Pigmented purpuric dermatosis in children: a retrospective cohort with emphasis on treatment and outcomes.

BACKGROUND: Data regarding the course and treatment of pigmented purpuric dermatoses (PPD) in the paediatric population are limited. Although treatments for pigmented purpura are not well established, vitamin C and rutoside have been reported to be an effective treatment option and are widely utilized. OBJECTIVE: To assess the clinical course and utility of vitamin C and rutoside in paediatric patients with PPD treated at Ann & Robert H. Lurie Children's Hospital of Chicago between 2008 and 2018. METHODS: A retrospective review of all children with PPD managed at our hospital between 2008 and 2018 was performed. Additional follow-up was obtained via telephone interviews. RESULTS: A total of 101 patients met inclusion criteria. The female: male ratio was 1.3 : 1, and the median age at diagnosis was 8.8 years (IQR, 5.7-12.9). Median follow-up was 7.13 months (IQR, 3-17.4). The most common PPD subtypes were lichen aureus (43%) and Schamberg (34%). Fifty-three (52%) patients had evaluable follow-up documentation via their medical record or phone questionnaire. Twenty-eight patients were treated with vitamin C or rutoside or combination therapy. Twenty-five patients received no treatment. Clearance of the rash was noted in 24 (45.3%) patients overall, including 10 (42%) patients in the treated group and 14 (58%) patients in the untreated group. Recurrence was noted in seven (13.2%) patients. Treatment with vitamin C and/or rutoside was well tolerated without side effects. None of the patients were subsequently diagnosed with vasculitis, coagulopathy or cutaneous T-cell lymphoma. CONCLUSION: Pigmented purpuric dermatosis in children is a benign disorder with high rates of complete resolution. Treatment with vitamin C and rutoside is well tolerated, but in this cohort, there did not appear to be an advantage over watchful waiting without therapy.

Corrigendum to "A Novel Neutrosophic Method for Automatic Seed Point Selection in Thyroid Nodule Images".

[This corrects the article DOI: 10.1155/2019/7632308.].

A Novel Neutrosophic Method for Automatic Seed Point Selection in Thyroid Nodule Images.

The thyroid nodule is one of the endocrine issues caused by an irregular cell development. This rate of survival can be improved by earlier nodule detection. Accordingly, the accurate recognition of the nodule is of the utmost importance in providing powerful results in building the survival rate. The reduction in the accuracy of manual or semiautomatic segmentation methods for thyroid nodule detection is due to many factors, basically, the lack of experience of the sonographer and latency of operation. Most lesion regions in ultrasound images are homogeneous. Therefore, the value of entropy in these regions is high compared to its neighbours. Based on this criterion, a novel procedure for automatically selecting the seed point in thyroid nodule images is proposed. The proposed system consists of three components: neutrosophic image enhancement and speckle reduction to reduce speckle noise and automatic seed selection algorithm extracted from the centre of candidate block in ultrasound thyroid images based on the principle that most of its Higher Order Spectra Entropies (HOSE) from Radon Transform (RT) at different angles are within the range between average and maximum entropies, and the region growing image segmentation is applied with the constant threshold. The performance of proposed automatic segmentation method is compared with other methods in terms of calculating, True Positive (TP) value (96.44 ± 3.01%), False Positive (FP) value (3.55 ± 1.45%), Dice Coefficient (DC) value (92.24 ± 6.47%), Similarity Index (SI) (80.57 ± 1.06%), and Hausdroff Distance (HD) (0.42 ± 0.24 pixels). The proposed system can be considered as an added value to the malignancy diagnosis in thyroid nodule by an endocrinologist.

Kidnapping and Mental Health in Iraqi Refugees: The Role of Resilience.

Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms.