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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.
Differentiation Induction in Acute Promyelocytic Leukemia
Published in Gertjan J. L. Kaspers, Bertrand Coiffier, Michael C. Heinrich, Elihu Estey, Innovative Leukemia and Lymphoma Therapy, 2019
Before the introduction of ATRA, extramedullary disease (EMD) in APL was rarely reported. However, the occurrence of this phenomenon is increasingly observed after treatment with ATRA. While the incidence of EMD appears to be increased in patients receiving ATRA, a report by the GIMEMA compared the risk of developing EMD in two consecutive studies, the LAP0389 and AIDA. Patients receiving ATRA did not appear to have an overall increased risk of EMD (40). However, an increased risk of central nervous system disease was suggested. It is possible that the prolonged survival achieved by treatment with ATRA may account for the perceived increased occurrence of EMD or possibly lack of exposure to ara-C in many patients. Common sites of EMD are the skin (particularly at sites where vascular disruption occurred), central nervous system, external auditory canal, and testis (41–43). Risk factors for developing EMD in APL appear to be a hyperleukocytosis at diagnosis, microgranular variant of APL, and the bcr3 type of the PML-RARα fusion transcript (41). Patients with EMD at relapse may still be salvaged with differentiation therapy. Tsimberidou and colleagues, reported treating two patients with CNS relapse with a combination of ATRA, arsenic trioxide, and gemtuzumab ozogamicin and both achieved CR (42). Others reported successful treatment of EMD relapses with ATRA containing regimens as well (44,45).
Other neurological diseases
Published in Claude Leray, Dietary Lipids for Healthy Brain Function, 2017
Neurological disorders discussed in this chapter are considered as integral part of the nervous system diseases. They most often affect the brain, but they also the spinal cord and nerves. Besides Alzheimer’s disease (Chapter 4), three other major neurological diseases show motor and sometimes mental aspects at different times in life: Parkinson’s disease (Section 5.1), multiple sclerosis (Section 5.2), and epilepsy (Section 5.3).
Neuromuscular disorders in women and men with spinal cord injury are associated with changes in muscle and tendon architecture
Published in The Journal of Spinal Cord Medicine, 2023
Larissa Santana, Emerson Fachin-Martins, David Lobato Borges, Jonathan Galvão Tenório Cavalcante, Nicolas Babault, Frederico Ribeiro Neto, João Luiz Quagliotti Durigan, Rita de Cássia Marqueti
Central nervous system diseases, including brain or spinal cord injury (SCI) and may result in movement disorders, almost always manifested by paralyzed muscles with preserved innervations.1 In the first month after the SCI, muscle thickness decreases by up to 40%, with the period of up to three months indicated as the “early stage” of disuse paraplegia.2,3 In addition, a decrease in muscle mass ranging from 20% to 40% has been demonstrated in lower limb extensor muscles.4 Individuals with incomplete SCI undergo marked atrophy of all affected lower extremity muscles, with a 24% (tibialis anterior) to 31% (quadriceps femoris) reduction in cross-sectional area (CSA).5 Moreover, loss of muscle mass and force could be primarily related to a decrease in muscle fiber numbers due to an early degenerative muscle process after SCI.4,6 Besides the muscle loss, neurogenic osteoporosis in men with SCI can also be considered by reductions in trabecular bone mass by 50–60% and cortical bone mass by 30%.7,8.
Enhanced anti-angiogenetic effect of transferrin receptor-mediated delivery of VEGF-trap in a glioblastoma mouse model
Published in mAbs, 2022
Peng Zhao, Yasuaki Anami, Peng Gao, Xuejun Fan, Leike Li, Kyoji Tsuchikama, Ningyan Zhang, Zhiqiang an
Diseases in the central nervous system (CNS), including cancer (e.g., glioblastoma (GBM) and glioma), neurodegenerative diseases (e.g., Parkinson’s disease and Alzheimer’s disease), autoimmune diseases (e.g., multiple sclerosis), nervous system disease (e.g., amyotrophic lateral sclerosis), and genetic disorders (e.g., lysosomal storage diseases (LSDs)), are often difficult to treat. Antibody and protein-based drug modalities are promising options in treating CNS diseases, yet a very limited number of approved therapies are in this category.1, 2 One of the major hurdles for developing antibody and protein-based therapeutics for CNS diseases is the low brain entry, which is largely due to existence of the blood-brain barrier (BBB).3 The BBB is formed by the endothelial cell tight and adherent junctions that severely restrict the entry of macromolecules administered peripherally.4–6
Correlates of Concurrent Morbid Obesity and Tobacco Use Disorder Nationally in the Veterans Health Administration
Published in Journal of Dual Diagnosis, 2020
Walter Roberts, Robert A. Rosenheck
This finding is novel in that it describes a less well-recognized multimorbidity process. The most commonly described multimorbidity process (complementarity) is that multiple diseases exert an additive negative effect on health, quality of life, functional outcomes, and mortality risk (Marengoni et al., 2011). We observed this additive pattern of risk in the current study in that the multimorbid group showed higher rates of medical and psychiatric disease compared to the single condition groups. This pattern suggests that multiple disease states signal likely signal underlying health vulnerabilities and may place additive stress on affected organ systems, resulting in poorer general health outcomes. Alternatively, the presence of one disease state might mitigate some of the processes and problems associated with a co-occurring condition. This relationship between disease states has been described for non–central nervous system diseases (Stiehm, 2006), but far fewer examples of this multimorbidity pattern have been described for behavioral conditions. Given the potentially ameliorative effect of overeating/obesity in this context, it is possible that treating this condition may have the unintended effect of potentiating substance use disorder risk in tobacco users.