The Experts below are selected from a list of 2745 Experts worldwide ranked by ideXlab platform
John Varga - One of the best experts on this subject based on the ideXlab platform.
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eosinophilia myalgia syndrome
Reference Module in Biomedical Sciences#R##N#Encyclopedia of Toxicology (Third Edition), 2014Co-Authors: Jeffrey A. Allen, John VargaAbstract:Eosinophilia–myalgia syndrome (EMS) is a multisystem disease characterized by subacute onset of myalgias and peripheral eosinophilia, followed by chronic neuropathy and Skin Induration. An epidemic of EMS in 1989 was linked to l-tryptophan consumption originating from a single source. Following the US Food and Drug Administration ban on the sale of l-tryptophan, EMS incidence declined rapidly. Xenobiotic triggered acute inflammation in a genetically susceptible host likely mediates the early phase of EMS. Late in the disease, cytokine activation and upregulation of collagen and extracellular matrix genes may drive the sustained fibrotic response. The exact etiologic agent responsible for EMS remains unknown.
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post epidemic eosinophilia myalgia syndrome associated with l tryptophan
Arthritis & Rheumatism, 2011Co-Authors: Jeffrey A. Allen, Alicia Peterson, Robert L Sufit, Monique Hinchcliff, Matthew J Mahoney, Tammara A Wood, Frederick W Miller, Michael L Whitfield, John VargaAbstract:Eosinophilia-myalgia syndrome (EMS) is characterized by subacute onset of myalgias and peripheral eosinophilia, followed by chronic neuropathy and Skin Induration. An epidemic of EMS in 1989 was linked to consumption of L-tryptophan that had originated from a single source. Following the ban by the Food and Drug Administration (FDA) on the sale of L-tryptophan, the incidence of EMS declined rapidly. Moreover, no new cases have been described since the FDA ban was lifted in 2005. We report the clinical, histopathologic, and immunogenetic features of a new case of L-tryptophan-associated EMS, along with evidence of activated transforming growth factor β and interleukin-4 signaling in the lesional Skin.
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systemic sclerosis scleroderma a treatable multisystem disease
American Family Physician, 2008Co-Authors: Monique Hinchcliff, John VargaAbstract:Systemic sclerosis (systemic scleroderma) is a chronic connective tissue disease of unknown etiology that causes widespread microvascular damage and excessive deposition of collagen in the Skin and internal organs. Raynaud phenomenon and scleroderma (hardening of the Skin) are hallmarks of the disease. The typical patient is a young or middle-age woman with a history of Raynaud phenomenon who presents with Skin Induration and internal organ dysfunction. Clinical evaluation and laboratory testing, along with pulmonary function testing, Doppler echocardiography, and high-resolution computed tomography of the chest, establish the diagnosis and detect visceral involvement. Patients with systemic sclerosis can be classified into two distinct clinical subsets with different patterns of Skin and internal organ involvement, autoantibody production, and survival. Prognosis is determined by the degree of internal organ involvement. Although no disease-modifying therapy has been proven effective, complications of systemic sclerosis are treatable, and interventions for organ-specific manifestations have improved substantially. Medications (e.g., calcium channel blockers and angiotensin-II receptor blockers for Raynaud phenomenon, appropriate treatments for gastroesophageal reflux disease) and lifestyle modifications can help prevent complications, such as digital ulcers and Barrett esophagus. Endothelin-1 receptor blockers and phosphodiesterase-5 inhibitors improve pulmonary arterial hypertension. The risk of renal damage from scleroderma renal crisis can be lessened by early detection, prompt initiation of angiotensin-converting enzyme inhibitor therapy, and avoidance of high-dose corticosteroids. Optimal patient care includes an integrated, multidisciplinary approach to promptly and effectively recognize, evaluate, and manage complications and limit end-organ dysfunction.
A Barzilai - One of the best experts on this subject based on the ideXlab platform.
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SPECIAL ARTICLE Autoimmune Syndrome Induced by Adjuvants (ASIA) in the Middle East: morphea following silicone implantation
2016Co-Authors: Shaye Kivity, M Katz, Pnina Langevitz, Iris Eshed, D Olchovski, A BarzilaiAbstract:Morphea and other scleroderma-like Skin conditions are occasionally linked with exposure to chemical compounds such as silicone. We treated a 56-year-old woman with generalized severe Skin Induration accompanied with systemic symptoms and peripheral eosinophilia, which appeared 2.5 years after breast silicone implantation and abdominal liposuction. Blood test results and histopathological examination of her Skin suggested the diagnosis of morphea overlapping with eosinophilic fasciitis. Her Skin disease was presumed to be an autoimmune reaction to silicone implantation. While the removal of the implants did not improve her illness, treatment with 1mg/kg prednisone and PUVA bath was initiated, with some improve-ment. This patient illustrates an example of ASIA (Autoimmune Syndrome Induced by Adjuvants), as her disease appeared following exposure to an adjuvant stimulus, with ‘typical’, although not well-defined, autoimmune manifestations. Lupus (2012) 21, 136–139. Key words: ASIA; morphea; scleroderma; silicone Case report A 56-year-old female was admitted to our depart-ment due to Skin thickening and hardening over he
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autoimmune syndrome induced by adjuvants asia in the middle east morphea following silicone implantation
Lupus, 2012Co-Authors: Shaye Kivity, M Katz, Pnina Langevitz, Iris Eshed, D Olchovski, A BarzilaiAbstract:Morphea and other scleroderma-like Skin conditions are occasionally linked with exposure to chemical compounds such as silicone. We treated a 56-year-old woman with generalized severe Skin Induration accompanied with systemic symptoms and peripheral eosinophilia, which appeared 2.5 years after breast silicone implantation and abdominal liposuction. Blood test results and histopathological examination of her Skin suggested the diagnosis of morphea overlapping with eosinophilic fasciitis. Her Skin disease was presumed to be an autoimmune reaction to silicone implantation. While the removal of the implants did not improve her illness, treatment with 1 mg/kg prednisone and PUVA bath was initiated, with some improvement. This patient illustrates an example of ASIA (Autoimmune Syndrome Induced by Adjuvants), as her disease appeared following exposure to an adjuvant stimulus, with 'typical', although not well-defined, autoimmune manifestations.
Mateusz Spalek - One of the best experts on this subject based on the ideXlab platform.
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chronic radiation induced dermatitis challenges and solutions
Clinical Cosmetic and Investigational Dermatology, 2016Co-Authors: Mateusz SpalekAbstract:Chronic radiation dermatitis is a late side effect of Skin irradiation, which may deteriorate patients' quality of life. There is a lack of precise data about its incidence; however, several risk factors may predispose to the development of this condition. It includes radiotherapy dose, fractionation, technique, concurrent systemic therapy, comorbidities, and personal and genetic factors. Chronic radiation dermatitis is mostly caused by the imbalance of proinflammatory and profibrotic cytokines. Clinical manifestation includes changes in Skin appearance, wounds, ulcerations, necrosis, fibrosis, and secondary cancers. The most severe complication of irradiation is extensive radiation-induced fibrosis (RIF). RIF can manifest in many ways, such as Skin Induration and retraction, lymphedema or restriction of joint motion. Diagnosis of chronic radiation dermatitis is usually made by clinical examination. In case of unclear clinical manifestation, a biopsy and histopathological examination are recommended to exclude secondary malignancy. The most effective prophylaxis of chronic radiation dermatitis is the use of proper radiation therapy techniques to avoid unnecessary irradiation of healthy Skin. Treatment of chronic radiation dermatitis is demanding. The majority of the interventions are based only on clinical practice. Telangiectasia may be treated with pulse dye laser therapy. Chronic postirradiation wounds need special dressings. In case of necrosis or severe ulceration, surgical intervention may be considered. Management of RIF should be complex. Available methods are rehabilitative care, pharmacotherapy, hyperbaric oxygen therapy, and laser therapy. Future challenges include the assessment of late Skin toxicity in modern irradiation techniques. Special attention should be paid on genomics and radiomics that allow scientists and clinicians to select patients who are at risk of the development of chronic radiation dermatitis. Novel treatment methods and clinical trials are strongly needed to provide more efficacious therapies.
Shaye Kivity - One of the best experts on this subject based on the ideXlab platform.
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SPECIAL ARTICLE Autoimmune Syndrome Induced by Adjuvants (ASIA) in the Middle East: morphea following silicone implantation
2016Co-Authors: Shaye Kivity, M Katz, Pnina Langevitz, Iris Eshed, D Olchovski, A BarzilaiAbstract:Morphea and other scleroderma-like Skin conditions are occasionally linked with exposure to chemical compounds such as silicone. We treated a 56-year-old woman with generalized severe Skin Induration accompanied with systemic symptoms and peripheral eosinophilia, which appeared 2.5 years after breast silicone implantation and abdominal liposuction. Blood test results and histopathological examination of her Skin suggested the diagnosis of morphea overlapping with eosinophilic fasciitis. Her Skin disease was presumed to be an autoimmune reaction to silicone implantation. While the removal of the implants did not improve her illness, treatment with 1mg/kg prednisone and PUVA bath was initiated, with some improve-ment. This patient illustrates an example of ASIA (Autoimmune Syndrome Induced by Adjuvants), as her disease appeared following exposure to an adjuvant stimulus, with ‘typical’, although not well-defined, autoimmune manifestations. Lupus (2012) 21, 136–139. Key words: ASIA; morphea; scleroderma; silicone Case report A 56-year-old female was admitted to our depart-ment due to Skin thickening and hardening over he
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autoimmune syndrome induced by adjuvants asia in the middle east morphea following silicone implantation
Lupus, 2012Co-Authors: Shaye Kivity, M Katz, Pnina Langevitz, Iris Eshed, D Olchovski, A BarzilaiAbstract:Morphea and other scleroderma-like Skin conditions are occasionally linked with exposure to chemical compounds such as silicone. We treated a 56-year-old woman with generalized severe Skin Induration accompanied with systemic symptoms and peripheral eosinophilia, which appeared 2.5 years after breast silicone implantation and abdominal liposuction. Blood test results and histopathological examination of her Skin suggested the diagnosis of morphea overlapping with eosinophilic fasciitis. Her Skin disease was presumed to be an autoimmune reaction to silicone implantation. While the removal of the implants did not improve her illness, treatment with 1 mg/kg prednisone and PUVA bath was initiated, with some improvement. This patient illustrates an example of ASIA (Autoimmune Syndrome Induced by Adjuvants), as her disease appeared following exposure to an adjuvant stimulus, with 'typical', although not well-defined, autoimmune manifestations.
Robert Lindeboom - One of the best experts on this subject based on the ideXlab platform.
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Tuberculin Skin Testing Is Useful in the Screening for Nontuberculous
2016Co-Authors: Mycobacterial Cervicofacial, Lymphadenitis In Children, Jerome A. Lindeboom, J. Kuijper, Jan M. Prins, Robert LindeboomAbstract:(See the editorial commentary by Hill on pages 1552–4) Background. We evaluated the diagnostic usefulness of tuberculin Skin testing in the screening for nontuber-culous mycobacterial (NTM) infection in children. Methods. We enrolled 180 children who had chronic cervicofacial lymphadenitis in our study. Skin testing was done using antigens of Mycobacterium tuberculosis, Mycobacterium avium, Mycobacterium kansasii, and My-cobacterium scrophulaceum. The reference standard for NTM infection was a positive culture result, identification by PCR, or both. Receiver operating characteristic analysis was used to identify the optimal cutoff point in Skin Induration for the detection of NTM infection. Accuracy of the mycobacterial Skin tests was quantified using sensitivity and specificity rates and positive and negative predictive values at the optimal Skin Induration cutoff. Results. A total of 112 NTM infections were identified, of which 83 were caused by M. avium, 21 by Myco-bacterium haemophilum, and 8 by other NTM species. At the optimal cutoff for a positive test (5 mm), tuberculin Skin testing had a sensitivity and specificity of 70 % and 98%, respectively, and a positive predictive value and a negative predictive value of 98 % and 64%, respectively, compared with a sensitivity and a specificity of 93 % and 97%, respectively; M. avium sensitin, the best-performing Skin test, had positive and negative predictive values of 98 % and 90%, respectively
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tuberculin Skin testing is useful in the screening for nontuberculous mycobacterial cervicofacial lymphadenitis in children
Clinical Infectious Diseases, 2006Co-Authors: Jerome A. Lindeboom, Jan M. Prins, E J Kuijper, Elisabeth Bruijnesteijn S Van Coppenraet, Robert LindeboomAbstract:Background. We evaluated the diagnostic usefulness of tuberculin Skin testing in the screening for nontuberculous mycobacterial (NTM) infection in children. Methods. We enrolled 180 children who had chronic cervicofacial lymphadenitis in our study. Skin testing was done using antigens of Mycobacterium tuberculosis, Mycobacterium avium, Mycobacterium kansasii, and Mycobacterium scrophulaceum. The reference standard for NTM infection was a positive culture result, identification by PCR, or both. Receiver operating characteristic analysis was used to identify the optimal cutoff point in Skin Induration for the detection of NTM infection. Accuracy of the mycobacterial Skin tests was quantified using sensitivity and specificity rates and positive and negative predictive values at the optimal Skin Induration cutoff. Results. A total of 112 NTM infections were identified, of which 83 were caused by M. avium, 21 by Mycobacterium haemophilum, and 8 by other NTM species. At the optimal cutoff for a positive test (5 mm), tuberculin Skin testing had a sensitivity and specificity of 70% and 98%, respectively, and a positive predictive value and a negative predictive value of 98% and 64%, respectively, compared with a sensitivity and a specificity of 93% and 97%, respectively; M. avium sensitin, the best-performing Skin test, had positive and negative predictive values of 98% and 90%, respectively. Conclusion. Tuberculin Skin testing could be valuable as a first step in the diagnostic analysis of cervicofacial lymphadenitis in children without a history of TB exposure or bacille Calmette-Guerin vaccination.