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Handbook of Clinical Neurology 2022Limbic encephalitis (LE) is a clinical syndrome defined by subacutely evolving limbic signs and symptoms with structural and functional evidence of mediotemporal damage... (Review)
Review
Limbic encephalitis (LE) is a clinical syndrome defined by subacutely evolving limbic signs and symptoms with structural and functional evidence of mediotemporal damage in the absence of a better explanation than an autoimmune (or paraneoplastic) cause. There are features common to all forms of LE. In recent years, antibody(ab)-defined subtypes have been established. They are distinct regarding underlying pathophysiologic processes, clinical and magnetic resonance imaging courses, cerebrospinal fluid signatures, treatment responsivity, and likelihood of a chronic course. With immunotherapy, LE with abs against surface antigens has a better outcome than LE with abs to intracellular antigens. Diagnostic and treatment challenges are, on the one hand, to avoid overlooking and undertreatment and, on the other hand, to avoid overdiagnoses and overtreatment. LE can be conceptualized as a model disease for the consequences of new onset mediotemporal damage by different mechanisms in adult life. It may be studied as an example of mediotemporal epileptogenesis.
Topics: Adult; Autoantibodies; Humans; Immunotherapy; Limbic Encephalitis; Magnetic Resonance Imaging
PubMed: 35964988
DOI: 10.1016/B978-0-12-823493-8.00024-9 -
The Nurse Practitioner Mar 2011The presentation of endocarditis varies from patient to patient, making it a difficult infection to diagnose correctly. While some patients will develop symptoms acutely... (Review)
Review
The presentation of endocarditis varies from patient to patient, making it a difficult infection to diagnose correctly. While some patients will develop symptoms acutely over days, it may take weeks or months for symptoms to develop as in the case of subacute bacterial endocarditis.
Topics: Adult; Anti-Bacterial Agents; Endocarditis, Subacute Bacterial; Humans; Male; Nurse Practitioners
PubMed: 21325924
DOI: 10.1097/01.NPR.0000393971.15598.0c -
Nihon Rinsho. Japanese Journal of... Oct 2005
Review
Topics: Autoantibodies; Diagnosis, Differential; Humans; Hypothyroidism; Prognosis; Reference Standards; Thyroid Gland; Thyroiditis; Thyroiditis, Subacute; Thyrotoxicosis
PubMed: 16279615
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... 1971
Review
Topics: Age Factors; Brain; Electroencephalography; Humans; Prognosis; Sex Factors; Subacute Sclerosing Panencephalitis
PubMed: 4931313
DOI: No ID Found -
American Heart Journal Oct 1993Myocardial free wall rupture accounts for between 8% and 17% of mortality after myocardial infarction. In up to 40% of cases death occurs subacutely over a matter of... (Review)
Review
Myocardial free wall rupture accounts for between 8% and 17% of mortality after myocardial infarction. In up to 40% of cases death occurs subacutely over a matter of hours, not minutes. Illustrative clinical cases and data suggest that a high degree of clinical suspicion, along with the early use of echocardiography, could significantly reduce mortality resulting from myocardial free wall rupture complicating myocardial infarction. Myocardial free wall rupture should be suspected in patients with recent myocardial infarction who have recurrent or persistent chest pain, hemodynamic instability, syncope, pericardial tamponade, or transient electromechanical dissociation. In this clinical situation, emergent echocardiography showing a pericardial effusion or pericardial thrombus is highly suggestive of free wall rupture. Surgical exploration and rupture repair is the definitive diagnostic and therapeutic procedure.
Topics: Aged; Aged, 80 and over; Echocardiography; Emergencies; Heart Rupture, Post-Infarction; Heart Ventricles; Humans; Incidence; Male; Middle Aged; Risk Factors
PubMed: 8213454
DOI: 10.1016/0002-8703(93)90711-h -
Journal of Toxicology 2022Plant-based medicines have effectively managed several ailments in humans and animals since prehistoric times. However, the pharmacologic efficacy and safety of many...
Plant-based medicines have effectively managed several ailments in humans and animals since prehistoric times. However, the pharmacologic efficacy and safety of many plants currently used in traditional medicine have not been explored empirically, which raises serious public health concerns, derailing further research and their integration into the conventional healthcare system. Despite the longstanding ethnomedicinal usage of shoot extract to treat inflammation, microbial infections, and diarrhoea, among other diseases, there is insufficient scientific data to appraise its toxicity profile and safety. Accordingly, we investigated the subacute toxicity of the aqueous shoot extract of in Sprague Dawley rats (both sexes) for 28 days based on the Organisation for Economic Cooperation and Development guideline 407. In this study, all the experimental rats treated orally with 40 mg/Kg BW, 200 mg/Kg BW, and 1000 mg/Kg BW of the aqueous shoot extract of remained normal, like the control group rats, and did not show any clinical signs of subacute toxicity, and no morbidity or mortality was recorded. Besides, the weekly body weight gains and the haematological and biochemical parameters of experimental rats orally administered with the studied plant extract at the tested doses and in the control group were comparable ( > 0.05). No pathologic alterations in internal organs were observed following necroscopy. Further, the differences in weights of the liver, kidney, and spleen of experimental rats which were subacutely treated with the studied plant extract and the control rats were insignificant ( > 0.05). Moreover, no histopathological changes were observed in tissue sections of the liver, kidney, and spleen obtained from all the experimental rats. Our findings demonstrate that the aqueous shoot extract of may be safe as it does not elicit subacute toxicity in Sprague Dawley rats. Further toxicological and pharmacological studies using other model animals and in clinical setups are encouraged to fully appraise the efficacy and safety of the studied plant extract.
PubMed: 36061215
DOI: 10.1155/2022/6283066 -
Cureus Feb 2023Marchiafava-Bignami disease (MBD) is rare and often associated with chronic alcohol consumption; however, cases have been described in non-alcoholic patients with...
Marchiafava-Bignami disease (MBD) is rare and often associated with chronic alcohol consumption; however, cases have been described in non-alcoholic patients with nutritional deficits. This disease manifests itself through an array of neurological signs and symptoms, from mild dysarthria or mild confusion to coma and death, and can present acutely, subacutely, or chronically, depending on their severity. The evolution of imaging technology makes magnetic resonance imaging (MRI) the gold standard for the diagnosis of this disease, although computed tomography (CT) scan is usually in the first line owing to its greater availability. The main feature for the diagnosis of MBD by brain MRI is the identification of areas of demyelination and necrosis of the corpus callosum. We report a 55-year-old male with subacute neurological deterioration whose MRI demonstrated atrophy and demyelination of the corpus callosum.
PubMed: 36909031
DOI: 10.7759/cureus.34692 -
Continuum (Minneapolis, Minn.) Apr 2018This article reviews the clinical presentation, diagnostic evaluation, and management of immune-mediated myelopathies. (Review)
Review
PURPOSE OF REVIEW
This article reviews the clinical presentation, diagnostic evaluation, and management of immune-mediated myelopathies.
RECENT FINDINGS
The discovery of several neural autoantibodies and their antigenic targets has revolutionized the investigation and treatment of immune-mediated myelopathies. Detection of these serologic biomarkers can support or establish a diagnosis of an autoimmune myelopathy, and, in the case of paraneoplastic syndromes, indicate the likely presence of an underlying malignancy. Distinctive lesion patterns detected on spinal cord or brain MRI narrow the differential diagnosis in patients with acute or subacute inflammatory myelopathies, including those not associated with autoantibody markers.
SUMMARY
Immune-mediated myelopathies usually present acutely or subacutely and have a broad differential diagnosis. A systematic diagnostic approach using data from the clinical setting and presentation, MRI lesion patterns, CSF data, and autoantibody markers can differentiate these disorders from noninflammatory myelopathies, often with precise disease classification. This, in turn, provides prognostic information, especially whether the disorder is likely to relapse, and facilitates therapeutic decision making. Diagnostic accuracy informs selection of acute immunotherapy aimed at arresting and reversing recent neurologic injury and, when necessary, selection of long-term treatment for prevention of disease progression or relapse.
Topics: Autoantibodies; Humans; Magnetic Resonance Imaging; Prognosis; Recurrence; Spinal Cord; Spinal Cord Diseases
PubMed: 29613897
DOI: 10.1212/CON.0000000000000582 -
Japanese Circulation Journal Oct 1971
Review
Topics: Animals; Aorta; Cattle; Chickens; Dogs; Endocarditis, Subacute Bacterial; Fibrinogen; Horses; Humans; Mitral Valve; Neisseria gonorrhoeae; Staphylococcus; Streptococcus; Streptococcus pneumoniae; Swine; Tricuspid Valve
PubMed: 4400846
DOI: 10.1253/jcj.35.1203 -
Radiologie (Heidelberg, Germany) Aug 2022Cavernous malformations or cavernomas belong to the angiodysplasias. They may be sporadic or familial and cause symptoms (epilepsy) despite the absence of... (Review)
Review
CLINICAL/METHODICAL ISSUE
Cavernous malformations or cavernomas belong to the angiodysplasias. They may be sporadic or familial and cause symptoms (epilepsy) despite the absence of a left-to-right shunt. In addition to intracranial locations, spinal cavernomas are also found.
STANDARD RADIOLOGICAL METHODS
Magnetic resonance imaging (MRI) and computed tomography (CT) are used for diagnosis PERFORMANCE: MRI, except for acutely or subacutely hemorrhaged cavernomas, is superior to CT for lesion detection.
ACHIEVEMENTS
CT is reserved for acute diagnosis. MRI, especially susceptibility-sensitive gradient echo sequences, can also detect cavernomas without (sub-)acute hemorrhage or calcifications.
PRACTICAL RECOMMENDATIONS
MRI is also useful for differentiating the familial form vs. sporadic form. Digital subtraction angiography (DSA) is used for differential diagnosis in rare cases, as cavernomas show no correlate here.
Topics: Angiography, Digital Subtraction; Diagnosis, Differential; Hemangioma, Cavernous; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 35726070
DOI: 10.1007/s00117-022-01028-0