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Gabriella Maria Pitt Gameiro Sales, Izabel Crystine Pereira Barbosa, Laura Maia Sampaio Canejo Neta, Paloma Lopes de Melo, Raphael de Azevedo Leitão, Hugo Moura de Albuquerque Melo
INTRODUCTION: Chikungunya (CHIK) is a tropical arbovirus, transmitted by the female mosquito Aedes aegypti and Aedes albopictus. In Brazil, there have been cases reported since 2014. The initial manifestations of this virus are sudden onset high fever, headache, chills, rashes, myalgia and intense joint pain. Usually, CHIK presents the acute and chronic phases, the latter characterized by bilateral polyarthralgia, which can last for months or even years. During this period, autoimmune diseases can be triggered, making the picture even more complicated...
January 2018: Revista da Associação Médica Brasileira
Zhanli Fu, Meng Liu, Xueqi Chen, Xing Yang, Qian Li
A 36-year-old woman suffering from oral ulcerations, skin rash, and dyspnea was suspected of having paraneoplastic pemphigus. An F-FDG PET/CT was performed to detect the underlying neoplasms and revealed an F-FDG-avid mass in the lower right retroperitoneum. The mucocutaneous lesions and dyspnea were relieved after the tumor excision, and the pathology indicated Castleman disease.
March 20, 2018: Clinical Nuclear Medicine
Arash Maleki, Hossein Aghaei, Stacey Lee
Purpose: To report the efficacy and safety of interferon alpha 2b in the treatment of pseudophakic cystoid macular edema resistant to conventional therapy. Observations: A 64-year-old patient presented with pseudophakic cystoid macular edema in her left eye, which developed two months after an uncomplicated cataract surgery and was resistant to multiple topical NSAIDs and multiple intravitreal bevacizumab injections over the course of nine months. She also developed side effects to oral acetazolamide and intravitreal triamcinolone injection; a skin rash and a rise in intraocular pressure (34 mmHg), respectively...
June 2018: American Journal of Ophthalmology Case Reports
Diane E Griffin, Wen-Hsuan W Lin, Ashley N Nelson
Measles is an acute systemic viral disease with initial amplification of infection in lymphoid tissue and subsequent spread over 10-14 days to multiple organs. Failure of the innate response to control initial measles virus (MeV) replication is associated with the ability of MeV to inhibit the induction of type I interferon and interferon-stimulated antiviral genes. Rather, the innate response is characterized by the expression of proteins regulated by nuclear factor kappa B and the inflammasome. With eventual development of the adaptive response, the rash appears with immune cell infiltration into sites of virus replication to initiate the clearance of infectious virus...
2018: F1000Research
Thanisorn Sukakul, Supenya Varothai
Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Interestingly, not only the clinical presentation was atypical, but blood tests for anti-desmoglein 1 and 3 antibodies by ELISA technique were also negative...
2018: Case Reports in Medicine
D D K Abeyaratne, C Liyanapathirana, C L Fonseka, P W M C S B Wijekoon
Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is an antineutrophil cytoplasmic antibody- (ANCA-) associated small vessel vasculitis with multisystem involvement. It is characterized with asthma, eosinophilia, and renal and peripheral nervous system involvement. However, EGPA presenting with bullous skin eruption is an uncommon dermatological manifestation. We report a rare case of EGPA overlapped with mixed essential cryoglobulinemia presenting with a bullous skin eruption...
2018: Case Reports in Medicine
Rajesh Yadav, Dundaiah Somashekar, Samir V Sodha, Kayla F Laserson, Srinivasa Venkatesh, Himanshu Chauhan
OBJECTIVES: Torrential rainfall and flooding from September 2-6, 2014 submerged >350 villages in Jammu and Kashmir state. We conducted rapid needs assessment in capital Srinagar from 27 September to 1 October to assess population health and safety needs. METHODS: Based on Community Assessment for Public Health Emergency Response (CASPER) methodology, we selected 7 households each from 30 census blocks using 2-stage cluster sampling. We collected information on demographics, needs, and illnesses using structured questionnaire...
March 21, 2018: Disaster Medicine and Public Health Preparedness
Maria Isabel de Oliveira, Gislene Mitsue Namiyama, Gabriela Bastos Cabral, João Leandro Ferreira, Noemi Taniwaki, Ana Maria Sardinha Afonso, Isabella Rillo Lima, Luís Fernando Macedo de Brigido
A great variety of viruses which cause exanthema share other clinical manifestations, making the etiologic identification a very difficult task, relying exclusively on the clinical examination. Rubella virus (RV) infection during the early stages of pregnancy can lead to serious birth defects, known as congenital rubella syndrome (CRS). In the present report, we described the presence of Zika virus (ZIKV) particles in urine samples and also ZIKV isolation in SIRC cells from the urine of a patient in acute phase of suspected rubella disease...
2018: Revista do Instituto de Medicina Tropical de São Paulo
Dong-Wook Kim, Susanne Saussele, Loretta A Williams, Hesham Mohamed, Yuanxin Rong, Teresa Zyczynski, Javier Pinilla-Ibarz, Elisabetta Abruzzese
Chronic, low-grade adverse events are common in patients with chronic myeloid leukemia who are treated with imatinib. These events may decrease patient quality of life and adherence, and may ultimately contribute to a suboptimal response. Alternative, second-generation tyrosine kinase inhibitors, such as dasatinib, are available with the potential to reduce adverse events, improve tolerability, and support long-term treatment goals. We present the final, primary analysis of DASPERSE/CA180-400 (NCT01660906), an open-label, multicenter, phase IV study designed to determine whether chronic, low-grade nonhematologic adverse events in imatinib-treated patients improve after switching to dasatinib, without affecting efficacy...
March 20, 2018: Annals of Hematology
Antonis Fanouriakis, Christina Adamichou, Sofia Koutsoviti, Stylianos Panopoulos, Chrysanthi Staveri, Anastasia Klagou, Christina Tsalapaki, Lamprini Pantazi, Styliani Konsta, Clio P Mavragani, Despoina Dimopoulou, Styliani Ntali, Georgios Katsikas, Kyriaki A Boki, Dimitrios Vassilopoulos, Pinelopi Konstantopoulou, Stamatis-Nick Liossis, Antonia Elezoglou, Maria Tektonidou, Prodromos Sidiropoulos, Abdulsamet Erden, Petros P Sfikakis, George Bertsias, Dimitrios T Boumpas
BACKGROUND: Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings. METHODS: Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least 3 months, due to active disease refractory to at least one conventional immunosuppressant. Disease activity, including the recently defined lupus low disease activity state (LLDAS) and remission (clinical SLEDAI-2K = 0), accrual of organ damage, flares and side effects were documented...
February 23, 2018: Seminars in Arthritis and Rheumatism
Sagar B Kudchodkar, Hyeree Choi, Emma L Reuschel, Rianne Esquivel, Jackie Jin-Ah Kwon, Moonsup Jeong, Joel N Maslow, Charles C Reed, Scott White, J Joseph Kim, Gary P Kobinger, Pablo Tebas, David B Weiner, Kar Muthumani
Vaccines are considered one of the greatest advances in modern medicine. The global burden of numerous infectious diseases has been significantly reduced, and in some cases, effectively eradicated through the deployment of specific vaccines. However, efforts to develop effective vaccines against infectious pathogens such as influenza, HIV, dengue virus (DENV), chikungunya virus (CHIKV), Ebola virus, and Zika virus (ZIKV) have proven challenging. Zika virus is a mosquito-vectored flavivirus responsible for periodic outbreaks of disease in Africa, Southeast Asia, and the Pacific Islands dating back over 50 years...
March 16, 2018: Microbes and Infection
Henry Chubb, Rashed Karim, Sébastien Roujol, Marta Nuñez-Garcia, Steven E Williams, John Whitaker, James Harrison, Constantine Butakoff, Oscar Camara, Amedeo Chiribiri, Tobias Schaeffter, Matthew Wright, Mark O'Neill, Reza Razavi
BACKGROUND: Cardiovascular magnetic resonance (CMR) imaging has been used to visualise post-ablation atrial scar (PAAS), generally employing a three-dimensional (3D) late gadolinium enhancement (LGE) technique. However the reproducibility of PAAS imaging has not been determined. This cross-over study is the first to investigate the reproducibility of the technique, crucial for both future research design and clinical implementation. METHODS: Forty subjects undergoing first time ablation for atrial fibrillation (AF) had detailed CMR assessment of PAAS...
March 19, 2018: Journal of Cardiovascular Magnetic Resonance
Lisa M Daum, Lindsay R Sklar, Darius R Mehregan
The term blueberry muffin rash is used to describe the clinical presentation of dermal extramedullary hematopoiesis. The common culprits of this rash include a TORCH (toxoplasmosis, other agents, rubella, cytomegalovirus, herpes) infection or hematologic dyscrasia. Association of this rash with hereditary spherocytosis is extremely rare. We present a unique case of a neonate born with a blueberry muffin rash secondary to hereditary spherocytosis.
February 2018: Cutis; Cutaneous Medicine for the Practitioner
Eunoo Bak, Namju Kim, Sang In Khwarg, Ho-Kyung Choung
SIGNIFICANCE: Herpes zoster ophthalmicus (HZO) has variable initial manifestations, and acute orbital inflammation may be the first sign without apparent zoster rash. This case series is significant for presenting diverse clinical features and treatment options of HZO with acute orbital inflammation. PURPOSE: To report a case series of patients diagnosed as HZO with acute orbital inflammation including two cases with unique presentations. CASE REPORTS: Medical records of four patients of HZO with acute orbital inflammation were reviewed...
March 16, 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Mohammed Sami Alhaddad, Afnan Khalifah AlBarjas, Lolowah Ebraheem Alhammar, Abdullatif Sami Al Rashed, Lorina Ineta Badger-Emeka
Background: Acinetobacter baumannii , is an emerging nosocomial multidrug resistance pathogen with the rapid spread of clones being reported in health-care settings and hospitals worldwide. Carbapenem resistance in this bacterium has been attributed to D OXA β-lactamases with OXA-51-like β-lactamase, being present in all A. baumannii isolate. The present study looks into the antibiotics susceptibility and molecular characterization of clinical A. baumannii isolates from Intensive Care Unit (ICU) samples in Al-Hofuf, South-eastern region of Saudi Arabia...
January 2018: International Journal of Applied and Basic Medical Research
Purva V Sharma, Michael Witteman, Swethika Sundaravel, Tulisa Larocca, Yuanming Zhang, Harry Goldsztajn
Adult T cell lymphoma (ATL), is a peripheral T cell neoplasm associated with infection by human T-lymphotropic virus (HTLV). This is a case of a 28-year-old lady who presented with back pain for the past month and recent onset weakness in her lower extremities bilaterally. She has a history of T-cell lymphoma secondary to HTLV-1 under remission since 2014 and systemic lupus erythematosus complicated by lupus nephritis. On physical examination patient had hyper-reflexia in both knees, ankle clonus bilaterally and spasticity in both her lower extremities...
February 2018: Intractable & Rare Diseases Research
Takako Miyamae, Takuma Hara, Aki Hanaya, Yumi Tani, Takayuki Kishi, Hisashi Yamanaka
A 10-year-old girl manifested persistent fever, skin rash, leg pain, fatigue, and joint pain. Based on muscle weakness, elevated muscle-derived enzymes, magnetic resonance imaging, and skin biopsy results, the diagnosis was juvenile idiopathic inflammatory myopathies (JIIM). Chest CT was normal; the anti-melanoma differentiation-associated protein-5 (anti-MDA5) autoantibody was positive. Initial manifestations subsided after prednisolone (PSL) and methotrexate treatment. After the PSL dosage was decreased, the patient presented with metacarpophalangeal (MCP) joint pain and swelling in both index fingers, synovial fluid, and signals on power Doppler ultrasound...
2018: Case Reports in Rheumatology
Filipa Caeiro Alves, Rute Aguiar, Pedro Pessegueiro, Carlos Pires
Thrombotic microangiopathy (TMA) comprises a process of sequential endothelial damage, microvascular thrombosis, consumptive thrombocytopenia and microangiopathic haemolytic anaemia that can affect several organs, including the kidney. A 36-year-old woman was presented with a petechial rash 3 weeks after an upper respiratory tract infection. Laboratory results showed normocytic normochromic anaemia, thrombocytopenia and evidence of TMA with decreased haptoglobin, elevated serum lactate dehydrogenase and a peripheral blood smear with numerous schistocytes...
March 17, 2018: BMJ Case Reports
M Haas, J T Siveke, M Schenk, M M Lerch, K Caca, J Freiberg-Richter, L Fischer von Weikersthal, F Kullmann, A Reinacher-Schick, M Fuchs, S Kanzler, V Kunzmann, T J Ettrich, S Kruger, C B Westphalen, S Held, V Heinemann, S Boeck
INTRODUCTION: In metastatic pancreatic ductal adenocarcinoma (mPDAC) treatment, erlotinib is known to be more effective in patients developing skin rash. Treatment with the FOLFIRINOX regimen is only performed in fit patients following defined inclusion criteria. The present study investigates the efficacy of gemcitabine plus erlotinib (gem/erlotinib) in rash-positive patients fit for FOLFIRINOX. PATIENTS AND METHODS: For this prospective phase II study, 150 patients were recruited in 20 centres...
March 14, 2018: European Journal of Cancer
Neil H Segal, Aiwu R He, Toshihiko Doi, Ronald Levy, Shailender Bhatia, Michael J Pishvaian, Rossano Cesari, Ying Chen, Craig B Davis, Bo Huang, Aron D Thall, Ajay K Gopal
Purpose: Utomilumab (PF-05082566) is an agonistic mAb that engages the immune costimulatory molecule 4-1BB/CD137. In this first-in-human, phase I, open-label, multicenter, multiple-dose study (NCT01307267) we evaluated safety, tolerability, pharmacokinetics, preliminary clinical activity, and pharmacodynamics of single-agent utomilumab in patients with advanced malignancies. Experimental Design: Dose escalation was based on a standard 3+3 design for doses of utomilumab from 0.006 to 0.3 mg/kg every 4 weeks and a time-to-event continual reassessment method for utomilumab 0...
March 16, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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