Zusammenfassung
Die Therapie peripherer vestibulärer Funktionsstörungen stellt eine Herausforderung für viele HNO-Ärzte dar. Diese besteht nicht nur in der Durchführung der differenzierten ...neurootologischen Diagnostik, sondern auch in der Therapie und in der Verlaufskontrolle von Patienten mit vestibulärer Funktionsstörung. Insbesondere die Qualitätssicherung solcher Therapie wird in der Regel nicht adäquat abgebildet und dokumentiert. Die deutsche, validierte Version des Dizziness Handicap Inventory (DHI) bietet eine praktikable Möglichkeit zur Evaluierung und Verlaufskontrolle der Therapieergebnisse. In einer Studie wurden die Beschwerden von Patienten, welche in der HNO-Klinik des Universitätsklinikums Aachen aufgrund einer unilateralen peripheren vestibulären Funktionsstörung behandelt wurden, prä- bzw. posttherapeutisch mittels DHI erfasst und ausgewertet. Die posttherapeutische Erhebung des DHI-Scores erfolgte telefonisch. Die Auswertung der erhobenen DHI-Scores ergab in 92 % der Fälle eine signifikante Reduzierung der Schwindelbeschwerden. Es bestätigte sich die Eignung des DHI als Instrument zur Qualitätssicherung für die Funktionsdiagnostik und die darauf folgende Therapie von vestibulären Funktionsstörungen.
One of the causal agents of human sporotrichosis, Sporothrix schenckii, is the type species of the genus Sporothrix. During the course of the last century the asexual morphs of many Ophiostoma spp. ...have also been treated in Sporothrix. More recently several DNA-based studies have suggested that species of Sporothrix and Ophiostoma converge in what has become known as Ophiostoma s. lat. Were the one fungus one name principles adopted in the Melbourne Code to be applied to Ophiostoma s. lat., Sporothrix would have priority over Ophiostoma, resulting in more than 100 new combinations. The consequence would be name changes for several economically important tree pathogens including O. novo-ulmi. Alternatively, Ophiostoma could be conserved against Sporothrix, but this would necessitate changing the names of the important human pathogens in the group. In this study, we sought to resolve the phylogenetic relationship between Ophiostoma and Sporothrix. DNA sequences were determined for the ribosomal large subunit and internal transcribed spacer regions, as well as the beta-tubulin and calmodulin genes in 65 isolates. The results revealed Sporothrix as a well-supported monophyletic lineage including 51 taxa, distinct from Ophiostoma s. str. To facilitate future studies exploring species level resolution within Sporothrix, we defined six species complexes in the genus. These include the Pathogenic Clade containing the four human pathogens, together with the S. pallida-, S. candida-, S. inflata-, S. gossypina- and S. stenoceras complexes, which include environmental species mostly from soil, hardwoods and Protea infructescences. The description of Sporothrix is emended to include sexual morphs, and 26 new combinations. Two new names are also provided for species previously treated as Ophiostoma.
Summary
Background
Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering skin disorder characterized by linear deposits of IgA along the dermoepidermal junction, visualized by direct ...immunofluorescence (DIF). It is usually spontaneous and drug induced.
Objectives
To compare the clinical and histological forms of LABD.
Methods
This retrospective single‐centre cohort study concerned 28 patients diagnosed with LABD between 1 January 1995 and 31 December 2010. Imputability, determined according to the French imputability method (modified Bégaud score) and Naranjo score, enabled classification into drug‐induced and spontaneous LABD groups. Clinical and histological features were compared by blinded analysis of images and histological patterns.
Results
Sixteen patients had spontaneous LABD and 12 had drug‐induced LABD. Nikolsky sign and large erosions were significantly more frequent in drug‐induced than spontaneous LABD (P = 0·003 and P = 0·03, respectively), with no between‐group differences for erythematous plaques, target or target‐like lesions, string of pearls, location, mucosal involvement or histological features.
Conclusions
Drug‐induced LABD was more severe than the spontaneous form, with lesions mimicking toxic epidermal necrolysis. Because LABD may be polymorphic and sometimes life threatening, DIF assay is recommended for all patients with Nikolsky sign and large erosions.
What's already known about this topic?
Linear IgA bullous dermatosis (LABD) is a rare autoimmune dermatosis usually considered spontaneous or drug induced.
Clinical features are polymorphic, and pseudotoxic epidermal necrolysis forms have been described.
To date, spontaneous and drug‐induced LABD have not been compared.
What does this study add?
Drug‐induced LABD, often with Nikolsky sign and large erosions, is more severe than the spontaneous form.
The genus Ceratocystis was established in 1890 and accommodates many important fungi. These include serious plant pathogens, significant insect symbionts and agents of timber degradation that result ...in substantial economic losses. Virtually since its type was described from sweet potatoes, the taxonomy of Ceratocystis has been confused and vigorously debated. In recent years, particulary during the last two decades, it has become very obvious that this genus includes a wide diversity of very different fungi. These have been roughly lumped together due to their similar morphological structures that have clearly evolved through convergent evolution linked to an insect-associated ecology. As has been true for many other groups of fungi, the emergence of DNA-based sequence data and associated phylogenetic inferences, have made it possible to robustly support very distinct boundaries defined by morphological characters and ecological differences. In this study, DNA-sequence data for three carefully selected gene regions (60S, LSU, MCM7) were generated for 79 species residing in the aggregate genus Ceratocystis sensu lato and these data were subjected to rigorous phylogenetic analyses. The results made it possible to distinguish seven major groups for which generic names have been chosen and descriptions either provided or emended. The emended genera included Ceratocystis sensu stricto, Chalaropsis, Endoconidiophora, Thielaviopsis, and Ambrosiella, while two new genera, Davidsoniella and Huntiella, were described. In total, 30 new combinations have been made. This major revision of the generic boundaries in the Ceratocystidaceae will simplify future treatments and work with an important group of fungi including distantly related species illogically aggregated under a single name.
Management von Hals-Nasen-Ohren-Notfällen Taeger, J.; Goncalves, M.; Duong Dinh, T. A. ...
Medizinische Klinik, Intensivmedizin und Notfallmedizin,
04/2024, Letnik:
119, Številka:
3
Journal Article
Zusammenfassung
Notfallsituationen im Hals-Nasen-Ohren(HNO)-Bereich können Kliniker vor erhebliche Herausforderungen stellen und erfordern aufgrund der Beteiligung verschiedener Organsysteme oftmals ...ein interdisziplinäres Vorgehen. Zielgerichtete Strategien helfen dabei, Schäden an Sinnes- oder Wahrnehmungsorganen zu vermeiden und lebensbedrohliche Blutungs- bzw. Atemwegskomplikationen zu beherrschen. Dieser Artikel soll einen Überblick über die Managementstrategien von HNO-Notfällen bieten. Diagnostisch wie therapeutisch spielt hierbei das gesamte Spektrum von einfachen konservativen bis hin zu hochkomplexen operativen Maßnahmen eine Rolle. Es werden Aspekte wie Blutungen, Atemwegsprobleme, Entzündungen, Hörstörungen, Schwindel, die Fazialisparese und Verletzungen des Kopf-Hals-Bereichs beleuchtet. Darüber hinaus werden auch wichtige Themen, wie präventive Maßnahmen und mögliche Komplikationen, behandelt, um eine optimale Versorgung der Patienten sicherzustellen.
The Ophiostomatales was erected in 1980. Since that time, several of the genera have been redefined and others have been described. There are currently 14 accepted genera in the Order. They include ...species that are the causal agents of plant and human diseases and common associates of insects such as bark beetles. Well known examples include the Dutch elm disease fungi and the causal agents of sporotrichosis in humans and animals. The taxonomy of the Ophiostomatales was confused for many years, mainly due to the convergent evolution of morphological characters used to delimit unrelated fungal taxa. The emergence of DNA-based methods has resolved much of this confusion. However, the delineation of some genera and the placement of various species and smaller lineages remains inconclusive. In this study we reconsidered the generic boundaries within the Ophiostomatales . A phylogenomic framework constructed from genome-wide sequence data for 31 species representing the major genera in the Order was used as a guide to delineate genera. This framework also informed our choice of the best markers from the currently most commonly used gene regions for taxonomic studies of these fungi. DNA was amplified and sequenced for more than 200 species, representing all lineages in the Order. We constructed phylogenetic trees based on the different gene regions and assembled a concatenated data set utilising a suite of phylogenetic analyses. The results supported and confirmed the delineation of nine of the 14 currently accepted genera, i.e. Aureovirgo , Ceratocystiopsis , Esteya , Fragosphaeria , Graphilbum , Hawksworthiomyces , Ophiostoma , Raffaelea and Sporothrix . The two most recently described genera, Chrysosphaeria and Intubia , were not included in the multi-locus analyses. This was due to their high sequence divergence, which was shown to result in ambiguous taxonomic placement, even though the results of phylogenomic analysis supported their inclusion in the Ophiostomatales . In addition to the currently accepted genera in the Ophiostomatales , well-supported lineages emerged that were distinct from those genera. These are described as novel genera. Two lineages included the type species of Grosmannia and Dryadomyces and these genera are thus reinstated and their circumscriptions redefined. The descriptions of all genera in the Ophiostomatales were standardised and refined where this was required and 39 new combinations have been provided for species in the newly emerging genera and one new combination has been provided for Sporothrix . The placement of Afroraffaelea could not be confirmed using the available data and the genus has been treated as incertae sedis in the Ophiostomatales . Paleoambrosia was not included in this study, due to the absence of living material available for this monotypic fossil genus. Overall, this study has provided the most comprehensive and robust phylogenies currently possible for the Ophiostomatales . It has also clarified several unresolved One Fungus-One Name nomenclatural issues relevant to the Order.
Vascular skin symptoms in COVID‐19: a French observational study Bouaziz, J.D.; Duong, T.A.; Jachiet, M. ...
JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology,
September 2020, Letnik:
34, Številka:
9
Journal Article
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