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J Curtis

Publications and source records attributed to J Curtis.

169 records · Page 10Linked to original sources

Herpes zoster: etiology, clinical course, and suggested management.

Herpes zoster is an acute viral infection that results from reactivation of a latent varicella-zoster virus often acquired as chickenpox during childhood. Fifty percent of all people living to the age of 85 will have an attack of zoster. The goal of intervention is to reduce associated pain and discomfort. A prompt diagnosis and appropriate management can best be achieved by understanding the disease and treatment options. While herpes zoster occurs with greater frequency in the geriatric population, it can occur throughout an individual's life span. The nurse practitioner working in any setting is likely to see patients present with herpes zoster. A protocol for patient management is included in this article as a resource for the nurse practitioner who encounters this diagnosis.

Clinical Protocols↗

Immunostaining of cardiac biopsy specimens in the diagnosis of acute vascular (humoral) rejection: a control study.

The diagnosis of acute vascular (humoral) rejection in heart transplant biopsies is classically based on immunofluorescent studies of frozen tissue that show vascular staining for immunoglobulin and complement. We have noted that some pathologists have used immunostaining of formalin-fixed, paraffin-embedded tissue in testing for vascular rejection. To determine the specificity of immunostaining of heart biopsy specimens in the diagnosis of vascular rejection, we studied tissue from 68 consecutive endomyocardial biopsies from 16 patients without clinical or histologic evidence of vascular rejection. In each case, routinely processed formalin-fixed, paraffin-embedded tissue was stained for immunoglobulin G and immunoglobulin M with an avidin-biotin immunoperoxidase technique. Frozen tissue from each case was also stained for immunoglobulin G, immunoglobulin M, C3, and Clq by immunofluorescence. Immunoperoxidase stains on formalin-fixed tissue showed vascular staining for immunoglobulin in 67 of 68 (99%) of the cases. Staining was ablated if the antibodies were absorbed with their appropriate immunoglobulin. Immunofluorescent studies on frozen tissue showed no vascular staining for immunoglobulin or complement. We conclude that immunoperoxidase studies of routinely processed, formalin-fixed, paraffin-embedded tissues are nonspecific in the diagnosis of heart acute vascular rejection. The positive staining in fixed tissues may be due to labeling of passive immunoglobulins that are "fixed" in the vessels during routine processing but are washed away in techniques using frozen tissue.

Acute Disease↗