Diseases of the Nails
Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang in Roxburgh's Common Skin Diseases, 2022
There are two main clinical presentations: A small reddish or bluish spot <1 mm, seen through the nail, often in the lunula, associated with sharp pain.A longitudinal erythronychia with distal notching glomus tumors, frequently associated with Recklinghausen neurofibromatosis (NF) type I.Laboratory studies: The patient will experience severe pain when a pin is pressed against the area. The cold test (ice cube) exacerbates the pain. Interestingly, a tourniquet placed at the base of the digit stops the pain. Dermatoscopy may preoperatively localize the tumor, while a flat-plate x-ray should reveal a depression on the dorsal aspect of the distal phalangeal bone or even a cyst in about 50% of cases. If the tumor cannot be localized, an MRI offers the highest sensitivity. Sometimes, the coexistence of several tumors may be diagnosed.
The Sleeping Brain
Hanno W. Kirk in Restoring the Brain, 2020
Published reports of the benefits of neurofeedback for persons with epilepsy, insomnia and ADHD appeared in the 1970s.92,93,94 This is not a new therapy. By now the collective literature is robust. Therapeutic protocols of NF are based on accepted principles of neuroanatomy and neurophysiology. Moreover, NF, through its effects on brain self-regulation, holds the promise of uncovering much of the inner workings of brain functioning. The effect size of improvements with NF compares favorably to that of pharmacotherapy, and NF avoids the potential deleterious effects of medications used to treat these conditions. Thus far there are no indications that NF produces any long-term adverse effects when it is in qualified, competent hands. Finally, the evidence indicates that effects of NF are long lasting – a clear advantage over the usual pharmacotherapy. As such, it is incumbent upon clinicians/researchers who treat persons with neuropsychological conditions to consider seriously the information contained in this chapter, and in this volume. This will require a paradigm shift among all health care professionals, but the benefits to our patients are potentially enormous.
Toxic shock syndrome
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
Necrotizing fasciitis is defined as a deep-seated infection of the hypodermic tissue, progressing to destroy fascia, and sparing muscle tissue (Figures 25.8 through 25.12). The most common causal agent is GAS. A history of superficial, blunt trauma precedes the infection. Early distinction from simple cellulitis is often difficult, distinguished by “out-of-proportion” pain. Late markers comprise tense edema, stark erythema, and bullae impending rupture, which turn bluish over time. NF is associated with a multitude of systemic symptoms and high morbidity, in spite of usage of antibiotics, dialysis, ventilators, IV fluids, and improved surgical techniques. It is postulated that newer strains of GAS are highly virulent, and thereby somewhat resistant to conventional therapy [17].
The efficacy of neurofeedback for alcohol use disorders – a systematic review
Published in The World Journal of Biological Psychiatry, 2023
Forum Dave, Ravikesh Tripathi
Eleven EEG-based NF studies have been included in our study. Ghosh et al. (2014) reported that after 10 sessions of EEG NF training the patient’s cognitive deficiencies, anxiety and sadness were significantly reduced. Passini et al. (1977) studied the therapeutic effectiveness of alpha-wave biofeedback therapy for alcoholics, and reported that 10 h-long alpha training sessions had significant improvement in long-term therapeutic benefits on anxiety than the control group. DeGood and Valle (1978) reported that the self-regulation of occipital alpha density was found to be superior in non-users of alcohol compared to users of alcohol after alpha biofeedback sessions. Ko and Park (2018) investigated whether NF training can normalise the excessive high-beta and low-alpha waves. They found no significant difference between the two experimental and control group when it came to reducing brain hyperarousal. The experiment group that received NF training, on the other hand, had a significant rise in fundamental psychological need satisfaction, alcohol abstinence self-efficacy and self-regulation.
Pharmacotherapeutic options for cancer cachexia: emerging drugs and recent approvals
Published in Expert Opinion on Pharmacotherapy, 2023
Lorena Garcia-Castillo, Giacomo Rubini, Paola Costelli
Anti-cytokine strategies are based on the blockade of a cytokine synthesis or action. Relevant examples are etanercept, infliximab, pentoxifylline, and thalidomide. Pentoxifylline, an agent reducing blood viscosity, etanercept, and infliximab, both anti-TNF-α monoclonal antibodies, have been studied as TNF-α targeting agents, showing that no improvement of cachexia could be observed in cancer patients [33,35]. Thalidomide is a glutamic acid derivative able to suppress several cytokines (including TNF-α and IL-6) and to inhibit NF-kB, thereby exerting, among others, an anti-inflammatory effect. Patients treated for four weeks with thalidomide gained 0.37 kg of body weight and 1.0 cm3 in arm muscle mass, while the placebo group lost 2.21 kg and 4.6 cm3, respectively [33]. The most promising results came from a phase II study in which non-small cell lung cancer patients administered a humanized anti-IL6 antibody showed improvement of anemia and cachexia [36]. Consistently, tocilizumab, an anti-IL6 receptor antibody was reported to effectively counteract cachexia. However, nowadays no anti-IL6 strategy reached the approval for clinical use.
Identifying aggressive subsets within diffuse large B-cell lymphoma: implications for treatment approach
Published in Expert Review of Anticancer Therapy, 2022
Timothy J Voorhees, Narendranath Epperla
Shipp and colleagues developed an alternative genetic subtype strategy utilizing WES with an expanded set to capture structural variants from 304 DLBCL patient samples along with consensus clustering [6]. This analysis described five distinct clusters, termed C1-C5. Interestingly, there was considerable overlap between several clusters to those described by Staudt and colleagues. C1 was characterized by BCL6 structural variants and NOTCH2 mutations, which closely aligned with the BN2 subtype. C3 was characterized by BCL2 structural variants and EZH2 mutations, closely resembling the EZB subtype. C2 and C4 represented new categories not previously described. C2 was characterized TP53 inactivating mutations and 17p copy loss, which coincided with frequent deletion 9p21.13/CDKN2A and deletion 13q14.2/RB1. C4 was characterized by mutations in histone linker proteins, BCR/PI3K pathway, NF-kB modifiers, and RAS/JAK/STAT pathway family members. With respect to clinical outcomes, small differences in PFS were observed between the clusters with C3 and C5 having the worst PFS and C1 and C4 having the best PFS. However, compared to the IPI risk stratification, no cluster was particularly effective in risk stratifying DLBCL.
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