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Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
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Pericarditis III: Medical Management01:17

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Autoimmune Disorders01:29

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Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
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Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
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Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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Pulse immunosuppressive therapy for multiple sclerosis during the SARS-CoV-2 lockdown de-escalation plan: Safety

G Valero-López1, E Carreón-Guarnizo2, R Hernández-Clares2

  • 1Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, España; CSUR Esclerosis Múltiple y Unidad de Neuroinmunología Clínica, Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, España.

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Summary

A new safety algorithm helps multiple sclerosis (MS) patients safely resume pulse immunosuppressive therapy (PIT) during COVID-19. This approach combines symptom screening and PCR testing to prevent SARS-CoV-2 infections in MS patients receiving treatment.

Keywords:
COVID-19Esclerosis múltipleImmunosuppressantsInmunosupresoresMultiple sclerosisPCRSARS-CoV-2Tratamientos

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • The COVID-19 pandemic significantly impacted multiple sclerosis (MS) care, leading to the suspension of disease-modifying therapies like pulse immunosuppressive therapy (PIT).
  • Uncertainty regarding SARS-CoV-2 transmission from asymptomatic/presymptomatic patients receiving immunosuppressants necessitated revised treatment protocols.
  • Resuming PIT is crucial for managing MS effectively during the pandemic's easing phases.

Purpose of the Study:

  • To introduce a safety algorithm for the resumption of pulse immunosuppressive therapy (PIT) in multiple sclerosis (MS) patients.
  • To facilitate the safe continuation of MS treatment amidst the COVID-19 pandemic.
  • To prevent SARS-CoV-2 infections in healthcare settings during PIT administration.

Main Methods:

  • Development of a clinical and microbiological screening algorithm based on clinical experience and published evidence.
  • Integration of a symptom checklist via teleconsultation 48 hours prior to PIT.
  • Inclusion of SARS-CoV-2 PCR testing from nasopharyngeal swabs 24 hours before PIT sessions.

Main Results:

  • The algorithm aids in identifying contagious asymptomatic/presymptomatic individuals and those with mild SARS-CoV-2 symptoms.
  • It enables the temporary withdrawal of PIT for high-risk patients, thereby preventing infections.
  • The screening process aims to minimize SARS-CoV-2 transmission within day hospitals.

Conclusions:

  • The developed safety algorithm demonstrates a favorable risk-benefit ratio for resuming PIT.
  • Systematic PCR testing offers high sensitivity for detecting presymptomatic SARS-CoV-2 cases.
  • Combining PCR testing with early symptom detection enhances patient safety and optimizes the identification of high-risk individuals before PIT administration.