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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Psychoneuroimmunology: Cardiovascular Disease01:27

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Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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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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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Nephrotic Syndrome I : Introduction01:24

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Vascular Spasm01:16

Vascular Spasm

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The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
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Primary CNS vasculitis (PCNSV): a cohort study.

Ayush Agarwal1, Jyoti Sharma1, M V Padma Srivastava1

  • 1Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Scientific Reports
|August 5, 2022
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Summary
This summary is machine-generated.

Primary CNS Vasculitis (PCNSV) is a rare condition. This study found that myelitis and delayed diagnosis predict poorer outcomes, while early treatment may reduce relapses in PCNSV patients.

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Area of Science:

  • Neurology
  • Immunology
  • Vascular Medicine

Background:

  • Primary CNS Vasculitis (PCNSV) is a rare, serious inflammatory condition affecting the brain and spinal cord's blood vessels.
  • Diagnosis is often delayed, and treatment relies on limited evidence, highlighting the need for outcome predictors.
  • Understanding factors influencing long-term outcomes is crucial for managing PCNSV patients.

Purpose of the Study:

  • To identify clinical, laboratory, imaging, and treatment-related factors associated with 2-year outcomes in primary CNS Vasculitis.
  • To determine predictors of good functional outcome (modified Rankin Scale 0-2) at two years post-diagnosis.
  • To contribute to the understanding of this rare neurological disorder.

Main Methods:

  • A cohort study of 82 biopsy and/or angiographically proven PCNSV cases (2010-2019).
  • Data collected prospectively and retrospectively on clinical, imaging, histopathology, treatment, and functional outcomes (mRS).
  • Statistical analysis included univariate and stepwise multiple logistic regression to identify outcome predictors.

Main Results:

  • The median age at presentation was 34 years, with a median diagnostic delay of 23 months; 70.7% presented with seizures.
  • 65.2% of patients achieved a good functional outcome (mRS 0-2) at 2 years.
  • Myelitis and longer diagnostic delay were associated with poorer outcomes; hemorrhages on SWI MRI may be a sensitive marker.

Conclusions:

  • Primary CNS Vasculitis outcomes are influenced by disease characteristics and diagnostic timeliness.
  • Early intervention with corticosteroids and immunosuppressants may be beneficial in reducing relapses.
  • Further multi-center randomized controlled trials are needed to establish optimal immunosuppressive strategies for PCNSV.