Psychogenic nonepileptic seizures

Early diagnosis and treatment of tuberculous meningitis (TBM) saves lives, but current laboratory diagnostic tests lack sensitivity and the best treatment regimens are uncertain. This article reviews the advances towards better TBM diagnosis and treatments made over the last 2 years. A modified Ziehl-Neelsen stain, interferon-gamma release assays and Mycobacterium tuberculosis antigen detection assays have all shown promise as new TBM diagnostic tests. HIV-associated TBM carries an especially grave prognosis and there are new data describing the optimal timing of antiretroviral treatment initiation and the clinical predictors of TBM immune reconstitution inflammatory syndrome. The pharmacokinetic and pharmacodynamic properties of different fluoroquinolones for TBM treatment have been compared, and there are intriguing new data to suggest higher doses of rifampicin given intravenously may improve the survival. Finally, there are preliminary data to suggest that the beneficial effect of adjunctive corticosteroids on TBM survival may be augmented by aspirin and predicted by a polymorphism in a gene responsible for eicosanoid synthesis. Much remains to be done to improve the outcome from TBM. There have been important advances in the treatment, which may influence treatment guidelines in the near future, but there remains an urgent need for better diagnostic tests.

The CODES trial for dissociative seizures: a landmark study and inflection point.

The aim of the review is to provide up-to-date information on the multiple roles of epidermal keratinocytes in the immune reactions associated with allergic contact dermatitis and atopic dermatitis skin diseases. In the last two decades, it has become clear that keratinocytes are highly active immunological cells, with major control over the acute and the chronic phases of skin inflammation by means of cytokine/chemokine production and surface molecule expression. Keratinocyte responses in skin allergic reactions are rather disease-specific and keratinocytes from genetically determined skin disorders, including atopic dermatitis, show intrinsic abnormalities in their capacity to respond to trigger factors. Lymphokines and cytokines released by T lymphocytes and other immune cells represent the most important stimuli that elicit the inflammatory activation of keratinocytes. Depending on the type and extent of T-cell infiltrate present in allergic contact dermatitis and atopic dermatitis skin lesions, keratinocytes are exposed to different cytokine micromilieu and, in turn, produce flogosis mediators qualitatively and quantitatively specific for each disease. Keratinocyte-derived inflammatory molecules amplificate skin immune responses associated with allergic contact dermatitis and atopic dermatitis, and contribute to the disease process and clinical phenotype development.

Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population. Airway stenting is highly effective in palliating symptoms of airway obstruction. There are several types of stents available with different advantages and disadvantages depending mainly on the material they are made from. Clinical outcomes seem to be comparable between silicone and self-expanding metal stents. Self-expanding metal stents have proven to be efficient in recanalizing 'complex' central airway obstructions. Preliminary data show that a new self-expanding 'hybrid' stent appears to be effective and safe for malignant airway obstruction. Airway stent complications vary according to the type of stent and the type of obstruction. Multidetector computed tomography seems to be a valuable adjunct to bronchoscopy in detecting and characterizing stent complications. A clear definition of airway stent-related infection is urgently needed to provide adequate diagnosis and management of this complication. Metal stent fracture is less common in patients with malignant airway obstruction as compared with benign disease, and this could be partially explained by the decreased survival and shorter exposure to stent in the former population. Airway stents are of great help in palliating symptoms of malignant central airway obstruction. Unfortunately, there have been no recent striking advances in stent technology and the ideal stent has yet to be designed.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-Print For Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions All Articles Images Videos Podcasts Blogs Advanced Search November 1993 - Volume 9 - Issue 6 Previous Abstract Next Abstract Full Text Access for Subscribers: Individual Subscribers Log in for access Institutional Users Access through Ovid® Not a Subscriber? Buy Subscribe Request Permissions You can read the full text of this article if you: Select an option Log In Buy Article Subscribe Content & Permissions Access through Ovid Log In Access through Ovid Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Current Opinion in Gastroenterology. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Stomach and duodenum edited by Mitchell L. Schubert: PDF OnlyControl of exocrine and endocrine secretion from the stomachSchubert, Mitchell L. MD Author Information Medical College of Virginia and McGuire VA Medical Center, Richmond, Virginia, USA Current Opinion in Gastroenterology: November 1993 - Volume 9 - Issue 6 - p 889-901 Buy Abstract This review of the past year's literature focuses on progress in the elucidation of the pathways and mechanisms controlling gastric exocrine (ie, acid and pepsin) and endocrine (ie, gastrin, histamine, somatostatin, and prostaglandin) secretion at the central, peripheral, and intracellular levels by neural, hormonal, and paracrine agents. The use of selective receptor antagonists (eg, bombesin/gastrin-releasing peptide antagonists, vasoactive intestinal peptide antagonists, gastrin antagonists, cholecystokinin-A antagonists, and muscarinic antagonists), antisera (eg, somatostatin antiserum and secretin anti-serum), inhibitors (eg, indomethacin, NG-nitro-L-arginine methyl ester, and omeprazole) and toxins (eg, capsaicin) have furthered our understanding of the potential physiologic role for bombesin/gastrin-releasing peptide, vasoactive intestinal peptide, gastrin, cholecystokinin, acetylcholine, prostaglandin, nitric oxide, hydrochloric acid, and sensory neurons in the regulation of gastric secretion. The increased use of molecular biologic techniques has provided new insights into the function of receptors (eg, gastrin, histamine, acetylcholine, somatostatin, and neuropeptide Y) and the transduction pathways to which they are coupled. Much progress has been made in our understanding of gastric physiology; much more, however, remains to be learned. Current Opinion in Gastroenterology 1993, 9:889-901 © Lippincott-Raven Publishers. Source Control of exocrine and endocrine secretion from the stomach Current Opinion in Gastroenterology9(6):889-901, November 1993. Full-Size Email + Favorites Export View in Gallery Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Current Opinion in Gastroenterology. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Related Articles Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Current Opinion in Gastroenterology. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Article Level Metrics Related Links Articles in PubMed by Mitchell L. Schubert, MD Articles in Google Scholar by Mitchell L. Schubert, MD Other articles in this journal by Mitchell L. Schubert, MD Related Videos Data is temporarily unavailable. Please try again soon. Back to Top Never Miss an Issue Get new journal Tables of Contents sent right to your email inbox Get New Issue Alerts Browse Journal Content Most Popular For Authors About the Journal Past Issues Current Issue Register on the website Subscribe Get eTOC Alerts For Journal Authors Submit an article How to publish with us Customer Service Activate your journal subscription Activate Journal Subscription Browse the help center Help Contact us at: EMAIL: [email protected] TEL: (USA): TEL: (Int’l): 800-638-3030 (within USA) 301-223-2300 (international) Privacy Policy (Updated June 1, 2020) Legal Disclaimer Terms of Use Open Access Policy Feedback Sitemap RSS Feeds LWW Journals Copyright © 2022 Wolters Kluwer Health, Inc. and/or its subsidiaries. All rights reserved.

WHIM syndrome (the association of warts, hypogammaglobulinemia, recurrent bacterial infections, and 'myelokathexis') is a rare congenital form of neutropenia associated with an unusual immune disorder involving hypogammaglonulinemia and abnormal susceptibility to warts. In this review, we describe the clinical, laboratory and genetic features of WHIM syndrome. The identification of chemokine receptor CXCR4 as the causative gene of WHIM syndrome yields new interest in the study of this disease as a model for the comprehension of CXCR4 biology in humans and highlights the importance of the chemokine network for inducing effective immune responses and governing leukocyte trafficking. CXCR4 participates in several biological processes (bone marrow hematopoiesis, cardiogenesis, angiogenesis, neurogenesis) and is implicated in different clinical pathologic conditions (WHIM, HIV infection, tumor metastatization, autoimmunity). Pharmacologic agents that modulate CXCR4 expression/function are already available and promise a wide range of future clinical applications.

Hepcidin is a recently discovered hepatic peptide that regulates intestinal iron absorption as well as maternal-fetal iron transport across the placenta. It probably also affects the release of iron from hepatic stores and from macrophages involved in the recycling of iron from hemoglobin. Connecting iron metabolism to innate immunity, hepcidin is a key mediator of hypoferremia of inflammation. The essential role of hepcidin in iron metabolism is being elucidated through mouse and human genetics, biochemistry, and cell biology. Studies of hepcidin are leading to fundamental understanding of iron homeostasis and pointing to potential treatments for hemochromatosis and anemia of inflammation (anemia of chronic disease).

Dopamine is one of the major natriuretic hormone. It acts as an autocrine or paracrine factor to inhibit Na+ transport in several tubular segments. Na+,K(+)-ATPase is an important target protein for dopamine. Studies of the tubular effects of dopamine have provided new information about the coupling of dopamine to intracellular signaling systems and about the molecular mechanism for dopamine interaction with other hormones. Several lines of evidence now suggest that abnormalities of the renal dopamine system can lead to salt-sensitive hypertension.

Over the past several decades, there have been many advances in the equipment, instrumentation and techniques of performing cataract surgery. This review will address the impact of these advances on the safety profile of cataract surgery. Recent studies have demonstrated a decline in the risk of serious postoperative adverse events (endophthalmitis, suprachoroidal hemorrhage, retinal detachment) following cataract surgery. Factors that increase the risk of serious complications from cataract surgery include patient-related factors (male sex, concomitant diabetic retinopathy, same day cataract surgery combined with another intraocular surgery, tamsulosin use) and surgeon-related factors (low surgical volume, limited experience, operating on patients who are most prone to adverse events). Cataract surgery continues to be a very well tolerated surgical procedure with few patients experiencing serious sight-threatening adverse events. Studies in the literature have helped surgeons identify patients who are at high risk for surgical complications and develop strategies to limit surgical complications when operating on these patients. As multifocal intraocular lenses, femtosecond laser technology, and other surgical innovations continue to gain popularity, it will be interesting in the coming years to determine whether there will be a continued reduction in complications of cataract surgery.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-Print For Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions All Articles Images Videos Podcasts Blogs Advanced Search February 1992 - Volume 3 - Issue 1 Previous Abstract Next Abstract Full Text Access for Subscribers: Individual Subscribers Log in for access Institutional Users Access through Ovid® Not a Subscriber? Buy Subscribe Request Permissions You can read the full text of this article if you: Select an option Log In Buy Article Subscribe Content & Permissions Access through Ovid Log In Access through Ovid Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Current Opinion in Lipidology. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Nutrition and Therapeutics: PDF OnlyThe effects of nutrients on lipoprotein susceptibility to oxidationBerry, Elliot M. Author Information Department of Medicine, Hadassah University Hospital, Jerusalem, Israel Current Opinion in Lipidology: February 1992 - Volume 3 - Issue 1 - p 5-11 Buy Abstract There is accumulating evidence that oxidatively modified low-density lipoproteins have a role in the pathogenesis of atherosclerosis. The susceptibility of low-density lipoprotein to oxidative stress depends on the balance between its content of polyunsaturated fatty acids and antioxidants, in particular vitamin E. Both these nutrients are derived entirely from dietary sources. © Lippincott-Raven Publishers. Source The effects of nutrients on lipoprotein susceptibility to oxidation Current Opinion in Lipidology3(1):5-11, February 1992. Full-Size Email + Favorites Export View in Gallery Email to Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Current Opinion in Lipidology. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Related Articles Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Current Opinion in Lipidology. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Article Level Metrics Related Links Articles in PubMed by Elliot M. Berry Articles in Google Scholar by Elliot M. Berry Other articles in this journal by Elliot M. Berry Related Videos Data is temporarily unavailable. Please try again soon. Back to Top Never Miss an Issue Get new journal Tables of Contents sent right to your email inbox Get New Issue Alerts Browse Journal Content Most Popular For Authors About the Journal Past Issues Current Issue Register on the website Subscribe Get eTOC Alerts For Journal Authors Submit an article How to publish with us Customer Service Activate your journal subscription Activate Journal Subscription Browse the help center Help Contact us at: EMAIL: [email protected] TEL: (USA): TEL: (Int’l): 800-638-3030 (within USA) 301-223-2300 (international) Privacy Policy (Updated June 1, 2020) Legal Disclaimer Terms of Use Open Access Policy Feedback Sitemap RSS Feeds LWW Journals Copyright © 2022 Wolters Kluwer Health, Inc. and/or its subsidiaries. All rights reserved.

Diagnosis and therapy of polycythemia vera are controversial since the molecular basis of polycythemia vera remains unknown. Distinguishing between polycythemia vera and other polycythemic disorders can be very challenging. The purpose of this review is to discuss the recent progress in this area and critically review the published data in context of our knowledge of other polycythemic disorders. Erythropoietin is the principal regulator of regulator of erythropoiesis; its production is regulated by the degree of hypoxia. Our knowledge of cellular responses to hypoxia has recently exploded and led to the elucidation of the molecular basis of a polycythemia caused by augmentation of hypoxic sensing, Chuvash polycythemia. Similar progress in understanding the molecular basis of polycythemia vera has been elusive. A simple, readily available laboratory test to establish a diagnosis of polycythemia vera would be highly desirable; however, none exists. The value of quantization of neutrophil PRV-1 mRNA, platelet c-mpl expression, in vitro assays of erythroid progenitor cells, serum erythropoietin levels, establishing clonality in female subjects using assays employing X-chromosome-based polymorphism assays, and the progress in the chromosomal location of the gene is discussed. Integration of this information underlies the complexity of the molecular biology of polycythemia vera and indicates likely interaction of multiple genetic events in the genesis of polycythemia vera. The existence of family clustering of PV may facilitate the search for PV molecular basis. Only collaborative interaction of clinical researchers and laboratory scientists will lead to meaningful progress in determining the molecular basis of PV.

Obesity, which has reached epidemic proportions in the United States and other western countries, may be complicated by hypertension, an increased incidence of renal cancer or proteinuria. Patients with obesity-associated proteinuria show focal glomerulosclerosis and glomerulomegaly on biopsy, usually have minimal clinical edema and relatively normal levels of serum albumin, cholesterol and blood pressure, and can progress to end-stage renal disease. Severe obesity may also be an additive risk factor in patients with preexisting nephropathy or reduced renal mass. The pathophysiology of obesity-associated proteinuria is unclear but may include hyperfiltration, increased renal venous pressure, glomerular hypertrophy, hyperlipidemia and increased synthesis of vasoactive and fibrogenic substances, including angiotensin II, insulin, leptin and transforming growth factor-beta1. These substances may individually or interactively affect glomerular hyperfiltration, mesangial cell hypertrophy and matrix production, and the production of collagen, fibronectin, transforming growth factor-beta and other fibrogenic mediators of change. Although angiotensin-converting enzyme inhibition has proven to have an impact, perhaps temporarily, on obesity-associated proteinuria in humans, weight reduction early in the course of the disease would appear the most important therapeutic approach.

As glaucoma surgeons continue to search for an improvement over trabeculectomy, the ExPRESS miniature glaucoma shunt has gained interest as a possible contender. Peer-reviewed literature on ExPRESS is beginning to accumulate allowing an evidence-based review to assess the potential benefits and limitations compared to trabeculectomy. The current surgical procedure for ExPRESS implantation will be described followed by results of studies comparing ExPRESS to trabeculectomy, focusing on the following outcomes: success, intraocular pressure, and complications. Case reports of late complications specific to the ExPRESS device will be summarized. Finally, an economic analysis comparing ExPRESS to trabeculectomy will be provided as additional evidence to contribute to the decision matrix on deciding which filtration procedure to recommend. Despite a large number of ExPRESS implant procedures worldwide, there is a paucity of high-quality studies comparing ExPRESS to trabeculectomy. From the available literature to date the outcomes (success and early complications) of ExPRESS are similar to trabeculectomy. Reports of late complications related to device extrusion and malposition are beginning to be published; however, the significantly increased cost for ExPRESS surgery is likely to be the main limitation to widespread adoption of this procedure.

Clinical Neurophysiology: EEG–Video Monitoring

To characterize non-epileptic seizures (NES) in the elderly and compare their features with NES of a younger control group. The database of the epilepsy monitoring unit of the Cleveland Clinic Foundation (CCF) was searched for patients aged 60 years and older having undergone long-term video-/EEG monitoring between 1994 and 2002, with the subsequent diagnosis of NES. Videotapes of all events were evaluated by independent observers. NES were classified based on the clinical manifestations recorded on video, EEG and imaging data, and compared with a control group of younger adults with NES. Thirty-nine elderly patients were included. Seventeen of them (44%) had NES only, six (15%) had both epilepsy and NES. The control group consisted of 20 patients, two of them had NES and epilepsy. The NES were classified as physiological in 10 elderly patients (43%) and one control patient. They included TIA, syncope, movement disorders and sleep disorders. Psychogenic NES were found in 13 elderly and 19 control patients and were associated with somatoform disorders, anxiety disorders, mood disorders and reinforced behavior pattern. Psychogenic NES consisted of predominant motor activity in 8 (61%) elderly and 13 (68%) control patients, unresponsiveness in 4 (31%) elderly and 2 (11%) control patients and subjective symptoms in 1 (8%) elderly and 4 (21%) control patients. Twelve (71%) of the patients of each group without evidence for epilepsy were on anticonvulsant drugs at the time of admission. NES are a frequent problem in elderly patients referred to a comprehensive epilepsy center. In contrast to a younger control group, physiological and psychogenic NES are equally frequent in the elderly. Loss of responsiveness was seen in only 20% of patients with psychogenic NES. Although most of the patients did not have any evidence for epilepsy, more than two thirds of these patients had been placed on anticonvulsive drugs.