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Unifying Concepts

The Gell-Coombs Classification of Hypersensitivity Reactions

The original Gell and Coomb’s classification categorizes hypersensitivity reactions into four subtypes according to the type of immune response and the effector mechanism responsible for cell and tissue injury: type I, immediate or IgE mediated; type II, cytotoxic or IgG/IgM mediated; type III, IgG/IgM immune complex mediated; and type IV, delayed-type hypersensitivity or T-cell mediated. Continue reading “The Gell-Coombs Classification of Hypersensitivity Reactions”

Saint Elian Wound Score System for Diabetic Foot Ulcers

Foot ulcerations are among the most complex and heterogeneous complications in patients with diabetes. Skin ulcers need to be managed in different ways dependent on their etiology and pathogenesis.

The 10 Saint Elian Wound Score System (SEWSS) categories is helpful in guiding treatment decisions based on severity subcategories.

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Classification of Caustic-Induced Gastrointestinal Injuries

Caustic substances injure tissue by means of a chemical reaction on direct physical contact. Often thought of as acids or bases, caustics broadly include desiccants, vesicants, and protoplasmic poisons. The term “corrosive” is often used interchangeably with “caustic,” but corrosion implies a mechanical degradation, which does not always apply to caustics. Continue reading “Classification of Caustic-Induced Gastrointestinal Injuries”

Testing to Diagnose Hormone-Secreting Pituitary Tumors

Pituitary adenomas account for approximately 15% of intracranial tumors. Management of these benign tumors requires diagnosis of the specific intrasellar disease and comprehensive, multidisciplinary treatment of local mass effects and peripheral endocrinopathies. Since tumors can produce different hormones, their consequences and management vary widely. Continue reading “Testing to Diagnose Hormone-Secreting Pituitary Tumors”

Diagnosis of Hereditary Angioedema (HAE)

Angioedema, also known as Quincke edema or “angioneurotic edema”, is defined as the localized nonpitting edema of deep dermal, subcutaneous, or submucosal tissues resulting from the increase in vascular permeability and extravasation of intravascular fluids; although it can coincide with urticaria in a histamine-mediated process, a differentiating feature is that urticarial wheals are limited to the mid and papillary dermis. Continue reading “Diagnosis of Hereditary Angioedema (HAE)”

Diagnostic Criteria for Chronic Rhinosinusitis (CRS)

Chronic rhinosinusitis is defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 consecutive weeks, in addition to objective evidence. Objective evidence of chronic rhinosinusitis may be obtained on physical examination (anterior rhinoscopy, endoscopy) or radiography, preferably from sinus computed tomography. Continue reading “Diagnostic Criteria for Chronic Rhinosinusitis (CRS)”

Diagnostic Criteria for Bulimia Nervosa (DSM-5)

Bulimia nervosa is an eating disorder characterized by binge eating followed by inappropriate compensatory behaviors designed to prevent weight gain. In addition, the self-evaluation of individuals with bulimia nervosa is excessively influenced by weight and body shape. The major change in criteria for diagnosis of bulimia nervosa is reducing the binge frequency threshold from twice per week in DSM-IV to once per week in DSM-5. The other differences include the DSM-IV differentiating between purging and nonpurging type (the DSM-5 does not) and the DSM-5 specifying criteria for partial remission, full remission, and severity, while the DSM-IV does not.
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Diagnostic Criteria for Anorexia Nervosa (DSM-V)

Anorexia nervosa is a severe psychiatric disorder characterized by starvation and malnutrition, a high prevalence of coexisting psychiatric conditions, marked treatment resistance or no response to treatment, frequent medical complications, and a substantial risk of death. Continue reading “Diagnostic Criteria for Anorexia Nervosa (DSM-V)”

Viral Dynamics of Coronavirus (Covid-19)

A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities. Continue reading “Viral Dynamics of Coronavirus (Covid-19)”

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