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Mottling sign

Manpreet Randhawa, Steven Wang, James J Leyden, Gabriela O Cula, Alessandra Pagnoni, Michael D Southall
BACKGROUND: Sunscreens are known to protect from sun damage; however, their effects on the reversal of photodamage have been minimally investigated. OBJECTIVE: The aim of the prospective study was to evaluate the efficacy of a facial sun protection factor (SPF) 30 formulation for the improvement of photodamage during a 1-year use. METHODS: Thirty-two subjects applied a broad spectrum photostable sunscreen (SPF 30) for 52 weeks to the entire face...
October 4, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Caterina Longo
The aim of the current review is to provide an overview of the use of reflectance confocal microscopy to detect early skin aging signs. This new imaging tool holds the promise to morphologically explore the epidermis and upper dermis at nearly histologic resolution and over time. The main confocal findings of aged skin include the presence of irregular honeycombed pattern, linear skin furrows, mottled pigmentation, and distinct collagen types (coarse and huddled).
October 2016: Dermatologic Clinics
Kate E Hughes, Colin Seguin, Brent Felton, Mary J Hughes, David Castle
BACKGROUND: First described by Morgagni in 1761, aortic dissection (AD) is an acute life-threatening and time-sensitive disease process with an increasing mortality approaching 1% for every 1-hour delay in diagnosis within the first 48 hours. Despite continued surgical advancement, overall in-hospital mortality remains significant (27.4%). CASE REPORT: A 56-year-old woman presented to an outlying emergency department with a complaint of isolated lumbar pain associated with right lower extremity paresthesia and paralysis that progressed to the left...
October 2016: Journal of Emergency Medicine
Kwang Hee Won, Sang Hyung Lee, Mi Hye Lee, Do-Young Rhee, Un-Cheol Yeo, Sung Eun Chang
BACKGROUND: Laser toning using low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum laser (QSNY) has gained popularity in the treatment of photoaging and associated mottled pigmentation (PMP). However, hypopigmentation or lack of efficacy has been reported depending on the fluences used. OBJECTIVE: To compare a novel fractional 1064-nm QSNY with conventional 1064-nm QSNY for the treatment of photoaging associated mottled pigmentary lesions except epidermal lesions of lentigines and freckles through a randomized, split-face, double-blind study...
June 1, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Hiroaki Matsumoto, Yasuhisa Yoshida, Yutaka Hirata
Type A acute aortic dissection (TAAAD) sometimes presents with acute stroke-like symptoms. When intravenous tissue plasminogen activator (IV-tPA) therapy is considered for acute ischemic stroke, TAAAD must be excluded. Painless TAAAD presenting with acute stroke may be easily missed. Two cases of painless TAAAD presenting with acute stroke in which IV-tPA therapy was considered are reported. In these cases, cervical magnetic resonance angiography (MRA) was useful for detecting TAAAD, and IV-tPA therapy was canceled...
September 2016: Magnetic Resonance Imaging
Bruno de Paula Freitas, João Rafael de Oliveira Dias, Juliana Prazeres, Gielson Almeida Sacramento, Albert Icksang Ko, Maurício Maia, Rubens Belfort
Importance: The Zika virus (ZIKV) has rapidly reached epidemic proportions, especially in northeastern Brazil, and has rapidly spread to other parts of the Americas. A recent increase in the prevalence of microcephaly in newborn infants and vision-threatening findings in these infants is likely associated with the rapid spread of ZIKV. Objective: To evaluate the ocular findings in infants with microcephaly associated with presumed intrauterine ZIKV infection in Salvador, Bahia, Brazil...
February 9, 2016: JAMA Ophthalmology
Camila V Ventura, Mauricio Maia, Bruna V Ventura, Vanessa Van Der Linden, Eveline B Araújo, Regina C Ramos, Maria Angela W Rocha, Maria Durce C G Carvalho, Rubens Belfort, Liana O Ventura
PURPOSE: In 2015, a twenty-fold increase in the prevalence of microcephaly in Brazil was reported, and the Ministry of Health associated this abnormal prevalence with the maternal-fetal Zika virus (ZIKV) transmission. METHODS: We assessed the ophthalmological findings of ten mothers and their infants that had been clinically diagnosed with ZIKV-related microcephaly and presented ocular abnormalities, born from May to December 2015. RESULTS: Seven mothers (70...
February 2016: Arquivos Brasileiros de Oftalmologia
J C Lewejohann, H Braasch, M Hansen, C Zimmermann, E Muhl, T Keck
BACKGROUND: Appropriate fluid resuscitation is a fundamental aspect for the hemodynamic management of septic shock patients and should ideally be achieved before vasopressors and positive inotropic substances are administered. The development of hemodynamic monitoring has revealed that in some cases patients had been improperly treated with high-dose catecholamines for initially insufficient fluid resuscitation. The aim of this study was to show that in some cases it is possible to actively reduce catecholamines by a volume challenge adapted according to the individual patient needs...
September 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Samuel C Allred, Karen E Weck, Adil Gasim, Amy K Mottl
AIMS: X-linked Alport syndrome (AS) is a monogenic inherited disorder of type IV collagen, a structural protein in the kidney and cochlea. Males typically exhibit a severe phenotype with end-stage renal disease (ESRD) and/or deafness by early adulthood. Because of the presence of two X chromosomes, females often have a less severe phenotype and hence the diagnosis of AS is often not considered. Herein, we present a case of an adolescent girl with proteinuria and hematuria in the setting of a strong family history of AL...
November 2015: Clinical Nephrology
Zartash Javaid, Shahzaib M Rehan, Ayad Al-Bermani, Gareth Payne
We write to report a rare case of unilateral cancer-associated retinopathy previously undocumented in the literature. Cancer-associated retinopathy is an uncommon paraneoplastic syndrome. It is characterised by retinal antigen autoantibodies causing rod and cone dysfunction and abnormal electroretinography findings with consequent progressive visual loss.Our patient, known to have a primary cervical intraepithelial neoplasia, presented with unilateral blurred vision as well as a disturbance in colour and night vision...
August 4, 2015: Scottish Medical Journal
Hiroshi Iseki, Michihiro Takagi, Kenji Kawashima, Tomoyuki Shibahara, Yoshiko Kuroda, Hiroshi Tsunemitsu, Makoto Yamakawa
To clarify the pathogenicity of Japanese type 1 porcine reproductive and respiratory syndrome virus (PRRSV) isolate in experimentally infected pigs, we evaluated clinical signs and monitored viremia for 21 days post-inoculation (dpi). Lungs were mottled, tanned and reddish in appearance; had lesions predominantly in the cranial, middle and accessory lobes; and failed to collapse at 10 dpi. Although microscopic lesions of lungs were reproduced using the Japanese emerging type 1 PRRSV isolate under experimental conditions, no significant differences were noted between the challenge and control groups regarding mean rectal temperature and daily weight gain...
January 2016: Journal of Veterinary Medical Science
Evelien Hilde Verstraete, Koen Blot, Ludo Mahieu, Dirk Vogelaers, Stijn Blot
BACKGROUND AND OBJECTIVES: Blood culture is the gold standard to diagnose bloodstream infection but is usually time-consuming. Prediction models aim to facilitate early preliminary diagnosis and treatment. We systematically reviewed prediction models for health care-associated bloodstream infection (HABSI) in neonates, identified superior models, and pooled clinical predictors. DATA SOURCES: LibHub, PubMed, and Web of Science. METHODS: The studies included designed prediction models for laboratory-confirmed HABSI or sepsis...
April 2015: Pediatrics
S Kaur, M Kizoulis, J Fantasia, T Oddos, N Bigot, P Galera, S Tucker-Samaras, J J Leyden, M D Southall
BACKGROUND: The nuclear factor-κB (NF-κB) pathway is a key mediator of inflammation; however, few studies have examined the direct effects of NF-κB inhibition on the skin. OBJECTIVES: To investigate NF-κB activity in cultured human fibroblasts and to investigate the effects of 4-hexyl-1,3-phenylenediol (an NF-κB inhibitor) on elastin and collagen gene expression in vitro and on the clinical appearance of photodamaged skin. METHODS: The amount and activity of NF-κB in human fibroblasts obtained from donors (17-78 years old) was measured after transfection with a NF-κB reporter and a luciferase promoter system...
July 2015: British Journal of Dermatology
Orsolya Orosz, Miklós Czeglédi, Irén Kántor, István Balogh, Attila Vajas, Lili Takács, András Berta, Gergely Losonczy
PURPOSE: NEUROD1 is a tissue-specific basic helix loop helix (bHLH) protein involved in the development and maintenance of the endocrine pancreas and neuronal elements. Loss of NEUROD1 causes ataxia, cerebellar hypoplasia, sensorineural deafness, and severe retinal dystrophy in mice. Heterozygous loss-of-function mutations in NEUROD1 have previously been described as a cause of maturity-onset diabetes of the young (MODY) and late-onset diabetes. To date, homozygous loss-of-function NEUROD1 mutations have only been detected in two patients...
2015: Molecular Vision
Paolo Fraccaro, Massimo Nicolo, Monica Bonetto, Mauro Giacomini, Peter Weller, Carlo Enrico Traverso, Mattia Prosperi, Dympna OSullivan
BACKGROUND: To investigate machine learning methods, ranging from simpler interpretable techniques to complex (non-linear) "black-box" approaches, for automated diagnosis of Age-related Macular Degeneration (AMD). METHODS: Data from healthy subjects and patients diagnosed with AMD or other retinal diseases were collected during routine visits via an Electronic Health Record (EHR) system. Patients' attributes included demographics and, for each eye, presence/absence of major AMD-related clinical signs (soft drusen, retinal pigment epitelium, defects/pigment mottling, depigmentation area, subretinal haemorrhage, subretinal fluid, macula thickness, macular scar, subretinal fibrosis)...
2015: BMC Ophthalmology
Seyed Mohammad Alavi, Mohammad Mehdi Khoshkho, Shokrolah Salmanzadeh, Mehdi Eghtesad
BACKGROUND: Diabetes mellitus (DM) due to suppressive effect on cellular immunity can impact on progression of tuberculosis (TB). OBJECTIVES: The aim of this study was to investigate the impact of DM on the epidemiological, clinical and para clinical aspects of pulmonary TB. PATIENTS AND METHODS: The information of 148 admitted pulmonary TB patients in infectious ward of Razi hospital in Ahvaz from 2009 to 2010 was extracted from their medical files...
September 2014: Jundishapur Journal of Microbiology
Shyam Verma, Piyush Bhargav, Tushar Toprani, Vishal Shah
Tophi are the visible dermatological signs of gout. A case of tophaceous gout in a middle-aged man with no other metabolic derangement is being presented with multiple tophi on the hands and feet overlying joints as well as on the fingers and toes. We thought it to be of educational value to demonstrate needle-like crystals of urate by polarizing microscopy. X-rays of hands and feet showed dramatic destructive changes. The patient presented with mottled hypopigmentation on anterior and posterior knees and dorsa of hands and feet where he applied hot "aankda" leaves and covered them with bandage resulting in irritant dermatitis with postinflammatory hypopigmentation...
November 2014: Indian Journal of Dermatology
Michael R Kozlowski
PURPOSE: Senescence of the retinal pigment epithelial (RPE) cell layer has been implicated in the occurrence of age-related macular degeneration (AMD). The present study examines whether the ability of vascular endothelial growth factor (VEGF) to decrease the barrier function of RPE cells is enhanced in senescent RPE cells, which could contribute to the pathology of "wet" AMD. METHODS: Low or high population doubling level (PDL) range ARPE-19 human RPE cells were cultured in 6-well plates on membrane-containing inserts...
March 2015: Journal of Ocular Pharmacology and Therapeutics
Thierry Boulain, Julie Boisrame-Helms, Stephan Ehrmann, Jean-Baptiste Lascarrou, Adrien Bouglé, Arnaud Chiche, Karim Lakhal, Stéphane Gaudry, Sébastien Perbet, Arnaud Desachy, Séverin Cabasson, Isabelle Geneau, Patricia Courouble, Noémie Clavieras, Pablo L Massanet, Frédéric Bellec, Yoan Falquet, François Réminiac, Philippe Vignon, Pierre-François Dequin, Ferhat Meziani
PURPOSE: To describe the current practices of volume expansion in French intensive care units (ICU). METHODS: In 19 ICUs, we prospectively observed the prescription and monitoring practices of volume expansion in consecutive adult patients with shock [sustained hypotension and/or need of vasopressor therapy, associated with at least tachycardia and/or sign (s) of hypoperfusion]. Patients were included at the time of prescription of the first fluid bolus (FB). Thereafter, all the FBs administered during the 96 h following shock onset were surveyed...
February 2015: Intensive Care Medicine
Halden F Scott, Aaron J Donoghue, David F Gaieski, Ronald F Marchese, Rakesh D Mistry
BACKGROUND: Early detection of compensated pediatric septic shock requires diagnostic tests that are sensitive and specific. Four physical exam signs are recommended for detecting pediatric septic shock prior to hypotension (cold extremities, mental status, capillary refill, peripheral pulse quality); this study tested their ability to detect patients who develop organ dysfunction among a cohort of undifferentiated pediatric systemic inflammatory response syndrome patients. METHODS: A prospective cohort of 239 pediatric emergency department patients <19 years with fever and tachycardia and undergoing phlebotomy were enrolled...
2014: BMC Emergency Medicine
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