scholarly journals Clinical and Forensic Aspects of the Different Subtypes of Argyria

2021 ◽  
Vol 10 (10) ◽  
pp. 2086
Author(s):  
Luís Mota ◽  
Ricardo Jorge Dinis-Oliveira
Keyword(s):  
Systemic Absorption ◽  
Histopathological Analysis ◽  
Wide Range ◽  
Silver Deposits ◽  
Specific Tissue ◽  
Eye Lesions ◽  
Dark Blue ◽  
Typical Skin ◽  
Viable Treatment

Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

scholarly journals Mucocutaneous Horn in Dog

2019 ◽  
Vol 48 ◽  
Author(s):  
Joyce Maíra De Araújo ◽  
Stephanie Carrelo De Lima ◽  
Eric Schmidt Rondon
Keyword(s):  
Anal Sphincter ◽  
Surgical Planning ◽  
Inflammatory Infiltrate ◽  
Morphological Characteristics ◽  
Histopathological Analysis ◽  
Human Beings ◽  
Wide Range ◽  
The Masses ◽  
Mucocutaneous Junction

Background: Cutaneous horn is a circumscribed exophytic lesion composed of dense, compact keratin with hyperplastic epidermis, which is primarily orthokeratotic and may include foci of parakeratosis. The hyperkeratotic protuberance resembles a horn but lack bone. In humans, it is well-documented with a wide range of primary epidermal lesions identified. In dogs, the reports are rare and brief. The diagnosis is based on its appearance and excisional biopsy reveals the triggering lesion. The objective of the present work is to describe the clinical presentation, predictive benignancy finds, treatment and follow-up of a case of cutaneous horns that arose from anal mucocutaneous boundary in a dog.Case: A 6-month-old male Pug presented two tumors in the anus noted in the early months of life. Complete blood count, serum chemistry profile, surgery, histopathological analysis and postoperative outcome were performed. Possible relapses were follow-up until 11 months after surgery. On physical examination, the dog was otherwise healthy. The two horn-like tumors were protruding from the mucocutaneous junction of the external anal sphincter in a sun-protected area. Both were higher than wide in base or, in other words, they had a high height-to-base ratio. During surgery, the masses were excised using an electronic scalpel and sent to histopathological analysis. The post-operative care consisted of cephalexin and meloxicam prescriptions. Also, it was recommended 0.9% NaCl solution wound flushing followed by topical chlorhexidine digluconate solution (1%) whenever dirt or defecation were noticed. The surgical wound healed after two weeks by second intention. Histopathology found well-delimited masses that covers the epidermis and dermis and displaces the cutaneous appendages towards the underlying musculature with an aggregate of lymphoplasmohistiocytic inflammatory infiltrate in the adjacent dermis. These finds and the presence of orthokeratotic hyperkeratosis and epidermis hyperplasia confirmed the clinical diagnosis of cutaneous horns. There were no signs of malignance. After surgery, no relapse occurred.Discussion: To the best of the authors’ knowledge, this is the first confirmed case of cutaneous horns in mucocutaneous junction. Furthermore, the tumors were found in a region with little exposure to sunlight which is unusual. The tumor’s narrow bases and the absence of continuous and dense inflammatory infiltrate shown to be predictive of benignancy as occurs in human beings. During surgical planning, it was decided not to establish wide margins around the masses. The decision considered the morphological signs of benignancy of the tumors described for human beings as no surveys about prevalence of benignity or malignancy associated with cutaneous horns were found in dogs. In addition, a more extensive excision could promote anal sphincter dysfunction. There was no tumors recurrence suggesting that the primary underlying lesions have been healed and confirming that predictive benignancy morphological characteristics applied in human patients can be useful for small animals. Veterinary clinicians and surgeons must be in constant vigil of cutaneous horns uncommon presentations and report them to create a solid database that can be useful for prognosis and surgical planning. The morphological predictive factors can be applied to avoid unnecessary extensive surgical excisions that could lead to functional or cosmetic impairment.

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

scholarly journals Zebrafish Models to Study New Pathways in Tauopathies

2021 ◽  
Vol 22 (9) ◽  
pp. 4626
Author(s):  
Clément Barbereau ◽  
Nicolas Cubedo ◽  
Tangui Maurice ◽  
Mireille Rossel
Keyword(s):  
Cognitive Deficits ◽  
Tau Protein ◽  
Common Point ◽  
Transgenic Models ◽  
Synaptic Loss ◽  
Wide Range ◽  
Transgenic Lines ◽  
Functional Consequences ◽  
The Common

Tauopathies represent a vast family of neurodegenerative diseases, the most well-known of which is Alzheimer’s disease. The symptoms observed in patients include cognitive deficits and locomotor problems and can lead ultimately to dementia. The common point found in all these pathologies is the accumulation in neural and/or glial cells of abnormal forms of Tau protein, leading to its aggregation and neurofibrillary tangles. Zebrafish transgenic models have been generated with different overexpression strategies of human Tau protein. These transgenic lines have made it possible to highlight Tau interacting factors or factors which may limit the neurotoxicity induced by mutations and hyperphosphorylation of the Tau protein in neurons. Several studies have tested neuroprotective pharmacological approaches. On few-days-old larvae, modulation of various signaling or degradation pathways reversed the deleterious effects of Tau mutations, mainly hTauP301L and hTauA152T. Live imaging and live tracking techniques as well as behavioral follow-up enable the analysis of the wide range of Tau-related phenotypes from synaptic loss to cognitive functional consequences.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals PROGNOSTIC FACTORS OF RENAL TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
G Martínez Izquierdo ◽  
A R Arnaiz Pérez ◽  
E Escolano Fernández ◽  
M Merayo Álvarez ◽  
B Carrasco Aguilera ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Radical Nephrectomy ◽  
Univariate Analysis ◽  
Malignant Neoplasms ◽  
Histopathological Analysis ◽  
Chi Square ◽  
Renal Sinus ◽  
Chi Square Test

Abstract INTRODUCTION Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary. MATERIAL AND METHODS A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively. RESULTS The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004). CONCLUSIONS Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.

scholarly journals Is podocytopathy another image of renal affection in p-SLE?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hend H. Abdelnabi
Keyword(s):  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Histopathological Analysis ◽  
Immune Deposits ◽  
Foot Process ◽  
Lupus Podocytopathy ◽  
Focal Segmental Sclerosis ◽  
Nephrotic Range Proteinuria

Abstract Background Lupus podocytopathy (LP) is a renal affection described in systemic lupus erythematosus (SLE) patients with nephrotic range proteinuria, characterized by diffuse foot process effacement without immune deposits and glomerular proliferation. This study describes LP, its pathological features and outcomes of pediatric (p-SLE) patients in comparison to the usual lupus nephritis (LN) cases. Methodology A retrospective cohort study conducted on a 10-year registration (2010–2019) of 140 p-SLE patients at the Pediatric Department, Tanta University. Histopathological analysis with light microscopy (LM) and immunofluorescence (IF) of all renal biopsies were evaluated according to the International Society of Nephrology Renal Pathology Society (ISN/RPS) grading system. In addition, some biopsies were examined with electron microscopy (EM). Results Eighty-six p-SLE cases (61.4%) had renal involvement; seventy-nine biopsies (91.86%) of them met the classification criteria of LN as defined by ISN/RPS system. Five biopsies were normal (MCD) and two showed focal segmental sclerosis (FSGN) that did not meet any known classification of LN. Hence, they were reevaluated using EM that revealed diffuse effaced podocytes without glomerular sub-epithelial, endocapillary or basement membrane immune deposits, and were classified as having lupus podocytopathy, representing (8.14%) of all LN biopsies. Those seven cases showed good response to steroids with a complete remission duration of 3.40 ± 1.95 weeks. However, some case had 1–3 relapses during the duration of follow up. Conclusions LP is a spectrum of p-SLE, not an association as it is related to disease activity and its initial presentation.

scholarly journals Debridement, Antibiotics, and Implant Retention Is a Viable Treatment Option for Early Periprosthetic Joint Infection Presenting More Than 4 Weeks After Index Arthroplasty

2019 ◽  
Vol 71 (3) ◽  
pp. 630-636 ◽  
Author(s):  
Claudia A M Löwik ◽  
Javad Parvizi ◽  
Paul C Jutte ◽  
Wierd P Zijlstra ◽  
Bas A S Knobben ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Viable Option ◽  
Time Intervals ◽  
Implant Retention ◽  
Time Point ◽  
Viable Treatment

Abstract Background The success of debridement, antibiotics, and implant retention (DAIR) in early periprosthetic joint infection (PJI) largely depends on the presence of a mature biofilm. At what time point DAIR should be disrecommended is unknown. This multicenter study evaluated the outcome of DAIR in relation to the time after index arthroplasty. Methods We retrospectively evaluated PJIs occurring within 90 days after surgery and treated with DAIR. Patients with bacteremia, arthroscopic debridements, and a follow-up <1 year were excluded. Treatment failure was defined as (1) any further surgical procedure related to infection; (2) PJI-related death; or (3) use of long-term suppressive antibiotics. Results We included 769 patients. Treatment failure occurred in 294 patients (38%) and was similar between time intervals from index arthroplasty to DAIR: the failure rate for Week 1–2 was 42% (95/226), the rate for Week 3–4 was 38% (143/378), the rate for Week 5–6 was 29% (29/100), and the rate for Week 7–12 was 42% (27/65). An exchange of modular components was performed to a lesser extent in the early post-surgical course compared with the late course (41% vs 63%, respectively; P < .001). The causative microorganisms, comorbidities, and durations of symptoms were comparable between time intervals. Conclusions DAIR is a viable option in patients with early PJI presenting more than 4 weeks after index surgery, as long as DAIR is performed within at least 1 week after the onset of symptoms and modular components can be exchanged.

scholarly journals Penile Mondor’s in a Covid-19 patient on prophylactic anti-thrombosis with rivaroxaban: a case report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Murat Tuğrul Eren ◽  
Hakan Özveri ◽  
Hilal Kurtoğlu
Keyword(s):  
Male Patient ◽  
Antibody Test ◽  
Inflammatory Cells ◽  
Thromboembolism Prophylaxis ◽  
Case Presentation ◽  
Subacute Phase ◽  
Dorsal Vein ◽  
Wide Range ◽  
Underlying Causes

Abstract Background Penile Mondor’s disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. Following the occurrence of thrombotic events in the affected veins, the lumen often becomes occluded with fibrin and inflammatory cells. A hyper-coagulative state is one of the underlying causes although most cases of PMD are idiopathic. Coronavirus disease-2019 infection (COVID-19) is associated with frequent thrombotic events. Inflammation and thrombosis play a central role in the course and outcome of COVID-19, which can predispose to both venous and arterial thromboembolism. In this report, we present a 33-year-old male patient diagnosed with PMD during the subacute phase of COVID-19 infection while on prophylactic antithrombotic treatment. Case Presentation A 33-year-old male patient was diagnosed as PMD which occurred during the subacute phase of COVID-19 infection, while he was on active treatment of COVID-19 by prophylactic antithrombotic Rivaroxaban 15 mg therapy and curative antiviral medication. There was no recent sexual intercourse or trauma to the genitals. His PCR test for COVID-19 had become negative, and antibody test was positive at the time of his PMD’s onset. Rivaroxaban was replaced by Enoxaparin (8000 IU/0.8 ml.), a low molecular weight heparin administered subcutaneously and twice daily. On the third day of this medication, all coagulative measurements returned to normal. PMD disappeared in the second week. Conclusion Low-dose Rivaroxaban 15 mg is not safe for some COVID-19-associated thromboembolism prophylaxis, and careful follow-up is critical due to the possibility of a wide range of pathologic thrombotic manifestations in COVID-19 infection.

RELATIONSHIP OF ELEVATED BLOOD TYROSINE TO THE ULTIMATE INTELLECTUAL PERFORMANCE OF PREMATURE INFANTS

PEDIATRICS ◽  
1972 ◽  
Vol 49 (2) ◽  
pp. 218-224 ◽  
Author(s):  
John H. Menkes ◽  
Doris W. Welcher ◽  
Helene S. Levi ◽  
Joseph Dallas ◽  
Neil E. Gretsky
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Maximum Level ◽  
Intellectual Performance ◽  
Wide Range Achievement Test ◽  
Follow Up Study ◽  
Wide Range ◽  
Significant Difference ◽  
Picture Completion

Blood tyrosine concentrations were followed from birth to nursery discharge in 71 premature infants fed a high protein formula supplemented by 60 mg/day of ascorbic acid. In 89% of infants blood tyrosine concentrations were abnormal, and in 38% of infants the maximum level observed was 15.0 mg/100 ml or higher. Maximum blood tyrosine levels correlated significantly with gestational age (p = < 0.05) but not with birth weight. In a follow-up study performed at 15 months of age, infants with high tyrosine levels had no increase in the incidence of neurological abnormalities. Between 7 and 8 years of age a second follow-up study was performed on 62 children. This included a WISC, a Wide-Range Achievement Test (WRAT), and tests for psychomotor and language maturity. Two children had died in the interval, and five of the 62 were retarded for full testing. The full scale WISC I.Q. of all children correlated with birth weight at the 10% confidence level (p = < 0.1). The mean WISC I.Q. of high and low tyrosine subjects was 82.9 and 81.6 respectively. When infants were grouped by birth weight, a significant difference was detected in subjects weighing 2,000 gm or more. High tyrosine infants had a significantly lower performance I.Q. than low tyrosine infants (82.4 and 97.8 respectively; p = < 0.02). Significant differences were recorded in the scores on Object Assembly, Picture Assembly, and Picture Completion of the WISC. Significant differences were also seen on the Spelling subtest of the WRAT (p = < 0.02). We observed no adverse effect of high tyrosine levels on the intellectual performance of smaller premature infants, who on the whole have a greater risk for other complications of prematurity.

Abstract P002: Heavy Alcohol Consumption Increases the Risk of Atrial Fibrillation -Circulatory Risk in Communities Study(CIRCS)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Fumihiko Sano ◽  
Tetsuya Ohira ◽  
Akihiko Kitamura ◽  
Hironori Imano ◽  
Renzhe Cui ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alcohol Consumption ◽  
Medical History ◽  
Moderate Alcohol Consumption ◽  
Heavy Alcohol ◽  
Ethanol Drinking ◽  
Wide Range ◽  
Detailed Medical History ◽  
Heavy Alcohol Consumption

Background— Evidence on the relationship of a wide range of alcohol consumption with risk of incident atrial fibrillation has been limited. Methods— Between 1991 and 1995, 8602 Japanese men and women aged 30 to 80 years and free of clinical atrial fibrillation took part in the first examination of the Circulatory Risk in Communities Study(CIRCS)- a population based cohort study of cardiovascular risk factors, cardiovascular disease incidence, and their trends in Japanese communities. In the first examination, we checked a detailed medical history, physical examination, blood and urine examination, and electrocardiogram (ECG). An interviewer obtained histories in detail for weekly alcohol intake. In the follow-up period, incident atrial fibrillations were ascertained by annual ECG record and medical history of treatment of atrial fibrillation. ECGs were coded with the Minnesota Code by trained physician-epidemiologists. Differences in baseline characteristics between atrial fibrillation cases and controls were compared using Student t-tests or chi-squared tests. The hazard ratios (HRs) of incidence of atrial fibrillation and 95% confidence interval (CI) relative to the never-drinking group were calculated with adjustment for age and other potential confounding factors using the Cox proportional hazard model. Results— During an average follow-up of 6.4 years, 290 incident atrial fibrillation occurred. The higher incidence rate of atrial fibrillation was observed among participants with more than 69 g of ethanol drinking per week, compared with less than 69 g of ethanol drinking per week. On the other hand, light to moderate alcohol consumption was not associated with risk of atrial fibrillation. Compared with the never drinking group, the multivariable-adjusted HRs of past, light (<23 g), light moderate (23-46 g), moderate (46-69 g), and heavy (>69 g) drinking groups were 1.20 (95% CI, 0.61-2.35), 0.85 (95% CI, 0.57-1.27), 1.05 (95% CI, 0.63-1.75), 1.34 (95% CI, 0.78-2.32), and 2.92 (95% CI, 1.61-5.28), respectively. Conclusions— Heavy alcohol consumption was associated with the higher risk of atrial fibrillation, whereas there was no association of less than moderate alcohol consumption and atrial fibrillation.

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