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Related Concept Videos

Myasthenia Gravis: Overview and Treatment01:20

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Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
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The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Myocarditis III: Medical Management01:14

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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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Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Related Experiment Video

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Author Spotlight: Advanced Integrated Model for Sepsis-Induced Myopathy and Single-Cell Metabolic Analysis
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Critical illness myopathy after COVID-19.

Sergio Bagnato1, Cristina Boccagni1, Giorgio Marino1

  • 1Rehabilitation Department, Giuseppe Giglio Foundation, Cefalù, PA, Italy.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|August 9, 2020
PubMed
Summary

This case study highlights critical illness myopathy in a COVID-19 patient after prolonged intensive care unit (ICU) stay. Early diagnosis and rehabilitation are crucial for managing ICU-acquired weakness in these patients.

Keywords:
Direct muscle stimulationElectromyographyICU-acquired weaknessRehabilitationSARS-CoV-2

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) can necessitate prolonged intensive care unit (ICU) stays.
  • ICU stays are associated with the development of ICU-acquired weakness.
  • Critical illness myopathy (CIM) is a potential complication in critically ill patients.

Observation:

  • A patient developed diffuse and symmetrical muscle weakness following extended ICU care for COVID-19.
  • Neurophysiological testing, including EMG and direct muscle stimulation (DMS), was performed.
  • Findings indicated myopathy, particularly in lower limb muscles.

Findings:

  • Nerve conduction studies revealed normal sensory conduction but low-amplitude compound muscle action potentials (CMAPs).
  • Electromyography (EMG) showed myopathic changes.
  • Post-DMS CMAP was absent in the quadriceps and reduced in the tibialis anterior, confirming CIM.

Implications:

  • COVID-19 patients requiring long ICU admissions are at high risk for developing CIM and ICU-acquired weakness.
  • Prompt diagnosis and management of CIM are essential for patient recovery.
  • Health systems need to ensure access to comprehensive pulmonary and motor rehabilitation services for post-COVID-19 patients.