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Rapid Course (rapid + course)
Selected AbstractsAre there Characteristics of Infectious Diseases that Raise Special Ethical Issues?1DEVELOPING WORLD BIOETHICS, Issue 1 2004Charles B. Smith ABSTRACT This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. [source] Clinical history and new prognostic indicators in metachromatic leukodystrophyJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2004U Del Carro Objective: To study clinical phenotypes and to increase knowledge of natural history of different variants of metachromatic leukodystrophy (MLD). Background: Little is known about factors influencing age of onset, progression rate and peripheral nerve involvement in MLD due to its rarity, heterogeneity and paucity of serial clinical and instrumental reports. Methods: 15 biochemically and molecularly characterized MLD patients were evaluated along a two-year follow-up period with clinical, electroneurographic (ENG) and brain MRI recordings. Results: Late infantile patients had a progressive and rapid course, whereas juvenile form showed marked variability. Different clinical presentations were associated with similar levels of ARSA activity; mutation screening indicated a high prevalence of rare or private mutations. In all late infantile and in the adult patient, ENG revealed a severe polyneuropathy. In juvenile patients a milder polyneuropathy or even normal tests were found. The earliest MRI change was periventricular white matter signal alterations, with initial involvement of posterior regions in a majority of late infantile patients, while in juvenile forms white matter lesions were mainly anterior. Conclusions: MLD course is highly variable and only partially influenced by age of onset, especially among juvenile patients. No clear-cut correlations exist between clinical phenotype and biochemical or molecular characterization. The presence of peripheral neuropathy at onset seems a strong indicator of a poorer clinical outcome. [source] Fulminant parvovirus B19-associated pancarditis with haemophagocytic lympho-histiocytosis in an immunocompetent adultAPMIS, Issue 10 2009AMANJIT BAL Myocarditis is a common cardiac disease that is identified on routine postmortem examinations. Initially, coxsackie viruses, other enteroviruses and adenoviruses were thought to be more common causes of myocarditis; however, recently, parvovirus B19 (PVB19) as well as human herpesvirus 6 (HHV6) have entered the arena. We describe autopsy findings of a patient who had a lethal myocarditis with haemophagocytic lympho-histiocytosis in a course of systemic PVB19 infection. The present case illustrates the unusually severe and rapid course of PVB19 myocarditis with associated haemophagocytic lympho-histiocytosis leading to death. [source] Post-traumatic inclusion cysts of the iris: a longterm prospective case seriesACTA OPHTHALMOLOGICA, Issue 8 2007Viney Gupta Abstract. Purpose:, Post-traumatic cysts of the iris pose a diagnostic and therapeutic challenge for ophthalmic surgeons. This prospective case series highlights the clinical spectrum and longterm outcomes of different modes of treatment in these cases. Methods:, Eleven cases of post-traumatic iris inclusion cysts, treated with Nd:YAG laser and/or surgical excision were evaluated prospectively over periods ranging from 6 months to 3 years. Ultrasound biomicroscopy features and postoperative outcomes in each were evaluated. Results:, Laser iridotomy of the cyst offers a non-invasive method of therapy in these cases but has a high rate of recurrence. The outcomes in most cases were poor, with worse results and more complications encountered in younger age groups. Conclusions:, Iris inclusion cysts have overall poor surgical outcomes as the result of the extensive proliferation of epithelial cells, which may explain why the condition takes a rapid course in younger patients and why severe complications are encountered postoperatively in this age group. [source] | ||||||||||