. The most common cause of cervical lymphadenopathy was reactive hyperplasia (23 patients, 38.3%) followed by Tuberculous lymphadenopathy (15patients, 25%). Lymphomas (13 patients, 21.7%) and metastatic deposits (7 patients, 11.7%).Conclusions: The most common cause of cervical lymphadenopathy was reactive hyperplasia followed by tuberculous lymphadenopathy. Tuberculous lymphadenopathy continues to be a major health problem, and this may be explained by situation in this country in the last few decades that affected the socio-economic, health care and the living standard of population.

scholarly journals Diabetic foot ulcer and its surgical management

2019 ◽  
Vol 8 (1) ◽  
pp. 25
Author(s):  
Darshan J. Lakhani ◽  
Jignesh P. Dave ◽  
Jignesh K. Ramani ◽  
Kartik K. Agrawal ◽  
Chirag R. Makadiya ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Surgical Management ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Class ◽  
Arterial Disease ◽  
Limb Amputation ◽  
Surgical Approaches ◽  
Female Ratio

Background: Almost 80% population of diabetic foot are from low to middle income countries like India, a country with second largest number of diabetic populations. Prevalence of diabetes mellitus in India is 9.3%. Lower extremity diseases, including peripheral neuropathy, peripheral arterial disease, and foot ulceration, is twice common in diabetic subjects. the most feared consequence of diabetic foot ulcer is limb amputation, which is seen 10 to 30 times more often in person with diabetes. The objective of this study concentrates on surgical management of diabetic foot ulcer.Methods: This is an observational prospective study of 100 cases for evaluation of diabetic foot ulcer and its surgical management at P.D.U. Hospital, Rajkot from January 2017 to November 2018.Results: The average age of presentation is 55.70 year. The male to female ratio was 1.27:1. Most of the patients are from lower middle class and upper lower class according to modified kuppuswamy socioeconomic classification. Most of the patients have duration of diabetes more than 5 years.  Most common microorganism grown from culture was Staphylococcus aureus. This study has higher rate of amputations of 74% due to late presentation and neglected disease due to peripheral neuropathy causes decreased pain sensation. There was no mortality in this study.Conclusions: Management of diabetic foot ulcer is by multimodal approach with conservative and surgical approaches. Preventive measures, early diagnosis and timely surgical intervention prevents limb amputations in diabetic foot ulcer.

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