Quantitative Sudomotor Axon Reflex and Related Tests

2009 ◽  
pp. 629-636
Author(s):  
Phillip A. Low
Keyword(s):  
Clinical Applications ◽  
Response To Treatment ◽  
Dynamic Tests ◽  
Axon Reflex ◽  
Sudomotor Function ◽  
Definition Of

The application of noninvasive, sensitive, quantitative, and dynamic tests of sudomotor function enhances significantly our ability to quantitate one aspect of the autonomic deficit. The QSART has an important role in clinical applications to better definition of the course of neuropathy, its response to treatment, and further exploration of sudomotor physiology.

Quantitative Sudomotor Axon Reflex and Related Tests

2016 ◽  
pp. 628-634
Author(s):  
Phillip A. Low
Keyword(s):  
Nerve Fibers ◽  
Clinical Applications ◽  
Screening Tests ◽  
Response To Treatment ◽  
Dynamic Tests ◽  
Axon Reflex ◽  
Sudomotor Function ◽  
Distal Nerve ◽  
Definition Of ◽  
Small Nerve

Small distal nerve fibers are often selectively involved in some patients with axonal neuropathies (distal small-fiber neuropathy). One method of testing the integrity of these small nerve fibers is to study the postganglionic sympathetic sudomotor “C” fiber function. The application of noninvasive, sensitive, quantitative, and dynamic tests of sudomotor function significantly enhances the ability to quantitate one aspect of the autonomic deficit. The quantitative sudomotor axon reflex test (QSART) has an important role in clinical applications to better definition of the course of neuropathy, its response to treatment, and further exploration of sudomotor physiology. Simpler methods are available as screening tests. This chapter reviews the use of methods to measure sudomotor fiber function.

Serum cortisol and 11 deoxycortisol by liquid chromatography: clinical studies and comparison with radioimmunoassay.

1979 ◽  
Vol 25 (10) ◽  
pp. 1700-1703 ◽  
Author(s):  
E Canalis ◽  
A M Caldarella ◽  
G E Reardon
Keyword(s):  
Liquid Chromatography ◽  
Oral Administration ◽  
Serum Cortisol ◽  
Clinical Applications ◽  
Adrenal Function ◽  
Dynamic Tests ◽  
Oral Ingestion ◽  
Chromatographic Procedure ◽  
Normal Humans ◽  
Liquid Chromatographic

Abstract We describe a liquid-chromatographic procedure for separating and measuring cortisol and 11-deoxycortisol in serum. We quantitated these steroids in patients who were undergoing various tests of pituitary and (or) adrenal function and compared the results with those obtained by two radioimmunoassays done in two different laboratories. Results of 48 tests done in 37 functionally normal humans are presented. Cortisol values for sera collected in the morning as determined by liquid chromatography were (mean +/- SD) 134 +/- 54 micrograms/L. Serum cortisol concentrations increased from 136 +/- 65 to 321 +/- 80 micrograms/L 60 min after injecting synthetic corticotropin and increased from 107 +/- 46 to 242 +/- 31 micrograms/L after insulin-induced hypoglycemia. Serum cortisol decreased from 142 +/- 49 to 26 +/- 20 micrograms/L after oral administration of metyrapone, while 11-deoxycortisol increased from less than 10 to 210 +/- 53 micrograms/L. Serum cortisol measured less than 10 micrograms/L the morning after oral ingestion of dexamethasone. Results of the dynamic tests of adrenal function correlated well with previously reported studies. However, the cortisol values obtained by our technique were generally lower than those obtained by radioimmunoassay, possibly owing to lack of specificity of the latter methods used here for comparison. In contrast, values for 11-deoxycortisol were the same by both methods. The present studies confirm the usefulness of liquid chromatography for measuring these two steroids in serum during tests of pituitary and adrenal function. Future refinements of the technique should continue to increase its clinical applications.

scholarly journals Circulating Tumor Cells in Metastatic Breast Cancer: Clinical Applications and Future Possibilities

2020 ◽  
Vol 10 (9) ◽  
pp. 3311
Author(s):  
Maggie Banys-Paluchowski ◽  
Florian Reinhardt ◽  
Tanja Fehm
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Therapy Monitoring ◽  
Metastatic Breast ◽  
Study Groups ◽  
Clinical Applications ◽  
Response To Treatment ◽  
Cellsearch System

Circulating tumor cells (CTCs) have gained importance as an emerging biomarker in solid tumors in the last two decades. Several detection assays have been introduced by various study groups, with EpCAM-based CellSearch system being the most widely used and standardized technique. In breast cancer, detection of CTCs correlates with clinical outcome in early and metastatic settings. CTC persistence beyond first cycle of palliative chemotherapy indicates poor response to treatment in metastatic situation. Beyond prognostication and therapy monitoring, CTC counts can guide treatment decisions in hormone receptor positive HER2-negative metastatic breast cancer. Furthermore, CTC-based therapy interventions are currently under investigation in clinical trials. In this review, we focus on the current state of knowledge and possible clinical applications of CTC diagnostics in patients with metastatic breast cancer.

scholarly journals Mechanisms and Clinical Applications of Genome Instability in Multiple Myeloma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Antonia Cagnetta ◽  
Davide Lovera ◽  
Raffaella Grasso ◽  
Nicoletta Colombo ◽  
Letizia Canepa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Genomic Instability ◽  
Molecular Basis ◽  
Genome Instability ◽  
Dna Recombination ◽  
Clinical Applications ◽  
Response To Treatment ◽  
Chromosomal Segregation ◽  
Telomere Function ◽  
Mitotic Regulation

Ongoing genomic instability represents a hallmark of multiple myeloma (MM) cells, which manifests largely as whole chromosome- or translocation-based aneuploidy. Importantly, although it supports tumorigenesis, progression and, response to treatment in MM patients, it remains one of the least understood components of malignant transformation in terms of molecular basis. Therefore these aspects make the comprehension of genomic instability a pioneering strategy for novel therapeutic and clinical speculations to use in the management of MM patients. Here we will review mechanisms mediating genomic instability in MM cells with an emphasis placed on pathogenic mutations affecting DNA recombination, replication and repair, telomere function and mitotic regulation of spindle attachment, centrosome function, and chromosomal segregation. We will discuss the mechanisms by which genetic aberrations give rise to multiple pathogenic events required for myelomagenesis and conclude with a discussion of the clinical applications of these findings in MM patients.

Depressed patients with schizophrenic or paranoid symptoms

1980 ◽  
Vol 10 (4) ◽  
pp. 665-675 ◽  
Author(s):  
I. F. Brockington ◽  
R. E. Kendell ◽  
S. Wainwright
Keyword(s):  
Family History ◽  
Affective Disorders ◽  
Final Diagnosis ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Affective Psychosis ◽  
Manic Depressive ◽  
Paranoid Symptoms ◽  
Definition Of

SYNOPSISFamily history, response to treatment and outcome are reported in a series of 76 patients presenting with both depression and schizophrenic or paranoid symptoms. About 10% of psychotic admissions to the Maudsley and Bethlem Royal Hospitals met a study definition of ‘schizodepressive’ illness. The patients were highly heterogeneous in history, clinical picture and outcome. Many followed a typical schizophrenic course, and others a typical course for affective disorders, but only 4 were given a final diagnosis of manic depressive disease. The best predictors of poor outcome were a mode of onset as an exacerbation of previous psychotic symptoms and the presence of schizophrenic symptoms at some time without depression. The best predictors of good outcome were Stephens' criteria of good prognosis schizophrenia and Kasanin's concept of ‘acute schizo-affective psychosis’. These findings are not easily reconciled with Kraepelin's two entities principle but suggest a continuum of outcome between schizophrenia and unipolar depressive psychosis.

scholarly journals Flu pandemics: homeopathic prophylaxis and definition of the epidemic genius

2021 ◽  
Vol 8 (28) ◽  
pp. 100-109
Author(s):  
Renan Marino
Keyword(s):  
Public Health ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Viral Genetics ◽  
Clinical Evolution ◽  
Common Etiology ◽  
Definition Of ◽  
Do So

Recent studies on viral genetics establish swine-H1N1 – responsible for the ongoing pandemics – as a remainder or continuation of the agent causing the flu epidemics of 1918. This study aimed at analyzing whether this common etiology also result in significant correlations of clinical manifestations. To do so, data were collected to compare the clinical evolution of cases in the 1918 and 2009 epidemics.  This historical revision was the ground for evaluating the response to treatment including homeopathy in the former epidemics. It is discussed the convenience of including homeopathic prophylaxis grounded on the diagnosis of the epidemic genius among public health actions.

Treatment of 287 Patients(pts) with Severe Aplastic Anemia(SAA) Using Cyclosporine-A(Csa) and Prednisone(Pred): 15 Year Follow-Up from a Single Instituition.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2816-2816
Author(s):  
Marco A. Bitencourt ◽  
Carmem M.S. Bonfim ◽  
Jefferson Ruiz ◽  
Daniela C. Setubal ◽  
Vaneuza M. Funke ◽  
...  
Keyword(s):  
Disease Duration ◽  
Hematological Parameters ◽  
Previous Treatment ◽  
Response To Treatment ◽  
Blood Transfusions ◽  
Type I ◽  
Gingival Hypertrophy ◽  
Red Blood Cell Transfusions ◽  
Definition Of

Abstract Introduction: Allogeneic Stem Cell transplantation from an HLA identical sibling is considered the treatment of choice for young pts. For pts without a suitable donor, immunosupressive treatment with cyclosporine (Csa) + prednisone (Pred) + Antithymocyte globulin (ATG) is an effective alternative treatment. In 1988, as ATG supply was not regular in our country, we decided to initiate a trial using only Csa +Pred to treat SAA without a matched sibling donor. Material and Methods: All pts had the diagnosis of SAA according to established criteria (Camitta et al Blood1976; 48:63–70) and 95 pts had received previous treatment (androgens, Csa alone or steroids). Treatment: Csa: 12mg/kg/day BID from day(D)1- D8, then 7mg/kg/day BID until 1 year. After 1 year, Csa was slowly weaned (5% each month) until definitively stopped. Csa levels were maintained between 200-400ng/ml. Pred:2mg/kg/day from D1-D14 then 1mg/kg/day from D15- D45. From that day on Pred dose was weaned 20% each week until stopped. Prophylactic antibiotics were given according to common practice. Number of pts: 287. Period: 12/1988 to 01/2004. Age: 2-74y (Median: 22). Disease duration: 10–4015days (Median:100). Previous transfusions: 0-160UI (M:10). At diagnosis, granulocytes counts ranged from 0-3110/ul(M:540/uL) and platelet counts from 1000-53000/uL(M:11000/uL). Treatment evaluation was performed at 6weeks, 3,6 and 12 months and then yearly after. Definition of response: Type I: independence of red cells and platelets transfusions and improvement of hematological parameters (Hb>10g/dL, platelets>50.000/uL and granulocytes>1000/uL). Type II: Improvement of hematological parameters (not enough to reach the hematological counts previously specified) with or without dependence of blood transfusions. Type III: No evidence of improvement and dependence of blood transfusions. Results: Overall survival is 63% with a median follow-up of 7 y(6months- 15 years). Response to treatment: TypeI was achieved in 138pts (48%) and all but one pt is alive. These pts have a normal life, free of infections and are transfusion independent. TypeII occurred in 21 pts(7,3%) and 13 pts are alive with only 1 pt dependant of red blood cell transfusions every 45 days. TypeIII occurred in 128pts (44%) and 50 pts are still alive. Most pts responded between 3 and 6m of treatment. Response to treatment was significantly influenced by: Granulocytes at diagnosis >500/uL (p=0,0001); platelets at diagnosis >12000/ul (p=0,01); age>22y(p=0,0061) and previous transfusions < 10UI (p=0,008). Granulocytes at diagnosis >500/uL (p=0,02), platelets at diagnosis >10000/uL (p=0,01)and disease duration >45 days (p=0,02) significantly affected survival. Toxicity was tolerated and well controlled. Hypertension, gingival hypertrophy and diabetes mellitus were frequent complications. Relapse occurred in 19% (31pts) and twenty-two pts(70%) responded to a second treatment using the same drugs but 9pts became cyclosporine dependant. Clonal or malignant disease occurred in 5 pts (2AML and 3 PNH). Conclusion: This data demonstrates that Csa +Pred is an effective treatment for pts with SAA without a suitable donor. Pts may become free of infections and transfusion independent and are able to live normal lives even though their blood counts are still subnormal

Understanding Asthma

2012 ◽  
Author(s):  
Linda Pearce ◽  
Samantha Prigmore
Keyword(s):  
Best Practice ◽  
Hospital Admissions ◽  
Immunoglobulin E ◽  
Response To Treatment ◽  
British Thoracic Society ◽  
Comprehensive Overview ◽  
Health Nursing ◽  
Definition Of ◽  
The Uk ◽  
Different Characteristics

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with asthma in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the causes, risk factors, and impact of asthma, before exploring best practice to deliver care, as well as to prevent or minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with asthma can be found in Chapters 15 and 22, respectively. In the absence of a standardized definition of asthma, it is accurately described as:…Airway inflammation and hyper-responsiveness characterised by widespread reversible narrowing of the airways, which varies either spontaneously or in response to treatment. (British Thoracic Society/Scottish Intercollegiate Guidelines Network, 2009)…The clinician diagnosis of asthma is based on symptoms, patient history, lung function testing (including peak expiratory flow rate diary), and the demonstration of an efficacious response to a trial of inhaled therapy. An estimated 5.4 million people in the UK are receiving treatment for asthma (Lung and Asthma Information Agency, 2006). In 2006–07, there were 67,077 hospital admissions for asthma in England, over 40% of which were for children under the age of 15 (Asthma UK, 2010). Asthma is estimated to cost the NHS £1 billion per year. With one in five households affected, asthma accounts for at least 12.7 million workdays lost each year (Asthma UK, 2005). In 2008, there were 1,071 deaths in England and Wales due to asthma (Office for National Statistics, 2009). Atopy is a genetically based condition in which individuals have a tendency to hypersensitivity in their reaction to allergens and other triggers. The reaction is usually immediate and localized, and manifests in diseases such as asthma, hay fever, and contact dermatitis. Genetic studies (Holloway et al., 2010) investigating atopy and asthma have shown linkages to many chromosomal locations indicating genetic heterogeneity (having different characteristics and qualities). There is genetic control over the ability to produce significant quantities of immunoglobulin E (IgE), a blood plasma protein that activates allergic reactions by acting as an antibody, when exposed to environmental allergens.

scholarly journals Identifying and treating refractory ITP: difficulty in diagnosis and role of combination treatment

Blood ◽  
2020 ◽  
Vol 135 (7) ◽  
pp. 472-490 ◽  
Author(s):  
Oriana Miltiadous ◽  
Ming Hou ◽  
James B. Bussel
Keyword(s):  
Combination Treatment ◽  
Response To Treatment ◽  
Current Therapy ◽  
Combination Treatments ◽  
Useful Components ◽  
Effective Combination ◽  
Insufficient Response ◽  
Critical Components ◽  
Definition Of ◽  
Refractory Itp

Abstract Immune thrombocytopenia (ITP) is the most common acquired thrombocytopenia after chemotherapy-induced thrombocytopenia. Existing guidelines describe the management and treatment of most patients who, overall, do well, even if they present with chronic disease, and they are usually not at a high risk for bleeding; however, a small percentage of patients is refractory and difficult to manage. Patients classified as refractory have a diagnosis that is not really ITP or have disease that is difficult to manage. ITP is a diagnosis of exclusion; no specific tests exist to confirm the diagnosis. Response to treatment is the only affirmative confirmation of diagnosis. However, refractory patients do not respond to front-line or other treatments; thus, no confirmation of diagnosis exists. The first section of this review carefully evaluates the diagnostic considerations in patients with refractory ITP. The second section describes combination treatment for refractory cases of ITP. The reported combinations are divided into the era before thrombopoietin (TPO) and rituximab and the current era. Current therapy appears to have increased effectiveness. However, the definition of refractory, if it includes insufficient response to TPO agents, describes a group with more severe and difficult-to-treat disease. The biology of refractory ITP is largely unexplored and includes oligoclonality, lymphocyte pumps, and other possibilities. Newer treatments, especially rapamycin, fostamatinib, FcRn, and BTK inhibitors, may be useful components of future therapy given their mechanisms of action; however, TPO agents, notwithstanding failure as monotherapy, appear to be critical components. In summary, refractory ITP is a complicated entity in which a precise specific diagnosis is as important as the development of effective combination treatments.

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