1
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Rubin A, Shah RR, Khan S, Haroon A, Rao B. Imaging Tools for Noninvasive Hair Assessment. Cutis 2023; 112:E52-E57. [PMID: 37611291 DOI: 10.12788/cutis.0834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Trichology tools historically have been limited in their ability to provide noninvasive detailed assessments of the hair and scalp. Recent advances in diagnostic and treatment monitoring technologies have begun to fill this gap. Global photography previously relied on a film camera and stereotactic imaging equipment but has been simplified by the advent of cameras that use software analysis and provide adjustable outlines to match facial features for the capture of standardized views. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) both enable in vivo visualization of subcutaneous structures and provide new insight into the dynamic subclinical changes of alopecia. Recent efforts focus on training convolutional neural networks to quantify various hair parameters on OCT scans. When scalp biopsy is necessary, trichoscopy, RCM, and OCT can guide in selecting biopsy sites. Because of the growing clinical applications of these technologies, clinicians should be aware of the advantages and limitations of noninvasive hair-imaging tools.
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Affiliation(s)
- Alexandra Rubin
- Center for Dermatology, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey. Dr. Rao also is from Department of Dermatology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Rohan R Shah
- Center for Dermatology, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey. Dr. Rao also is from Department of Dermatology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Samavia Khan
- Center for Dermatology, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey. Dr. Rao also is from Department of Dermatology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Attiya Haroon
- Center for Dermatology, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey. Dr. Rao also is from Department of Dermatology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Babar Rao
- Center for Dermatology, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey. Dr. Rao also is from Department of Dermatology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
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Light A, Kanthabalan A, Pavlou M, Omar R, Adeleke S, Giganti F, Brew-Graves C, Emara A, Haroon A, Latifoltojar A, Sidhu H, Freeman A, Orczyk C, Nikapota A, Dudderidge T, Hindley R, Payne H, Mitra A, Bomanji J, Winkler M, Horan G, Punwani S, Ahmed H, Shah T. Tumor characteristics of multiparametric MRI-detected and -undetected lesions in patients with suspected radiorecurrent prostate cancer: An analysis from the FOcal RECurrent Assessment and Salvage Treatment (FORECAST) trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Ouellette S, Razi S, Haroon A. 34774 Assessing penetration, delivery, and mode of action of dissolving microneedle patches for reducing under-eye wrinkles using reflectance confocal microscopy. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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4
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Otto TS, Rubin A, Haroon A, Ashforth G, Rao BK. 35328 Morbidities associated with solitary keratoacanthomas. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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5
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Desai AD, Shah R, Haroon A, Wassef C. Bullous Pemphigoid Following the Moderna mRNA-1273 Vaccine. Cureus 2022; 14:e24126. [PMID: 35573488 PMCID: PMC9106564 DOI: 10.7759/cureus.24126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
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6
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Ranpariya V, Haroon A, John A, Wassef C. Extrafacial Merkel Cell Carcinoma Presenting as a Cyst. J Drugs Dermatol 2022; 21:304-308. [PMID: 35254761 DOI: 10.36849/jdd.6248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin tumor that presents as an erythematous or violaceous nodule in elderly white males with an extensive history of sun exposure. Herein, we report two cases of extrafacial MCC. On exam, lesions presented as a cystic nodule and a firm plaque. We summarize tools from literature review that may aid in earlier diagnosis of MCC as well as implications of primary tumor location in prognosis. In addition, we provide an algorithm for diagnostic workup. MCC is an aggressive malignancy with a poor prognosis and a high risk of local recurrence and nodal metastasis. It is imperative to include MCC in differential diagnosis of cyst/nodule in order to facilitate early detection. J Drugs Dermatol. 2022;21(3):304-308. doi:10.36849/JDD.6248.
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Rubin A, Haroon A, Rao BK, Firoz BF. Utility of Optical Imaging in a Patient With Recurrent, Multifocal Hydroxyurea-Associated Basal Cell Carcinoma. Dermatol Surg 2022; 48:155-156. [PMID: 34743120 DOI: 10.1097/dss.0000000000003279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alexandra Rubin
- Department of Pathology & Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Center for Dermatology, Somerset, New Jersey
- Rao Dermatology, Atlantic Highlands, New Jersey
| | | | - Babar K Rao
- Rao Dermatology, Atlantic Highlands, New Jersey
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Shah R, Jamgochian M, Haroon A, Pappert A, Miller J. A 14-year-old with dermatitis artefacta secondary to aerosolized spray deodorant: A rare case with an important learning opportunity. JAAD Case Rep 2021; 19:71-73. [PMID: 34917729 PMCID: PMC8669259 DOI: 10.1016/j.jdcr.2021.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rohan Shah
- Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Attiya Haroon
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Amy Pappert
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Jason Miller
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
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Rubin A, Haroon A, Chuchvara N, Rao BK, Firoz BF. 25886 Recurrent basal cell carcinoma of the scalp in a patient on long-term hydroxyurea therapy. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shah T, Kanthabalan A, Pavlou M, Adeleke S, Giganti F, Brew-Graves C, Williams N, Haroon A, Sidhu H, Freeman A, Orczyk C, Nikapota A, Dudderidge T, Hindley R, Virdi J, Arya M, Mitra A, Payne H, Bomanji J, Winkler M, Horan G, Moore C, Emberton M, Punwani S, Ahmed H. MRI and targeted biopsies compared to transperineal mapping biopsies for targeted ablation in recurrent prostate cancer after radiotherapy: Primary outcomes of the FORECAST trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Khan S, Chuchvara N, Cucalon J, Haroon A, Rao B. Evaluating residual melanocytic atypia in a post-excision scar using in vivo reflectance confocal microscopy. Skin Res Technol 2021; 27:985-987. [PMID: 33651471 DOI: 10.1111/srt.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/23/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Samavia Khan
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA
| | - Nadiya Chuchvara
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA
| | | | - Attiya Haroon
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA
| | - Babar Rao
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA.,Rao Dermatology, Fresno, CA, USA.,Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
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12
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Mehandru SK, Haroon A, Masud A, Shah J, Kaur S, Masud A, Hossain A, Asif A, Vachharajani TJ. Metabolic Acidosis, Hyperkalemia, and Renal Unresponsiveness to Aldosterone Syndrome: Response to Treatment with Low-Potassium Diet. Saudi J Kidney Dis Transpl 2020; 31:1134-1139. [PMID: 33229781 DOI: 10.4103/1319-2442.301183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gordon syndrome involves hyperkalemia, acidosis, and severe hypertension (HTN) with hypercalciuria, low renin and aldosterone levels. It is commonly observed in children and adolescents. Such patients respond successfully to sodium restriction and thiazide diuretics. In this article, we present three cases of metabolic acidosis, hyperkalemia, and renal unresponsiveness to aldosterone (MeHandRU Syndrome). All three patients did not have HTN or hypercalciuria and demonstrated normal renin and aldosterone levels. These patients did not respond to thiazide-type diuretic therapy and salt restriction. Two males (aged 55- and 62-year) and a female patient (aged 68-year) presented to the clinic with unexplained hyperkalemia (5.9 mEq/L, 5.9 mEq/L and 6.2 mEq/L, respectively). On physical examination, blood pressure (BP) was found to be normal (<140/90 mm Hg). Over the counter potassium supplement, nonsteroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, potassium sparing diuretic use, as well as hyporeninemic hypoaldosteronism states such as diabetes mellitus were excluded. Plasma renin and aldosterone levels were normal. All three patients had low transtubular potassium gradient, despite high serum potassium levels. None of the patients reported a family history of hyperkalemia or kidney failure. All failed to demonstrate a response to hydrochlorothiazide and salt restriction. After careful consideration, strict low potassium diet (<2 g/day) was initiated in consultation with the dietician. Diuretic therapy was discontinued while BP remained within normal range (<140/90 mm Hg). At eight weeks, all three patients demonstrated normalization of potassium and correction of acidosis. At follow-up of six months, all patients are maintaining a normal potassium level. We suggest that potassium restriction can be successful in patients presenting with MeHandRU syndrome.
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Affiliation(s)
- Sushil K Mehandru
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Attiya Haroon
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Avais Masud
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Jay Shah
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Supreet Kaur
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Aisha Masud
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Amir Hossain
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Arif Asif
- Department of Medicine, Division of Nephrology, Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine at Seton Hall University, Neptune, New Jersey, USA
| | - Tushar J Vachharajani
- Department of Nephrology and Hypertension, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Chuchvara N, Reilly C, Haroon A, Wassef C, Maghari A, Rao B. Atypical cells on reflectance confocal microscopy may not represent melanoma: A case of axillary pigmented extramammary Paget disease. J Cutan Pathol 2020; 47:1170-1174. [DOI: 10.1111/cup.13804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/12/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Nadiya Chuchvara
- Center for Dermatology Rutgers Robert Wood Johnson Medical School Somerset NJ USA
| | - Catherine Reilly
- Center for Dermatology Rutgers Robert Wood Johnson Medical School Somerset NJ USA
| | - Attiya Haroon
- Center for Dermatology Rutgers Robert Wood Johnson Medical School Somerset NJ USA
| | - Cindy Wassef
- Center for Dermatology Rutgers Robert Wood Johnson Medical School Somerset NJ USA
| | - Amin Maghari
- Department of Pathology and Laboratory Medicine Rutgers Robert Wood Johnson Medical School New Brunswick NJ USA
| | - Babar Rao
- Center for Dermatology Rutgers Robert Wood Johnson Medical School Somerset NJ USA
- Department of Dermatology Weill Cornell Medicine New York NY USA
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Francisco G, Eilers S, Haroon A, Virmani P, Cha J, Pappert A, Rao B. No wonder it itches: quick bedside visualization of a scabies infestation using reflectance confocal microscopy. J Cutan Pathol 2019; 45:877-879. [PMID: 30419160 DOI: 10.1111/cup.13336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Gina Francisco
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Steven Eilers
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Attiya Haroon
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Pooja Virmani
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Jisun Cha
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Amy Pappert
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
| | - Babar Rao
- Rutgers - Robert Wood Johnson Medical School, Department of Dermatology, Somerset, New Jersey, USA
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15
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Mahida H, Haroon A, Ajam F, Gubeladze A, Calderon D, Apolito R, Hossain MA. Iliac Artery Occlusion in a Patient With Allograft Renal Transplant Causing Refractory Heart Failure and Simulating Renal Artery Stenosis With Solitary Kidney. J Med Cases 2019. [DOI: 10.14740/jmc3218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Wells WA, Thrall M, Sorokina A, Fine J, Krishnamurthy S, Haroon A, Rao B, Shevchuk MM, Wolfsen HC, Tearney GJ, Hariri LP. In Vivo and Ex Vivo Microscopy: Moving Toward the Integration of Optical Imaging Technologies Into Pathology Practice. Arch Pathol Lab Med 2018; 143:288-298. [PMID: 30525931 DOI: 10.5858/arpa.2018-0298-ra] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The traditional surgical pathology assessment requires tissue to be removed from the patient, then processed, sectioned, stained, and interpreted by a pathologist using a light microscope. Today, an array of alternate optical imaging technologies allow tissue to be viewed at high resolution, in real time, without the need for processing, fixation, freezing, or staining. Optical imaging can be done in living patients without tissue removal, termed in vivo microscopy, or also in freshly excised tissue, termed ex vivo microscopy. Both in vivo and ex vivo microscopy have tremendous potential for clinical impact in a wide variety of applications. However, in order for these technologies to enter mainstream clinical care, an expert will be required to assess and interpret the imaging data. The optical images generated from these imaging techniques are often similar to the light microscopic images that pathologists already have expertise in interpreting. Other clinical specialists do not have this same expertise in microscopy, therefore, pathologists are a logical choice to step into the developing role of microscopic imaging expert. Here, we review the emerging technologies of in vivo and ex vivo microscopy in terms of the technical aspects and potential clinical applications. We also discuss why pathologists are essential to the successful clinical adoption of such technologies and the educational resources available to help them step into this emerging role.
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Affiliation(s)
- Wendy A Wells
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Michael Thrall
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Anastasia Sorokina
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jeffrey Fine
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Savitri Krishnamurthy
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Attiya Haroon
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Babar Rao
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Maria M Shevchuk
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Herbert C Wolfsen
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Guillermo J Tearney
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lida P Hariri
- From the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Wells); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Thrall); the Department of Pathology, University of Illinois at Chicago, Chicago (Dr Sorokina); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Fine); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Krishnamurthy); the Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey (Drs Haroon and Rao); the Department of Pathology, Weill Cornell Medical College, New York, New York (Dr Shevchuk); the Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida (Dr Wolfsen); and the Wellman Center for Photomedicine (Dr Tearney) and the Department of Pathology (Drs Tearney and Hariri), Massachusetts General Hospital, Harvard Medical School, Boston
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17
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Wolf S, Goiriz R, Dhairyawan R, Paige D, Rizvi H, Haroon A, Montoto S. Brentuximab vedotin in multifocal cutaneous anaplastic large cell lymphoma in a patient with human immunodeficiency virus following Hodgkin lymphoma. Clin Exp Dermatol 2018; 44:562-564. [PMID: 30430604 DOI: 10.1111/ced.13824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2018] [Indexed: 01/10/2023]
Affiliation(s)
- S Wolf
- Department of Haemato-Oncology, Barts Health NHS Trust, London, UK
| | - R Goiriz
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - R Dhairyawan
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - D Paige
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - H Rizvi
- Department of Pathology, Barts Health NHS Trust, London, UK
| | - A Haroon
- Department of Imaging, Barts Health NHS Trust, London, UK
| | - S Montoto
- Department of Haemato-Oncology, Barts Health NHS Trust, London, UK
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18
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Curras-Martin D, Campbell N, Haroon A, Hossain MA, Asif A. Recurrent optic neuritis as the only manifestation of chronic hepatitis B virus flare: a case report. J Med Case Rep 2018; 12:316. [PMID: 30326966 PMCID: PMC6192156 DOI: 10.1186/s13256-018-1810-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/20/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Autoimmune reactions have been associated with acute hepatitis B virus infection. Among these optic neuritis is a rare presentation with only a handful of cases reported in the literature thus far. The pathophysiologic mechanism governing this phenomenon includes high levels of circulating immune complexes, tissue deposit, and complement activation cascade. CASE PRESENTATION In this report, we present the case of a 46-year-old African American man with a past medical history of untreated chronic hepatitis B virus, diagnosed 5 years ago, who presented to our facility on two occasions with the chief compliant of blurry vision. He was diagnosed with optic neuritis associated with acute on chronic hepatitis B virus infection, where the recurrent visual impairment was the main presenting symptom. Because hepatitis constituted a relative contraindication for steroid therapy, our patient was solely treated with antiviral medication. Antiviral therapy resulted in complete resolution of his symptoms and improvement in his liver function. CONCLUSIONS Further studies are necessary to conclusively establish whether antiviral therapy can be employed as the sole therapy in immune complex-mediated optic neuritis, in the setting of active recurrent hepatitis B infection.
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Affiliation(s)
- Diana Curras-Martin
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753 USA
| | - Natasha Campbell
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753 USA
| | - Attiya Haroon
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753 USA
| | - Mohammad A. Hossain
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753 USA
| | - Arif Asif
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753 USA
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19
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Rao BK, John AM, Francisco G, Haroon A. Diagnostic Accuracy of Reflectance Confocal Microscopy for Diagnosis of Skin Lesions: An Update. Arch Pathol Lab Med 2018; 143:326-329. [DOI: 10.5858/arpa.2018-0124-oa] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an aesthetically significant site, or in children. Recently, noninvasive techniques, including reflectance confocal microscopy (RCM), optical coherence tomography, and Raman spectroscopy, have enabled dermatologists to manage skin lesions in real time without the need for biopsy.
Objective.—
To report the updated diagnostic accuracy of RCM for equivocal skin lesions.
Design.—
In this study, we retrospectively reviewed our data of clinically suspicious lesions from 2010 to 2017 that were evaluated by RCM.
Results.—
Our results showed an overall sensitivity of 98.2% and specificity of 99.8%.
Conclusions.—
In conclusion, RCM is a noninvasive real-time tool with the potential to diagnose skin lesions with high accuracy and without biopsy.
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Affiliation(s)
- Babar K. Rao
- From the Department of Dermatology, Rutgers, Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Ann M John
- From the Department of Dermatology, Rutgers, Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Gina Francisco
- From the Department of Dermatology, Rutgers, Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Attiya Haroon
- From the Department of Dermatology, Rutgers, Robert Wood Johnson Medical School, Somerset, New Jersey
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20
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John AM, Haroon A, Francisco G, Rao BK. Reflectance confocal microscopy and melanocytic lesions: The road to saving a biopsy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ann Mary John
- Rutgers Robert Wood Johnson Medical School, Somerset, NJ
| | - Attiya Haroon
- Rutgers Robert Wood Johnson Medical School, Somerset, NJ
| | - Gina Francisco
- Rutgers Robert Wood Johnson Medical School, Somerset, NJ
| | - Babar K Rao
- Weill Cornell Medical College, New York City, NY
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21
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Zubair R, Haroon A, Rao B. Bedside diagnosis of lentigo maligna with reflectance confocal microscopy. J Cutan Pathol 2018; 45:553-555. [PMID: 29693252 DOI: 10.1111/cup.13264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/13/2018] [Accepted: 04/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Raheel Zubair
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Attiya Haroon
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Babar Rao
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
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22
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Mehandru S, Haroon A, Masud A, Patel M, Sadiang-Abay E, Costanzo EJ, Vachharajani TJ. Pregnancy and hemodialysis access: A case for patient satisfaction in favor of a tunneled dialysis catheter. J Vasc Access 2018; 19:663-666. [PMID: 29506430 DOI: 10.1177/1129729817747540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation. All three patients were switched to daily hemodialysis (six sessions/week) as soon as the pregnancy was discovered. The three patients had refused the placement of an arteriovenous access and expressed their strong preference for tunneled hemodialysis catheter. All had been educated about the risks and benefits of catheter, grafts, and fistulas. Patient preference was acknowledged and dialysis therapy was continued with tunneled hemodialysis catheter. Pregnancy was uneventful in two patients with the delivery of a healthy baby. The third patient had a miscarriage. Patient preference for tunneled hemodialysis catheter and satisfaction is important and can result in a successful outcome in pregnant patients. Nonetheless, in keeping with the National Kidney Foundation guidelines as well as the Fistula First, an arteriovenous fistula should be offered to hemodialysis patients. At the same time, patient's preference and wish should be respected and followed.
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Affiliation(s)
- Sushil Mehandru
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
| | - Attiya Haroon
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
| | - Avais Masud
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
| | - Mayurkumar Patel
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
| | - Elmer Sadiang-Abay
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
| | - Eric J Costanzo
- 1 Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Seton Hall University, Neptune, NJ, USA
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23
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Iriarte C, Rao B, Haroon A, Kirkorian AY. Acral pigmented Spitz nevus in a child with transepidermal migration of melanocytes: Dermoscopic and reflectance confocal microscopic features. Pediatr Dermatol 2018; 35:e99-e102. [PMID: 29314193 DOI: 10.1111/pde.13385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acral pigmented Spitz nevi are seldom reported in the literature. We report a new case on the palm of a 4-year-old girl that demonstrated correlation between features observed on dermoscopy and reflectance confocal microscopy (RCM). Histopathology revealed a benign intraepidermal Spitz nevus with transepidermal elimination of melanocytes that showed on RCM as focal atypical bright cells concerning for malignancy. This case is one of few reports in the literature combining dermoscopy, reflectance confocal microscopy, and histology for an acral Spitz nevi, which are rarely evaluated by RCM given the thickness of the stratum corneum in acral sites.
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Affiliation(s)
- Christopher Iriarte
- Department of Dermatology, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
| | - Babar Rao
- Department of Dermatology, Rutgers-Robert Wood Johnson School of Medicine, Piscataway Township, NJ, USA
| | - Attiya Haroon
- Department of Dermatology, Rutgers-Robert Wood Johnson School of Medicine, Piscataway Township, NJ, USA
| | - Anna Yasmine Kirkorian
- Department of Dermatology, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA.,Division of Dermatology, Children's National Health System, Washington, DC, USA
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24
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Bajwa R, DePalma JA, Khan T, Cheema A, Kalathil SA, Hossain MA, Haroon A, Madhurima A, Zheng M, Nayer A, Asif A. C3 Glomerulopathy and Atypical Hemolytic Uremic Syndrome: Two Important Manifestations of Complement System Dysfunction. Case Rep Nephrol Dial 2018; 8:25-34. [PMID: 29594148 PMCID: PMC5836224 DOI: 10.1159/000486848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/15/2018] [Indexed: 01/10/2023] Open
Abstract
The advances in our understanding of the alternative pathway have emphasized that uncontrolled hyperactivity of this pathway causes 2 distinct disorders that adversely impact the kidney. In the so-called atypical hemolytic uremic syndrome (aHUS), renal dysfunction occurs along with thrombocytopenia, anemia, and target organ injury to multiple organs, most commonly the kidney. On the other hand, in the so-termed C3 glomerulopathy, kidney involvement is not associated with thrombocytopenia, anemia, or other system involvement. In this report, we present 2 cases of alternative pathway dysfunction. The 60-year-old female patient had biopsy-proven C3 glomerulopathy, while the 32-year-old female patient was diagnosed with aHUS based on renal dysfunction, thrombocytopenia, anemia, and normal ADAMTS-13 level. The aHUS patient was successfully treated with the monoclonal antibody (eculizumab) for complement blockade. The patient with C3 glomerulopathy did not receive the monoclonal antibody. In this patient, management focused on blood pressure and proteinuria control with an angiotensin-converting enzyme inhibitor. This article focuses on the clinical differences, pathophysiology, and treatment of aHUS and C3 glomerulopathy.
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Affiliation(s)
- Ravneet Bajwa
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - John A DePalma
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Taimoor Khan
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Anmol Cheema
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Sheila A Kalathil
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Mohammad A Hossain
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Attiya Haroon
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Anne Madhurima
- bDepartment of Hematology/Oncology, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Min Zheng
- cDepartment of Pathology, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Ali Nayer
- dMiami Renal Institute, North Miami Beach, FL, USA
| | - Arif Asif
- aDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
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25
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Attique HB, Naik S, Haroon A, Trivedi RD. Long-Term Peritoneal Dialysis May Result in Vascular Changes Within the Peritoneal Cavity, Leading to Reduced Efficacy of Intravenous Antibiotics in Treatment of Bacterial Peritonitis. Am J Med 2017; 130:e449-e450. [PMID: 28601541 DOI: 10.1016/j.amjmed.2017.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/09/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Hassan Bin Attique
- Division of Nephrology, Department of Medicine, University of Connecticut, Farmington
| | - Snehal Naik
- Department of Medicine, University of Connecticut, Farmington
| | - Attiya Haroon
- Rutgers Robert Wood Johnson Medical School, Piscataway Township, NJ
| | - Ruchir D Trivedi
- Division of Nephrology, Department of Medicine, University of Connecticut, Farmington.
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26
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Abstract
Biopsy and histologic evaluation have been the gold standard to diagnose skin tumors. Reflectance confocal microcopy (RCM) is a noninvasive, innovative diagnostic technique that enables visualization of different skin layers at an almost histologic resolution. RCM has been proven beneficial in management of various cutaneous lesions. This article highlights the clinical significance and future of RCM to diagnose common skin cancers. However, RCM cannot replace currently standard histopathologic diagnosis. More studies are required to better compare the sensitivity and specificity of skin cancer diagnosis using RCM.
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Affiliation(s)
- Attiya Haroon
- Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, 1 Worlds Fair Drive, 2nd Floor, Suite 2400, Somerset, NJ 08873, USA.
| | - Shahram Shafi
- Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, 1 Worlds Fair Drive, 2nd Floor, Suite 2400, Somerset, NJ 08873, USA
| | - Babar K Rao
- Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, 1 Worlds Fair Drive, 2nd Floor, Suite 2400, Somerset, NJ 08873, USA
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27
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Haroon A, Shafi S, Rao B. Adult xanthogranuloma diagnosed on reflectance confocal microscopy. J Cutan Pathol 2017; 44:809-810. [DOI: 10.1111/cup.12971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Attiya Haroon
- Department of Dermatology, Rutgers; Robert Wood Johnson Medical School; Somerset New Jersey
| | - Shahram Shafi
- Department of Dermatology, Rutgers; Robert Wood Johnson Medical School; Somerset New Jersey
| | - Babar Rao
- Department of Dermatology, Rutgers; Robert Wood Johnson Medical School; Somerset New Jersey
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28
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Mehandru S, Haroon A, Singh V, Masud A, Costanzo EJ, Patel M, Sadiang-Abay E, Asif A. Atypical Presentation of Gordon Syndrome and Its Management: A Report of Three Patients. J Med Cases 2017. [DOI: 10.14740/jmc2874w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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29
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Hossain MA, Mahida H, Haroon A, Costanzo EJ, Consentino J, Salman L, Asif A. Heroin Epidemic and Acute Kidney Injury: An Under-Recognized but Important Consequence of Opioid Overdose. J Med Cases 2017. [DOI: 10.14740/jmc2898w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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30
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Kanthabalan A, Shah T, Arya M, Punwani S, Bomanji J, Haroon A, Illing RO, Latifoltojar A, Freeman A, Jameson C, van der Meulen J, Charman S, Emberton M, Ahmed HU. The FORECAST study - Focal recurrent assessment and salvage treatment for radiorecurrent prostate cancer. Contemp Clin Trials 2015; 44:175-186. [PMID: 26184343 DOI: 10.1016/j.cct.2015.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND One-third of men may experience biochemical failure by 8years following radical radiotherapy for localised prostate cancer. Over 90% of men are started on androgen deprivation therapy (ADT) which is non-curative and confers systemic side-effects. Focal salvage therapy (FST) limits collateral tissue damage and may improve therapeutic ratios. In order to deliver FST, distant disease must be ruled-out and intra-prostatic disease must be accurately detected, localised and characterised. AIM FORECAST - Focal Recurrent Assessment and Salvage Treatment - is a study designed to evaluate a novel imaging-based diagnostic and therapeutic complex intervention pathway for men who fail radiotherapy. METHODS Men with biochemical failure following radical prostate radiotherapy, prior to salvage therapy will be recruited. They will undergo whole-body multi-parametric MRI (WB-MRI), choline PET/CT, bone-scan and pelvic-mpMRI and then MRI transperineal-targeted biopsies (MRI-TB) and Transperineal Template Prostate Mapping Biopsy (TPM). Those suitable for FST will undergo either high intensity focused ultrasound (HIFU) or cryotherapy. RESULTS Primary outcome measures: a) the accuracy of WB-MRI to detect distant metastatic disease; b) accuracy of prostate mpMRI in local detection of radiorecurrent prostate cancer; c) detection accuracy of MRI-TB; and d) rate of urinary incontinence following FST. CONCLUSION Focal salvage therapy may confer lower rates of morbidity whilst retaining disease control. In order to deliver FST, intra- and extra-prostatic disease must be detected early and localised accurately. Novel diagnostic techniques including WB-MRI and MRI-TB may improve the detection of distant and local disease whilst reducing healthcare burdens compared with current imaging and biopsy strategies.
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Affiliation(s)
- A Kanthabalan
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK.
| | - T Shah
- Division of Surgery and Interventional Science, University College London, UK
| | - M Arya
- Department of Urology, UCLH NHS Foundation Trust, UK
| | - S Punwani
- Department of Radiology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - J Bomanji
- Institute of Nuclear Medicine, UCLH NHS Foundation Trust, UK
| | - A Haroon
- Centre for Medical Imaging and Computing, University College London, UK
| | - R O Illing
- Department of Radiology, UCLH NHS Foundation Trust, UK
| | - A Latifoltojar
- Department of Urology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - A Freeman
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | - C Jameson
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | | | - S Charman
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Emberton
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
| | - H U Ahmed
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
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31
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Higa F, Haroon A, Iha Y, Tasato D, Nakamura H, Kinjo T, Tamayose M, Furugen M, Miyagi K, Haranaga S, Tateyama M, Fujita J. Interleukin-17A in Legionella pneumonia: A Retrospective Study. Jpn J Infect Dis 2015; 68:148-50. [DOI: 10.7883/yoken.jjid.2014.171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Futoshi Higa
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Attiya Haroon
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Yoshikazu Iha
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Daisuke Tasato
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Hideta Nakamura
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Takeshi Kinjo
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Maki Tamayose
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Makoto Furugen
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Kazuya Miyagi
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Shusaku Haranaga
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Masao Tateyama
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
| | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus
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32
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Bhutta ZA, Giuliani F, Haroon A, Knight HE, Albernaz E, Batra M, Bhat B, Bertino E, McCormick K, Ochieng R, Rajan V, Ruyan P, Cheikh Ismail L, Paul V. Standardisation of neonatal clinical practice. BJOG 2013; 120 Suppl 2:56-63, v. [DOI: 10.1111/1471-0528.12312] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2012] [Indexed: 11/27/2022]
Affiliation(s)
- ZA Bhutta
- Division of Women & Child Health; The Aga Khan University; Karachi; Pakistan
| | - F Giuliani
- SCDU Neonatologia; Dipartimento di Scienze Pediatriche e dell'Adolescenza; Università degli Studi di Torino; Torino; Italy
| | - A Haroon
- Division of Women & Child Health; The Aga Khan University; Karachi; Pakistan
| | - HE Knight
- Nuffield Department of Obstetrics & Gynaecology; Oxford Maternal & Perinatal Health Institute; Green Templeton College; University of Oxford; Oxford; UK
| | | | - M Batra
- University of Washington School of Medicine; Seattle; WA; USA
| | - B Bhat
- Department of Family & Community Health; Ministry of Health; Muscat; Sultanate of Oman
| | - E Bertino
- SCDU Neonatologia; Dipartimento di Scienze Pediatriche e dell'Adolescenza; Università degli Studi di Torino; Torino; Italy
| | - K McCormick
- Department of Paediatrics; John Radcliffe Hospital; Oxford; UK
| | - R Ochieng
- Faculty of Health Sciences; Aga Khan University; Nairobi; Kenya
| | - V Rajan
- Ketkar Nursing Home; Nagpur; India
| | - P Ruyan
- Maternal & Child Health Centre; Beijing Obstetrics & Gynaecology Hospital; Capital Medical University; Beijing; China
| | - L Cheikh Ismail
- Nuffield Department of Obstetrics & Gynaecology; Oxford Maternal & Perinatal Health Institute; Green Templeton College; University of Oxford; Oxford; UK
| | - V Paul
- Department of Paediatrics and WHO Collaborating Centre for Training & Research in Newborn Care; All India Institute of Medical Sciences; New Delhi; India
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Lessard B, Aumand-Bourque C, Chaudury R, Gomez D, Haroon A, Ibrahimian N, Mackay S, Noel MC, Patel R, Sitaram S, Valla S, White B, Maric M. Poly(ethylene-co-butylene)-b-(styrene-ran-maleic anhydride)2 Compatibilizers via Nitroxide Mediated Radical Polymerization. INT POLYM PROC 2013. [DOI: 10.3139/217.2425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Telechelic poly(ethylene-ran-butylene) initiator terminated with [tert-butyl[1-(diethoxyphosphoryl)-2,2-dimethylpropyl]amino] nitroxide groups (PEB-(SG1)2) was used to initiate the controlled radical copolymerization of maleic anhydride (MA) and styrene (ST). The ST/MA copolymerizations were performed in 1,4-dioxane at 110°C and resulted in PEB-b-P(ST-ran-MA)2 triblock copolymers with relatively narrow molecular weight distributions
(
M
¯
m
/
M
¯
n
≈
1.5
)
. Gel permeation chromatography (GPC) indicated that the initiator used was ≈93% efficient. The resulting copolymers were then blended as 20 wt.% dispersions in nylon 6 (PA6) at 230°C. With as little as 10 mol.% of MA in the feed to make the PEB-b-P(ST-ran-MA)2, blends were deemed dynamically compatibilized based on the reduced particle size. All of the PEB-b-P(ST-ran-MA)2/PA6 blends resulted in a minor phase particle size
D
¯
vs
=
0.1
μm while the PEB-b-P(ST)/PA6 blend had
D
¯
vs
=
1.15
μm (i.e. no MA in the copolymer). Tensile testing revealed yield stresses and strains decreased steadily from pure PA6 to non-reactive PEB-b-P(ST)2/PA6 to PEB-b-P(ST-ran-MA)2/PA6. However, no difference in tensile properties was observed between PEB-b-P(ST-ran-MA)2/PA6 samples made from PEB-b-P(ST-ran-MA)2 copolymer of varying MA content.
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Affiliation(s)
- B. Lessard
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - C. Aumand-Bourque
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - R. Chaudury
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - D. Gomez
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - A. Haroon
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - N. Ibrahimian
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - S. Mackay
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - M.-C. Noel
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - R. Patel
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - S. Sitaram
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - S. Valla
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - B. White
- Department of Chemical Engineering, McGill University, Montreal, Canada
| | - M. Maric
- Department of Chemical Engineering, McGill University, Montreal, Canada
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Aldridge M, Maclean J, Haroon A, Bomanji J, Walker C, Fersht N. PD-0470: 177 Lutetium DOTATATE for advanced progressive meningioma ñ A pilot study. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32776-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Haroon A, Zumla A, Bomanji J. Role of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Focal and Generalized Infectious and Inflammatory Disorders. Clin Infect Dis 2012; 54:1333-41. [DOI: 10.1093/cid/cis193] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Higa F, Koide M, Haroon A, Haranaga S, Yamashiro T, Tateyama M, Fujita J. Legionella pneumophila contamination in a steam towel warmer in a hospital setting. J Hosp Infect 2012; 80:259-61. [PMID: 22266131 DOI: 10.1016/j.jhin.2011.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 12/15/2011] [Indexed: 11/29/2022]
Abstract
For prevention of nosocomial legionellosis, environmental investigation to identify possible infectious sources is essential. An environmental study in a ward of our hospital revealed that a steam towel warmer was contaminated with legionella whereas no legionella was detected in tap water supplies and shower heads. Water in the apparatus may be a reservoir of legionella. We abandoned the use of all steam towel warmers in our hospital. Based on this finding, we recommend that steam towel warmers in hospital settings be avoided. Otherwise, the apparatus should be drained, cleaned and dried every day.
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Affiliation(s)
- F Higa
- Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of Ryukyus, Okinawa, Japan.
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Haroon A, Higa F, Fujita J, Watanabe A, Aoki N, Niki Y, Kadota JI, Yanagihara K, Kaku M, Hori S, Cash HL, Kohno S. Pulmonary computed tomography findings in 39 cases of Streptococcus pneumoniae pneumonia. Intern Med 2012; 51:3343-9. [PMID: 23257518 DOI: 10.2169/internalmedicine.51.7326] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The main objective of our study was to describe the pulmonary distribution of consolidation and ground-glass opacity (GGO) in chest computed tomography (CT) scans of Streptococcus pneumoniae pneumonia. In addition, the percentage of other pulmonary abnormalities was also reported. METHODS We retrospectively evaluated chest CT examinations performed between November 2008 and January 2010 in 39 patients with S. pneumoniae pneumonia. Eight patients with Haemophilus influenzae pneumonia were also included for comparison. PATIENTS There were 19 women and 28 men with clinical symptoms of fever and productive cough and laboratory findings of leukocytosis with markedly high C-reactive protein levels. Chest X-ray scores before and after treatment were calculated. The average score before treatment was 4. The average score after treatment was 0. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusions. The distribution of parenchymal disease was also analyzed. RESULTS The chest CT findings in the patients with S. pneumoniae pneumonia consisted primarily of consolidation (56.4%), ground-glass opacity (71.7%), interlobular reticular opacity (69.2%), centrilobular nodules (53.8%), interlobular septal thickening (46.6%), bronchial wall thickening (46.6%), lymph node enlargement (10.2%) and pleural effusion (10.2%). Segmental distribution (65.7%) was seen more frequently than non-segmental distribution (35.9%). Abnormal findings were noticed bilaterally in 14 patients and unilaterally in 25 patients. On both the right and left sides, predominant zonal distributions were seen in the lower lobes. In contrast, among the eight patients with H. influenzae pneumonia, one patient had both segmental and non-segmental distributions and the remaining seven patients had only segmental distributions. CONCLUSION In conclusion, segmental distributions of parenchymal abnormalities are more common than non-segmental distributions on chest CT scans of patients with S. pneumoniae pneumonia.
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Affiliation(s)
- Attiya Haroon
- Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Japan.
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Haroon A, Koide M, Higa F, Tateyama M, Fujita J. Identification of Legionella pneumophila serogroups and other Legionella species by mip gene sequencing. J Infect Chemother 2011; 18:276-81. [PMID: 22015397 DOI: 10.1007/s10156-011-0324-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 09/29/2011] [Indexed: 10/16/2022]
Abstract
The virulence factor known as the macrophage infectivity potentiator (mip) is responsible for the intracellular survival of Legionella species. In this study, we investigated the potential of the mip gene sequence to differentiate isolates of different species of Legionella and different serogroups of Legionella pneumophila. We used 35 clinical L. pneumophila isolates and one clinical isolate each of Legionella micdadei, Legionella longbeachae, and Legionella dumoffii (collected from hospitals all over Japan between 1980 and 2007). We used 19 environmental Legionella anisa isolates (collected in the Okinawa, Nara, Osaka, and Hyogo prefectures between 1987 and 2007) and two Legionella type strains. We extracted bacterial genomic DNA and amplified out the mip gene by PCR. PCR products were purified by agarose gel electrophoresis and the mip gene was then sequenced. The L. pneumophila isolates could be divided into two groups: one group was very similar to the type strain and was composed of serogroup (SG) 1 isolates only; the second group had more sequence variations and was composed of SG1 isolates as well as SG2, SG3, SG5, and SG10 isolates. Phylogenetic analysis displayed one cluster for L. anisa isolates, while other Legionella species were present at discrete levels. Our findings show that mip gene sequencing is an effective technique for differentiating L. pneumophila strains from other Legionella species.
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Affiliation(s)
- Attiya Haroon
- Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases (First Department of Internal Medicine), University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan
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Choudhary S, Rajesh A, Mayer NJ, Mulcahy KA, Haroon A. Renal oncocytoma: CT features cannot reliably distinguish oncocytoma from other renal neoplasms. Clin Radiol 2009; 64:517-22. [PMID: 19348848 DOI: 10.1016/j.crad.2008.12.011] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 12/04/2008] [Accepted: 12/15/2008] [Indexed: 12/22/2022]
Abstract
AIM To retrospectively review the computed tomography (CT) imaging features of a series of histologically confirmed renal oncocytomas and to determine whether imaging features are predictive of this subtype of benign renal epithelial tumour. MATERIALS AND METHODS From May 2001 to October 2007, 21 patients with 28 renal masses, confirmed as renal oncocytoma on histological examination of the resection specimen, were identified from the pathology database at our institution. The preoperative imaging findings were retrospectively analysed to determine characteristic features, if any, to predict this rare subtype of benign renal tumour. RESULTS There were 11 female and 10 male patients and the age at presentation ranged from 40-80 years (mean age 65.9 years). The size of the masses ranged from 1.2-12 cm in diameter (mean diameter 4.9 cm). All masses showed contrast enhancement. In 18 (64.3%) lesions the enhancement of the tumour was isodense to renal cortex. Ten (35.7%) lesions were hypodense to renal cortex. In three (10.7%) lesions, a well-defined stellate central scar was seen at CT and confirmed pathologically. In two (7.1%) lesions, a central scar was identified pathologically, but not seen on CT. The size of the central scars ranged from 10-29 mm diameter on CT. Twenty-two (78.6%) lesions did not demonstrate a scar on CT or pathologically. None of the patients had regional lymphadenopathy or distant metastasis. CONCLUSION Renal oncocytoma is typically described as being hypervascular and homogeneous, with a characteristic central stellate scar on CT. The present study demonstrates that these imaging features are found in only a small proportion of these tumours. Therefore, imaging characteristics alone are unreliable when differentiating between oncocytoma and renal cell carcinoma, and histopathological diagnosis remains the reference standard.
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Affiliation(s)
- S Choudhary
- Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
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