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Brain and Nerve = Shinkei Kenkyu No... May 2024Fisher syndrome is recognized as a variant of Guillain-Barré syndrome, encompassing acute onset immune-mediated neuropathies marked by the classical triad of ataxia,... (Review)
Review
Fisher syndrome is recognized as a variant of Guillain-Barré syndrome, encompassing acute onset immune-mediated neuropathies marked by the classical triad of ataxia, areflexia, and ophthalmoplegia. Generally, Fisher syndrome follows a self-limited course with a good prognosis. Ophthalmoplegia, typically bilateral, progresses to complete external ophthalmoplegia within 1-2 weeks. Ataxia, often very severe, may cause an inability to walk without support despite normal strength. Fisher syndrome is also frequently concomitant with additional clinical features, including ptosis, internal ophthalmoplegia, facial nerve palsy, sensory deficits, and bulbar palsy. The confirmation of an antecedent infection is often established. Among the ganglioside antibodies, anti-GQ1b antibodies exhibit positivity in over 80% of patients. The syndrome manifests in three distinct types: a partial subtype exhibiting only a subset of the triad symptoms, Bickerstaff's brainstem encephalitis marked by impaired consciousness and pyramidal tract signs, and an overlapping subtype with Guillain-Barré syndrome, characterized by weakness in the extremities.
Topics: Humans; Miller Fisher Syndrome; Gangliosides; Prognosis; Guillain-Barre Syndrome
PubMed: 38741489
DOI: 10.11477/mf.1416202636 -
History of Psychiatry Dec 2023A new psychiatric institution emerged in the late nineteenth and early twentieth centuries: the psychopathic hospital. This institution represented a significant...
A new psychiatric institution emerged in the late nineteenth and early twentieth centuries: the psychopathic hospital. This institution represented a significant development in the history of psychiatry, as it marked the profession's reorientation from asylum-based to hospital-based care, and in this way presaged the deinstitutionalization movement that would begin half a century later. Psychopathic hospitals were also an important marker of psychiatry's efforts to redefine its professional boundaries and respond to its vociferous critics. This entailed both a rapprochement with general medicine in an effort to assert its scientific bona fides and a redefinition of its scope of practice to absorb non-certifiable 'borderland' cases in order both to emphasize non-coercive treatment and to enlarge the profession's boundaries.
Topics: Humans; Psychiatry; Hospitals, Psychiatric
PubMed: 37691414
DOI: 10.1177/0957154X231194910 -
International Journal of Molecular... Dec 2023Cardiometabolic diseases (CMD) remains the major cause of morbidity and mortality in Western countries, with a marked increased in the last years [...].
Cardiometabolic diseases (CMD) remains the major cause of morbidity and mortality in Western countries, with a marked increased in the last years [...].
Topics: Humans; Risk Factors; Cardiovascular Diseases; Lipids
PubMed: 38139288
DOI: 10.3390/ijms242417460 -
Journal of the Neurological Sciences Jul 2023To assess marked central canal T2-hyperintensity in patients with myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) myelitis compared to myelitis...
OBJECTIVE
To assess marked central canal T2-hyperintensity in patients with myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) myelitis compared to myelitis patients with aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD) and multiple sclerosis (MS).
MATERIAL/METHODS
Two blinded raters evaluated spinal cord magnetic resonance imaging (MRIs) of myelitis patients with MOGAD (n = 63), AQP4 + NMOSD (n = 37), and MS (n = 26), assessing for marked central canal T2-hyperintensity and its evolution. If there were conflicting results, a third neurologist assessed the MRI.
RESULTS
Marked central canal T2-hyperintensity was more frequent in patients with MOGAD (18/63[29%]) than MS (1/26[4%]; p = 0.01) myelitis but did not differ from AQP4 + NMOSD (13/37[35%]; p = 0.49). Marked central canal T2-hyperintensity had completely resolved on follow-up axial MRI for most MOGAD (12/14[86%]) and AQP4 + NMOSD (10/10[100%]; p = 0.49) patients.
CONCLUSIONS
Marked central canal T2-hyperintensity is a common transient radiologic accompaniment of MOGAD and AQP4 + NMOSD myelitis, but not MS myelitis.
Topics: Myelin-Oligodendrocyte Glycoprotein; Myelitis, Transverse; Magnetic Resonance Imaging; Autoantibodies; Multiple Sclerosis; Diagnosis, Differential; Humans; Male; Female; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Spinal Canal; Spinal Cord
PubMed: 37201267
DOI: 10.1016/j.jns.2023.120687 -
World Journal of Transplantation Sep 2023Type 1 diabetes mellitus (T1DM) is one of the important causes of chronic kidney disease (CKD) and end-stage renal failure (ESRF). Even with the best available treatment... (Review)
Review
Type 1 diabetes mellitus (T1DM) is one of the important causes of chronic kidney disease (CKD) and end-stage renal failure (ESRF). Even with the best available treatment options, management of T1DM poses significant challenges for cli nicians across the world, especially when associated with CKD and ESRF. Substantial increases in morbidity and mortality along with marked rise in treatment costs and marked reduction of quality of life are the usual consequences of onset of CKD and progression to ESRF in patients with T1DM. Simultaneous pancreas-kidney transplant (SPK) is an attractive and promising treatment option for patients with advanced CKD/ESRF and T1DM for potential cure of these diseases and possibly several complications. However, limited availability of the organs for transplantation, the need for long-term immunosuppression to prevent rejection, peri- and post-operative complications of SPK, lack of resources and the expertise for the procedure in many centers, and the cost implications related to the surgery and postoperative care of these patients are major issues faced by clinicians across the globe. This clinical update review compiles the latest evidence and current recommendations of SPK for patients with T1DM and advanced CKD/ESRF to enable clinicians to care for these diseases.
PubMed: 37746036
DOI: 10.5500/wjt.v13.i5.208