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Cardiovascular Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
About 50% of patients lose peripheral pulses because the dissection occludes a branch artery. This can include the spinal arteries, so patients can present with paraplegia. There may be AR if the dissection dislocates the aortic valve ring or MI if it involves a coronary orifice.
No organ can make the body sick
Published in Dinesh Kumar Jain, Homeopathy, 2022
Kent also said, “One organ cannot make another organ sick”. But the whole medical knowledge says that one damaged organ always damages the other organ. I am giving a few examples. Chronic obstructive lung disease is a disease of the lung. After sometime, this disease damages the heart, which is labeled as cor pulmonale. Cancer of one organ affects various organs of the body by metastasis. “Carcinoma in the kidney affects adrenal gland, bone, brain, heart, lung, liver, lymph node, ovary, pancreas, skin, spleen, thyroid gland and muscles” (Lee, 1976, p. 538). Similarly, cancer of many organs can affect other organs of the body. Disease of the pancreas gives rise to diabetes mellitus. Diabetes of prolonged duration damages the kidney, eye, and nervous system. Damage in the brain also causes damage to other organs of the body. Brain controls all functions of the body. Damage in the brain leads to hemiplegia, paraplegia, vision loss, speech loss, etc. Hemiplegia means paralysis of half of the body, and paraplegia means paralysis of both the lower limbs. Conclusively, Kent was again wrong in his observations.
Neuropsychiatry in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
The first cinematic presentation of these neurologic symptoms appeared in a short educational film by Arthur Hurst. a neurologist at the Royal Victoria Hospital, Netley. War Neurosis was filmed in Seale Hayne Military Hospital in 1917 and 1918 and showed several abnormal movements, postures (dystonia), and gaits in 21 soldiers (Figure 8.2). One soldier with receptive aphasia does not respond to questions, except that the sudden introduction of the word “bomb,” would suddenly cause the soldier to dive under his bed. Hurst used intertitles to explain the best approach to their problems, which he postulated as “education,” followed by “persuasion” and “re-education,” combined in most cases with “manipulation”—all rather vague descriptions of interventions that seemed to have originated in his mind. Cures could be rapid; one example showed an abnormal gait at 2 pm that was “cured” by 3 pm. In another, a patient with functional paraplegia for 18 months was “cured after a quarter of an hour’s suggestion and re-education.” Sudden recovery of memory after 8 months of complete amnesia was described. Eighteen patients (86%) had partial or complete recovery, two were not shown in the film, and one had no benefit.
Pre-implantation genetic testing for Marfan syndrome using mini-sequencing
Published in Journal of Obstetrics and Gynaecology, 2022
Sirivipa Piyamongkol, Krit Makonkawkeyoon, Vorasuk Shotelersuk, Opas Sreshthaputra, Tawiwan Pantasri, Rekwan Sittiwangkul, Theera Tongsong, Wirawit Piyamongkol
The genetic basis of Marfan syndrome is from various mutations within the fibrillin-1 (FBN-1) gene, with over 400 mutations having been reported. About a quarter of MFS are a result of de novo mutations (Robinson et al. 2002). The FBN-1 gene is 230-kb in size, located on 15q21.1 (Lee et al. 1991). The FBN-1 gene is composed of 65 exons, encoding a 2871 amino acid long profibrillin. Profibrillin is then cleaved into FBN-1 by the furin convertase enzyme. Structural defects in fibrillin protein caused decreased vascular strength (Robinson et al. 2006). Some Marfan patients require emergency surgery for aortic root dissection and many need prophylactic aortic root replacement. Aortic surgery is a major surgical procedure with a high intraoperative and postoperative mortality risk even in experienced centres (Fletcher et al. 2020). Permanent paraplegia is one of the most devastating complications with an incidence of 3–5% in elective cases and 19% in emergency cases (Robinson et al. 2006). In addition, re-operative cardiac surgery is not uncommon in Marfan syndrome patients with aortopathy due to dissection of other parts of the aorta (Fletcher et al. 2020).
Acute exercise improves glucose effectiveness but not insulin sensitivity in paraplegia
Published in Disability and Rehabilitation, 2022
Gary J. Farkas, Ann M. Swartz, Ashraf S. Gorgey, Arthur S. Berg, David R. Gater
This study is not without limitations. First, this study had a small sample size in both the SCI and AB groups raising the possibility of a type 2 error. However, this sample size is consistent with exercise-based SCI research [19,56,57,62]. Second, we did not control for or monitor diet; although, participants were provided a standard lunch and dinner through the GCRC and were fasted for 10–12 h prior to each IVGTT. Third, we did not match AB controls based on demographic characteristics and only examined individuals with motor complete paraplegia. Individuals with incomplete injuries and/or lower levels of injury (e.g., paraplegia) may have disproportionate changes in cardiorespiratory function following the injury, and therefore confound the study findings. This study controlled for level and completeness of injury by only including individuals with motor complete paraplegia. Future research will need to evaluate the influence of diet on acute glucose kinetics and if a dichotomy exists between persons with tetraplegia and paraplegia.
Clinically suspected fibrocartilaginous embolism: a case report and literature review
Published in International Journal of Neuroscience, 2022
Wencan Ke, Chao Chen, Shuai Li, Bingjin Wang, Saideng Lu, Cao Yang
Neurologic deterioration after surgery is a serious complication. Paraplegia during medical treatment may result from mechanical damage to the spinal cord or disturbances of the blood supply [1]. Spinal cord infarction (SCI) occurs rarely, always resulting in severe sequelae, such as numbness and paralysis of all 4 extremities, dyspnea, decreased blood pressure and even death [2, 3]. In case of acutely progressive spinal cord symptoms, diagnosis of SCI is often difficult to distinguish from acute myelitis and other myelopathies, as these patients may have similar clinical presentations. Fibrocartilaginous embolism (FCE) is an uncommon cause of SCI, which was first reported in a 15-year-old boy after autopsy in 1961 [4]. Here, we report the case of an older woman who developed acute spinal cord symptom on the 10th day after thoracic spine surgery, with a presumptive diagnosis of FCE based on the typical clinical and radiological features. Furthermore, 40 clinically suspected cases of FCE were reviewed.