scholarly journals Magnesium: The Forgotten Electrolyte—A Review on Hypomagnesemia

2019 ◽  
Vol 7 (4) ◽  
pp. 56 ◽  
Author(s):  
Faheemuddin Ahmed ◽  
Abdul Mohammed
Keyword(s):  
Clinical Practice ◽  
General Population ◽  
Medical Literature ◽  
Clinical Manifestations ◽  
The Body ◽  
Sodium Potassium ◽  
Comprehensive Review ◽  
Organ Systems ◽  
Life Threatening

Magnesium is the fourth most abundant cation in the body and the second most abundant intracellular cation. It plays an important role in different organ systems at the cellular and enzymatic levels. Despite its importance, it still has not received the needed attention either in the medical literature or in clinical practice in comparison to other electrolytes like sodium, potassium, and calcium. Hypomagnesemia can lead to many clinical manifestations with some being life-threatening. The reported incidence is less likely than expected in the general population. We present a comprehensive review of different aspects of magnesium physiology and hypomagnesemia which can help clinicians in understanding, identifying, and treating this disorder.

scholarly journals Hemophagocytic Lymphohistiocytosis: A Life Threatening Cytopenic Condition

2021 ◽  
Vol 15 (2) ◽  
pp. 98-102
Author(s):  
Suranjit Kumar Saha ◽  
MM Shahin Ul Islam ◽  
Nasir Uddin Ahmed ◽  
Prativa Saha
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Gene Mutations ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Hematopoietic Stem ◽  
Organ Systems ◽  
Life Threatening ◽  
Poor Outcomes

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that occurs in many underlying conditions in all age. This is characterized by unbridled activation of cytotoxic T lymphocytes, natural killer (NK) cells and macrophages resulting in raised cytokine level. Those cytokines and immune mediated injury occur in multiple organ systems. It may be primary and secondary. Primary HLH is familial, childhood presentation and associated with gene mutations. Secondary HLH is acquired, adulthood presentation that occurs in infections, malignancies inflammatory and autoimmune diseases etc. Clinical manifestations include fever, splenomegaly, lymphadenopathy, neurologic dysfunction, coagulopathy, features of sepsis etc. Laboratory investigation includes cytopenias, hypertriglyceridemia, hyperferritinemia, abnormal liver function, hemophagocytosis, and diminished NKcell activity. Treatment modalities include immunosuppressive, immunomodulatory agents, cytostatic drugs, T-cell antibodies, anticytokine agents and hematopoietic stem cell transplantation (HSCT). Besides those, aggressive supportive care combined with specific treatment of the precipitating factor can produce better outcome. With treatment more than 50% of children who undergo transplant survive, but adults have quite poor outcomes even with aggressive management. Faridpur Med. Coll. J. 2020;15(2): 98-102

scholarly journals Marfan's syndrome: an overview

2010 ◽  
Vol 128 (6) ◽  
pp. 360-366 ◽  
Author(s):  
Shi-Min Yuan ◽  
Hua Jing
Keyword(s):  
Connective Tissue ◽  
Aortic Surgery ◽  
Clinical Manifestations ◽  
The Body ◽  
Dominant Negative ◽  
Dominant Negative Effect ◽  
Contributory Factor ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Organ Systems

Marfan's syndrome is an autosomal dominant condition with an estimated prevalence of one in 10,000 to 20,000 individuals. This rare hereditary connective tissue disorder affects many parts of the body. The diagnosis of Marfan's syndrome is established in accordance with a review of the diagnostic criteria, known as the Ghent nosology, through a comprehensive assessment largely based on a combination of major and minor clinical manifestations in various organ systems and the family history. Aortic root dilation and mitral valve prolapse are the main presentations among the cardiovascular malformations of Marfan's syndrome. The pathogenesis of Marfan's syndrome has not been fully elucidated. However, fibrillin-1 gene mutations are believed to exert a dominant negative effect. Therefore, Marfan's syndrome is termed a fibrillinopathy, along with other connective tissue disorders with subtle differences in clinical manifestations. The treatment may include prophylactic β-blockers and angiotensin II-receptor blockers in order to slow down the dilation of the ascending aorta, and prophylactic aortic surgery. Importantly, β-blocker therapy may reduce TGF-β activation, which has been recognized as a contributory factor in Marfan's syndrome. The present article aims to provide an overview of this rare hereditary disorder.

Increase in T3 levels during hypocorticism in patients with chronic secondary adrenocortical insufficiency

1992 ◽  
Vol 126 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Ronald Comtois ◽  
Josée Hébert ◽  
Jean-Paul Soucy
Keyword(s):  
Adrenal Insufficiency ◽  
Medical Literature ◽  
Clinical Manifestations ◽  
Adrenocortical Insufficiency ◽  
Primary Adrenal Insufficiency ◽  
Sodium Potassium ◽  
Acth Deficiency ◽  
Differential White Blood Cell ◽  
Peripheral Conversion ◽  
Cortisol Deficiency

The clinical and biochemical manifestations of secondary adrenocortical insufficiency are not well defined in the medical literature. This study was designed to determine the clinical and laboratory features suggesting the diagnosis of adrenal insufficiency in 15 chronic ACTH deficiency patients during low and normal cortisol states. Except for fatigue and weakness, the characteristic clinical manifestations of primary adrenal insufficiency occurred rarely. ACTH deficiency did not significantly modify blood glucose, serum calcium, sodium, potassium and differential white blood cell count. However, serum T4 was lower (65±19 vs 95±21 nmol/l, p< 0.001) during cortisol deficiency, while T3 was higher (2.4±0.67 vs 2.0±0.60 nmol/l, p<0.001). Furthermore, rT3 decreased significantly during hypocorticism (0.27±0.07 vs 0.18±0.07 nmol/l, p<0.001). TheT4/T3 ratio was significantly lower than the normal in 15 out of the 17 episodes of ACTH deficiency (29±12.5 vs 57±9.4, p<0.0001). We conclude that the increase in T3 and decrease in T4 levels are associated with chronic secondary adrenocortical insufficiency. This laboratory feature could be due, at least in part, to the increased peripheral conversion of T4 to T3 during cortisol deficiency.

scholarly journals Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

2021 ◽  
Vol 7 (2) ◽  
pp. 79
Author(s):  
Jasminka Talapko ◽  
Martina Juzbašić ◽  
Tatjana Matijević ◽  
Emina Pustijanac ◽  
Sanja Bekić ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Virulence Factors ◽  
Oral Candidiasis ◽  
Clinical Manifestations ◽  
The Body ◽  
Host Immune System ◽  
Normal Flora ◽  
Virulence Traits ◽  
Organ Systems ◽  
Wide Range

Candida albicans is a common commensal fungus that colonizes the oropharyngeal cavity, gastrointestinal and vaginal tract, and healthy individuals’ skin. In 50% of the population, C. albicans is part of the normal flora of the microbiota. The various clinical manifestations of Candida species range from localized, superficial mucocutaneous disorders to invasive diseases that involve multiple organ systems and are life-threatening. From systemic and local to hereditary and environmental, diverse factors lead to disturbances in Candida’s normal homeostasis, resulting in a transition from normal flora to pathogenic and opportunistic infections. The transition in the pathophysiology of the onset and progression of infection is also influenced by Candida’s virulence traits that lead to the development of candidiasis. Oral candidiasis has a wide range of clinical manifestations, divided into primary and secondary candidiasis. The main supply of C. albicans in the body is located in the gastrointestinal tract, and the development of infections occurs due to dysbiosis of the residential microbiota, immune dysfunction, and damage to the muco-intestinal barrier. The presence of C. albicans in the blood is associated with candidemia–invasive Candida infections. The commensal relationship exists as long as there is a balance between the host immune system and the virulence factors of C. albicans. This paper presents the virulence traits of Candida albicans and clinical manifestations of specific candidiasis.

scholarly journals Erdheim–Chester Disease

2015 ◽  
Vol 1 (3) ◽  
pp. 55-57
Author(s):  
Mamatha Patil ◽  
Deepak Jaiswal
Keyword(s):  
Medical Literature ◽  
Young Male ◽  
Normal Function ◽  
The Body ◽  
Loose Connective Tissue ◽  
Erdheim Chester Disease ◽  
Organ Systems ◽  
Erdheim Chester ◽  
Chester Disease ◽  
System Organ

ABSTRACT Erdheim–Chester disease (ECD) is an extremely rare disorder that can affect many different organs of the body. This is an unusual form of non-Langerhans-cell histiocytosis. This is characterized by excessive production and accumulation of histiocytes. The normal function of the histiocytes is to fight infections. Histiocytes accumulate in the loose connective tissue of various organ systems of the body and cause thickening of tissues and may become dense and fibrotic. In the absence of successful treatment, the disease is debilitating and can result in multi-system organ failure. Erdheim–Chester disease is often described in the medical literature as an extremely rare1 entity. Erdheim–Chester disease usually presents in adults aged between 40 and 60 years. Here we present a case report of ECD in a 26-year-old young male patient with progressive course over a period of 4 years with symptoms suggestive of multi-organ involvement. How to cite this article Patil M, Jaiswal D. Erdheim–Chester Disease. J Med Sci 2015;1(3):55-57.

Gas Embolism: Part II. Arterial Gas Embolism and Decompression Sickness

1996 ◽  
Vol 11 (5) ◽  
pp. 261-283 ◽  
Author(s):  
Mark M. Wilson ◽  
Frederick J. Curley
Keyword(s):  
Health Care Providers ◽  
Decompression Sickness ◽  
Tissue Injury ◽  
Clinical Manifestations ◽  
The Body ◽  
Care Providers ◽  
Gas Embolism ◽  
Treatment Regimens ◽  
Organ Systems ◽  
High Index Of Suspicion

Gas emboli syndromes are known to occur in many different settings, and they may result in life-threatening emergencies. Venous gas embolization was discussed previously in Part I of this review. Gas emboli that gain access to the arterial circulation or that result from exposures to decreased ambient pressures in the environment are discussed in Part II. The prevalence of arterial gas emboli and decompression sickness are likely not as high as for venous gas emboli. Most cases are preventable, and prompt treatment is frequently effective. Once present, gas bubbles generally distribute themselves throughout the body based on the relative blood flow at the time, thus making the nervous system, heart, lung, and skin the primary organ systems involved. Both mechanical and biophysical effects lead to intravascular and extracellular alterations that result in tissue injury. The clinical manifestations of these disorders are varied, and a high index of suspicion in the appropriate settings will aid health care providers in prompt recognition of these problems and allow timely intervention with specific therapy. Management of arterial gas emboli and decompression sickness is similar, with a focus on hyberbaric chamber therapy and intermittent hyperoxygenation. Recompression schedules in current use have withstood the test of time. Research continues to refine our understanding of these diseases and to optimize the treatment regimens available.

Fundamentals of pathology

2021 ◽  
Author(s):  
Aleksandr Tyukavin
Keyword(s):  
Academic Discipline ◽  
Molecular Genetic ◽  
Clinical Manifestations ◽  
Cloud Service ◽  
First Aid ◽  
The Body ◽  
Basic Algorithm ◽  
Technical Schools ◽  
Life Threatening ◽  
Mechanisms Of Development

The textbook reveals the concepts of health and disease, presents modern ideas about the causes and conditions of the occurrence of actual types of pathology. The importance of molecular genetic factors of heredity and reactivity in the formation of typical pathological processes is shown. The main regularities and features of manifestations of organ and system dysfunction in various types of pathology are described. Special attention is paid to the causes and mechanisms of development of socially significant diseases of the heart and blood vessels, brain, respiratory organs and other vital systems of the body. A separate section of the textbook provides up-to-date information on first aid. The criteria of safe conditions for first aid are described; the main clinical manifestations of emergency conditions in accidents, injuries, poisoning and diseases are described. A list of first aid measures for life-threatening conditions is presented. The cloud service contains a video of the basic algorithm for conducting cardiopulmonary resuscitation in a pharmacy or office. It is written in accordance with the program of the academic discipline "Fundamentals of Pathology" in the specialty 33.02.01 "Pharmacy" and refers to the educational and methodological publications of the cycle of general professional disciplines for students of pharmaceutical technical schools.

scholarly journals Lupus Vasculitis: An Overview

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1626
Author(s):  
Patrizia Leone ◽  
Marcella Prete ◽  
Eleonora Malerba ◽  
Antonella Bray ◽  
Nicola Susca ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Pulmonary Hemorrhage ◽  
Small Vessels ◽  
Mild Disease ◽  
System Disease ◽  
Organ Systems ◽  
Life Threatening ◽  
Prompt Diagnosis

Lupus vasculitis (LV) is one of the secondary vasculitides occurring in the setting of systemic lupus erythematosus (SLE) in approximately 50% of patients. It is most commonly associated with small vessels, but medium-sized vessels can also be affected, whereas large vessel involvement is very rare. LV may involve different organ systems and present in a wide variety of clinical manifestations according to the size and site of the vessels involved. LV usually portends a poor prognosis, and a prompt diagnosis is fundamental for a good outcome. The spectrum of involvement ranges from a relatively mild disease affecting small vessels or a single organ to a multiorgan system disease with life-threatening manifestations, such as mesenteric vasculitis, pulmonary hemorrhage, or mononeuritis multiplex. Treatment depends upon the organs involved and the severity of the vasculitis process. In this review, we provide an overview of the different forms of LV, describing their clinical impact and focusing on the available treatment strategies.

scholarly journals Clinical Manifestations and Causes of Anaphylaxis. Analysis of 382 Cases from the Anaphylaxis Registry in West Pomerania Province in Poland

2020 ◽  
Vol 17 (8) ◽  
pp. 2787 ◽  
Author(s):  
Iwona Poziomkowska-Gęsicka ◽  
Michał Kurek
Keyword(s):  
Hypersensitivity Reaction ◽  
Immunoglobulin E ◽  
Clinical Manifestations ◽  
Primary Care Providers ◽  
Diagnostic Methods ◽  
Skin Tests ◽  
Care Providers ◽  
Organ Systems ◽  
Life Threatening ◽  
Systemic Hypersensitivity

Anaphylaxis is most commonly defined as an acute, severe, potentially life-threatening systemic hypersensitivity reaction. Current expert consensus has defined anaphylaxis as a serious reaction that is rapid in onset and can be fatal, and is a severe, potentially life-threatening systemic hypersensitivity reaction that is still rarely diagnosed. For safety reasons, patients should visit an allergologist to identify potential causes of this reaction. There are no data from other health care centres in Poland presenting characteristics of anaphylactic reactions. Clinical manifestations of anaphylaxis should be analysed, because some patients (10–30%) with anaphylaxis can present without cutaneous findings. This lack of skin/mucosa involvement can lead to misdiagnosis or delayed diagnosis of anaphylaxis. Objectives—to gather epidemiological data on anaphylactic reactions, to identify clinical manifestations of anaphylaxis (organ systems involved), to present diagnostic methods useful for the identification of anaphylaxis triggers, and most importantly, to find causes of anaphylaxis. In this retrospective analysis, we used a questionnaire-based survey regarding patients visiting the Clinical Allergology Department, Pomeranian Medical University (PMU) in Szczecin, between 2006 and 2015. The registry comprised patients with grade II (Ring and Messmer classification) or higher anaphylaxis. Patients with grade I anaphylaxis (e.g., urticaria) were not included in the registry. The incidence of anaphylaxis was higher in women. Clinical manifestations included cutaneous and cardiovascular symptoms, but more than 20% of patients did not present with cutaneous symptoms, which may create difficulties for fast and correct diagnosis. Causes of anaphylaxis were identified and confirmed by means of detailed medical interview, skin tests (STs), and measurement of specific immunoglobulin E (sIgE) and tryptase levels. In the analysed group, the most common cause of anaphylaxis (allergic and nonallergic) was Hymenoptera stinging (wasp), drugs (nonsteroidal anti-inflammatory drugs, NSAIDs) and foods (peanuts, tree nuts, celery). The incidence of anaphylaxis is low, but because of its nature and potentially life-threatening consequences it requires a detailed approach. Comprehensive management of patients who have had anaphylaxis can be complex, so partnerships between allergy specialists, emergency medicine and primary care providers are necessary. Monitoring its range is very important to monitor changes in allergy development.

scholarly journals Hepatitis Lupus in Systemic Lupus Erythematosus in Male Patients

2021 ◽  
Vol 7 (2) ◽  
pp. 428-434
Author(s):  
Andikha Putra ◽  
Raveinal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Abdominal Ultrasound ◽  
The Body ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Methyl Prednisolone ◽  
Organ Systems ◽  
Lupus Hepatitis

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterized by autoantibodies against the cell nucleus and involves many organ systems in the body with unknown etiologies and various clinical manifestations, disease course and prognosis. SLE can be found at all ages, generally appearing at age 9-58 years with a peak at age 28 years. It is more common in women with a ratio of women to men 15: 1 to 22: 1. The highest incidence and prevalence of SLE was found in North America 23.2 / 100.000 population / year and 241 / 100.0000 population. In Indonesia, there has been an increase in visits to SLE patients from 17.9-27.2% in 2015 to 30.3-58% in 2017. One of the manifestations of SLE is hepatitis lupus, which is inflammation of the liver tissue. Lupus hepatitis can occur in 20-50% of patients with SLE. It was reported that a 20-year-old man presented with complaints of pain in the joints of the right and left hands which increased since 1 week. The patient also complained of reddish patches on the face, hair loss and mouth sores. Physical examination revealed anemic eye conjunctiva, malar rash, oral ulcer. During the joint examination, there was tenderness in bilateral MCP and PIP. The abdominal examination revealed hepatomegaly. Investigations revealed anemia, thrombocytopenia, increased liver function. Abdominal ultrasound revealed hepatomegaly. ANA profile examination was positive for anti RNP, anti-sm, and anti- ribosomal protein antibodies. The patient was diagnosed with Systemic Lupus Erythematosus with lupus hepatitis according to the ACR (American College of Rheumatology) criteria in which the patient had 6 criteria. The patient was given therapy with 2x125 mg of intravenous methyl prednisolone for 3 days and hydroxychloroquine 1x200 mg orally and other symptomatic drugs.

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