Gbs 2010
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The document summarizes key changes to CDC guidelines for prevention of early-onset group B Streptococcus (GBS) disease. These include expanded laboratory detection options for GBS, revised thresholds for reporting GBS in urine cultures, clarified definitions of adequate antibiotic prophylaxis, and recommendations for neonatal management and treatment of penicillin-allergic pregnant women. Laboratories are no longer required to report low levels of GBS in urine cultures but providers should still consider these women GBS positive. Clindamycin susceptibility testing is important for penicillin-allergic high-risk patients.
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Multiple Sclerosis and Stem Cells Therapy
Multiple sclerosis is generally referred to as an autoimmune disease or disorder in which the nerve cells of brain and spinal cord are attacked by patients own immune system.
The patient's bodys immune system perceives myelin sheet as an intruder and attack it resulting in damage due to which this sheet no longer carry the messages properly causing the message transmission process to be slowed, distorted or stopped altogether.
At present there is no cure available for multiple sclerosis, however, using certain drugs such as interferon’s, exercise and physiotherapy it is possible to manage the attacks and symptoms.
Researchers hope that stem cell therapies may provide new approaches that can both prevent damage and enable us to repair it.
Epstein-Barr virus genetic variants are associated with multiple sclerosis.
Rosella Mechelli, Caterina Manzari, Claudia Policano, Anita Annese, Ernesto Picardi, Renato Umeton, Arianna Fornasiero, Anna Maria D’Erchia, Maria Chiara Buscarinu, Cristina Agliardi, Viviana Annibali, Barbara Serafini, Barbara Rosicarelli, Silvia Romano, Daniela F. Angelini, Vito A.G. Ricigliano, Fabio Buttari, Luca Battistini, Diego Centonze, Franca R. Guerini, Sandra D’Alfonso, Graziano Pesole, Marco Salvetti, Giovanni Ristori
OBJECTIVE:
We analyzed the Epstein-Barr nuclear antigen 2 (EBNA2) gene, which contains the most variable region of the viral genome, in persons with multiple sclerosis (MS) and control subjects to verify whether virus genetic variants are involved in disease development.
METHODS:
A seminested PCR approach and Sanger sequencing were used to analyze EBNA2 in 53 patients and 38 matched healthy donors (HDs). High-throughput sequencing by Illumina MiSeq was also applied in a subgroup of donors (17 patients and 17 HDs). Patients underwent gadolinium-enhanced MRI and human leucocyte antigen typing.
RESULTS:
MS risk significantly correlated with an excess of 1.2 allele (odds ratio [OR] = 5.13; 95% confidence interval [CI] 1.84-14.32; p = 0.016) and underrepresentation of 1.3B allele (OR = 0.23; 95% CI 0.08-0.51; p = 0.0006). We identified new genetic variants, mostly 1.2 allele- and MS-associated (especially amino acid variation at position 245; OR = 9.4; 95% CI 1.19-78.72; p = 0.0123). In all cases, the consensus sequence from deep sequencing confirmed Sanger sequencing (including the cosegregation of newly identified variants with known EBNA2 alleles) and showed that the extent of genotype intraindividual variability was higher than expected: rare EBNA2 variants were detected in all HDs and patients with MS (range 1-17 and 3-19, respectively). EBNA2 variants did not seem to correlate with human leucocyte antigen typing or clinical/MRI features.
CONCLUSIONS:
Our study unveils a strong association between Epstein-Barr virus genomic variants and MS, reinforcing the idea that Epstein-Barr virus contributes to disease development.
Medicine 5th year, 6th lecture/part one (Dr. Mohammed Tahir)
Multiple Sclerosis (MS) is an autoimmune disease where the body's immune system attacks the protective myelin sheath surrounding the nerves. It is a lifelong disease with no known cure. Common symptoms include fatigue, weakness, numbness, vision problems, and cognitive issues. While there is no single known cause, genetic and environmental factors such as latitude, infections, and family history are associated with increased risk. Diagnosis involves ruling out other conditions through clinical evaluation and tests such as MRI and lumbar puncture. Treatment focuses on managing symptoms and reducing relapse rate through medications, while rehabilitation and alternative therapies can also help those affected cope with the disease.
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...Fundación Ramón Areces
Ciclo de conferencias y debates en Ciencias.
Fundación Ramón Areces-Nature Publishing Group.
Jorge R. Oksenberg. Universidad de California, San Francisco, EE. UU.
Madrid, 2 de febrero de 2012Effects of Antioxidants on Age and Multiple Sclerosis-Related Oxidative Stress
Abstract: Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system (CNS). The pathogenesis of MS involves neurodegeneration which may be due to oxidative stress. Antioxidants such as vitamins have been studied as modifiers and biomarkers of oxidative stress in MS patients. MS progression, specifically that in which relapsing-remitting multiple sclerosis (RRMS) transitions to secondary-progressive multiple sclerosis (SPMS), is independent of disease onset and duration, but correlated with age. Because of the neurodegenerative effects of oxidative stress and the age-dependent course of MS, it is possible that the transition from RRMS to SPMS is caused by levels of oxidative stress that may increase with age. This study investigates the role of antioxidants α-tocopherol, glutathione, and uric acid on oxidative stress and subsequent MS progression. Further, I intend to compare the different effects of antioxidant supplements on RRMS patients, SPMS patients, and relatively healthy individuals based on cerebrospinal fluid and serum samples.
MS Genetics Presentation_Julia_Feb 2014Invesot
An early diagnosis kit is being developed that combines genetic and immunological tests to diagnose multiple sclerosis (MS) with high accuracy through a simple blood test. The kit leverages proven technologies from MS Genetics and Louphius that have shown accuracy rates of 83% and 91% respectively in differentiating MS from other conditions. By combining results from tests measuring gene expression, genetic risk alleles, and anti-glycan antibodies through conditional probability, the kit aims to outperform individual tests to enable early and differential diagnosis of MS with a high positive predictive value. A Horizon 2020 project is proposed to further optimize and validate the individual tests and their combined use in an integrated classification system to facilitate early treatment and reduce disability.
Challenges in the treatment against multiple sclerosis
Challenges in treating multiple sclerosis include fully understanding its pathogenesis and developing more precise and rapid diagnostics. Current diagnostic techniques involve magnetic resonance imaging, genetic testing, analysis of cerebrospinal fluid, and biomarker identification. Treatment approaches utilize drugs like interferon-beta, glatiramer acetate, fingolimod, and natalizumab. Research into therapeutic monoclonal antibodies produced through recombinant DNA technology, like alemtuzumab, may further advance treatment options for multiple sclerosis.
Cotsapas ASHG 2011
Preliminary report describing a targeted sequencing study in 1500 MS cases and 1500 controls. I presented this at the ASHG 2011 session on large scale resequencing.
Multiple Sclerosis Diagnostics Dr C Bourque
1. Multiple Sclerosis (MS) is a disease of the central nervous system that results in demyelination and damage to the protective myelin sheaths surrounding nerve fibers. Common symptoms include visual problems, muscle weakness, sensory issues, and coordination and balance issues.
2. The diagnosis of MS is based on clinical evidence of lesions in the brain and spinal cord disseminated in time and space. MRI and lumbar puncture are important tests to support the diagnosis.
3. There are different clinical courses of MS including relapsing-remitting, secondary-progressive, primary-progressive and progressive-relapsing. The McDonald criteria from 2001 is now commonly used to diagnose MS based on clinical and
Multiple sclerosis
Multiple sclerosis is a chronic disease that damages the protective sheath surrounding nerve fibers in the brain and spinal cord. The immune system attacks this sheath, called myelin, which causes communication problems between the brain and body. The cause is unknown but likely involves genetic and environmental factors. Symptoms vary depending on the location of damage but can include numbness, vision problems, weakness, and impaired coordination. Diagnosis involves neurological exams, MRI images showing lesions in the brain and spine, and analysis of cerebrospinal fluid. While there is no cure, treatments aim to reduce frequency and severity of attacks and manage symptoms. Prognosis depends on the specific symptoms and disease progression in early years.
Disease modifying therapy presentation
This document provides information on disease modifying therapies (DMTs) licensed for use in the UK to treat multiple sclerosis (MS). It outlines the 7 DMT drugs approved, including beta interferons, glatiramer acetate, natalizumab, and fingolimod. It describes how these drugs work to reduce inflammation and immune cell activity that causes MS symptoms. Side effects, dosage regimens, storage requirements, and reasons for stopping or switching drugs are discussed. Travel tips and additional resources for patients prescribed DMTs are also mentioned.
MS Disease modifying agents for multiple sclerosis
This document summarizes disease modifying drugs for multiple sclerosis. It discusses established agents like interferon beta, glatiramer acetate, natalizumab, and mitoxantrone that have been proven to reduce relapse rates and disability progression in clinical trials. Side effects and administration methods are provided for each. Other potential agents are mentioned, including immunosuppressants like azathioprine, cyclophosphamide, and immune modulators like methotrexate and intravenous immunoglobulin, but they have not been conclusively proven to benefit MS through phase III trials.
Multiple Sclerosis SEMINAR
This document provides information on Multiple Sclerosis (MS), including its epidemiology, etiology, clinical presentation, diagnostic tests, disease course, and treatment options. MS is an immune-mediated disease that attacks the central nervous system, destroying myelin and axons. Common symptoms include visual changes, numbness, weakness, and balance issues. Diagnosis involves MRI, lumbar puncture for cerebrospinal fluid analysis, and evoked potentials testing. The disease course varies between relapsing-remitting, primary progressive, and secondary progressive forms. Treatment focuses on reducing inflammation and disability through medications like interferon beta, glatiramer acetate, and natalizumab, as well as managing symptoms with drugs for pain,
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Epstein-Barr virus genetic variants are associated with multiple sclerosis.
Epstein-Barr virus genetic variants are associated with multiple sclerosis.
Medicine 5th year, 6th lecture/part one (Dr. Mohammed Tahir)
Medicine 5th year, 6th lecture/part one (Dr. Mohammed Tahir)
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...
Effects of Antioxidants on Age and Multiple Sclerosis-Related Oxidative Stress
Effects of Antioxidants on Age and Multiple Sclerosis-Related Oxidative Stress
Challenges in the treatment against multiple sclerosis
Challenges in the treatment against multiple sclerosis
MS Disease modifying agents for multiple sclerosis
MS Disease modifying agents for multiple sclerosis
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The document discusses neonatal infection risks associated with prolonged rupture of membranes and strategies for prevention and management. Key points:
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Fungal sepsis,final,nnf kerala,kims,2019 - Dr Karthik Nagesh
This document summarizes key information on fungal infections in newborns. It finds that invasive candidiasis is most common in extremely low birth weight infants. Risk factors include central lines, prolonged antibiotic use, and TPN. Diagnosis relies on detecting Candida in blood or other sterile sites. Early treatment with antifungals like amphotericin B or fluconazole is important to prevent complications. Prophylaxis with fluconazole may benefit high-risk infants to reduce invasive infections.
TB in special situation 2022.pptx
1) A pregnant woman presented with reactivated tuberculosis and was treated with a first-line anti-tuberculosis regimen for 6 months while closely monitored.
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This document discusses pre-labour rupture of membranes (PROM), specifically defining it as rupture of membranes before the onset of labour. It describes the typical incidence rates of term and preterm PROM. The document then outlines the clinical diagnosis and assessment process, including examination findings and additional tests that can be used. Expectant and active management strategies are described for term and preterm PROM cases. Complications associated with PROM are also summarized.
Neonatal Sepsis AAP 2013
Presentation on Prevention and Management of Infants With Suspected or Proven Neonatal Sepsis
References:
American Academy of Pediatrics. Prevention and Management of Infants With Suspected or Proven Neonatal Sepsis, 2013.
American Academy of Pediatrics. Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis, 2012.
CARE OF PREGNANT WOMEN WITH AYURVEDA IN COVID19
This document provides information on caring for pregnant women with Ayurveda during the COVID-19 pandemic. It discusses the effects of COVID-19 on pregnancy and the fetus, routine antenatal care during the pandemic, care for suspected or confirmed COVID-19 cases, intrapartum care, postpartum care, discharge counseling, and Ayurvedic aspects of care. It provides guidance on testing, monitoring, delivery and various care scenarios. It also outlines prophylactic Ayurvedic measures including yoga, formulations and therapies to boost immunity and provides an Ayurvedic approach for symptomatic management and recovery.
Infections during pregnancy
ceratin bacterial, viral, fungal, protozoal and parasitic infections prevails in pregnancy. diagnosis and management
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This document discusses pulmonary tuberculosis in pregnant women. It notes that 30% of global TB cases are in India, and 5% of pregnant women have active TB disease. It outlines symptoms of TB in pregnancy like fatigue, fever, and cough. It discusses evaluating and treating TB in pregnancy, including using directly observed therapy. Side effects on the fetus are considered minimal. Vaginal delivery is generally safe while avoiding certain drugs. Breastfeeding is also generally recommended while taking precautions if the mother has active TB.
Hpv vaccination
HPV vaccination provides protection against HPV strains that cause cervical cancer and genital warts. The FDA has approved several HPV vaccines, including a quadrivalent vaccine protecting against strains 16, 18, 6, and 11, and a bivalent vaccine protecting against 16 and 18. Vaccination is recommended between ages 9-14 with a two dose schedule, or ages 15 and older with a three dose schedule. HPV vaccination has been shown to be safe and effective with common side effects being mild local reactions. Screening is still recommended for vaccinated individuals as the vaccines do not protect against all cancer-causing HPV strains.
Red Hot Antibiotics in Pregnancy
This was a joint lecture for the Chong Hua Hospital Postgraduate Course by OB-infectious disease specialist Dr Helen Madamba and IM-infectious disease specialist Dr Mitzi Chua.
6
This document discusses tuberculosis (TB) in children, the relationship between TB and HIV, and TB during pregnancy. It notes that 10-20% of TB cases are in children under 5 years old. Children are usually sputum-negative and not infectious. The main sources of infection are adults with sputum-positive TB. Treatment involves several anti-TB drugs given in specific doses over several months. Chemoprophylaxis is recommended for children exposed to sputum-positive individuals. Co-infection with HIV greatly increases the risk of active TB. Diagnosis is more difficult and extra-pulmonary TB is more common. Standard TB treatment is still used but drug interactions with HIV medications must be considered. TB in pregnancy does not typically
Naco guidelines update 2015
early infant diagnosis and immunization and cotrimoxazole prophylaxis as well as breast feeding revised protocols
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This document summarizes evidence and guidelines around the evaluation and management of possible early-onset neonatal sepsis. It finds that restricting unnecessary evaluation and antibiotics is important. Clinical monitoring can identify red flags and is often sufficient for well-appearing late preterm and term infants, especially with serial exams over 12 hours. While tests have limited predictive value, stopping antibiotics by 36 hours for reassuring infants is recommended. Several adjuvant therapies like exchange transfusions, immunoglobulins, and colony stimulating factors show promise but require more research before routine use.
Covid19 & pregnancy
The document discusses COVID-19 and pregnancy from the perspective of an obstetrician. It covers vertical transmission, sexual transmission, diagnosis, effects on pregnancy, and management. Key points include: no evidence of vertical transmission, increased risk of severe infection and DVT for pregnant women, ultrasound and CT are recommended for diagnosis with low radiation exposure, and a multidisciplinary team approach is needed with separate prenatal clinics and delivery rooms for infected patients.
Community acquired pneumonia in children
These guidelines provide recommendations for diagnosing and managing community-acquired pneumonia in children. Key points include:
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oxford university Group B streptococcus
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Updates in Viral STIs in Pregnancy
This is a discussion of hepatitis B, hepatitis C and HIV in pregnancy, the optimal screening for these infections and the integration of management approach based on evidence. Lecture given during the 2018 PIDSOG post-graduate course "High-Yield OBGYN Infections 2.0: From Confusion to Clarity" at the Conrad Manila on November 12, 2018.
UTI in Pregnancy
This document provides guidelines for urinary tract infections (UTIs) during pregnancy. It discusses that UTIs are the most common medical complications of pregnancy and are associated with risks like preterm delivery. It outlines recommendations for screening, diagnosing, and treating asymptomatic bacteriuria, acute cystitis, and acute pyelonephritis during pregnancy. Treatment is recommended for asymptomatic bacteriuria to reduce risks, and symptomatic UTIs should be promptly treated with appropriate antibiotics based on culture and sensitivity testing. Post-treatment cultures are advised to confirm resolution of infections.
SYPHILIS.pptx
1) Pregnant women with syphilis can transmit the infection to their fetus through the placenta or during birth, potentially causing consequences like premature delivery, low birth weight, or congenital anomalies.
2) Congenital syphilis presents in infants as symptoms like rashes, nasal discharge, or bone abnormalities and is diagnosed through tests of body fluids, lesions, or the placenta to detect Treponema pallidum.
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Kpsc diabetes in pregnancy pathway 8.6.2012
The document outlines guidelines for managing diabetes in pregnancy across medical centers. It discusses:
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2. Risk stratification of patients into low, medium, and high risk groups based on diabetes history and control. This determines interventions like medication management and fetal monitoring.
3. Screening all prenatal patients for GDM risk and providing diabetes education. High risk patients receive early glucose testing while low risk patients are tested at 24-28 weeks.
4. Postpartum follow-up
Economy
The document discusses issues with the current scheduling system including too many changes and vague requests. It proposes implementing scheduled cesarean sections on call days to improve efficiency by ensuring the primary surgeon performs the surgery and eliminating wasted time. This could add 30 hours of clinic access per month. Some providers argue they are too busy, but deliveries have decreased so scheduling cesareans this way could help protect staffing levels. No more than 2 cesareans would be scheduled per provider per call day.
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This document provides guidelines for managing twin pregnancies, including determining chorionicity and amnioticity. It recommends that all twins undergo an NT ultrasound before 14 weeks to validate chorionicity/amnionicity and detect early complications. Management of monochorionic twins requires more intensive surveillance due to increased risks of complications affecting fetal growth and well-being. Dichorionic twins generally require less frequent monitoring while monochorionic twins should be monitored more closely, with delivery planned before 37 weeks.
New Progesterone Guideline for Preterm labor and incidental shortened cervix
This document summarizes recommendations for using progesterone to prevent preterm birth based on a woman's history and cervical length. It recommends 17-hydroxyprogesterone caproate injections weekly from 16-20 weeks until 36 weeks for women with a prior spontaneous preterm birth. For women without a prior preterm birth but an incidental short cervical length of 10-20mm before 24 weeks, it recommends daily vaginal progesterone until 36 weeks. Safety follow-up of children exposed to 17-hydroxyprogesterone caproate in clinical trials found no differences compared to placebo.
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The document discusses improving patient satisfaction scores related to communication about medications at Riverside Medical Center's maternity service. The goal is to increase the HCAHPS medication communication score from 66% to 75% by December 2012 and 85% by June 2013. This will be achieved through education of providers, patients, and staff. Providers will be educated on medications through meetings and flashcards. Patients will receive verbal and written information about new medications. Staff will track medication discussions on patient care boards. Progress will be measured through education documentation and eventual HCAHPS scores.
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This document discusses coccidioidomycosis (Valley fever) during pregnancy. It notes that the infection is more severe when acquired during pregnancy, especially in the third trimester, and that the use of azole antifungals during pregnancy can be teratogenic. It reviews literature on cases of coccidioidomycosis in pregnancy and the effect of sex hormones on fungal growth. It also discusses the risk of birth defects from azole exposure during pregnancy, specifically the Antley-Bixler syndrome. The document provides recommendations for managing coccidioidomycosis in pregnant women based on their infection status and trimester.
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Von Willebrand disease is the most common inherited bleeding disorder caused by mutations that decrease or impair von Willebrand factor, which promotes platelet adhesion and clotting. It ranges from mild to severe. Type I is the most common form with a quantitative deficiency, while type II has qualitative defects affecting function. Treatment involves desmopressin, which releases stored VWF, or VWF replacement for refractory or severe cases. Careful management is needed around procedures and delivery to maintain adequate VWF and factor VIII levels through replacement to prevent bleeding.
Hini2012 update
The document provides guidelines for evaluating and managing patients with influenza-like illness (ILI) during pregnancy. It describes the symptoms of ILI and H1N1 flu. Patients with mild ILI symptoms and no risk factors can be treated as outpatients, while those with concerning signs, comorbidities, or symptom progression warrant further evaluation and treatment including Tamiflu and possible hospitalization.
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This document discusses the management of postpartum hemorrhage (PPH). It defines PPH and risk factors. It outlines the roles and responsibilities of the nursing team in responding to a PPH. It also details the differential diagnosis, initial resuscitation steps, and therapeutic escalation based on the severity of bleeding and patient's response to treatment. The goal is to recognize and treat PPH early through decisive clinical response and prevent complications like shock.
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The document discusses evidence that magnesium sulfate administered to mothers at risk of preterm birth reduces the risk of cerebral palsy in infants. Several large randomized controlled trials and meta-analyses involving over 15,000 women found magnesium sulfate decreased the risk of cerebral palsy without increasing mortality. The number needed to treat to prevent one case of cerebral palsy is estimated at 63 women. The document also describes a modified magnesium sulfate neuroprotection protocol used at Riverside Hospital for imminent preterm deliveries between 23 and 33 weeks.
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