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Malaise
Kinds of Malaise Terms modified by Malaise Selected AbstractsChanges in abundance of Vespula germanica and V. vulgaris in EnglandECOLOGICAL ENTOMOLOGY, Issue 1 2001Michael E. Archer Summary 1. Thirteen time series, varying from 17 to 27 years, of the abundance of Vespula germanica and V. vulgaris from lowland England are examined. The time series depend on either spring queens and workers taken in Malaise or suction traps, or collected colonies. 2. During the late 1970s and early 1980s, the abundance of V. germanica declined abruptly but that of V. vulgaris did not. 3. During the early 1980s, the 2-year cycle of annual abundance of V. vulgaris changed to a nearly perfectly damped pattern of annual abundances. 4. The most likely factor causing these population changes was the increased use of pesticides acting directly by killing the wasps and indirectly by reducing their food resources. 5. The difference in response of the two species to increased pesticide use may be related to a difference in foraging ability. [source] NOTES ON SOME FORSIUS, TYPES OF ASIAN SAWFLIES (HYMENOPTERA: TENTHREDINOIDEA) WITH DESCRIPTION OF A NEW SPECIES,INSECT SCIENCE, Issue 4 2000WEI Mei-cai Abstract, Some types of E. Asian sawfly species described by Forsius in 1931 are examined. One new species is described based on the paratypes of a species described by Forsius: Eutomostethus forsiusi sp. nov. Three new combinations are provided: Nesoselandria annamitica (Forsius 1931) comb. nov., Birmindia gracilis (Forsius 1931) comb. nov. and Eutomostethus sikkimensis (Forsius 1931), comb. nov., two synonyms are proposed: Birmindia gracilis (Forsius 1931) =Birmindia albipes Malaise 1947, syn. nov. and Indotaxonus tricoloricornis (Konow, 1898) =Conaspidia dubiosa Forsius 1931, syn. nov. [source] Seasonality of a Diverse Beetle Assemblage Inhabiting Lowland Tropical Rain Forest in AustraliaBIOTROPICA, Issue 3 2009Peter S. Grimbacher ABSTRACT One of the least understood aspects of insect diversity in tropical rain forests is the temporal structuring, or seasonality, of communities. We collected 29,986 beetles of 1473 species over a 4-yr period (45 monthly samples), with the aim to document the temporal dynamics of a trophically diverse beetle assemblage from lowland tropical rain forest at Cape Tribulation, Australia. Malaise and flight interception traps were used to sample adult beetles at five locations at both ground and canopy levels. Beetles were caught throughout the year, but individual species were patchy in their temporal distribution, with the 124 more abundant species on average being present only 56 percent of the time. Climatic variables (precipitation, temperature, and solar radiation) were poorly correlated with adult beetle abundance, possibly because: (1) seasonality of total beetle abundance was slight; (2) the peak activity period (September,November) did not correspond to any climatic maxima or minima; or (3) responses were nonlinear owing to the existence of thresholds or developmental time-lags. Our results do not concur with the majority of tropical insect seasonality studies suggesting a wet season peak of insect activity, perhaps because there is no uniform pattern of insect seasonally for the humid tropics. Herbivores showed low seasonality and individual species' peaks were less temporally aggregated compared to nonherbivores. Canopy-caught and larger beetles (> 5 mm) showed greater seasonality and peaked later in the year compared to smaller or ground-caught beetles. Thus seasonality of adult beetles varied according to the traits of feeding ecology, body size, and habitat strata. [source] P43 Acute urticaria to infliximabCONTACT DERMATITIS, Issue 3 2004Ana Giménez-Arnau Infliximab is a chimeric antitumor necrosis factor-alpha monoclonal antibody used to treat Crohn's disease and rheumatoid arthritis. Acute infusion reactions, headache, fever, chills, urticaria and chest pain were seen in 17% of patients with infliximab compared with 7% of those receiving placebo. Other adverse cutaneous reactions are fungal dermatitis, eczema, seborrhoea, hordeolum, bullous eruption, furunculosis, periorbital oedema, hyperkeratosis, rosacea, verruca, skin pigmentation, alopecia, leukocytoclastic vasculitis, lichenoid drug eruption, erythema multiforme, perniosis-like eruption, granuloma annulare and acute folliculitis. Any pathogenic mechanism has been suggested. Patch test with infliximab can induce flare-up of lesions, nausea and malaise and suggest a percutaneous absortion. A sixty years-old man with atopy background and rheumatoid arthritis treated with Remicare®, infliximab who developed a severe acute urticaria with angioedema is presented. The lesions appearance after previous endovenous administrations and the worsening spreading wheals days after the injection clinically suggested an hypersensitivity mechanism. The protocolized study drug hypersensitivity performed showed only the Prick Test positivity with infliximab at 30/60 minutes. Patch test with infliximab was negative and any adverse event was reported. Actually the patient is treated with etanercept and this drug is well tolerated. This result suggested a type I hypersensitivity mediated reaction. Urticaria could be induced as immunologic reaction of the host against the murine part of infliximab, just as it hapens with other antichimeric antibodies. [source] Gastric bleeding due to Dieulafoy's ulcer successfully treated with an esophageal variceal ligation (EVL) kitDIGESTIVE ENDOSCOPY, Issue 3 2001Yoshihide Chino Dieulafoy's ulcer is a cause of life-threatening upper gastrointestinal hemorrhage. With advanced endoscopic procedures, Dieulafoy's ulcer is easily diagnosed and treated. However, a few patients still need surgery to stop bleeding or they will die of shock. Further improved procedures are therefore required to treat bleeding in Dieulafoy's ulcer. A 77-year-old man was admitted to our hospital with hematemesis and general malaise. He had moderate anemia and azotemia but no past history of gastric ulcer. He was diagnosed with Dieulafoy's ulcer endoscopically. Dieulafoy's ulcer was ligated with an endoscopic variceal ligation kit without surgery. Although an ulcer was found at the ligation point after 1 week, the ulcer changed to the scar on administration of Histamine H2 receptor blockers. The patient has suffered no recurrent ulcer and no bleeding for 24 months. Endoscopic variceal ligation may be an alternative new method for hemostasis of Dieulafoy's ulcer. [source] NHS malaise: diagnosis and treatment optionsECONOMIC AFFAIRS, Issue 4 2001Heather Gage The paper questions whether the recent reform package of the NHS will solve its ongoing problems, or whether a more fundamental reappraisal of the system is required. [source] How sustainable is the Japanese recovery?ECONOMIC OUTLOOK, Issue 4 2004Article first published online: 14 OCT 200 For nearly two years the Japanese economy has grown significantly faster than commentators expected, raising the question of whether the country has finally broken out of its long economic malaise. This article by Simon Knapp examines recent developments to see whether this recovery is sustainable. It argues that over the last year the recovery has broadened out beyond merely the export sector, although there are good reasons to believe that growth as measured by GDP has been overstated and that many serious structural problems remain. Business investment has surged on the back of rising profitability and an improved labour market has helped lift consumer confidence. At the same time the paper recognises the importance of China's boom in stimulating the Japanese economy over the last two years, and estimates that this factor may have boosted the level of GDP by between 1 to 2%. With Chinese growth now moderating to more sustainable levels, export growth will slow over the next year or so. However, domestic demand should now be strong enough, in the absence of major external shocks, to generate GDP growth of around 1.5 to 2% per annum in the medium term; a respectable figure given the country's falling population. [source] Diagnosis at dusk: Malignant hypertension and phaeochromocytoma in a 6-year-old girlEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2008John Corcoran Abstract Phaeochromocytoma is a rare catecholamine-secreting tumour that may arise at any age, but is particularly unusual in childhood. The case of a 6-year-old girl who presented with a prolonged history of general malaise, headaches and abdominal pain is reported. On examination, she was noted to have malignant hypertension. Subsequent imaging of the abdomen demonstrated a left adrenal mass, with the diagnosis of phaeochromocytoma being confirmed by serial raised urinary metanephrines. Sympathetic blockade was established prior to definitive surgical treatment, resulting in complete resolution of the patient's symptoms and hypertension. Genetic screening of the family has since identified a previously undocumented missense mutation in the patient's VHL gene. The case raises the importance of routine measurement of blood pressure in all paediatric patients regardless of age, presentation or other factors. [source] May the weak force be with you: The power of the mass media in modern politicsEUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 2 2006KENNETH NEWTON Television is often said to undermine democratic government popular support for leaders and institutions. In spite of all that has been written about media malaise, however, both theory and evidence suggests that the media are a comparatively weak force whose effects can be deflected, diluted and diffused by stronger forces. These include bedrocks political values associated with class, religion, age, gender and education, as well as social networks and discussions, distrust of the mass media, and personal knowledge and experience. Equally, the variables that mediate the media may also magnify its effects so that what appears to be a large media effect is, in fact, the result of an interaction between the media and other forces. This article lays out the argument of the media malaise literature that covers government and politics, then outlines the social forces that mediate the media, and finally provides some evidence to illustrate the argument that the media are generally a weak force in society. [source] Overview of adverse reactions to nefopam: an analysis of the French Pharmacovigilance databaseFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2007G. Durrieu Abstract Nefopam is widely used for the relief of moderate acute pain. Its safety profile remains to be specified. The objective of the study was to review adverse reactions to nefopam spontaneously reported to the French Pharmacovigilance system. All cases of adverse drug reactions (ADRs) associated with nefopam, registered in the French Pharmacovigilance database from January 1, 1995 to December 31, 2004, were reviewed. For each reported ADR, information about patient (age, gender, medical history), drug exposure (suspected and concomitantly used drugs), characteristics of ADRs (imputability score, time of onset, seriousness, outcome) were collected. A total of 114 ADRs with an imputability rated from ,plausible' (I2) to ,likely' (I3) and ,very likely' (I4) was analysed. The most frequent ADRs included ,expected' ADRs such as sweating, nausea, tachycardia, malaise or vomiting; 61 ADRs were ,unexpected. No overdose was reported; 26 ADRs (23%) were considered as ,serious'. Most of them were ,unexpected', including neuropsychiatric (hallucinations, convulsions) or cutaneous (pruritus, erythema, urticaria) ADRs. Six cases of anaphylactic ADRs (two angioedema and four anaphylactic shocks) were reported, all occurring shortly after use of nefopam during the post-operative period. Physicians should be aware of the possible occurrence of some serious ADRs when using nefopam such as convulsions and anaphylactic shocks, especially when the drug is used in special medical conditions, like post-operative periods. [source] Western utopianism/dystopianism and the political mediocrity of critical urban researchGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 3-4 2002Guy Baeten This paper seeks to summarise the interplay between utopian and dystopian thinking throughout the twentieth century with a particular focus on the city. The gradually shrinking appeal of the socialist utopia and its replacement with the globalised free,market as a ,revanchist utopia' left socialist utopian thinking in a state of disarray towards the end of the previous century. Utopian thinking, both as a literary and political genre has been rendered marginal in contemporary political practices. Urban dystopia, or ,Stadtschmerz', is now prevalent in critical Western thinking about city and society. It is concluded that the declining political impact of critical urban research is caused partly by its lack of engagement with crafting imaginative alternative futures for the city. The works by Sennett, Sandercock and the Situationists, among others, may contain elements to reverse the current utopian malaise in urban research. [source] Significance of interferon-, for the treatment of hepatitis C virus infection in hemodialyzed patientsHEPATOLOGY RESEARCH, Issue 9 2010Mikio Zeniya Aim:, We evaluated the adverse effects and efficacy associated with interferon-, (IFN-,) for the treatment of hepatitis C virus (HCV) infection in 20 hemodialyzed (HD) patients. Methods:, IFN-, was administrated at a dose of 3 MIU three times a week for 24 weeks simultaneously at the time of HD for the patients of genotype 2a whose viral loads were less than 150 KIU/mL and considered to respond well to IFN therapy. Results:, There was a sustained virological response (SVR) rate of this treatment in 90% of the patients, and sex, age and HD duration had no affect. Slight adverse effects such as fever, malaise and itching were observed during the treatment periods but none serious in any of the patients. Also, no significant difference in adverse effect was observed between 3 MIU and higher dose (6 MIU) groups. Conclusion:, Because IFN-, can be administrated easily into the circuit of HD, adverse effects can be monitored earlier and taken measures against quickly. Taken together, IFN-,-based therapy has a potential for HCV treatment in HD patients but further studies for the patients who have higher viral loads will be required to confirm this. [source] CHARTING THE "TRANSITIONAL PERIOD": THE EMERGENCE OF MODERN TIME IN THE NINETEENTH CENTURYHISTORY AND THEORY, Issue 1 2006GÖRAN BLIX ABSTRACT This paper seeks to chart a concept of historical experience that French Romantic writers first developed to describe their own relationship to historical time: the notion of the "transitional period." At first, the term related strictly to the evolving periodic conception of history, one that required breaks, spaces, or zones of indeterminacy to bracket off periods imagined as organic wholes. These transitions, necessary devices in the new grammar of history, also began to attract interest on their own, conceived either as chaotic but creative times of transformation, or, more often, as slack periods of decadence that possessed no proper style but exhibited hybrid traits. Their real interest, however, lies in their reflexive application to the nineteenth century itself, by writers and historians such as Alfred de Musset, Chateaubriand, Michelet, and Renan, who in their effort to define their own period envisioned the "transitional period" as a passage between more coherent and stable historical formations. This prospective self-definition of the "age of history" from a future standpoint is very revealing; it shows not just the tension between its organic way of apprehending the past and its own self-perception, but it also opens a window on a new and paradoxical experience of time, one in which change is ceaseless and an end in itself. The paper also presents a critique of the way the term "modernity" has functioned, from Baudelaire's initial use to the present, to occlude the experience of transition that the Romantics highlighted. By imposing on the nineteenth-century sense of the transitory a heroic period designation, the term "modernity" denies precisely the reality it describes, and sublimates a widespread temporal malaise into its contrary. The paper concludes that the peculiarly "modern" mania for naming one's period is a function of transitional time, and that the concept coined by the Romantics still governs our contemporary experience. [source] Supra-elevated CA 19-9 in a benign hepatic cystadenomaHPB, Issue 1 2004CR Scoggins Background Elevated CA 19-9 may be found in both cystadenomas and cystadenocarcinomas of the liver. Case outline A 59-year-old woman presented with right upper quadrant abdominal pain, malaise and weight loss. Physical examination and laboratory evaluation revealed a mass in the right upper quadrant and a CA 19-9 level of 68 661 U/ml. CT scan demonstrated a cystic liver mass. She underwent a right hepatectomy, and her CA 19-9 returned to normal. Pathologic analysis revealed no malignancy. Discussion In hepatic cystic neoplasms, an elevated CA 19-9 should not be used to establish the diagnosis of malignancy nor should it preclude resection. [source] Medium-term results of oral tacrolimus treatment in refractory inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 2 2007Siew C. Ng MRCP Abstract Background: This study aimed to evaluate the efficacy of oral tacrolimus in patients with inflammatory bowel disease (IBD) refractory to conventional therapy, including azathioprine, 6-mercaptopurine, and infliximab. Methods: Retrospective review of all patients with IBD treated with oral tacrolimus was undertaken. Tacrolimus was administered at an initial dose of 0.05 mg/kg twice daily, aiming for serum trough levels of 5,10 ng/mL. We evaluated clinical response, a retrospective estimated Crohn's disease activity index (CDAI) for Crohn's disease (CD), modified Truelove-Witts index for ulcerative colitis (UC), and modified pouch disease activity index (mPDAI) for pouchitis. Patients had been monitored clinically for benefit and side effects and by whole blood tacrolimus level approximately every 4 weeks for the duration of treatment. Clinical remission was defined as an estimated CDAI <150 (CD), an inactive disease score on the Truelove-Witts index (UC), and mPDAI <5 (pouchitis). Results: Twelve patients with CD, six with UC, and one with pouchitis, all resistant to previous therapies, were treated for a median of 5 months. After 4 weeks 10 CD (83%), four UC (67%) patients, and one pouchitis patient had a clinical response. There was a median reduction of the estimated CDAI of 108 points (range 35,203; P = 0.002) and stool frequency of three per day at week 4. Remission was achieved in 42% (5/12) of CD and 50% (3/6) of UC patients at the end of follow-up. Side effects included temporary elevated creatinine (n = 1), tremor (n = 3), arthralgia (n = 1), insomnia (n = 1), and malaise (n = 1). Four patients discontinued treatment due to side effects. Conclusion: Oral tacrolimus is well tolerated and effective in patients with refractory IBD in the short- to medium-term. Further controlled, long-term evaluation is warranted. (Inflamm Bowel Dis 2007) [source] Whose job is it anyway?: organizational information competencies for value creationINFORMATION SYSTEMS JOURNAL, Issue 4 2000Joe Peppard Abstract. Research highlights that most business managers continue to be dissatisfied with the value they perceive they are deriving from their organization's information systems investments. On examining the literature, the dominant perspective is that creating value through information systems is primarily the responsibility of the IS function. Accordingly, to address this chronic malaise, attention generally focuses on the IS function with proposed prescriptions ranging from re-skilling the IS professional through re-engineering the IS function to the ultimate sanction of outsourcing. This paper examines the problem of value creation from IS investments from an organizational as opposed to an IS functional perspective. Drawing on resource-based theory, the paper argues that the effective deployment and exploitation of information should be viewed as a ,strategic asset'. To leverage value from IS, the paper proposes that organizations must recognize and develop information competencies and that the elements of these competencies are distributed throughout the organization and not solely resident in the IS function. Through a multimethodological approach these information competencies are identified and described. The resultant competencies are then studied in an organizational context. The paper ends by drawing conclusions and articulating further research directions and opportunities [source] Low-grade fever: how to distinguish organic from non-organic formsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2010M. Affronti Summary Background and aim:, Low-grade fever (LGF) is defined as a body temperature between 37.5 and 38.3 °C, which is below the classical value reported for fever of unknown origin (FUO). We attempted to characterise its epidemiology, aetiology and clinical aspects to improve the methodological approach to diagnosis. Design and Methods:, We reviewed and evaluated a survey of patients with LGF, followed as outpatients of our Department, a tertiary referral centre from 1997 to 2008. The same classifications were applied for classical FUO, and in the patients diagnosed with LGF, we also investigated for habitual hyperthermia (HH). Results:, Seventy-three patients were selected and divided into two groups: group A included 32 patients classified with organic fever and group B included 41 patients with HH. Aetiology of organic LGF was: infectious disease 59%; neoplasm 3.1%; inflammatory non-infectious disease 6.2%; miscellaneous 18.7%; undiagnosed 12.5%. Mean age was significantly higher in the organic fever than in the HH group (p < 0.02). Splenomegaly and loss of weight were significantly associated with organic fever (p < 0.05), while dizziness and general malaise were associated with HH. Lack of any pathological signs at physical examination was significantly more frequent in HH (p < 0.0001). Among the biochemical tests, white blood cells and C-reactive protein were more frequently above normal limits in group A than in group B (p < 0.05). Conclusions:, In our experience, LGF requires the same methodological diagnostic approach as FUO, because there is no relationship between body temperature values and the severity of the underlying diseases, and the aetiological spectrum is also the same. [source] Unilateral sacroiliitis associated with systemic isotretinoin treatmentINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2010Mauro Barbareschi MD Background, Acne fulminans is the most severe form of inflammatory acne characterized by the acute onset of inflammatory nodules and plaques, most commonly on the chest and the back. The lesions undergo rapid suppuration, leaving ragged hemorrhagic ulcers. Typically, it affects adolescent males with a history of mild to moderate acne. The affected patients often have constitutional symptoms such as fever, malaise, arthralgias, and myalgias. Leukocytosis is commonly associated. Sacroiliitis is reported in 21% of acne fulminans patients in association with arthritis and in a few cases it is reported during isotretinoin treatment, suggesting the drug triggering. Conclusion, We report a case of a young male patient in whom the induction of acne fulminans by systemic isotretinoin was associated with unilateral sacroiliitis. [source] Severe cutaneous reactions caused by barbiturates in seven Iranian childrenINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2009Setareh Mamishi MD Background, The severe adverse cutaneous reactions of erythema multiforme (EM), Stevens,Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare mucocutaneous diseases associated with significant morbidity and mortality. The most common cause is antiepileptic drugs, particularly carbamazepine and lamotrigine, as well as the barbiturates group (phenobarbital and phenytoin). In this article, we present seven children with severe adverse cutaneous reactions caused by barbiturates. Case Reports, The age of the affected children was between 2 and 11 years and they all had a history of taking barbiturates. Their symptoms started 1,3 weeks after the initiation of barbiturates, including a prodrome characterized by 2,3 days of malaise, fever, cough and anorexia, after which the skin and mucosal lesions appeared and worsened. The skin lesions varied from rash to large bullae, plus different forms of mucous membrane involvement. The offending drugs (barbiturates) were stopped immediately and care was largely supportive. Conclusion, As a result of the morbidity and/or mortality associated with EM, SJS and TEN, physicians should keep in mind their differential diagnosis when cutaneous reactions are observed in patients undergoing barbiturate therapy. Furthermore, although TEN and SJS are life-threatening diseases, early detection and appropriate care can lead to a decrease in the incidence of death. The strategies described here seem to be successful and safe because, despite the serious conditions, our patients responded well. All survived. [source] Late-onset Papillon,Lefevre syndrome with pyogenic liver abscesses: report of one caseINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2009Ameneh Yazdanfar MD A 25-year-old woman living in Hamedan, Iran, presented originally at 7 years of age with erythematous, hyperkeratotic lesions on the palms and soles with extension to the dorsal side of the hands and feet. Involvement of the elbows and knees was also seen. From 12 years of age, she started to lose her teeth. At the same age, she experienced fever, chills, malaise, myalgia, and right upper quadrant abdominal pain. With a diagnosis of pyogenic liver abscesses, the patient underwent successful surgical treatment. ,Examination revealed erythematous, hyperkeratotic, scaling plaques on the palms and soles, dorsal side of the hands and feet (Fig. 1), elbows and knees. All the teeth were missing from the mouth (Fig. 2), and she used a dental prosthesis. A surgical scar was observed on the right upper quadrant of the abdomen (Fig. 3). Skull X-ray and computed tomography scan were normal. Skin biopsy of the dorsal right hand demonstrated hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis with a mild inflammatory infiltrate around the vessels (Fig. 4). Figure 1. Hyperkeratotic plaques on the hands and feet Figure 2. Loss of permanent teeth Figure 3. Surgical scar on the right upper quadrant of the abdomen and hyperkeratotic plaques on the hand Figure 4. Hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis (hematoxylin and eosin, ×40) [source] Wegener's granulomatosis presenting as pyoderma gangrenosumINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2003Hajnal Irén Szõcs MD A 59-year-old male patient developed a necrotizing ulceration on the right shin. Both clinical and histopathologic examinations suggested pyoderma gangrenosum. After temporary improvement of skin symptoms under peroral glucocorticoid treatment, a hemorrhagic-purulent discharge started from the nose, he began to have fever, malaise, cough, and a chest X-ray revealed inflammation in the lung. Cerebral CT and MRI disclosed midline bone loss within the nasal septum and granulomatosus tissue masses protruding into the right orbit. The c-ANCA test was positive, serum IgA was elevated, and he had microhaematuria and proteinuria. In this severe case of Wegener's granulomatosis prolonged methylprednisone and cyclophosphamide treatment was initiated. Both the skin symptoms and the granulomatosus infiltrations resolved. [source] A child with spider bite and glomerulonephritis: a diagnostic challengeINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2000Jennifer M. Lung MD A previously healthy 7-year-old white boy presented to St. Louis Children's Hospital with a 1-day history of headache, malaise, temperature of 38.7 °C, and a progressively erythematous, tender calf with central dusky purpura. On the morning of admission, his mother noticed a 2-mm crust on the patient's right calf with a 3-cm × 3-cm area of surrounding erythema. No history of recent trauma or bite was obtained. He had suffered two episodes of nonbloody, nonbilious emesis during the last day. In addition, over the previous 12 h, he presented brown urine without dysuria. His mother and brother had suffered from gastroenteritis over the previous week without bloody diarrhea. On initial physical examination, there was a 6-cm × 11-cm macular tender purpuric plaque with a central punctum on the right inner calf, which was warm and tender to the touch, with erythematous streaking towards the popliteal fossa ( Fig. 1). The inguinal area was also erythematous with tender lymphadenopathy and induration, but without fluctuance. Laboratory studies included an elevated white blood cell count of 20,800/,L with 6% bands, 86% segs, and 7% lymphocytes, hemoglobin of 12.5 g/dL, hematocrit of 35.1%, and platelets of 282,000/,L. The prothrombin time/activated partial tissue thromboplastin was 10.4/28.0 s (normal PT, 9.3,12.3 s; normal PTT, 21.3,33.7 s) and fibrinogen was 558 mg/dL (normal, 192,379 mg/dL). Urinalysis showed 1+ protein, 8,10 white blood cells, too numerous to count red blood cells, and no hemoglobinuria. His electrolytes, blood urea nitrogen (BUN), and creatine were normal. The urine culture was negative. Blood culture after 24 h showed one out of two bottles of coagulase negative Staphylococcus epidermidis. Figure 1. (A) 7-year-old boy with painful purpura of the calf The patient's physical examination was highly suggestive of a brown recluse spider bite with surrounding purpura. Over the next 2 days, the surrounding rim of erythema expanded. The skin within the plaque cleared and peeled at the periphery. The coagulase negative staphylococci in the blood culture were considered to be a contaminant. Cefotaxime and oxacillin were given intravenously. His leg was elevated and cooled with ice packs. The patient's fever resolved within 24 h. The lesion became less erythematous and nontender with decreased warmth and lymphadenopathy. The child was discharged on Duricef for 10 days. Because the patient experienced hematuria rather than hemoglobinuria, nephritis was suggested. In this case, poststreptococcal glomerulonephritis was the most likely cause. His anti-streptolysin-O titer was elevated at 400 U (normal, <200 U) and C3 was 21.4 mg/dL (normal, 83,177 mg/dL). His urine lightened to yellow,brown in color. His blood pressure was normal. Renal ultrasound showed severe left hydronephrosis with cortical atrophy, probably secondary to chronic/congenital ureteropelvic junction obstruction. His right kidney was normal. [source] Severe antibody-mediated agranulocytosisINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2008H. JOHNSEN Summary A 56-year-old female with Crohn's disease was admitted to the hospital with malaise, fever, and a low white blood cell count (0.8 × 109/l) with no granulocytes or myeloid precursor cells in the bone marrow. The leucopenia was initially thought to be the result of an infection and she was treated with antibiotics and granulocyte colony-stimulating factor (G-CSF, filgrastim). However, the bacterial cultures and viral tests were all negative. The patient's condition deteriorated and she became morbidly ill, but recovered after high dose steroid treatment. Six weeks later she relapsed whilst receiving 7.5 mg daily dose of prednisolone. She recovered quickly after being given high dose methylprednisolone in combination with filgrastim. A high maintenance dose of prednisolone was tapered over 5 months. She has not relapsed since and is currently well. Antibodies to the human neutrophil antigen (HNA)-3a were detected, but these antibodies could not easily explain her agranulocytosis as she had a HNA-3a negative phenotype. It seems plausible that her agranulocytosis was immune mediated through autoantibodies directed towards the early myeloid cells. [source] Against difference and diversity in social work: the case of human rightsINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 3 2009Stephen A. Webb This article argues that the politics of the ,right to difference' and celebration of diversity in social work is a malign tendency that is symptomatic of the malaise of postmodernism and other fashionable trends in human rights discourse. It is suggested that a normative concept of human rights as worked through postmodern preoccupations with difference and diversity is a morally bankrupt perspective. The fixation of the ,right to difference' in social work runs parallel with neoliberalism with its celebration of diversity. The article offers a set of conceptual devices for rethinking social work ethics through the writings of Alain Badiou. His subtractive ontology of truth is presented as an essentialist alternative to the relativist discourses of difference. If social work is to recover a progressive stance, we must reinstall the concepts of sameness and equality. Therefore, social work should be ,indifferent to differences' by transcending the politics of difference. [source] Advanced renal cell carcinoma in which a combination of IFN-, and meloxicam was thought to be effectiveINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2003SHUJI YOSHINO Abstract An 83-year-old man with left renal cell carcinoma (RCC; pT4N0M0) was treated with postoperative combined subcutaneous injection therapy of alpha interferon (IFN-,) and IFN gamma-1a (IFN-,-1a). Metastasis to the pleura occurred 3 months after surgery. The metastatic lesion grew while the treatment was changed to intramuscular injection of IFN-,-2b due to the presence of severe general malaise, which seemed to be caused by IFN-, and IFN-, therapy. As melosalgia associated with sciatica was also severe, treatment with meloxicam, which is known as a potent cyclooxigenase-2 inhibitor among commercially available non-steroidal anti-inflammatory drugs, was combined, resulting in significant improvement in activity of daily life, 43.2% decrease in the size of the pleural metastasis and complete regression of retroperitoneal residual tumor. [source] Seasonal inventory and status of flying insects, in Kihansi Gorge, TanzaniaAFRICAN JOURNAL OF ECOLOGY, Issue 3 2009Edward K. Msyani Abstract Sampling of flying insects in Kihansi Gorge was conducted in six micro-habitats namely Lower, Upper, Main, Mid-Gorge and Mhalala Spray Wetlands and adjacent forest. The four traps used were, malaise, pitfall, light and artificial substrate sampler, besides sweep netting and beating. In the wet season, 65,549 flying insects (65.13%) were recorded when compared to 35,633 flying insects (34.87%) in dry season. At its peak, 29,783 flying insects (29.15%) were recorded at the start of wet season (December 2004). The abundance value was significant (,2 = 1794.98, d.f. = 5, P , 0.001). The favourable weather condition at the beginning of the wet season might have triggered emergence of high numbers of winged insects like ants, to facilitate migration through dispersal and reproduction, and some aquatic insects (Plecoptera, Odonata and Trichoptera) moulted and entered into terrestrial life to raise terrestrial abundance. No association was recorded between abundance of flying insects and amphibians (Kihansi Spray Toad; Nectophynoides asperginis), for Mid-Gorge and Main Spray Wetlands (r = ,0.71, n = 4, P = 0.147 and r = ,0.69, n = 5, P = 0.201) respectively. Résumé On a récolté des échantillons d'insectes volants dans la Kihansi Gorge, dans six micro-habitats à savoir les Lower, Upper, Main, et Mid-Gorge et les Mhalala Spray Wetlands ainsi que dans les forêts voisines. Les quatre pièges utilisés étaient le piège malaise, le piège-fosse ou Barber, le piège lumineux et l'échantillonnage sur substrat artificiel, auxquels s'ajoutaient le filet et la frappe. En saison des pluies, 65.549 insectes volants (65,13%) ont été rapportés, comparéà 35.633 (34,87%) en saison sèche. Le maximum a été atteint avec 29.783 insectes volants (29,15%) capturés au début de la saison des pluies, en décembre 2004. L'abondance avait une valeur significative (,2 = 1 794,98, d.f. = 5, P , 0.001). Les conditions climatiques favorables au début de la saison des pluies peuvent avoir suscité l'émergence d'insectes ailés qui devaient se reproduire et se disperser, comme les fourmis, et de certains insectes aquatiques (Plécoptères, Odonates et Trichoptères) qui entament leur vie terrestre pour augmenter l'abondance des espèces. On n'a rapporté aucune association entre l'abondance des insectes ailés et les amphibiens (crapaud de Kihansi Spray, Nectophynoides asperginis) pour la Mid-gorge ni pour les Main Spray Wetlands (r = ,0,71, n = 4, P = 0.147; et r = ,0,69, n = 5, P = 0.201) respectivement. [source] Granulomatous tattoo reaction and erythema nodosum in a young woman: common cause or coincidence?JOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2008Uwe Wollina MD Summary Tattooing has become quite popular in Western countries. With the increasing prevalence, there is also an increased risk of adverse effects. We describe a 17-year-old female patient with a black and red,colored tattoo, who developed immediately after red tattooing general malaise with fever, nausea, and vomiting. A bullous reaction was temporarily seen within the red part of her tattoo. The reaction later shifted to a subacute dermatitis with bacterial superinfection. Two months later, she felt ill again. She developed painful tender nodules on the anterior aspect of both lower legs identified as erythema nodosum without sarcoidosis. Is this is a unique case of adverse reaction to tattoo pigments with a type I and a type IV reaction, or is this a coincidence? The treatment was initiated with systemic and topical corticosteroids and topical antibiotics combined with compression bandages for the legs. After 3 weeks of treatment, the erythema nodosum completely resolved and did not reappear during a 1-year follow-up. The treatment of the local reactions, however, was unsatisfactory without complete response. There is an indispensable need for regulation of tattoo pigments and tattooing to improve consumer safety. [source] Chronic fatigue syndrome: assessment of increased oxidative stress and altered muscle excitability in response to incremental exerciseJOURNAL OF INTERNAL MEDICINE, Issue 3 2005Y. JAMMES Abstract. Objectives., Because the muscle response to incremental exercise is not well documented in patients suffering from chronic fatigue syndrome (CFS), we combined electrophysiological (compound-evoked muscle action potential, M wave), and biochemical (lactic acid production, oxidative stress) measurements to assess any muscle dysfunction in response to a routine cycling exercise. Design., This case,control study compared 15 CFS patients to a gender-, age- and weight-matched control group (n = 11) of healthy subjects. Interventions., All subjects performed an incre-mental cycling exercise continued until exhaustion. Main outcome measures., We measured the oxygen uptake (Vo2), heart rate (HR), systemic blood pressure, percutaneous O2 saturation (SpO2), M-wave recording from vastus lateralis, and venous blood sampling allowing measurements of pH (pHv), PO2 (PvO2), lactic acid (LA), and three markers of the oxidative stress (thiobarbituric acid-reactive substances, TBARS, reduced glutathione, GSH, and ascorbic acid, RAA). Results., Compared with control, in CFS patients (i) the slope of Vo2 versus work load relationship did not differ from control subjects and there was a tendency for an accentuated PvO2 fall at the same exercise intensity, indicating an increased oxygen uptake by the exercising muscles; (ii) the HR and blood pressure responses to exercise did not vary; (iii) the anaerobic pathways were not accentuated; (iv) the exercise-induced oxidative stress was enhanced with early changes in TBARS and RAA and enhanced maximal RAA consumption; and (v) the M-wave duration markedly increased during the recovery period. Conclusions., The response of CFS patients to incremental exercise associates a lengthened and accentuated oxidative stress together with marked alterations of the muscle membrane excitability. These two objective signs of muscle dysfunction are sufficient to explain muscle pain and postexertional malaise reported by our patients. [source] Fuzzy Legality in Regulation: The Legislative Mandate RevisitedLAW & POLICY, Issue 4 2001Margit Cohn How does law interact with regulatory reality, and why does legislative mandate, which presumably stands at the apex of a regulatory package, often deviate from its ideal-type as exclusive organizer of action? These questions are treated in this article through the concept of "fuzzy legality," which serves as a common title for six different legal arrangements that stray from the ideal-type legislative mandate, while enabling "perfectly legal" industry behavior. Against the background of potential dangers involved in such practices, the article traces the politics of preference for fuzziness both by regulators and regulatees. It reassesses calls for responsive and reflexive law as a cure for the regulatory malaise: these may have been voiced due to existing overly rigid regulatory frameworks, rather than the intrinsic flaw of legal constructs. [source] Hope and Purification in the Writings of Ayi Kwei Armah and Ama Ata AidooORBIS LITERARUM, Issue 2 2010Clayton G. MacKenzie Taban Lo Liyong sees the task of the African writer as one of "reconstructing Africa from the imperial wreck of the last two thousand seasons" (Liyong 1990, 171). The erosion of the African culture by modernization and colonialism has deprived indigenous peoples of their religions, their traditions, their mores, and in some cases their languages. It is not clear, though, what form Liyong's "reconstruction" is to take. Other commentators, like the Nigerian poet Tanure Ojaide, seem more specific in demanding that the African artist should take a moral, political line in asserting that his/her active role is to "remedy a bad situation" (Ojaide 1994, 17). The object would be to purify an African way of life that has been tainted by invasive, self-gratifying, materialistic attitudes. But, again, what is that "remedy" to be? While recognition of Africa's postcolonial malaise is widespread, and its cause axiomatically and correctly assigned to the experience of colonialism, African writers have been somewhat tentative in suggesting what exactly it is that should be done. It is one thing to identify a problem, and to express it in the most forthright or damning terms, but quite another to locate and postulate the possible means for its resolution. The two Ghanaian artists whose work this paper addresses, Ayi Kwei Armah and Ama Ata Aidoo, have been all too frequently accused of the pessimistic recitation of African ills. Molly Mahood has spoken of the "almost total disillusionment" (Fraser 1980, 15) of Armah's The Beautyful Ones Are Not Yet Born; and Liyong has described the work as one of those "tearing down exercises" (Liyong 1990, 176). Adeola James has identified a "certain somberness" (James 1990, 17) and Arlene Elder a "pessimism" (Elder 1987, 117) in Aidoo's short stories; and Femi Ojo-Ade has styled the Ghana of No Sweetness Here as "hell" (Oje-Ade 1987, 174). The optimistic dimensions of their work have often gone unnoticed. Even contemporary readings that have attempted to soften the gloom of the two texts have sought in some way to qualify their observations. Tsegaye Wodajo's excellent study of five Armah novels, Hope in the Midst of Despair: A Novelist's Cures for Africa (2005), perceives The Beautyful Ones Are Not Yet Born as a literature of protest that finds a hopeful riposte in the later novels. And while Nanna Jane Opoku-Agyemang's fine 1999 essay brings a valuable comparative dimension to No Sweetness Here, her insights fail to lift the pall of despair that is customarily judged to hang over this collection of eleven stories. This paper will argue that Aidoo's No Sweetness Here and Armah's The Beautyful Ones Are Not Yet Born offer greater scope for optimism than many critics have hitherto suggested; and that both articulate a process of purification that actively opposes the dystopian settings of their respective narratives. [source] | ||||||||||||||||||||||||||||||||||||||||