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Antiviral Drugs as Tools for Nanomedicine
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
HIV (human immunodeficiency virus) is a virus that attacks the immune system. If HIV remains untreated, it can lead to AIDS (acquired immunodeficiency syndrome). There is currently no effective cure for this syndrome; once infected, it is for life. HIV-infected people are at higher risk of developing cancer, although it is globally diminished in the era of highly active antiretroviral treatment (HAART) (Shmakova et al. 2020) (Figure 12.7).
Cervical insufficiency
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Sonia S. Hassan, Roberto Romero, Francesca Gotsch, Lorraine Nikita, Tinnakorn Chaiworapongsa
In a manner similar to preterm labor, pre-eclampsia, small for gestational age, fetal death, and preterm premature rupture of membranes (PROM), the clinical conditions that describe cervical insufficiency can be considered “an obstetrical syndrome” (98). Cervical ripening in the midtrimester may be the result of (i) the loss of connective tissue after a cervical operation such as conization (99–101) or loop electrosurgical excision procedure (LEEP) (101), (ii) a congenital disorder such as cervical hypoplasia after diethylstilbestrol (DES) exposure (102–105), (iii) intrauterine infection (106–108), (iv) a suspension of progesterone action (34,35): there is experimental evidence that progesterone can reverse cervical compliance induced by the administration of dexamethasone to pregnant sheep (109). Moreover, recent studies have indicated that progesterone administration to women with a short cervix can reduce the rate of preterm birth (110,111), or (v) a cervical disorder. Each of these different causes of the syndrome could be affected by genetic or environmental factors (Figure 5) (42). Moreover, more than one mechanism of disease may be operative in a specific patient. The possibility of novel and yet to be discovered mechanisms of disease playing a role must also be considered.
Cotard’s syndrome (le délire de négation)
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
If the syndrome occurs in association with some organic state, the treatment will be that of the underlying condition, if this is possible. If it is part of a pre-senile or a senile dementia, then there is little likelihood of improvement. If, however, it is part of a toxic confusional state, then it may clear completely with adequate treatment, and examples of this are reported in the literature, including a case of typhoid fever manifested as an acute Cotard’s syndrome (Campbell et al., 1981). Ahlheid’s (1968) three patients with mixed pathology give us an indication of the prognosis in such cases.
“They are dealing with people’s lives…”: Diagnostic and post-diagnostic healthcare experiences in primary progressive aphasia
Published in International Journal of Speech-Language Pathology, 2023
Tisha Ho, Anne Whitworth, Deborah Hersh, Jade Cartwright
First contacts with the health system typically involve the person with PPA approaching their general practitioner (GP) or a medical specialist with concerns relating to language (Prorok et al., 2013). Once initiated, the diagnostic assessment process usually involves a battery of tests, neuroimaging, and a series of other medical investigations (Nickels & Croot, 2014). For an accurate clinical diagnosis to be made, neuropsychological assessments are often recommended in conjunction with comprehensive language assessment and the medical team is then tasked with delivering diagnostic and prognostic information to the client (Volkmer et al., 2020). People with dementia and their families have raised concerns about how diagnostic information is conveyed, resulting in uncertainty about the future and lack of direction regarding where to go next (Quinn et al., 2008). In a study on prognostication in post-stroke aphasia, Cheng et al. (2020) highlighted the sensitivity required in communicating prognostic information and considering a person’s current and evolving needs. In the context of PPA, prognostication can be particularly challenging due to the variable and complex nature of the syndrome (Henry & Grasso, 2018; Volkmer et al., 2023). Although several studies have investigated evidence-based guidance and support for prognostication in post-stroke aphasia and the broader dementia literature, to our knowledge, such guidelines are not available in the context of PPA. The way in which diagnoses are communicated, however, is critical in setting up subsequent healthcare trajectories (Cheng et al., 2020).
Mechanical filtration of the cerebrospinal fluid: procedures, systems, and applications
Published in Expert Review of Medical Devices, 2023
In some AE cases, clinical syndromes are characteristic of their associated antigen-specific autoantibody, but unspecific clinical pictures are also common. While the most common AE are the neuromyelitis optica spectrum disorders and the anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis, the number of AE and associated antibodies described in the last decades has been increasing continuously [25]. Patients may present with a variety of syndromes. In some cases, they may develop rapid and profound deterioration in the level of consciousness and present in a coma or with established focal neurological deficits, causing ventilatory impairment or failure to protect the airway. Treatment of experimental-autoimmune-encephalomyelitis (EAE) mice with CSF exchange enriched with mesenchymal stem cells secretions caused a significant delay in the onset of EAE and amelioration of the clinical symptoms, paralleled by a reduction in axonal damage and demyelination [26].
Discovering strengths in patients with medically unexplained symptoms – a focus group study with general practitioners
Published in Scandinavian Journal of Primary Health Care, 2022
Ingjerd Helene Jøssang, Aase Aamland, Stefan Hjörleifsson
General practitioners (GPs) meet many patients with persistent and disabling symptoms without corresponding objective findings. Such symptoms do not fit with the traditional biomedical disease model. ‘Medically unexplained symptoms’ (MUS) is one of the notions used for such conditions [1]. Conditions like chronic fatigue syndrome, irritable bowel syndrome and fibromyalgia are among the most well-known MUS entities, while musculoskeletal pain, tiredness, gastrointestinal complaints, dizziness and different sensory symptoms are often also ‘medically unexplained’. GPs play a key role in the follow-up and management of patients with MUS. Although ascertaining the prevalence of MUS is notoriously difficult, we know that the prevalence in general practice is high [2]. Depending on the definition of MUS, studies have suggested that a range between 3% and more than 2/3 of all consultations in general practice involve MUS [3–5]. MUS also cause big costs in society due to for instance health care use and sick leave [6,7].