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Related Concept Videos

Assessing Body Temperature - Temporal Artery01:19

Assessing Body Temperature - Temporal Artery

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Here is a stepwise guide to assessing the body temperature at the temporal artery using a temporal artery thermometer
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.  
Step 3: Assess the patient's...
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Equipments Used to Measure Body Temperature01:13

Equipments Used to Measure Body Temperature

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Body temperature can be assessed using various devices and measured in Celsius or Fahrenheit.
Glass-bulb Thermometer:
Glass-bulb thermometers are hollow glass tubes with a bulb tip containing liquid such as ethanol or mercury. Historically, glass bulb mercury thermometers were the standard device to measure body temperature. Today, mercury thermometers are prohibited in many countries due to the hazardous effects of mercury and the risk of exposure if the glass bulb breaks. In general,...
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Temperature Measurement Sites01:14

Temperature Measurement Sites

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A thermometer measures body temperature. The common sites for measuring body temperature are the oral cavity, axillary region, temporal artery, and skin surface, such as the forehead, abdomen, and axilla. True core body temperature is assessed in the rectum, tympanic membrane, pulmonary artery, esophagus, and urinary bladder.
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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Is all inflammation within temporal artery biopsies temporal arteritis?

Liwei Jia1, Marta Couce1, Jill S Barnholtz-Sloan2

  • 1Department of Pathology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106.

Human Pathology
|July 23, 2016
PubMed
Summary

Patients with inflammation in small vessels of temporal artery biopsies (TABs) do not face increased risks for adverse events. Treatment with corticosteroids for such findings is likely unnecessary and potentially harmful in elderly patients.

Keywords:
Giant cell arteritisSmall vessel vasculitisTemporal arteritisTemporal artery biopsyVasa vasorum vasculitis

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Area of Science:

  • Vascular Inflammation
  • Rheumatology
  • Geriatric Medicine

Background:

  • Temporal arteritis (TA) predominantly affects elderly individuals, often with comorbidities.
  • Patients with TA are susceptible to adverse effects from corticosteroid therapy.
  • Perivascular inflammation in small vessels of temporal artery biopsies (TABs) is sometimes observed in non-TA cases.

Purpose of the Study:

  • To investigate if patients with inflammation in small vessels or adventitia of TABs, but without transmural TA, are at higher risk for TA-like adverse events.
  • To evaluate the potential benefits versus risks of corticosteroid treatment in this patient group.

Main Methods:

  • Retrospective review of 343 TABs performed between 2002 and 2012.
  • Identification of cases with inflammation (>15 perivascular lymphocytes) in small vessels/adventitia, excluding transmural TA.
  • Comparison of adverse cardiovascular events and mortality in 39 cases with matched controls over a 5-year follow-up.

Main Results:

  • Of 343 TABs, 56 (20%) showed inflammation in small vessels/adventitia without transmural TA.
  • Over a mean 5-year follow-up, 15% of cases and 18% of controls experienced stroke, cardiovascular events, or death.
  • No patients with study-positive TABs received corticosteroid therapy before or after biopsy.

Conclusions:

  • Inflammation confined to small vessels or adventitia in TABs does not correlate with an increased risk of TA-like adverse events.
  • The risks associated with prolonged corticosteroid therapy likely outweigh potential benefits in elderly patients with non-specific vascular inflammation.
  • Diagnosis of vasculitis should be reserved for cases demonstrating clear temporal arteritic damage.