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Topic: Janeway lesions

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	eMedicine - Dermatologic Manifestations of Cardiac Disease : Article by Vibhuti N Singh, MD, MPH, FACC, FSCAI (Site not responding. Last check: 2007-10-19)
		Janeway lesions are small hemorrhages with a slightly nodular appearance that occur on the palms and soles.
		White lesions of calcinosis cutis are firm papules ranging from white to whitish-yellow with an irregular surface and are seen in patients with scleroderma and in patients with subcutaneous tissue and intermuscular fascial planes associated with dermatomyositis.
		Wyre HW: The diagonal earlobe crease: a cutaneous manifestation of coronary artery disease.
	www.emedicine.com /derm/topic548.htm (8012 words)

	Infective Endocarditis in children Pediatric Oncall (Site not responding. Last check: 2007-10-19)
		The cardiac lesions that predispose to endocarditis are those that result in high velocity turbulent flows leading to eddy currents and/or denudation of endocardial epithelium.
		Finger clubbing may develop in acyanotic lesions or may already be present in cyanotic heart disease.
		Janeway lesions – They are flat, nontender erythematous lesions on the thenar or hypothenar eminences.
	www.pediatriconcall.com /fordoctor/DiseasesandCondition/infective_endocarditis.asp (1825 words)

	Liver Lesions -- Recommendations and Resources (Site not responding. Last check: 2007-10-19)
		Lesions can also be inflicted intentionally during surgery, for example to specific regions of the brain to treat epilepsy.
		Primary lesions are those that are directly associated with the disease process and usually appear early in the course of the disease.
		Those appearing later are called secondary lesions and may be a result of the ongoing disease process and changes to the primary lesions.
	www.becomingapediatrician.com /health/87/liver-lesions.html (543 words)

	White : Diseases of the Skin - Vasculitis and Related Disorders - SMALL-VESSEL LEUKOCYTOCLASTIC VASCULITIS
		This section addresses the causes, relevant investigations, and main differential diagnoses of this constellation of features, in which the histological correlate is a leukocytoclastic small-vessel vasculitis (leukocytoclasis implies the presence of fragmented nuclear remnants of neutrophil polymorphs in the perivascular and vessel-wall infiltrate).
		Individual lesions are a few millimeters to 1cm in diameter, purpuric, often palpable, and may be necrotic (especially around the ankles).
		The lesions are often more angular or stellate in shape compared with the circles and arcs of ordinary urticaria, and there may be associated purpura or bruising, although this can also occur in ordinary urticaria (especially if scratched due to itch).
	www.merckmedicus.com /ppdocs/us/hcp/content/white/chapters/white-ch-011-s005.htm (1631 words)

	Cecil Textbook of Medicine : />
		The skin should be carefully examined for embolic phenomena such as petechiae, Osler's nodes, Janeway's lesions, and splinter hemorrhages.
		Janeway's lesions are hemorrhagic, nonpainful macules most commonly found on the palms and soles; they are embolic in origin and are less frequently noted than the other cutaneous stigmata.
		Splinter hemorrhages are nonblanching, linear, brownish-red lesions in the nail beds perpendicular to the direction of growth of the nail; they may also be seen as a result of local trauma.
	www.merckmedicus.com /ppdocs/us/common/cecils/chapters/310_007.htm (1605 words)

	Turner White Communications - Review of Clinical Signs Questions
		The term "Janeway lesion" was coined by American physician Dr. Emanuel Libman.
		Janeway lesions are usually erythematous and nodular, and may appear hemorrhagic.
		Janeway lesions are usually found on the palms and soles.
	www.turner-white.com /rcs/may00/rcs_may00_endocard.htm (234 words)

	Postgraduate Medicine: Compiling the identifying features of bacterial endocarditis
		Lesions that are not affected by turbulent or high-velocity blood flow are less likely to develop into endocarditis.
		Skin inspection may show Janeway lesions (ie, flat, nontender, irregular, erythematous spots <5 mm in diameter on the palms and soles), Osler's nodes (ie, painful, tender, erythematous nodules on the extremities), and petechiae.
		Infectious endocarditis and sudden unexpected death: incidence and morphology of lesions in intravenous addicts and non-drug abusers.
	www.postgradmed.com /issues/2000/01_00/harris.htm (3327 words)

	Untitled Document
		Subungual splinter hemorrhages occur on the midportion of the nail bed and are suggestive, but not diagnostic, of bacterial endocarditis.
		Janeway lesions are painless erythematous macules to nodules on the palms or soles from septic emboli.
		Lesions with purulent purpura (white to gray centers with surrounding hemorrhagic halos) represent progression of Janeway lesions or initial metastatic pustules.
	dermatology.wustl.edu /dermsub/caseofmonth/7-8-2003a.html (480 words)

	THE MERCK MANUAL OF GERIATRICS, Ch. 90, Infective Endocarditis
		The underlying cardiac lesions that predispose the elderly to endocarditis tend to differ from those in younger patients.
		The second condition is bacteremia, which results in colonization of the lesion.
		Osler nodes (small, raised, tender subcutaneous nodules in the pads of the digits or on thenar eminences) and Janeway lesions (small, nontender hemorrhagic or erythematous macules on the palms or soles) may occur.
	www.merck.com /pubs/mm_geriatrics/sec11/ch90.htm (1573 words)

	Schamberg's Disease and Other Nonpalpable Purpuras - New Treatments, October 2, 2005 (Site not responding. Last check: 2007-10-19)
		Schamberg's disease, or pigmented purpuric dermatitis, is an idiopathic capillaritis that causes petechial lesions of the lower legs (occasionally the arms and trunk) in association with hyperpigmentation.
		The center of the lesion is dark gray, indicative of necrosis and impending slough.
		Splinter hemorrhages (linear, red to brown streaks under the fingernails or toenails); Osler nodes (2- to 15-mm, tender, red nodules on the pads of the fingers and toes); and Janeway lesions (small, painless plaques and palpable, purpuric nodules on the palms or soles) may be seen.
	www.ccspublishing.com /journals3a/schambers_disease.htm (529 words)

	Coda
		Janeway realizes that she isn't dead that her father is some kind of alien come to harvest her consciousness.
		I presumed that the reason Janeway kept dying was that the entity was trying to convince her to accept death.
		Just where does the pod with Janeway's body come from, the memorial service is in the messhall which is on the top part of the saucer section but the pod looked real close, considering the launchers for probes and torpedos where the pod should have come from are on the secondary hull.
	www.nitcentral.com /voyager/coda.htm (10618 words)

	The Johns Hopkins AIDS Service: Case Rounds (Site not responding. Last check: 2007-10-19)
		Sarcoidosis is not described as a complication of HIV infection, though it is a relatively common disease in the general population and thus is seen concurrently with HIV disease.
		Skin lesions are typically papules which may be present on the palms or soles; they epithelialize and thicken to produce keratoderma blenorrhagicum.
		The skin lesions shown in the photographs are not characteristic of erythema multiforme.
	www.hopkins-aids.edu /educational/caserounds/caserounds_3.html (1293 words)

	A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis -- Farrior ...
		A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis -- Farrior and Silverman 70 (2): 239 -- Chest
		A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis
		Janeway's lesions and Osler's nodes are regarded as excellent clues to the
	www.chestjournal.org /cgi/content/abstract/70/2/239 (204 words)

	JANEWAY (Site not responding. Last check: 2007-10-19)
		"JANEWAY" is a common misspelling or typo for: January.
		I don't know what you told Janeway, but you got him eatin' right out of your hand.
		The following table summarizes the usage of "JANEWAY" based on a population census conducted in the United States.
	www.websters-online-dictionary.org /definition/JANEWAY (337 words)

	CPC: Case Study (Site not responding. Last check: 2007-10-19)
		None of these lesions commonly extends into the chest wall, or is particularly common in children.
		The presence of an elevated white blood cell count and the tenderness of the mass lesion in the chest wall are difficult to reconcile with a malignancy, and are more suggestive of an inflammatory or infectious process.
		The presence of a heart murmur, along with poor dentition, suggests that the process might be endocarditis with septic embolization and chest wall abscess.
	oac.med.jhmi.edu /cpc/cases/2003/cpc5_answer.html (957 words)

	Untitled Document
		The common medical and postmortem complication are, multiple cardiovascular accidents (stroke), herniated brain stem, clubbing of the fingertips, small hemorrhages known as petechiae and irregular flat erythematous lesions known an Janeway lesions.
		One must be cognizant that the skin lesion may be infectious and communicable, often with antibiotic resistant microorganisms that may infect the embalmer.
		The necrosis is due to a lack of circulation secondary to vegetative organisms, atherosclerosis and emboli, which have migrated from the primary lesion.
	www.biomed.lib.umn.edu /hw/intravenous.html (1030 words)

	Janeway lesions - General Practice Notebook (Site not responding. Last check: 2007-10-19)
		Janeway lesions are painless palmar macules seen in patients with infective endocarditis.
		The information provided herein should not be used for diagnosis or treatment of any medical condition.
		Oxbridge Solutions Ltd® is an independent company owned by the authors which does not receive income from any other organisation or individual.
	www.gpnotebook.com /cache/2134179849.htm (79 words)

	CARDITIS
		Infective endocarditis is usually preceded by the formation of a predisposing cardiac lesion.
		Bacteria and platelets tend to accumulate tend to accumulate on the downstream or low-pressure side of a valvular lesion (Venturi effect).
		Janeway lesions- painless hemorrhagic plaques on the palms and soles.
	www.kcom.edu /faculty/chamberlain/Website/lectures/lecture/CARDITIS.htm (3140 words)

	eMedicine - Infective Endocarditis : Article by John L Brusch, MD, FACP
		The peripheral lesions of subacute IE are observed in only approximately 20% of patients, compared with 85% in the preantibiotic era.
		Janeway lesions are irregular erythematosus and painless macules (1-4 mm in diameter).
		In summary, the indications for performing echocardiography with Doppler in patients with IE are (1) to provide a baseline in proven or highly suggestive cases of IE and (2) to provide a means of documenting complications during therapy.
	www.emedicine.com /MED/topic671.htm (12730 words)

	Pediatric Page on Infective Endocarditis - from California Pacific Medical Center's Department of Pediatrics
		Endocarditis may affect congenital heart lesions (most commonly, tetralogy of Fallot, VSD, aortic stenosis, PDA and transposition of the great arteries), valves affected by rheumatic heart disease and mitral valve prolapse.
		Embolization of vegetation occurs in 50% of all cases and may be to the brain, liver, spleen, kidneys, peripheral limbs, and/or lungs.
		Petechiae, splinter hemorrhages and Janeway lesions (flat, painless, red to bluish red spots on the palms and soles) result from embolization.
	www.cpmc.org /advanced/pediatrics/physicians/pedpage-205cardio.html (818 words)

	An approach to the diagnostic use of echocardiography
		Oscillating intracardiac mass on valve or supporting structures or in the path of regurgitant jets, or on iatrogenic devices, in the absence of an alternating explanation, or
		Janeway’s lesions: nontender, hemorrhagic macules on palms and soles--<10%.
		MV lesions are most likely to embolize and lesions >10mm are more likely to embolize.
	www.med.unc.edu /medicine/web/endocarditis.htm (858 words)

	janeway lesions Resources
		Janeway lesions are seen in people with acute..
		Skip navigation Medical Encyclopedia Janeway lesion on the finger Janeway lesions are seen in people with acute bacterial endocarditis.
		Pathognomonic findings of Janeway lesions on the palms and soles...
	www.dermatologyneworleans.com /dermatologist/janeway-lesions.html (140 words)

	Bacterial Infections of the Mouth Including Gingivitis and Periodontitis from Dermatology / Diseases Of The Oral Mucosa (Site not responding. Last check: 2007-10-19)
		The lesion of BE is a vegetation that develops on a heart valve.
		Cardiac lesions are usually valvular with vegetative lesions occurring on the line of contact with damaged valve cusps.
		Embolizations of these friable lesions are vegetations that detach and lodge in distal arterioles of every organ system causing infection and infarction of remote tissues including extremities, spleen, kidney, bowel, or brain.
	author.emedicine.com /DERM/topic657.htm (7836 words)

	eMedicine - Endocarditis : Article by Keith Marill, MD (Site not responding. Last check: 2007-10-19)
		Pathophysiology: Infective endocarditis generally occurs as a consequence of nonbacterial thrombotic endocarditis, which results from turbulence or trauma to the endothelial surface of the heart.
		Transient bacteremia then leads to seeding of lesions with adherent bacteria, and infective endocarditis develops.
		Janeway lesions - Nontender maculae on the palms and soles
	www.emedicine.com /emerg/topic164.htm (2939 words)

	Endocarditis, Pericarditis, and Myocarditis (Site not responding. Last check: 2007-10-19)
		In the classic review of the clinical presentation of endocarditis in children by Johnson et al, fever was present in 87%, new murmur in 85%, splenomegaly in 65%, congestive heart failure in 34%, systemic emboli in 30% and pericardial effusion in 21%.
		Pathognomonic findings of Janeway lesions on the palms and soles and Osler’s nodes are less common in children.
		The clinical presentation of infective endocarditis may vary with the causative organism.
	home.coqui.net /myrna/myocar.htm (1398 words)

	Management of Patients With Valvular Heart Disease Guidelines:Evaluation and Management of Infective Endocarditis
		Clinical suspicion of infective endocarditis may be raised by the presence of fever and other systemic symptoms coupled with physical findings such as Osler's nodes, petechiae, Janeway lesions, Roth spots, splenomegaly, and a cardiac murmur.
		At present, these physical signs are less commonly encountered, and definitive diagnosis is made by demonstrating an offending organism by blood culture.
		These consequences include valvular vegetations; valvular regurgitation; ventricular dysfunction; and associated lesions such as abscesses, shunts, and ruptured chordae (495).
	www.acc.org /clinical/guidelines/valvular/jac5929fla112.htm (1201 words)

	Lesion Liver -- Recommendations and Resources (Site not responding. Last check: 2007-10-19)
		Skin Lesions can include moles, cysts, warts or skin tags.
		Most are benign but are sometimes removed if they are painful, unsightly or restrict movement.
		Other topics related to Lesion Liver: Lesions Liver
	www.becomingapediatrician.com /health/85/lesion-liver.html (540 words)

	[No title]
		Evidence of endocardial involvement by echo (endocardial vegetation, paravalvular abscess, new partial dehiscence of prosthetic valve, or new valvular regurgitation Minor criteria: Predisposition: Predisposing heart condition or IVDU.
		Fever: (38* Vascular phenomena: Arterial emboli, septic pulmonary infarcts, mycotic aneurysm, conjunctival hemorrhages, or Janeway lesions.
		Nonmobile echogenic densities on the valves may be consistent w/vegetations, but not pathognomonic for infective endocarditis.
	cybermed.ucsd.edu /isp/2002/antons/endocarditis.doc (735 words)

	Postgraduate Medicine: The many faces of Staphylococcus aureus infection
		An important clue to this diagnosis is the presence of focal, rounded, and sometimes cavitary infiltrates on chest radiograph; these infiltrates are the result of septic pulmonary embolization (figure 2: not shown).
		Findings resulting from immunologic phenomena, such as splenomegaly, Osler's nodes, positive rheumatoid factor, and immune complex glomerulonephritis, tend to be less common in S aureus endocarditis than in classic subacute endocarditis, such as that caused by viridans streptococci.
		However, findings resulting directly from infection of distal vessels, such as Janeway lesions, petechiae, and conjunctival or retinal lesions, may be seen.
	www.postgradmed.com /issues/2001/10_01/weems.htm (3301 words)

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