1/6. Low power laser therapy and analgesic action.OBJECTIVE: The semiconductor or laser diode (GaAs, 904 nm) is the most appropriate choice in pain reduction therapy. SUMMARY BACKGROUND DATA: Low-power density laser acts on the prostaglandin (PG) synthesis, increasing the change of PGG2 and PGH2 into PG12 (also called prostacyclin, or epoprostenol). The last is the main product of the arachidonic acid into the endothelial cells and into the smooth muscular cells of vessel walls, that have a vasodilating and anti-inflammatory action. methods: Treatment was performed on 372 patients (206 women and 166 men) during the period between May 1987 and January 1997. The patients, whose ages ranged from 25 to 70 years, with a mean age of 45 years, suffered from rheumatic, degenerative, and traumatic pathologies as well as cutaneous ulcers. The majority of patients had been seen by orthopedists and rheumatologists and had undergone x-ray examination. All patients had received drug-based treatment and/or physiotherapy with poor results; 5 patients had also been irradiated with He:Ne and CO2 lasers. Two-thirds were experiencing acute symptomatic pain, while the others suffered long-term pathology with recurrent crises. We used a pulsed diode laser, GaAs 904 nm wavelength once per day for 5 consecutive days, followed by a 2-day interval. The average number of applications was 12. We irradiated the trigger points, access points to the joint, and striated muscles adjacent to relevant nerve roots. RESULTS: We achieved very good results, especially in cases of symptomatic osteoarthritis of the cervical vertebrae, sport-related injuries, epicondylitis, and cutaneous ulcers, and with cases of osteoarthritis of the coxa. CONCLUSIONS: Treatment with 904-nm diode laser has substantially reduced the symptoms as well as improved the quality of life of these patient, ultimately postponing the need for surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/6. sarcoidosis presenting with large vessel vasculitis and osteosclerosis-related bone and joint pain.A 34-year-old African-American female diagnosed earlier with idiopathic thrombocytopenic purpura (ITP), lymphadenopathy, splenomegaly, uveitis, and pulmonary nodules, developed a subclavian artery aneurysm, and generalized annular osteosclerotic lesions with disabling arthralgias. Biopsies from bone and lymph node revealed non-caseating granulomas and no evidence of malignancy or infection, confirming the clinical impression of sarcoidosis.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
3/6. Atypical presentation of churg-strauss syndrome: another "forme fruste" of the disease?Vasculitis is a clinicopathologic process characterized by inflammation and damage to blood vessels. A broad and heterogenous group of syndromes may result from this process, because any type, size, and location of blood vessel may be involved. The cause of these conditions remains unclear, but an autoimmune inflammatory process, characterized by involvement of both neutrophils and endothelial cells, seems to play an important role. In 1951, Churg and Strauss described a clinical syndrome of severe asthma, hypereosinophilia with eosinophilic infiltrates, eosinophilic vasculitis, and granulomata in various organs. asthma may precede this vasculitis by many years. We report a case of anti-neutrophil cytoplasmic antibody-positive, pauci-immune, crescentic, necrotizing glomerulonephritis with peripheral and interstitial eosinophilia but without asthma. This is very unusual in churg-strauss syndrome.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/6. Silica exposure and systemic vasculitis.Work in Department of Energy (DOE) facilities has exposed workers to multiple toxic agents leading to acute and chronic diseases. Many exposures were common to numerous work sites. Exposure to crystalline silica was primarily restricted to a few facilities. I present the case of a 63-year-old male who worked in DOE facilities for 30 years as a weapons testing technician. In addition to silica, other workplace exposures included beryllium, various solvents and heavy metals, depleted uranium, and ionizing radiation. In 1989 a painful macular skin lesion was biopsied and diagnosed as leukocytoclastic vasculitis. By 1992 he developed gross hematuria and dyspnea. Blood laboratory results revealed a serum creatinine concentration of 2.1 mg/dL, ethrythrocyte sedimentation rate of 61 mm/hr, negative cANCA (antineutrophil cytoplasmic antibody cytoplasmic pattern), positive pANCA (ANCA perinuclear pattern), and antiglomerular basement membrane negative. Renal biopsy showed proliferative (crescentric) and necrotizing glomerulonephritis. The patient's diagnoses included microscopic polyangiitis, systemic necrotizing vasculitis, leukocytoclastic vasculitis, and glomerulonephritis. Environmental triggers are thought to play a role in the development of an idiopathic expression of systemic autoimmune disease. Crystalline silica exposure has been linked to rheumatoid arthritis, scleroderma, systemic lupus erythematosus, rapidly progressive glomerulonephritis and some of the small vessel vasculitides. DOE workers are currently able to apply for compensation under the federal Energy Employees Occupational Illness Compensation Program (EEOICP). However, the only diseases covered by EEOICP are cancers related to radiation exposure, chronic beryllium disease, and chronic silicosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/6. Henoch-Schonlein purpura in an adult Filipino man: a case report and literature review.Henoch-Schonlein purpura (HSP) is a form of cutaneous small vessel vasculitis that can involve visceral organs and is associated with deposition of immunoglobulin a (IgA)-containing immune complexes. HSP may appear after a remote history of infection (often an upper respiratory tract infection) as a rash with palpable petechiae or purpura. In addition, a patient with HSP usually complains of arthralgia and abdominal pain. Renal involvement also is common. HSP may be confused with other systemic autoimmune diseases because they all can present with similar symptoms. prognosis is good and recovery usually occurs without treatment. Although HSP predominately affects children, the condition also can be seen in adults. We present a case of adult-onset HSP in an otherwise healthy Filipino man and review the literature.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/6. livedo reticularis and thrombotic purpura related to the use of diphenhydramine associated with pyrithyldione.We describe the case of a young woman who habitually took large doses of a combination of diphenhydramine and pyrithyldione. She complained of arthralgia, painful recurring plaques and nodules, together with persistent reticular purpuric mottling and areas of necrosis on her legs. There were positive antinuclear antibodies and rheumatoid factor and histologically massive thrombosis of the dermal vessels without signs of vasculitis. Other cases of similar adverse reactions attributed to this drug combination used as a hypnotic have been described.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |