Severe leukocytoclastic vasculitis secondary to the use of a naproxen and requiring amputation: a case report

<p>Abstract</p> <p>Introduction</p> <p>Leukocytoclastic vasculitis (also known as hypersensitivity vasculitis and cutaneous necrotizing vasculitis) can present with various manifestations, which often delays the diagnosis and treatment. In order to show the importance of the early recognition of leukocytoclastic vasculitis, we present a case which occurred secondary to the use of a common pharmaceutical, naproxen. We were unable to find a case of leukocytoclastic vasculitis secondary to naproxen in the literature.</p> <p>Case presentation</p> <p>We present the case of a 33-year-old African American woman with below the knee and bilateral digital gangrene from hypersensitivity vasculitis secondary to the non-steroidal anti-inflammatory medication naproxen.</p> <p>Conclusion</p> <p>This is an original case report focusing on the rheumatologic management of leukocytoclastic vasculitis. However, other specialties, such as internal medicine, dermatology, infectious disease, general surgery and pathology, can gain valuable information by reviewing this case report. Reporting a case of leukocytoclastic vasculitis secondary to treatment with naproxen will advance our understanding of this disease etiology by adding yet another non-steroidal anti-inflammatory drug to the list of potential causes of leukocytoclastic vasculitis.</p

MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist

In the pediatric gymnast, stress-related physeal injuries have been well described with characteristic imaging findings. However, a spectrum of overuse injuries, some rarely reported in the literature, can be encountered in the gymnast’s hand and wrist. To demonstrate the MR appearance of a spectrum of overuse injuries in the skeletally immature wrist and hand of pediatric gymnasts. A total of 125 MR exams of the hand and wrist in skeletally immature children were performed at our institution during a 2-year period. Clinical histories were reviewed for gymnastics participation. MR studies of that subpopulation were reviewed and abnormalities tabulated. Of the MR studies reviewed, ten gymnasts were identified, all girls age 12–16 years (mean age 14.2 years) who presented with wrist or hand pain. Three of these children had bilateral MR exams. Abnormalities included chronic physeal injuries in three children. Two girls exhibited focal lunate osteochondral defects. Triangular fibrocartilage tears were present in three girls, one of whom had a scapholunate ligament tear. Two girls manifested metacarpal head flattening and necrosis. A variety of soft-tissue and osseous lesions can be encountered in the skeletally immature gymnast. Familiarity with these stress-related injuries is important for accurate diagnosis

The International Remote Monitoring Project: Results of the Swedish Nuclear Power Facility field trial

The Swedish Nuclear Power Inspectorate (SKI) and the US Department of Energy (DOE) sponsored work on a Remote Monitoring System (RMS) that was installed in August 1994 at the Barseback Works north of Malmo, Sweden. The RMS was designed to test the front end detection concept that would be used for unattended remote monitoring activities. Front end detection reduces the number of video images recorded and provides additional sensor verification of facility operations. The function of any safeguards Containment and Surveillance (C/S) system is to collect information which primarily is images that verify the operations at a nuclear facility. Barseback is ideal to test the concept of front end detection since most activities of safeguards interest is movement of spent fuel which occurs once a year. The RMS at Barseback uses a network of nodes to collect data from microwave motion detectors placed to detect the entrance and exit of spent fuel casks through a hatch. A video system using digital compression collects digital images and stores them on a hard drive and a digital optical disk. Data and images from the storage area are remotely monitored via telephone from Stockholm, Sweden and Albuquerque, NM, USA. These remote monitoring stations operated by SKI and SNL respectively, can retrieve data and images from the RMS computer at the Barseback Facility. The data and images are encrypted before transmission. This paper presents details of the RMS and test results of this approach to front end detection of safeguard activities

Exploiting schemas in data synchronization

Increased reliance on optimistic data replication has led to burgeoning interest in tools and frameworks for synchronizing disconnected updates to replicated data. But good data synchronizers are challenging both to specify and to build. We have implemented a generic synchronization framework, called Harmony, that can be used to build state-based synchronizers for a wide variety of tree-structured data formats. A novel feature of this framework is that the synchronization process—in particular, the recognition of conflicts—is driven by the schema of the structures being synchronized. We formalize Harmony’s synchronization algorithm, prove that it obeys a simple and intuitive specification, and illustrate, using simple address books as a case study, how it can be used to synchronize trees representing a variety of specific forms of application data, including sets, records, tuples, and relations