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Toxoplasma gondii
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Acquired toxoplasmosis may rarely be associated with multiple organ involvement (339). The most prominent is central nervous system disease with or without concomitant involvement of the lung, heart, liver, and muscle. This occurs as a result of diffuse and uncontrolled dissemination of the organism throughout the body (13). As a result, patients may present with nonspecific neurological symptoms such as confusion, seizures, disorientation, and lethargy. Patients may also complain of symptoms and signs of fever, arthralgia, myalgia, and maculopapular rash. Muscle biopsy may reveal evidence of myositis (337,338). Cardiac involvement may be associated with congestive heart failure and electrocardiographic abnormalities due to arrhythmias (327). Toxoplasma has also been implicated as a cause of diffuse interstitial pneumonitis in the healthy adult (341a,341b,341c,342).
Medical Problems in Alcoholics
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Figure 10 illustrates data on the prevalence of central nervous system disease at various ages in comparison with liver disease to make the important point that older persons have more CNS disease. In this figure, permanent CNS disease included Wernicke-Korsakoff psychosis, cerebellar degeneration, and cerebral atrophy found on CT scanning. The most prevalent CNS lesion after withdrawal is complete is a defect in short-term memory, which disappears after 3 to 12 weeks of abstinence.
Apparent Sudden Visual Loss: An Essential Approach
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Other: In cases of suspected giant cell arteritis, palpate the superficial temporal artery pulses; an absent pulse and thickened vessel is highly suspicious of giant cell arteritis. This is best palpated just anterior and superior to the tragus (above the zygomatic arch of the temporal bone). In cases of suspected central nervous system disease (e.g. stroke, multiple sclerosis), it may be necessary to perform a neurological examination (cranial nerve examination and upper and lower limb neurological examination). In cases of amaurosis fugax, central retinal artery occlusion and ocular ischaemic syndrome, it can be useful to auscultate the carotids for bruits.
Age, creatinine, and ejection fraction (ACEF) score as predictive values for late non-valvular atrial fibrillation recurrence after radiofrequency ablation
Published in Clinical and Experimental Hypertension, 2023
Yan Luo, Yan Tang, Wenchao Huang, Shiqiang Xiong, Yu Long, Hanxiong Liu
Exclusion criteria were defined as follows: 1) the patient had left atrial thrombosis or other absolute contraindications for catheter ablation surgery; 2) history of left intra-atrial catheter ablation and left atrial surgery; 3) AF caused by reversible and pathological factors, including hyperthyroidism, drugs, or alcoholism; 4) left ventricular dysfunction<30% or severe cardiac valvular disease, including severe aortic stenosis or aortic insufficiency, severe mitral valve stenosis or incomplete closure, and mitral valve replacement surgery; 5) patients with serious liver disease (i.e., three times the normal value of transaminase), malignant tumors, autoimmune tumors, and other diseases; 6) acute coronary syndrome requiring interventional treatment; 7) active presence of hemorrhagic disease, systemic infection, organ failure, or any other factor precluding surgery; 8) patients with cognitive impairment, central nervous system disease, or severe peripheral nerve disease; 9) patients with incomplete clinical records; and 10) life expectancy less than 1 year. A total of 325 eligible patients with baseline blood creatinine levels, age, and EF values, together with complete clinical data availability, were included and considered suitable for post analysis.
Management of Neonatal Herpes Simplex Infection: A Rare Case of Blepharoconjunctivitis and Concurrent Epithelial and Stromal Keratitis
Published in Ocular Immunology and Inflammation, 2018
Rita J. C. Matos, Joana M. S. Pires, Dionísio Cortesão
Neonatal herpes is the most severe manifestation of HSV infection occurring during pregnancy or during the perinatal period.3 Disseminated and central nervous system disease can be devastating, with a considerable mortality rate and an elevated risk of permanent neurologic disabilities, including cerebral palsy and mental retardation, among the survivors.3 Although SEM disease has a lower level of morbidity and mortality, the risk of dissemination is high if the treatment is not promptly initiated.1 In our case, visceral dissemination was ruled out clinically and biomechanically, so we classified the herpetic infection as a SEM disease. In these cases, infants typically respond well to systemic acyclovir therapy, and prognosis for normal neurologic development is good.1 In the present case, despite the clinical presentation (presence of skin vesicles, unilateral blepharoconjunctivitis, and clear discharge), which pointed towards herpetic conjunctivitis, the ulcer was geographic and the time of presentation was compatible with other bacterial conjunctivitis. We thus decided to start empiric treatment while the test results were processing. Topical acyclovir was not used because there are local toxicity issues with topical agents that can be avoided using oral regimes. In a recent review, the authors concluded that acyclovir is safe and well tolerated as a treatment in the pediatric population, and preferable to difficult and toxic eye-drop regimes.4
Prevalence of Low Scores on Executive Functions Tests in a Spanish-Speaking Pediatric Population from 10 Latin American Countries and Spain
Published in Developmental Neuropsychology, 2020
Itziar Benito-Sánchez, Isabel Gonzalez, Rafael E. Oliveras-Rentas, Rosario Ferrer-Cascales, Ivonne Romero-García, Juan Carlos Restrepo Botero, Ivan Darío Delgado-Mejía, Esperanza Vergara-Moragues, Diego Rivera, Juan Carlos Arango-Lasprilla
The parents (or guardians) of each potential child or adolescent participants answered a sociodemographic questionnaire about the subjects’ medical history and health status. Participants were excluded according to the following criteria: a) having a history of a central nervous system disease that is associated with neuropsychological problems (e.g. epilepsy, brain injury, movement disorders, multiple sclerosis, brain tumor, stroke); b) having a history of alcohol abuse and/or consumption of psychotropic substances; c) having some type of active or uncontrolled systemic disease associated with cognitive impairment (e.g. diabetes mellitus, hypothyroidism, vitamin B12 deficiency); d) having a history of psychiatric illness (e.g. mayor depression, bipolar mood disorder, psychosis); e) having severe sensory deficits (e.g. loss of vision and/or hearing) that affect the administration of or performance on the tests; f) being on a psychiatric or other medications that could alter cognitive performance; g) having an intellectual or learning disability or other neurodevelopmental disorders; h) having a history of pre-peri-, and post-natal problems (e.g. hypoxia, jaundice, seizures, hydrocephalus, spine bifida, neuromuscular disorders); i) having a score of >5 on the Alcohol Use Disorders Identification Test (AUDIT-C) for participants 12 years of age and older; and j) using psychoactive substances such as heroin, barbiturates, amphetamines, methamphetamines, or cocaine in the last 6 months for participants 12 years of age and older. For further information regarding study’s procedure, see Rivera and Arango-Lasprilla (2017), and Rivera, Olabarrieta-Landa, & Arango-Lasprilla (2017a). The centers that agreed to participate in the study requested approval from their institution/center’s ethics committee.