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Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
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Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

Jeffrey Shije1, Thomas H Brannagan1

  • 1Peripheral Neuropathy Center, Neurological Institute, Columbia University, New York, New York.

Seminars in Neurology
|October 23, 2019
PubMed
Summary

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune nerve disorder. While treatable with corticosteroids, IV immunoglobulin (IVIG), or plasmapheresis, some patients show poorer responses, necessitating alternative therapies.

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Area of Science:

  • Neurology
  • Immunology
  • Peripheral Nervous System Disorders

Background:

  • Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a prevalent autoimmune condition impacting peripheral nerves and nerve roots.
  • CIDP often manifests as progressive or relapsing weakness and reduced reflexes.
  • Diagnosis is supported by electrodiagnostic studies, CSF analysis, and nerve biopsy.

Purpose of the Study:

  • To review the diagnosis and management of CIDP.
  • To highlight treatment variability and identify patient subgroups with distinct responses.
  • To discuss advanced therapies for refractory CIDP cases.

Main Methods:

  • Literature review of CIDP diagnosis, treatment, and outcomes.
  • Analysis of clinical features and treatment responses in CIDP patients.
  • Examination of the role of specific autoantibodies (e.g., IgG4) in disease presentation and management.

Main Results:

  • Most CIDP patients respond well to first-line treatments: corticosteroids, IV immunoglobulin (IVIG), and plasmapheresis.
  • A subset of CIDP patients with IgG4 autoantibodies exhibit unique clinical characteristics and a diminished response to IVIG.
  • Refractory CIDP cases may benefit from chemotherapy, other immunomodulatory agents, or hematopoietic stem cell transplantation.

Conclusions:

  • CIDP management requires individualized treatment strategies due to variable patient responses.
  • Identification of specific autoantibodies may guide therapeutic decisions.
  • Ongoing treatment is often necessary for disease stability, though remission or cure is possible for some individuals.