The present pandemic of severe acute respiratory syndrome is caused by the coronavirus (2019-nCoV), commonly called COVID-19. Starting from China, it has spread worldwide, causing major morbidity and mortality. It primarily involves the pulmonary system, but other organ systems are not spared. Treatment is still elusive and evolving. The exact pathogenesis of renal damage from COVID-19 virus and the magnitude of renal failure in this infection are not very clear. PubMed was searched to identify published literature from 2019 to present using the following keywords COVID-19, acute kidney injury, creatinine, blood urea nitrogen, chronic kidney disease, renal replacement therapy, and dialysis. Cited references were also used to further identify relevant articles and literature elsewhere on the web. This review looks at the burden and influence of the COVID-19 pandemic on the kidneys and on the implications it will have on public health planning.
The present pandemic of severe acute respiratory syndrome is caused by the coronavirus (2019-nCoV), commonly called COVID-19. Starting from China, it has spread worldwide, causing major morbidity and mortality. It primarily involves the pulmonary system, but other organ systems are not spared. Treatment is still elusive and evolving. The exact pathogenesis of renal damage from COVID-19 virus and the magnitude of renal failure in this infection are not very clear. PubMed was searched to identify published literature from 2019 to present using the following keywords COVID-19, acute kidney injury, creatinine, blood urea nitrogen, chronic kidney disease, renal replacement therapy, and dialysis. Cited references were also used to further identify relevant articles and literature elsewhere on the web. This review looks at the burden and influence of the COVID-19 pandemic on the kidneys and on the implications it will have on public health planning.
Delusional parasitosis (DP) has been described as among the most challenging diagnosis to manage in dermatology and psychiatry literature. Patients with this perplexing and enigmatic condition present potentially to a wide range of specialties including primary or emergency care, dermatology, infectious diseases, neurology, and psychiatry. DP is probably underdiagnosed from patients' underreporting of symptoms of being infested with parasites, resulting from the associated social stigma. In addition, specialists who most often encounter these patients often possess low familiarity and comfort level in the diagnosis and therapy of this disorder. To our knowledge, we present only the fifth case of delusional parasitosis that was associated with complex visual hallucinations. Both concurrent conditions were treated successfully with aripiprazole. Interestingly, in all of these prior cases including ours, the patients were elderly (age range, 74-95 years). Delusions of ocular parasitosis has been described in fymptom management of the concurrent delusional parasitosis and complex visual hallucinations. The slow titration of aripiprazole to 6 mg led to a 75% reduction in the delusions and hallucinations. He initially declined higher dosages of the aripiprazole because of sedation and personal wariness of medications in general. However, a therapeutic relationship was nurtured based on respect, careful listening, and provision of options. Eventually, he agreed to a higher dosage of aripiprazole and thus titrate antipsychotic therapy that he rejected when prescribed by the dermatology and psychiatry specialists. We attempted to approximate the 15-mg dosage that led to remission of symptoms in previous case reports.
The vocal cord is innervated by the recurrent laryngeal nerve and the superior laryngeal nerve, which are branches of the vagus nerve. The nucleus ambiguous is a motor nucleus of the vagus nerve and it is located in the medulla. It receives supratentorial upper motor regulatory fibers. Commonly, this regulation is bilaterally represented in the brain. https://www.selleckchem.com/products/z-vad.html Less commonly, it is contralaterally represented. This case describes a rare presentation.
We present a female patient in her early sixties with a past medical history significant for hypertension who presented with acute right-sided weakness and expressive aphasia (National Institutes of Health Stroke Scale = 20). Computed tomography (CT)-head was unremarkable but she was outside the window for chemical thrombolytic therapy. CT-angiogram revealed occlusion of the left extracranial and intracranial internal carotid artery and, thus, she was deemed not a candidate for mechanical thrombectomy. CT-perfusion scans (Rapid software) showed a large penumbra within the respective vascular territory affected including the operculum and the insula. The core infarction was relatively small and located in the left basal ganglia. After inducing therapeutic hypertension, the patient's aphasia improved. Surprisingly, this unmasked a moderate to severe hypophonic voice. The patient underwent flexible fiberoptic laryngoscopy which showed a paralyzed left vocal cord but without signs of inflammation.
Our case is a rare case of transient ipsilateral vocal cord paralysis associated with anterior unilateral cerebral ischemia. The paralysis resolved with improvement of the cerebral ischemic penumbra.
Our case is a rare case of transient ipsilateral vocal cord paralysis associated with anterior unilateral cerebral ischemia. The paralysis resolved with improvement of the cerebral ischemic penumbra.
The evidence supporting the effectiveness of weight loss interventions with low to medium intensity is limited.
To measure the effectiveness of a family-based weight management intervention in pediatric primary care to reduce body weight in children.
Electronic medical record data of pediatric patients in Kaiser Permanente Orange County, California, who were enrolled in weight management between April 2014 and December 2018 (family-based behavior-changing weight management [FB-WMG], n = 162) and compared with a control group (CG) of patients who were referred but did not enroll (Ref-CG, n = 203) and an area-matched CG also matched by sex, age, zip code, and body mass index (BMI) (Area-CG, n = 287). BMI was measured at the first visit (or index date) and after 6 months.
Children enrolled in the FB-WMG had 5 (interquartile range = 3-6) sessions over the first 6 months of the program. Most FB-WMG patients (69.1%) reduced or maintained BMI over 6 months, compared with 45.8% of Ref-CG (p < 0.001) and 57.
The present pandemic of severe acute respiratory syndrome is caused by the coronavirus (2019-nCoV), commonly called COVID-19. Starting from China, it has spread worldwide, causing major morbidity and mortality. It primarily involves the pulmonary system, but other organ systems are not spared. Treatment is still elusive and evolving. The exact pathogenesis of renal damage from COVID-19 virus and the magnitude of renal failure in this infection are not very clear. PubMed was searched to identify published literature from 2019 to present using the following keywords COVID-19, acute kidney injury, creatinine, blood urea nitrogen, chronic kidney disease, renal replacement therapy, and dialysis. Cited references were also used to further identify relevant articles and literature elsewhere on the web. This review looks at the burden and influence of the COVID-19 pandemic on the kidneys and on the implications it will have on public health planning.
The present pandemic of severe acute respiratory syndrome is caused by the coronavirus (2019-nCoV), commonly called COVID-19. Starting from China, it has spread worldwide, causing major morbidity and mortality. It primarily involves the pulmonary system, but other organ systems are not spared. Treatment is still elusive and evolving. The exact pathogenesis of renal damage from COVID-19 virus and the magnitude of renal failure in this infection are not very clear. PubMed was searched to identify published literature from 2019 to present using the following keywords COVID-19, acute kidney injury, creatinine, blood urea nitrogen, chronic kidney disease, renal replacement therapy, and dialysis. Cited references were also used to further identify relevant articles and literature elsewhere on the web. This review looks at the burden and influence of the COVID-19 pandemic on the kidneys and on the implications it will have on public health planning.
Delusional parasitosis (DP) has been described as among the most challenging diagnosis to manage in dermatology and psychiatry literature. Patients with this perplexing and enigmatic condition present potentially to a wide range of specialties including primary or emergency care, dermatology, infectious diseases, neurology, and psychiatry. DP is probably underdiagnosed from patients' underreporting of symptoms of being infested with parasites, resulting from the associated social stigma. In addition, specialists who most often encounter these patients often possess low familiarity and comfort level in the diagnosis and therapy of this disorder. To our knowledge, we present only the fifth case of delusional parasitosis that was associated with complex visual hallucinations. Both concurrent conditions were treated successfully with aripiprazole. Interestingly, in all of these prior cases including ours, the patients were elderly (age range, 74-95 years). Delusions of ocular parasitosis has been described in fymptom management of the concurrent delusional parasitosis and complex visual hallucinations. The slow titration of aripiprazole to 6 mg led to a 75% reduction in the delusions and hallucinations. He initially declined higher dosages of the aripiprazole because of sedation and personal wariness of medications in general. However, a therapeutic relationship was nurtured based on respect, careful listening, and provision of options. Eventually, he agreed to a higher dosage of aripiprazole and thus titrate antipsychotic therapy that he rejected when prescribed by the dermatology and psychiatry specialists. We attempted to approximate the 15-mg dosage that led to remission of symptoms in previous case reports.
The vocal cord is innervated by the recurrent laryngeal nerve and the superior laryngeal nerve, which are branches of the vagus nerve. The nucleus ambiguous is a motor nucleus of the vagus nerve and it is located in the medulla. It receives supratentorial upper motor regulatory fibers. Commonly, this regulation is bilaterally represented in the brain. https://www.selleckchem.com/products/z-vad.html Less commonly, it is contralaterally represented. This case describes a rare presentation.
We present a female patient in her early sixties with a past medical history significant for hypertension who presented with acute right-sided weakness and expressive aphasia (National Institutes of Health Stroke Scale = 20). Computed tomography (CT)-head was unremarkable but she was outside the window for chemical thrombolytic therapy. CT-angiogram revealed occlusion of the left extracranial and intracranial internal carotid artery and, thus, she was deemed not a candidate for mechanical thrombectomy. CT-perfusion scans (Rapid software) showed a large penumbra within the respective vascular territory affected including the operculum and the insula. The core infarction was relatively small and located in the left basal ganglia. After inducing therapeutic hypertension, the patient's aphasia improved. Surprisingly, this unmasked a moderate to severe hypophonic voice. The patient underwent flexible fiberoptic laryngoscopy which showed a paralyzed left vocal cord but without signs of inflammation.
Our case is a rare case of transient ipsilateral vocal cord paralysis associated with anterior unilateral cerebral ischemia. The paralysis resolved with improvement of the cerebral ischemic penumbra.
Our case is a rare case of transient ipsilateral vocal cord paralysis associated with anterior unilateral cerebral ischemia. The paralysis resolved with improvement of the cerebral ischemic penumbra.
The evidence supporting the effectiveness of weight loss interventions with low to medium intensity is limited.
To measure the effectiveness of a family-based weight management intervention in pediatric primary care to reduce body weight in children.
Electronic medical record data of pediatric patients in Kaiser Permanente Orange County, California, who were enrolled in weight management between April 2014 and December 2018 (family-based behavior-changing weight management [FB-WMG], n = 162) and compared with a control group (CG) of patients who were referred but did not enroll (Ref-CG, n = 203) and an area-matched CG also matched by sex, age, zip code, and body mass index (BMI) (Area-CG, n = 287). BMI was measured at the first visit (or index date) and after 6 months.
Children enrolled in the FB-WMG had 5 (interquartile range = 3-6) sessions over the first 6 months of the program. Most FB-WMG patients (69.1%) reduced or maintained BMI over 6 months, compared with 45.8% of Ref-CG (p < 0.001) and 57.
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